Education of the catholic practicing medicine

by Bernard Ars, M.D., Ph.D., President of the World Federation of Catholic Physicians

This text by Prof. Dr. Benard Ars was made available to the participants of the 26th World Congress of Catholic Physicians that took place in Rome, Institute Augustinianum, from 15 to 17 September 2022.

Catholic physicians have always contributed to the progress of science and care, but especially to the accompaniment of suffering towards more humanity. Today, it seems that we doubt them and that they doubt themselves. What is the situation?

The facts

There is no Catholic medicine, but there are Catholics who practice medicine. And this is fortunate and indispensable. And this explains the multitude of testimonies in medical practice. And this demonstrates the total personal freedom of each physician.

Behind the word “physician” there is a multitude of “realities”. Moreover, the physician is not only a caregiver, but he also heals. According to Canguilhem, “medicine is an art at the crossroads of several types of knowledge”.

In medicine, there are currently three main types of actors with very different professional issues:

• general practitioners, confronted with economic-social, multicultural, deontological and ethical difficulties of the person-to-person relationship;
• hospital specialists, confronted with difficulties of economic profitability of hospital institutions, and of ethics in the face of the domination of techno-sciences, of the technological industry and not only pharmaceutical, as well as in the face of consumerism of care;
• physicians who are researchers in biology and medical sciences, very often invested in disciplines whose potential outlets correspond, without their realizing it, to objectives that are not related to the dignity of the human person and the common good. Most importantly, researchers are shaping the medical practice that will be the practice in twenty years.

Behind the word “Catholic” there is also a multitude of “manifestations”, from social welfare to devout contemplation. Can we ask ourselves what distinguishes a good non-believing physician, caring for his patients, from a Catholic physician? Perhaps it is at the level of the ethics of action?

In the search for Truth, there are essentially two paths, the metaphysical path, that of “Why?” which can be inspired by theology, in case of faith in God; and the scientific path, that of “How”? Unity is realized in the coherent action of the individual, that is, in the ethics of action.

For a nonbeliever, it is exclusively the ethics of “living together”, as he wil call it. The Catholic believer shares this concern for “living together”, but he sees it as the fruit of a charity that comes from God, of a Love that invites and inhabits him to love his neighbor as himself, discovering in each person – and especially in the most fragile – the image and likeness of God, the foundation of an unconditional respect for the dignity of the person. These two approaches are fundamentally different, but this does not prohibit dialogue.

In fact, all physicians, whether nonbelievers or believers, Catholics or others, possess a human nature and a moral conscience that require them to serve the greatness and dignity of the human person, notably by respecting the prohibition of killing or stealing from the patient, of lying to him or her, and by living out a duty of justice and solidarity towards other human beings, especially those who are vulnerable and suffering. This constitutes a broad common basis for the ethical practice of all physicians. Where there is real disagreement between believers and non-believers is in the conception of the dignity of the human person. For the former, this dignity comes from natural reason, enlightened and reinforced by the Revelation of God, who creates Man “in His image and likeness”. It is intangible, absolute, linked to the being of the person, in which there is an “imprint” of Transcendence. For the latter, this dignity has nothing transcendent, it is relative and is of the order of having. The non-believer believes he is authorized to judge the value of a life by subjective criteria.

Faith is a grace, a healing force for all men, and also for the whole human being, in particular for his reason and for that dimension of reason which we call “conscience”. It provides additional light and strength in discerning and applying the law of “conscience”. It also invites him to recognize and respect the person of Christ in the sufferer, to love him with the love of Christ, to care for his spiritual well-being and to pray for his patient. Faith helps the believing physician to answer the questions of suffering and death, enabling him to share his answers with his patients. In order to witness, in today’s world, to the hope that is in us Catholics, by “simply living”, it is necessary to be educated and instructed. In other words, it is necessary to be edified intellectually and spiritually, as well as to have useful tools.

At present, in the name of a false neutrality, but rather by dogmatism and ideological proselytism, the non-denominational educational establishments refuse the recognition of the existence of a Transcendence in our humanity and assail Christianity, as well as Christendom. As for the Universities, the High Schools, the Christian denominational educational institutions, the majority of them do not educate and instruct young people fundamentally, in depth, in the awakening and development of faith in God, and even less in the Gospel, in humanism, in Christian culture and history.

