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May 13, 2008 01:08 PM
Basic Care for Patients in the Vegeative State
Health Progress
May-June 2008Volume 89, Number 3
On Basic Care For Patients In The 'Vegetative' State
A Response to Dr. Hardt and Fr. O'Rourke
BY CARDINAL JUSTIN F. RIGALI, JCD, & BISHOP WILLIAM E. LORI, STD
Cardinal Rigali is archbishop of Philadelphia and chairman of the Committee on Pro-Life Activities, U.S. Conference of Catholic Bishops (USCCB); and Bishop Lori is bishop of Bridgeport , Conn. , and chairman of the Committee on Doctrine, USCCB.
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In a 2004 address on care for patients diagnosed as being in a "vegetative state," Pope John Paul II affirmed the human dignity of these patients and the obligation to provide them with ordinary care, including food and water, even with artificial assistance. On Sept. 14, 2007, through its "Responses to Certain Questions of the United States Conference of Catholic Bishops Concerning Artificial Nutrition and Hydration," the Congregation for the Doctrine of the Faith (CDF), with the approval of Pope Benedict XVI, reaffirmed and further explained this papal teaching. (The CDF's "Responses" was accompanied by a "Commentary," which offered further explanation.) The U.S. Conference of Catholic Bishops (USCCB) has welcomed this important clarification of Catholic Church teaching and has provided its own set of questions and answers to promote a better understanding of it in the United States. 1
Unfortunately, confusion about this teaching and opposition to some aspects of it persist in some quarters. For example, a recent Health Progress article by John J. Hardt, Ph.D. and Fr. Kevin D. O'Rourke, OP, JCD, STM, titled, "Nutrition and Hydration: The CDF Response, In Perspective," misinterprets the Holy See's documents in important respects, and even makes the charge that the CDF interprets euthanasia in a way that is "at odds with the traditional teaching of moral theology." 2
As chairmen of the U.S. Bishops' Committees on Doctrine and on Pro-Life Activities, we offer the following points to prevent misunderstanding and to help those involved in Catholic health care ministry more fully understand the church's teaching.
First, contrary to the "Rules for Interpretation" referred to by Hardt and Fr. O'Rourke, 3 the CDF document was not issued in the form of a canonical decree. Nor is it merely a public policy statement motivated by the threat of legalized euthanasia in certain countries in Europe. It is an authoritative statement of moral truth, reaffirming a teaching by the Catholic Church's ordinary magisterium regarding how we are to exercise our freedom responsibly as children of God.
Second, not everything in the CDF's "Responses" applies solely to patients in a "vegetative state." For example, the CDF's first response states that "the administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life." Certainly this basic principle applies when patients have chronic but stable debilitating conditions that are less extreme than the "vegetative state." As the CDF "Commentary" notes, helpless patients with conditions such as quadriplegia, mental illness or Alzheimer's disease also must not be deprived of basic care and "abandoned to die" because their long-term care may burden others. The phrase "in principle" (which in this context means "as a general rule") is also important, because providing assisted food and fluids may cease to be obligatory in particular circumstances. The U.S. bishops asked whether such circumstances occur only when food and fluids "cannot be assimilated by the patient's body or cannot be administered to the patient without causing significant physical discomfort," and the CDF answered in the affirmative. The CDF "Commentary" notes that such circumstances will be "rare" and "exceptional" for a patient in a "vegetative state"; they may occur far more frequently for patients with progressively deteriorating or terminal conditions.
Also, the CDF "Commentary" notes the obligation to provide assisted feeding may not apply "in very remote places or in situations of extreme poverty" because we are not held to do something that is impossible in practical terms. But the CDF's statement about the general or presumptive obligation to provide food and fluids as a form of ordinary care clearly has broad application.
