Happy First Friday of May. Much of this post is compiled from previously-published articles, lightly edited.
Medicine and Morals by Dr. John Marshall (N.Y.: Hawthorn, 1960, hc, 1960 imprimatur) is part 129 of the Twentieth-Century Encyclopedia of Catholicism edited by Henri Daniel-Rops. I found thirty-two volumes of the encyclopedia at an estate sale. Marshall’s book is surprisingly modern in its concerns, including discussion of fertility issues, abortion, and end-of-life realities. But it begins with laying down a solid Christian anthropology. It was written when Catholics still maintained a substantial presence in hospitals and overall medical care.
This post contains material previously published in the following: “The Bookends of Catholic Health Care,” Catholic Exchange, Oct. 19, 2022: https://catholicexchange.com/the-bookends-of-catholic-health-care/; “Theology of the Body Versus Body Mutilations,” Crisis, 4/5/23: https://www.crisismagazine.com/opinion/theology-of-the-body-vs-body-mutilations; “The New Abnormal: A Review,” Catholic Exchange, 11/16/22: https://catholicexchange.com/the-new-abnormal-a-review/.
Dismantling the Incarnation: Theology of the Body 2.0?
“My body, my choice” are the words often associated with pro-abortion. “My body, my rights” is Amnesty’s campaign slogan for individuals to have the right to make to make their own choices about their health, body, and sexual life. And thus we now have a society where abortion, transgenderism, surrogacy and various forms of fertility manipulation have become or are becoming the “norm.” We may ask where all these killings and body exploitations will end. The answer is simple: It will end only when we go back to the foundation of the creation of human life and back to our Creator. Our bodies are first and foremost not ours but God’s. “Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price. So glorify God in your body.” (1 Corinthians 6:19-20 ESV)
Pope John Paul II’s catechesis on humans and sexuality, now known as the Theology of the Body (TOB), built on traditional teaching about the two sexes, while adding to Papa Wojtyla’s writing about love, responsibility, complementarity, and marital love as self-giving. The bulk of this work emphasized human beings as endowed with dignity and blessed by having body and soul. Some in the Church thought the Polish pope’s teachings were a little too frank, but while there are still critics of TOB, the teaching has gained widespread acceptance as healthy, realistic, and Catholic.
Three recent developments suggest TOB needs to be revisited. For example, while the USCCB’s doctrinal note on Catholicism and the body seems to stand firm against the scourge of transgenderism, the Catholic Health Association’s response is equivocal. So-called surrogacy (renting a woman’s womb) and various forms of fertility manipulation are corroding notions about parenthood. And on a less-dire but still fraught issue, the Archdiocese of Vienna is promoting Catholic interest in tattoos, perhaps as a way of seeming hip or relevant.
John Paul II’s TOB was anchored in an anthropology still recognizably rooted in Catholicism, whereas the latest developments seemingly treat the body as a platform. Just as the neo-Marxist, post-deconstructive left has assaulted the accepted grammar of many languages by inventing or misusing pronouns, they are likewise assaulting received and manifest wisdom about the human body. As the USCCB notes, “Pope Benedict XVI explained that the natural world has an ‘inbuilt order,’ a ‘grammar’ that ‘sets forth ends and criteria for its wise use, not its reckless exploitation’” (1-2).
Our bodies are our own and our own responsibility up to a point. The USCCB statement goes on to point out, “The body is not an object, a mere tool at the disposal of the soul, one that each person may dispose of according to his or her own will, but it is a constitutive part of the human subject, a gift to be received, respected, and cared for as something intrinsic to the person” (5). This document rests on magisterial teaching from Pius XII and others, outlining the limits of medical intervention in terms of a repair of a defect or sacrificing a part in order to save the whole.
The USCCB draws the line at “alter[ing] the fundamental order of the body” (9) via genetic engineering or transhumanist replacement of the given body by cyber parts. But they especially focus on acceptance of transgender manipulation: “These interventions involve the use of surgical or chemical techniques that aim to exchange the sex characteristics of a patient’s body for those of the opposite sex or for simulations thereof” (10). The statement stresses the incompatibility of such interventions with Catholic health care, which respects God’s gift of the body as immutable and not to be customized at our whim. While acknowledging there are many forms of suffering, including in those who “identify as transgender” (12, n.), this document asserts that just because we can do some things, does not mean we should.
