© 2014 by the Catholic Health Association of the United States The Nurse as Promoter of the Family:...

© 2014 by the Catholic Health Association of the United States

The Nurse as Promoter of the Family:Ethical Challenges and Opportunities

FR. THOMAS NAIRN, OFM, PH.D.Acting Ecclesiastical Assistant, CICIAMS

Senior Director, Ethics

Catholic Health Association

CICIAMS WORLD CONGRESS

DUBLIN, IRELAND

25 SEPTEMBER 2014


Introduction

My background

My initial understanding of my task this morning

Importance of developing a Catholic ethical framework

• Ability to analyze the nurse’s responsibilities

Three questions I will raise in this presentation

• Is it part of the Catholic nurse’s ethical responsibility to promote and protect strong, healthy families? And, if so, why?

• If it is, how does the Catholic nurse exercise this responsibility?• What are some specific areas where the Catholic nurse can exercise this

responsibility?25 September 2014

The Nurse as Promoter of the Family: Ethical Challenges and Opportunities

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© 2014 by the Catholic Health Association of the United States 325 September 2014


Why

HowWhat

© 2014 by the Catholic Health Association of the United States 4


Is it part of the Catholic nurse’s ethical responsibility to promote and protect strong,

healthy families? And, if so, why?

25 September 2014


The why question and the Catholic nurse’s responsibility


25 September 2014

Actually two questions:

Is there a link between the terms “health” and “family”?

Is showing this link really part of the nurse’s responsibility?


Health and Family: Secular and Catholic Understandings

• Often use same words but with different understandings!• Secular understanding of “family”

– Differences in different culture– In my culture, expansion of idea of family

Blended families Single parent families Domestic partnerships Same-sex marriage Technology and expansion of family

Donor gametes Surrogate motherhood

– Other cultures? My experience in Zimbabwe


25 September 2014



• Catholic understanding of “family”

– A faithful, permanent, heterosexual union of life and love open to children

– A “school for humanity”

“Principal school of the social virtues which are necessary to every society” (Vatican II)

“The first and irreplaceable school of social life and an example and stimulus for the broader community”

Family relationships marked by respect, justice, dialogue and love (Pope John Paul II)


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A School for Humanity

“In a society that tends more and more to relativize and trivialize the very experience of love and sexuality, exalting its fleeting aspects and obscuring its fundamental values, it is more urgent than ever to proclaim and bear witness that the truth of conjugal love and sexuality exist where there is a full and total gift of persons, with the characteristics of unity and fidelity. This truth, a source of joy, hope, and life, remains impenetrable and unattainable as long as people close themselves off in relativism and skepticism.”

» Compendium of Social Doctrine


25 September 2014



• Catholic understanding of “family”

– A faithful, permanent, heterosexual union of life and love open to children

– A “domestic church”


25 September 2014

“Christian married couples help each other attain holiness . . . . In what may be regarded as the domestic Church, the parents, by word and example, are the first heralds of the faith to their children.” (Vatican II)

“The Christian family constitutes a specific realization of the Church . . . this happens where there is care and love for the little ones, the sick, the aged; where there is mutual service every day; when there is a sharing of goods, of joys and of sorrows.” (Pope John Paul II)



• Secular understanding of health

– Absence of disease

– “State of complete physical, mental, and social well-being” (WHO)


25 September 2014



• Catholic understanding of “health”– “. . . embraces all that pertains to prevention, diagnosis, treatment,

and rehabilitation for greater equilibrium – physical, psychic, and spiritual well-being of a person.” (Charter for Health Care Workers)

– “Health means wholeness – not only physical but also spiritual and psychological wholeness; not only individual but social and institutional wholeness.” (U.S. bishops)

– Health and holiness– Health and human flourishing (Aristotle)

Happiness not an emotion; flourishing relates to human goods

External goods (wealth, reputation)

Goods of the body (health, pleasure)

Goods of the soul (wisdom, virtue)


25 September 2014



• Catholic understanding of “health”

– Health and human flourishing (Thomas Aquinas)

“The Lord willed to show that Job had not served God for the health of the body, just as he had already shown that Job did not serve him because of exterior goods. Job served God because of love (virtue)” Commentary on the Book of Job

– “I came that you may have life and have it in abundance.” (Jn 10:10)


25 September 2014



• In the Catholic understanding, health and family are related

– “The well-being of the individual person and of human and Christian society is intimately linked with the healthy condition of that community produced by marriage and family.” (Vatican II)

– Marriage, the family, and human flourishing

Family is the institution that is indispensable in fostering the conditions where human life can flourish

Family should be the place where people come to learn the deepest truth about themselves – that they are loved

Family and the Catholic vision of the good life (“flourishing”)


25 September 2014


The Role of the Catholic Nurse

• “In the person of the patient . . . the family is always affected. Helping the relatives, and their cooperation with health care workers are a valuable component of health care. The health care worker is called to give the family of the patient – either individually or through membership in appropriate organizations – not only treatment also enlightenment, counsel, direction and support.” (Charter for Catholic Health Workers)

• The nurse’s limited but important responsibility …


25 September 2014

– Respect relationships– Understand that family relationships can help or hinder

healing– Understand that the health of the family is related to the

health of the individual and the health of society– Health and human flourishing – Health and social justice



25 September 2014

How does the Catholic nurse exercise this responsibility?


