By JULIE MINDA
Cardinal Peter Kodwo Appiah Turkson, prefect of the Vatican’s Dicastery for Promoting Integral Human Development, addresses participants in CHA’s 2017 Ecclesiology and Spiritual Renewal Program for Health Care Leaders. Sr. Carol Keehan, DC, CHA president and chief executive officer, seen here with Cardinal Turkson, welcomed him and members of his staff to the May 4 session held at the Hotel Columbus, near Vatican City.
Cardinal Peter Kodwo Appiah Turkson, who will deliver the closing lecture of the 2017 Catholic Health Assembly in New Orleans, recently shared his thoughts on the role of the Catholic health ministry with Catholic Health World. Cardinal Turkson is the prefect of the Vatican's Dicastery for Promoting Integral Human Development, a department established in January by combining four pontifical councils overseeing issues and church works that relate to the sick and other vulnerable populations.
What is the main message you hope to convey in your address to the Catholic Health Assembly?
The meeting brings together leaders from across the ministry for learning, networking, celebration and renewal. My message to them would be, first of all, an expression of gratitude to them for the magnificent work they are doing — that of taking care of millions of sick brothers and sisters, which is an integral part of the church's mission.
Secondly, I wish to encourage them not to be discouraged by the significant challenges the ministry is facing. They should rather persevere in their response to the call to serve Christ in the sick and suffering brothers and sisters.
Thirdly, we know that the healing ministry of the church is but a continuation of the healing ministry of Jesus through the centuries, and as such, it must continuously be modelled after the eloquent example of the master and motivated by the love of Christ for humanity. With the help of God's grace, (people in the Catholic health ministry) will let the characteristics of Christ's healing ministry shine out in their own service. In this way they will be able to build bridges through faith as the theme of this year's assembly suggests.
What are some of the key priorities you think the U.S. Catholic health ministry should have at this time in its history?
I do believe some of these priorities are spelled out by the United States Conference of Catholic Bishops in the Ethical and Religious Directives for Catholic Health Care Services, where they are referred to as normative principles that inform the church's healing ministry. They include:
- The commitment to promote and defend human dignity, which is the foundation for the concern to respect the sacredness of every human life from conception till its natural end — and the right to adequate health care.
- Fidelity to the biblical mandate to care for the poor, which must be expressed in concrete action at all levels of Catholic health care.
- Advocacy and care for those whose social condition puts them at the margins of society. Pope Francis reiterated in a May 2016 address to aspiring doctors that "health, indeed, is not a consumer good, but a universal right which means that access to health care services cannot be a privilege."
- Contributions to the common good.
- The exercise of responsible stewardship of health care resources.
- Advocacy for conscience rights. In a pluralistic society, (ministry members should) be aware that Catholic health care (organizations) will encounter requests for medical procedures contrary to the moral teaching of the church.
- Addressing the holistic needs of a person. Care should not be limited to the physical needs, it must embrace the psychological, social and spiritual dimensions of the person.
What are some of the challenges the health care ministry faces and how should the ministry respond to those challenges?
The challenges of Catholic health care ministry in contemporary society are varied. However I wish to single out just a few:
Antilife mentality versus the Gospel of life: Catholic health care providers and workers are referred to by the New Charter for Health Care Workers as "guardians and servants of human life." (The charter is a revision of a theological, moral and medical guide for ministry health care workers. Its translation into English from Italian is nearing completion.)
The activity of Catholic health care providers and workers is basically a service to life and health, which are primary goods of the human person. Being true to this mission may prove to be an uphill struggle in today's cultural and social context, in which science and the practice of medicine risk losing sight of their inherent ethical dimension.
We live in times in which, as St. John Paul II often noted, there is a strong cultural war between the culture of life and the culture of death. There is a growing, and, in some cases, an affirmed antilife mentality, which is also supported by antilife legislation. The latter tends to oblige Catholic health care providers to become manipulators of life or even agents of death, which certainly touches the core mission of Catholic health care workers, as custodians and servants of life. The antilife mentality and legislation touch on all stages of human life, from its initial stages to its natural end: procreation, living and death. This includes artificial means of fertility control, contraceptives and abortion, genetic manipulation, euthanasia, assisted suicide.
In the face of this challenge, the responsibility to commit oneself to absolute respect for human life and its sacredness is greatly increased. In "Evangelium Vitae," St. John Paul II reminds us that "the Gospel of life is at the heart of Jesus' message. Lovingly received day after day by the church, it is to be preached with dauntless fidelity as 'good news' to the people of every age and culture." Thus Pope Francis, addressing members of the Federation of Catholic Medical Associations, urged them to "be witnesses and diffusers of the 'culture of life.'"
