Charter for Health Care Workers

May 1994
Pontifical Council for Pastoral Assistance
Document Type: Other Ecclesial Pronouncements

PREACE
After lon!" careful an# multi$#iscipline preparation" the Charter for %ealth Care &or'ers
is no( )ein! pu)lishe# at the initiati*e of the Pontifical Council for Pastoral Assistance to
%ealth Care &or'ers+
,othin! happens )y chance in human affairs" an# e*en chronolo!ical coinci#ence can
ha*e sym)olic meanin!s+ -n fact" the a(aite# #ocument is )ein! pu)lishe# a fe( months
after the institution .e)ruary 11" 1994/" )y the %oly ather" 0ohn Paul --" of the Pontifical
Aca#emy for 1ife" (hich i#eally" operati*ely an# in its statutary finality is closely
associate# (ith the tas's of the Office for Pastoral Assistance to %ealth Care &or'ers+
An# this Office cannot )ut feel flattere# that the Con!re!ation for the Doctrine of the
aith appro*e# an# 2uic'ly confirme# in its entirety the te3t of the Charter su)mitte# to it:
another reason for its full *ali#ity an# secure authority" )ut also a concrete proof of the
inter#icastery cooperation e3pressly #esire# in the motu proprio (hich set up the
Pontifical Council for Pastoral Assistance to %ealth Care &or'ers+
There are many reasons for recommen#in! a 'no(le#!e" the #i*ul!ation an# the
application of the #irecti*es containe# in this #eontolo!ical co#e for those en!a!e# in
health care+ -ts pu)lication fills a lacuna (hich (as stron!ly felt not only in the Church
)ut also )y all those (ho empathi4e (ith the primary tas' it fulfills of promotin! an#
#efen#in! life+
The e3traor#inary a#*ances of science an# technolo!y in the *ery *ast fiel# of health
an# me#icine ha*e pro#uce# an in#epen#ent #iscipline calle# )ioethics" or ethics of life+
This e3plains (hy" especially from Pius 5-- on(ar#s" the ma!isterium of the Church has
inter*ene# (ith increasin! interest" (ith consistent firmness an# e*er more e3plicit
#irecti*es concernin! all the comple3 pro)lems arisin! from the in#issolu)le )on#
)et(een me#icine an# morality+ ,one of these pro)lems can )e consi#ere# neutral at
this time in relation to %ippocratic ethics an# Christian morality+ %ence the re2uirement"
strictly respecte# in the Charter for %ealth Care &or'ers" for an or!anic an# e3hausti*e
synthesis of the Church6s position on all that pertains to the affirmation" in the fiel# of
health care" of the primary an# a)solute *alue of life: of all life an# the life of e*ery
human )ein!+
Therefore" after an intro#uction on the fi!ure an# essential tas's of health care (or'ers"
or )etter" of the 7ministers of life"7 the Charter !athers its #irecti*es aroun# the triple
theme of procreation" life an# #eath+ An# so thatas often happens#ou)tful
interpretations may not pre*ail o*er the o)8ecti*e (orth of the contents" in the re#action
of the #ocument the inter*entions of the 9upreme Pontiffs an# authoritati*e te3ts issue#
)y the Offices of the Roman Curia ha*e almost al(ays )een 2uote# #irectly+ These
inter*entions sho( conclusi*ely that the position of the Church on the fun#amental
pro)lems of )ioethics" (hile safe!uar#in! the sacre# limits impose# )y the promotion
an# #efense of life" is hi!hly constructi*e an# open to true pro!ress in science an#
technolo!y" (hen this pro!ress is (el#e# to that of ci*ili4ation+
At the )e!innin! of the Charter the acti*ity of the health care (or'er is sai# to )e 7a form
of Christian (itness+7
%um)ly" )ut also prou#ly" (e can say that this Charter for %ealth Care &or'ers is part of
the 7ne( e*an!eli4ation7 (hich" in ser*ice to life" especially for those (ho suffer" has" in
imitation of Christ6s ministry" its 2ualifyin! moment+
The hope then is that this (or'$tool may )ecome an inte!ral part of the initial an#
on!oin! formation of health care (or'ers" so that their (itness may )e proof that the
Church" in its #efense of life" opens its heart an# its arms to all people since Christ6s
messa!e is a##resse# to all people+
Car#+ ioren4o An!elini Presi#ent of the Pontifical Council for Pastoral Assistance to
%ealth Care &or'ers
INTRODUCTION
M-,-9TER9 O 1-E
1+ The (or' of health care persons is a *ery *alua)le ser*ice to life + -t e3presses a
profoun#ly human an# Christian commitment" un#erta'en an# carrie# out not only as a
technical acti*ity )ut also as one of #e#ication to an# lo*e of nei!h)or+ -t is 7a form of
Christian (itness+7.1/ 7Their profession calls for them to )e !uar#ians an# ser*ants of
human life7 . E*an!elium :itae ;9/+
1ife is a primary an# fun#amental !oo# of the human person+ Carin! for life" then"
e3presses" first an# foremost" a truly human acti*ity in #efense of physical life+
-t is to this that professional or *oluntary health care (or'ers #e*ote their acti*ity+ These
are #octors" nurses" hospital chaplains" men an# (omen reli!ious" a#ministrators"
*oluntary care !i*ers for those (ho suffer" those in*ol*e# in the #ia!nosis" treatment an#
reco*ery of human health+ The principal an# sym)olic e3pression of 7ta'in! care7 is their
*i!ilant an# carin! presence at the sic')e# + -t is here that me#ical an# nursin! acti*ity
e3presses its lofty human an# Christian *alue+
<+ %ealth care acti*ity is )ase# on an interpersonal relationship of a special 'in#+ -t is 7a
meetin! )et(een trust an# conscience+7.</ The 7trust7 of one (ho is ill an# sufferin! an#
hence in nee#" (ho entrusts himself to the 7conscience7 of another (ho can help him in
his nee# an# (ho comes to his assistance to care for him an# cure him+ This is the
health care (or'er+.=/
or him 7the sic' person is ne*er merely a clinical case7an anonymous in#i*i#ual on
(hom to apply the fruit of his 'no(le#!e7)ut al(ays a 6sic' person"6 to(ar#s (hom7 he
sho(s a sincere attitu#e of 7sympathy"7 in the ethymolo!ical sense of the term+7.4/
This re2uires lo*e: a*aila)ility" attention" un#erstan#in!" sharin!" )ene*olence" patience"
#ialo!ue+ 79cientific an# professional e3pertise7 is not enou!h> (hat is re2uire# is
7personal empathy (ith the concrete situations of each patient+7.?/
=+ To safe!uar#" reco*er an# )etter the state of health means ser*in! life in its totality+ -n
fact" 7sic'ness an# sufferin! are phenomena (hich" (hen e3amine# in #epth" as'
2uestions (hich !o )eyon# me#icine to the essence of the human con#ition in this
(orl#+ -t is easy to see" therefore" ho( important in socio$me#ical$me#ical ser*ice is the
presence+++of (or'ers (ho are !ui#e# )y an holistic human *ision of illness an# hence
can a#opt a (holly human approach to the sufferin! patient+7.@/
-n this (ay" the health care (or'er" if animate# )y a truly Christian spirit" (ill more easily
)ecome a(are of the #eman#in! missionary #imension of his profession: 7his entire
humanity comes into play7 here 7an# nothin! less than complete commitment is re2uire#
of him+7.A/
To spea' of mission is to spea' of *ocation :.;/ the response to a transcen#ent call
(hich ta'es shape in the sufferin! an# appealin! countenance of the patient in his care+
To care lo*in!ly for a sic' person is to fulfill a #i*ine mission" (hich alone can moti*ate
an# sustain the most #isintereste#" a*aila)le an# faithful commitment" an# !i*es it a
priestly *alue+7.9/ 7&hen he presents the heart of his re#empti*e mission" 0esus says: 6-
came that they may ha*e life" an# ha*e it a)un#antly6 .0n 1B:1B/++++ -t is precisely in this
6life6 that all the aspects an# sta!es of human life achie*e their full si!nificance7
. E*an!elium :itae 1/+
The health care (or'er is the !oo# 9amaritan of the para)le" (ho stops )esi#e the
(oun#e# person" )ecomin! his 7nei!h)or in charity .cf+ 1' 1B:<9$=A/+.1B/
4+ This means that health$care is a ministerial instrument of Co#6s outpourin! lo*e for the
sufferin! person> an#" at the same time" it is an act of lo*e of Co#" sho(n in the lo*in!
care for the person+ or the Christian" it is an actuali4e# continuation of the healin! lo*e
of Christ" (ho 7(ent a)out #oin! !oo# an# healin! e*eryone7 .Acts 1B:=;/+.11/ An# at
the same time it is lo*e for Christ: he is the sic' person7- (as sic'7(ho assumes the
face of a sufferin! )rother> since he consi#ers as #one to himself7you #i# it to me7
the lo*in! care of one6s )rother .cf+ Mt <?: =14B/+.1</
Profession" *ocation an# mission meet an#" in the Christian *ision of life an# health" they
are mutually inte!rate#+ 9een in this li!ht" health care assumes a ne( an# more e3alte#
meanin! as 7ser*ice to life7 an# 7healin! ministry+7.1=/ Minister of life".14/ the health
care (or'er is 7the minister of that Co#" (ho in 9cripture is presente# as 6a lo*er of life76
.&is 11:<@/+.1?/ To ser*e life is to ser*e Co# in the person: it is to )ecome 7a
colla)orator (ith Co# in restorin! health to the sic' )o#y7.1@/ an# to !i*e praise an#
!lory to Co# in the lo*in! (elcome to life" especially if it )e (ea' an# ill+.1A/
?+ The Church" (hich consi#ers 7ser*ice to the sic' as an inte!ral part of its
mission"7.1;/ assumes it as an e3pression of its ministry+.19/ 7The Church+++has al(ays
seen me#icine as an important support for its o(n re#eemin! mission to humanity+7 -n
fact" 7ser*ice to man6s spirit cannot )e fully effecti*e e3cept it )e ser*ice to his psycho$
physical unity+ The Church 'no(s (ell that physical e*il imprisons the spirit" 8ust as
spiritual e*il su)8ects the )o#y+7.<B/
-t follo(s that the therapeutic ministry of health care (or'ers is a sharin! in the
pastoral.<1/ an# e*an!eli4in!.<</ (or' of the Church+ 9er*ice to life )ecomes a ministry
of sal*ation" that is" a messa!e that acti*ates the re#eemin! lo*e of Christ+ 7Doctors"
nurses" other health care (or'ers" *oluntary assistants" are calle# to )e the li*in! ima!e
of Christ an# of his Church in lo*in! the sic' an# the sufferin!:7.<=/ (itnesses of 7the
!ospel of life+7.<4/
@+ 9er*ice to life is such only if it is faithful to the moral la(" (hich e3presses e3i!ently its
*alue an# its tas's+ Desi#es technico$professional competence" the health care (or'er
has ethical responsi)ilities+ 7The ethical la(" foun#e# on respect for the #i!nity of the
person an# on the ri!hts of the sic'" shoul# illuminate an# !o*ern )oth the research
phase an# the application of the fin#in!s+7.<?/ -n fi#elity to the moral la(" the health care
(or'er actuates his fi#elity to the human person (hose (orth is !uarantee# )y the la("
an# to Co#" (hose (is#om is e3presse# )y the la(+
%e #ra(s his )eha*ioral #irecti*es from that fiel# of normati*e ethics (hich no(a#ays is
calle# )ioethics+ %ere" (ith *i!ilant an# careful attention" the ma!isterium of the Church
has inter*ene#" (ith reference to 2uestions an# #isputes arisin! from the )iome#ical
a#*ances an# from the chan!in! cultural ethos + This )ioethical ma!isterium is for the
health care (or'er" Catholic or other(ise" a source of principles an# norms of con#uct
(hich enli!hten his conscience an# #irect himespecially in the comple3ity of mo#ern
)iotechnical possi)ilitiesin his choices" al(ays respectin! life an# its #i!nity+
A+ The continuous pro!ress of me#icine #eman#s of the health care (or'er a thorou!h
preparation an# on!oin! formation so as to ensure" also )y personal stu#ies" the
re2uire# competence an# fittin! professional e3pertise+
9i#e$)y$si#e (ith this" they shoul# )e !i*en a soli# 7ethico$reli!ious formation"7.<@/
(hich 7promotes in them an appreciation of human an# Christian *alues an# refines their
moral conscience+7 There is nee# 7to #e*elop in them an authentic faith an# a true sense
of morality" in a sincere search for a reli!ious relationship (ith Co#" in (hom all i#eals of
!oo#ness an# truth are )ase#+7.<A/
7All health care (or'ers shoul# )e tau!ht morality an# )ioethics+7.<;/ To achie*e this+
those responsi)le for their formation shoul# en#ea*or to ha*e chairs an# courses in
)ioethics put in place+
;+ %ealth care (or'ers" especially #octors" cannot )e left to their o(n #e*ices an#
)ur#ene# (ith un)eara)le responsi)ilities (hen face# (ith e*er more comple3 an#
pro)lematic clinical cases arisin! from )iotechnical possi)ilitiesmany of (hich are at
an e3perimental sta!eopen to mo#ern me#icine" an# from the socio$me#ical import of
certain 2uestions+
To facilitate choices an# to 'eep a chec' on them" the settin! up of ethical committees in
the principal me#ical centers shoul# )e encoura!e#+ -n these commissions" me#ical
competence an# e*aluation is confronte# an# inte!rate# (ith that of other presences at
the patient6s si#e" so as to safe!uar# the latter6s #i!nity an# me#ical responsi)ility itself+
.<9/
9+ The sphere of action of health care (or'ers consists" in !eneral" of (hat is containe#
in the terms an# concepts of health an# me#icine especially+
The term an# concept of health em)races all that pertains to pre*ention" #ia!nosis"
treatment an# reha)ilitation for !reater e2uili)rium an# the physical" psychic an# spiritual
(ell$)ein! of the person+ The term an# concept of me#icine" on the other han#" refers to
all that concerns health policy" le!islation" pro!rammin! an# structures+.=B/
The full concept of health reflects #irectly on that of me#icine+ -n fact" 7institutions are
*ery important an# in#ispensa)le> ho(e*er" no institution can of itself su)stitute for the
human heart" human compassion" human lo*e" human initiati*e" (hen it is a 2uestion of
helpin! another in his sufferin!+7.=1/
The meetin! an# the practical synthesis of the #eman#s an# #uties arisin! from the
concepts of health an# me#icine are the )asis an# (ay for humani4in! me#icine+ This
must )e present )oth at the personal$professional le*elthe #octor$patient relationship
an# at the socio$policy le*el so as to safe!uar# in institutional an# technolo!ical
structures the human$Christian interests in society an# the institutional an# technolo!ical
infrastructures+ The first )ut not (ithout the secon#" since such humani4ation as (ell as
)ein! a lo*e$charity tas' is 7an o)li!ation of 8ustice+7.=</ 7.This humani4ation
stren!thens/ the )ases of the 6ci*ili4ation of life an# lo*e"6 (ithout (hich the life of
in#i*i#uals an# of society itself loses its most !enuinely human 2uality7 . E*an!elium
:itae <A/+
1B+ The present charter (ants to !uarantee the ethical fi#elity of the health care (or'er:
the choices an# )eha*ior enfleshin! ser*ice to life+
This fi#elity is outline# throu!h the sta!es of human e3istence: procreation" li*in!" #yin!"
as reference points for ethical$pastoral reflections+
I. PROCREATION
11+ 7-n the )i)lical narrati*e" the #ifference )et(een man an# other creatures is sho(n
a)o*e all )y the fact that only the creation of man is presente# as the result of a special
#ecision on the part of Co#" a #eli)eration to esta)lish a particular an# specific )on# (ith
the Creator : 61et us ma'e man in our ima!e" after our li'eness6 .Cen 1:<@/+ The life
(hich Co# offers to man is a !ift )y (hich Co# shares somethin! of himself (ith his
creature+ 7.==/
76Co# himself (ho sai#" it is not !oo# for man to )e alone .Cen <:1;/ an# (ho ma#e
man from the )e!innin! male an# female .Mt 19:4/" (ishe# to share (ith man a certain
participation in his o(n creati*e (or'+ Thus he )lesse# male an# female sayin!:
-ncrease an# multiply 76.Cen 1:<;/+ The !eneration of a ne( human )ein! is therefore
7an e*ent (hich is #eeply human an# full of reli!ious meanin!" insofar as it in*ol*es )oth
the spouses" (ho form 6one flesh6 .Cen <:<4/" an# Co# (ho ma'es himself present+7.=4/
%ealth care (or'ers len# their ser*ice (hen7 e*er they help the parents to procreate
responsi)ly" supportin! the con#itions" remo*in! o)stacles an# protectin! them from
in*asi*e techni2ues un(orthy of human procreation+
Cenetic manipulation
1<+ The e*er$(i#enin! 'no(le#!e of the human !enetic patrimony .!enome/" the
in#i*i#uation an# mappin! of the acti*ity of the !enes" (ith the possi)ility of transferrin!
them" mo#ifyin! them or su)stitutin! them" opens up untol# prospects to me#icine an#
at the same time creates ne( an# #elicate ethical pro)lems+
-n moral e*aluation a #istinction must )e ma#e )et(een strictly therapeutic manipulation"
(hich aims to cure illnesses cause# )y !enetic or chromosome anomalies .!enetic
therapy/" from manipulation alterin! the human !enetic patrimony+ A curati*e
inter*ention" (hich is also calle# 7!enetic sur!ery"7 7(ill )e consi#ere# #esira)le in
principle+ pro*i#e# its purpose is the real promotion of the personal (ell$)ein! of the
in#i*i#ual" (ithout #ama!in! his inte!rity or (orsenin! his con#ition of life+7.=?/
1=+ On the other han#" inter*entions (hich are not #irectly curati*e" the purpose of (hich
is 7the pro#uction of human )ein!s selecte# accor#in! to se3 or other pre#etermine#
2ualities"7 (hich chan!e the !enotype of the in#i*i#ual an# of the human species" 7are
contrary to the personal #i!nity of the human )ein!" to his inte!rity an# to his i#entity+
Therefore they can )e in no (ay 8ustifie# on the prete3t that they (ill pro#uce some
)eneficial results for humanity in the future"7.=@/ 7no social or scientific usefulness an#
no i#eolo!ical purpose coul# e*er 8ustify an inter*ention on the human !enome unless it
)e therapeutic" that is its finality must )e the natural #e*elopment of the human
)ein!+7.=A/
14+ -n any case" this type of inter*ention 7shoul# not pre8u#ice the )e!innin!s of human
life" that is" procreation lin'e# to not only the )iolo!ical )ut also the spiritual union of the
parents" unite# in the )on# of matrimony+7.=;/
The ne!ati*e ethical e*aluations outline# here apply to all !enetic manipulatory
inter*entions concerne# (ith em)ryos+ On the other han# there are no moral o)8ections
to the manipulation of human )o#y cells for curati*e purposes an# the manipulation of
animal or *e!eta)le cells for pharmaceutical purposes+
ertility control
1?+ 7&ithout inten#in! to un#erestimate the other en#s of marria!e" it must )e sai# that
true marrie# lo*e an# the (hole structure of family life (hich results from it is #irecte# to
#isposin! the spouses to cooperate *aliantly (ith the lo*e of the Creator an# 9a*ior"
(ho throu!h them (ill increase an# enrich his family from #ay to #ay+7.=9/ 7&hen a ne(
person is )orn of the con8u!al union of the t(o" he )rin!s (ith him into the (orl# a
particular ima!e an# li'eness of Co# himself: the !enealo!y of the person is inscri)e# in
the *ery )iolo!y of !eneration + -n affirmin! that the spouses" as parents" cooperate (ith
Co# the Creator in concei*in! an# !i*in! )irth to a ne( human )ein!" (e are not
spea'in! merely (ith reference to the la(s of )iolo!y++++ De!ettin! is the continuation of
Creation+7.4B/
7Those are consi#ere# to e3ercise responsi)le parenthoo# (ho pru#ently an#
!enerously #eci#e to ha*e a lar!e family" or (ho" for serious reasons an# (ith #ue
respect for the moral la(" choose to ha*e no more chil#ren for the time )ein! or e*en for
an in#eterminate perio#+7.41/ -n the latter case there is the pro)lem of )irth control+
1@+ -n e*aluatin! )eha*ior (ith re!ar# to this control" the moral 8u#!ment 7#oes not
#epen# solely on !oo# intentions an# on the e*aluation of moti*es> it is #etermine# )y
o)8ecti*e criteria" criteria #ra(n from the #i!nity of the human person an# human
action+7.4</ -t is a 2uestion of the #i!nity of the man an# the (oman an# of their most
intimate relationship+ Respect for this #i!nity sho(s the truth of their marrie# lo*e+
&ith re!ar# to the marria!e act" this e3presses 7the in#issolu)le )on# )et(een the t(o
meanin!s of the act: the uniti*e meanin! an# the procreati*e meanin!+7.4=/ -n fact" the
acts )y (hich the partners fully e3press themsel*es an# (hich intensify their union are
the same ones that !enerate life an# *ice$*ersa+.44/
1o*e (hich uses 7)o#y lan!ua!e7 to e3press itself is at once uniti*e an# procreati*e: 7it
clearly implies )oth spousal an# parental si!nificance+7.4?/
This )on# is intrinsic to the marria!e act: 7man may not )rea' it on his o(n initiati*e"7
(ithout #enyin! the #i!nity proper to the person an# 7the inner truth of marrie# lo*e+7.4@/
1A+ Therefore" (hile it is la(ful" for !ra*e reasons" to ta'e a#*anta!e of a 'no(le#!e of
the (oman6s fertility an# fore!o the use of marria!e in the fertile perio#s" recourse to
contracepti*e practice is illicit+.4A/
,atural metho#s imply a marria!e act (hich" on the one han# #oes not result in a ne(
life an# (hich" on the other han#" is still intrinsically life$#irecte#+.4;/ 7-t is precisely this
respect (hich ma'es le!itimate" at the ser*ice of responsi)le procreation" the use of
natural metho#s of re!ulatin! fertility + rom the scientific point of *ie(" these metho#s
are )ecomin! more an# more accurate an# ma'e it possi)le in practice to ma'e choices
in harmony (ith moral *alues+7.49/
Artificial means contra#ict 7the nature of the man an# the (oman an# of their most
intimate relationship+7.?B/ %ere se3ual union is separate# from procreation: the act is
#epri*e# of its natural openness to life+ 7Thus the ori!inal import of human se3uality is
#istorte# an# falsifie#" an# the t(o meanin!s" uniti*e an# procreati*e" inherent in the
*ery nature of the con8u!al act" are artificially separate#: in this (ay the marria!e union
is )etraye# an# its fruitfulness is su)8ecte# to the caprice of the couple+7.?1/
This occurs in 7e*ery action (hich" either in anticipation of the con8u!al act" or in its
accomplishment" or in the #e*elopment of its natural conse2uences" proposes" (hether
as an en# or as a means" to ren#er procreation impossi)le+7.?</
1;+ %ere" then" is 7the #ifference" )oth anthropolo!ical an# moral" )et(een contraception
an# recourse to the rhythm of the cycle+7.?=/
7-t is not a #istinction simply of techni2ues or metho#s" (here the #ecisi*e element
(oul# )e the artificial or natural character of the proce#ure+ 7.?4/ -t is a #ifference
in*ol*in! 7t(o irreconcila)le concepts of the human person an# of human se3uality+7.??/
The 7#ifference"7 then" must )e reco!ni4e# an# illustrate#: 7The ultimate reason for
e*ery natural metho# is not 8ust its effecti*eness or )iolo!ical relia)ility" )ut its
consistency (ith the Christian *ision of se3uality as e3pressi*e of marrie# lo*e+7.?@/ 7-t is
fre2uently asserte# that contraception" if ma#e safe an# a*aila)le to all" is the most
effecti*e reme#y a!ainst a)ortion++++ &hen loo'e# at carefully" this o)8ection is clearly
unfoun#e#++++ -n#ee#" the pro$a)ortion culture is especially stron! precisely (here the
Church6s teachin! on contraception is re8ecte#+7.?A/
19+ Rather than #irections for use" natural metho#s are in 'eepin! (ith the meanin! of
con8u!al lo*e" (hich !i*es #irection to the life of the couple: 7The choice of the natural
rhythms in*ol*es acceptin! the cycle of the person" that is the (oman" an# there)y
acceptin! #ialo!ue" reciprocal respect" share# responsi)ility an# self$control++++ -n this
conte3t+++con8u!al communion is enriche# (ith those *alues of ten#erness an# affection
(hich constitute the inner soul of human se3uality" in its physical #imension also+7.?;/
<B+ %ealth care (or'ers can contri)ute" (hen opportunities occur in their fiel#" to(ar#s
an acceptance of this human an# Christian concept of se3uality )y ma'in! a*aila)le to
marrie# people" an# e*en )efore that to youn! people" the re2uire# information for
responsi)le )eha*ior" respectful of the special #i!nity of human se3uality+.?9/
This is (hy the Church appeals to their 7responsi)ility7 in 7effecti*ely helpin! couples to
li*e their lo*e (ith respect for the structures an# finalities of the con8u!al act (hich
e3presses that lo*e+7.@B/
Artificial procreation
<1+ The application to humans of )iotechnolo!y learne# from animal fertili4ation has
ma#e possi)le *arious inter*entions in human procreation" !i*in! rise to serious
2uestions of moral la(fulness+ 7The *arious techni2ues of artificial repro#uction" (hich
(oul# seem to )e at the ser*ice of life an# (hich are fre2uently use# (ith this intention"
actually open the #oor to ne( threats a!ainst life+7.@1/
The e*aluati*e ethical criterion must ta'e account of the ori!inality of human procreation"
(hich 7#eri*es from the ori!inality itself of the human person+7.@</ 7,ature itself #ictates
that the transmission of human life )e a personal an# conscious act an#" as such"
su)8ect to the most holy la(s of Co#: immuta)le an# in*iola)le la(s (hich must )e
ac'no(le#!e# an# o)ser*e#+7.@=/ This personal act is the intimate union of the lo*e of
the spouses (ho" in !i*in! themsel*es completely to each other" !i*e life + -t is a sin!le"
in#i*isi)le act" at once uniti*e an# procreati*e" con8u!al an# parental+.@4/
This act7an e3pression of the reciprocal !ift (hich" in the (or#s of 9cripture" )rin!s
a)out a union 6in one flesh76.@?/is the source of life+
<<+ %umans are not at li)erty to )e i!norant of an# to i!nore the meanin!s an# *alues
intrinsic to human life from its *ery )e!innin!+ 7An# therefore means cannot )e use# nor
la(s follo(e# (hich may )e licit in the transmission of animal or *e!eta)le life+7.@@/ The
#i!nity of the human person #eman#s that it come into )ein! as a !ift of Co# an# as the
fruit of the con8u!al act" (hich is proper an# specific to the uniti*e an# procreati*e lo*e
)et(een the spouses" an act (hich of its *ery nature is irreplacea)le+
E*ery means an# me#ical inter*ention" in the fiel# of procreation" must al(ays )e )y
(ay of assistance an# ne*er su)stitution of the marria!e act+ -n fact" 7the #octor is at the
ser*ice of people an# human procreation: he has no authority to #o as he (ills (ith them
or to ma'e #ecisions a)out them+ Me#ical inter*ention respects the #i!nity of the
persons (hen it aims at helpin! the marria!e act++++ On the contrary" sometimes me#ical
inter*ention replaces the con8u!al act++++ -n this case" the me#ical action is not" as it
shoul# )e" at the ser*ice of the marria!e union" )ut it appropriates the procreati*e
function an# thus is contrary to the #i!nity an# inaliena)le ri!hts of the spouses an# of
the e3pecte# chil#+7.@A/
<=+ 7The use of such artificial means is not necessarily for)i##en if their function is
merely to facilitate the natural act" or to ensure that a normally performe# act reaches its
proper en#+7.@;/ This is homolo!ous artificial insemination" that is" (ithin matrimony (ith
the semen of the partner" (hen this is o)taine# throu!h a normal marria!e act+
<4+ Dut homolo!ous -:ET . ertili4ation in *itro (ith em)ryo transfer / is illicit )ecause
conception is not the result of a con8u!al act7the fruit of the con8u!al act specific to the
lo*e )et(een the spouses7.@9/)ut outsi#e it: in *itro throu!h techni2ues (hich
#etermine the con#itions an# #eci#e the effect+.AB/ This is not in accor# (ith the lo!ic of
7#onation"7 proper to human procreation" )ut 7pro#uction7 an# 7#ominion"7 proper to
thin!s an# effects+ -n this case the chil# is not )orn as a 7!ift7 of lo*e" )ut as a la)oratory
7pro#uct+7.A1/
Of itself" -:ET 7separates the acts (hich are #estine# for human procreation in the
con8u!al act"7 an act (hich is 7in#issolu)ly corporeal an# spiritual+7 ertili4ation ta'es
place outsi#e the )o#ies of the spouses+ -t is not 7actually effecte# nor positi*ely (ille#
as an e3pression of an# fruit of the specific act of con8u!al union"7 )ut as a 7result7 of a
technical inter*ention+.A</ 7.Man/ no lon!er consi#ers life as a splen#i# !ift of Co#"
somethin! 6sacre#6 entruste# to his responsi)ility an# thus also to his lo*in! care an#
6*eneration+6 1ife itself )ecomes a mere 6thin!"6 (hich man claims as his e3clusi*e
property" completely su)8ect to his control an# manipulation+7.A=/
<?+ The #esire for a chil#" sincere an# intense thou!h it )e" )y the spouses" #oes not
le!itimi4e recourse to techni2ues (hich are contrary to the truth of human procreation
an# to the #i!nity of the ne( human )ein!+.A4/
The #esire for a chil# !i*es no ri!ht to ha*e a chil#+ The latter is a person" (ith the
#i!nity of a 7su)8ect+7 As such" it cannot )e #esire# as an 7o)8ect+7 The fact is that the
chil# is a su)8ect of ri!hts: the chil# has the ri!ht to )e concei*e# only (ith full respect for
its personhoo#+.A?/
<@+ Desi#es these intrinsic reasons of the #i!nity of the person an# its conception"
homolo!ous -:ET is also morally ina#missi)le )ecause of the circumstances an#
conse2uences of its present$#ay practice+
-n fact" it is effecte# at the cost of numerous em)ryonal losses" (hich are procure#
a)ortions+ -t coul# also in*ol*e con!ealment" (hich means suspension of life" of the so$
calle# 7spare7 em)ryos" an# often e*en their #estruction+.A@/
Enaccepta)le is 7post mortem7 insemination" that is" (ith semen" !i*en #urin! his
lifetime" )y the #ecease# spouse+
These are a!!ra*atin! factors in a technical proce#ure alrea#y morally illicit in itself" an#
(hich remains such e*en (ithout these factors+.AA/
<A+ %eterolo!ous techni2ues are 7)ur#ene#7 (ith the 7ethical ne!ati*ity7 of conception
outsi#e of marria!e+ Recourse to !ametes of people other than the spouses is contrary
to the unity of marria!e an# the fi#elity of the spouses" an# it harms the ri!ht of the chil#
to )e concei*e# an# )orn in an# from a marria!e+ 7 Procreation then+++e3presses a
#esire" or in#ee# the intention" to ha*e a chil# 6at all costs"6 an# not )ecause it si!nifies
the complete acceptance of the other an# therefore an openness to the richness of life
(hich the chil# represents+7.A;/
These techni2ues" in fact" i!nore the common an# unitary *ocation of the partners to
paternity an# maternityto 7)ecome father an# mother only throu!h one another7an#
they cause 7a rupture )et(een !enetic parenthoo#" !estational parenthoo# an#
e#ucational responsi)ility"7 (hich" from the family" has repercussions in society+.A9/
A further reason for unla(fulness is the commerciali4ation an# eu!enic selection of the
!ametes+
<;+ or the same reasons" a!!ra*ate# )y the a)sence of the marria!e )on#" artificial
insemination of the unmarrie# an# coha)itants is morally unaccepta)le+.;B/
<9+ E2ually contrary to the #i!nity of the (oman" to the unity of marria!e an# to the
#i!nity of the procreation of a human person is 7surro!ate7 motherhoo#+
To implant in a (oman6s (om) an em)ryo (hich is !enetically forei!n to her or 8ust to
fertili4e her (ith the con#ition that she han# o*er the ne(ly )orn chil# to a client means
separatin! !estation from maternity" re#ucin! it to an incu)ation (hich #oes not respect
the #i!nity an# ri!ht of the chil# to )e 7concei*e#" )orne in the (om)" )rou!ht to )irth
an# e#ucate# )y its o(n parents+7.;1/
=B+ The *er#ict of moral unla(fulness o)*iously concerns the (ays )y (hich human
fertili4ation ta'es place" not the fruit of these techni2ues" (hich is al(ays a human )ein!"