To that assertion the Catholic Health Association (CHA) of the United States (whose motto is “A Passionate Voice for Compassionate Care”) in its brief “Statement on the Doctrinal Note on the Moral Limits to Technological Manipulation of the Human Body” seems not as certain as the bishops of the USCCB. The rhetoric of this statement is non-committal, seeming to affirm Catholic principles but on close reading is full of hints that providers could be free to do as they see fit in order to affirm human dignity. “As public-serving ministries, Catholic health care providers also follow applicable federal and state laws which recognize the freedom of Catholic institutions to follow the ERDs in ways that make our health care authentically Catholic. We remain committed to honoring the human dignity of everyone, including transgender patients and their families, and to providing them with the best possible medical and spiritual care," said Sister Mary Haddad, RSM, CHA president and CEO. This is the Orwellian language of obfuscation, not the grammar of an inbuilt order.
So too is the chaos, heartache, and manipulation in the field of fertility today. What was once the straightforward story of the birds and the bees, has grown into a nightmare. As children we sang about a couple we saw kissing: first comes love, then comes marriage, then comes “Joe” with the baby carriage. No more. There could be no worthwhile children’s song about in-vitro fertilization, egg-freezing, embryo implantation, or surrogacy. CBS News recently ran a multi-part series on “Facing Fertility,” which should, frankly, not be watched while eating. The series introduces us to women experiencing difficulties—biological or self-created—having children. What all this talk and technology boils down to seems not to “empower” women, but rather turn them into mere vectors for harvest or implantation, especially those women who “rent” their womb in order for infertile couples or gay “couples” to have a biological child.
Both transgender mutilation and this interference in God’s plan of new life are heavy going for the average Catholic. The third example provides some relief, since it is—pardon the pun—only skin deep. Anyone with eyes to see has noticed the no-longer shocking proliferation of “body art,” a.k.a. tattoos. Having made it through a 1980s stint in the Navy ink-free, I can now in this century choose to express my Catholicism through tattoos. “As part of a FREE TATTOO WALK-IN,” the press release from the Archdiocese of Vienna declares, “interested parties can choose from a small repertoire of Christian motifs and have them inked by the renowned tattoo artist Silas Becks from Stuttgart.” To kick off the April 15 event, there will be “a tattoo service for colorful people in the Ruprechtskirche (Ruprechtsplatz 1, 1010 Vienna), which will be followed by a discussion at 7:00 p.m. about the controversial position of tattooing in Christianity.” I interpreted this as some sort of liturgy for the tattooed. Don’t worry. The artist is a “devout Catholic” and the sponsor for the event is Quo vadis? An Institution of the Religious Orders of Austria.
Where does all this leave us? In the quicksand of our corrupted times, when Frankenstein is introductory reading in medical ethics and people have willingly become living billboards. As a quick antidote I suggest reading “Song of Songs.” It’s a story lacking surgically manipulated bodies and with no ink in sight. In short: a theology of the body. Amen.
The Bookends of Catholic Health Care
Could anyone have predicted that less than a quarter of the way through the twenty-first century, many of us would be seriously questioning the ethics, practices, and philosophies of one of the most powerful segments of our society, the medical establishment? But the COVID-19 pandemic upended many of our assumptions and presuppositions. “Losing trust in doctors and the medical establishment is a sad consequence of the pandemic,” writes physician Dr. Joel S. Hirschorn. Given this significant upheaval in our dealings with the medical world, now is a good time for Catholics to remind themselves of the Catholic roots of medicine and how the Faith can help put all things medical back into a properly-ordered system. Fortunately, we have a number of guides to help us.
It is no exaggeration to say that the Catholic Church laid the foundation for modern medical infrastructure and practice. Unfortunately, the medical establishment and its partner, the insurance industry, have moved into a post-modern era where tradition is devalued and superseded in the name of efficiency. Many of the popes of the past 150 years have addressed medicine and medical care; the Catechism of the Catholic Church (CCC) touches on sickness in several locations, especially in Part Two, Chapter Two, Article Five.