And the Holy Father noted that '"being Catholic entails a greater responsibility, first of all to (oneself), through a commitment consistent with (one's) Christian vocation; and then to contemporary culture, by contributing to recognizing the transcendent dimension of human life, the imprint of God's creative work, from the first moment of its conception. This is a task of the new evangelization that often requires going against the tide and paying for it personally. The Lord is also counting on (Catholic health care workers) to spread the 'Gospel of life.'"
Universal access to health care services: Universal health coverage has for several decades now been, and is still, a top priority for the United Nations agencies, especially the World Health Organization. Much has been done by state and non-state actors, toward the achievement of this goal. Nevertheless, we are still far from the desired goal, since for many poor communities, access to the much needed health care services remains an unachieved objective up to the present day. With respect to the right of everyone to enjoy the highest attainable standard of physical and mental health, working towards this goal is a moral obligation. Moreover, access to affordable quality care represents a challenge not only for the low-income countries; it has also become an increasingly urgent issue for higher-income countries as well.
The Catholic Church, through her many health care institutions around the world, contributes to the enhancement of universal access, especially in the poor communities situated in the hard-to-reach areas of numerous countries. Very often, these Catholic health care institutions, like other faith-based institutions, have to operate on tight budgets, yet they oftentimes serve communities with no health insurance coverage, who have to pay out of pocket for the services received and many times cannot afford the cost of the services.
In order to enhance the much desired goal of universal access, policy makers have to work hand in hand with intellectual property rights owners on various avenues to enhance access to affordable essential medicines. This means adopting a rights approach to health care, advocacy for the vulnerable groups and exploring the implications of the principle that health care is a basic social good, subject to the demands of distributive and social justice.
States need to work closely with non-state health care providers, for example Catholic health care and other faith-based health care providers, in support of their efforts to bring services to the communities, in respect of basic justice and human dignity.
Good management of available resources and appeals to people of good will can help to reserve some resources for outreach programs for the less fortunate members of society.
Finally, Catholic health care ministry must continue to affirm the right of each person to health care as well as its duty to continue its service to humanity in response and fidelity to the mission and mandate of Jesus Christ.
You have been very instrumental in promoting the pope's encyclical on environmentalism. What message would you want to convey to the ministry, regarding environmentalism?
When I talk of environmentalism, I am referring to advocacy of the preservation, restoration or improvement of the natural environment.
The question of a healthy environment is a key element in the protection and promotion of our health. We normally say that "a healthy mind in a healthy body," one could extend this and say "a healthy body or person in a healthy environment."
Today, more than ever, environmental concerns must be high on the agenda of all leaders, more so when it comes to health care providers. In the last decades humanity has made a lot of progress in curative medicine. However for one reason or another, there has been some laxity with regard to preventive medicine, which had helped us to control many preventable and infectious diseases, which are now making a comeback.
In "Laudato Si' … On Care for Our Common Home," Pope Francis invites us to take care of our common home. Moreover, he reminds us that "the human environment and the natural environment deteriorate together … and it affects the most vulnerable people on the planet."
What responsibilities do Catholic health care leaders have to promote environmental preservation?
It is interesting to note that Pope Francis addresses the (Laudato Si') encyclical to all people, because as he says, "we need a conversation that includes everyone, since the environment challenge we are undergoing, and its human roots, concern and affect us all."
Each one of us has a responsibility, but leaders have a greater responsibility to set the example, mobilize others, advocate for environmental concerns, and promote initiatives for the care of our common home.
In section number 211 of Laudato Si' the pope outlines a number of initiatives that each one of us can undertake to help the environment. At the forefront we have education in environmental responsibility, in order to promote actions that significantly affect our environment: avoiding the use of plastic and paper, reducing water consumption, separating refuse, cooking only what can reasonably be consumed, showing care for other living beings, using public transport or carpooling, planting trees, turning off unnecessary lights, recycling and other useful practices.
The encyclical also touches on some topical issues, showing that protection of nature and genuine human ecology also confirm Catholic teaching on (the following) issues:
- In response to transgender issues, the pope notes that "Learning to accept our body, to care for it and to respect its fullest meaning, is an essential element of any genuine human ecology. Also, valuing one's own body in its femininity or masculinity is necessary if I am going to be able to recognize myself in an encounter with someone who is different ... It is not a healthy attitude which would seek 'to cancel out sexual difference because it no longer knows how to confront it.'"
