CONGREGATION FOR THE DOCTRINE OF THE FAITH
Letter
SAMARITANUS BONUS
on the care of persons in the critical and terminal phases of life
Introduction
The Good Samaritan who goes out of his way to aid an injured man (cf. Lk 10:30-37) signifies Jesus Christ who encounters man in need of salvation and cares for his wounds and suffering with “the oil of consolation and the wine of hope”.[1] He is the physician of souls and bodies, “the faithful witness” (Rev 3:14) of the divine salvific presence in the world. How to make this message concrete today? How to translate it into a readiness to accompany a suffering person in the terminal stages of life in this world, and to offer this assistance in a way that respects and promotes the intrinsic human dignity of persons who are ill, their vocation to holiness, and thus the highest worth of their existence?
The remarkable progressive development of biomedical technologies has exponentially enlarged the clinical proficiency of diagnostic medicine in patient care and treatment. The Church regards scientific research and technology with hope, seeing in them promising opportunities to serve the integral good of life and the dignity of every human being.[2] Nonetheless, advances in medical technology, though precious, cannot in themselves define the proper meaning and value of human life. In fact, every technical advance in healthcare calls for growth in moral discernment[3] to avoid an unbalanced and dehumanizing use of the technologies especially in the critical or terminal stages of human life.
Moreover, the organizational management and sophistication, as well as the complexity of contemporary healthcare delivery, can reduce to a purely technical and impersonal relationship the bond of trust between physician and patient. This danger arises particularly where governments have enacted legislation to legalize forms of assisted suicide and voluntary euthanasia among the most vulnerable of the sick and infirm. The ethical and legal boundaries that protect the self-determination of the sick person are transgressed by such legislation, and, to a worrying degree, the value of human life during times of illness, the meaning of suffering, and the significance of the interval preceding death are eclipsed. Pain and death do not constitute the ultimate measures of the human dignity that is proper to every person by the very fact that they are “human beings”.
In the face of challenges that affect the very way we think about medicine, the significance of the care of the sick, and our social responsibility toward the most vulnerable, the present letter seeks to enlighten pastors and the faithful regarding their questions and uncertainties about medical care, and their spiritual and pastoral obligations to the sick in the critical and terminal stages of life. All are called to give witness at the side of the sick person and to become a “healing community” in order to actualize concretely the desire of Jesus that, beginning with the most weak and vulnerable, all may be one flesh.[4] It is widely recognized that a moral and practical clarification regarding care of these persons is needed. In this sensitive area comprising the most delicate and decisive stages of a person’s life, a “unity of teaching and practice is certainly necessary.”[5]