Third, in applying the church's longstanding moral tradition against euthanasia to the present question, the CDF is in full accord with that tradition. In 1980, the CDF (with the approval of Pope John Paul II) issued a "Declaration on Euthanasia" defining "euthanasia" as "an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated." 4 In its more recent "Responses" and accompanying "Commentary," the CDF is stating that this issue is of particular concern regarding medically assisted food and fluids. Food and water are basic necessities of life, without which anyone (sick or healthy) would soon die. When they are withdrawn from a seriously disabled patient who needs help from others to obtain such basic care—withdrawn not because the means themselves are useless or excessively burdensome, but because someone has judged that patient's continued life to be useless or burdensome—the patient's death is the first result, and any other intended goals would seem to be met only through this death. The argument that in such cases the cause of death is merely the underlying condition (the inability to eat and swallow for oneself) is not valid, and is explicitly rejected by the CDF:
Patients in a "vegetative state" breathe spontaneously, digest food naturally, carry on other metabolic functions, and are in a stable situation. But they are not able to feed themselves. If they are not provided artificially with food and liquids, they will die, and the cause of their death will be neither an illness nor the "vegetative state" itself, but solely starvation and dehydration. 5
Fourth, this brings us to the argument by Hardt and Fr. O'Rourke that the "significant financial hardships" of providing assisted food and fluids to patients in the "vegetative state" in the U.S. may justify withdrawing such care and letting the patient die. 6 In reality, providing the complete range of long-term care for these helpless patients may indeed become very costly, and families should not be abandoned to carry these burdens alone. But providing food and fluids generally accounts for a very small fraction of this cost. If food and fluids are targeted for removal because this will lead to the patient's early death, thus saving the significant costs of other care, then it seems clear that the patient's death is being intended precisely as a means to saving these other costs. In other words, this would be a decision to practice euthanasia by omission.
Fifth, nothing in the CDF's "Responses" or in Pope John Paul II's address of 2004 provides a basis for withdrawing food and fluids based on a far broader category of "psychic burden." Hardt and Fr. O'Rourke say that some may "feel" the continued life of a patient in a "vegetative state" is a burden to others, or is not a benefit. This may be true, but such feelings do not justify euthanasia by omission or the deliberate withdrawal of basic care owed to patients because of their human dignity.
Sixth, regarding advance directives such as the "living will," Hardt and Fr. O'Rourke claim that under the Ethical and Religious Directives for Catholic Health Care Services (ERDs) people may continue to make advance decisions regarding their care (Directives 25 and 28). 7 This is true as far as it goes. However, Directive 28 provides that "the free and informed health care decision of the person or the person's surrogate is to be followed so long as it does not contradict Catholic principles " (emphasis added). Moreover, Directive 24, not cited by Hardt and Fr. O'Rourke, also speaks of generally respecting patients' and surrogates' decisions, but adds:
The institution, however, will not honor an advance directive that is contrary to Catholic teaching. If the advance directive conflicts with Catholic teaching, an explanation should be provided as to why the directive cannot be honored.
The CDF's "Responses" provide clarifications as to what Catholic moral principles require of us on the provision of food and fluids, out of respect for the perduring human dignity of even the most severely cognitively disabled of our brothers and sisters.
On the relationship between the ERDs and the CDF's "Responses," the USCCB had this to say in its Q&A document:
Directive 58 already speaks of "a presumption in favor of providing nutrition and hydration to all patients, including patients who require medically assisted nutrition and hydration." The Address and the Responses clarify how this presumption applies to the patient in a "vegetative state" as to other patients, and provide further guidance as to how the Directives should be interpreted and implemented. 8
We fully intend that the next edition of the ERDs will be amended to reflect this doctrinal clarification.
While we disagree with other claims by Hardt and Fr. O'Rourke, we believe these are the most important points in need of clarification. Certainly, when they say it is "questionable" whether the Catholic community will rise to the challenge of caring for the basic needs of patients in the "vegetative state," we hope their pessimism is unwarranted. It is precisely in caring for the poorest and most helpless of patients, those whose value and dignity are dismissed by others, that Catholic health care most clearly lives up to its mission and demonstrates the need for specifically Catholic health care providers in our secularized society. It is in meeting the moral challenge of caring for the most helpless that we will live up to our own God-given dignity.
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NOTES
The U.S. Conference of Catholic Bishops news release of Sep. 14, 2007, on this development, with links to the CDF's "Responses" and "Commentary," and the USCCB's related Q&A, can be found at www.usccb.org/comm/archives/2007/07-143.shtml. Pope John Paul II's March 20, 2004, address can be found at
www.vatican.va/holy_father/john_paul_ii/speeches/2004/
march/documents/hf_jp-ii_spe_20040320_congress-fiamc_en.html.
John Hardt and Kevin O'Rourke, "Nutrition and Hydration: The CDF Response, In Perspective," Health Progress , November-December 2007.
Hardt and O'Rourke, 45.
Congregation for the Doctrine of the Faith, "Declaration on Euthanasia," (May 5, 1980) www.vatican.va/roman_curia/congregations/cfaith/documents/
rc_con_cfaith_doc_19800505_euthanasia_en.html.
Congregation for the Doctrine of the Faith, "Commentary." See note one above for link information.
