A new season in bioethical reflections is at hand. We are witnessing extraordinary developments in life sciences and in the new "converging technologies" (genetics, information technology, nanotechnologies and neurosciences), which open up unprecedented possibilities for interventions on living matter. The human body is exposed to practices that risk reducing it to the status of any neutral biological subject, as if it were an entity independent of the person rather than its basis in space and in history. This approach, veined with Gnostic contempt, risks obfuscating the symbolic scope of the body and its essential role in the advancement of a meaningful world.
On the other hand, globalization is profoundly transforming the context in which bioethical questions are posed.
Cultures find themselves coexisting in closer relations as a direct result of the growth in the movement of peoples and the intensification in communications. There is a growing public awareness that environmental phenomena and peoples' lives are increasingly interconnected. There is also a better understanding that inequalities and imbalances in the conditions of life in society and in the different parts of the planet are not due to random factors, but are the effects of choices that neglect justice and the legitimate needs of all the Earth’s populations, present and future.
There are many examples of problems related to clinical practice and biomedical research in which these interconnections are apparent. To cite only some which have the most immediate bioethical impact: the definition and compliance with the rules of scientific research that are the same for everyone and equally respectful of the dignity and rights of people; the principle of the prohibition of the commercial exploitation of the human body or its parts on the international market; the prohibition of interventions on the genome that introduce modifications destined to be inherited by descendants; the fight against the threat of bio-terrorism.
The classical topics of bioethics have therefore taken on a far wider scope. Then again, the number of themes dealt with has also expanded: food safety, inequalities in access to care and in the distribution of the results of scientific research, environmental factors on health.
"Technology that puts itself at the service of the care for life, refusing to discard it when it does not meet standards of efficiency and wellbeing decided by a machine, is a real blessing. When technology takes power, with our passive complicity, we ourselves become responsible for the loss of that blessing. We must be lords of technology, at the service of life; and not masters of life, subject to technology. This is the covenant that we must seal. The complexity of this discernment is certainly real. It requires a period of careful and open listening and critical understanding of the phenomena that surround us. The tools that we have are,
all in all, not very sophisticated or dependable. Scientific research is an irreplaceable part of this covenant. The hidden pitfall in new technological resources is the great extent of their invisibility. They cannot be perceived physically or mentally by individuals or by the community. They are not large and impressive machines. They are virtual relationships and the results of calculations. Even before they establish connections between humans, these devices connect with each other.
Artificial intelligences, algorithms that can learn, so-called machine learning, and other cognitive computer systems are the vehicles of this revolution. These systems are spreading more and more to every area of our life as in the past steam and electricity changed the way we carried out all our activities. For this reason, closely connected with this meeting, artificial intelligence will be the theme of next year’s workshop. We want to approach this new frontier forcefully and passionately, with as much wide cooperation as possible. To honor, with science and conscience, the task that has been authoritatively entrusted to us".
(From the Opening Address, by Archbishop Vincenzo Paglia)
"Virtues in Ethics of Life" is the theme of the workshop organized by the Pontifical Academy for Life, which will be held on March 4th, in the New Synod Hall, on the occasion of the 22nd Plenary Assembly of the Members of the Pontifical Academy for Life.
The work of the first session, entitled "The dynamics and completion of the moral act in the virtues" (moderated by Msgr. Fernando Chomali and Prof. Mónica López Barahona), will be opened by Alfredo Cruz Prados, University of Navarra (Spain), with a lecture on "Knowledge and the experience of the good: analogy, differences and the synergy between speculative and practical reason." This session will then continue with lectures by Angel Rodgriguez Luno, Pontifical University of the Holy Cross, on "The intentionality of the human act: good and evil from a moral perspective;" Antonio Da Re, University of Padua, on "Virtue ethics and moral life;" and Luciano Sandrin, Camillianum (Rome), on "Mercy and compassion."
During the second session, entitled "Biomedical ethics from a virtues perspective" (moderated by John Haas [USA] and Mounir Farag [Egypt]), Jeffrey Bishop, Saint Louis University (USA), will give a lecture on "Medical decision-making and the problems of 'Proceduralist bioethics';" Maureen Condic, University of Utah (USA), will speak on "Virtues beyond the utilitarian approach in biomedical research" and Reiko Joh, of the Association of Catholic Nurses of Japan (Japan), will discuss "Ethical virtues in the nursing profession."