to )e (elcome# as a !ift of Co#6s !oo#ness an# nurture# (ith lo*e+.;</
=1+ Artificial insemination techni2ues no(a#ays coul# open the (ay to attempts or
pro8ects of fertili4ation )et(een human an# animal !ametes" to !estation of human
em)ryos in animal or artificial (om)s" of se3less repro#uction of human )ein!s throu!h
t(innin! fission" clonin!" partheno!enesis+
9uch proce#ures are contrary to the human #i!nity of the em)ryo an# of procreation"
an# thus they are to )e consi#ere# morally reprehensi)le+.;=/
=<+ Me#icine #irecte# to the inte!ral !oo# of the person cannot prescin# from the ethical
principles !o*ernin! human procreation+
%ence the 7ur!ent appeal7 to #octors an# researchers to !i*e 7an e3emplary (itness of
the respect #ue to the human em)ryo an# to the #i!nity of procreation+7.;4/
==+ Me#ical ser*ice to life accompanies the life of the person throu!hout their (hole life$
span+ -t is protection" promotion an# care of health" that is" of the inte!rity an# psycho$
physical (ell$)ein! of the person" in (hom life 7is enfleshe#+7.;?/
-t is a ser*ice )ase# on the #i!nity of the human person an# on the ri!ht to life" an# it is
e3presse# not only in pre*ention" treatment an# reha)ilitation )ut also in an holistic
promotion of the person6s health+
=4+ This responsi)ility commits the health care (or'er to a ser*ice to life e3ten#in! 7from
its *ery )e!innin! to its natural en#"7 that is" 7from the moment of conception to
#eath+7.;@/
II. LIFE
De!innin! of life an# )irth
=?+ 7rom the time that the o*um is fertili4e#" a life is )e!un (hich is neither that of the
father nor of the mother> it is rather the life of a ne( human )ein! (ith its o(n !ro(th+ -t
(oul# ne*er )e ma#e human if it (ere not human alrea#y++++ Ri!ht from the fertili4ation
the a#*enture of a ne( life )e!ins" an# each of its capacities re2uires timea rather
len!thy timeto fin# its place an# to )e in a position to act+7.;A/
Recent a#*ances in human )iolo!y ha*e come to pro*e that 7in the 4y!ote arisin! from
fertili4ation" the )iolo!ical i#entity of a ne( human in#i*i#ual is alrea#y present+7.;;/ -t is
the in#i*i#uality proper to an autonomous )ein!" intrinsically #etermine#" #e*elopin! in
!ra#ual continuity+
Diolo!ical in#i*i#uality" an# therefore the personal nature of the 4y!ote is such from
conception+ 7%o( can anyone thin' that e*en a sin!le moment of this mar*elous process
of the unfol#in! of life coul# )e separate# from the (ise an# lo*in! (or' of the Creator"
an# left prey to human capriceF7.;9/ As a result" it is erroneous an# mista'en to spea'
of a preem)ryo" if )y this is meant a sta!e or con#ition of prehuman life of the concei*e#
human )ein!+.9B/
=@+ Prenatal life is fully human in e*ery phase of its #e*elopment+ %ence health care
(or'ers o(e it the same respect" the same protection an# the same care as that !i*en
to a human person+
Cynecolo!ists an# o)stetricians especially 7must 'eep a careful (atch o*er the
(on#erful an# mysterious process of !eneration ta'in! place in the maternal (om)" to
ensure its normal #e*elopment an# successful outcome (ith the )irth of the ne(
chil#+7.91/
=A+ The )irth of a chil# is an important an# si!nificant sta!e in the #e*elopment )e!un at
conception+ -t is not a 7leap7 in 2uality or a ne( )e!innin!" )ut a sta!e" (ith no )rea' in
continuity" of the same process+ Chil#)irth is the passa!e from maternal !estation to
physiolo!ical autonomy of life+
Once )orn" the chil# can li*e in physiolo!ical in#epen#ence of the mother an# can enter
a ne( relationship (ith the e3ternal (orl#+
-t may happen" in the case of premature )irth" that this in#epen#ence is not fully
reache#+ -n this case health care (or'ers are o)li!e# to assist the ne()orn chil#"
ma'in! a*aila)le to it all the con#itions necessary for attainin! this in#epen#ence+
-f" #espite e*ery effort" the life of the chil# is at serious ris'" health care (or'ers shoul#
see to the chil#6s )aptism accor#in! to the con#itions pro*i#e# )y the Church+ -f an
or#inary minister of the sacrament is una*aila)lea priest or a #eaconthe health care
(or'er has the faculty to confer it+.9</
The *alue of life: unity of )o#y an# soul
=;+ The respect" protection an# care proper to human life #eri*es from its sin!ular
#i!nity+ 7-n the (hole of *isi)le creation it .human life/ has a uni2ue *alue+7 7The human
)ein!" in fact" is the 6only creature that Co# has (ante# for its o(n sa'e+ E*erythin! is
create# for humans+ The human )ein!6.9=/ alone" create# in the ima!e an# li'eness of
Co# .cf+ Cen 1:<@$<A/ is not an# cannot )e for any other or others )ut for Co# alone"
an# this is (hy he e3ists+ The human )ein! alone is a person : he has the #i!nity of a
su)8ect an# is of *alue in himself+ 7.94/
=9+ %uman life is irre#uci)ly )oth corporeal an# spiritual+ 7Dy *irtue of its su)stantial
union (ith a spiritual soul" the human )o#y cannot )e consi#ere# merely an amal!am of
tissues" or!ans an# functions" nor can it )e measure# )y the same stan#ar#s as the
)o#y of animals" )ut it is a constituti*e part of the person (ho )y means of it manifests
himself an# acts+7.9?/ 7E*ery human person" in his unrepeata)le uni2ueness" is ma#e
up not only of spirit )ut also of a )o#y" so that in the )o#y an# throu!h it the person is
reache# in his concrete reality+7.9@/
4B+ E*ery inter*ention on the human )o#y 7touches not only the tissues" the or!ans an#
their functions" )ut in*ol*es also at *arious le*els the person himself+7.9A/
%ealth$care must ne*er lose si!ht of 7the profoun# unity of the human )ein!" in the
o)*ious interaction of all his corporal functions" )ut also in the unity of his corporal"
affecti*e" intellectual an# spiritual #imensions+7 One cannot isolate 7the technical
pro)lem pose# )y the treatment of a particular illness from the care that shoul# )e !i*en
to the person of the patient in all his #imensions+ -t is (ell to )ear this in min#"
particularly at a time (hen me#ical science is ten#in! to(ar#s speciali4ation in e*ery
#iscipline+7.9;/
41+ Re*ealin! the person".99/ the )o#y" in its )iolo!ical ma'e$up an# #ynamic" is the
foun#ation an# source of moral accounta)ility + &hat is an# (hat happens )iolo!ically is
not neutral+ On the contrary it has ethical rele*ance: it is the in#icati*e$imperati*e for
action+.1BB/ The )o#y is a properly personal reality" the si!n an# place of relations (ith
others" (ith Co# an# (ith the (orl#+.1B1/
One cannot prescin# from the )o#y an# ma'e the psyche the criterion an# source of
morality: su)8ecti*e feelin!s an# #esires cannot replace or i!nore o)8ecti*e corporal
con#itions+ The ten#ency to !i*e the former pri#e of place o*er the latter is the )asis for
contemporary psycholo!i4ation of ethics an# la(" (hich ma'es in#i*i#ual (ishes .an#
technical possi)ilities/ the ar)iter of the la(fulness of )eha*ior an# of inter*entions on
life+
The health care (or'er cannot ne!lect the corporeal truth of the person an# )e (illin! to
satisfy #esires" (hether su)8ecti*ely e3presse# or le!ally co#ifie#" at *ariance (ith the
o)8ecti*e truth of life+
-n#isposa)ility an# in*iola)ility of life
4<+ 7The in*iola)ility of the person" a reflection of the a)solute in*iola)ility of Co#
himself" has its first an# fun#amental e3pression in the in*iola)ility of human life+7.1B</
7The 2uestion: 6&hat ha*e you #oneF6 .Cen 4:1B/" (hich Co# a##resses to Cain after he
has 'ille# his )rother A)el" interprets the e3perience of e*ery person: in the #epths of his
conscience" man is al(ays remin#e# of the in*iola)ility of lifehis o(n life an# that of
othersas somethin! (hich #oes not )elon! to him" )ecause it is the property an# !ift
of Co# the Creator an# ather+7.1B=/
The )o#y" in#i*isi)ly (ith the spirit" shares in the #i!nity an# human (orth of the person:
)o#y$su)8ect not )o#y$o)8ect" an# as such is in#isposa)le an# in*iola)le+.1B4/ The )o#y
cannot )e treate# as a )elon!in!+ -t cannot )e #ealt (ith as a thin! or an o)8ect of (hich
one is the o(ner an# ar)iter+
E*ery a)usi*e inter*ention on the )o#y is an insult to the #i!nity of the person an# thus
to Co# (ho is its only an# a)solute 1or#: 7The human )ein! is not master of his o(n life:
he recei*es it in or#er to use it" he is not the proprietor )ut the a#ministrator" )ecause
Co# alone is 1or# of life+7.1B?/
4=+ The fact that life )elon!s to Co# an# not to the human )ein!.1B@/ !i*es it that sacre#
character.1BA/ (hich pro#uces an attitu#e of profoun# respect: 7a #irect conse2uence of
the #i*ine ori!in of life is its in#isposa)ility" its untoucha)ility" that is" its
sacre#ness+7.1B;/ -n#isposa)le an# untoucha)le )ecause sacre#: it is 7a natural
sacre#ness" (hich e*ery ri!ht reason can reco!ni4e" e*en apart from reli!ious
faith+7.1B9/
Me#ical health acti*ity is a)o*e all a *i!ilant an# protecti*e ser*ice to this sacre#ness: a
profession (hich #efen#s the non$instrumental *alue of this !oo# 7in itself7that is" not
relati*e to another or others )ut to Co# alone(hich human life is+.11B/ 7Man6s life
comes from Co#> it is his !ift" his ima!e an# imprint" a sharin! in his )reath of life+ Co#
therefore is the sole 1or# of this life : man cannot #o (ith it as he (ills+7.111/
44+ This must )e affirme# (ith particular ri!or an# recei*e# (ith *i!ilant a(areness at a
time of in*asi*e #e*elopment in )iome#ical technolo!y" (here the ris' of a)usi*e
manipulation of human life is increasin!+ The techni2ues in themsel*es are not the
pro)lem" )ut rather their presume# ethical neutrality+ ,ot e*erythin! (hich is technically
possi)le can )e consi#ere# morally a#missi)le+
Technical possi)ilities must )e measure# a!ainst ethical la(fulness" (hich esta)lishes
their human compati)ility" that is" their effecti*e employment in the protection of an#
respect for the #i!nity of the human person+.11</
4?+ 9cience an# technolo!y 7cannot )y themsel*es !i*e the meanin! of human
e3istence an# pro!ress+ 9ince they are or#aine# for the human )ein! from (hom they
recei*e their ori!in an# increase" it is from the person an# his moral *alues that they
#ra( #irection for their finality an# a(areness of their limits+7.11=/
This is (hy science an# (is#om shoul# !o han# in han#+ 9cience an# technolo!y are
e3tremist" that is" they are constantly e3pan#in! their frontiers+ &is#om an# conscience
trace out for them the impassa)le limits of the human+.114/
Ri!ht to life
4@+ The #i*ine lor#ship of life is the foun#ation an# !uarantee of the ri!ht to life" (hich is
not" ho(e*er" a po(er o*er life+.11?/ Rather" it is the ri!ht to li*e (ith human #i!nity"
.11@/ as (ell as )ein! !uarantee# an# protecte# in this fun#amental" primal an#
unsuppressi)le !oo# (hich is the root an# con#ition of e*ery other !oo#$ri!ht of the
person+.11A/
7The su)8ect of this ri!ht is the human )ein! in e*ery phase of his #e*elopment" from
conception to natural #eath> an# in e*ery con#ition" either health or sic'ness" perfection
or han#icap" (ealth or paupery 7.11;/
4A+ The ri!ht to life poses a t(o$fol# 2uestion for the health care (or'er+ irst of all" he
must not thin' that he has a ri!ht$po(er o*er the life he is carin! for" somethin! (hich
neither he nor the patient himself has+ an# therefore cannot )e !i*en )y the latter+.119/
The ri!ht of the patient is not one of o(nership nor a)solute" )ut it is )oun# up (ith an#
limite# )y the finality esta)lishe# )y nature+.1<B/ 7,o one+++can ar)itrarily choose
(hether to li*e or #ie> the a)solute master of such a #ecision is the Creator alone" in
(hom 6(e li*e an# mo*e an# ha*e our )ein!76 .Acts 1A:<;/+.1<1/
%ereon the limits themsel*es of the ri!ht of the su)8ect to #ispose of his o(n life
7arises the moral limit of the action of the #octor (ho acts (ith the consent of the
patient+7.1<</
4;+ 9econ#ly" the health care (or'er effecti*ely !uarantees this ri!ht: 7the intrinsic
finality7 of his profession 7is the affirmation of the ri!ht of the human )ein! to his life an#
his #i!nity+7.1<=/ %e fulfills it )y assumin! the correspon#in! #uty of pre*enti*e an#
therapeutic care of the health".1<4/ an# of the impro*ement" (ithin the am)it an# (ith
the means at his #isposal" of the 2uality of life of the persons an# their life en*ironment+
.1<?/ 7On our 8ourney (e are !ui#e# an# sustaine# )y the la( of lo*e: a lo*e (hich has
as its source an# mo#el the 9on of Co# ma#e man" (ho 6)y #yin! !a*e life to the
(orl#+7.1<@/
49+ The fun#amental an# primary ri!ht of e*ery human )ein! to life" (hich is
particulari4e# as the ri!ht to protection of health" su)or#inates the tra#e union ri!hts of
health care (or'ers+
This means that any 8ust claims of health (or'ers must )e processe# (hile safe!uar#in!
the ri!ht of the patient to #ue care" )ecause of its in#ispensa)ility+ %ence" if there is a
stri'e" essential an# ur!ent me#ical$hospital ser*ices for the safe!uar#in! of health
shoul# )e pro*i#e# fore*en )y means of appropriate le!al measures+
Pre*ention
?B+ 9afe!uar#in! health commits the health care (or'er particularly in the area of
pre*ention+
Pre*ention is )etter than cure" )oth )ecause it spares the person the #iscomfort an#
sufferin! from the illness" an# )ecause it spares society the costs" an# not only
economic costs" of treatment+
?1+ Me#ical pre*ention" properly so calle#" (hich consists in a#ministerin! particular
me#icines" *accination" screenin! tests to ascertain pre#ispositions" in prescri)in!
)eha*ior an# ha)its to pre*ent the occurrence" the sprea# an# the (orsenin! of the
illness" essentially )elon!s to health care (or'ers+ This mi!ht )e for all the mem)ers of a
society" for !roups of people or for in#i*i#uals+
?<+ There is also me#ical pre*ention in the (i#er sense of the term" in (hich the (or' of
the health care (or'er is )ut a part of the pre*enti*e commitment set in motion )y
society+ This is the type of pre*ention use# in cases of so$calle# social illnesses" such as
#ru!$#epen#ency" alcoholism" to)acco a##iction" A-D9> of the pro)lems of social sectors
of in#i*i#uals such as a#olescents" the han#icappe#" the a!e#> of ris's to health tie# up
(ith the con#itions an# (ays of li*in! no(a#ays" such as in foo#" the en*ironment" the
(or'$place" sports" ur)an traffic" the use of transportation means" of machines an#
#omestic electrical appliances+
-n these cases pre*enti*e inter*ention is the primary an# most effecti*e reme#y" if not"
in#ee#" the only possi)le one+ Dut it nee#s a concerte# effort from all sectors of a
society+ Pre*ention in this case is more than a me#ical$health action+ -t in*ol*es a
sensiti4in! of the culture" throu!h a reco*ery of for!otten *alues an# e#ucation in them"
to a more so)er an# inte!ral concept of life" information a)out ris'y ha)its" the formation
of a political consensus for supportin! la(s+
The effecti*e an# efficacious possi)ility of pre*ention is lin'e# not only" nor primarily" to
the techni2ues a#opte#" )ut to the reasons )ehin# it an# to their )ein! ma#e concrete
an# ma#e 'no(n in that culture+
9ic'ness
?=+ Althou!h it shares in the transcen#ent *alue of the person" corporeal life" of its
nature" reflects the precariousness of the human con#ition+ This is sho(n especially in
sic'ness an# sufferin!" (hich affect the (hole person a#*ersely+ 79ic'ness an# sufferin!
are not e3periences (hich affect only the physical su)stance of the human )ein!" )ut
they affect him in his entirety an# in his somatic$spiritual unity+7.1<A/
9ic'ness is more than a clinical fact" me#ically controlle#+ -t is al(ays the con#ition of a
human )ein!" the sic' person+ -t is (ith this holistic human *ie( of sic'ness that health
care (or'ers shoul# relate to the patient+ -t means that they ha*e" to!ether (ith the
re2uisite technical$professional competence" an a(areness of *alues an# meanin!s that
ma'e sense of sic'ness an# of their o(n (or'" an# ma'es e*ery in#i*i#ual clinical case
a human encounter+
?4+ The Christian 'no(s )y faith that sic'ness an# sufferin! share in the sal*ific efficacy
of the Re#eemer6s cross+ 7Christ6s re#emption an# its sal*ific !race touches the (hole
person in his human con#ition an# hence also in sic'ness" sufferin! an# #eath+7.1<;/
7On the Cross" the miracle of the serpent lifte# up )y Moses in the #esert .0n =:14$1?> cf+
,um <1:;$9/ is rene(e# an# )rou!ht to full an# #efiniti*e perfection+ To#ay" too" )y
loo'in! upon the one (ho (as pierce#" e*ery person (hose life is threatene#
encounters the sure hope of fin#in! free#om an# re#emption+7.1<9/
Dorne 7in close union (ith the sufferin!s of 0esus"7 sic'ness an# sufferin! assume 7an
e3traor#inary spiritual fruitfulness+7 9o that the sic' person can say (ith the Apostle: 7- fill
up in my )o#y (hat is (antin! to the sufferin!s of Christ" for the sa'e of his )o#y (hich
is the Church7 .Col 1:<4/+.1=B/
rom this ne( Christian meanin!" the sic' person can )e helpe# to #e*elop a triple
salutary attitu#e to the illness: an 7 a(areness 7 of its reality 7(ithout minimi4in! it or
e3a!!eratin! it7> 7 acceptance"7 7not (ith a more or less )lin# resi!nation7 )ut in the
serene 'no(le#!e that 7the 1or# can an# (ishes to #ra( !oo# from e*il7> 7 the o)lation"7
7ma#e out of lo*e for the 1or# an# one6s )rothers an# sisters+7.1=1/
??+ -n the person of the patient" in any case" the family is al(ays affecte#+ %elpin! the
relati*es" an# their cooperation (ith health care (or'ers are a *alua)le component of
health care+
The health care (or'er is calle# to !i*e the family of the patienteither in#i*i#ually or
throu!h mem)ership in appropriate or!ani4ationsto!ether (ith the treatment also
enli!htenment" counsel" #irection an# support+.1=</
Dia!nosis
?@+ Cui#e# )y this inte!rally human an# properly Christian *ie( of sic'ness" the health
care (or'er shoul# see'" first an# foremost" to fin# the illness an# analy4e it in the
patient: this is the #ia!nosis an# relate# pro!nosis+
A con#ition for any treatment is the pre*ious an# e3act in#i*i#uation of the symptoms
an# causes of the illness+
?A+ -n this" the health care (or'er (ill ma'e his o(n the 2uestions an# an3ieties of the
patient an# he must !uar# himself from the t(ofol#" opposin! pitfalls of 7hopeless7 an#
7tenacious7 #ia!nosis+
-n the first case the patient is force# to !o from one specialist or health care ser*ice to
another" (ithout fin#in! the #octor or #ia!nostic center capa)le an# (illin! to treat his
illness+ O*er$speciali4ation an# fra!mentation of clinical competencies an# #i*isions"
(hile ensurin! professional e3pertise" is #ama!in! to the patient (hen health ser*ices in
the place pre*ent a carin! an# !lo)al approach to his illness+
-n the secon# case" instea#" one persists until some illness is foun# at any cost+ -t may
)e throu!h i!norance" la4iness" for !ain" or for ri*alry that an illness is #ia!nose# or
pro)lems are treate# as me#ical (hen" in fact" they are not me#ical$health in nature+ -n
this case the person is not helpe# to percei*e the e3act nature of their pro)lem" thus
mislea#in! them a)out themsel*es an# their responsi)ilities+
?;+ The #ia!nosis #oes not pose" in !eneral" pro)lems of an ethical or#er (hen these
e3cesses are e3clu#e# an# it is con#ucte# in full respect for the #i!nity an# inte!rity of
the person" particularly (ith re!ar# to the use of instrumentally in*asi*e techni2ues+ Of
itself" its purpose is therapeutic: it is an action to promote health+
%o(e*er" particular pro)lems are pose# )y pre#icti*e #ia!nosis" )ecause of the possi)le
repercussions at a psycholo!ical le*el an# the #iscriminations it coul# lea# to an# to
prenatal #ia!nosis+ -n the latter case (e are #ealin! (ith a su)stantially ne( possi)ility
(hich is rapi#ly #e*elopin!" an# as such merits separate treatment+
Prenatal #ia!nosis
?9+ The e*er$e3pan#in! 'no(le#!e of intrauterine life an# the #e*elopment of
instruments !i*in! access to it ma'e it possi)le no(a#ays to #ia!nose prenatal life" thus
openin! the (ay for e*er more timely an# effecti*e therapeutic inter*entions+
Prenatal #ia!nosis reflects the moral !oo#ness of e*ery #ia!nostic inter*ention+ At the
same time" ho(e*er" it presents its o(n ethical pro)lems" connecte# (ith the #ia!nostic
ris' an# the purpose for its re2uest an# practice+
@B+ The ris' factor concerns the life an# physical inte!rity of the em)ryo" an# only in part
that of the mother" relati*e to the *arious #ia!nostic techni2ues an# the perceptual ris'
(hich each presents+
%ence" there is nee# 7to e*aluate carefully the possi)le ne!ati*e conse2uences (hich
the necessary use of a particular in*esti!ati*e techni2ue can ha*e7 an# 7a*oi# recourse
to #ia!nostic proce#ures a)out (hich the honest purpose an# su)stantial harmlessness
cannot )e sufficiently !uarantee#+7 An# if a certain amount of ris' must )e ta'en"
recourse to #ia!nosis shoul# ha*e reasona)le in#ications" to )e ascertaine# in a
#ia!nostic center+.1==/
Conse2uently" 7such #ia!nosis is licit if the metho#s use#" (ith the consent of the
parents (ho ha*e )een a#e2uately instructe#" safe!uar# the life an# inte!rity of the
em)ryo an# its mother an# #oes not su)8ect them to #isproportionate ris's+7.1=4/
@1+ The o)8ecti*es of prenatal #ia!noses (arrantin! their re2uest an# practice shoul#
al(ays )e of )enefit to the chil# an# the mother> their purpose is to ma'e possi)le
therapeutic inter*entions" to )rin! assurance an# peace to pre!nant (omen (ho are
an3ious lest the fetus )e #eforme# an# are tempte# to ha*e an a)ortion" to prepare" if
the pro!nosis is an unhappy one" for the (elcome of a han#icappe# chil#+
Prenatal #ia!nosis 7is !ra*ely contrary to the moral la( (hen it contemplates the
possi)ility" #epen#in! on the result" of pro*o'in! an a)ortion+ A #ia!nosis re*ealin! the
e3istence of a #eformity or an here#itary #isease shoul# not )e e2ui*alent to a #eath
sentence+7.1=?/
E2ually unla(ful is any #irecti*e or pro!ram of ci*il an# health authorities or of scientific
or!ani4ations (hich support a #irect connection )et(een prenatal #ia!nosis an#
a)ortion+ The specialist (ho" in carryin! out the #ia!nosis an# communicatin! the result"
(oul# *oluntarily contri)ute to the esta)lishin! an# support of a connection )et(een
prenatal #ia!nosis an# a)ortion (oul# )e !uilty of illicit colla)oration+.1=@/
Therapy an# reha)ilitation
@<+ After #ia!nosis comes therapy an# reha)ilitation: the puttin! into effect of those
curati*e an# me#ical inter*entions (hich lea# to the cure an# personal an# social
reinte!ration of the patient+
Therapy is a me#ical action properly so$calle#" aime# at com)atin! the causes"
manifestations an# complications of the illness+ Reha)ilitation" on the other han#" is an
amal!am of me#ical" physiotherapeutic" psycholo!ical measures an# functional
e3ercises" aime# at re*i*in! or impro*in! the psychophysical efficiency of people in
some (ay han#icappe# in their a)ility to inte!rate" to relate an# to (or' pro#ucti*ely+
Therapy an# reha)ilitation 7are aime# not only at the (ell$)ein! an# health of the )o#y"
)ut of the person as such (ho is stric'en )y )o#ily illness+7.1=A/ All therapy aime# at the
inte!ral (ell$)ein! of the person is not content (ith clinical success" )ut *ie(s the
reha)ilitati*e action as a restorin! of the in#i*i#ual to his full self" throu!h the reacti*ation
or reappropriation of physical functions (ea'ene# )y the illness+
@=+ The patient has a ri!ht to any treatment from (hich he can #ra( salutary )enefit+
.1=;/
Responsi)ility for health care imposes on e*eryone 7the #uty of carin! for himself an# of
see'in! treatment+7 Conse2uently" 7those (ho care for the sic' shoul# )e *ery #ili!ent in
their (or' an# a#minister the reme#ies (hich they thin' are necessary or useful+7.1=9/
,ot only those aime# at a possi)le cure" )ut also those (hich alle*iate pain an# )rin!
