material-carta-agentes-sanitarios

summary of the New Charter for Health Workers (2017)

Foundation: committee Pontifical Council for Pastoral Health Care.
source : Holy See.
language original: Italian.
Copyright of the original Italian: Unknown.
Spanish translation: Santa Sede.
Copyright of the Spanish translation: Unknown.
Date: 6 February 2017.
Checked on 16 August 2018.

Full text

presentation and summary

Taken from Infocatólica

The New Charter for Health Care Workers was presented this morning at the Holy See Press Office. The text stems from the need to update the magisterium due to the achievements of the biomedical research and the new social and health realities since 1994.

presentationJean-Marie Mate Musivi Mupendawatu, Secretary of the Dicastery for the Service of the Integral Human development and Prof. Antonio Gioacchino Spagnolo, Full Professor of Bioethics and director of the Institute of Bioethics and Medical Humanities at School of Medicine and Surgery of the Sacred Heart Catholic University of Rome.

Cardinal Peter Kodwo Appiah Turkson, Prefect of the Dicastery for the Service of the Integral Human development , was scheduled to participate, but due to an indisposition of the Cardinal, Monsignor Mupendawatu read his intervention.

In his message, Cardinal Turkson recalled the recently deceased Archbishop Zygmunt Zimowski, president of the then Pontifical committee for the Pastoral Care of Health, to whom we owe the New Charter for Health Care Workers, which revises and updates the theological-moral-medical vademecum born from the intuition of the first president of that committee, Cardinal Fiorenzo Angelini, translated into 19 languages and for twenty years the basic text for health care workers.

Mupendawatu explained that the New Charter for Health Workers "doctrinally reaffirms the sacredness of life and its unavailability as a gift of God".

Professor Spagnolo then took the floor and gave a comprehensive illustration of the new document.

"The achievements of the biomedical research and the new social and health realities since 1994 as well as the pronouncements of the Magisterium of the Catholic Church emanating in the field of life and health sciences (those of Popes John Paul II, Benedict XVI, Francis, the documents of the Congregation for the Doctrine of the Faith and the Pontifical Academy for Life) made it necessary to review and revise the Charter for Health Care Workers, the documents of the Congregation for the Doctrine of the Faith and of the Pontifical Academy for Life) made it necessary to revise and update the Charter for Health Care Workers - he explained - The document kept its original structure as an instrument for a serious preparation and a continuous training in the ethical field of health care workers, to maintain the necessary professional skill and their vocation to be ministers of life".

Biomedicine present among health actors

"First of all, a broader spectrum of people involved in the field of biomedicine was taken into account: along with the classic professional figures (staff medical, nursing and auxiliary), others working at different levels in the world of health, such as biologists, pharmacists, territorial health agents, administrators, legislators in the field of health, agents in the public and private sectors, were also taken into consideration".

"Some of the new articles concern them specifically, while at the same time they are asked to take special responsibility in the performance of their service. All these agents carry out their daily work in an interpersonal relationship, distinguished by the trust of a person marked by suffering and illness, who turns to science and to the conscience of a health professional who goes to meeting to assist and cure them.

"The Charter aims to support the ethical fidelity of health care workers, in those decisions and behaviours that embody the service of life, and this fidelity is described following the stages of human existence: generating, living, dying, as moments of ethical-pastoral reflections".

Fertility and infertility

Thus, Spagnolo continued, the "generate" section further specifies the criteria for the treatment of infertility and reference letter to natural methods, not only for fertility regulation, but also as methods to achieve pregnancy.

A article was also incorporated on the freezing of ovarian tissue (Art. 38), an ethically sustainable response in the case of cancer therapies that may alter a woman's fertility.

Subsequently, new attempts at human generation are analysed on laboratory (Art. 39): between human and animal gametes, the gestation of human embryos in animal or artificial wombs, the asexual reproduction of human beings by means of twin fission, cloning, parthenogenesis and other similar techniques. These are all procedures that are in contrast to the human dignity of the embryo and of procreation, and are therefore considered morally unacceptable.

"Among prenatal diagnosis, which is acceptable under certain conditions, pre-implantation diagnosis (Art. 36) is stigmatised as an expression of a eugenic mentality that legitimises selective abortion to prevent the birth of children suffering from various diseases".

"In the "living" section, the usual position on abortion is confirmed and new articles are added on embryo reduction, interception, contraception, foetuses with anencephaly, ectopic pregnancies, protection of the right to life (art. 51-59). Attention is also given to the question of prevention and vaccines, a recent topic of discussion public (art.69-70). Current, from a scientific point of view, the reference letter to gene therapy and regenerative medicine (80-82)."

Right to medicines

"On the social level, the document focuses on the topic access of the population to available medicines and technologies (Art. 91), access to which is still not guaranteed to large sections of the population, especially in countries in development - particularly in those characterised by political instability or limited resources - and which, particularly in the case of so-called "rare" and "neglected" diseases, is accompanied by the concept of "orphan drugs" (Art. 92). And health stakeholders and their professional associations are asked to promote awareness-raising among institutions, organisations attendance and the health industry, so that the right to health protection is extended to the entire population and health justice is achieved, safeguarding sustainability, research and health".

"Another novelty are the references to the participation in experimentation of minors or adults unable to decide, in vulnerable subjects, in women of reproductive age in emergency situations".

The right to die well

"Finally, this section highlights the role of the advisory service of clinical ethics (art. 140) which can help to identify the conflicts and ethical doubts that healthcare agents, patients and their families may experience in the clinical internship , thus facilitating the resolution with shared diagnostic-therapeutic decisions at the bedside, in the framework of the values of medicine and ethics".

"With regard to the section "dying", "the attitude towards the patient in the terminal phase of the illness is analysed, the place where the professionalism and ethical responsibilities of health care workers are verified (article 145). In this context, a very topical aspect, - considered in the Charter and currently under discussion in the Italian Parliament - is the reference letter to the anticipated manifestation of the patient's will (Art. 150) on the treatments he/she would want to undergo or not if, in the course of his/her illness or due to a sudden trauma, he/she would no longer be able to express his/her consent".

"The Charter affirms that the reasonable will and legitimate interests of the patient must always be respected, but the physician is not, however, a mere executor, and retains the right and duty to refuse a will contrary to his conscience".

"An equally significant topic is that of nutrition and hydration, even if artificially administered. (art. 152). Considered among the basic care due to the dying person when they are not too burdensome or have no benefit, their unjustified suspension may have the sense of a real act of euthanasia, but is obligatory, to the extent and until it is demonstrated that they fulfil their proper purpose: the hydration and nutrition of the patient. The ethics of deep palliative sedation in the near-death phase, carried out agreement with the correct ethical protocols and subject to continuous monitoring, is confirmed".

"The background scenario of this section is the protection of the dignity of dying (art. 149) in the sense of respecting the patient in the final phase of life, excluding both hastening death (euthanasia) and reatrasing it with the so-called "therapeutic overkill".

Certainly," he concluded, "the Charter cannot be exhaustive with regard to all the problems and issues that arise in the context of health and illness, but it has been drawn up in order to provide as clear guidelines as possible for the ethical problems faced today in the world of health in general, in harmony with the teachings of Christ, and with the Magisterium of the Church".

The new post-1994 Magisterial references recalled in the Charter are:

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