CCBI News: Infinite Dignity; AI Benefits; Palliative Care and Human Dignity

April 12, 2024

Dear Friends of CCBI,

Dignitas Infinita

The Dicastery for the Doctrine of the Faith published Dignitas Infinita (Infinite Dignity) on April 8, 2024, reaffirming the Church’s stance on the inherent dignity of human life from conception until natural death. The Vatican press release said. “…the Church insists that the dignity of every human person, precisely because it is intrinsic, remains in all circumstances.” The document reaffirms the wrongness of euthanasia and assisted suicide, among other factors pointing out that “…suffering does not cause the sick to lose their dignity, which is intrinsically and inalienably their own.” The Dicastery emphasized the importance of palliative care, saying:

Remember that the right to care and treatment for all must always be prioritized so that the weakest, particularly the elderly and the sick, are never rejected….Life is a right, not death, which must be welcomed, not administered. And this ethical principle concerns everyone, not just Christians or believers. As mentioned above, the dignity of each person, no matter how weak or burdened by suffering, implies the dignity of us all.

CCBI will report further on the document next week, but it is already clear that the Church’s stance remains solidly consistent, ‘ad infinitum.’

AI Benefits in Health Care?

Eric Topol, MD, Director of the Scripps Institute for Translational Research, is a proponent of the benefits of AI in building up personalized or precision medicine using electronic health records, images, etc., “…to reboot approaches for treating cancer, anticipating neurodegenerative diseases, partition risk for cardiovascular and metabolic diseases, and more….” He is increasingly opposed to measures such as mass screening, which he claims is not cost efficient as well as producing many false negatives and false positives. His approach underscores the idea, “…that the combination of AI with the plethora of data, from polygenic risk scores, gut microbiome data, to “organ clocks,” which evaluate the age of individual organs instead of the age of the person, can further facilitate the field’s ability to predict and address neurological diseases with longer time scales, such as Alzheimer’s….” Such predictions would be valuable for diagnosis and prognosis, for budgetary allocations and for preventive medicine.

Just as interesting is Topol’s hope that the use of AI in more fields would allow physicians added time for a more ‘human’ exchange with their patients. He cites examples such as recording real-time conversations with patients along with steps taken during physical examinations and the results. This could be important in reminding physician and patient alike of what was decided and recommended. It is well known that some patients can be unclear about consultations if, for example, there is a new diagnosis, and a recording would also clarify upcoming appointments, lab tests, prescriptions, etc. Dr Topol suggests this relatively simple digital tool could save an average of three hours per day otherwise spent on data entry. Useful on a few fronts!

According to Topol, another side of the use of AI is less well known: its capacity for coaching in the promotion of empathy, a characteristic sometimes lacking in busy medical (and other professional) appointments. He points out that, “If you ask for coaching, [AI] will tell [the doctor how they] didn’t show any sympathy or let the patient express their concern. It’s promoting empathy like we’ve not seen before.” This could be a useful training tool in medical and other fields, especially since more emphasis is being placed on the need for human formation these days, e.g., for seminarians, recently under discussion at the first part of the current Synod on Synodality. It is paradoxical to think that AI could coach humans to be more relational and empathetic in our behaviour, but we may be surprised!

Palliative Care and Human Dignity

Dignity is clearly the theme of the new Vatican teaching, Dignitas Infinita, and an article by BC’s Dr Kim Adzich refers to this in quoting Dame Cicely Saunders: “You matter because you are you, and you matter until the last moment of your life.” This beautifully mirrors the approach of Catholic teaching, as does Dr Adzich when he states: “Dignity is the inherent worthiness of being human, of mattering until that last breath.” In his article Dr Adzich also refers to another world famous palliative care physician, Canadian Dr Harvey Max Chochinov, the founder of ‘dignity therapy,’ who states, “For anyone privileged to look after patients at whatever stage of the life cycle, the duty to uphold, protect, and restore the dignity of those who seek our care embraces the very essence of medicine.”

In harmony with this view, Dr Adzich points out some best practices based on his own approach to patients, which are of interest to anyone involved in accompanying others during severe illness or in the dying process. They could also, for example, be useful for discussion in upcoming “Horizons of Hope” sessions in parishes and elsewhere, when we look at how we might best relate to those we will accompany at these stages, including members of our own families. Those who have experienced hospice training sessions will be familiar with these practices, but many may not be, so they are quoted here from Dr Adzich’s article, albeit more briefly:

• Try to see each person for who they are as a person (“personhood”), rather than the illness they bear (“patienthood”). This includes how they would like to be addressed, permission to use their first name, learning the names of their family members/caregivers, noticing family photos and asking about them, etc.
• [Say something like this]: “I know a lot about your medical illness but tell me about who you are as a person, about your life, and what’s most important to you now.”  Listen to their stories and you will hear their human journey.
• Sit at their level and listen intently.
• Turn your phone to silent. Be fully present. Dame Cicily Saunders said ‘suffering is really only unbearable when nobody cares.’
• Take time to answer all their questions, explore their fears, and hear their needs. Gently, if invited, talk about what dying might look like.

Adzich quotes the words of Ram Das, “We are all just walking each other home,” with home being a place where you feel that you matter: you are safe, secure, and heard.” He adds, “Symptom management is vital, but so is showing how much you care for the unique person before you who shares their journey with you.” 

It is clear that Dignitas Infinita, in its insistence on our innate human dignity by virtue of being made in God’s image and likeness, encapsulates the virtue of human empathy advocated by people as varied as Topol, Saunders, Chochinov and Adzich in palliative care and in the medical field, in general. Empathy is an emotional skill or habit that needs to be practised and observed. Dr Topol advocates the use of AI tools to develop empathy; Dr Adzich advocates best practices based on experience for the same purpose; the Dicastery asks us to remember our inherent dignity, gifted to us by the Creator: all point to our innate capacity for empathy and ask us all, not only palliative care physicians and nurses, to chart a more intentionally empathetic approach to the ill or dying person who is always more than a patient. 

‘Dignitas Infinita’: New Vatican Document on Human Dignity Condemns Gender Transition, Surrogacy, Abortion| National Catholic Register (ncregister.com)
Machines Bring Efficiency…and Empathy? Eric Topol Talks AI in Precision Medicine (genengnews.com)
“Personhood,” Not “Patienthood”: 6 tips on dignity-conserving practice in palliative care – International Association for Hospice & Palliative Care (hospicecare.com)

Pope Francis’ Intentions for April: For The Role of Women

We pray that the dignity and immense value of women be recognized in every culture, and for the end of discrimination that they experience in different parts of the world.

Moira and Bambi