relief in incura)le cases+
@4+ The health care (or'er (ho cannot effect a cure must ne*er cease to treat+.14B/ %e
is )oun# to apply all 7proportionate7 reme#ies+ Dut there is no o)li!ation to apply
7#isproportionate7 ones+
-n relation to the con#itions of a patient" those reme#ies must )e consi#ere# or#inary
(here there is #ue proportion )et(een the means use# an# the en# inten#e#+ &here
this proportion #oes not e3ist" the reme#ies are to )e consi#ere# e3traor#inary+
To *erify an# esta)lish (hether there is #ue proportion in a particular case" 7the means
shoul# )e (ell e*aluate# )y comparin! the type of therapy" the #e!ree of #ifficulty an#
ris' in*ol*e#" the necessary e3penses an# the possi)ility of application" (ith the result
that can )e e3pecte#" ta'in! into account the con#itions of the patient an# his physical
an# moral po(ers+7.141/
@?+ The principle here propose# of appropriate me#ical treatment in the reme#ies can )e
thus specifie# an# applie#:
7-n the a)sence of other reme#ies" it is la(ful to ha*e recourse" (ith the consent of the
patient" to the means ma#e a*aila)le )y the most a#*ance# me#icine" e*en if they are
still at an e3perimental sta!e an# not (ithout some element of ris'+7
7-t is la(ful to interrupt the application of such means (hen the results #isappoint the
hopes place# in them"7 )ecause there is no lon!er #ue proportion )et(een 7the
in*estment of instruments an# personnel7 an# 7the foreseea)le results7 or )ecause 7the
techni2ues use# su)8ect the patient to sufferin! an# #iscomfort !reater than the )enefits
to )e ha#+7
7-t is al(ays la(ful to )e satisfie# (ith the normal means offere# )y me#icine+ ,o one
can )e o)li!e#" therefore" to ha*e recourse to a type of reme#y (hich" althou!h alrea#y
in use" is still not (ithout #an!ers or is too onerous+7 This refusal 7is not the e2ui*alent of
suici#e+7 Rather it mi!ht si!nify 7either simple acceptance of the human con#ition" or the
(ish to a*oi# the puttin! into effect of a reme#y #isproportionate to the results that can
)e hope# for" or the #esire not to place too !reat a )ur#en on the family or on
society+7.14</
@@+ or the restoration of the person to health" inter*entions may )e re2uire#" in the
a)sence of other reme#ies" (hich in*ol*e the mo#ification" mutilation or remo*al of
or!ans+
Therapeutic manipulation of the or!anism is le!itimi4e# here )y the principle of totality"
.14=/ an# for this *ery reason also calle# the principle of therapeuticity" )y *irtue of
(hich 7each particular or!an is su)or#inate# to the (hole of the )o#y an# shoul# )e
su)8ecte# to it in case of conflict+ Conse2uently" the one (ho has recei*e# the use of the
(hole or!anism has the ri!ht to sacrifice a particular or!an if )y 'eepin! it" it or its
acti*ity mi!ht cause apprecia)le harm to the (hole or!anism" (hich cannot )e a*oi#e#
other(ise+7.144/
@A+ Physical life" althou!h on the one han# manifestin! the person an# sharin! his
(orth" so that it cannot )e #ispose# of as an o)8ect" on the other han# it #oes not
e3haust the *alue of the person nor #oes it represent the !reatest !oo#+.14?/
This is (hy part of it can )e #ispose# of le!itimately for the (ell$)ein! of the person+ 0ust
as it can )e sacrifice# or put at ris' for a hi!her !oo# 7such as the !lory of Co#" the
sal*ation of souls an# ser*ice to one6s nei!h)or+7.14@/ 7Corporeal life is a fun#amental
!oo#" a con#ition here )elo( of all the others> )ut there are hi!her *alues for (hich it
coul# )e le!itimate or e*en necessary to e3pose oneself to the #an!er of losin! it+7.14A/
Anal!esia an# anesthesia
@;+ Pain" on the one han#" has of itself a therapeutic function" )ecause 7it eases the
confluence of the physical an# psychic reaction of the person to a )out of illness"7.14;/
an# on the other han# it appeals to me#icine for an alle*iatin! an# healin! therapy+
@9+ or the Christian" pain has a lofty penitential an# sal*ific meanin!+ 7-t is" in fact" a
sharin! in Christ6s Passion an# a union (ith the re#eemin! sacrifice (hich he offere# in
o)e#ience to the ather6s (ill+ Therefore" one must not )e surprise# if some Christians
prefer to mo#erate their use of pain'illers" in or#er to accept *oluntarily at least part of
their sufferin!s an# thus associate themsel*es in a conscious (ay (ith the sufferin!s of
Christ+7.149/
Acceptance of pain" moti*ate# an# supporte# )y Christian i#eals" must not lea# to the
conclusion that all sufferin! an# all pain must )e accepte#" an# that there shoul# )e no
effort to alle*iate them+.1?B/ On the contrary this is a (ay of humani4in! pain+ Christian
charity itself re2uires of health care (or'ers the alle*iation of physical sufferin!+
AB+ 7-n the lon! run pain is an o)stacle to the attainment of hi!her !oo#s an#
interests+7.1?1/ -t can pro#uce harmful effects for the psycho$physical inte!rity of the
person+ &hen sufferin! is too intense" it can #iminish or impe#e the control of the spirit+
Therefore it is le!itimate" an# )eyon# certain limits of en#urance it is also a #uty for the
health care (or'er to pre*ent" alle*iate an# eliminate pain+ -t is morally correct an# ri!ht
that the researcher shoul# try 7to )rin! pain un#er human control+7.1?</
Anesthetics li'e pain'illers" 7)y #irectly actin! on the more a!!ressi*e an# #istur)in!
effects of pain" !i*es the person more control" so that sufferin! )ecomes a more human
e3perience+7.1?=/
A1+ 9ometimes the use of anal!esic an# anaesthesic techni2ues an# me#icines in*ol*es
the suppression or #iminution of consciousness an# the use of the hi!her faculties+ -n so
far as the proce#ures #o not aim #irectly at the loss of consciousness an# free#om )ut
at #ullin! sensiti*ity to pain" an# are limite# to the clinical nee# alone" they are to )e
consi#ere# ethically le!itimate+.1?4/
The informe# consent of the patient
A<+ To inter*ene me#ically" the health care (or'er shoul# ha*e the e3press or tacit
consent of the patient+
-n fact" he 7#oes not ha*e a separate an# in#epen#ent ri!ht in relation to the patient+ -n
!eneral" he can act only if the patient e3plicitly or implicitly .#irectly or in#irectly/
authori4es him+7.1??/ &ithout such authori4ation he !i*es himself an ar)itrary po(er+
.1?@/
Desi#es the me#ical relationship there is a human one: #ialo!ic" non$o)8ecti*e+ The
patient 7is not an anonymous in#i*i#ual7 on (hom me#ical e3pertise is practice#" )ut 7a
responsi)le person" (ho shoul# )e calle# upon to share in the impro*ement of his health
an# in )ecomin! cure#+ %e shoul# )e !i*en the opportunity of personally choosin!" an#
not )e ma#e to su)mit to the #ecisions an# choices of others+7.1?A/
9o that the choice may )e ma#e (ith full a(areness an# free#om" the patient shoul# )e
!i*en a precise i#ea of his illness an# the therapeutic possi)ilities" (ith the ris's" the
pro)lems an# the conse2uences that they entail+.1?;/ This means that the patient
shoul# )e as'e# for an informe# consent +
A=+ &ith re!ar# to presume# consent" a #istinction must )e ma#e )et(een the patient
(ho is in a con#ition to 'no( an# (ill an# one (ho is not+
-n the former" consent cannot )e presume#: it must )e clear an# e3plicit+
-n the latter case" ho(e*er" the health care (or'er can" an# in e3treme situations must"
presume the consent to therapeutic inter*entions" (hich from his 'no(le#!e an# in
conscience he thin's shoul# )e ma#e+ -f there is a temporary loss of 'no(in! an#
(illin!" the health care (or'er can act in *irtue of the principle of therapeutic trust" that is
the ori!inal confi#ence (ith (hich the patient entruste# himself to the health care
(or'er+ 9houl# there )e a permanent loss of 'no(in! an# (illin!" the health care (or'er
can act in *irtue of the principle of responsi)ility for health care" (hich o)li!es the health
care (or'er to assume responsi)ility for the patient6s health+
A4+ &ith re!ar# to the relati*es" they shoul# )e informe# a)out or#inary inter*entions"
an# in*ol*e# in the #ecision ma'in! (hen there is 2uestion of e3traor#inary an# optional
inter*entions+
Research an# e3perimentation
A?+ A therapeutic action (hich is apt to )e increasin!ly )eneficial to health is for that *ery
reason open to ne( in*esti!ati*e possi)ilities+ These are the result of a pro!ressi*e an#
on!oin! acti*ity of research an# e3perimentation" (hich thus succee#s in arri*in! at ne(
me#ical a#*ances+
To procee# )y (ay of research an# e3perimentation is a la( of e*ery applie# science:
scientific pro!ress is structurally connecte# (ith it+ Diome#ical sciences an# their
#e*elopment are su)8ect to this la( also+ Dut they operate in a particular fiel# of
application an# o)ser*ation (hich is the life of the human person+
The latter" )ecause of his uni2ue #i!nity" can )e the su)8ect of research an# clinical
e3perimentation (ith the safe!uar#s #ue to a )ein! (ith the *alue of a su)8ect an# not
an o)8ect+ or this reason" )iome#ical sciences #o not ha*e the same free#om of
in*esti!ation as those sciences (hich #eal (ith thin!s+ 7The ethical norm" foun#e# on
respect for the #i!nity of the person" shoul# illuminate an# #iscipline )oth the research
sta!e an# the application of the results o)taine# from it+7.1?9/
A@+ -n the research sta!e" the ethical norm re2uires that its aim )e to 7promote human
(ell$)ein!+7.1@B/ Any research contrary to the true !oo# of the person is immoral+ To
in*est ener!ies an# resources in it contra#icts the human finality of science an# its
pro!ress+.1@1/
-n the e3perimental sta!e" that is" testin! the fin#in!s of research on a person" the !oo#
of the person" protecte# )y the ethical norm" #eman#s respect for pre*ious con#itions
(hich are essentially lin'e# (ith consent an# ris'+
AA+ irst of all" the consent of the patient + %e 7shoul# )e informe# a)out the
e3perimentation" its purpose an# possi)le ris's" so that he can !i*e or refuse his
consent (ith full 'no(le#!e an# free#om+ -n fact" the #octor has only that po(er an#
those ri!hts (hich the patient himself !i*es him+7.1@</
This consent can )e presume# (hen it is of )enefit to the patient himself" that is" (hen
there is a 2uestion of therapeutic e3perimentation+
A;+ 9econ#ly" there is the ris' factor + Of its nature" e*ery e3perimentation has ris's+
%ence" 7it cannot )e #eman#e# that all #an!er an# all ris' )e e3clu#e#+ This is )eyon#
human possi)ility> it (oul# paraly4e all serious scientific research an# (oul# 2uite often
)e #etrimental to the patient++++ Dut there is a le*el of #an!er that the moral la( cannot
allo(+7.1@=/
A human su)8ect cannot )e e3pose# to the same ris' as )ein!s (hich are not human+
There is a threshol# )eyon# (hich the ris' )ecomes humanly unaccepta)le+ This
threshol# is in#icate# )y the in*iola)le !oo# of the person" (hich for)i#s him 7to
en#an!er his life" his e2uili)rium+ his health" or to a!!ra*ate his illness+7.1@4/
A9+ E3perimentation cannot )e )e!un an# !enerali4e# until e*ery safe!uar# has )een
put in place to !uarantee the harmlessness of the inter*ention an# to lessen the ris'+
7The pre$clinical )asic phase" carrie# out carefully" shoul# !i*e the (i#est #ocumentation
an# the most secure pharmacal$to3icolo!ical !uarantees an# ensure operational
safety+7.1@?/
To ac2uire these assurances" if it )e useful an# necessary" the testin! of ne(
pharmaceutical pro#ucts or of ne( techni2ues shoul# first )e #one on animals )efore
they are trie# on humans+ 7-t is certain that the animal is for the ser*ice of man an# can
therefore )e the o)8ect of e3perimentation+ %o(e*er" it shoul# )e treate# as one of
Co#6s creatures" meant to cooperate in man6s !oo# )ut not to )e a)use#+7.1@@/ -t follo(s
that all e3perimentation 7shoul# )e carrie# out (ith consi#eration for the animal" (ithout
causin! it useless sufferin!+7.1@A/
&hen these !uarantees are in place" in the clinical phase e3perimentation on the human
person must )e in accor# (ith the principle of proportionate ris'" that is" of #ue
proportion )et(een the a#*anta!es an# foreseea)le ris's+ %ere a #istinction must )e
ma#e )et(een e3perimentation on a sic' person" for therapeutic reasons" an# on a
healthy person" for scientific an# humanitarian reasons+
;B+ -n e3perimentation on a sic' person" #ue proportion is attaine# from a comparison of
the con#ition of the sic' person an# the foreseea)le effects of the #ru!s or the
e3perimental metho#s+ %ence the ris' rate (hich mi!ht )e proportionate an# le!itimate
for one patient may not )e so for another+
-t is a *ali# principleas alrea#y sai#that 7in the a)sence of other reme#ies" it is licit to
ha*e recourse" (ith the consent of the patient" to means ma#e a*aila)le )y the most
a#*ance# me#icine" e*en if they are still at an e3perimental sta!e an# are not (ithout
some ris'+ Dy acceptin! them the patient mi!ht also !i*e an e3ample of !enerosity for
the )enefit of humanity+7.1@;/ Dut there must al(ays )e 7!reat respect for the patient in
the application of ne( therapy still at the e3perimental sta!e+++(hen these are still hi!h$
ris' proce#ures+7.1@9/
7-n #esperate cases" (hen the patient (ill #ie if there is no inter*ention" if there is a
me#ication a*aila)le" or a metho# or an operation (hich" thou!h not e3clu#in! all
#an!er" still has some possi)ility of success" any ri!ht$thin'in! person (oul# conce#e
that the #octor coul# certainly" (ith the e3plicit or tacit consent of the patient" procee#
(ith the application of the treatment+7.1AB/
;1+ Clinical e3perimentation can also )e practice# on a healthy person" (ho *oluntarily
offers himself 7to contri)ute )y his initiati*e to the pro!ress of me#icine an#" in that (ay"
to the !oo# of the community+7 -n this case" 7once his o(n su)stantial inte!rity is
safe!uar#e#" the patient can le!itimately accept a certain #e!ree of ris'+7.1A1/
This is le!itimi4e# )y the human an# Christian soli#arity (hich moti*ates the !esture:
7To !i*e of oneself" (ithin the limits mar'e# out )y the moral la(" can )e a (itness of
hi!hly meritorious charity an# a means of such si!nificant spiritual !ro(th that it can
compensate for the ris' of any insu)stantial physical impairment+7.1A</
-n any case" it is a #uty to al(ays interrupt the e3perimentation (hen the results
#isappoint the e3pectations+
;<+ 9ince the human in#i*i#ual" in the prenatal sta!e" must )e !i*en the #i!nity of a
human person" research an# e3perimentation on human em)ryos an# fetuses is su)8ect
to the ethical norms *ali# for the chil# alrea#y )orn an# for e*ery human su)8ect+
Research in particular" that is the o)ser*ation of a !i*en phenomenon #urin! pre!nancy"
can )e allo(e# only (hen 7there is moral certainty that there (ill )e no harm either to the
life or the inte!rity of the e3pecte# chil# an# the mother" an# on con#ition that the
parents ha*e !i*en their consent+7.1A=/
E3perimentation" on the other han#" is possi)le only for clearly therapeutic purposes"
(hen no other possi)le reme#y is a*aila)le+ 7,o finality" e*en if in itself no)le" such as
the foreseein! of a usefulness for science" for other human )ein!s or for society" can in
any (ay 8ustify e3perimentation on li*e human em)ryos an# fetuses" (hether *ia)le or
not" in the maternal (om) or outsi#e of it+ The informe# consent" normally re2uire# for
clinical e3perimentation on an a#ult" cannot )e !i*en )y the parents" (ho may not
#ispose either of the physical inte!rity or the life of the e3pecte# chil#+ On the other
han#" e3perimentation on em)ryos or fetuses has the ris'" in#ee# in most cases the
certain fore'no(le#!e" of #ama!in! their physical inte!rity or e*en causin! their #eath+
To use a human em)ryo or the fetus as an o)8ect or instrument of e3perimentation is a
crime a!ainst their #i!nity as human )ein!s+7 7The practice of 'eepin! human em)ryos
ali*e" actually or in *itro" for e3perimental or commercial reasons"7 is especially an#
7alto!ether contrary to human #i!nity+7.1A4/
Donation an# transplantin! of or!ans
;=+ The pro!ress an# sprea# of transplant me#icine an# sur!ery no(a#ays ma'es
possi)le treatment an# cure for many illnesses (hich" up to a short time a!o" coul# only
lea# to #eath or" at )est" a painful an# limite# e3istence+.1A?/ This 7ser*ice to life"7.1A@/
(hich the #onation an# transplant of or!ans represents" sho(s its moral *alue an#
le!itimi4es me#ical practice+ There are" ho(e*er" some con#itions (hich must )e
o)ser*e#" particularly those re!ar#in! #onors an# the or!ans #onate# an# implante#+
E*ery or!an or human tissue transplant re2uires an e3plant (hich in some (ay impairs
the corporeal inte!rity of the #onor+
;4+ Autoplastic transplants" in (hich there is the e3plant an# implant on the same
person" are le!itimate in *irtue of the principle of totality )y (hich it is possi)le to #ispose
of a part for the inte!ral !oo# of the or!anism+
;?+ %omoplastic transplants" in (hich the transplant is ta'en from a person of the same
species as the recipient" are le!itimi4e# )y the principle of soli#arity (hich 8oins human
)ein!s" an# )y charity (hich prompts one to !i*e to sufferin! )rothers an# sisters+.1AA/
7&ith the a#*ent of or!an transplants" )e!un (ith )loo# transfusions" human persons
ha*e foun# a (ay to !i*e part of themsel*es" of their )loo# an# of their )o#ies" so that
others may continue to li*e+ Than's to science an# to professional trainin! an# the
#e#ication of #octors an# health care (or'ers+++ne( an# (on#erful challen!es are
emer!in!+ &e are challen!e# to lo*e our nei!h)or in ne( (ays> in e*an!elical termsto
lo*e 6e*en unto the en#6 .0n 1=:1/" e*en if (ithin certain limits (hich cannot )e
trans!resse#" limits place# )y human nature itself+7.1A;/
-n homoplastic transplants" or!ans may )e ta'en either from a li*in! #onor or from a
corpse+
;@+ -n the first case the remo*al is le!itimate pro*i#e# it is a 2uestion of or!ans of (hich
the e3plant (oul# not constitute a serious an# irrepara)le impairment for the #onor+
7One can #onate only (hat he can #epri*e himself of (ithout serious #an!er to his life or
personal i#entity" an# for a 8ust an# proportionate reason+7.1A9/
;A+ -n the secon# case (e are no lon!er concerne# (ith a li*in! person )ut a corpse+
This must al(ays )e respecte# as a human corpse" )ut it no lon!er has the #i!nity of a
su)8ect an# the en# *alue of a li*in! person+ 7A corpse is no lon!er" in the proper sense
of the term" a su)8ect of ri!hts" )ecause it is #epri*e# of personality" (hich alone can )e
the su)8ect of ri!hts+7 %ence" 7to put it to useful purposes" morally )lameless an# e*en
no)le7 is a #ecision 7not )e con#emne# )ut to )e positi*ely 8ustifie#+7.1;B/
There must )e certainty" ho(e*er" that it is a corpse" to ensure that the remo*al of
or!ans #oes not cause or e*en hasten #eath+ The remo*al of or!ans from a corpse is
le!itimate (hen the certain #eath of the #onor has )een ascertaine#+ %ence the #uty of
7ta'in! steps to ensure that a corpse is not consi#ere# an# treate# as such )efore #eath
has )een #uly *erifie#+7.1;1/
-n or#er that a person )e consi#ere# a corpse" it is enou!h that cere)ral #eath of the
#onor )e ascertaine#" (hich consists in the 7irre*ersi)le cessation of all cere)ral
acti*ity+7 &hen total cere)ral #eath is *erifie# (ith certainty" that is" after the re2uire#
tests" it is licit to remo*e or!ans an# also to surro!ate or!anic functions artificially in
or#er to 'eep the or!ans ali*e (ith a *ie( to a transplant+.1;</
;;+ Ethically" not all or!ans can )e #onate#+ The )rain an# the !ona#s may not )e
transplante# )ecause they ensure the personal an# procreati*e i#entity respecti*ely+
These are or!ans (hich em)o#y the characteristic uni2ueness of the person" (hich
me#icine is )oun# to protect+
;9+ There are also hetero!eneous transplants" that is" (ith or!ans of a #ifferent species
than that of the recipient+ 7-t cannot )e sai# that e*ery transplant of tissues .)iolo!ically
possi)le/ )et(een t(o in#i*i#uals of #ifferent species is morally reprehensi)le" )ut it is
e*en less true that e*ery hetero!eneous transplant )iolo!ically possi)le is not for)i##en
an# cannot raise o)8ections+ A #istinction must )e ma#e )et(een cases" #epen#in! on
(hich tissue or or!an is inten#e# for transplant+ The transplant of animal se3ual !lan#s
to humans must )e re8ecte# as immoral> )ut the transplant of the cornea of a non$human
or!anism to a human or!anism (oul# not create any pro)lem if it (ere )iolo!ically
possi)le an# a#*isa)le+7.1;=/
Amon! hetero!eneous transplants are also inclu#e# the implantin! of artificial or!ans"
the la(fulness of (hich is con#itione# )y the )eneficial effect for the person an# respect
for his #i!nity+
9B+ The me#ical inter*ention in transplants 7is insepara)le from a human act of
#onation+7.1;4/ -n life or in #eath the person from (hom the remo*al is ma#e shoul# )e
a(are that he is a #onor" that is" one (ho freely consents to the remo*al+
Transplants presuppose a free an# conscious pre*ious #ecision on the part of the #onor
or of someone (ho le!itimately represents him" normally the closest relati*es+ 7-t is a
#ecision to offer" (ithout recompense" part of someone6s )o#y for the health an# (ell$
)ein! of another person+ -n this sense" the me#ical act of transplantin! ma'es possi)le
the act of #onation of the #onor" that sincere !ift of himself (hich e3presses our
essential call to lo*e an# communion+7.1;?/
The possi)ility" than's to )iome#ical pro!ress" of 7pro8ectin! )eyon# #eath their *ocation
to lo*e7 shoul# persua#e persons 7to offer #urin! life a part of their )o#y" an offer (hich
(ill )ecome effecti*e only after #eath+7 This is 7a !reat act of lo*e" that lo*e (hich !i*es
life to others+7.1;@/
91+ As part of this o)lati*e 7economy7 of lo*e" the me#ical act itself of transplantin!" of
e*en 8ust )loo# transfusion" 7is not 8ust another inter*ention+7 -t 7cannot )e separate#
from the #onor6s act of !i*in!" from life$!i*in! lo*e+7.1;A/
%ere the health care (or'er 7)ecomes a me#iator of somethin! (hich is particularly
meanin!ful" the !ift of self )y a persone*en after #eathso that another mi!ht
li*e+7.1;;/
Depen#ency
9<+ Depen#ency" in me#ical$health terms" is an a##iction to a su)stance or pro#uct
such as #ru!s" alcohol" narcotics" to)accofor (hich the in#i*i#ual feels an
uncontrolla)le nee#" an# the pri*ation of (hich can cause him psycho$physical
#isor#ers+
The phenomenon of #epen#ency is escalatin! in our societies" (hich is #istur)in! an#"
un#er certain aspects" #ramatic+ This is relate#" on the one han#" to the crisis of *alues
an# meanin! (hich contemporary society an# culture.1;9/ is e3periencin! an#" on the
other han#" to the stress an# frustrations )rou!ht a)out )y the 2uest for efficiency" )y
acti*ism an# )y the hi!h competiti*eness an# anonymity of social interaction+
Dou)tless" the e*ils cause# )y #epen#ency an# their cure are not a matter for me#icine
alone+ Dut it #oes ha*e a pre*enti*e an# therapeutic role+
Dru!s
9=+ Dru!s an# #ru!$#epen#ency are almost al(ays the result of an a*oi#a)le e*asion of
responsi)ility" an aprioristic contestation of the social structure (hich is re8ecte# (ithout
positi*e proposals for its reasona)le reform" an e3pression of masochism moti*ate# )y
the a)sence of *alues+
One (ho ta'es #ru!s #oes not un#erstan# or has lost the meanin! an# the *alue of life"
thus puttin! it at ris' until it is lost: many #eaths from o*er#ose are *oluntary suici#es+
The #ru!$user ac2uires a nihilistic mental state" superficially preferrin! the *oi# of #eath
to the all of life+
94+ rom the moral *ie(point 7usin! #ru!s is al(ays illicit" )ecause it implies an
un8ustifie# an# irrational refusal to thin'" (ill an# act as free persons+7.19B/
To say that #ru!s are illicit is not to con#emn the #ru!$user+ That person e3periences his
con#ition as 7a hea*y sla*ery7 from (hich he nee#s to )e free#+.191/ The (ay to
reco*ery cannot )e that of ethical culpa)ility or repressi*e la(" )ut it must )e )y (ay of
reha)ilitation (hich" (ithout con#onin! the possi)le fault of the person on #ru!s"
promotes li)eration from his con#ition an# reinte!ration+
9?+ The #eto3ification of the person a##icte# to #ru!s is more than me#ical treatment+
Moreo*er" me#icines are of little or no use+ Deto3ification is an inte!rally human process
meant to 7!i*e a complete an# #efiniti*e meanin! to life"7.19</ an# thus to restore to the
one a##icte# that 7self confi#ence an# salutary self$esteem7 (hich help him to reco*er
the 8oy of li*in!+.19=/
-n the reha)ilitation of a person a##icte# to #ru!s it is important 7that there )e an attempt
to !et to 'no( the in#i*i#ual an# to un#erstan# his inner (orl#> to )rin! him to the
#isco*ery or re#isco*ery of his #i!nity as a person" to help him to rea(a'en an#
#e*elop" as an acti*e su)8ect" those personal resources" (hich the use of #ru!s has
suppresse#" throu!h a confi#ent reacti*ation of the mechanisms of the (ill" #irecte# to
secure an# no)le i#eals+7.194/
9@+ Esin! #ru!s is anti$life+ 7One cannot spea' of 6the free#om to ta'e #ru!s6 nor of 6the
ri!ht to #ru!s"6 )ecause a human )ein! #oes not ha*e the ri!ht to harm himself an# he
cannot an# must not e*er a)#icate his personal #i!nity (hich is !i*en to him )y
Co#"7.19?/ an# e*en less #oes he ha*e the ri!ht to ma'e others pay for his choice+
Alcoholism
9A+ Enli'e ta'in! #ru!s" alcohol is not in itself illicit: 7its mo#erate use as a #rin' is not
contrary to moral la(+7.19@/ &ithin reasona)le limits (ine is a nourishment+
7-t is only the a)use that is reprehensi)le7:.19A/ alcoholism" (hich causes #epen#ency"
clou#s the conscience an#" in the chronic sta!e" pro#uces serious harm to the )o#y an#
the min#+
9;+ The alcoholic is a sic' person (ho nee#s me#ical assistance to!ether (ith help on
the le*el of soli#arity an# psychotherapy+ A pro!ram of inte!rally human reha)ilitation
must )e put in place for him".19;/
9mo'in!