How Does the Nurse Exercise this Responsibility?

• The health care worker is called to give the family of the patient . . . “not only treatment also enlightenment, counsel, direction and support.” (Charter for Catholic Health Workers)

– Nurse as teacher and communicator

– Nurse as supporter and advocate

– Nurse as minister and healer


25 September 2014


Nurse as Teacher and Communicator

• The Church’s vision of health and family v. the family as it often is experienced

– “The family has the mission to become more and more what it is, that is to say, a community of life and love, in an effort that will find fulfillment, as will everything created and redeemed, in the Kingdom of God.” (Pope John Paul II)

– Difference between health and human flourishing as personal fulfillment and as human goods related to the virtuous life in society

– Lessons to be learned

Respect for intrinsic dignity

Centrality of love

Family as leaven and example to larger society


25 September 2014


Conferred Dignity v. Intrinsic Dignity

DANIEL SULMASY, MD, UNIVERSITY OF CHICAGO, USA

25 September 2014


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“The persons who are most vulnerable, particularly in a health care system, are those whose dignity already has been called into question by society before they ever enter the office, clinic, or emergency room – homeless persons, those living with HIV, injection drug users, retarded persons, demented persons, the frail elderly, undocumented aliens, and others. Anyone whose worth has been ascribed to anything other than being a member of the human community is vulnerable. Those whose attributed dignity has been assaulted are most at risk for believing that their own intrinsic dignity has been vanquished. This risk applies, above all to the sick, frail and dying.”


Nurse as Teacher and Communicator

• The Church’s vision of health and family v. the family as it often is experienced

– Exercising nurse’s professional responsibilities to promote healthy families

Relationship between nurse and midwife and new parents

Nurse as clarifier of medical (ethical) decisions

– U.S. v. Zimbabwe

Nurse and the Catholic end-of-life moral tradition


25 September 2014


Nurse as Supporter and Advocate

• Image of family often given by contemporary society

– Marriage as personal fulfillment

– Marriage as a consumer good (Christopher Vogt, St. John University)

Seek marriage to fulfill our own needs and wants

“Right to a child”

“Conscious uncoupling” (London Tablet)

• Catholic/Christian image: Marriage and family as vocation

– Marriage as an intrinsic good that demands a reorientation in love

– Need support of community to live out one’s vocation


25 September 2014


Nurse as Supporter and Advocate

• Role of the Catholic nurse

– The Church as a “field hospital”

“The thing the church needs most today is the ability to heal wounds and to warm the hearts of the faithful; it needs nearness, proximity. I see the church as a field hospital after battle. It is useless to ask a seriously injured person if he has high cholesterol and about the level of his blood sugars! You have to heal his wounds. Then we can talk about everything else.” (Pope Francis)

“The family too is a field hospital, where it is necessary to bind many wounds, dry many tears, and establish reconciliation and peace time and time again.” (Cardinal Walter Kasper)

– Unique opportunities of the Catholic nurse

Support and challenge


25 September 2014


Nurse as Minister and Healer

• Healing v. curing– Called to heal the entire person, promoting health of body, mind,

and spirit

– The nurse as spiritual care provider Not nurse’s primary responsibility

Many health care facilities have chaplains and pastoral care professionals

Relation between physical care and spiritual care

Visibility of the nurse

“Attention and intention”

“The fact that there is a team of health care providers does not alter the personal character of the interaction between the provider and the patient.” US Ethical and Religious Directives


25 September 2014



25 September 2014

What are some specific areas where the Catholic nurse can exercise this responsibility?


• Many areas will be discussed throughout the day• Areas of particular focus

– Times throughout the life process Where life is injured or fostered

Where people are born or die

Where curing and healing or their opposites take place

– Situations where family life, health and wholeness are especially threatened

War and violence

Poverty

Child abandonment and sexual exploitation

Epidemics

Areas where the nurse can exercise this ethical responsibility as promoter of the family


25 September 2014


To summarize…


25 September 2014

Why is promoting and protecting families part of the nurse’s ethical responsibility?

• The well-being of the individual person and of human and Christian society is intimately linked with the health of the family

How does the Catholic nurse exercise this responsibility?

• As teacher and communicator

• As supporter and advocate

• As minister and healer

What are some specific areas where the Catholic nurse can exercise this responsibility?

• Specific times throughout the life process

• Specific situations where family life, health and wholeness are especially threatened



25 September 2014

Family and the workplace can also be a parched place where faith nonetheless has to be preserved and communicated. Yet it is starting from the experience of this desert, from this void, that we can again discover the joy of believing, its vital importance for us men and women. In the desert we rediscover the value of what is essential for living; thus, in today’s world there are innumerable signs, often expressed implicitly or negatively, of the thirst for God, for the ultimate meaning of life. And, in the desert, people of faith are needed who, by the example of their own lives, point out the way to the Promised Land and keep hope alive. In these situations we are called to be living sources of water from which others can drink. At times, this becomes a heavy cross, but it was from the cross, from his pierced side, that our Lord gave himself to us as a source of living water. Let us not allow ourselves to be robbed of hope!

» Pope Francis

© 2014 by the Catholic Health Association of the United States 2725 September 2014


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