For a particularly well-written book dealing with the destruction of the older model of medicine we have God’s Hotel: Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine (hereafter GH) by physician and historian of medicine Victoria Sweet. In it she tells with fascinating and colorful detail of changes in a public hospital alongside her studies of St. Hildegard of Bingen and lessons from the Camino to Compostela. For insights concerning paths forward to a renewed authentically Catholic vision of health and medicine, there are the critiques of Catholic psychiatrist Dr. Aaron Kheriaty and the advice of Melody Lyons in The Sunshine Principle: A Radically Simple Guide to Natural Catholic Healing (hereafter SP), a corrective to freeform New Age health advice. To bring our story full-circle, Lyons frequently refers to St. Hildegard in her overview of Catholic medicine and health.
What makes Catholic medicine and healthcare different? Compassion. The Greeks and others had extensive knowledge of herbs and aspects of bodily health. To this compendium of knowledge Christians added a view of all human beings as made in the image and likeness of God; they also took to heart scriptural admonitions to practice charity as if to Christ Himself. Jesus taught medical principles through His incarnation and His concern for healing bodily and spiritual illnesses and afflictions. We have only to think of the Lord’s parable of the Good Samaritan and how he combined care for his neighbor with generosity and treatment of the injured man’s wounds. This concern for the poor, the traveler, and—in general—the neighbor, fueled the development of hospices, hospitals, medicine, and religious orders devoted to care for the sick. There are also many examples of Catholic saints who were healers and tended to the sick: St. Luke, Ss. Cosmas and Damian, St. Pantaleon, St. Damien of Molokai, St. Marianne Cope, and St. Gianna Beretta Molla. Although physician care and nursing is now done primarily by secular laity, there are still religious orders today specifically dedicated to the sick such as the Dominicans of Hawthorne and the Little Workers of the Sacred Hearts, the latter made well-known recently by surgeon Sister Deirdre Byrne.
In looking at western medical history, many in the medical field--Catholic or not—consider St. Hildegard of Bingen to embody medical wisdom as known in the Middle Ages. The polymath nun’s book on medicine “surprised” Victoria Sweet: “Before the reductive modern medicine I’d learned in medical school, there had been a different medical system in the West….It’s approach, I realized as I studied Hildegard’s medicine, was not mechanistic: The body was not imagined as a machine nor disease as a mechanical breakdown” (GH, 5). Learning about Hildegard helped Sweet try to recover aspects of medicine such as observation, relationship, and even thinking about diagnoses in conjunction with explanatory methods like the four ancient elements of air, water, fire, and earth. It shouldn’t surprise anyone that an emphasis on herbs and elements would beckon New Age practitioners, some of whom have tried to appropriate Hildegard for decidedly un-Catholic purposes. The key to properly situating Hildegard within the Faith is obedience, writes Melody Lyons: “[New Agers] miss the point that connecting and yielding to God’s order ultimately brings the greatest freedom. [Hildegard] was a spirited, bold, prolific, artistic, preaching polymath, and yet still submissive to the laws of Christ, the teachings of the Church, and the Rule of Saint Benedict” (SP, 4).
Pope Benedict XVI recognized St. Hildegard’s qualities in his Apostolic Letter Proclaiming Saint Hildegard of Bingen, professed nun of the Order of Saint Benedict, a Doctor of the Universal Church: “Human beings are seen as a unity of body and soul. The German mystic shows a positive appreciation of corporeity and providential value is given even to the body’s weaknesses. The body is not a weight from which to be delivered. Although human beings are weak and frail, this “teaches” them a sense of creatureliness and humility, protecting them from pride and arrogance.” Such a view is far, far away from the hedonistic and fear-driven world of materialistic medicine ascendant in the twenty-first century. It is also a bulwark against the growing threat of transhumanism.
