Guiding Principles For Catholic Healthcare Professionals During a Pandemic

CMA Press Release 2020-3-27

Guiding Principles For Catholic Healthcare Professionals During a Pandemic
The Ethics Committee of the Catholic Medical Association
Catholic physicians and health care workers for centuries have led the world in the care for the most vulnerable during times of crisis. Recalling our commissioning by the Divine Physician, the Catholic Christian physician has a special calling—different from the secular world—in that he or she sees the human person as an invaluable creation of God whose individual worth should never be sacrificed—even in the midst of a pandemic. Because of this immutable truth, Catholic physicians have an obligation to lead in times of crisis and to ensure both the upholding of human dignity and the safeguarding of the public health.
Our belief in evidence-based clinical care and public health measures should be translated through the lens of Catholic medical ethics and social teaching with respect to justice and the just distribution of scare resources.
Catholic social teaching is therefore predicated on these key principles: (1) the inherent and fundamental principle of the dignity of human life; (2) the principle of subsidiarity; and (3) the principle of solidarity.
The dignity of human life is the lens through which all care for the sick—in time of crisis or not—should be viewed. God does not make man the arbiter of the value of life and in humility the Catholic health care worker recognizes that no choice should be made that sacrifices the innate dignity of the individual human person, even when questions about scarce resources arise. In short, the human person should not be forgotten in questions about the health of the human race.
The principle of subsidiarity teaches that all decisions are, generally speaking, first and best made at the most fundamental level—beginning with the competent individual and his or her family, and from there proceeding to the different levels of government. This liberty should still, provided it does not jeopardize the public health, be a fundamental principle in times of health crisis.
The principle of solidarity becomes especially important in times of health crisis—when the chronically ill, the elderly, the immune compromised, and other vulnerable populations are at increased risk; here it is imperative that the Catholic healthcare worker and administrators and policy makers continue to re-commit to the Catholic vision of the “other” as “another I,”—as St Pope John Paul II writes–a communio personarum
The Catholic Medical Association therefore proposes some guiding principles during this time of pandemic
1.     We have an obligation to support proper authorities working to ameliorate a public health crisis. The COVID-19 pandemic is a public health crisis. As Catholics committed to a social doctrine rooted in the respect due to every human person and promotion of the common good (the sum total of social conditions which allow people…to reach their fulfilment more fully and more easily)[1] we support efforts to mitigate the effects of the disease on both personal and societal levels.
2.     We recognize that an uncontrolled pandemic is a crisis situation, which can stress a healthcare system beyond its available resources. We know that material goods are not infinite, and as Catholics we should be responsible stewards of the health care resources we have available (see Ethical and Religious Directives for Health Care Services (ERDs), #4)[2]. We are also called to use our abilities to be creative and innovative in the setting of material limitations.
3.     We acknowledge the importance of the relationship between the patient and his or her caregivers, physicians, nurses, and other health care professionals. These caregivers are obligated to act at all times with professional competence as well as to enter into a relationship with patients that respects their individual inviolable human dignity.
4.     We know that persons with mental or physical disabilities, whether due to age, disease process, or injury, are to be treated no less as unique persons of incomparable worth (ERDs, #3). However we also know that these disabilities may in themselves be limiting factors to hoped-for benefits of medical interventions in the setting of a diagnosis of COVID-19.
5.     We appreciate that “the well-being of the whole person must be taken into account in deciding about any therapeutic intervention or use of technology.” (ERDs, #33) Catholic physicians are called to care for the person, not simply to treat disease. Using accepted clinical criteria, it is appropriate for certain interventions not to be used if they are not likely to benefit the patient, or for interventions to be discontinued when they are not contributing to recovery of the patient. While these decisions are made as appropriate and with respect for the individual patient, they can be assisted by studied and standardized tools, such as those utilizing objective vital organ parameters as indicating potential for survival.
