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Spirituality, Religious Wisdom, and the Care of the PatientSpirituality, Religious Wisdom and the Care of the Patient Sidney Callahan Sidney Callahan, Ph.D., holds the McKeever Chair in Moral Theology at St. John’s University, Queens, New York. She is a columnist for Commonweal Magazine and a board member or consultant for numerous secular and Catholic organizations that concern ethics and public life including the Notre Dame Center for Ethics and Culture, the Catholic Common Ground Initiative, and the Hastings Center. She is the author of many books including In Good Conscience: Reason and Emotion in Moral Decision Making and Abortion: Understanding Differences (co-edited with Daniel Callahan). Thank you for providing this wonderful series and for asking me to take part in this session on Dignity And The Care Of The Patient: An Islamic/Catholic Dialogue I will begin with some general thoughts about spirituality and then move to some resources that the Catholic religious tradition has to offer for patient care. Many Spiritualities Catholic belief in God’s Life Giving Holy Spirit working everywhere in the world, and especially within human hearts and minds leads to the acknowledgment that many different spiritualities exist. The “spirit,” is generally used to refer to an inner dimension of the person. This spiritual core can be seen as the deepest center of the person. It is here that a person reflects and experiences ultimate reality. An ultimate reality will necessarily transcend the individual in some way and include more things than what can be easily seen or touched. Spirituality will concern the highest values held by a person and is a universal characteristic of human beings. As Michael Downey a Christian theologian writes in Understanding Christian Spirituality, “All human beings are spiritual in so far as all have the capacity to know and be known, to love and be loved, to be free and enable others to be free.” (p.33) Many other definitions of spirituality stress the depth, inwardness and ultimate grounding of the spiritual quest for meaning. It is clear that human spirituality can take different forms. Certainly, spirituality is not confined to organized religious groups or traditional faiths holding to doctrinal beliefs and traditions. In defining spirituality you do not have to start from the top, as Catholics do, with the Holy Spirit, identified as one Divine person of the Triune God. The slippery word “spirit,” with a small s, can refer to the human spirit. Spiritual experiences can refer to moments of heightened consciousness and episodes of awareness infused with deep meaning, intense emotional investment and aesthetic character. A transcendent “secular spirituality” can exist without any recognition of a Divinity or Creator that exists beyond the natural world of humankind. Today we see secular spiritualities that emerge in human experiences of art, music, nature, exercise, sex, diet, crystals, dreams, creative work, martial arts, or even fly fishing. Many practices that give aesthetic pleasure and heightened cognitive awareness are meaningful to persons and are not always attributed to an ultimate Divine Reality. When people tell you, “ I’m spiritual but not religious,” they can be referring to their meaningful moments of secular spirituality or “stripped down” spirituality. Another level in a spiritual quest may acknowledge some ultimate reality beyond the natural world but not to membership in an organized doctrinally defined faith. Here the person seeks transcendent meaning by getting in touch with, or becoming atuned to some larger reality of Spirit, with a capital S-- a Great Spirit, or World Spirit, or Higher Power. Persons pursue the Spirit through inner spiritual meditation, prayer, worship, vision quests or a disciplined practice. Psychologists have studied “peak experiences,” or epiphanies of various kinds which induce a belief in a benevolent ordered reality beyond the human sphere. When experiences of a Spirit is identified with goodness and benevolence, then the seeker can feel the need to respond with right action and corresponding compassion. Spiritual seekers then embrace the moral requirements of behaving with truth and compassion, perhaps in the disciplined path of an eight fold way or a twelve step program. The numinous experience of a transcendent reality and the ethical imperative become fused. Many eclectic forms of stripped down spirituality exist in America; they often attract seekers who have an allergy to highly doctrinal and organized religious institutions. Monotheistic Religions and Spirituality There is nothing stripped down about the spirituality present in highly traditional monotheistic religions in which the Spirit is affirmed as Personal Creator, and a transcendent wholly Other, Holy One. The Sons of Abraham, within Judaism, Christianity and Islam are peoples of the book who worship a God Who is a Self-Revealing Creator. In Christianity God is both transcendent and immanent in history, acting