Fulfilling their role as teacher and shepherd, Popes have spoken about the proper moral approach to medicine, sickness, and health. In his 1952 address, “The Moral Limits Of Medical Research And Treatment,” Pius XII noted that, while it is doctors who decide about medical procedures, they do so in collaboration with the patient, who is a moral being in his own right. The Church and civil government also have roles to play. In 1954 the same pope commented on ethical considerations in medical practice and warned the assembled doctors that “the demands of natural morality, which forbid us to consider and treat the body of a human being merely as a thing, or as that of an animal, must at all times be dutifully respected.” Three decades closer to our time, John Paul II in the apostolic letter Salvifici Doloris wrote: “Human suffering evokes compassion; it also evokes respect, and in its own way it intimidates. For in suffering is contained the greatness of a specific mystery.” He expounds on this theme further in the same document, pointing out medicine’s limits: “Medicine, as the science and also the art of healing, discovers in the vast field of human sufferings the best known area, the one identified with greater precision and relatively more counterbalanced by the methods of ‘reaction’ (that is, the methods of therapy). Nonetheless, this is only one area. The field of human suffering is much wider, more varied, and multi-dimensional. Man suffers in different ways, ways not always considered by medicine, not even in its most advanced specializations. Suffering is something which is still wider than sickness, more complex and at the same time still more deeply rooted in humanity itself.” Contrast this to the widespread (though anecdotal) belief that doctors see themselves in “godlike” terms. Medicine as known by Hildegard and others throughout tradition firmly rejected any self-aggrandizement, instead giving God the credit for healing and medical knowledge.
As a final example along these lines, consider an October 2022 letter in the Wall Street Journal from a Catholic M.D. regarding contraception. The doctor writes that “In my 43 years as a family physician, I found that Catholic moral teaching helped me and my patients, including non-Catholics, lead happier lives.” That approach would seem at odds with a medicine that treats patients as “platforms” on which different treatments or replacement parts can be loaded, not to mention an algorithm-driven practice of inputting data and breaking down exams into proper codes and time chunks.
Before considering the trends and causes of the destruction of traditional Catholic medicine, it is instructive to briefly focus on how throughout the past 2000 years Catholicism has responded to one of the most fearsome of scourges—plague, as well as epidemics and insidious diseases such as leprosy. Even in the first century, society noticed that Christians cared for the victims of plague. Certainly not every Catholic rushed to help plague victims, but many canonized saints and others did. St. Roch recovered from plague and is often invoked against disease. St. Charles Borromeo ministered to people in sixteenth century Italy and his (un-canonized) cousin Federico supply moving depictions of faith during plague in Alessandro Manzoni’s classic The Betrothed. St. Aloysis Gonzaga died from helping during an epidemic. St. Damien of Molokai was infected with and died from leprosy while ministering to lepers. And in the twentieth century, Blessed Pier Giorgio Frassati most likely contracted polio from his work with the sick.
How did both traditional and Catholic medicine go astray? By losing sight of the compassionate and faith-filled approach to patients—made by God—and instead embracing systems, efficiency, technology, pharmaceuticals, and government intrusion. As the CCC (2288) puts it: “Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them, taking into account the needs of others and the common good. Concern for the health of its citizens requires that society help in the attainment of living-conditions that allow them to grow and reach maturity: food and clothing, housing, health care, basic education, employment, and social assistance.” Sweet sums up the final change in her hospital as it moved from an older, still recognizably rooted in the Medieval model to a 21st Century paradigm: “In the new Laguna Honda, the old-fashioned ‘medical model’ of physicians would be replaced by a ‘social model’—whatever that was—and ‘health-care workers,’ nurses, social workers, and psychologists not physicians, would take care of ‘clients’” (GH, 325). It should be noted that Laguna Honda cared for many homeless and mentally-ill patients, but the changes reflect trends throughout medical systems, especially in the U.S.
Additional factors include the effect of medical insurance on all healthcare in terms of cost, focus, scheduling and bureaucracy. Because Catholic hospitals are so prevalent in the U.S., many places are dominated by them. This, plus an erosion of the Faith in recent decades, means that sometimes both the public and staff forget the avowed Catholic mission of the hospitals. The application of outside pressure from government—especially the federal government—has further challenged and diluted the Catholicism of Catholic medicine and healthcare.
The onset of the COVID-19 pandemic revealed significant weaknesses in both modern healthcare and Catholic medicine, as well as society and Catholicism in general. Fear of infection separated family members from one another and doctors from patients. Debates raged about proper treatments and protection against the disease. Nurses and others were fired for refusing an experimental and novel vaccine. Debates about science were subsumed by politics. Medical ethicists and moral theologians groped for approaches to a divisive disease. Worst of all from a Catholic perspective, bishops around the world closed parishes out of fear of infection and/or imposed harsh and inflexible conditions on the dispensing of the Eucharist. Some times priests were even denied access to dying patients in hospitals and nursing homes. “Predictably, this has left devout Catholics adrift,” writes Auguste Meyrat.