6.     “We are not the owners of our lives and, hence, do not have absolute power over life. We have a duty to preserve our life and to use it for the glory of God, but the duty to preserve life is not absolute….The use of life-sustaining technology is judged in light of the Christian meaning of life, suffering, and death. In this way two extremes are avoided: on the one hand, an insistence on useless or burdensome technology even when a patient may legitimately wish to forgo it and, on the other hand, the withdrawal of technology with the intention of causing death.” (ERDS, Introduction to Part Five)
7.     We believe that persons in danger of death from illness, accident, advanced age, or similar condition should be provided with appropriate opportunities to prepare for death (ERDs, #55). This is no less true in the setting of critical illness due to COVID-19. Catholics should be provided spiritual support, and, as a general rule, they should have the opportunity to receive the sacraments in order to prepare well for death. We know that due to public health concerns and “no-visitor” policies in hospitals and nursing homes priests may be prevented from administering these sacraments. We acknowledge the mercy of God extended by the Church in her extraordinary granting of special indulgences in the setting of COVID-19[3] but also encourage consideration of the Holy See’s recognition that cases of serious need will occur and find ways to provide for communal absolution as well as the  sacrament of reconciliation in this time of pandemic, possibly including “extraordinary hospital chaplains” to assist in this ministry. In the absence of clergy, assisting the patient in making a perfect  act of contrition is part of the spiritual care of the patient.[4] Also part of such spiritual care is in helping the patient invoke the plenary indulgence (Apostolic Blessing) usually imparted by the priest after the Anointing of the Sick, when the patient is near death, but can be sought directly by the patient.[5]
8.     We recognize that some elderly and perhaps others with chronic illness would prefer not to be admitted to hospitals with the knowledge that they will have no possibility of family or loved ones to accompany them, due to “no-visitor” policies due to COVID-19, in their disease and possibly their final illness. We encourage the development of home health care specifically for COVID-19 patients, including palliative care and hospice that truly respects the human dignity of these patients.
9.     We encourage Catholic bishops, priests, and hospital chaplains to be innovative in their care of the elderly, sick, and dying and to work in coordination and solidarity with physicians and other healthcare workers for the healing of body and soul. At a time when the faithful are not able to congregate in their usual houses of worship, it is necessary for the clergy to support the faithful in safe and sincere ways. While live-streamed Mass and other on-line resources have the potential to reach many people, often these are not so accessible to the elderly and the disabled. We encourage pastors and appointed lay ministers to call sick parishioners whether at home or in the hospital to provide spiritual support.
10. We confirm that Catholic physicians and healthcare professionals may never condone or participate in euthanasia or assisted suicide in any way (ERDs, #60).
11. We believe that, as appropriate and to the degree possible, Catholic clinicians and leaders should be positively engaged in influencing the formulation of practices and guidelines concerning the just and equitable use of limited medical resources for the sake of the common good, in accord with the principles of Catholic social teaching including the prudent stewardship, subsidiarity, and solidarity.
12. We encourage all Catholic healthcare workers to use this time of solitude and social distancing to deepen their own prayer life, to recommit to their divine vocation, to be creative and intentional—not merely in scientific and clinical pursuits aimed at the control of this virus—but also in enhancing a joyful family life and in their personal vocations, always guided by a trust in Divine Providence, in the Wisdom of the Holy Spirit and in Jesus Christ, “who makes all things new.”
[1]Catechism of the Catholic Church, § 1906
[2]Religious and Ethical Directives for Catholic Health Care Services, 6th Edition, U.S. Catholic Conference of Bishops, 2018
[5] United States Conference of Catholic Bishops, Manual of Indulgences (Washington,DC: United States Conference of Catholic Bishops, 2006), n. 12.
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The Catholic Medical Association is a national, physician-led community of 2,500 healthcare professionals consisting of more than 109 local guilds. CMA mission is to inform, organize, and inspire its members, in steadfast fidelity to the teachings of the Catholic Church, to uphold the principles of the Catholic faith in the science and practice of medicine.
Jill Blumenfeld
blumenfeld@cathmed.org
cathmed.org