99+ &ith re!ar# to to)acco also" the ethical unla(fulness is not in its use )ut in its a)use+
At the present time it is esta)lishe# that e3cessi*e smo'in! #ama!es the health an#
causes #epen#ency+ This lea#s to a pro!ressi*e lo(erin! of the threshol# of a)use+
9mo'in! poses the pro)lem of #issuasion an# pre*ention" (hich shoul# )e #one
especially throu!h health e#ucation an# information" e*en )y (ay of a#*ertisements+
Psychopharmaceuticals
1BB+ Psychopharmaceuticals are a special cate!ory of me#icines use# to counter
a!itation" #elirium an# hallucinations an# to o*ercome an3iety an# #epression+.199/
1B1+ To pre*ent" contain an# o*ercome the ris' of #epen#ency an# a##iction"
psychopharmaceuticals shoul# )e su)8ect to me#ical control+ 7Recourse to tran2uili4in!
su)stances on me#ical a#*ice in or#er to alle*iatein (ell$#efine# casesphysical an#
psycholo!ical sufferin! shoul# )e !o*erne# )y *ery pru#ent criteria in or#er to offset
#an!erous forms of a##iction an# #epen#ency+7.<BB/
-t is the tas' of health authorities" #octors an# those responsi)le for research centers to
apply themsel*es in or#er to re#uce these ris's to a minimum throu!h apt measures of
pre*ention an# information+7.<B1/
1B<+ A#ministere# for therapeutic purposes an# (ith #ue respect for the person"
psychopharmaceuticals are ethically le!itimate+ The !eneral con#itions for la(fulness in
reme#ial inter*ention applies to these also+
-n particular" the informe# consent of the patient is re2uire# an# his ri!ht to refuse the
therapy must )e respecte#" ta'in! into account the a)ility of the mental patient to ma'e
#ecisions+ Also to )e respecte# is the principle of therapeutic proportionality in the
choice an# a#ministration of these me#icines" on the )asis of an accurate etiolo!y of the
symptoms an# the moti*es for the su)8ect6s re2uestin! this me#icine+.<B</
1B=+ ,on$therapeutic use an# a)use of psychopharmaceuticals is morally illicit if the
purpose is to impro*e normal performance or to procure an artificial an# euphoric
serenity+ This use of psychopharmaceuticals is the same as that of any narcotic
su)stance so the ethical *er#ict alrea#y !i*en in the case of #ru!s is *ali# also here+
Psycholo!y an# psychotherapy
1B4+ There is alrea#y ample e*i#ence that all )o#ily illness has a psycholo!ical
component" either as a co$efficient or as an after$effect+ This is (hat psychosomatic
me#icine is concerne# (ith" (here the therapeutic *alue #epen#s on the #octor$patient
relationship+.<B=/
%ealth care (or'ers shoul# see' to relate to the patient in such a (ay that their
humanitarian attitu#e reinforces their professionalism an# their competence is more
effecti*e throu!h their a)ility to un#erstan# the patient+
A human an# lo*in! approach to the patient" re2uire# )y an inte!rally human *ie( of
illness an# stren!thene# )y faith".<B4/ is the 'ey to this therapeutic effecti*eness of the
#octor$patient relationship+
1B?+ Psycholo!ical #isor#ers an# illnesses can )e #ealt (ith an# treate# throu!h
psychotherapy + This inclu#es a *ariety of metho#s )y (hich someone can help another
to )e cure# or at least to impro*e+
Psychotherapy is essentially a !ro(in! process" that is" a path of li)eration from
chil#hoo# pro)lems" or from the past" in any case" (hich ena)les the in#i*i#ual to
assume his i#entity" role an# responsi)ilities+
1B@+ Psychotherapy is morally accepta)le as a me#ical treatment+.<B?/ Dut it must
respect the person of the patient" (ho allo(s access into his inner (orl#+
This respect prohi)its the psychotherapist from *iolatin! the pri*acy of the other (ithout
his consent an# o)li!es him to (or' (ithin these limits+ 70ust as it is unla(ful to
appropriate the !oo#s of another or in*a#e his corporal inte!rity (ithout his permission"
so it is not permissi)le to enter the inner (orl# of another person a!ainst his (ishes"
(hate*er )e the techni2ues an# metho#s employe#+7.<B@/
The same respect prohi)its the influencin! or forcin! of the patient6s (ill+ 7The
psycholo!ist (hose only #esire is the !oo# of the patient" (ill )e all the more careful to
respect the limits to his action set #o(n )y the moral co#e in thatin a manner of
spea'in!he hol#s in his han#s the psycholo!ical faculties of a person" his a)ility to act
freely" to achie*e the no)lest i#eals (hich his personal #estiny an# his social callin!
imply+7.<BA/
1BA+ rom the moral stan#point" lo!otherapy an# counselin! are pri*ile!e# forms of
psychotherapy+ Dut they are all accepta)le" pro*i#e# that they are practice# )y
psychotherapists (ho are !ui#e# )y a profoun# ethical sense+
Pastoral care an# the 9acrament of Anointin! of the 9ic'
1B;+ Pastoral care of the sic' consists in spiritual an# reli!ious assistance+ This is a
fun#amental ri!ht of the patient an# a #uty of the Church .cf+ Mt 1B:;> 1' 9:<" 1B:9/+ ,ot
to assure it" not to support it" to ma'e it #iscretionary or to impe#e it is a *iolation of this
ri!ht an# infi#elity to this #uty+
This is the essential an# specific" thou!h not e3clusi*e" tas' of the health care pastoral
(or'er+ Decause of the necessary interaction )et(een the physical" psycholo!ical an#
spiritual #imension of the person" an# the #uty of !i*in! (itness to their o(n faith" all
health care (or'ers are )oun# to create the con#itions )y (hich reli!ious assistance is
assure# to anyone (ho as's for it" either e3pressly or implicitly+.<B;/ 7-n 0esus" the
6&or# of life"6 Co#6s eternal life is thus proclaime# an# !i*en+ Than's to this proclamation
an# !ift" our physical an# spiritual life" also in its earthly phase" ac2uires its full *alue an#
meanin!" for Co#6s eternal life is in fact the en# to (hich our li*in! in this (orl# is
#irecte# an# calle#+7.<B9/
1B9+ Reli!ious assistance implies that there )e" (ithin the health care structure" the
possi)ility an# the means to carry this out+
The health care (or'er shoul# )e totally a*aila)le to support an# acce#e to the patient6s
re2uest for reli!ious assistance+
&here such assistance" for !eneral or particular reasons" cannot )e !i*en )y the
pastoral (or'er" it shoul# )e !i*en #irectly(ithin possi)le an# allo(a)le limits)y the
health care (or'er" respectin! the free#om an# the reli!ious affiliation of the patient an#
a(are that" in #oin! so" he #oes not #etract from the ri!hts of health care assistance
properly so calle#+
11B+ Reli!ious assistance to the sic' is part of the (i#er *ision of me#ical$pastoral
assistance" that is" of the presence an# acti*ity of the Church (hich is meant to )rin! the
(or# an# the !race of the 1or# to those (ho suffer an# to those (ho care for them+
-n the ministry of thosepriests" reli!ious an# laity(ho in#i*i#ually or as communities
are en!a!e# in the pastoral care of the sic'" the mercy of Co# li*es on" (ho in Christ
has )oun# to human sufferin!" an# the tas' of e*an!eli4ation" sanctification an# charity
entruste# to the Church )y the 1or# is carrie# out in a sin!ular an# pri*ile!e# manner+
.<1B/
This means that pastoral care of the sic' has a special place in catechesis" in the litur!y
an# in charity+ Respecti*ely" it is a matter of e*an!eli4in! illness" helpin! a person to
unco*er the re#empti*e meanin! of sufferin! )orne in communion (ith Christ> of
cele)ratin! the sacraments as efficacious si!ns of the recreati*e an# *itali4in! !race of
Co#> of (itnessin! )y means of the 7#ia'onia7 .ser*ice/ an# the 7'oinonia7 .communion/
to the therapeutic po(er of charity+
111+ -n pastoral care of the sic'" the lo*efull of truth an# of !race of Co# comes near
to them in a special sacrament meant for them: the Anointin! of the 9ic' +.<11/
A#ministere# to any Christian (ho is in a life$threatenin! con#ition" this sacrament is a
reme#y for )o#y an# spirit" relief an# stren!th for the patient in his corporealspiritual
inte!rity castin! li!ht on the mystery of sufferin! an# #eath an# )rin!in! a hope (hich
opens the human present to the future of Co#+ 7The (hole person recei*es help from it
for his sal*ation> he feels stren!thene# in his trust in Co# an# he recei*es reinforcement
a!ainst the temptations of the #e*il an# the fear of #eath+7.<1</
9ince it has the efficacy of !race for the sic' person" the Anointin! of the 9ic' 7is not the
sacrament of those only (ho are at the point of #eath+7 %ence 7the suita)le time to
recei*e it is (hen one of the faithful" either from illness or ol#$a!e" )e!ins to )e in #an!er
of #eath+7.<1=/
As (ith all the sacraments" the Anointin! of the 9ic' shoul# also )e prece#e# )y a
suita)le catechesis so that the recipient" the sic' person" is a conscious an# responsi)le
su)8ect of the !race of the sacrament" an# not an unconscious o)8ect of the rite of
imminent #eath+.<14/
11<+ The proper minister of the Anointin! of the 9ic' is the priest only" an# he shoul#
see that it is conferre# 7on those of the faithful (hose state of health is seriously
threatene# )y ol#$a!e or illness+7 To e*aluate the seriousness of the illness it is sufficient
7to ha*e a pru#ent or pro)a)le 8u#!ment+7
Cele)ratin! communal Anointin! mi!ht help to o*ercome ne!ati*e pre8u#ices a!ainst the
Anointin! of the 9ic'" an# help to *alue the meanin! of this sacrament an# the sense of
ecclesial soli#arity+
Anointin! can )e repeate# if the sic' person" ha*in! reco*ere# from the illness for (hich
the sacrament (as recei*e#" shoul# a!ain )ecome ill" or if in the course of the same
illness his Con#ition shoul# (orsen+
-t can )e !i*en )efore sur!ery if the reason for sur!ery is 7a #an!erous illness+7
Anointin! may )e conferre# on the el#erly 7)ecause of the nota)le #iminishin! of their
stren!th" e*en if they #o not ha*e any serious illness+7
-f the con#itions are present" it can also )e conferre# on chil#ren" 7pro*i#e# they ha*e
sufficient use of reason+7
-n the case of sic' people (ho are unconscious or #epri*e# of the use of reason" it is to
)e Conferre# 7if there is reason to )elie*e that in possession of their faculties they
themsel*es" as )elie*ers" (oul# ha*e" at least implicitly" re2ueste# holy Anointin!+7
7The sacrament cannot )e conferre# on a patient (ho is alrea#y #ea#+7.<1?/
7&hen there is a #ou)t (hether the sic' person has attaine# the use of reason" or
(hether the person is !ra*ely ill or (hether the person is #ea#" this sacrament is to )e
conferre#+7.<1@/
11=+ The Eucharist" also" as :iaticum" has a special si!nificance an# efficacy for the
patient+ 7:iaticum of the )o#y an# )loo# of Christ stren!thens the )elie*er an# furnishes
him (ith the ple#!e of resurrection" as the 1or# has sai#: The one (ho eats my flesh
an# #rin's my )loo# has eternal life" an# - (ill raise him up on the last #ay7 .0n @:?4/+
.<1A/
or the sic' person" the Eucharist is this *iaticum of life an# hope+ 7Communion in the
form of :iaticum is" in fact" a special si!n of participation in the mystery cele)rate# in the
sacrifice of the Mass" the mystery of the #eath of the 1or# an# of his passin! to the
ather+7.<1;/
Therefore it is the #uty of a Christian to re2uest an# recei*e :iaticum" an# the Church
has a pastoral responsi)ility to a#minister it+.<19/
The minister of :iaticum is a priest+ Dut he may )e su)stitute# )y a #eacon or an
e3traor#inary minister of the Eucharist+.<<B/
III. DEATH
114+ or the health care (or'er" ser*in! life means assistin! it ri!ht up to its natural
completion+
1ife is in Co#6s han#s: %e is the 1or#" %e alone #eci#es the final moment+ E*ery faithful
ser*ant !uar#s this fulfillment of Co#6s (ill in the life of e*ery person entruste# to his
care+ %e #oes not consi#er himself the ar)iter of #eath" 8ust as an# )ecause he #oes not
consi#er himself the ar)iter of anyone6s life+
Terminal illnesses
11?+ &hen the state of one6s health #eteriorates to an irre*ersi)le an# fatal con#ition" a
person enters into a terminal state of earthly e3istence+ or him life is particularly an#
pro!ressi*ely precarious an# painful+ To illness an# physical sufferin! is a##e# the
psycholo!ical an# spiritual #rama of #etachment (hich #eath si!nifies an# implies+
As such" the terminally ill patient is one (ho nee#s human an# Christian
accompaniment" an# it is here that #octors an# nurses are calle# on to ma'e their e3pert
an# unrenouncea)le contri)ution+ &hat is in 2uestion is special me#ical assistance for
the #yin! person" so that also in #yin! he must 'no( an# (ill as a li*in! human )ein!+
7,e*er more than in the pro3imity of #eath an# in #eath itself is life to )e cele)rate# an#
e3tolle#+ This must )e fully respecte#" protecte# an# assiste# e*en in one (ho is
e3periencin! its natural en#++++ The attitu#e to the terminally ill is often the aci# test of a
sense of 8ustice an# charity" of the no)ility of min#" of the responsi)ility an# professional
a)ility of health care (or'ers" )e!innin! (ith #octors+7.<<1/
11@+ Dyin! is part of life as its ultimate phase+ -t shoul# )e care# for" then" as )elon!in!
to it+ %ence it calls for the therapeutic responsi)ility of the health care (or'er 8ust as
much an# no less than e*ery other moment in human life+
The #yin! person shoul# not )e #ismisse# as incura)le an# a)an#one# to his o(n
resources an# those of the family" )ut shoul# )e reentruste# to the care of #octors an#
nurses+ These" interactin! an# inte!ratin! (ith the assistance !i*en )y chaplains" social
(or'ers" relati*es an# frien#s" allo( the #yin! person to accept an# li*e out his #eath+
.<<</ To help one to #ie means to help him to li*e intensely the final e3perience of his
life+ &here possi)le an# (hen the one concerne# (ishes" he shoul# )e !i*en the
opportunity of spen#in! his last #ays at home (ith suita)le me#ical assistance+
11A+ A terminally ill person shoul# )e !i*en (hate*er me#ical assistance helps to
alle*iate the pain accompanyin! #eath+ This (oul# inclu#e the so$calle# palliati*e or
symptomatic treatment+
The most important assistance is 7lo*in! presence7 at the )e#si#e of the #yin! person+
.<<=/ There is a proper me#ical$health presence (hich" thou!h not #ecei*in! him"
ma'es him feel ali*e" a person amon! persons" )ecause he is recei*in!" li'e e*ery )ein!
in nee#" attention an# care+ This carin! attention !i*es confi#ence an# hope to the
patient an# ma'es him reconcile# to #eath+.<<4/ This is the uni2ue contri)ution (hich
#octors an# nurses" )y their )ein! human an# Christianmore than )y their e3pertise
can an# shoul# ma'e to the #yin! person" so that re8ection )ecomes acceptance an#
an!uish !i*es (ay to hope+
-n this (ay human #yin! is (ith#ra(n from the phenomenon of 7)ein! o*erly
me#icali4e#"7 in (hich the terminal phase of life 7ta'es place in cro(#e# an# acti*ity$
#ominate# en*ironments" controlle# )y me#ical health personnel (hose principal
concern is the )iophysical aspect of the illness+7 All of this 7is )ein! seen increasin!ly as
#isrespectful to the comple3 human state of the sufferin! person+7.<<?/
11;+ 7Defore the mystery of #eath (e are po(erless> human certainties (a*er+ Dut it is
precisely in the face of such a chec'mate that Christian faith+++)ecomes a fount of
serenity an# peace++++ &hat seems meanin!less ta'es on meanin! an# (orth+7.<<@/
&hen this 7chec'mate7 ta'es place in the life of a person" in this #ecisi*e hour of his
e3istence" the (itness of the health care (or'er6s faith an# hope in Christ has a
#eterminin! role+ -t #isplays ne( hori4ons of meanin!" that is" of resurrection an# life" to
the one (ho sees the prospects of earthly e3istence )ein! close# to him+
7O*er an# a)o*e all human consolations" no one can )e )lin# to the enormous help
!i*en to the #yin! an# to their families )y faith in Co# an# the
hope of eternal life+7.<<A/ To ma'e faith an# hope present is for #octors an# nurses the
hi!hest form of humani4in! #eath+ -t is more than alle*iatin! a sufferin!+ -t means
applyin! one6s s'ills in or#er to 7ma'e !oin! to Co# easy for the patient+7.<<;/
Death (ith #i!nity
119+ The ri!ht to life is specifie# in the terminally ill person as 7a ri!ht to #ie in total
serenity" (ith human an# Christian #i!nity+7.<<9/
This cannot )e interprete# as the po(er to 'ill oneself or to !i*e this po(er to others" )ut
to e3perience #yin! in a human an# Christian (ay an# not flee from it 7at any cost+7 This
ri!ht is )ein! e3plicitly e3presse# )y people to#ay in or#er to safe!uar# themsel*es at
the point of #eath a!ainst 7the use of techni2ues that run the ris' of )ecomin!
a)usi*e+7.<=B/
Contemporary me#icine" in fact" has at its #isposal metho#s (hich artificially #elay
#eath" (ithout any real )enefit to the patient+ -t is merely 'eepin! one ali*e or prolon!in!
life for a time" at the cost of further" se*ere sufferin!+ This is the so$calle# 7therapeutic
tyranny"7 (hich consists 7in the use of metho#s (hich are particularly e3haustin! an#
painful for the patient" con#emnin! him in fact to an artificially prolon!e# a!ony+7.<=1/
This is contrary to the #i!nity of the #yin! person an# to the moral o)li!ation of acceptin!
#eath an# allo(in! it at last to ta'e its course+ 7Death is an ine*ita)le fact of human life7:
.<=</ it cannot )e uselessly #elaye#" fleein! from it )y e*ery means+.<==/
1<B+ A(are that he is 7neither the lor# of life nor the con2ueror of #eath"7 the health care
(or'er" in e*aluatin! means" 7shoul# ma'e appropriate choices" that is" relate to the
patient an# )e !ui#e# )y his real con#ition+7.<=4/
%ere he (ill apply the principlealrea#y state#of 7 appropriate me#ical treatment"7
(hich can )e specifie# thus: 7&hen ine*ita)le #eath is imminent" #espite the means
use#" it is la(ful in conscience to #eci#e to refuse treatment that (oul# only secure a
precarious an# painful prolon!ation of life" )ut (ithout interruptin! the normal treatment
#ue to the patient in similar cases+ %ence the #octor nee# ha*e no concern> it is not as if
he ha# faile# to assist the person in #an!er+7.<=?/
The a#ministration of foo# an# li2ui#s" e*en artificially" is part of the normal treatment
al(ays #ue to the patient (hen this is not )ur#ensome for him: their un#ue suspension
coul# )e real an# properly so$calle# euthanasia+
1<1+ or the #octors an# their assistants it is not a 2uestion of #eci#in! the life or #eath
of an in#i*i#ual+ -t is simply a 2uestion of )ein! a #octor" that is" of posin! the 2uestion
an# then #eci#in! accor#in! to one6s e3pertise an# one6s conscience re!ar#in! a
respectful care of the li*in! an# the #yin! of the patient entruste# to him+ This
responsi)ility #oes not al(ays an# in all cases in*ol*e recourse to e*ery means+ -t mi!ht
also re2uire the renunciation of certain means to ma'e (ay for a serene an# Christian
acceptance of #eath (hich is inherent in life+ -t mi!ht also mean respect for the (ishes of
the patient (ho refuses the use of such means+.<=@/
The use of pain'illers for the terminally ill
1<<+ Amon! the me#icines a#ministere# to terminally ill patients are pain'illers+ These"
(hich help to ma'e the course of the illness less #ramatic" contri)ute to the
humani4ation an# acceptance of #eath+.<=A/
This" ho(e*er" #oes not constitute a !eneral norm of )eha*ior+.<=;/ 7%eroic )eha*ior7
cannot )e impose# on e*eryone+.<=9/ An# then" *ery often" 7pain #iminishes the moral
stren!th7 of the person:.<4B/ sufferin!s 7a!!ra*ate the state of (ea'ness an# physical
e3haustion" impe#in! the impulse of the spirit an# #e)ilitatin! the moral po(ers instea#
of supportin! them+ The suppression of pain" instea#" )rin!s or!anic an# psychic relief
ma'in! prayer easier an# ena)lin! one to !i*e oneself more !enerously+7.<41/
7%uman an# Christian pru#ence su!!ests the use for most patients of me#icines (hich
alle*iate or suppress pain" e*en if this causes torpor or re#uce# luci#ity+ &ith re!ar# to
those (ho are una)le to e3press their (ishes" one can reasona)ly suppose that they
(ish to ta'e pain'illers an# these can )e a#ministere# accor#in! to me#ical
a#*ice+7.<4</
The use of pain'illers (ith the #yin!" ho(e*er" is not (ithout its pro)lems+
1<=+ irst" their use mi!ht ha*e the effect" of not only alle*iatin! pain" )ut also of
hastenin! #eath +
&hen 7proportionate reasons7 so re2uire" 7it is permitte# to use (ith mo#eration
narcotics (hich alle*iate sufferin!" )ut (hich also hasten #eath+7.<4=/ -n this case
7#eath is not inten#e# or sou!ht in any (ay" althou!h there is a ris' of it for a reasona)le
cause: (hat is inten#e# is simply the alle*iation of pain in an effecti*e (ay" usin! for that
purpose those pain'illers a*aila)le to me#icine+7.<44/
1<4+ There is also the possi)ility that pain'illers (ill cause unconsciousness in the #yin!
person+ This use must recei*e special consi#eration+.<4?/
7&ithout serious reasons" the #yin! person must not )e #epri*e# of
consciousness+7.<4@/ 9ometimes the systematic use of narcotics (hich re#uce the
consciousness of the patient is a cloa' for the fre2uently unconscious (ish of the health
care (or'er to #iscontinue relatin! to the #yin! person+ -n this case it is not so much the
alle*iation of the patient6s sufferin! that is sou!ht as the con*enience of those in
atten#ance+ The #yin! person is #epri*e# of the possi)ility of 7li*in! his o(n life"7 )y
re#ucin! him to a state of unconsciousness un(orthy of a human )ein!+.<4A/ This is
(hy the a#ministration of narcotics for the sole purpose of #epri*in! the #yin! person of
a conscious en# is 7a truly #eplora)le practice 7.<4;/
-t is a #ifferent matter (hen there is a serious clinical case for the a#ministration of
anal!esics (hich suppress consciousness" as (hen there is *iolent an# un)eara)le
pain+ -n this case the anesthetic is sai# to )e licit" pro*i#e# certain con#itions are fulfille#:
that the #yin! person has fulfille# or coul# still fulfill his moral" family an# reli!ious
o)li!ations+.<49/
Tellin! the truth to a #yin! person
1<?+ Tellin! the truth a)out the #ia!nosis an# pro!nosis to the #yin! person" an# more
!enerally to those sufferin! from an incura)le illness" poses a pro)lem of
communication+
To inform someone that they are #yin! is #ifficult an# #ramatic" )ut this is not an
e3emption from )ein! truthful + Communication )et(een a #yin! person an# those in
atten#ance cannot )e )ase# on pretense+ This is ne*er a human possi)ility for the #yin!