There are many ways medicine can be reformed, but doctors, other providers, nurses, and administrators first need to realize they have lost the trust many people had in them pre-pandemic. Melody Lyons’ suggestions in The Sunshine Principle are a good place to start because they emphasize personal responsibility for health and working to prevent disease and deterioration rather than relying exclusively on medical and chemical interventions after a breakdown in one’s body. Lyons emphasizes nutrition and exercise, but also the spiritual aspects of health which secular medicine often overlooks. In this she is pointing us to the best aspects of pre-modern medicine and a Christ-centered view of humans as body and soul. It does not reject modern medicine, but acknowledges that oftentimes by the time we go to the doctor problems have already gone too far. “Ask any physician, and you’ll find that the majority of medical school is spent learning to diagnose disease, not to prevent it,” she writes (SP, 18).
Isn’t it time Catholics demanded more Catholicism from their health care, especially from Catholic hospitals? There has long been a debate about the separation of Church and state, but must we give in to the separation of Faith and medicine? It’s past time for a robust debate on how to improve medicine, and to return catholic medicine to its Catholic roots of accurate knowledge, compassion, and focus on God’s mission for us in a fallen world.
The New Abnormal: A Review
How do we move ahead in a post-pandemic era? And what are the lessons to be learned from our challenging recent history? Catholic psychiatrist and bioethicist Aaron Kheriaty has thought a great deal about these questions and his answers are found in his just-released book The New Abnormal: The Rise of the Biomedical Security State (Regnery Publishing, 2022). The result is a brilliant mix of scientific observations, personal experiences, philosophical reflections, prudent policy prescriptions, and even a few speculative hints about dystopian possibilities of the near future.
Kheriaty, who lost his previous job as clinical psychiatrist and teacher at UC-Irvine in a dispute over mandated vaccines and natural immunity, begins the book in an unexpected time and place: 1947 Nuremberg. He does this to provide historical context for threats to freedom in our time. He briefly surveys the eugenics movement and its appropriation by the Nazi regime. Germany’s medical professionals were well-trained and as good as any in the world, but they lost their way. “Instead of seeing the sick as individuals in need of compassionate medical care, German doctors became willing agents of a sociopolitical program driven by a cold utilitarian ethos,” writes Kheriaty (xvii). After the war the revulsion at the perversion of medicine led to the Nuremberg Code, which emphasized informed consent as a cornerstone of ethical medical treatment.
That code and other ethical agreements remained as part of the medical-bioethical landscape…until 2020. Kheriaty asserts that “[d]uring the covid pandemic, the public health and medical establishment once again abandoned the principle of free and informed consent to advance a supposed greater good” (xxi). Having laid the groundwork for his argument and narrative, he sums up by issuing this frightening declaration: “The unholy alliance of (1) public health, (2) digital technologies of surveillance and control, and (3) the police powers of the state—what I call the Biomedical Security State—has arrived” (xxii). While this probably seems like a heavy meal to digest, the reader can be assured that Kheriaty writes clearly and is grounded in scientific medicine and a solid ethical worldview. His story, while alarming, is neither conspiracy theory nor exercise in despair.
After the Nuremberg prologue, Dr. Kheriaty continues with four long chapters and an epilogue: “Locked Up: The Biomedical Security State”; “Locked Down & Locked Out: A New Societal Paradigm”; “Locked In: The Coming Technocratic Dystopia”; “Reclaiming Freedom: Human Flourishing in a More Rooted Future”; and, “Seattle, 2030.” Sprinkled throughout what could be a gloomy read, we encounter stories of solidarity and resilience. The author makes sure to show us that human interaction cannot—must not—be stymied by government interference in our lives and the functioning of society. “Consider the human goods we sacrificed to preserve bare biological life at all costs: friendships, holidays with family, work, visiting the sick and dying, worshipping God, and burying the dead” (14). But to resist or even question, we must know as much of a situation’s history as possible. Kheriaty lays out the pieces of the puzzle: states of emergency, agency capture of regulators by the regulated, loosening bonds of social cohesion, and the religion of scientism.