Abortion in Gibraltar

From CMA’s Embers newsletter:

A CMA member shared that on March 19, the Feast of St. Joseph,  Gibraltar, the last place in Europe that bans all abortions as criminal acts and which is 70% Catholic, will hold a referendum to allow for abortion in certain circumstances. We invite you to join us in a novena with this prayer to St. Joseph, dating from the early Church, beginning March 10:

“Oh, St. Joseph, whose protection is so great, so strong, so prompt before the throne of God. I place in you all my interests and desires. Oh, St. Joseph, do assist me by your powerful intercession, and obtain for me from your divine Son all spiritual blessings, through Jesus Christ, our Lord. So that, having engaged here below your heavenly power, I may offer my thanksgiving and homage to the most loving of Fathers.

Oh, St. Joseph, I never weary of contemplating you, and Jesus asleep in your arms; I dare not approach while He reposes near your heart. Press Him in my name and kiss His fine head for me and ask him to return the Kiss when I draw my dying breath. St. Joseph, Patron of departing souls – Pray for me (and that Gibralter continues to protect the unborn).”

National CMA Opportunities

If you’re a CMA member and would like to help expand the Finger Lakes Guild, please consider attending the Leadership Training Meeting, which will be held June 18-21, 2020 at the University of St. Mary of the Lake (Mundelein Seminary) in Mundelein, Illinois.

Medical Student and Resident Boot Camp & Retreat

This is a wonderful offering and is open to medical students (current and accepted) as well as residents of any year.  Please click on the link above to learn more!

Talking Talking at CMA National Conference

I received word yesterday that my proposal to present a breakout session at the 2020 CMA National Meeting in San Diego has been accepted!  I’m honored and, in no small way, humbled to be given this opportunity!

The session is entitled: Improving the patient-doctor relationship through communication excellence.  It will be based on my work developing and leading the ACT Program at the U of R with a special emphasis on how communication can help us reclaim [and maintain] the doctor patient relationship.

I hope to see you in sunny San Diego this September!

In Christ,

Tom Carroll
Guild President

Conscience Protections Struck Down!

CMA Responds After Two Federal Judges Block Conscience Protection Rule 

Philadelphia, PA—The Catholic Medical Association is disappointed to learn two federal judges ruled to block The Department of Health and Human Services’ Conscience Protection Rule.

CMA previously expressed its support of HHS’ Conscience Rule, which aims to “protect healthcare providers, individuals, and other health care entities from having to provide, participate in, pay for, or refer for services which violate their conscience.”

“The protection of conscience is essential to the nature of every human life. It is furthermore a critical component of our role as health care workers. Without the freedom to exercise conscience, patients will no longer be able to trust in us never to abandon them,” said CMA President, Dr. John Schirger.

CMA believes the courts’ actions violate religious freedom and put the lives of patients at risk.

“The ruling is based in part on a lack of evidence of complaints about the rule. Conscience should be protected in principle and from the outset. It is unreasonable to require violations of conscience before conscience can be protected,” said Barbara Golder, M.D., J.D., Editor-in-Chief of CMA’s Linacre Quarterly.

Back in May of 2019, Co-Chair of CMA’s Ethics Committee, Dr. Marie Hilliard, warned of the importance of conscience rights when HHS initially shared its Conscience Rule.

“Without this protection, healthcare workers cannot be true advocates for our patients, especially if the best interest of the patient is being violated. As Catholic healthcare professionals, we never abandon patients even if it means we must transfer their care if they are requesting a procedure that violates their well-being or our professional integrity. Thus, this final rule is very protective of not only professionals but of the human beings served,” said Dr. Hilliard.

“The patient’s autonomy does not supersede the conscience of a physician. Therefore, the physician must be free to refuse to participate in immoral procedures, and free to refuse to refer to other providers who might be willing to perform such procedures,” said Dr. Lester Ruppersberger, OBGYN and Past President of CMA.

CMA is hopeful the courts will come to understand the need to protect the conscience rights of healthcare workers in the country and reverse their decisions.

“It must not be forgotten that when a health care professional refuses to perform procedures or recommend therapies based on a conscientious objection, they do so as not to violate or injure the physical, mental or spiritual health of their patients,” said Dr. Greg Burke, Co-Chair of CMA’s Ethics Committee.

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The Catholic Medical Association is a national, physician-led community of over 2,300 healthcare professionals consisting of 109 local guilds. CMA mission is to inform, organize, and inspire its members, in steadfast fidelity to the teachings of the Catholic Church, to uphold the principles of the Catholic faith in the science and practice of medicine.

 

Jill Blumenfeld

Communications Manager

blumenfeld@cathmed.org

President’s Note

Being the first day of a new year, it is natural to reflect on the events of the past year and consider what the upcoming year may bring. The Guild certainly had an active 2017! We sponsored two evening presentations at St Bernard’s, discussing Medical Missions in May and a Catholic perspective on Physician Assisted Suicide in September. Both events were well attended and most successful. We cosponsored Peter Colosi’s talk on Euthanasia in August as well.  Our annual summer Soiree was a most pleasant evening marked by beautiful weather and gracious company. I especially enjoyed being able to introduce our Guild to Physicians, Nurses and Healthcare workers who were not previously aware of our presence in the community.