During the third session: "The rediscovery of the virtues" (moderated by Adriano Pessina and Laura Palazzani [Italy]), the speakers will be Roberto Dell'Oro, Loyola Marymount University (USA), on "Professionalism and virtues;" Gabriella Gambino, University of Tor Vergata, on "Care and justice;" Antonio Amado Fernandez, University de Los Andes (Chile), on "Educating in virtue within the biomedical discipline." "The virtuous institution in service to life" will be discussed by Mounir Farag, of the St. Joseph Institute for the Family pro Vita and Bioethics/OMS (Egypt); Andrew Pinsent, Oxford University (UK) will speak on "Current research trends in virtue ethics;" Adam Rybicki, Catholic University of Lublin (Poland), will speak about "The defense of life between parresia, mercy and forgiveness;" and Eberhard Schockenhoff, University of Freiburg (Germany), will give a lecture on "The Christian perspective on the virtues."
The increased life expectancy of the world population, due to better quality of life, hygiene-healthcare measures available to increasing numbers of people, and progressively expanding prevention efforts, raises new and serious challenges to which we must provide answers.
Greater longevity is also associated with an increase in morbidity with respect to other stages of life. In the elderly, these often manifest as multiple pathology, which complicate the situation of disability and dependence typical of old age.
Confronting this issue from a proper perspective requires solid ethical principles that allow the elderly and disabled to be treated as individuals in all their aspects, i.e. by respecting their dignity, providing human and material resources proportionate to their physical and psychological needs, and also facilitating the spiritual guidance that allows them to accept the loneliness, dependence, the disability itself and the event of death from a perspective of reason, which may relieve their suffering and open their hope to transcendence.
Dignity of the elderly and disabled
Post-modern society often experiences a distortion of the concept of human dignity. The influence of utilitarian theories and hedonist ethics leaves little or no room for the treatment and care of the disabled or elderly.
Dignity and usefulness often appear as closely related concepts, so that the first is inconceivable without the second. It seems that productivity (mainly economic) and the level of autonomy (applied in all senses) are what determine the level of personal dignity that might be attributed to someone.
An elderly person is increasingly more dependent and less productive, which would mean – if we hold to the above theories – a gradual loss of dignity that would make them less deserving of the resources allocated to their medical and psychological care, rehabilitation, daily assistance and spiritual guidance.
Unfortunately, this is not a new phenomenon in our post-modern society, and there are many sad events in history where man unduly takes it upon himself to decide who has dignity and who does not, favouring the former and penalising, enslaving or eliminating the latter.
While this is nothing new, the scale at which this phenomenon is occurring is, and is a challenge before which we cannot simply stand by and do nothing. Having dignity is peculiar to human beings, whether or not they are productive (in an economic sense). Having dignity is inherent to the person, whether or not they are dependent (even completely dependent). Therefore, considering the human person as a subject of dignity beyond their physical, mental or spiritual conditions is the opposite of that proposed by utilitarianism or hedonism.
Productivity, usefulness and level of well-being, postulates of post-modern society, turn the elderly and dependent into enemies. It is within this framework where arguments advocating euthanasia, eugenics and social marginalisation gather strength.
Similarly, there are more than a few elderly people who, endorsing these theories, try to live as if they were not old, i.e. sculpting their appearance to simulate the youthfulness of the past, adopting slogans that incite “dynamism” in old age, artificially promoting late fertility and motherhood (rather anachronistic), and even being pushed into experiencing youthful adventures, as a way of pretending what is not.
Old age, however, should be reclaimed as a stage, the last stage of life, which offers its own richness, not in any way inferior to the richness of other stages, just different.
dimensión espiritual en la vejez y la discapacidad trata la XXª Asamblea de la Academia Pontificia para la VidaIt is precisely in old age that the right circumstances occur to discover the value of human life aside from its productive capacity, client of consumerism or victim of hedonism.