Scientism is distinct from science and scientific inquiry, Kheriaty points out. “The characteristic feature of science is warranted uncertainty, which leads to intellectual humility. The characteristic feature of scientism is unwarranted certainty, which leads to intellectual hubris” (54). In other words, scientism upholds so-called science as the only proper form of knowledge and rejects any questioning or skepticism. It is prone to misuse as a political tool and typically accompanies a materialistic worldview. That heavy-handed framework clashes with how science and medicine have long operated through trial and error, experimentation, imaginative solutions, and, most of all, respect for individual humans as made in the image and likeness of God.
Kheriaty’s own story makes for a fascinating sub-plot. As a doctor, ethicist, and teacher he was closely involved with figuring out how to respond to covid and help patients. As the lockdowns unfolded he encountered staggering amounts of fear, worry, and depression. His grasp of bioethics and knowledge of history led him to speak out against new methods of trying to control spread of the covid virus, especially when they superseded societal freedom and individual liberty. “Freedom of movement, of association, of domicile in one’s country of origin, and access to public spaces and public events—these quickly went from basic rights to special privileges conferred by governments as rewards for good behavior” (68). His medical training also led him to critique the development and imposition of a new and mostly untested vaccine. In his own case, he fought against a mandatory vaccination because of a prior covid infection. His argument at the time did not prevent him from being fired. He also touches on the devastating impact of restrictions on work and supply chains.
Indeed, that is one of the constant themes of this book: technology and safety should never eclipse the humanity of our lives. For instance, “[t]here is clearly no such thing as a medication—or a vaccine—that’s always good for everyone in every circumstance all the time” (137). Technology and cultural immersion endanger our sense of ourselves and nudge us to trade autonomy and dignity for convenience. “Today, routine biometric verification for things from mobile phones to lunch lines gets young people used to the idea that their bodies are tools used in transactions” (155). Connected to abuse of genetic and biometric data is the ominous specter of transhumanism, which Kheriaty characterizes as “clearly a religion—a particular type of neo-Gnostic religion” (167). To all these dehumanizing trends the author counsels resistance, but emphatically “nonviolent resistance and civil disobedience” (184).
The book’s final chapter lays out policy proposals for steering clear of dystopia. I found this chapter to be only somewhat persuasive. Kheriaty’s suggestions are certainly prudent and logical; however, they mostly deal with changing the political and medical climate. But bureaucracy and institutional entropy are like the invasive Japanese Knotweed in my back yard, which is to say impossible to eradicate. On other points Kheriaty is spot-on. “The first and most necessary step is to overcome our fear,” he writes (191). And [t]he enemy is not pain or illness. The enemy is fear. The enemy is hatred or indifference toward our fellow human beings” (192). Fear of death was manifest during the pandemic. As Catholics, we are taught to not fear death, but rather to spend our lives preparing for it and to live in a state of grace. During a pandemic or even “normal” times we can bear witness to Christ by living with courage and fighting fear. We can also resist mask mandates that dehumanize us and separate us from others, covering up our God-created uniqueness. Of importance to religious believers, we can engage with our faith authorities to make sure no one is abandoned again because “too many religious leaders and clergy unfortunately showed themselves during the pandemic to be willing chaplains to the new technocracy” (204).
Readers should not skip the epilogue, in which Kheriaty (a native of the Pacific Northwest) posits a dystopian Seattle in 2030. In this uncomfortable scenario, we are asked to consider what life might be like if current trends in pharmaceuticals and their marketing are joined with further developments in social control to create a two-tiered society reminiscent of many well-known alternative futures in literature and movies. Thankfully, Dr. Kheriaty lightens a somber story with some wry humor.
While The New Abnormal is not an explicitly Catholic book, Aaron Kheriaty founds it in Catholic principles of justice, humanity, clear philosophical first principles, subsidiarity, solidarity, and important spiritual goods. He brings in examples from classical and contemporary philosophy, C.S. Lewis, and George Orwell. The prose is clear but some of the concepts can be a little heady at times. This is a valuable piece of work from a man with unique qualifications. His is a prophetic voice calling us to understand and take action while never forgetting the God Who made us.