- On abortion: "Since everything is interrelated, concern for the protection of nature is also incompatible with the justification of abortion. How can we genuinely teach the importance of concern for other vulnerable beings, however troublesome or inconvenient they may be, if we fail to protect a human embryo, even when its presence is uncomfortable and creates difficulties? (Quoting the encyclical letter "Caritas in Veritate," the pope says in Laudato Si',) 'If personal and social sensitivity towards the acceptance of the new life is lost, then other forms of acceptance that are valuable for society also wither away.'"
- On genetically modified food: "This, then, is the correct framework for any reflection concerning human intervention on plants and animals, which at present includes genetic manipulation by biotechnology for the sake of exploiting the potential present in material reality…. Any legitimate intervention will act on nature only in order 'to favor its development in its own line, that of creation, as intended by God,'" (the pope said in Laudato Si', quoting St. John Paul II's 1983 address to the General Assembly of the World Medical Association.)On water as a fundamental right: "Access to safe drinkable water is a basic and universal human right, since it is essential to human survival and, as such, is a condition for the exercise of other human rights. Our world has a grave social debt towards the poor who lack access to drinking water, because they are denied the right to a life consistent with their inalienable dignity." All these and other issues addressed by Laudato Si' must occupy Catholic health care leaders in their endeavor to protect and promote human health. Following the example of St. Francis of Assisi, all of us need to realize, as the pope wrote in Laudato Si', " a healthy relationship with creation is one dimension of overall personal conversion, which entails the recognition of our errors, sins, faults and failures, and leads to heartfelt repentance and desire to change."
You are a native of Ghana and much of your priesthood was spent in West Africa. Please share what you learned in your ministry there that could be instructive for Catholic health ministry executives in the U.S. today.
I have had the privilege of ministering in both rural and urban communities, particularly in my home country Ghana, and I have experienced the joys and struggles of our people. Turning to the health care ministry in particular, the endeavor of the church to bring services to the people — especially those in hard to reach rural areas — is well known. Oftentimes they have to operate on tight budgets, without much support from the central governments, and are able to meet some of their expenses, thanks to the dedication of missionaries and assistance of donors, mainly churches, institutions and individuals in developed countries. Nevertheless, in all these struggles one notices certain common elements that enable them to get along with meager resources, reach out to as many people as possible and remain joyful even when it might seem that there is no room for joy.
I would refer to these elements as values. They include:
Hospitality: This aspect of welcoming whoever comes your way makes people feel at home even when you have very little to offer. During my pastoral visits, I would always be touched by the hospitality and generosity of the people in their simplicity, readiness and joy to share with you the little they had. In the history of the church some religious orders, like the Brothers of St. John of God, have made this value of hospitality part and parcel of their hospital ministry. When you are overwhelmed by budgetary concerns, you may find yourself turning away those who may not fit within your budget. Our preferential care for the poor and needy requires us to explore ways of making this value of hospitality a reality for those who knock at our door in need of care and assistance. This underscores our responsibility and engagement in advocacy for the vulnerable members in our communities.
Respect for the elderly: Older people are greatly respected in most African communities. They play a vital role in African society today. Across the continent, millions of families would not survive without the contribution of older people — from caring for orphaned grandchildren to providing much needed household income. Within the extended family system, the elderly are taken care of by family members. The situation seems to be changing and at times they risk to be left alone in their old age even in Africa. We are living in a society where more and more people live longer, and society needs to plan well for their livelihood and care. Basically, there has to be acceptance and appropriate planning for their well-being. St. John Paul II in his letter to the elderly called for acceptance and appreciation. He noted that "as the number of older people increases ... it will become more and more important to promote a widespread attitude of acceptance and appreciation of the elderly, and not relegate them to the fringes."
Importance of the family: The family is an important concept in Africa. By and large, each African belongs to a family which is much larger than an individual or nuclear family. One belongs to a wider community, commonly referred to as the extended family. The family provides a sense of belonging and security. Moreover, the unity of the family is very important and so family members have the obligation to maintain the cohesion of the community and the solidarity between them. The joys and difficulties of each member are shared by the family members.
I do believe that the family, whether nuclear or extended, remains a key institution of each society, which offers a point of reference as well as elements that could be explored by our health care ministry. If the family is such an important part of one's life, we cannot exclude it from the care and treatment of our patients. We have to explore ways of integrating the family into the care for our patients, in and out of hospital. This holds for all patients but more so for the children who have to be admitted for long periods in hospital and the chronically ill or terminal patients. What space or role do we offer to the family of the patient and how do we help them to come to terms with the illness of their family member or even empower them to assist him or her better?
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