The pope is designated to be the “Good Shepherd” for the entire Roman Catholic flock. In his role as leader of the world’s Catholics, a pope pronounces and endorses dogmas that every practicing Catholic must believe. Despite what many think, there are few Catholic dogmas, and these dogmas are restricted to areas of faith and morals. But, these dogmas do not encompass all that Catholics are asked to believe or all rules by which they are expected to live.
Additional rules emanate from interpretations of the Bible, other teachings, and its Tradition. In Catholicism, Tradition with a capital “T” refers to the continuity of the faith handed down by Jesus to the apostles. Tradition with a small “t” refers to matters such as liturgical or devotional activities, which the popes, bishops, theologians, and other Church leaders develop and promulgate for the entire Church through an interactive dialogue. This dialogue can be a formalized process such as a Council (The Second Vatican Council is an example). Some of the discussions can extend over years, even centuries.
A critical part of the Church’s teaching and spiritual direction that the Pope disseminates to the bishops, priests, and all Catholics (some are even directed to all people) are papal letters called encyclicals. Given the significant role that healing played in Jesus’ ministry and its centrality in the work of the early Church, it is surprising that there is no single encyclical devoted entirely to healing or healthcare. A number of the encyclicals and other papal documents, however, include important components that apply to healthcare. The teachings most relevant to healthcare fall into two categories:
Those that deal specifically with the unique sanctity of human life, sexuality, and procreation.
Those that address Catholic social mission and obligations.
In the former category, the encyclical that dominates and has had substantial impact on Catholic healthcare is Pope Paul VI’s encyclical Of Human Life, Humanae Vitae, issued in 1968, which proscribed the use of artificial contraception for married couples.(1) Given that sexual intercourse is allowed only in marriage, it did not address the use of artificial contraception outside of marriage.
At the time this encyclical was issued, some American theologians hoped that contraception would be an issue for individual couples to decide in line with their own conscience. When this was not the outcome, 72 theologians issued a “Statement of Dissent.”(2)
More than 50 years later, there is far from unanimity on this position among Catholic theologians, nor is there adherence to this prohibition among many Catholics.(3) In fact, 87% percent of American Catholic women who are at risk for pregnancy use artificial contraception and 98% of Catholic women have used it at some point in their lives.(4)
Nonetheless, Pope John Paul II and Pope Benedict XVI reaffirmed this prohibition. The writings and teachings of these two popes extended the sanctity of life teaching into proscription against a range of medical interventions including artificial insemination, in vitro fertilization, and euthanasia.(5) Pope Francis has not reversed any of these positions, nor is he likely to do so, but he does appear to have created some space for more dialogue and nuance of these issues.(5,6,7) For example, in his encyclical The Joy of Love, Amoris Laetitia, he notes:
“…While clearly stating the Church’s teaching, pastors are to avoid judgments that do not take into account the complexity of various situations and they are to be attentive …to how people experience and endure the distress because of their condition.”(8)
He also calls the Church to humility to:
“avoid presenting too abstract and almost theological ideal of marriage, far removed from the concrete situations and practical possibilities of real families.”(8)
He emphasizes the role of one’s conscience:
“We have been called to form consciences, not replace them.”(8)
Of course, this places an obligation on the Church to present the truths that form the correct conscience and on individuals to accept the obligation for forming an enlightened conscience.
Pope Francis’ teachings and actions fall heavily into the second category of Catholic beliefs of social mission and obligations. This area is called Catholic Social Teaching, CST. This does and should impact Catholic healthcare. While such teachings clearly began in the Old Testament and flowered with Jesus, CST first came to the forefront in contemporary times in 1891 with the publication of Pope Leo XIII’s encyclical Of New Things (Rerum Novarum).(9) This was written at a time of great social change and growing wealth disparity across the world — conditions that currently exist in America. The encyclical underscored the right of the Church to speak on societal issues, including private property, workers’ rights including the right to organize, and the role of the state and governments.(9)
Since this groundbreaking document, there have been subsequent encyclicals and other documents from seven popes, including several from Pope Francis, that taken together, have given rise to a set of principles that create the core of CST:(10,11)
The dignity of the human person.
The dignity of work/priority of labor over capital.
The person in the community/the common good.
Human rights/private property/role of government.
Options for those in poverty/preferential focus on the poor.
Solidarity/unity of humanity.
Care for creation.
These principles have direct applicability and relevance to healthcare, including:
The preferential care of the poor and vulnerable.
The right to healthcare.
The evil of excess profit.
The rights of workers including fair wages and the formation of unions.
The role of government to intervene to support human needs.
The judicious use of all resources and care for the environment.(10,11)
Excerpted from The Catholic Church and Its Hospitals: A Marriage Made in Heaven? by Patricia A. Gabow, MD, MACP.
REFERENCES
Pope Paul VI. Humanae Vitae. Encyclical Letter. July 25, 1968. https://www.vatican.va/content/paul-vi/en/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae.html .
Kauffman CJ. Ministry and Meaning: A Religious History of Catholic Health Care in the United States. New York: Herder and Herder, 1995.
Curran CE. Diverse Voices in Modern US Moral Theology. Washington, DC: Georgetown University Press, 2019.
Guttmacher Institute. Guttmacher Statistic on Catholic Women’s Contraceptive Use. Policy Analysis. Guttmacher Institute. February 15, 2012. https://www.guttmacher.org/article/2012/02/guttmacher-statistic-catholic-womens-contraceptive-use .
Keenan JF. What Is Pope Francis’ Effect on Healthcare? America: The Jesuit Review. May 18, 2018. https://www.americamagazine.org/politics-society/2018/05/18/what-pope-francis-effect-health-care .
Kaveny C. Pope Francis and Catholic Healthcare Ethics. Theological Studies. 2019; 80(1):186–201.
Salzman TA, Lawler MG. Pope Francis and the Transformation of Health Care Ethics. Washington, DC: Georgetown University Press, 2021.
Pope Francis. Amoris Laetitia. Post-Synodal Apostolic Exhortation. March 19, 2016. https://www.vatican.va/content/francesco/en/apost_exhortations/documents/papa-francesco_esortazione-ap_20160319_amoris-laetitia.html .
Pope Leo XIII. Rerum Novarum. Encyclical on Capitol and Labor. May 15, 1891. https://www.vatican.va/content/leo-xiii/en/encyclicals/documents/hf_l-xiii_enc_15051891_rerum-novarum.html .
DeBerri EP, Hug JE, Henriot PJ, Schultheis MJ. Catholic Social Teaching: Our Best Kept Secret. Maryknoll, NY: Orbis Books, 1992.
Lanari B. Seven Principles of Catholic Social Doctrine. Homiletic and Pastoral Review. 2009;110(3):52–57.