Hardt and O'Rourke, 46.
U.S. Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services , (Washington, D.C.) Fourth Edition, 2001, www.usccb.org/bishops/directives.shtml.
See note one above.
Copyright © 2008 CHA All rights reserved. Last updated: 04/21/08
May 13, 2008 11:55 AM
Re: Proposed Human/Animal Hybrid Ban
Cardinal Rigali Welcomes Proposed Human/Animal Hybrid Ban
WASHINGTON—Commenting on the introduction in Congress of a “Human-Animal Hybrid Prohibition Act,” Cardinal Justin Rigali, chairman of the United States Conference of Catholic Bishops’ Committee on Pro-Life Activities, today welcomed the legislation as “an opportunity to rein in an egregious and disturbing misuse of technology to undermine human dignity.”
The Human-Animal Hybrid Prohibition Act (H.R. 5910) was introduced in the House on April 24 by Rep. Chris Smith (R-NJ). Identical legislation, S. 2358, was introduced in the Senate last fall by Senator Sam Brownback (R-KS).
Cardinal Rigali’s statement follows:
“I commend Senator Brownback and Representative Smith for their leadership in seeking to prohibit the creation of human-animal hybrids. Their legislation offers an opportunity to rein in an egregious and disturbing misuse of technology to undermine human dignity.
“While this subject may seem like science fiction to many, the threat is all too real. The United Kingdom is preparing to authorize the production of cloned human embryos using human DNA and animal eggs, setting the stage for the creation of embryos that are half-human and half-animal. Researchers in New York have boasted of implanting ‘mouse/human embryonic chimeras’ into female mice, and California scientists say they may produce a mouse whose brain is entirely made up of human brain cells.
“The alleged promise of embryonic stem cells has already been used in attempts to justify destroying human embryos, and even to justify creating them solely for destructive research. Now, the same utilitarian argument is being used to justify an especially troubling form of
genetic manipulation, to create partly human creatures as mere objects for research or commercial use. Nothing more radically undermines human dignity than a project that can make it impossible to determine what is human and what is not.
“I encourage members of all parties to co-sponsor this legislation and bring it to swift approval in Congress, while there is still time for sound ethics and policy to place some restraints on the misuse of science.”
# # # # #
08-061
DD,CATHPRESS,CNS,RNS,Crux
For media inquiries, e-mail us at commdept@usccb.org
Office of Media Relations | 3211 4th Street, N.E., Washington DC 20017-1194 | (202) 541-3000 © USCCB. All rights reserved.
April 2, 2008 11:16 AM
Rethinking Embryonic Stem Cells
Rethinking Embryonic Stem Cells
The Reprogramming Breakthrough
Rev. Tadeusz Pacholczyk, Ph.D.
The recent discovery that regular old garden-variety skin cells can be converted into highly flexible (pluripotent) stem cells has rocked the scientific world. Two papers, one by a Japanese group and another by an American, have announced a genetic technique that produces stem cells without destroying (or using) any human embryos. This technique involves the transfer of four genes into the skin cells, triggering them to convert into pluripotent stem cells. It has been called “biological alchemy,” something like turning lead into gold. Many are hailing “cellular reprogramming” as a breakthrough of epic proportions, the stuff that Nobel Prizes are made of, a kind of Holy Grail in biomedical research.
As important as this advance may prove to be scientifically, it may be even more important to the ethical discussion. It offers a possible solution to a long-standing ethical impasse and a unique opportunity to declare a pause, maybe even a truce, in the stem cell wars, given that the source of these cells is ethically pristine and uncomplicated. As one stem cell researcher put it recently, if the new method really produces equally potent cells, as it has been touted to do, “the whole field is going to completely change. People working on ethics will have to find something new to worry about.”(1) Thus, science itself may have devised a clever way to heal the wound it opened back in 1998, when human embryos began to be sought out and destroyed for their stem cells. Dr. James Thomson (whose 1998 work originally ignited the controversy, and who also published one of the new breakthrough papers) acknowledged just such a possibility in comments to reporters: “Ten years of turmoil and now this nice ending.”(2) Whether this nice ending will actually play out remains to be seen, but a discovery of this magnitude, coupled with a strong ethical vision, certainly has the potential to move us beyond the contentious moral quagmire of destroying human embryos.
