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Thursday, August 16, 2018
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Holy Spirit Interactive: John M Travaline: The Theology of the Body and Health Care

The Theology of the Body and Health Care

by John M Travaline, M.D.

Pope John Paul II’s “theology of the body” is commonly viewed as papal teaching on sexual ethics. While this is certainly true, it is so much more than that, speaking to a variety of other day-to-day matters. For example, in that it concerns the human body, it informs people with bodily ailments and those who care for them. Indeed, the theology of the body speaks to the healing professions: nurses, therapists, doctors, religious, chaplains, and all who tend to people when they are ill.

In this article, I offer a reading of John Paul II’s view of the human person, as developed in his Theology Of The Body, that shows how we can understand one another in the context of health care.

The Basic Problem

While recovering in the hospital following the assassination attempt against him, John Paul II remarked that one of the problems with being a patient is a threat to losing one’s subjectivity. He recognized a tension between remaining a “subject of one’s illness” and becoming an “object of treatment.” [2] Health care is, or should be, viewed in its essence as a healing of the body-person. And at the center of this healing activity is the relationship between the healer and patient.

An essential element of personhood is one’s capacity to enter into relationships with other persons. This is fundamentally based upon the reality that we are created in the image and likeness of a relational, triune God. Further, the relationships that characterize this sense of personhood are relationships of love—or, in other terms, of complete self-donation.

The Body Is Made for Self-Donation

It is important for one who tends to the body in a healing context to recognize that the essence of the body is to be a gift to another. This notion finds its most clear expression in the context of marriage, wherein the nuptial meaning of the body is expressed. However, the body is apt for self-gift in many ways and in many capacities, whether one is married or unmarried.

In relationships in health care, there are at least two distinct, relevant aspects of self-donation. First, the healer (or anyone who tends to another who is ill) must be sensitive to the patient’s disposition in allowing him or herself to be cared for. In this way, the patient is actually being a gift for the healer; he is giving the healer his vulnerability and an opportunity for service.

Second, the healer has the opportunity to be a gift of self to the patient during each and every encounter. The healer—through his kindness, healing touch, and gentle words, and the use of his knowledge to benefit the patient—makes a true gift of himself in tending to the patient.

While many experiences afford us opportunities to be a gift to one another, those who tend to the sick are especially afforded opportunities for self-gift. Consider what Carl Anderson writes: “In every Good Samaritan situation, then, there is the invitation to give oneself and discover anew one’s true self: a being created out of love, in the image of a triune God, oriented toward others, with a great capacity for love and, therefore, a greater capacity for joy.” [3]

The Communion of Persons

In order to maintain a disposition of self-giftedness, particularly with regard to those who are ill and are suffering, one must appreciate the dignity of the person, who is created in God’s image and willed for his own sake. Further, as God is a community of persons—Father, Son, and Spirit—and as we are made in His image, we also manifest a community of persons in our relationships with others. In health care settings, those who encounter the sick have the greatest—or at least the most—opportunity on a regular basis for realizing this anthropological reality.

In his apostolic letter on suffering, John Paul II talks about suffering being present “in order to unleash love in the human person” (Salvifici Doloris, no. 29). Who is on the front line confronting much of people’s physical, emotional, and psychological suffering? Doctors, nurses, and therapists. And confronting spiritual suffering? Priests, ministers, and religious. In their call to the healing professions, they all are invited to enter into a communio personarum, a communion of persons.

Suffering also has a social and inter-human dimension (cf. Salvifici Doloris, no. 8). And because of this, there is an intimate relationship among suffering, communio, and all of those who tend to the sick. Whenever an act of kindness or mercy is given to another and that act is accepted, a communion of persons is formed. [4]

It is a gift to be attended to and cared for. It is also a gift to be the one who attends to the sick, who cares for the other, because the other, in essence, is Christ. Recall Jesus’ words: “I assure you, as often as you neglected to do it to one of these least ones, you neglected to do it to me” (Mt. 25:45). In giving oneself to another, one becomes an instrument of Christ’s mercy. It is an honor when one human being allows himself to be vulnerable in front of another. Those who have received care know that it can be quite difficult and humiliating, especially in this age and culture when confidence, invincibility, and independence are so prized. It is a gift to care for another because of the basic rewarding feeling that one gets when one ministers to another in need. It is indeed a gift to care for someone who is ill; and in the interaction between the care-giver and the patient, a communion of persons is formed. [5]

Examples of Communio personarum in Health Care Settings

Let’s look at a few examples of communio personarum that are present in health care.