As you may know, the Guild is a Chartered member of the Catholic Medical Association. The CMA is a national organization that attends to a myriad of concerns on a wider scale than any local Guild could possibly achieve. The CMA sponsors a Mid Year Forum that is focused on building stronger Guilds. I was able to attend this meeting for a second year in a row, and continue to find it a valuable investment of time. The main event of the CMA is their annual meeting, this year held in Denver. The theme was “Medicine at the Service of Marriage and the Family”. The topics addressed were wide ranging, from the Truth of the Human Person to avoiding Burnout to NFP to Bioethics to the Cultivation of a Healthy Society, among scores of other presentations. Fellow Board members Jean Parker and Angela Maupin were able to attend as well and we were able to network with many other Guild and CMA members from thoughout New York State. A highlight during the conference was the announcement that the New York Appellate Court unanimously rejected the argument that PAS is a constitutional right.

Our Guild is always looking to grow in membership and increase it’s visibility in our area.  Our intent is to make our evening programs of interest to our Catholic community, as well as the community at large. We reach out to our Medical Students and Residents, as well as other health care students, to inform them of our presence and serve as a resource to them on their personal and professional journeys. We hope to sponsor a Physician in training to attend the CMA’s Boot Camp this upcoming summer. We have sponsored tables at the Rochester Men’s and Women’s Conferences to introduce ourselves to those audiences.

Our Board is active and committed in the pursuit of making the Guild relevant to our community. I am sorry to say that our Vice President, Ellen Dailor, M.D.. will be leaving the Rochester area for a new position in Florida. We will miss her greatly. I am thrilled, however, to welcome four new members to our Board in the near future. Drs. Angela Maupin, Thomas Carroll and Bryan Stanistreet and Sue Moncynski, RN will bring a healthy, young energy to the Board, which we will all appreciate.

Looking ahead to 2018, I am excited to announce that the Finger Lakes Guild, together with the Buffalo and Syracuse Guilds, will be sponsoring a day long conference entitled “Catholic Perspectives on Modern Day Health Care” this May 5, 2018. We have an outstanding schedule of speakers, including Wesley Smith J.D., Anne Nolte, M.D., Father Robert McTeigue, S.J., PhD., and Thomas Carroll, M.D. The event will take place at the RIT Inn and Conference Center and will include celebration of the White Mass. Please be sure to mark this on your calendar today and look for further information on our Website in the upcoming months.

It has been a privilege to be involved with the Finger Lakes Guild and I look forward to working with you as we undertake new endeavors this upcoming year. For your part, I would ask you to stay involved. Join the Guild (see our website to access the 2018 membership form). Come to our events. Talk to a colleague or student about us. Invite them to join the Guild and attend one of our events with you. And by all means, join us in prayer that the Guild will continue to grow and be successful in all it’s endeavors!

Medical Student and Resident Bootcamp

Are you a Medical Student or Resident looking to deepen your understanding of how your Catholic Faith can guide you in your personal and professional journey as a Physician? Do you wonder how to respond to the challenges extended by your colleagues when the subject of the sanctity of human life is broached?

If so, perhaps we should ship you off to Boot Camp! No, we are not referring to a months long endless program of pushups and 10 mile long runs wearing a 40 pound backpack. We are referring to a one week long program sponsored by the Catholic Medical Association.

The goals are to assist Catholic medical students to:

    1. More fully live and understand the Catholic faith and moral tradition in order to thrive as faithful Catholic physicians.
    2. Develop skills to help organize Catholic support groups within medical schools and residency programs.
    3. Evangelize Catholics and non-Catholics encountered throughout medical training.

The 2018 Boot Camp is scheduled for June 18-24 in Mundelein, Illinois. The Finger Lakes Guild will be proud to sponsor a Medical Student or Resident, so there will be no cost to attend.

Check out more about the Boot Camp by visiting the website of the CMA at Cathmed.org. If you are interested, be sure to contact the Guild. You may use this contact form:

Boot Camp. A great chance to get into awesome (spiritual) conditioning!