Respecting Ethical Boundaries in Research
Reprogramming addresses significant ethical concerns even as it offers a highly practical technique for obtaining pluripotent stem cells. As Dr. Thomson himself put it, “Any basic microbiology lab can now do it, and it’s cheap and quick.”(3) Reprogramming also offers a way to avoid getting entangled in “therapeutic cloning,” a complex and unethical procedure which uses women’s eggs to clone embryos and get patient-specific stem cells. Reprogramming allows researchers to get patient-specific stem cells without using women’s eggs, without killing embryos, and without crossing moral lines.
The sheer practicality of the new reprogramming approach, coupled with its ethical advantages, makes it appealing enough that some researchers are in fact changing their research plans. Dr. Ian Wilmut, the researcher responsible for cloning Dolly the sheep, went so far as to announce that he will no longer pursue human therapeutic cloning, but will instead turn to reprogramming techniques. Yet when pressed by reporters, he still insists that all avenues need to be investigated: “Certainly using skin cells is much easier to accept socially than the use of embryos, but this was very much a personal decision and I still think we need to continue to work in both areas.”(4) There are a number of reasons that scientists and politicians continue to argue that the bio-industrial-complex emerging around destructive human embryo research must be safeguarded and every avenue of research, even unethical ones, must be pursued.
First, the financial investment that has already been made in this area is significant. Certain state initiatives, like Proposition 71 in California, have earmarked enormous sums of state taxpayer money (about $3 billion) to promote research that fosters human embryo destruction. When such astronomical sums are involved, and researchers, universities, and pharmaceutical companies sense a gold rush in the offing, ethics often become the first casualty of the scramble.
Second, some of the scientists who advocate the destruction of human embryos have never really taken the moral concerns too seriously, because the creed they subscribe to is that of the so-called “scientific imperative,” namely, that science must go forward, no matter what, as if it were the highest and most incontrovertible good known to mankind. This kind of modern dogmatism results in the view that science must be able to do essentially whatever it wants, and ethical viewpoints should not be allowed to interfere with experiments that researchers might want to do. That, of course, is a completely untenable position, because we regulate scientific research all the time. The very mechanism by which we dispense federal research money and grants imposes all kinds of checks and balances on what researchers can and cannot do. Certain types of research, like germ warfare studies or nuclear bomb development, are strictly regulated by the government today, and have been for decades. Other kinds of research are outright criminal, such as performing medical experiments on patients who do not give their consent. The idea that we ought to allow science to do whatever it wants is ultimately little more than “pie-in-the-sky” wishful thinking.
The Connections to IVF and Abortion
Another reason that embryocidal research in our laboratories can be expected to continue in the foreseeable future is that we have become largely acclimatized to human embryo destruction as part of what happens during infertility treatments. Many thousands of embryos are frozen or die each year at fertility clinics, and hardly a word is mentioned in respectable society. One of the most successful rallying cries in the stem cell debate has been, “Just give us the frozen embryos. They’re all going to be thrown away anyway.” Because of our unflinching pragmatism as a society, the proposal to get some good out of something that will be thrown into the dumpster seems like a no-brainer. We recycle our aluminum cans religiously, and try to maximize returns on every investment we make, so if young human embryos could be mined for their parts, we conclude that they would “not be wasted” either.
The first lapse in reasoning here, of course, occurs when we grant the assumption that it is somehow okay to discard very young humans. We wring our hands and tell ourselves that this is “inevitable”—we really can’t be expected to stop scientists from discarding young human beings as medical waste, because that could have the practical effect of generating suspicion around the sacred cow of in vitro fertilization. Hence, it must follow that it is okay for researchers to directly cause the death of young humans who have been thawed out and are now growing in the Petri dish on the laboratory bench, as long as somebody else was going to do the dastardly deed “anyway.” So long as clinics were planning to do evil anyway, that makes it okay for me to jump ahead of them in line and do the evil myself as a researcher. The flawed logic here is glaring, yet it sadly passes for respectable thinking and illuminated discourse in our universities and legislative bodies every day.
Yet another reason that embryo-destructive research will still likely be promoted in the future has to do with abortion. Several astute commentators have observed how the whole field of embryonic stem cell research has come to serve as a kind of “hedge” for abortion. In the same way that a hedge is placed around a garden in order to protect it, embryonic stem cells are becoming a place holder for abortion. As long as a kind of medical neo-cannibalism of embryos can be declared necessary for the maintenance of our personal health and well-being, then abortion on demand will more likely curry favor in our culture as well.