person an# #oes not contri)ute to the humani4ation of #yin!+
The person has a ri!ht to )e informe# of their con#ition + This ri!ht is not lessene#
(here there is a #ia!nosis an# pro!nosis of a terminal illness" rather" it is hei!htene#+
This information" in fact" is lin'e# to important responsi)ilities (hich cannot )e #ele!ate#
to another+ There are responsi)ilities )earin! on the treatment to )e applie# (ith the
informe# consent of the patient+
&ith the approach of #eath comes the responsi)ility to fulfill certain #uties in one6s
relationship (ith the family" settlin! possi)le le!al matters" resol*in! o)li!ations to a thir#
party+ or a )elie*er the approach of #eath re2uires that he )e fully a(are (hen he
performs certain actions" especially the reconcilin! encounter (ith Co# in the sacrament
of Penance+
The person cannot )e a)an#one# to unconsciousness in the #ecisi*e 7hour7 of his life"
ta'in! him a(ay from himself an# from his final an# most important #ecisions+ 7Death is
too essential a moment for its prospect to )e a*oi#e#+7.<?B/
1<@+ The #uty of )ein! truthful (ith the terminally ill patient #eman#s #iscernment an#
human tact on the part of me#ical personnel+
-t cannot consist of a #etache# an# in#ifferent communication of the #ia!nosis an#
rele*ant pro!nosis+ The truth must not remain unspo'en" )ut neither must it )e !i*en in
all its )are" cru#e reality+ -t shoul# )e !i*en in line (ith lo*e an# charity" callin! all those
(ho assist the patient in *arious (ays to )e attune# to this communion+
There is the nee# to esta)lish a relationship of trust" recepti*ity an# #ialo!ue (ith the
patient" see'in! the appropriate time an# (or#s+ There is a (ay of spea'in! that is
#iscernin! an# respectful of the patient6s moo#s" an# it shoul# )e in harmony (ith these+
There is a form of con*ersation (herein 2uestions are tactfully han#le# an# e*en
pro*o'e#" so that the patient is !ra#ually )rou!ht to an a(areness of his con#ition+ -f one
tries to )e present to the patient an# sensiti*e to his lot one (ill fin# the (or#s an# the
replies (hich ma'e it possi)le to communicate in truth an# in charity: 7!i*in! the truth in
lo*e7 .Eph 4:1?/+
1<A+ 7Each case has its o(n re2uirements" #epen#in! on the sensiti*ity an# a)ility of
each person" of his or her relationship (ith the patient an# the patient6s con#ition> to
pro*i#e for the patient6s possi)le reactions .re)ellion" #epression" resi!nation" etc+/" one
(ill prepare oneself to face them calmly an# tactfully+7.<?1/ -t is not the e3actness of
(hat is sai# that is important" )ut the relationship of soli#arity (ith the patient+ -t is not
simply a matter of !i*in! clinical facts" )ut of meanin!ful communication+
-n this relationship the prospect of #eath is not presente# as inescapa)le" an# it loses its
an!uishin! po(er: the patient #oes not feel isolate# an# con#emne# to #eath+ &hen the
truth is presente# to him in this (ay he is not left (ithout hope" )ecause it ma'es him
feel ali*e in a relationship of sharin! an# communion+ %e is not alone (ith his illness: he
feels truly un#erstoo#" an# he is at peace (ith himself an# (ith others+ %e is himself as
a person+ %is life" #espite e*erythin!" has meanin!" an# #yin! unfol#s (ith optimistic an#
transcen#ent meanin!+
The moment of #eath
1<;+ The use of resuscitati*e technolo!y an# the nee# for *ital or!ans for transplant
operations pose ane( to#ay the pro)lem of #ia!nosin! (hen #eath occurs+
Death is seen an# e3perience# )y people as a #ecomposition" a #issolution" a rupture+
.<?</ 7-t comes (hen the spiritual principle (hich !o*erns the unity of the in#i*i#ual is no
lon!er a)le to e3ercise its functions on an# in the or!anism an# the elements of the
latter" left to themsel*es" #issociate+
Certainly" this #estruction #oes not effect the entire human )ein!+ The Christian faith
an# not it aloneaffirms the continuance" )eyon# #eath" of man6s spiritual principle+7
aith nourishes in the Christian the hope of a!ain fin#in! his personal inte!rity
transfi!ure# an# #efiniti*ely possesse# in Christ7 .1 Cor 1?:<</+.<?=/
This faith fille# (ith hope #oes not pre*ent 7#eath .from/ )ein! a painful rupture+7 Dut
7the moment of this rupture is not #irectly percepti)le" an# the pro)lem is to i#entify the
si!ns+7.<?4/ To ascertain an# interpret these si!ns is not a matter for faith or morals )ut
for me#ical science: 7it is for the #octor+++to !i*e a clear" precise #efinition of #eath an# of
the moment of #eath+7.<??/ 79cientists" analysts an# scholars must continue their
research an# their stu#ies to #etermine in the most precise (ay possi)le the e3act
moment an# the irrefuta)le si!n of #eath+7.<?@/
Once this #etermination has )een achie*e#" in its li!ht the 2uestions an# moral conflicts
arisin! from ne( technolo!ies an# ne( therapeutic possi)ilities can )e resol*e#+ Moral
theolo!y" in fact" cannot )ut ac'no(le#!e the )iome#ical #etermination as the #ecisi*e
criterion+
1<9+ &ith re!ar# to this #etermination" the Pontifical Aca#emy of 9ciences has ma#e an
authoritati*e contri)ution+ irst (ith re!ar# to the )iome#ical #efinition of #eath : 7a
person is #ea# (hen he has irre*ersi)ly lost all a)ility to inte!rate an# coor#inate the
physical an# mental functions of the )o#y+7
9econ#" (ith re!ar# to the precise moment of #eath: 7#eath comes (hen: a/ the
spontaneous functions of the heart an# )reathin! ha*e #efiniti*ely cease#" or )/ the
irre*ersi)le arrest of all )rain acti*ity+7 -n reality 7)rain #eath is the true criterion of #eath"
althou!h the #efiniti*e arrest of car#io$respiratory acti*ity *ery 2uic'ly lea#s to )rain
#eath+7.<?A/
aith an# morals accept these fin#in!s of science+ %o(e*er" they #eman# of health care
(or'ers the most accurate use of the *arious clinical an# instrumental metho#s for a
certain #ia!nosis of #eath so that a patient is not #eclare# #ea# an# treate# as such
(hen in fact he is not #ea#+
Reli!ious assistance for the #yin!
1=B+ The crisis (hich the approach of #eath in*ol*es prompts the Christian an# the
Church to )e a )earer of the li!ht of truth (hich faith alone can cast on the mystery of
#eath+
Death is an e*ent (hich )rin!s one into the life of Co#" an# re*elation alone can
pronounce a (or# of truth a)out it+ This truth must )e )rou!ht in faith to the #yin!
person+ The annunciation 7full of !race an# truth7 .0n 1:14/ of the Cospel accompanies
the Christian from the )e!innin! to the en# of life+ The last (or# of the Cospel is the
(or# of life that con2uers #eath an# opens up the !reatest hope to the #yin! person+
1=1+ Death" then" must )e e*an!eli4e# : the Cospel must )e announce# to the #yin!
person+ -t is a pastoral #uty of the ecclesial community in each one of its mem)ers"
accor#in! to the responsi)ilities of each+ The hospital chaplain has a special o)li!ation
here" since he is calle# to minister to the #yin! (ithin the )roa#er limits of the pastoral
care of the sic'+
or him this #uty implies not only the role he personally carries out at the si#e of the
#yin! entruste# to his care" )ut also the promotion of this pastoral acti*ity" throu!h
or!ani4in! reli!ious ser*ices" formin! an# sensiti4in! health care (or'ers an# in*ol*in!
relati*es an# frien#s+
The announcement of the Cospel to the #yin! fin#s especially e3pressi*e an# effecti*e
forms in charity" prayer an# the sacraments+
1=<+ Charity means that !i*in! an# recepti*e presence (hich esta)lishes (ith the #yin!
person a communion )orn of attention" comprehension" concern" patience" sharin! an#
selflessness+
Charity sees in the #yin! person" as in no other" the face of the sufferin! an# #yin!
Christ callin! out for lo*e+ Charity to the #yin! personthis 7poor one7 (ho is
renouncin! all the !oo#s of this (orl#is a pri*ile!e# e3pression of lo*e of Co# in one6s
nei!h)or .cf+ Mt <?:=1$4B/+
1o*in! the #yin! (ith Christian charity is helpin! them to reco!ni4e an# feel *i*i#ly the
mysterious presence of Co# at their si#e: in the charity of a )rother the lo*e of Co#
)ecomes *isi)le+
1==+ Charity ena)les the relationship (ith the #yin! person to e3pan# in prayer" that is"
in communion (ith Co#+ -n this communion one relates to Co# as the ather (ho
(elcomes his chil#ren returnin! to %im+
To help the #yin! person to pray an# to pray (ith him means openin! up to him the
hori4ons of #i*ine life+ -t means" at the same time" enterin! into that 7communion of
saints7 in (hich all the relationships" (hich #eath seems to )rea' irrepara)ly" are re'nit
in a ne( (ay+
1=4+ A pri*ile!e# moment of prayer (ith the #yin! person is the cele)ration of the
sacraments: the !race$fille# si!ns of Co#6s sal*ific presence+
oremost is the sacrament of the Anointin! of the 9ic' throu!h (hich the %oly 9pirit"
completin! in the Christian his assimilation to Christ )e!un in )aptism" ma'es him
participate #efiniti*ely in the paschal triumph o*er sic'ness an# #eath+
:iaticum is Eucharistic nourishment" the )rea# of communion (ith Christ (hich !i*es the
#yin! person the stren!th to face the final an# #ecisi*e sta!e of life6s 8ourney+
Penance is the sacrament of reconciliation: at peace (ith Co#" the #yin! person is at
peace (ith himself an# (ith his nei!h)or
1=?+ -n this faith$fille# (ith charity the po(erlessness e3perience# (hen face# (ith the
mystery of #eath is not a!oni4in! an# paraly4in!+ The Christian fin#s hope an# in it the
possi)ility" #espite e*erythin!" to li*e an# not suffer #eath+
The suppression of life
1=@+ The in*iola)ility of human life means an# implies in the last analysis the
unla(fulness of e*ery act (hich #irectly suppresses human life+ 7The in*iola)ility of the
ri!ht to life of the innocent human )ein! from conception to #eath is a si!n an# a
re2uirement of the *ery in*iola)ility of the person" to (hom the Creator has !i*en the !ift
of life+7.<?;/
Co# himself 7is the *in#icator of e*ery innocent life+7 7%e (ill call man to account for the
life of man: each one (ill ha*e to ans(er for his )rother7 .Cen 9:?> cf+ Mt 19:1;> Rom
1=:9/+ An# his comman#ment is cate!orical: 7Thou shalt not 'ill7 .E3 <B:1=/: 7Do not 'ill
the innocent or the 8ust one )ecause - (ill not a)sol*e the !uilty one7 .E3 <=:A/+.<?9/
1=A+ This is (hy 7no one can ma'e an attempt on the life of an innocent person (ithout
opposin! Co#6s lo*e for that person" (ithout *iolatin! a fun#amental" unrenouncea)le
an# inaliena)le ri!ht+7.<@B/
This is a ri!ht that one has come #irectly from Co# .not from others: parents" society"
human authority/+ 7%ence there is no one" no human authority" no science" no me#ical"
eu!enic" social" economic or moral 6in#icator6 (hich can sho( or !i*e a *ali# 8uri#ical
8ustification for #irect" #eli)erate #isposal of an innocent human life" that is" a #isposal
aime# at its #estruction" either as an en# or as a means to another en# (hich in itself
may not )e at all illicit+7.<@1/
-n particular 7nothin! an# no one can authori4e the 'illin! of an innocent human )ein!"
(hether it is a fetus or an em)ryo" a chil# or an a#ult" el#erly" ill" incura)le or #yin!+
Moreo*er" no one can re2uest this homici#al act for themsel*es or for another for (hom
they are responsi)le" nor can they consent to it e3plicitly or implicitly+ ,o authority can
le!itimately impose it or permit it+ -t is" in fact" a *iolation of #i*ine la(+ an insult to the
#i!nity of the human person" a anti$life crime" an attempt on human'in# 7.<@</
1=;+ 7Ministers of life an# ne*er a!ents of #eath"7.<@=/ it is for health care (or'ers 7to
safe!uar# life" to )e (atchful o*er its e*olution an# #e*elopment throu!hout its (hole
e3istence" respectin! the plan #ra(n up )y the Creator+7.<@4/
This *i!ilant ministry of safe!uar#in! human life re8ects homici#e as a morally !ra*e act"
contrary to the me#ical mission" an# opposes *oluntary #eath" suici#e" as
7unaccepta)le"7 #issua#in! anyone tempte# to #o so from carryin! it out+.<@?/
Amon! the mo#alities of the suppression of life" homici#e or suici#e" there are t(o
a)ortion an# euthanasiaa!ainst (hich this ministry shoul# )e particularly *i!ilant an#
in a certain (ay prophetic" #ue to the cultural an# le!islati*e conte3t (hich is rather
fre2uently insensiti*e if not" in#ee#" fa*ora)le to their propa!ation+
A)ortion
1=9+ The in*iola)ility of the human person from conception prohi)its a)ortion as the
suppression of prenatal life+ This is 7a #irect *iolation of the fun#amental ri!ht to life of
the human )ein!7.<@@/ an# is 7an a)omina)le crime+7.<@A/
There is nee# to ma'e e3plicit reference to suppression of life )y a)ortion an# its moral
!ra*ity )ecause of the ease of recourse to this homici#al practice to#ay an# the ethical
in#ifference to(ar#s it in#uce# )y a he#onistic an# utilitarian cultureoffsprin! of
theoretical an# practical materialism(hich has spa(ne# a truly a)ortionist mentality+
The elimination of the un(ante# pre!nancy has )ecome a (i#e$sprea# phenomenon"
finance# )y ta3payer6s money an# facilitate# )y permissi*e an# !uarantee# le!islation+
.<@;/ All of this is the fatal cause for many people to a*oi# ta'in! responsi)ility for the
e3pecte# chil# an# so to )anali4e a serious sin+.<@9/
7Enfortunately" this #istur)in! state of affairs" far from #ecreasin!" is e3pan#in!++++ At the
same time a ne( cultural climate is #e*elopin! an# ta'in! hol#" (hich !i*es crimes
a!ainst life a ne( an#if possi)lee*en more sinister character" !i*in! rise to further
!ra*e concern: )roa# sectors of pu)lic opinion 8ustify certain crimes a!ainst life in the
name of the ri!hts of in#i*i#ual free#om" an# on this )asis they claim not only e3emption
from punishment )ut e*en authori4ation )y the state" so that these thin!s can )e #one
(ith total free#om an# in#ee# (ith the free assistance of health care systems+7.<AB/
14B+ The Church" li'e e*ery person (ho hol#s life #ear" cannot )ecome accustome# to
this mentality" an# she raises her *oice in #efense of life" especially that of the
#efenseless an# un'no(n" (hich em)ryonic an# fetal life is+
9he calls health care (or'ers to professional loyalty" (hich #oes not tolerate any action
(hich suppresses life" #espite 7the As' of incomprehension" misun#erstan#in!" an#
serious #iscrimination7 (hich this consistency mi!ht cause+.<A1/ i#elity to me#ical
health #e$le!itimi4es e*ery inter*ention" sur!ical or pharmaceutical" inten#e# to interrupt
the pre!nancy at any sta!e+
141+ -t is also true that in certain cases" )y refusin! an a)ortion" other important !oo#s
(hich it is only normal that one (oul# (ant to safe!uar#are put in 8eopar#y+ These
coul# )e: #an!er to the mother6s health" the )ur#en of another chil#" a serious
malformation of the fetus" a pre!nancy cause# )y rape+
These pro)lems cannot )e i!nore# or minimi4e#" nor the reasons supportin! them+ Dut it
must also )e affirme# that none of them can o)8ecti*ely !i*e the ri!ht to #ispose of
another6s life" e*en in the initial phase+ 71ife" in fact" is too fun#amental a !oo# for it to )e
compare# (ith certain #isa#*anta!es" e*en if they )e *ery !reat+7.<A</
14<+ Ethical #ele!itimi4ation applies to all forms of #irect a)ortion" since it is an
intrinsically )lame(orthy act+ The use of su)stances or means (hich impe#e the
implantation of the fertili4e# em)ryo or (hich cause its premature #etachment is also an
act of a)ortion+ A #octor (ho (oul# 'no(in!ly prescri)e or apply such su)stances or
means (oul# cooperate in the a)ortion+
-f the a)ortion follo(s as a foreseen )ut nor inten#e# or (ille# )ut merely tolerate#
conse2uence of a therapeutic act essential for the mother6s health" this is morally
le!itimate+ The a)ortion in this case is the in#irect result of an act (hich is not in itself
a)orti*e+.<A=/
14=+ -f the health care (or'er is face# (ith le!islation fa*ora)le to a)ortion he 7must
refuse politely )ut firmly+7.<A4/ 7One can ne*er o)ey a la( that is intrinsically immoral"
an# this is so in the case of a la( (hich a#mits" in principle" the la(fulness of
a)ortion+7.<A?/
As a result" #octors an# nurses are o)li!e# to )e conscientious o)8ectors + The !reat"
fun#amental *alue of life ma'es this o)li!ation a !ra*e moral #uty for me#ical personnel
(ho are encoura!e# )y the la( to carry out a)ortions or to cooperate pro3imately in
#irect a)ortion+
A(areness of the in*iola)le *alue of life an# of Co#6s la( protectin! it" is antece#ent to
all positi*e human la(+ &hen the latter is contrary to Co#6s la(" conscience affirms its
primary ri!ht an# the primacy of Co#6s la(: 7One must o)ey Co# rather than men7 .Acts
?:<9/+
7-t is not al(ays easy to follo( one6s conscience in o)e#ience to Co#6s la(+ -t may entail
sacrifice an# #isa#*anta!es" an# one can in no (ay #iscount this cost> sometimes
heroism is calle# for if one is to )e faithful to these #eman#s+ ,e*ertheless" it must )e
clearly state# that the roa# of !enuine pro!ress for the human person passes throu!h
this constant fi#elity to a conscience uphol#in! rectitu#e an# truth+7.<A@/
144+ As (ell as )ein! a mar' of professional loyalty" conscientious o)8ection on the part
of the health care (or'er" for the ri!ht reasons" is hi!hly meanin!ful as a social
con#emnation of a le!al in8ustice a!ainst innocent an# #efenseless life+
14?+ The !ra*ity of the sin of a)ortion an# the ease (ith (hich it is carrie# out" supporte#
)y la( an# the mo#ern mentality" prompts the Church to threaten the penalty of
e3communication for the Christian (ho procures it: 7One (ho procures an effecti*e
a)ortion incurs latae sententiae e3communication+7.<AA/
The e3communication has an essentially pre*entati*e an# pe#a!o!ical si!nificance+ -t is
a forceful call from the Church" meant to arouse insensiti*e consciences" to #issua#e
people from an act (hich is a)solutely incompati)le (ith Cospel #eman#s" an# to
a(a'en unreser*e# fi#elity to life+ One cannot )e in ecclesial communion an# at the
same time #isre!ar# the Cospel of life throu!h the practice of a)ortion+
The protection an# acceptance of the e3pecte# chil#" its preference to all other *alues" is
a #ecisi*e an# cre#i)le (itness (hich the Christian must !i*e no matter (hat+
14@+ %ealth care (or'ers ha*e special o)li!ations (ith re!ar# to a)orte# fetuses+
An a)orte# fetus" if it is still ali*e" shoul# )e )apti4e# if at all possi)le+.<A;/
A #ea# a)orte# fetus must )e !i*en the same respect as a human corpse+ This means
that it cannot )e #ispose# of as 8ust another item of ru))ish+ -f at all possi)le it shoul# )e
appropriately interre#+
1i'e(ise" the fetus cannot )e use# for e3perimentation or transplant if the a)ortion (as
cause# *oluntarily+ To #o so (oul# )e an un(orthy instrumentali4ation of a human life+
Euthanasia
14A+ A mentality e*er less rea#y to reco!ni4e life as a *alue in itself" relati*e to Co#
alone" in#epen#ent of ho( it came into )ein!> a concept of the 2uality of life in terms of
efficiency an# psychophysical satisfaction" incapa)le of seein! any meanin! in sufferin!
an# han#icap" an# hence to )e a*oi#e# at any cost an# )y e*ery means> a *ision of
#eath as an a)sur# en# to a life still to )e en8oye#" or as a li)eration from an e3istence
alrea#y consi#ere# meanin!less> all of this(ithin a culture (hich" lea*in! Co# asi#e"
ma'es man responsi)le to himself alone an# to freely esta)lishe# la(s of societyis the
soil of the euthanasia culture+ &here these con*ictions are #isseminate# 7it coul# seem
lo!ical an# 6human6 to en# one6s o(n life or that of another 6peacefully6" (hen all that is
left to it is sufferin! an# serious impairment+7.<A9/
7Dut this is really a)sur# an# inhuman+7.<;B/ Euthanasia is a homici#al act" (hich no
en# can 8ustify + Dy euthanasia is meant an action or omission (hich of its nature or )y
intention causes #eath" in or#er that all sufferin! may )e eliminate#+ Euthanasia6s terms
of reference" therefore" are to )e foun# in the intention of the (ill an# in the metho#s
use#+7.<;1/
The pity arouse# )y the pain an# sufferin! of terminally ill persons" a)normal )a)ies" the
mentally ill" the el#erly" those sufferin! from incura)le #iseases" #oes not authori4e any
form of #irect euthanasia" acti*e or passi*e+ This is not a 2uestion of helpin! a sic'
person" )ut rather the intentional 'illin! of a person+
14;+ Me#ical an# parame#ical personnelfaithful to the tas' of 7al(ays )ein! at the
ser*ice of life an# assistin! it to the en#7.<;</ cannot cooperate in any euthanistic
practice e*en at the re2uest of the one concerne#" an# much less at the re2uest of the
relati*es+ -n fact" the in#i*i#ual #oes not ha*e the ri!ht to euthanasia" )ecause he #oes
not ha*e a ri!ht to #ispose ar)itrarily of his o(n life+ %ence no health care (or'er can )e
the e3ecuti*e !uar#ian of a non$e3istent ri!ht+
-t is a #ifferent matter (hen there is 2uestion of the ri!ht" alrea#y mentione#" of #yin!
(ith human an# Christian #i!nity+ This is a real an# le!itimate ri!ht (hich me#ical
personnel are calle# on to safe!uar# )y carin! for the patient an# acceptin! the natural
termination of life+ There is a ra#ical #ifference )et(een 7#eath #ealin!7 an# 7consent to
#yin!7: the former is an act suppressin! life" the latter means acceptin! life until #eath+
149+ 7The pleas of !ra*ely ill persons (ho sometimes as' for #eath are not to )e
un#erstoo# as implyin! a true #esire for euthanasia> in fact it is almost al(ays a case of
an an!uishe# plea for help an# lo*e+ &hat a sic' person nee#s" )esi#es me#ical care" is
lo*e" the human an# supernatural (armth (ith (hich the sic' person can an# ou!ht to
)e surroun#e# )y those close to him or her" parents an# chil#ren" #octors an#
nurses+7.<;=/
The sic' person (ho feels surroun#e# )y a lo*in! human an# Christian presence #oes
not !i*e (ay to #epression an# an!uish as (oul# )e the case if one (ere left to suffer
an# #ie alone an# (antin! to )e #one (ith life+ This is (hy euthanasia is a #efeat for the
one (ho proposes it" #eci#es it an# carries it out+ ar from )ein! an act of mercy to the
patient" euthanasia is a !esture of in#i*i#ual an# social self$pity an# an escape from an
un)eara)le situation+
1?B+ Euthanasia upsets the #octor$patient relationship + On the part of the patient"
)ecause he relates to the #octor as one (ho can assure him of #eath+ On the part of the
#octor" )ecause he is no lon!er the a)solute !uarantor of life: the sic' person (ill )e
afrai# that the #octor may cause his #eath+ The #octor$patient relationship is a life$
trustin! one an# this is ho( it shoul# remain+
Euthanasia is a 7crime7 in (hich health care (or'ers" (ho are al(ays an# only
!uar#ians of life" can in no (ay cooperate+.<;4/
or me#ical science it mar's 7a )ac'(ar# step of surren#er" as (ell as an insult to the
personal #i!nity of the one (ho is #yin!+7.<;?/ -ts )ein! #epicte# as a 7further har)or of
#eath after a)ortion7 shoul# )e un#erstoo# as a 7#ramatic appeal7 for effecti*e"
unreser*e# fi#elity to life+.<;@/
,OTE9
1+ 0ohn Paul --" #urin! his *isit to Mercy Maternity %ospital in Mel)ourne" ,o*+ <;"
19;@" in -nse!namenti -5G< .19;@/ 1A=4" n+ ?+ 71ife an# physical health are precious !ifts
entruste# to us )y Co#+ &e must ta'e reasona)le care of them" ta'in! into account the
nee#s of others an# the common !oo#7 .CCC <<;;/+
<+ 0ohn Paul --" To the participants at t(o con!resses of me#icine an# sur!ery" Oct+
<A" 19;B" in -nse!namenti ---G<" p+ 1B1B" n+ @+
=+ 7-n e3ercisin! your profession" you are al(ays #ealin! (ith the human person" (ho
entrusts his )o#y to you" confi#ent of your competence as (ell as your solicitu#e an#
concern+ -t is the mysterious an# (on#erful reality of the life of a human )ein!" (ith his
sufferin! an# his hope" that you are #ealin! (ith+7 0ohn Paul --" To the participants at a
sur!ery con!ress" e)+ 19" 19;A" in -nse!namenti 5G1 .19;A/ =A4" n+ <+
4+ Cf+ 0ohn Paul --" To the participants at a me#ical con!ress on tumor therapy" e)+
<?" 19;< in -nse!namenti :G1" @9;+ Cf+ also 0ohn Paul --: 7,one of you can )e merely a
#octor of an or!an or an apparatus" )ut you must loo' to the (hole person"7 To the
&orl# Con!ress of Catholic Doctors" Oct+ =" 19;<" in -nse!namenti :G=" pp+ @A=$@A4" n+
4+
?+ Cf+ 0ohn Paul --" To the Con!ress of -talian Catholic Doctors" Oss+ Rom+ Oct+
1;"19;;+
@+ 0ohn Paul --" Motu Proprio 7 Dolentium hominum"7 e)+ 11"19;?" in -nse!namenti
:---G1" p+ 4A4" n+ <+ 7 Care for the health of its citi4ens re2uires that society help in the
attainment of li*in! con#itions that allo( them to !ro( an# reach maturity: foo# an#
clothin!" housin!" health care" )asic e#ucation" employment" an# social assistance7
.CCC <<;;/+
A+ 0ohn Paul --" To the participants at a me#ical con!ress on tumor therapy" e)+ <?"