to reveal GodSelf and to save humankind. Traditional world-wide high religions, have inspired scriptures, prophets and worshipers who give birth to ongoing historical communities. Through institutions continuity of doctrine and spiritual practice is achieved. Reforming groups also produce sects and schisms. Traditional religions provide “well winnowed” guidance for the spiritual seeker. In Christianity the Holy Spirit is worshiped as creatively working within the world to inspire, heal, console, empower and sanctify human hearts, inspire the Church community, and redeem the whole of creation. I think a Christian can claim that the aspirations of the human spirit in secular spiritualities and in stripped down spiritualities are manifestations of God as Holy Spirit. Once, however, you assert that the creation is not identical with God, but rather is God’s good work, doctrines of pantheism will not apply. With the Christian doctrine of Incarnation, i.e. that God enters history as a truly human being, then it follows that historical embodied humans keep their unique identities for eternity. The resurrection of the body assures Christian worshipers that they will not melt away into some form of Nirvana or collective entity. Once a seeker gets caught up in a “non-stripped down” “non-secular” spirituality of a traditional high religion, the way to holiness requires effort–lots of blood, sweat and tears. The arduous path of spiritual discipline leads away from egotism, illusion and self-deception–as well as toward joyful celebration. In Christianity, the God of Love, Three Persons in One, desires the healing and happiness of humankind. Human beings are created in God’s image and viewed as an eternal part of a good creation. Grace builds on nature and humankind is called to participate in God’s Divine Life of the Trinity, through union with Jesus Christ, truly human and truly divine. God becomes human so that humans can become God. Humans fully alive are the glory of God. Spirituality is a process of “perfecting a person’s humanity” by living in the “simple loving presence of God,” a process that entails what the great theologian Karl Rahner calls “the mysticism of everyday life.” Every thought, feeling and act is important, whatever you do in both word and work do for the glory of God. Implications and Resources for Catholic Health Care All Catholics are commanded to become holy and love their neighbor in imitation of Christ’s love for the world. They must seek to know God’s will through consulting the authority of Scripture, reason, the traditions and teachings of the church, the examples of great saints and theologians, and human experience. Today Catholics acknowledge that the Church is a learning church reading the signs of the times. As a living communion the Church must evolve and develop under the guidance of the Holy Spirit. Since faith and reason arise from the same Divine Creator, there can never be any ultimate contradiction between the truths of faith, morals, science or good medicine. Catholic doctrine affirms that God is a Trinity, three in one giving and receiving and fruitfully generating more love. Ultimate reality is a dynamic mutual relationship of love. So humankind is also basically embedded and embodied in relationships; we are members of one another, one family, one body. In the Trinity there is union in difference so humankind also is different and various, as well as one. God delights in difference and gives individuals the freedom to be unique. Different gifts and roles and styles are celebrated. Catholics respect the sanctity of the individual but also know that there is an intimate corporate unity of all. The philosopher Charles Taylor reminds us that there are “together goods” which we can only enjoy with others and in common. Isolated individuals cannot participate in the goods of mutuality and communion. Catholic moral theology tries to balance the good of the whole community with that of the individual, since they flourish together. While ethics and religion can be intellectually analyzed as different enterprises, Catholics who have faith in reason as a gift of God, will usually see them as practically integrated. Both faith and reason are grounded in a way of life. Moral reasoning can be shared with the world in the assurance that it will be accepted by all persons of good will. Reasons are important and become most convincing when they lead Catholics to live a life of charity and truth. One basic moral foundation for the vocation of health care workers is justice. Paul VI taught that “Justice is love’s absolute minimum.” The ideal of “just care” requires that all human beings be treated with dignity and equal respect. All humans are made in the image of God and as morally equal cannot be discriminated against or denied care. No one earns their intrinsic dignity which is a gift from God. All human beings no matter what their abilities or stage of growth possess an inalienable dignity granted by the Creator. Just care demands accountability from all. Everyone is responsible