The elderly man is a person, wiser than he was, and with a new perspective closer to looking towards transcendence. This, which the elderly have an opportunity to assess in their old age, is paradigmatic for the rest of society. The elderly and dependent bring awareness to the true value of existence beyond consumerism, productivity or the search for pleasure. This value is not the legacy of old age, though, but of wisdom, serenity of the mind, the perspective gained from experience and the need to provide answers to the basic questions of life: what am I? why am I? where am I going? why do I suffer? These represent a richness for all human beings, which the elderly person manifests with their dependent and limited way of living.
This stage can thus be defined as a prophetic time for every human being who, confronted with the purpose of their existence, is questioned about the meaning of their life, the hierarchy of their values and the urgency of their demands. Old age lays bare the depth of the person, who devoid of consumerist ties and pleasurable obsessions, asks himself in his solitude about his purpose and the reason for his existence.
Medical care in old age
Increased life expectancy in the elderly is changing the health care environment that they need. Living longer implies prolonging periods of dependence and increasing the likelihood that new chronic diseases will appear that complicate their care and require the dedication of major resources by healthcare systems.
Vascular diseases, hypertension, other cardiovascular problems, anaemia, eyesight and hearing problems, cognitive loss (especially memory loss), anxiety and depression, diabetes-related complications, obesity and smoking make up the framework of multiple pathologies that healthcare personnel must address in the treatment of the elderly.
Dementia cases are chronic and progressive in 30% of those affected, and only 10 % are reversible.
Alzheimer’s disease is one of the major causes of dementia in old age, and of death in people aged over 65 years.
In Italy, stroke is the second most common cause of dementia in the general population, and the third leading cause of death, after cardiovascular disease and cancer. Patients who survive these events show varying degrees of disability, which can make them completely dependent on a carer. This means a radical change in their lives, which will not allow them to return to their usual activities as normal.
Routine diagnosis of cognitive deficiencies in the elderly should be promoted to improve their treatment and future progress. Physiotherapy is a fundamental link in the chain of care for these patients, and should be properly coordinated with the other multidisciplinary interventions that will have to be adopted.
These situations of chronic disease are a challenge not only for the clinicians who must treat them, but also for carers, family members and professionals, who will require support and psychological-emotional training to enable them to confront very difficult and potentially long-lasting situations, in which the elderly or disabled person is cared for in a manner that their dignity as a person merits, by proper assistance, clinical support and spiritual guidance. The balance necessary in the way of caring for the elderly and disabled requires excellence in the quality of this care, which implies exhaustive exercise of care and attention to the anthropological complexity of the patient, in their physical, psychological and spiritual aspects.
Dear brothers and sisters,
I warmly welcome you on the occasion of your General Assembly, called to reflect on the theme "Assistance to the elderly and palliative care", and I thank the President for his kind words. I am especially pleased to greet Cardinal Sgreccia, who is a pioneer… Thank you.
Palliative care is an expression of the truly human attitude of taking care of one another, especially of those who suffer. It is a testimony that the human person is always precious, even if marked by illness and old age. Indeed the person, under any circumstances, is an asset to him/herself and to others and is loved by God. This is why when their life becomes very fragile and the end of the their earthly existence approaches, we fell the responsibility to assist and accompany them in the best way
Address oh His Holiness Pope Francis to Participants in The XXI General Assembly of The Pontifical Academy for Life.
The collection of studies contained in this volume was born out of the widely shared awareness that having an abortion leaves remnants of a profound suffering, and which in not a few cases leads to real psychological damage. the problem of post-abortion trauma today is of both a scientific and human relevance and we can no longer ignore it on account of the enormous spread of abortion in many countries of the world.
We see that in the current state of things, the debate regarding the existence and characteristics of post-abortion trauma often appears to be conditioned by an ethical approach present in various cultures, an approach that can vary between considering abortion to be essentially a means of birth control (by now the most common) and condemning it as a severely grave violation of the sacredness of unborn human life. in many of the studies conducted up until our current day – the collection, analysis and interpretation of data – the results are strongly influenced by the position assumed prior to any undertaken research. According to some individuals, easy access to abortion is a kind of modern success and otherwise abortion is seen above all as the deprivation of the future life of a being not yet born. In the latter case it is easier to recognize, in addition to the harm done to the baby, the damage inflicted upon the woman which continues to unfold after the fact.