19;<" in -nse!namenti :G1" p+ @9;" n+ 4+ Cf+ To the participants at a scientific con!ress"
May <1" 19;<" in -nse!namenti :G<" p+ 1A9<" n+ ?+
;+ 7As - ha*e sai# many times in my meetin!s (ith health care (or'ers" your *ocation
is one (hich commits you to the no)le mission of ser*ice to people in the *ast" comple3
an# mysterious fiel# of sufferin!7.0ohn Paul --" To representati*es of the -talian Catholic
Doctors" March 4"19;9" in -nse!namenti 5--G1" p+ 4;B" n+ <+/
9+ 0ohn Paul --" To the Association of -talian Catholic Doctors" Dec+ <;+ 19A;" in
-nse!namenti -" p+ 4=@+ 7Hou are a(are of the close relationship" the analo!y" the
interaction )et(een the mission of the priest on the one han# an# that of the health care
(or'er on the other: all are #e*ote#" in #ifferent (ays" to the sal*ation of the person" an#
care for his health" to free him from illness" sufferin! an# #eath" to promote in him life
(ell$)ein! an# happiness7 .0ohn Paul --" 7 Discourse for the 1<Bth anni*ersary of the
foun#ation of the 6Dam)in Cesu6 hospital" 7 March 1;" 19;9" in -nse!namenti 5--G1" @B?$
@B;" n+ </+
1B+ Cf+ 0ohn Paul --" Apost+ 1etter 9al*ifici #oloris" in -nse!namenti :--G1" =?=$=?;" nn+
<;$=B> To an international !roup of scientists" April <A" 19;4" in -nse!namenti :--G1"
11==$11=?" n+ <: To the Catholic health or!ani4ations of the Enite# 9tates" 9ept+ 14"
19;A" in -nse!namenti 5G= .19;A/ ?B@+
11+ 7The *ery personal relationship of #ialo!ue an# trust esta)lishe# )et(een you
an# the patient re2uires of you a le*el of humanity (hich" for the )elie*er" is foun# in the
richness of Christian charity+ This is the #i*ine *irtue (hich enriches all your actions an#
!i*es to your !estures" e*en the simplest of them" the po(er of an act performe# )y you
in inner communion (ith Christ7: 0ohn Paul -- To the Association of Dental Doctors" Dec+
14" 19;4" in -nse!namenti :--G<" 1?9<$1?94" n+ 4+ 7Hou )rin! to the sic'$room an# to the
operatin! ta)le somethin! of Co#6s charity" of the lo*e an# ten#erness of Christ" the
!reat Doctor of the soul an# the )o#y7: 0ohn Paul --" To the 6ate)enefratelli6 hospital"
April ?" 19;1" in -nse!namenti -:G1" p+ ;9?" n+ =+
1<+ Cf+ 0ohn Paul --" To the 6Armi#a Darelli6 trainin! school for professional nurses"
May <A" 19;9" in -nse!namenti 5--G1" p+ 1=@4" n+ =+ 7&hat a stimulus for the #esire#
6personali4ation6 of me#icine coul# come from Christian charity" (hich ma'es it possi)le
to see in the features of e*ery sic' person the a#ora)le face of the !reat" mysterious
Patient" (ho continues to suffer in those o*er (hom your profession )en#s" (isely an#
pro*i#entlyI7 .0ohn Paul --" To the participants at t(o con!resses of me#icine an#
sur!ery" Oct+ <A" 19;B" in -nse!namenti ---G<" p+ 1B1B" n+ A/+
1=+ Cf+ 0ohn Paul --" To the Association of -talian Catholic Doctors" Dec+ <;" 19A;" in
-nse!namenti 1" 4=A$4=;+
14+ Cf+ 0ohn Paul --" To the staff of the 6ate)enefratelli6 hospital" April ?" 19;1" in
-nse!namenti -:G1" p+ ;9?+ n+ =+
1?+ 0ohn Paul --" To the Association of -talian Catholic Doctors" Dec+ <;" 19A;" in
-nse!namenti 1" p+ 4=A+
1@+ 0ohn Paul --" To the -talian e#eration of Orthope#ic Technolo!y &or'ers" ,o*+
19" 19A9" in -nse!namenti --G<" p+ 1<BA" n+ 4> cf+ To the participants at a scientific
con!ress" May <1" 19;<" in -nse!namenti :G<" p+ 1A9<" n+ ?+
1A+ 7Hour (or'+++can )ecome a reli!ious act7 .0ohn Paul --" To the participants at a
sur!ery con!ress" e)+ 19" 19;A" in -nse!namenti 5G1 .19;A/ =A?" n+ => cf+ Paul :-"
-nse!namenti #i Paolo :-" *ol 1" 19@=" p+ 141/+
1;+ 0ohn Paul --" Motu Proprio 7 Dolentium hominum"7 e)+ 11" 19;?" in -nse!namenti
:---G1 .19;?/ p+ 4A?+
19+ 7E*ery concern for illness an# sufferin! is part of the life an# the mission of the
Church7 .0ohn Paul --" To the Catholic health or!ani4ations of the Enite# 9tates of
America" 9ept+ 14" 19;A" in -nse!namenti 5G= .19;A/ ?B<$?B=" n+ =/+ 7Allo(in! herself to
)e !ui#e# )y the e3ample of 0esus the 6Coo# 9amaritan6 .cf+ 1' 1B:<9=A/ an# uphel# )y
his stren!th" the Church has al(ays )een in the front line in pro*i#in! charita)le help: so
many of her sons an# #au!hters" especially men an# (omen reli!ious" in tra#itional an#
e*er ne( forms" ha*e consecrate# an# continue to consecrate their li*es to Co#" freely
!i*in! of themsel*es out of lo*e for their nei!h)or" especially for the (ea' an# nee#y7
.0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ <A/+
<B+ Cf+ 0ohn Paul --" To the (orl# Con!ress of Catholic #octors" Oct+ = 19;<" in
-nse!namenti :G=" p+ @A@" n+ =+ 7The 1or# 0esus Christ physician of our souls an#
)o#ies" (ho for!a*e the sins of the paralytic an# restore# him to )o#ily health" has (ille#
that his Church continue" in the po(er of the %oly 9pirit" his (or' of healin! an#
sal*ation e*en amon! her o(n mem)ers+ This is the purpose of the t(o sacraments of
healin!: the sacrament of Penance an# the sacrament of Anointin! of the 9ic' .CCC
14<1/+
<1+ 7Hour presence at the sic'$)e# is )oun# up (ith that of thosepriests" reli!ious
an# laity(ho are en!a!e# in apostolate to the sic'+ Juite a num)er of the aspects of
that apostolate coinci#e (ith the pro)lems an# tas's of the ser*ice to life ren#ere# )y
me#icine+ There is a necessary interaction )et(een the e3ercise of the me#ical
profession an# pastoral (or'" )ecause the one o)8ect of )oth is the human person" seen
in his #i!nity of a chil# of Co#" a )rother or sister nee#in!" 8ust li'e oursel*es" help an#
comfortin!7 .0ohn Paul --" To the &orl# Con!ress of Catholic Doctors" Oct+ = 19;<" in
-nse!namenti :G=" p+ @A@" n+ @/+
<<+ 7Hou" (hile you alle*iate sufferin!s an# try to cure them" at the same time are
(itnesses of the Christian *ie( of sufferin! an# of the meanin! of life an# #eath" in the
(ay it is tau!ht )y your Christian faith7 .0ohn Paul --" To the Catholic %ealth
Or!ani4ations of the Enite# 9tates of America" 9ept+ 14" 19;A" in -nse!namenti 5G=
.19;A/ pp+ ?B< an# ?B?+/
<=+ 0ohn Paul --" Apost+ E3hort+ Christifi#eles laici" Dec+ =B" 19;;" in -nse!namenti
5-G4" p+ <1@B" n+ ?=+
<4+ Cf+ 0ohn Paul --" To the participants at the -nternational Con!ress for Assistance
to the Dyin!" in Oss+ RoM+ March 1;" 199<" n+ @+ 7E*ery in#i*i#ual" precisely )y reason
of the mystery of the &or# of Co# (ho (as ma#e flesh .cf+ 0n 1: 14/" is entruste# to the
maternal care of the Church7 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?"
n+ =/+
<?+ 0ohn Paul --" To the participants at a sur!ery con!ress" e)+ 19"19;A in
-nse!namenti 5G1" p+ =A?" n+ =+ 7The a#*ance of science an# technolo!y" this splen#i#
(itness of the human capacity for un#erstan#in! an# for perse*erance" #oes not
#ispense humanity from the o)li!ation to as' the ultimate reli!ious 2uestions+ Rather it
spurs us on to face the most painful an# #ecisi*e of stru!!les" those of the heart an# of
the moral conscience7 0ohn Paul --" Encyclical :eritatis splen#or" n+ 1/+
<@+ Cf+ 0ohn Paul --" Motu Proprio 7 Dolentium hominum"7 e)+ 11" 19;?" in
-nse!namenti :---G1 .19;?/ p+ 4A?+ 7Especially si!nificant is the rea(a'enin! of an ethical
reflection on issues affectin! life+ The emer!ence an# e*er more (i#esprea#
#e*elopment of )ioethics is promotin! more reflection an# #ialo!ue)et(een )elie*ers
an# non$)elie*ers" as (ell as )et(een follo(ers of #ifferent reli!ionson ethical
pro)lems" inclu#in! fun#amental issues pertainin! to human life7 .0ohn Paul --"
Encyclical E*an!elium *itae" March <?" 199?" n+ <A/+
<A+ Cf+ 0ohn Paul --" To the Association of Catholic health care (or'ers" Oct+ <4"
19;@" in -nse!namenti -5G<" p+ 11A1" n+ =+ 7-n to#ay6s cultural an# social conte3t" in (hich
science an# the practice of me#icine ris' losin! si!ht of their inherent ethical #imension"
health$care professionals can )e stron!ly tempte# at times to )ecome manipulators of
life" or e*en a!ents of #eath7 0ohn Paul -- Encyclical E*an!elium *itae" March <?" 199?"
n+ ;9/+
<;+ 9yno# of Dishops" special Assem)ly for Europe" Conclu#in! 9tatement" in Oss+
RoM+ Dec+ <B" 1991" n+ 1B+ 7-t is illusory to claim that scientific research an# its
applications are morally neutral+ On the other han#" !ui#in! criteria cannot )e #e#uce#
from merely technical efficacy" nor from the usefulness to some to the #etriment of
others" nor" (orse still" from the #ominant i#eolo!ies+ 9cience an# technolo!y re2uire"
)y their *ery inner si!nificance" uncon#itional respect for the fun#amental criteria of
morality> they must )e at the ser*ice of the human person" of his inaliena)le ri!hts" of his
true an# inte!ral !oo#" in conformity (ith Co#6s plan an# (ill7 Con!+ Doct+ aith" -nstruct+
Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ -ntro#uction" <" p+ A= .cf+ CCC <<94/+
<9+ Ethical committees" compose# of specialists in the me#ical an# moral ner#s" are
also esta)lishe# )y !o*ernments" (hich !i*e them consultati*e an# super*isory roles+
7The Church is a(are that the issue of morality is one (hich #eeply touches e*ery
person> it in*ol*es all people" e*en those (ho #o not 'no( Christ an# his Cospel or Co#
himself+ 9he 'no(s that it is precisely on the path of the moral life that the (ay of
sal*ation is open to all 7 0ohn Paul --" Encyclical :eritatis splen#or" n+ =+ 7+++,o #ar'ness
of error or of sin can totally e3tin!uish in the human person the li!ht of Co# the Creator+
-n the #epths of his heart there al(ays remains a yearnin! for a)solute truth an# a thirst
to attain full 'no(le#!e of it+ This is elo2uently pro*e# )y man6s tireless research in all
fiel#s an# in e*ery sector+ %is search for the meanin! of life pro*es it e*en more .i)i#+" n+
-/+ Cf+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?+ n+ 4+
=B+ Cf+ 0ohn Paul --" To the plenary assem)ly of the Pontifical Council for Pastoral
Assistance to %ealth Care &or'ers" e)+ 9"199B" in -nse!namenti 5---G<" p+ 4B?" n+ 4+
=1+ 0ohn Paul --" Apost+ 1etter 9al*ifici #oloris" in -nse!namenti :--G1" <?4$=?@" n+ <9+
=<+ Cf+ To scientists an# health care (or'ers" ,o*+ 1<" 19;A" in -nse!namenti 5G=
.19;A/ 1B;;: 7The humani4ation of me#icine is a #uty of 8ustice" an# its implementation
cannot )e entirely #ele!ate# to others" since it re2uires the commitment of all+ -ts
operati*e fiel# is *ery *ast: it !oes from health e#ucation to the creation of !reater
sensiti*ity in those in pu)lic authority> from #irect in*ol*ement in one6s o(n (or'place to
forms of cooperationlocal" national an# international (hich are ma#e possi)le )y the
e3istence of so many or!ani4ations an# associations (hich ha*e amon! their purposes
the call" #irect or in#irect" for a nee# to ma'e me#icine e*er more human+7
==+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?+199?+ n+ =4+
=4+ -)i#+" n+ 4=+
=?+ 0ohn Paul --" To the &orl# Me#ical Association" Oct+ <9" 19;=" in -nse!namenti
:-G<" 9<1+ Cf+ Allocution to the participants at a con!ress of the Pontifical Aca#emy of
9ciences" Oct+ <=" 19;<" in -nse!namenti :G=" ;9?$;9;+
=@+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ ;?+ Cf+
0ohn Paul --" Apost+ E3hort+ Christifi#eles laici" Dec+ =B" 19;;" in -nse!namenti 5-G4" pp+
<1==$<1=?" n+ =;> cf+ %oly 9ee" Charter of the Ri!hts of the amily" Oct+ <<" 19;=" art+ 4+
=A+ 0ohn Paul --" To the Enion of -talian 0urists" Dec+ ?" 19;A" in -nse!namenti 5G="
.19;A/ 1<9?+ 7The Church remains #eeply conscious of her 6#uty in e*ery a!e of
e3aminin! the si!ns of the times an# interpretin! them in the li!ht of the Cospel" so that
she can offer in a manner appropriate to each !eneration replies to the continual human
2uestionin!s on the meanin! of this life an# the life to come an# on ho( they are
relate#76 .0ohn Paul --" Encyclical :eritatis splen#or" n+ </+
=;+ 0ohn Paul --" To the &orl# Me#ical Association" Oct+ <9 19;=" in -nse!namenti
:-G<"9<1$9<=+ Cf+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B
.19;;/ 9B$9<+
=9+ Cf+ Ecum+ Coun+ :atican --" Past+ Constit+ Cau#ium et spes" n+ ?B> Paul :-"
Encyclical %umanae *itae" in AA9 @B .19@;/ p+ 4;A+
4B+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ 4=+
41+ Cf+ Paul :-" Encyclical %umanae *itae" in AA9 @B .19@;/ p+ 4;A" n+ 1B+
4<+ Ecum+ Coun+ :atican --" Past+ Constit+ Cau#ium et spes" n+ ?1+
4=+ Cf+ Paul :-" Encyclical %umanae *itae" in AA9 @B .19@;/ p+ 4;;" n+ 1<+
44+ 7The inner structure of the marria!e act is such that" (hile it profoun#ly unites the
partners" it fits them for the !eneration of ne( life" accor#in! to la(s inscri)e# in the *ery
)ein! of the man an# the (oman7 .Paul :-" Encyclical %umanae *itae" in AA9 @B .19@;/
pp+ 4;;$4;9" n+ 1</+
4?+ Cf+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ 91+
4@+ Cf+ Paul :-" Encyclical %umanae *itae" n+ 1<> 0ohn Paul --" Apostol+ E3hort+
amiliaris Consortio" in AA9 A4 .19;</ p+ 11;" n+ =<+ 7Conse2uently" 6the one (ho
(ishes to un#erstan# himself thorou!hlyan# not 8ust in accor#ance (ith imme#iate"
partial" often superficial" an# e*en illusory stan#ar#s an# measures of )ein!must (ith
his unrest" uncertainty an# e*en his (ea'ness an# sinfulness" (ith his life an# #eath"
#ra( near to Christ++++76 .0ohn Paul --" Encyclical :eritatis splen#or" n+ ;/+
4A+ ,atural metho#s 7are #ia!nostic means for the fertile perio#s of the (oman"
(hich ma'e it possi)le to refrain from se3ual relations (hen le!itimate moti*es of
responsi)ility #ictate the a*oi#ance of conception7 .0ohn Paul --" To the participants at a
course for teachers of natural metho#s" 0an+ 1B" 199<" in Oss+ Rom+ 0an+ 11" 199<" n+ =/+
4;+ Cf+ Paul :-" Encyclical %umanae *itae" in AA9 @B .19@;/ p+ 4;;" n+ 11 an# p+ 49<"
n+ 1@+
49+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ 9A+
?B+ Cf+ Paul :-" Encyclical %umanae *itae" in AA9 @B .19@;/ p+ 4;9" n+ 1=> cf+ also
0ohn Paul --" Apostol+ E3hort+ amiliaris Consortio" in AA9 A4 .19;</ p+ 11;" n+ =<+
?1+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ <=+
?<+ Cf+ Paul :-" Encyclical %umanae *itae" in AA9 @B .19@;/ p+ 49B" n+ 14+
?=+ Cf+ 0ohn Paul --" Apostol+ E3hort+ amiliaris Consortio" in AA9 A4 .19;</ p+ 11;" n+
=<+
?4+ 0ohn Paul --" To the participants at a course for teachers of natural metho#s" 0an+
1B" 199<" in Oss+ Rom+ 0an+ 11" 199<" n+ =+
??+ Cf+ 0ohn Paul --" Apostol+ E3hort+ amiliaris Consortio" in AA9 A4 .19;</ p+ 11;" n+
=<+
?@+ 0ohn Paul --" To the participants at t(o con!resses on the pro)lems of matrimony"
the family an# fertility" 0une ;" 19;4" in -nse!namenti :--G1" 1@@4$1@@?+ 7On the innate
meanin! (hich is that of mutual" total #onation )y the partners" contraception imposes
an o)8ecti*ely contra#ictory meanin!" namely that of not !i*in! oneself completely to the
other7 .Apost+ E3hort+ amiliaris Consortio" =</+
?A+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ 1=+
?;+ 0ohn Paul --" Apost+ E3hort+ amiliaris Consortio" in AA9 A4 .19;</ p+ 1<B" n+ =<+
?9+ Cf+ i)i#" p+ 1<<" n+ ==+
@B+ -)i#" p+ 1<?" n+ =?+
@1+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ 14+
@<+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ A@+ @=+
0ohn 55---" Encyclical Mater et Ma!istra" ---" in AA9 ?= .19@1/ 44A+ Cf+ Pius 5--" To the
participants at a con!ress of the -talian Catholic Enion of O)stetricians" Oct+ <9" 19?1" in
AA9 4= .19?1/ ;?B+
@4+ Cf+ 0ohn Paul --" Ceneral Au#ience" 0an+ 1@" 19;B" in -nse!namenti ---G1 .19;B/
14;$1?<+
@?+ Cf+ Pius 5--" To the participants at a con!ress of the -talian Catholic Enion of
O)stetricians" Oct+ <9" 19?1" in AA9 4= .19?1/ ;?B+
@@+ 0ohn 55---" Encyclical Mater et Ma!istra" ---" in AA9 ?= .19@1/ 44A+
@A+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ 9@+
@;+ Pius 5--" To the participants at the -: -nternational Con!ress of Catholic Doctors"
9ept+ =B" 1949" in AA9 41 .1949/ ?@B+
@9+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ 9<+
AB+ 7%omolo!ous -:ET ta'es place outsi#e the )o#ies of the partners throu!h the
actions of thir# parties (hose competence an# technical acti*ity #etermine the success
of the inter*ention> it entrusts the life an# i#entity of the em)ryo to the po(er of #octors
an# )iolo!ists an# !i*es technolo!y #ominion o*er the ori!in an# #estiny of the human
person7 .i)i#+" p+ 9=/+
A1+ Cf+ i)i#+" AA9 ;B .19;;/ pp+ ;?$;@" 91$9<" 9@$9A+ 7The ori!in of a human person is
really the result of a #onation+ The conception shoul# )e the fruit of the lo*e of its
parents+ -t cannot )e #esire# nor concei*e# as the pro#uct of the inter*ention of me#ical
or )iolo!ical techni2ues: this (oul# )e to re#uce it to )ecomin! the o)8ect of scientific
technolo!y+ ,o one can su)8ect the arri*al of a chil# into the (orl# to con#itions of
technical efficiency (hich can )e e*aluate# accor#in! to parameters of control an#
#ominion7 .i)i#" p+ 9</+
A<+ Cf+ i)i#" AA9 ;B .19;;/ pp+ 91" 9<$94+
A=+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ <<+
A4+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/" p+ 9=+
A?+ Cf+ i)i#+" p+ 9A+ 7A chil# is not somethin! o(e# to one" )ut is a !ift+ The 6supreme
!ift of marria!e6 is a human person+ A chil# may not )e consi#ere# a piece of property"
an i#ea to (hich an alle!e# 6ri!ht to a chil#6 (oul# lea#+ -n this area" only the chil#
possesses !enuine ri!hts: the ri!ht 6to )e the fruit of the specific act of the con8u!al lo*e
of his parents"6 an# 6the ri!ht to )e respecte# as a person from the moment of his
conception76 .CCC <=A;/+
A@+ Cf+ i)i#+" p+ ;? an# ;4+ The 7so$calle# 6spare em)ryos6 are+++use# for research
(hich" un#er the prete3t of scientific or me#ical pro!ress" in fact re#uces human life to
the le*el of simple 6)iolo!ical material6 to )e freely #ispose# of7 .0ohn Paul --" Encyclical
E*an!elium *itae" March <?" 199?" n+ 14/+
AA+ Cf+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/" p+
94+ 7Certainly homolo!ous -:ET is not )ur#ene# (ith all the ethical ne!ati*ity (hich is
to )e foun# in e3tramatrimonial procreation> the family an# the marria!e are still the
am)ient of the )irth an# e#ucation of the chil#+7 %o(e*er" it is at *ariance (ith the #i!nity
of human procreation" #epri*in! it of the #i!nity (hich is proper an# connatural to it+
A;+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ <=+
A9+ Cf+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/" pp+
;A$;9+
;B+ Cf+ i)i#" p+ ;;> see also 0ohn Paul --" Encyclical E*an!elium *itae" March <?"