We Were Embryos
The argumentative continuity behind this position springs from the fact that each of us, remarkably, is an embryo who has grown up. This biological fact stares researchers in the face every time they choose to “disaggregate” a human embryo with their own hands. It makes many researchers edgy, touching them on some deeper level of their being. It makes many Americans queasy and eager to find alternatives. Dr. Thomson, who has overseen the destruction of numerous embryonic humans himself, had the honesty to acknowledge this fact in comments he made to The New York Times: “If human embryonic stem cell research does not make you at least a little bit uncomfortable, you have not thought about it enough.”(5) Dr. Shinya Yamanaka, the Japanese researcher who developed the reprogramming approach and published one of the two recent breakthrough papers, memorably described the problem after visiting a friend who worked at a fertility clinic. After looking down the microscope at one of the human embryos stored at the clinic, he later reflected back on the moment: “‘When I saw the embryo, I suddenly realized there was such a small difference between it and my daughters,’ said Dr. Yamanaka, forty-five, a father of two and now a professor at the Institute for Integrated Cell-Material Sciences at Kyoto University. ‘I thought, we can’t keep destroying embryos for our research. There must be another way.’”(6)
Drs. Yamanaka and Thomson have managed to pioneer another way, a powerful and practical way, but it is clear that several complex factors will influence how this major new stem cell discovery plays out in medicine and society. One thing is certain, however: those renegade researchers, lawmakers, and Hollywood personalities who have long dismissed ethical concerns and advocated human embryo destruction now find themselves at an important juncture because of this breakthrough. We can only hope that in the wake of this discovery, the siren call of harvesting human embryos will cease ringing in their ears and allow for a new era of ethical science to begin.
Rev. Tadeusz Pacholczyk, Ph.D.
Father Pacholczyk is a priest of the diocese of Fall River, Massachusetts, and serves as the Director of Education at The National Catholic Bioethics Center. This article is based on a nationally syndicated column.
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1 - Gretchen Vogel, “Researchers Turn Skin Cells Into Stem Cells,” Science Now Daily News, November 20, 2007, 1.
2 - Rick Weiss, “Advance May End Stem Cell Debate,” Washington Post, November 21, 2007, http://www.washingtonpost.com/wp-dyn/content/article/2007/11/20/AR2007112000546_pf.html.
3 - Marilynn Marchione, “Wis. Stem Cell Pioneer Shuns Limelight,” Associated Press, November 20, 2007; available at http://www.redorbit.com/news/health/1151927/wis_stem_cell_pioneer_shuns_limelight/index.html (reference updated March 31, 2008)
4 - Sarah Freeman, “‘Science Is a Wonderful Thing,’” Yorkshire Post, December 5, 2007, http://www.yorkshirepost.co.uk/features/Science-is-a-wonderful-thing.3555334.jp.
5 - Gina Kolata, “Man Who Helped Start Stem Cell War May End It,” New York Times, November 22, 2007, http://www.nytimes.com/2007/11/22/science/22stem.html.
6 - Martin Fackler, “Risk Taking Is in His Genes,” New York Times, December 11, 2007, http://www.nytimes.com/2007/12/11/science/11prof.html.
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March 2, 2008 12:36 PM
US Catholic Medical Association has called the ACOG to rescind an 'Ethics opinion on Conscience"
FOR IMMEDIATE RELEASE CONTACT: John Brehany, Ph.D., S.T.L.
February 29, 2008 Executive Director & Ethicist
Catholic Medical Association
215-877-9099; brehany@cathmed.org
CMA Calls for American College of Obstetricians and Gynecologists to Rescind
Ethics Opinion
DATELINE February 29, 2008 – The Catholic Medical Association (CMA) has called
upon the American College of Obstetricians and Gynecologists (ACOG) to rescind an
“ethics opinion” released last November by its Committee on Ethics. ACOG’s opinion
demands that ob-gyns opposed to abortion provide referrals for, and even perform,
abortions in certain situations, despite their conscientious belief that abortion involves the
killing of an unborn child. In a letter to ACOG president Kenneth Noller, M.D., CMA’s
president, Kathleen M. Raviele, M.D., F.A.C.O.G., said that the ethics opinion suffered
from substantial flaws in ethical analysis; created guidelines that were too vague and
contentious to be effective; and proposed solutions that were unjust, unworkable, and
harmful to the profession of medicine.
ACOG’s ethics opinion, titled “The Limits of Conscientious Refusal in
Reproductive Medicine,” came as a surprise to many ob-gyn doctors, since there was no
consultation among or vote taken of ACOG members prior to its release on November 7,
2007. “I was stunned when it came out,” said Lester Ruppersberger, D.O., a Fellow of
the American College of Obstetricians and Gynecologists. “This is an important and
complex topic. To spring this flawed mandate on the membership of ACOG and the
public is unfair and outrageous.”