In the neglected field of education, we are experiencing a triple revolution simultaneously.

• The crisis of transmission has turned the teacher into a mere companion, the student having to construct his or her own knowledge, and no longer a teacher who teaches by quality or by default.
• The digital revolution affects teaching by interfering in pedagogy through its numerous screens and in its fundamentals, through Artificial Intelligence.
• The explosion of knowledge in neurosciences allows us to better understand the cerebral functioning, but also the humanity of Man. By using functional Magnetic Resonance Imaging, these sciences give pedagogical recommendations.

Another fact, with a much more positive and permanent connotation: young people always possess two great “strengths”:

• on the one hand, the memory of people who have done them good, who have marked them, parents, educators, teachers, symbolic models; and
• on the other hand, the “professional vocation”, that is, what gives meaning to each of their actions, and in particular those that their profession requires them to do.

It is what makes a properly human gesture a personal act that I am happy to perform and that does good to those who benefit from it.

What to do?

To build, alongside professional training, a solid Christian humanistic education, either individual or in small groups, to which the Catholic who wishes to do so can be trained. This individual teaching can be provided by what Benedict XVI calls a “creative minority” who will support the Christian in his daily life, according to his personal and punctual needs. As for group teaching, it is a matter of creating evening, weekend, Sunday and vacation schools, “in person”, lasting from one to three years, in the form of “post-graduate” courses, with written motivation at the time of registration, and with exams and diplomas that are rewarding after the course. The sole objective of these schools must be to humanize in depth. To humanize is also to evangelize. To evangelize is also to humanize. As for the subject matter, it is more than obvious that the Catholic who practices medicine must show irreproachable professionalism, both in terms of “medical practice” and “research”. This is self-evident and will not be discussed here.

In formation, I see three components:

• First component:
  • Christian instruction in a vision of the human being, an anthropology that will help in immediate personal ethical discernment, and a minimal background in the philosophy of science. Philosophy will clearly pose the questions and a sound and healthy theology will answer them.
• Second component:
  • Openness to the inner life, as well as to its growth through depollution, and increase in personal freedom; not to mention initiation into true Christian prayer.
• Third component:
  • The initiation to Christian witness through “presence”, that kind of sober nobility that radiates by the mere fact of being present here and now. It is to transpire a Christian coherence of life. It is also to liberate the precariousness not only social, but also and above all existential, by a commitment and a humble action, where each day leads us. This is the exercise of charity. It is also to know how – through the word – to “give reason for the hope that is in us” (1 Pt 3:15).

Importance of philosophical and theological formation

Full of good will, the Catholic physician lacks anthropological and biblical reference points to nourish a Christian view of the patient, his medical practice and our society. A vision of the human being can be proposed based on tenderness. With Dominique Lambert, we understand by tenderness, the capacity to let oneself be touched by the life of another and to put oneself on the way and in action for him. The human being is an open relational reality. He is a being who can never be enclosed in a finite system. “Man infinitely surpasses Man” said Pascal. This openness to the world makes possible a vulnerability, i.e. a capacity to be reached by the other, which opens in its turn, to the possibility of a happy action with and for the other. At the heart of human nature, there is therefore essentially its tenderness. This implies a gratuity which is certainly not, by definition, something calculated, the fruit of an algorithm. As Dominique Lambert explains, the progressive emergence of life is a kind of local tenderization of the cosmos. Where life appears, systems emerge that open up, communicate, interact and suffer. The human being is this singular being who will carry this tenderness to its extreme point.

Importance of education to the inner life

Today’s society is overly focused on externality: superficial communication rather than deep knowledge, hyper-connection rather than true human relationship, noise rather than silence, festive excitement rather than meditation, agitation rather than contemplation, pathological solitude rather than contemplative solitude. Hence the importance of a careful education in the inner life! The inner life is the process that consists in going to the heart of things, to understand them from within. It is a path that passes through the consciousness. The regular exercise of the inner life allows discernment, when the external pressure requires it. The inner life requires a willingness to withdraw, an impulse to recollect oneself and therefore a time of true silence. Silence contains a prodigious liberating power. It is the silence of the solitary walker, of the passionate reader, of the amazed artist, of the contemplative and of the lover. Silence and isolation, in order to find oneself outside of any context of influence, constitute the two essential conditions of inner deepening. It is advisable to make discover, even to re-discover, the virtue of recollection, interiority which saves from hyper-activism, dispersion and distraction. The first of freedoms, inner freedom is the freedom to think according to one’s inner convictions and to align one’s actions with one’s ideals.