199?" n+ <=+
;1+ Cf+ i)i#" p+ ;9+
;<+ Cf+ i)i#" pp+ 9<$94+
;=+ Cf+ i)i#" p+ 9?+
;4+ Cf+ i)i#" pp+ 9?$9@+
;?+ Cf+ 0ohn Paul --" To the staff of the ne( 6Re!ina Mar!henta6 hospital" Dec+ <B"
19;1" in -nse!namenti -:G<" p+ 11A9" n+ =+
;@+ Cf+ 0ohn Paul --" To the participants at the =?th Ceneral Assem)ly of the &orl#
Me#ical Association" Oct+ <9" 19;=" in -nse!namenti :-G<" 91A$9<=" AA9 A@ .19;4/ =9B/>
To the Catholic health or!ani4ations of the Enite# 9tates of America" 9ept+ 14" 19;A" in
-nse!namenti 5G= .19;A/ ?BB$?BA> To the participants at the :-- 9ymposium of European
Dishops" Oct+ 1A" 19;9" in -nse!namenti 5--G<" p+ 94A" n+ A+
;A+ Con!+ Doct+ aith+ Declaration on Procure# A)ortion" 0une 1;" 19A4" in AA9 @@
.19A4/ A=;+
;;+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ A;$A9+
;9+ E*en the theory of the fourteenth #aythe #ay (hen the primiti*e strea'
appears" in (hich the cells lose their totipotentiality an# t(in #i*isions are no lon!er
possi)lecannot i!nore an# #eny the fun#amental an# #ecisi*e )io!enetic fact of the
human an# in#i*i#ual nature of the fruit of the conception+
9B+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ 44+
91+ 0ohn Paul --" To the participants at a con!ress for o)stetricians" 0an+ <@" 19;B" in
-nse!namenti ---G1" p+ 19<" n+ 1+
9<+ Cf+ Co#e of Canon 1a(" can+ ;@<G<+
9=+ 0ohn Paul --" To the participants at a con!ress for O)stetricians" 0an+ <@" 19;B" in
-nse!namenti ---G1" p+ 19<" n+ <+ Cf+ 0ohn Paul --" Encyclical :entatis splen#or" n+ 1=+
94+ Ecum+ Coun+ :at+ --" Past+ Constit+ Cau#ium et spes" n+ <4+
9?+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ A4+
9@+ 0ohn Paul --" To the participants at the =?th Ceneral Assem)ly of the &orl#
Me#ical Association" Oct+ <9" 19;=" in -nse!namenti :-G<" 91A$9<=" AA9 A@ .19;4/ =9=/+
7The human person" create# in the ima!e of Co#" is a )ein! at once corporeal an#
spiritual+ The )i)lical account e3presses this reality in sym)olic lan!ua!e (hen it affirms
that 6then the 1or# Co# forme# man of #ust from the !roun#" an# )reathe# into his
nostrils the )reath of life> an# man )ecame a li*in! )ein!6 .Cen <:A/+ Man" (hole an#
entire" is therefore (ille# )y Co#7 .CCC =@</+
9A+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ A4$A?+
7The unity of soul an# )o#y is so profoun# that one has to consi#er the soul to )e the
6form6 of the )o#y: i+e+" it is )ecause of its spiritual soul that the )o#y ma#e of matter
)ecomes a human" li*in! )o#y> spirit an# matter" in man" are not t(o natures unite#" )ut
rather their union forms a sin!le nature7 .CCC =@?/+
9;+ Cf+ 0ohn Paul --" To the participants at the =?th Ceneral Assem)ly of the &orl#
Me#ical Association" Oct+ <9" 19;=" in -nse!namenti :-G<" 9<B" n+ ?+
99+ 7The )o#y re*eals the human )ein!" e3presses the person an# is the first
messa!e of Co# to the human )ein! himself6 .0ohn Paul --" allocutions of 0an+ 9 an#
e)+ <B"19;B" in -nse!namenti ---G1" ;;9? an# 4<;$4=4/+
1BB+ The moral la(" in (hich )iolo!ical meanin!s ta'e shape" 7cannot )e seen as a
merely )iolo!ical norm7 )ut as inte!rally human: in it is e3presse# 7the rational or#er
accor#in! to (hich the human person is calle# )y the Creator to #irect an# re!ulate his
life an# his actions an#" in particular" souse an# #ispose of his o(n )o#y7: Con!+ Doct+
aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ p+ A4> Paul :-" Encyclical
%umanae *itae" in AA9 @B .19@;/ p+ 4;A" n+ 1B+
1B1+ Cf+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ <=+
1B<+ 0ohn Paul --" Apost+ E3hort+ Christifi#eles laici" Dec+ =B" 19;;" in -nse!namenti
5-G4" p+ <1==" n+ =;+
1B=+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ 4B+
1B4+ Cf+ Pius 5--" To the participants at the Con!ress of -talian Catholic O)stetricians"
Oct+ <9" 19?1" in AA9 4= .19?1/ ;=;: 0ohn Paul --" To the participants at the ?4th
up#atin! Course of the Catholic Eni*ersity" 9ept+ @" 19;4" in -nse!namenti :--G<" p+ ===+
7The human )o#y shares in the #i!nity of the 6ima!e of Co#6: it is a human )o#y
precisely )ecause it is animate# )y a spiritual soul" an# it is the (hole human person
that is inten#e# to )ecome" in the Do#y of Christ" a temple of the 9pirit7 .CCC =@4/+
1B?+ 0ohn Paul --" To the participants at a con!ress of the 7Mo*ement for 1ife" 7 Oct+
1<" 19;?" in -nse!namenti :-G<" 9==$9=@" n+ <+ Cf+ To scientists an# health care (or'ers"
,o*+ 1<" 19;A" in -nse!namenti 5G= .19;A/ 1B;4$1B;?" n+ <+ Cf+ Pius 5--" To the
mem)ers of the irst -nternational Con!ress of %istopatholo!y of the ,er*ous 9ystem"
9ept+ 14" 19?<" in AA9 44 .19?</ p+ A;<+
1B@+ Cf+ Pius 5--" Discourses an# Droa#casts" 5" :atican Poly!lot Press" 1949" pp+
9;ff> To the 79an 1uca7 -talian Enion of Me#ical Diolo!y" ,o*+ 1<" 1944" in Discourses
an# Droa#casts" :- cit+" 191ff> 0ohn Paul --" To the Pontifical Aca#emy of 9ciences" Oct+
<1" 19;?" in -nse!namenti :---G<" p+ 1B;1 n+ =+
1BA+ 0ohn Paul --" To the participants at a con!ress for o)stetricians" 0an+ <@" 19;B" in
-nse!namenti ---G1" p+ 19<" n+ <> To the participants at the con!ress of the -talian
Association of Anesthesiolo!y" Oct+ 4" 19;4" in -nse!namenti :--G<" p+ A?B" n+ 4> To the
Catholic health or!ani4ations of the Enite# 9tates of America" 9ept+ 14" 19;A" in
-nse!namenti 5G= .19;A/ ?B4+
1B;+ 0ohn Paul --" To the participants at a con!ress of the 7Mo*ement for 1ife"7 Oct+
1<" 19;?" in -nse!namenti :---G<" pp+ 9==$9=@" n+ <+
1B9+ 0ohn Paul --" To the participants at the --- Con!ress of the Association of
Catholic %ealth Care &or'ers" Oct+ <4" 19;@" in -nse!namenti -5G<" p+ 11A<+
11B+ 79cientists an# #octors must not thin' that they are lor#s of life" )ut rather its
e3pert an# !enerous ser*ants7 .0ohn Paul --" To the Pontifical Aca#emy of 9ciences"
Oct+ <1" 19;?" in -nse!namenti :---G<" p+ 1B;1" n+ =+
111+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ =9+
11<+ 0ohn Paul --" To the participants at a con!ress of the 7Mo*ement for 1ife"7 Dec+
4" 19;<" in -nse!namenti :G=" p+ 1?1=" n+ ?" To the Pontifical Aca#emy of 9ciences" Oct+
<=" 19;<" in -nse!namenti :G=" p+ ;9@" n+ <> To the participants at the Collo2uium of the
7,o*a 9pes7 international oun#ation" ,o*+ 9" 19;A" in -nse!namenti 5G= .19;A/ 1B?B$
1B?1" n+ <+
11=+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ A=+
114+ Ecum+ Coun+ :at+ --" Past+ Constit+ Cau#ium et spes" n+ 1?: 7Our a!e" more than
any of the past" nee#s such (is#om if all that man #isco*ers is to )e enno)le# throu!h
human effort+7
11?+ Cf+ Pont+ Coun+ 7Cor Enum7" 9ome ethical 2uestions relatin! to the !ra*ely in
an# the #yin!" 0uly <A" 19;1" in Enchiri#ion :aticanum" A+ Documenti ufficiali #ella 9anta
9e#e 19;B$19;1 + EDD" Dolo!na 19;?" p+ 11=A" n+ <+1+
11@+ Cf+ 0ohn Paul --" To the Association of -talian Catholic Doctors" Dec+ <;" 19;B" in
-nse!namenti ---G<" p+ 1BBA" n+ => To a #ele!ation of the 7oo# an# Disarmament
-nternational7 Association" e)+ 1=" 19;@" n+ =+
11A+ Cf+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A<
.19;B/ ?44$?4?> 0ohn Paul --" To the &orl# Me#ical Association" Oct+ <9" 19;=" in
-nse!namenti :-G<" 91;" n+ <> Apost+ E3hort+ Christifi#eles laici" Dec+ =B" 19;;" in
-nse!namenti 5-G4" p+ <1==$<1=?" n+ =;+
11;+ 0ohn Paul --" Apost+ E3hort+ Christifi#eles laici" Dec+ =B" 19;;" in -nse!namenti
5-G4" p+ <1==" n+ =;+ 7Man is not the master of life" nor is he the master of #eath+ -n life
an# in #eath" he has to entrust himself completely to the 6!oo# pleasure of the Most
%i!h"6 to his lo*in! plan7 .0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+
4@/+
119+ 7The #octor has only the po(er an# ri!hts o*er the patient (hich the latter !i*es
him" either e3plicitly or tacitly+ or his part" the patient cannot !i*e more ri!hts than he
has7 .Pius 5--" To the mem)ers of the irst -nternational Con!ress on %istopatholo!y of
the ,er*ous 9ystem" 9ept+ 14" 19?<" in AA9 44 .19?</ p+ A;<+/
1<B+ 7The patient is )oun# )y the immanent teleolo!y esta)lishe# )y nature+ %e has
the ri!ht to uselimite# )y the natural finalitythe faculties an# po(ers of his human
nature+7 .-)i#+/
1<1+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?"199?" n+ 4A+
1<<+ Cf+ Pius 5--" To the mem)ers of the irst -nternational Con!ress on
%istopatholo!y of the ,er*ous 9ystem" 9ept+ 14" 19?< in AA9 44 .19?</ p+ A;<+
1<=+ 0ohn Paul --" To the participants at a sur!ery con!ress" e)+ 19" 19;A" in
-nse!namenti 5-G1 .19;A/ =A4" n+ <+
1<4+ 0ohn Paul --" To the staff of the 6Re!ina Mar!herita hospital" Dec+ <B" 19;1" in
-nse!namenti -:G<" p+ 11A9" n+ =+
1<?+ Pont+ Coun+ 7Cor Enum"7 Community health" in Enchiri#ion :aticanum" @+
Documenti ufficiali #ella 9anta 9e#e 19AA$19A9 + EDD" Dolo!na 19;=" p+ =<?" n+ 1+<+
1<@+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ A9+
1<A+ 0ohn Paul --" Motu Proprio7 Dolentium hominum"7 e)+ 11" 19;?" in
-nse!namenti :---G1 .19;?/ pp+ 4A=$4A4+ 7-llness an# sufferin! ha*e al(ays )een amon!
the !ra*est pro)lems confronte# in human life+ -n illness man e3periences his
po(erlessness" his limitations" an# his finitu#e+ E*ery illness can ma'e us !limpse
#eath7 .CCC 1?BB/+ 7The mission of 0esus" (ith the many healin!s he performe#" sho(s
Co#6s !reat concern e*en for man6s )o#ily life 7 .0ohn Paul --" Encyclical E*an!elium
*itae" March <?"199?" n+ 4A/+
1<;+ 0ohn Paul --" Motu Proprio 7Dolentium hominum"7 e)+ 11" 19;?" in
-nse!namenti :---G1 .19;?/ pp+ 4A=$4A4+
1<9+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ ?B+
1=B+ Cf+ 0ohn Paul --" #urin! a *isit to Mercy Maternity %ospital in Mel)ourne" ,o*+
<;" 19;@" in -nse!namenti -5G< .19;@/ 1A==" n+ <+ 7The sic' too are sent as la)orers into
the 1or#6s *ineyar#+ The )ur#en that tires the mem)ers of the )o#y an# shatters the
serenity of the spins" far from #eterrin! them from (or' in the *ineyar#" calls them to li*e
out their human an# Christian *ocation an# to share in the !ro(th of the Kin!#om of Co#
in ne( (ays" (hich are also more *alua)le7 .0ohn Paul --" Apost+ E3hort+ Christifi#eles
laici" in -nse!namenti 5-G4" p+ <1@B" ?=/+
1=1+ 0ohn Paul --" Discourse in 1our#es" Au!ust 1?" 19;=" n+ 4 7On the cross" Christ
ma#e his o(n all the (ei!ht of e*il an# too' a(ay the sin of the (orl# .0n 1" <9/" of
(hich sic'ness is )ut a conse2uence" Dy his passion an# #eath on the cross" Christ has
!i*en ne( meanin! to sufferin!: no( it can confi!ure us to him an# unite us (ith his
re#empti*e passion+7
1=<+ 0ohn Paul --" Apost+ E3hort+ amiliaris Consortio" n+ A?+
1==+ Cf+ 0ohn Paul --" To the participants at a con!ress of 7Mo*ement for 1ife"7 Dec+
4" 19;<" in -nse!namenti" :G=" p+ 1?1<" n+ 4+
1=4+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ A9$
;B+ &ith re!ar# to the #ia!nostic techni2ues mostly use#" (hich are echo!raphy .an#
amniocentesis" it can )e sai# that the former appears to )e ris'$free (hereas the latter
contains elements of ris' consi#ere# accepta)le an# therefore proportionate+ The same
cannot )e sai# for other techni2ues" such as placentocentesis" fetoscopy an# the
collectin! of *illi samples (hich ha*e more or less hi!h le*els of ris'+
1=?+ -)i#+ 7Prenatal #ia!nosis" (hich presents no moral o)8ections if carrie# out in
or#er to i#entify the me#ical treatment (hich may )e nee#e# )y the chil#ren the (om)"
all too often )ecomes an opportunity for proposin! an# procurin! an a)ortion+ This is
eu!enic a)ortion" 8ustifie# in pu)lic opinion on the )asis of a mentality+++(hich accepts
life only un#er certain con#itions an# re8ects it (hen it is affecte# )y any limitation"
han#icap or illness7 .0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ 14/+
1=@+ Cf+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/
A9$;B+ 79ince it must )e treate# from conception as a person" the em)ryo must )e
#efen#e# in its inte!rity" care# for" an# heale#" as far as possi)le" li'e any other human
)ein!7 .CCC <<A4/+
1=A+ Cf+ 0ohn Paul --" Motu Proprio 7 Dolentium hominum"7 e)+ 11" 19;?" in
-nse!namenti :---G1 .19;?/ pp+ 4A=$4A4+ 7Those (hose li*es are #iminishe# or
(ea'ene# #eser*e special respect+ 9ic' or han#icappe# persons shoul# )e helpe# to
lea# li*es as normal as possi)le7 .CCC <<A@/+
1=;+ 7E*ery person has a primary ri!ht to (hat is necessary for the care of his or her
health an# therefore to suita)le me#ical assistance7 .0ohn Paul --" To the &orl#
Con!ress of Catholic Doctors" Oct+ =" 199<" in -nse!namenti :G=" p+ @A=" n+ =/+
1=9+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A< .19;B/ p+
?49+
14B+ 7E*en (hen it cannot cure" science can an# shoul# treat an# assist the sic'
person7 .0ohn Paul --" To the participants at a stu#y course on 7human preleu'emias"7
,o*+ 1?" 19;?" in -nse!namenti :---G<" p+ 1<@?" n+ ?+ Cf+ 0ohn Paul --" To t(o (or' !roups
set up )y the Pontifical Aca#emy of 9ciences" Oct+ <1" 19;?" in -nse!namenti :--G<" p+
1B;<" n+ 4+
141+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B in AA9 A< .19;B/
pp+ ?49$??B+
14<+ Cf+ i)i#+
14=+ 7The principle of totality states that the part e3ists for the (hole" an#
conse2uently that the !oo# Of the part is su)or#inate# to that of the (hole: that the
(hole is #eterminin! for the part an# it can #ispose of it in its o(n interests .Pius 5--" To
the mem)ers of the irst -nternational Con!ress on %istopatholo!y of the ,er*ous
9ystem" 9ept+ 14" 19?<" in AA9 44 .19?</ p+ A;A/+
144+ Pius 5--" To the mem)ers of the 55:- -talian Con!ress of Erolo!y" Oct+ ;" 19?="
in AA9 4? .19?=/ p+ @A4> cf+ Pius 5--" To the mem)ers of the irst -nternational Con!ress
on %istopatholo!y of the ,er*ous 9ystem" 9ept+ 14" 19?<" in AA9 44 .19?</ A;<$A;=+
The principle of totality is applie# at the out)rea' of the illness: there alone is *erifie#
7correctly7 the relation of the part to the (hole+ Cf+ i)i#" p+ A;A+ 7&here the relationship of
the part to the (hole is *erifie#" an# to the e3tent that it is *erifie#" the part is
su)or#inate# to the (hole" (hich can in its o(n interests #ispose of the part .i)i#/+ The
physical inte!rity of a person cannot )e impaire# to cure an illness of psychic or spiritual
ori!in+ %ere it is not a 2uestion Of #isease# or malfunctionin! or!ans+ An# so their
me#icosur!ical manipulation is an ar)itrary alteration of the physical inte!rity of the
person+
-t is not la(ful to sacrifice to the (hole" )y mutilatin! it" mo#ifyin! it or remo*in! it" a
part (hich is not patholo!ically relate# to the (hole+ An# this is (hy the principle of
totality cannot )e correctly ta'en as a criterion for le!itimati4in! antiprocreati*e
sterili4ation therapeutic a)ortion an# transse3ual me#icine an# sur!ery+ -t is #ifferent
(ith psychic sufferin!s an# spiritual #isor#ers (ith an or!anic )asis" that is" (hich arise
from a #efect or physical #isease: on these it is le!itimate to inter*ene therapeutically+
14?+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ A?+
14@+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A< .19;B/ p+
?4?+
14A+ Con!+ Doct+ aith" Declaration on Procure# A)ortion" 0une 1;" 19A4" in AA9 @@
.19A4/ A=@$A=A+
14;+ Cf+ 0ohn Paul --" To the participants at a con!ress of the -talian Association of
Anesthesiolo!y" Oct+ 4" 19;4" in -nse!namenti :--G<" p+ A49 n+ <+
149+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A< .19;B/
?4<$??<" ---+
1?B+ 7The Christian is )oun# to mortify the flesh an# apply himself to interior
purification++++ -nsofar as self$control an# control of #isor#ere# ten#encies cannot )e
ac2uire# (ithout the help of physical pain" this )ecomes a nee# an# it must )e accepte#"
)ut insofar as it is not re2uire# for this purpose" it cannot )e sai# that there is a strict
o)li!ation for it+ %ence the Christian is ne*er o)li!e# to #esire it> he sees it as a more or
less suita)le means" accor#in! to the circumstances" to the en# he is pursuin!7 .Pius
5--" To an international assem)ly of #octors an# sur!eons" e)+ <4" 19?A" in AA9 49
.19?A/ p+ 1=?/+
1?1+ -)i#" p+ 1=@+
1?<+ Cf+ Pont+ Coun+ 7Cor Enum"7 9ome Ethical Juestions Relatin! to the Cra*ely -ll
an# the Dyin!" 0uly <A" 19;1" in Enchiri#ion :aticanum" A" Documenti ufficiali #ella
9anta 9e#e 19;B$19;1+ EDD" Dolo!na 19;?" p+ 1141" n+ <+=+1> 0ohn Paul --" To t(o (or'
!roups set up )y the Pontifical Aca#emy of 9ciences" Oct+ <1" 19;?" in -nse!namenti
:---G<" p+ 1B;<" n+ 4+
1?=+ 0ohn Paul --" To the participants at a con!ress of the -talian Association of
Anesthesiolo!y" Oct+ 4" 19;4" in -nse!namenti :--G<" p+ A?B" n+ =+
1?4+ Cf+ Pius 5--" To an international assem)ly of #octors an# sur!eons" e)+ <4"
19?A" in AA9 49 .19?A/ pp+ 1=;$14=+
1??+ Pius 5--" To the #octors of the C+ Men#el -nstitute" ,o*+ <4" 19?A" in AA9 49
.19?A/ p+ 1B=1+
1?@+ 7The patient cannot )e the o)8ect of #ecisions (hich he (ill not ma'e" or" if he is
not a)le to #o so" (hich he coul# not appro*e+ The 7person"7 principally responsi)le for
his o(n life" shoul# )e the center of any assistin! inter*ention: others are there to help
him" not to replace him7 .Pont+ Coun+ 7Cor Enum"7 9ome Ethical Juestions Relatin! to
the Cra*ely -ll an# the Dyin!" 0uly <A" 19;1" in Enchiri#ion :aticanum A" Documenti
ufficiali #ella 9anta 9e#e 19;B$19;1+ EDD" Dolo!na 19;?" p+ 11=A" n+ <+1+</+
1?A+ 0ohn Paul --" To the &orl# Con!ress of Catholic Doctors" Oct+ =" 19;<" in
-nse!namenti :G=" p+ @A=" n+ 4+
1?;+ Cf+ 0ohn Paul --" To the participants at t(o con!resses on me#icine an# sur!ery"
Oct+ <A"19;B" in -nse!namenti ---G<" 1BB;$1BB9" n+ ?+
1?9+ 0ohn Paul --" To the representati*es of the -talian 9ociety of Me#icine an# the
-talian 9ociety of Ceneral 9ur!ery" Oct+ <A" 19;B" n+ =+
1@B+ 0ohn Paul --" To the participants at a con!ress on cancer" April <@" 19;@" in
-nse!namenti -5G1" 11?<$11?=+
1@1+ Cf+ 0ohn Paul --" To scientists an# health care (or'ers" ,o*+ 1<" 19;A" in
-nse!namenti 5G=" .19;A/ 1B;@$1B;A" n+ 4+ 79ome a)usi*e interpretations of scientific
research in the fiel# of anthropolo!y must also )e mentione#+ Ar!uin! from the !reat
*ariety of customs" )eha*ior patterns an# institutions present in humanity these theories
conclu#e" if not al(ays (ith the #enial of uni*ersal human *alues" at least (ith a relati*ist
conception of morality7 .0ohn Paul --" Encyclical :eritatis splen#or" n+ ==/+
1@<+ 0ohn Paul --" To the participants at t(o con!resses on me#icine an# sur!ery"
Oct+ <A" 19;B" in -nse!namenti ---G<"1BB9" n+ ?+
1@=+ Pius 5--" To the mem)ers of the irst -nternational Con!ress on %istopatholo!y
of the ,er*ous 9ystem" 9ept+ 14" 19?<" in AA9 44 .19?</ p+ A;;+
1@4+ 0ohn Paul --" To a conference on pharmacy in the syno# hall" Oct+ <4" 19;@" in
-nse!namenti -5G<" p+ 11;=> cf+ To the participants at a sur!ery con!ress" e)+ 19" 19;A"
in -nse!namenti 5G1 .19;A/ =A@" n+ 4+ 7Research or e3perimentation on the human )ein!
cannot le!itimate acts that are in themsel*es contrary to the #i!nity of persons an# to the
moral la(+ The su)8ects6 potential consent #oes not 8ustify such acts+ E3perimentation on
human )ein!s is not morally le!itimate if it e3poses the su)8ect6s life or physical an#
psycholo!ical inte!rity to #isproportionate or a*oi#a)le ris's7 .CCC <<9?/+
1@?+ Cf+ 0ohn Paul --" To the participants at t(o con!resses on me#icine an# sur!ery"
Oct+ <A" 19;B" in -nse!namenti ---G<" 1BB;$1BB9" n+ ?> To the participants at a stu#y
course on 7human preleu'emias" 7 ,o*+ 1?" 19;?" in -nse!namenti :---G<" p+ 1<@?" n+ ?+
1@@+ 0ohn Paul --" To the participants at a meetin! of the Pontifical Aca#emy of
9ciences" Oct+ <=" 19;<" in -nse!namenti :G=" p+ ;9A" n+ 4: 7Therefore" the re#uction in
e3periments on animals" (hich are pro!ressi*ely )ecomin! less necessary" is in
accor#ance (ith the !oo# of all creation7 .i)i# /+
1@A+ Cf+ 0ohn Paul --" To a conference on pharmacy in the syno# hall" Oct+ <4" 19;@"
in -nse!namenti -5G<" p+ 11;=+
1@;+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?"19;B" in AA9 A< .19;B/ p+
??B+ 7-t may happen" in #ou)tful cases" (hen 'no(n means ha*e faile#" that a ne(
metho#" as yet insufficiently teste#" offers" to!ether (ith rather #an!erous elements" a
!oo# pro)a)ility of success+ -f the patient consents" the application of the proce#ure in
2uestion is la(ful7 .Pius 5--" To the participants at the irst -nternational Con!ress on
%istopatholo!y of the ,er*ous 9ystem" 9ept+ 14" 19?<" in AA9 44 .19?</ p+ A;;/+
1@9+ 0ohn Paul --" To the participants at a stu#y course on 7human preleu'emias" 7
,o*+ 1?" 19;?" in -nse!namenti :---G<" p+ 1<@?" n+ ?+
1AB+ Pius 5--" To the participants at the :-- Assem)ly of the &orl# Me#ical
Association" 9ept+ =B" 19?4" in Pius 5--" Discourses to Doctors" Rome" 19@B" p+ =?;+
1A1+ Cf+ 0ohn Paul --" To the participants at t(o con!resses on me#icine an# sur!ery"
Oct+ <A" 19;B" in -nse!namenti ---G<" p+ 1BB9" n+ ?+
1A<+ -)i#
1A=+ Con!+ Doct+ aith" -nstruct+ Donum *itae" in AA9 ;B .19;;/ ;1$;=+ 7This
e*aluation of the morality of a)ortion is to )e applie# also to the recent forms of
inter*ention on human em)ryos (hich" althou!h carrie# out for purposes le!itimate in
themsel*es" ine*ita)ly in*ol*e the 'illin! of those em)ryos++++ The use of human em)ryos
or fetuses as an o)8ect of e3perimentation constitutes a crime a!ainst their #i!nity as
human )ein!s (ho ha*e a ri!ht to the same respect o(e# to a chil# once )orn" 8ust as to
e*ery person7 .0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ @=/+
1A4+ Cf+ Con!+ Doct+ aith" -nstruct+ Donum *itae" in AA9 ;B .19;;/ ;1$;=+ 7-
con#emn in a most e3plicit an# formal (ay e3perimental manipulation of the human
em)ryo" )ecause it is a human )ein!> from the moment of its conception until #eath it
can ne*er )e instrumentali4e# for any reason (hatsoe*er7 .0ohn Paul --" To the
participants at a meetin! of the Pontifical Aca#emy of 9ciences" Oct+ <?" 19;<" in AA9
A? .19;=/ =A/+ 7Respect for the human )ein! e3clu#es all 'in#s of e3perimental
manipulation or e3ploitation of the em)ryo7 .%oly 9ee" Charter on the Ri!hts of the
amily" 4G)" in Oss+ Rom+" Oct+ <?" 19;=/+
1A?+ Cf+ 0ohn Paul --" To the participants at the irst -nternational Con!ress on the
Transplant of Or!ans" 0une <B" 1991" in -nse!namenti 5-:G1 .1991/ 1A1B+
1A@+ -)i#" 7Or!an transplants are not morally accepta)le if the #onor or those (ho
le!itimately spea' for him ha*e not !i*en their informe# consent+ Or!an transplants
conform (ith the moral la( an# can )e meritorious if the physical an# psycholo!ical
#an!ers an# ris's incurre# )y the #onor are proportionate to the !oo# sou!ht for the
recipient+ -t is morally ina#missi)le #irectly to )rin! a)out the #isa)lin! mutilation or
#eath of a human )ein!" e*en in or#er to #elay the #eath of other persons7 .CCC <<9@/+
1AA+ Cf+ Pius 5--" To the #ele!ates of the -talian Association of Cornea Donors an#
the -talian Enion for the Dlin#" May 14" 19?@" in AA9 4; .19?@/ 4@4$4@?> 0ohn Paul --" To
the participants at the irst -nternational Con!ress on the Transplant of Or!ans" 0une <B
1991" in -nse!namenti 5-:G1 .1991/ 1A11+
1A;+ 0ohn Paul --" To the participants at the irst -nternational Con!ress on the
Transplant of Or!ans" 0une <B" 1991" in -nse!namenti 5-:G1 .1991/ 1A11+
1A9+ -)i#+" n+ 4+
1;B+ Cf+ Pius 5--" To the #ele!ates of the -talian Association of Cornea Donors an#
the -talian Enion for the Dlin# + May 14" 19?@ in AA9 4; .19?@/ pp+ 4@<$4@4+
1;1+ -)i#" pp+ 4@@$4@A+
1;<+ Cf+ Pontifical Aca#emy of 9ciences" Declaration on the Artificial Prolon!ation of