for good work according to the highest moral standards. Professional competence and effort is required from Christians who must also strive to make human institutions and social structures just. Catholic spirituality is always social and mindful of human dignity. Health professionals respect the dignity of their patients by being the best nurse, physician, or health care worker that they can be. Those who are called to heal, comfort and relieve suffering imitate the work of Christ the great physician. Christ comes to heal and comfort his people. Christ heals bodies, minds and hearts; he saves and liberates persons from sin. Every suffering to be relieved in the practice of the works of mercy, traditionally divided into corporal or spiritual works of mercy. All of these acts of loving service are devoted to relief of suffering. Christian disciples are told to see Christ in everyone and relieve their suffering as a way to love their neighbor. Great saints followed Christ in setting up hospitals and caring for the poor. Rodney Stark in The Rise Of Christianity claims that Christians prevailed in the ancient world because they nursed the sick during plagues and performed other acts of love for neighbors who were not their kin. To show mercy is to act with loving kindness, courtesy, respect and care as though caring for Christ. A gracious care giver may not be able to cure a patient but they can always respect their dignity and give comfort. On important doctrine within the Catholic tradition is the dignity given to the human body. God is embodied in the Incarnation and born of woman lives a fully human life. Jesus, son of Mary, the Mother of God, was vulnerable and could suffer, even to the horror of an unjust shameful death. Jesus also could share the joys of humankind and celebrate with all in table fellowship. Christ transcended the purity laws and declared all embodied life to be clean and good. Only things that come from the heart can create impurity, nothing that comes out of the body. To have a human body is to have dignity since it is like Christ, God incarnate. Christ accepts all of humankind, especially the poor and vulnerable such as women and children. The diseased and despised such as lepers the mentally ill, and sinners are accepted as beloved by God. All the ills and sufferings of flesh are accepted and healed. No one can lose dignity through their sufferings, impairments or disfigurements. Patients have their dignity respected in just care and their responsibilities are also recognized. Care giving is a relationship and patients who are equal in moral dignity can share in their treatment when it is possible. They can cooperate in their care and healing. They can communicate their privileged knowledge so it is important for care givers to take time to inform them and to listen to them. Patients have information and resources for cooperating in their treatment and healing. A patient’s spirituality and spiritual resources should be respected as well. Care givers should neither fear, or censor a patient’s explorations or expressions of spirituality. Why not take a spiritual history on intake? Spiritual autobiographies are enlightening, especially for atheists and agnostics. While nearly ninety percent of Americans report a belief in God, far fewer professionals do so. A patient might easily feel more free to share intimate sexual matters, than bring up prayer or experiences of God. In a secularized milieu, religion can be the original “don’t ask, don’t tell,” topic. Catholic tradition should counter these trends and welcome spiritual explorations and resources. Catholics also respect the fact that God acts in many ways and through different kinds of spiritualities, so tact and tolerance are necessary in Catholic healthcare institutions. Should care givers speak of own spirituality? Perhaps they should be reticent, unless asked or in response to the patient’s lead. In any situation where there is an asymmetry of position, power, or health, it is important to avoid intrusiveness or subtle coercion. I would speak of my faith and spiritual hopes and practices only if asked. A Christian could pray for a patient and for guidance, but not pray with them unless it was specifically requested. Yet surely, spiritual resources should be offered and made available to patients in a Catholic institution, unaccompanied by pressure. The Christian commitment to benevolent care and the relief of suffering can be communicated in large and small ways. As St. Francis said, “Always preach the gospel, sometimes use words.” Deeds and empathy, beneficence, courtesy and respect for the dignity of patients as fellow children of God will convey the good news. A care giver should be trustworthy and never lie, but always make an effort to offer patients hope for as full a life as is possible for them-- even if no cure is possible. Always, Christian care givers can be grateful for their vocation of healing. They can demonstrate gratitude to their patients for the privilege of caring for them. Published: March 22, 2002 |