In 1943, in London, in the service of Free France, Simone Weil wrote a manuscript that she entitled “Prelude to a declaration of duties towards the human being”. She maintains that the first need of the human soul is that of order. The person needs to “be in order”. The person needs order, in order to discern and to act. To be in order is to make sure that our actions are in accordance with our deepest convictions. It means committing ourselves: I do what I say, I say what I do.

Education in the inner life also includes, in our case, the initiation to true Christian prayer. What makes a prayer Christian is that it is lived in reference to Christ. Christ does not exempt us from addressing God. He gives us God, because he is God. In Christian prayer, Christ can have the task of the teacher who teaches us the prayer of the “Our Father”, and that of the model who shows us how to pray. Schools of interior life and Christian prayer, with individual and group instruction, are to be encouraged.

The quality of teachers should not be evaluated only on the collection of brilliant diplomas and prestigious previous functions. The teacher must live the coherent unity of life. What is at stake in this type of teaching is not immediacy or the spectacular, but the long and discrete time, in the slow and penetrating rooting in hope.

Importance of the experience of listening and compassion to social and existential precariousness

Courses of initiation to listening and compassion, well adjusted to the stated objectives, should be promoted in a thoughtful framework.

The Catholic who practices medicine will educate himself for a testimony, in his practice with the sick to whom he will bring fundamental answers concerning, among other things, the meaning of life and death, as well as that of suffering; but also in the cultural and social debates, dealing with the problems of the beginning and the end of life, as well as its manipulation, access to health services, as well as the family. Finally, he will learn about services for the social poverty of our time, for single mothers in difficulty, for people under the influence of new addictions, for the many people suffering from existential insecurity. It will educate itself for a help to the weakened of our time, as well as for an international health cooperation.

What result to obtain? Christian coherence of life!

What is it about? It is to live, consciously or unconsciously, every moment of the day in the presence of Jesus and thus to exercise one’s profession and daily obligations with the vision of the human being, proposed by the life and teaching of Jesus; which helps enormously to immediately take the right ethical attitude when it is urgently required. Our Christian religion is the only religion where God became incarnate. Jesus, true God and true Man, on earth, in Israel, teaches us by his life, the way to reach what he calls “his Kingdom”. He suffered, died and rose again to open the doors of this “Kingdom” to us, if we want it. This is what gives us hope and justifies us in spreading Hope.

The concern to combine positively, without separation or confusion, the deepest interior life and the most daily secular commitment, especially in medicine, is based on christological foundations. When Jesus tells us: “I am the Way, the Truth and the Life”, we feel it as a hand extended by God to the human being that we are. But we must want to learn and know “the faith”. Faith is not only a matter of “experience”, but certainly also of “teaching”. Catholic faith is a grace that purifies, heals, repairs and elevates reason, allowing it to be fully itself. Faith is at the same time a personal, interior act and a free adherence to an objective content that we have not invented, nor have we constructed as we please. By faith, we personally make an act by which we decide to entrust ourselves totally to God, in complete freedom. Moreover, faith is physically fulfilled, albeit soberly, in public witness, for it can never remain purely private. Faith has always encouraged the “and” rather than the “or”, in other words the unity of the person. The Catholic faith has sought from the first centuries to think of the unity of God and Man, in Jesus, and particularly in rejecting multiple heresies.

This unity of God and Man in Christ cannot consist in a juxtaposition or a separation, as is the case in Nestorianism; nor in a confusion of the two, either by reducing the humanity of Christ to his divinity, as is the case in Docetism and Monophysitism; or by reducing his divinity to his humanity, as is the case in Arianism. Nor can the unity of the divine and the human in Christ be thought of as a tension between the two. Rather, Catholic Christology involves the reciprocal promotion of the human and the divine – this is the message of Chalcedon – for which, far from being separated from each other, confused or opposed, the human and divine natures of Jesus are “safeguarded” in their respective properties.

Jesus thirsts for unity. It is from the heart of Jesus Christ that the unity of life of the Christian and of the Church flows. The education of the Catholic physician must, in his mission, materialize this purpose which is this coherent Christian unity of life.

References

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