Healthcare Professionals As Agents of Healing

From Welcoming Children with Disability

Comments of Bishop Kevin Doran at the Conference on Abortion, Disability and the Law

Jointly Hosted By Anscombe Bioethics Centre & Consultative Group on Bioethics of the Irish Catholic Bishops' Conference, 20 October, 2017

Reproduced with permission

I find that people are sometimes surprised when I say that the Church is not against death. The reality, however, is that death is part of the human condition. It is an essential element of the Church's mission to help people to prepare for death, in the hope of the Resurrection. The first references to this, our "ultimate end" are already to be found in the Rite of Baptism. So, we are not against death. But we do see each human life as a gift from God, which is not ours to dispose of.

I think it may be helpful to explore the difference between accepting death and causing death, with particular reference to healthcare. Healthcare professionals, of necessity, have to be able to accept death. Part of the relationship of trust that they have with their patients is that they tell the truth but, even when the truth is that they can offer no hope of healing, they continue to support life through ordinary means, until death comes. This applies whether patients are young or old, or even unborn.

Conscience is the process of making judgements based on truth, with a view to doing what is good. In healthcare, the truth concerned includes the facts of science and economics, but crucially, it must also include the truth about the human person and the meaning of his or her existence. Fidelity to the judgement of a well-formed conscience is crucial, not only for the well-being of the patient, but also for the integrity of the healthcare professional.

With the consent of the patient (or the parents, in the case of a child) healthcare professionals are given a unique access to the human body, for the express purpose of preventing and healing illness. They provide care for those who cannot be healed. There is nothing in the nature of healthcare that would suggest that the role of a healthcare professional ever includes intentionally bringing about the death of the patient, either by some action or by failing to act. Both Pope John Paul II and Pope Francis have spoken specifically about the responsibility of healthcare professionals in the light of this unique relationship of trust.

A unique responsibility belongs to health-care personnel….Their profession calls for them to be guardians and servants of human life. In today's cultural and social context, in which science and the practice of medicine risk losing sight of their inherent ethical dimension, health-care professionals can be strongly tempted at times to become manipulators of life, or even agents of death. In the face of this temptation their responsibility today is greatly increased. Its deepest inspiration and strongest support lie in the intrinsic and undeniable ethical dimension of the health-care profession, something already recognized by the ancient and still relevant Hippocratic Oath, which requires every doctor to commit himself to absolute respect for human life and its sacredness. (Pope John Paul II, Evangelium Vitae, 89)

And

Dear friends and physicians, you are called to care for life in its initial stage; remind everyone, by word and deed, that this is sacred — at each phase and at every age — that it is always valuable. And not as a matter of faith — no, no — but of reason, as a matter of science! There is no human life more sacred than another, just as there is no human life qualitatively more significant than another. The credibility of a healthcare system is not measured solely by efficiency, but above all by the attention and love given to the person, whose life is always sacred and inviolable. (Pope Francis, Address to International Federation Of Catholic Medical Associations, 20th Sept 2013)

In many jurisdictions where abortion is already legally permitted, Healthcare professionals who refuse to take a human life for reasons of conscience are regarded as troublesome and unreliable employees and not good candidates for promotion. By contrast, the New Charter for Healthcare Workers states that:

"Besides being a sign of professional integrity, a healthcare worker's earnestly motivated conscientious objection has the noble significance of a social denunciation of a legal injustice that is being perpetrated against innocent and defenceless lives". (New Charter, 60)

The manner in which conscientious objection is interpreted in the so-called "Protection of Life in Pregnancy Act" gives rise to real concern. Doctors and nurses are allowed under the Act to opt out of providing or participating in abortion, provided they refer the patient to someone else who will perform the procedure. In other words, they are still required to participate in what they believe to be fundamentally immoral. Healthcare administrators have no recourse to conscientious objection.

The difficulty here is that, in our liberal democracy, people who provide services are regarded as "delivery people" with no personal investment in what they deliver. The "customer is always right". It is, of course, very necessary that "healthcare delivery" should be efficient and effective, but it is a cause of concern when society focusses to such an extent on delivery that the essential meaning of healthcare and the essential role of the healthcare professional as "healer" and "advocate for life" is lost sight of. In such a scenario there is no room for the personal conscience of the healthcare professional.

[Full text of Welcoming Children with Disability]