1ife an# Determinin! the Precise Moment of Death" Oct+ <1" 19;?" n+ 1" =+
1;=+ Pius 5--" To the #ele!ates of the -talian Association of Cornea Donors an# the
-talian Enion for the Dlin#" May 14" 19?@" in AA9 4; .19?@/ pp+ 4@<$4@4+
1;4+ 0ohn Paul --" To the participants at the irst -nternational Con!ress on the
Transplant of Or!ans" 0une <B" 1991" in -nse!namenti 5-:G- .1991/ 1A11" n+ =+
1;?+ -)i#> cf+ Pius 5--" To the #ele!ates of the -talian Association for Cornea Donors
an# the -talian Enion for the Dlin#" May 14 19?@" in AA9 4; .19?@/ p+ 4@?+ Cf+ Pius 5--"
Discourses to Doctors p+ 4@A: 7-n a#*ertisin! .for cornea #onors/ an intelli!ent reser*e
shoul# )e maintaine# to a*oi# serious interior an# e3terior conflicts+ Also" is it necessary"
as often happens" to refuse any compensation as a matter of principleF The 2uestion
has arisen+ &ithout #ou)t there can )e !ra*e a)uses if recompense is #eman#e#> )ut it
(oul# )e an e3a!!eration to say that any acceptance or re2uirement of recompense is
immoral+ The case is analo!ous to that of )loo# transfusion> it is to the #onor6s cre#it if
he refuses recompense" )ut it is not necessarily a fault to accept it+7
1;@+ Cf+ 0ohn Paul --" To the participants at the irst international Con!ress on the
Transplant of Or!ans" 0une <B" 1991" in -nse!namenti 5-:G1 .1991/ 1A1<+
1;A+ Cf+ i)i#" A" p+ 1A1=" n+ ?+
1;;+ -)i#+" p+ 1A1=" n+ ?: 7The #ifficulty of the inter*ention" the nee# to act promptly"
an# the nee# for ma3imum concentration on the tas'" shoul# not lea# to the #octor6s
losin! si!ht of the mystery of lo*e containe# in (hat he is #oin!+7
7The #ifferent comman#ments of the Decalo!ue are really so many reflections of the
one comman#ment a)out the !oo# of the person" at the le*el of the many #ifferent
!oo#s (hich characteri4e his i#entity as a spiritual an# )o#ily )ein! in relationship (ith
Co#" (ith his nei!h)or an# (ith the material (orl#7 .0ohn Paul --" Encyclical :eritatis
splen#or" n+ 1=/+
1;9+ 7At the root of alcohol an# #ru! a)useta'in! into account the painful
comple3ity of causes an# situationsthere is usually an e3istential *acuum" #ue to an
a)sence of *alues an# a lac' of self$esteem" of trust in others an# in life in !eneral7
.0ohn Paul --" To the participants at the -nternational Conference on Dru!s an# Alcohol"
,o*+ <=" 1991" in -nse!namenti 5-:G< .1991/ 1<49" n+ <+
19B+ -)i#+" n+ 4+
191+ Cf+ 0ohn Paul --" To the participants at the :-- &orl# Con!ress of Therapeutic
Communities" 9ept+ A" 19;4" in -nse!namenti :--G<" p+ =4A" n+ =+
19<+ -)i#" p+ =?B" n+ A+
19=+ Cf+ 0ohn Paul --" Messa!e to the -nternational Con!ress in :ienna" 0une 4" 19;A"
in -nse!namenti :--G<" p+ =4A" n+ =+
194+ 0ohn Paul --" To the participants at the :-- &orl# Con!ress of Therapeutic
Communities" 9ept+ A" 19;4" in -nse!namenti :--G<" p+ =4A" n+ =+
19?+ 0ohn Paul --" To the participants at the -nternational Conference on Dru!s an#
Alcohol" ,o*+ <=" 1991" n+ 4+ 7The use of #ru!s inflicts *ery !ra*e #ama!e on human life
an# health+ Their use" e3cept on strictly therapeutic !roun#s" is a !ra*e offense+
Clan#estine pro#uction of an# traffic'in! in #ru!s are scan#alous practices+ They
constitute #irect cooperation in e*il" since they encoura!e people to practices !ra*ely
contrary to the moral la(7 .CCC <<91/+
19@+ 0ohn Paul --" To the participants at the -nternational Conference on Dru!s an#
Alcohol" ,o*+ <=" 1991" n+ 4+
19A+ -)i#" n+ 4+
19;+ 7The present economic con#itions in society" as (ell as the hi!h le*el of po*erty
an# unemployment" can )e contri)utary factors that increase in your people a sense of
unrest" insecurity" frustration an# social alienation" lea#in! them on to the illusory (orl#
of alcohol as an escape from the pro)lems of life7: 0ohn Paul --" To the participants at a
con!ress on alcoholism" in -nse!namenti :---G1" p+ 1A41+
199+ There are three cate!ories of psychopharmaceuticals+ The first is that of
neuroleptics" the antipsychotics (hich ha*e ma#e possi)le the closin! of psychiatric
hospitals" since they o*ercome a!itation" #eliria an# hallucinations" an# so ma'e it
useless to confine an# isolate patients> in any case" these measures (ere non$curati*e+
The secon# cate!ory is comprise# of se#ati*es or tran2uili4ers an# the thir#
anti#epressi*es +
<BB+ 0ohn Paul --" To the participants at the -nternational Conference on Dru!s an#
Alcohol" ,o*+ <=" 1991" n+ 4+
<B1+ -)i#+
<B<+ Cf+ Pius 5--" To the -nternational Con!ress of ,europsychopharmacolo!y" 9ept+
9" 19?;" in Discourses an# Droa#casts :ol+ 55" pp+ =<A$===+
<B=+ This is confirme# )y the fre2uency an# the con*iction (ith (hich patients tell the
#octor: 7,o( that - ha*e spo'en to you - feel )etter+7 An# in fact 8ust as 7there is
therapeutic input (hich physical healin! can )rin! to the spirit of the patient> in*ersely"
there is a therapeutic input (hich can )e )rou!ht to physical sufferin! throu!h
psycholo!ico$spiritual comfortin!+7 Paul :-" To the --- &orl# Con!ress of the -nternational
Colle!e of Psychosomatic Me#icine" 9ept+ 1; 19A?" in AA9 @A .19A?/ ?44+
<B4+ Cf+ 0ohn Paul --" Motu Proprio Dolentium hominum" e)+ 11" 19;;" in
-nse!namenti :---G1" p+ 4A4+
<B?+ 7Consi#ere# in its totality" mo#ern psycholo!y #eser*es appro*al from the moral
an# reli!ious *ie(point+7 .Pius 5--" To the mem)ers of the 5--- -nternational Con!ress on
Applie# Psycholo!y" April 1B" 19?;" in AA9 ?B .19?;/ p+ <A4+
<B@+ -)i#" p+ <A@+
<BA+ -)i#" p+ <;1+
<B;+ 7E3perience teaches that man" nee#in! either pre*entati*e or therapeutic
assistance" re*eals nee#s that !o )eyon# actual or!anic patholo!y+ -t is not only suita)le
treatment that he (ants from the #octortreatment (hich" in any case" sooner or later
(ill fatally sho( itself to )e insufficient)ut the human support of a )rother" (ho can
share (ith him a life *ie(" in (hich also the mystery of sufferin! an# #eath (ill ma'e
sense+ An# (hence can )e ha#" if not in faith" this tran2uili4in! response to the supreme
2uestions of e3istenceF7 .0ohn Paul --" To the &orl# Con!ress of Catholic Doctors" Oct+
=" 19;<" in -nse!namenti :G=" p+ @A?" n+ @/+
<B9+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ =B+
<1B+ 7A uni2ue li!ht shines from the paschal mystery on the specific tas' (hich
pastoral health care is calle# to fulfill in the !reat commitment of e*an!eli4ation7 .0ohn
Paul --" To the plenary assem)ly of the Pontifical Council for Pastoral Assistance to
%ealth Care &or'ers" e)+ 11" 199<" in Oss+ Rom+ e)+ 1<" 199<" n+ A/+ Cf+ CCC 1?B=+
<11+ -n the an3ious an# painful state in (hich he fin#s himself" the seriously ill person
nee#s a special !race from Co# to 'eep him from losin! heart+ There is the #an!er that
temptation mi!ht ma'e his faith (a*er+ or this *ery reason" Christ (ishe# to !i*e his
sic' faithful the stren!th an# the *ery real support of the sacrament of Anointin!7 .Con!+
Di*+ &orship" 9acrament of Anointin! an# Pastoral Care of the 9ic'" ,o*+ 1A" 19A<+ E#+
Typica" :at+ Poly!lot Press" 19A<" p+ ;1" n+ ?/+ Cf+ CCC 1?11+
<1<+ -)i#" n+ @+
<1=+ Cf+ Ecum+ Coun+ :atican --" Constit+ on the 9acre# 1itur!y 9acrosanctum
Concilium" n+ A=+ Cf+ CCC 1?14+
<14+ 7Dy the !race of this sacrament the sic' person recei*es the stren!th an# the !ift
of unitin! himself more closely to Christ6s Passion> in a certain (ay he is consecrate# to
)ear fruit )y confi!uration to the 9a*ior6s re#empti*e Passion7 .CCC 1?<1/+ The sic'
(ho recei*e this sacrament" 7)y freely unitin! themsel*es to the passion an# #eath of
Christ"7 7contri)ute to the !oo# of the people of Co#7 .1C 11/+ 7Dy cele)ratin! this
sacrament" the Church" in the communion of saints" interce#es for the )enefit of the sic'
person" an# he" for his part" throu!h the !race of this sacrament" contri)utes to the
sanctification of the Church an# to the !oo# of all people for (hom the Church suffers
an# offers herself throu!h Christ to Co# the ather7 .CCC 1?<</+
<1?+ Cf+ Con!+ Di*+ &orship" The 9acrament of Anointin! an# Pastoral Care of the
9ic'" nn+ ;$19+
<1@+ Co#e of Canon 1a(" can+ 1BB?> cf+ can+ 1BB4$1BBA+
<1A+ Con!+ Di*+ &orship" The 9acrament of Anointin! an# Pastoral Care of the 9ic'"
n+ <@+ Cf+ CCC 1?<4+
<1;+ -)i#+" n+ <@+
<19+ 7All the )apti4e# (ho can recei*e %oly Communion are o)li!e# to recei*e
:iaticum+ -n fact all the faithful" (ho for any reason are in #an!er of #eath" are )oun# )y
precept to recei*e %oly Communion" an# pastors shoul# ta'e care that the
a#ministration of this sacrament )e not #eferre#" so that the faithful can )enefit from it
(hile they are still in full possession of their faculties7 .-)i#" n+ <A/+
<<B+ Cf+ i)i#" n+ <9+
<<1+ 0ohn Paul --" To the participants at the -nternational Con!ress of the 7Omnia
%ominis7 Association" Au!+ <?" 199B" in -nse!namenti 5---G<" p+ =<;+ 79uch a situation
can threaten the alrea#y fra!ile e2uili)rium of an in#i*i#ual6s personal an# family life"
(ith the result that" on the one han#" the sic' person" #espite the help of increasin!ly
effecti*e me#ical an# social assistance ris's feelin! o*er(helme# )y his or her o(n
frailty> an# on the other han#" those close to the sic' person can )e mo*e# )y an
un#erstan#a)le e*en if misplace# compassion7 .0ohn Paul --" Encyclical E*an!elium
*itae" March <?" 199?" n+ 1?/+
<<<+ Cf+ Con!+ Doct+ aith" Declaration on Euthanasia" May ? 19;B+ in AA9 A< .19;B/
p+ ??1+
<<=+ Cf+ 0ohn Paul --" To the participants at the -nternational Con!ress on Assistance
to the Dyin!" in Oss+ Rom+ March 1;" 199< n+ ?+
<<4+ 7-t is only a human presence" #iscreet an# carin!" (hich allo(s the patient to
e3press himself an# to fin# a human an# spiritual comfort" that (ill ha*e a tran2uili4in!
effect7 .Pont+ Coun+ 7Cor Enum"7 9ome Ethical Juestions Relatin! to the Cra*ely -ll an#
the Dyin!" 0uly <A" 19;1" in Enchiri#ion :aticanum A" Documenti ufficiali #ella 9anta
9e#e 19;B$19;1+ EDD" Dolo!na 19;?" p+ 11?1" n+ 4+=/+
<<?+ Cf+ 0ohn Paul --" To the participants at the -nternational Con!ress on Assistance
to the Dyin!" in Oss+ Rom+ March 1;" 199<" n+ ?+
<<@+ -)i#" n+ 1+ 76-t is in re!ar# to #eath that man6s con#ition is most shrou#e# in
#ou)t6 .C9" 1;/+ -n a sense )o#ily #eath is natural" )ut for faith it is in fact 6the (a!es of
sin6 .Rm+ @:<=/+ or those (ho #ie in Christ6s !race it is a participation in the #eath of the
1or#" so that they can also share his Resurrection7 .CCC 1BB@> cf+ also CCC 1BB9/+
<<A+ 0ohn Paul --" To t(o (or' !roups set up )y the Pontifical Aca#emy of 9ciences"
Oct+ <1" 19;?" in -nse!namenti" :---G<" p+ 1B;=" n+ @> cf+ To the participants at the
-nternational Con!ress on Assistance to the Dyin!" in Oss+ Rom+ March 1;" 199<" n+ ?+
<<;+ 0ohn Paul --" To t(o (or' !roups set up )y the Pontifical Aca#emy of 9ciences"
Oct+ <1" 19;?" in -nse!namenti :---G<" p+ 1B;=" n+ @+ Cf+ CCC 1B1B+ 7Death itself is
anythin! )ut an e*ent (ithout hope+ -t is the #oor (hich opens (i#e on eternity an#" for
those (ho li*e in Christ" an e3perience of participation in the mystery of his #eath an#
resurrection7 .0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ 9A/+
<<9+ Cf+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A<
.19;B/ p+ ?49+
<=B+ -)i#+
<=1+ Cf+ 0ohn Paul --" To the participants at the -nternational Con!ress on Assistance
to the Dyin!" in Oss+ Rom March 1;" 199<" n+ 4+ Cf+ 0ohn Paul --" Encyclical E*an!elium
*itae" March <?" 199?" n+ @?+
<=<+ 0ohn Paul --" To t(o (or' !roups set up )y the Pontifical Aca#emy of 9ciences"
Oct+ <1" 19;?" in -nse!namenti :---G<" p+ 1B;<" n+ ?+
<==+ 7rom this point of *ie(" the use of therapeutic means can sometimes raise
pro)lems7: Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A<
.19;B/ p+ ?49+
<=4+ Cf+ 0ohn Paul --" To t(o (or' !roups set up )y the Pontifical Aca#emy of
9ciences" Oct+ <1" 19;?" in -nse!namenti :---G<" p+ 1B;<+ n+ ?+
<=?+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A< .19;B/ p+
??1+ Cf+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ @?+
<=@+ Cf+ Pont+ Coun+ 7Cor Enum"7 9ome Ethical Juestions Relatin! to the Cra*ely -ll
an# the Dyin!" 0uly <A" 19;1" in Enchiri#ion :aticanum" A" Documenti ufficiali #ella
9anta 9e#e 19;B$19;1+ EDD" Dolo!na 19;?" p+ 11@?" n+ A+<> i)i#+" p+ 114=" n+ <+4+1:
7Earthly life is a fun#amental )ut not a)solute !oo#+ %ence the limits of the o)li!ation to
'eep a person ali*e must )e specifie#+ The #istinctionalrea#y outline#)et(een
6proportionate6 means" (hich must ne*er )e renounce# so as not to anticipate or cause
#eath" an# 6#isproportionate6 means" (hich can )e an#" so as not to fall into therapeutic
tyranny" must )e renounce#" is a #ecisi*e ethical criterion for specifyin! these limits+
%ere the health care (or'er fin#s a meanin!ful an# reassurin! !ui#eline for the
solution of the comple3 cases entruste# to his responsi)ility+ &e are thin'in! in particular
of states of permanent an# irre*ersi)le coma" of tumorous patholo!ies (ith unhappy
pro!nosis" of the a!e# in !ra*e an# terminal states of life+7
<=A+ Cf+ 0ohn Paul --" To the participants at the con!ress of the -talian Association of
Anesthesiolo!y" Oct+ 4" 19;4" in -nse!namenti :--G<" p+ A49" n+ <> To t(o (or' !roups set
up )y the Pontifical Aca#emy of 9ciences" Oct+ <1" 19;?" in -nse!namenti :---G<" p+
1B;<" n+ 4+
<=;+ or the )elie*er 7pain" especially that of the final moments of life" assumes a
special meanin! in Co#6s sal*ific plan"7 as 7a participation in the passion7 an# 7union
(ith the re#empti*e sacrifice7 of Christ+ or this reason the Christian can )e freely
in#uce# to accept pain (ithout alle*iation or to mo#erate the use of pain'illers: cf+ Con!+
Doct+ aith" Declaration on Euthanasia" May ? 19;B" in AA9 A< .19;B/ p+ ?4A+
<=9+ Cf+ Pius 5--" To an international assem)ly of #octors an# sur!eons" e)+ <4"
19?A" in A 4? 49 .19?A/ p+ 14A> To the participants at a con!ress on
neuropsychopharmacolo!y" 9ept+ 9" 19?;" in AA9 ?B .19?;/ p+ @94> Con!+ Doct+ aith"
Declaration on Euthanasia" May ?" 19;B" in AA9 A< .19;B/ p+ ?4A+
<4B+ Cf+ 0ohn Paul --" To t(o (or' !roups set up )y the Pontifical Aca#emy of
9ciences" Oct+ <1" 19;?" in -nse!namenti :---G<" p+ 1B;<" n+ 4+
<41+ Cf+ Pius 5--" To an international assem)ly of #octors an# sur!eons" e)+ <4"
19?A" in AA9 49 .19?A/ p+ 144+
<4<+ Cf+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B+ in AA9 A<
.19;B/ pp+ ?4A$?4;+
<4=+ Cf+ Pius 5--" To the participants at a con!ress on neuropsychopharmacolo!y"
9ept+ 9" 19?;" in AA9 ?B .19?;/ p+ @94+
<44+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A< .19;B/ p+
?4;+ Cf+ Pius 5--" To an international assem)ly of #octors an# sur!eons" e)+ <4" 19?A"
in AA9 49 .19?A/ p+ 14@> To the participants at a con!ress on
neuropsychopharrnacolo!y" 9ept+ 9" 19?;" 7DME =<9+7 Cf+ 0ohn Paul --" Encyclical
E*an!elium *itae" March <?" 199?" n+ @?+
<4?+ Cf+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A<
.19;B/ p+ ?4;+
<4@+ Pius 5--" To an international assem)ly of #octors an# sur!eons" e)+ <4" 19?A"
in AA9 49 .19?A/ pp+ 144$14?+
<4A+ Cf+ Pont+ Coun+ 7Cor Enum"7 9ome Ethical Juestions Relatin! to the Cra*ely -ll
an# to the Dyin!" 0uly <A" 19;1" in Enchiri#ion :aticanum A" Documenti ufficiali #ella
9anta 9e#e 19;B$19;1+ EDD" Dolo!na 19;?" p+ 11?=" n+ 4+4+
<4;+ Cf+ Pius 5--" To an international assem)ly of #octors an# sur!eons" e)+ <4"
19?A" in AA9 49 .19?A/ 14?+
<49+ Cf+ Pius 5--" To an international assem)ly of #octors an# sur!eons" e)+ <4"
19?A" in AA9 49 .19?A/ p+ 14=$14@> Con!+ Doct+ aith" Declaration on Euthanasia" May
?" 19;B" in AA9 A< .19;B/ p+ ?4;+ 7-f the patient o)stinately refuses an# persists in
as'in! for the narcosis" the #octor may a!ree to it (ithout there)y )ecomin! !uilty of
formal cooperation in the fault committe#+ This" in fact" #oes not #epen# on the narcosis"
)ut on the immoral (ill of the patient> (hether the anal!esic it !i*en to him or not" his
)eha*ior (ill )e i#entical: he (ill not #o his #uty+7 .Pius 5--" To an international assem)ly
of #octors an# sur!eons" e)+ <4" 19?A" in AA9 49 .19?A/ p+ 14@/+
<?B+ Cf+ Pont+ Coun+ 7Cor Enum"7 9ome Ethical Juestions Relatin! to the Cra*ely -ll
an# the Dyin!" in Enchiri#ion :aticanum A" Documenti ufficiali #ella 9anta 9e#e 19;B$
19;1+ EDD" Dolo!na 19;?" p+ 11?9" n+ @+1+1+ 7Death is the en# of man6s earthly
pil!rima!e" of the time of !race an# mercy (hich Co# offers him so as to (or' out his
earthly life in 'eepin! (ith the #i*ine plan" an# to #eci#e his ultimate #estiny7 .CCC
1B1=/+
<?1+ Pont+ Coun+ 7Cor Enum"7 9ome Ethical Juestions Relatin! to the Cra*ely -ll an#
the Dyin!" in Enchiri#ion :aticanum A Documenti ufficiali #ella 9anta 9e#e 19;B$19;1+
EDD" Dolo!na 19;?" p+ 11?9" n+ @+1+<+
<?<+ Cf+ Ecum+ Coun+ :atican --" Past+ Constit+ Cau#ium et spes" n+ 1;> 0ohn Paul --"
Apost+ 1etter 9al*ifici #oloris" in -nse!namenti :-- 11" ===$==?" n+ 1?> To the participants
at the Meetin! of the Pontifical Aca#emy of 9ciences on 7Determinin! the Moment of
Death"7 Dec+ 14" 19;9" in -nse!namenti 5--G<" p+ 1?<A" n+ 4+
<?=+ Cf+ 0ohn Paul --" To the participants at the Meetin! of the Pontifical Aca#emy of
9ciences on 7Determinin! the Moment of Death"7 Dec+ 14" 19;9" in -nse!namenti 5--G<"
1?<=$1?<9" n+ 4+
<?4+ Cf+ i)i#+
<??+ Pius 5--" To a !roup of #octors" ,o*+ <4" 19?A" 7DME 4=<" 4=4+7
<?@+ 0ohn Paul --" To the participants at the meetin! of the Pontifical Aca#emy of
9ciences on 7Determinin! the Moment of Death" 7 Dec+ 14" 19;9" in -nse!namenti 5--G<+
1?<=$1?<9+ n+ @+
<?A+ Cf+ Pontifical Aca#emy of 9ciences" Declaration on the Artificial Prolon!ation of
1ife an# Determinin! E3actly the Moment of Death" n+ 1+
<?;+ Con!+ Doct+ aith" -nstruct+ Donum *itae" e)+ <<" 19;A" in AA9 ;B .19;;/ A?$
A@> cf+ 0ohn Paul --" To the participants at the Thir# Ceneral Assem)ly of the &orl#
Me#ical Association" Oct+ <9" 19;=" n+ <+
<?9+ Cf+ 0ohn Paul --" To the participants at a meetin! of the 7Mo*ement for 1ife" 7
Oct+ 1<" 19;?" in -nse!namenti :---G<" 9==$9=@ n+ <+
<@B+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A< .19;B/ p+
?44+ Cf+ 0ohn Paul --" Encyclical :eritatis splen#or" n+ 1=+
<@1+ Cf+ Pius 5--" To the con!ress of the -talian Catholic Enion of O)stetricians" Oct+
<9" 19?1" in AA9 4= .19?1/ p+ ;=;+ 79cripture specifies the prohi)ition containe# in the
fifth comman#ment: 7Do not slay the innocent an# the ri!hteous7 .E3+ <=:A/+ The
#eli)erate mur#er of an innocent person is !ra*ely contrary to the #i!nity of the human
)ein!" to the !ol#en rule" an# to the holiness of the Creator+ The la( for)i##in! it is
uni*ersally *ali#: it o)li!es each an# e*eryone" al(ays an# e*ery(here7 .CCC <<@1/+
<@<+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A< .19;B/
?44$?4?+ 7-t is un8ustifie# to #iscriminate )et(een the #ifferent life sta!es+ The ri!ht to life
is still intact in an ol# person" e*en if he or she is *ery #e)ilitate#> an incura)ly ill person
#oes not lose it+ -t is no less le!itimate in the ne()orn chil# than in the mature person7
Con!+ Doct+ aith" Declaration on Procure# A)ortion" 0une 1;" 19A4" in AA9 @@ .19A4/
A=A$A=;+
<@=+ 0ohn Paul --" To the Association of -talian Catholic Doctors" Dec+ <;" 19A;" in
-nse!namenti 1" p+ 4=;+
<@4+ 0ohn Paul --" To the &orl# Con!ress of Catholic Doctors" Oct+ ="19;<" in
-nse!namenti :G= @A1+
<@?+ Cf+ Con!+ Doct aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A< .19;B/
p+ ?4?: 7E*eryone has the o)li!ation of li*in! in conformity (ith Co#6s plan+ :oluntary
#eath" that is suici#e+++is a refusal on man6s part to accept Co#6s (ill an# his lo*in!
purpose+ Desi#es" suici#e is often a #enial of lo*e for oneself" a re8ection of the natural
aspiration for life" a renouncement of one6s #uties of 8ustice an# charity to one6s
nei!h)or" to the *arious communities an# to society at lar!e" althou!h at times there
may )eas (e 'no(psycholo!ical factors (hich attenuate or" in#ee#" ta'e a(ay
responsi)ility+ A clear #istinction shoul# )e ma#e" ho(e*er" )et(een suici#e an#
sacrifice ma#e for a hi!her moti*esuch as Co#6s !lory" the sal*ation of souls" ser*ice
to one6s nei!h)or)y (hich one !i*es one6s life or puts it in #an!er7 .i)i#+/+
<@@+ %oly 9ee" Charter on the Ri!hts of the amily" art+ 4 la+
<@A+ Ecum+ Coun+ :atican --" Past+ Constit+" Cau#ium et spes" n+ ?1+ Cf+ Paul :-" To
the participants at the 55--- ,ational Con!ress of the Enion of -talian Catholic 0urists" in
AA9 @4 .19A</ pp+ AA@$AA9+
<@;+ Cf+ 0ohn Paul --" To the representati*es of the 7Mo*ement for life" 7 0an+ <?"
19;@" in -nse!namenti -5G1" 19B$19<" n+ =+
<@9+ Cf+ 0ohn Paul --" To t(o international !roups of scholars" ,o*+ =" 19A9" in
-nse!namenti --G<" pp+ 1B=4$1B==?+
<AB+ 0ohn Paul --" Encyclical E*an!elium *itae" March <?" 199?" n+ 4+
<A1+ Cf+ 0ohn Paul --" To the Association of -talian Catholic Doctors" Dec+ <;" 19A;" in
-nse!namenti - p+ 4=; Con!+ Doct+ aith Declaration on Procure# A)ortion" 0une
1;"19A1" in AA9 @@ .19A4/ A44" n+ <4+ 79ince the first century the Church has affirme#
the moral e*il of e*ery procure# a)ortion+ This teachin! has not chan!e# an# remains
unchan!ea)le+ Direct a)ortion" that is to say" a)ortion (ille# either as an en# or a
means" is !ra*ely contrary to the moral la(+ 6Hou shall not 'ill the em)ryo )y a)ortion
an# shall not cause the ne()orn to perish6 . Di#ache <" </7 .CCC <<A1/+ <A<+ Cf+ Con!+
Doct+ aith" Declaration on Procure# A)ortion" 0une 1;" 19A4" in AA9 @@ .19A4/ A=9+
<A=+ C Pius 5-- To 7ace of the amily7 an# the 7Associations of 1ar!e amilies" 7
,o*+ <A" 19?1" in AA9 4= .19?1/ p+ ;?9+
<A4+ Cf+ 0ohn Paul --" To the participants at a meetin! for o)stetricians" 0an+ <@" 19;B"
in -nse!namenti ---G1" p+ 194" n+ =+
<A?+ Con!+ Doct+ aith" Declaration on Procure# A)ortion" 0une 1;" 19A4+ in AA9 @@
.19A4/ A44+ n+ <<+
<A@+ -)i#" n+ <4+
<AA+ Co#e of Canon 1a(" can+ 1=9;+ 1atae sententiae means that the
e3communication nee# not )e pronounce# )y authority in e*ery sin!le case+ -t is
incurre# )y anyone (ho procures an a)ortion )y the simple fact of ha*in! *oluntarily
procure# it (hile a(are of the e3communication+
<A;+ Cf+ Co#e of Canon 1a(" can+ ;A1+
<A9+ 0ohn Paul --" To the participants at the ?4th Ep#atin! Course of the Catholic
Eni*ersity" 9ept+ @" 19;4" in -nse!namenti :--G<" ===$==4+
<;B+ -)i#+" p+ ==4" n+ =+ 7&hate*er its moti*es an# means" #irect euthanasia consists
in puttin! an en# to the li*es of han#icappe#" sic' or #yin! persons+ -t is morally
unaccepta)le7 .CCC <<AA/+
<;1+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A< .19;B/
pp+ ?4?$?4@+
<;<+ Cf+ 0ohn Paul --" To the participants at the --- &orl# Con!ress of the
7-nternational Colle!e of Psychosomatic Me#icine"7 9ept+ 1;" 19A?+ in AA9 @A .19A?/
?4?+
<;=+ Con!+ Doct+ aith" Declaration on Euthanasia" May ?" 19;B" in AA9 A< .19;B/ p+
?4@+ Cf+ 0ohn Paul --" To the participants at the -nternational Con!ress on Assistance to
the Dyin!" in Oss+ ROm+ March 1;" 199<" nn+ =" ?+
<;4+ Cf+ 0ohn Paul --" To t(o (or' !roups set up )y the Pontifical Aca#emy of
9ciences" Oct+ <1" 19;?" n+ =+
<;?+ Cf+ 0ohn Paul --" To the participants at a stu#y course on 7human preleu'emias"
7 ,o*+ 1?" 19;?" in -nse!namenti :---G<" p+ 1<@?" n+ ?+
<;@+ Cf+ 0ohn Paul --" To the participants at the ?4th Ep#atin! Course of the Catholic
Eni*ersity" 9ept+ @" 19;4" in -nse!namenti :--G<" p+ ==4" n+ 4+