First, consider the provision of artificial hydration and nutrition to a patient in a state of permanent unconsciousness. Such an action affirms the value and dignity of the patient as a person. In the very act of caring for the person, solidarity is maintained with the person, and the true meaning of compassion is realized. This notion of maintaining solidarity, communion, or connectedness with a patient is critical to understanding relationships with the sick as reflecting communio personarum. Maintaining solidarity affirms the dignity of the person and promotes good realized by both the one tending to the patient and the patient himself, even if the patient is in a state of permanent unconsciousness, and even if the patient may not perceive benefit. [6]

Second, consider the impact of spousal health on the care-giving spouse’s own health and mortality. This was the subject of an article in the New England Journal of Medicine in which nearly 520,000 couples were studied to explore this relationship. [7] Over 730,000 spouses were hospitalized at least once over nine years of observation. Without getting into the details of the study, the bottom line was that hospitalization of a spouse is associated with an increased risk of the death of the care-giving spouse. Doesn’t this seem to reveal some profound truth about the complete self-donation of spouses? Is this not a manifestation of communio personarum? And, that this study concerns spouses; the nuptial union; is this not the primordial communio personarum?

Lastly, in another study, over 12,000 elderly patients were analyzed with respect to their satisfaction with physician care. [8] The authors found that if someone accompanied the patients on medical visits, the patients were more satisfied with their interaction and relationship with their physician and their physician’s care of them. Here again is evidence demonstrating an aspect of the communion of persons and the benefit of self-giving.

Patients accompanied by another person, spouses caring for each other, persons caring for patients even when the patient has no awareness; all are manifestations of communio personarum evident in our clinics, hospitals, and nursing homes every day.

Threats to the Body and the Communion of Persons

Present day realities reside within the medical field that threaten human freedom, assail human personhood, and blur the distinctions between men and women as created uniquely in the image and likeness of God. Sadly, the medical professions do not unanimously reject these realities. For this reason, various organizations and faithful laity fight these anti-person, anti-life forces, and they work to preserve a culture of life, uphold authentic human freedom, and convey hope in the midst of suffering.

Let’s look at some of the issues and practices that degrade the human person as created male and female in the image and likeness of God. These threatening forces may be categorized according to the primary mechanism by which they destroy the authentic meaning of personhood.

    Category 1: Issues that blur the distinction between man and woman. These include homosexual agendas (such as same-sex marriage and domestic partnership arrangements) and gender re-assignment surgery.

    Category 2: Issues that see the person as primarily an object to be used. These include certain organ procurement practices for organ transplantation; possibly donation after cardiac death; embryonic stem cell research and development; and euthanasia and physician-assisted suicide.

    Category 3: Issues that rupture communio personarum. These include various reproductive technologies (such as contraception and in vitro fertilization) and an erosion of medical professionalism.

Response to the Threats

The theology of the body exposes these practices in our society as lies about who we are. Unfortunately, we can be duped, and in this case, duped into sustaining a culture of death. The theology of the body tells us that same-sex marriage and gender re-assignment are incompatible with who we truly are. God is a Trinity; in His image we, therefore, must be relational. And we are; created as male and female to relate to each other in a self-donative way. The theology of the body tells us that certain organ procurement practices, embryonic stem cell research, and physician-assisted suicide are direct assaults on the person created for love relationships—persons who are not to be used as commodity or discarded as useless or unwanted. The theology of the body tells us that various reproductive technologies also are lies, breaking down the truth of man and woman, made for nuptial relationship and made to share in communio personarum.

John Paul II’s teaching on the theology of the body is a crucial element in our response to forces threatening our society, particularly in matters of health care. Its relevance to health care is undeniable, and everyone, whether directly or indirectly involved with caring for the sick, will be enriched by an integrative view of the person as packaged and delivered in The Theology of the Body.

[1] A version of this article was presented at the 77th Annual Educational Conference of the Catholic Medical Association, “Theology of the Body: Modern Challenges to Health, Conscience, and Human Dignity,” in Baltimore, Maryland, on October 9, 2008.
[2] George Weigel, Witness to Hope: The Biography of Pope John Paul II (New York, NY: HarperCollins, 2005), p. 415.
[3] Carl Anderson, A Civilization of Love, What Every Catholic Can Do to Transform the World (New York, NY: Harper Collins, 2008), p. 63.
[4] Mary Healy, Men and Women Are from Eden: A Study Guide to John Paul II’s Theology of the Body (Cincinnati, OH: Servant Books, 2005), p. 26.
[5] Tara L. Seyfer and John M. Travaline. The Theology of the Body and modern medicine: informing the practice of healing. Linacre Quarterly 2008; 75:16-30 (February 2008).
[6] See pages 180 ff, Germain Grisez’s essay in Artificial Nutrition and Hydration, and the Permanently Unconscious Patient. Ronald P. Hamel and James J. Walter, editors. Georgetown University Press, 2007.
[7] Nicholas A. Christakis and Paul D. Allison. Mortality after hospitalization of a spouse. N Engl J Med 2006; 354:719-30.
[8] Jennifer L. Wolff and Debra L. Roter, “Hidden in Plain Sight,” Archives of Internal Medicine, 168 (2008): 1409–15.

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