According to Dr. Raviele, there are several fatal flaws in the opinion. “But what
is new and what is worst,” she explained, “is the opinion’s demand that all physicians
refer for and perform abortions.” “The committee that wrote this opinion shows no
respect for the beliefs of others. They have moved from believing that abortion should be
legal to defining it as ‘standard care’ under reproductive services. If physicians refuse to
go along with these demands they risk having an ethics complaint filed against them, and
this could cause them to lose their certification through the American Board of Obstetrics
and Gynecology. Because hospitals use board certification to grant hospital privileges,
pro-life physicians could lose their ability to admit patients to hospitals.”
CMA’s Executive Director, John F. Brehany, Ph.D., pointed out that ACOG’s
ethics committee is trying to exert a high level of control over physicians. “The opinion
actually discourages physicians from exercising ethical judgment in daily practice; it tells
them that this is a job for professional organizations,” Brehany noted. “Moreover, the
opinion suggests that physicians need ‘scripting’ to explain issues to patients. It says that
doctors must employ ‘professionally accepted characterizations of reproductive
services’.”
The CMA urged ACOG’s Committee on Ethics to rescind its opinion when the
committee meets March 17-18. The CMA urges physicians, their patients, and members
of the public to contact ACOG at their headquarters, to protest this denial of conscience
rights and religious freedom.
CMA’s letter to ACOG can be read in its entirety at www.cathmed.org.
The Catholic Medical Association is the nation’s largest professional organization
of Catholic physicians. More information on the CMA can be found at
www.cathmed.org.
January 28, 2008 10:01 AM
Cardinal Rigali "Roe v. Wade will not stand" at pro-life Rally
Roe v. Wade 'will not stand,' cardinal says at pro-life vigil Mass
By Mark Pattison
Catholic News Service
WASHINGTON (CNS) -- Roe v. Wade, the 35-year-old Supreme Court decision that legalized abortion virtually on demand, "will not stand," Cardinal Justin Rigali of Philadelphia said in his homily at a Jan. 21 evening Mass that opened the annual National Prayer Vigil for Life.
"Roe v. Wade is incompatible with human dignity," said Cardinal Rigali, chairman of the U.S. bishops' Committee on Pro-Life Activities. "It must not stand. It cannot stand. It will not stand."
His declaration drew applause from the packed Basilica of the National Shrine of the Immaculate Conception in Washington. It was one of five times that the cardinal's remarks during his homily were met with applause.
Cardinal Rigali, echoing the New Testament reading from First Corinthians for the St. Agnes feast day Mass of Jan. 21, told the packed church that, "instead of choosing 'great' or impressive people in the eyes of the world, God uses the humble, the foolish, the weak and 'those who count for nothing' to accomplish his purposes."
"It is when we least expect it that the tiniest among us can humble the powerful," he said.
One example the cardinal cited was an embryo glimpsed by stem-cell researcher Dr. Shinya Yamanaka. The doctor was quoted in The New York Times as saying, "When I saw the embryo, I suddenly realized there was such a small difference between it and my daughters. ... I thought, we can't keep destroying embryos for our research. There must be another way."
Yamanaka announced in December a technique that successfully turned adult skin cells into the equivalent of human embryonic stem cells without using an actual embryo.
"If God can use a helpless embryo to change a human heart, he can certainly use us with all our limitations and weaknesses," Cardinal Rigali said.
"By seeking holiness and using the gifts God has given you to accomplish his will in your life," he continued, "you are contributing mightily to that kingdom we all long for, where there will be no more crying or pain or death. Certainly no abortion. No euthanasia. No assisted suicide. No deep-freezing of embryos as though they were merchandise. And no destruction of human life in the name of science."
Cardinal Rigali said, "Our value does not come from being so-called 'productive' members of society, but from Emmanuel, God always with us."
He added, "We possess, or will be given, enough time and resources to build a culture of life together."
During his homily, Cardinal Rigali drew a comparison between those attending the Mass and the new Knights of Columbus Incarnation Dome at the basilica, which required 2.4 million pieces of colored glass cut and assembled in Italy and shipped in 346 boxes for five months of installation.
"We too, dear friends, are called to a massive undertaking," Cardinal Rigali said. "This urgent project is well under way, but we know it is far from complete."
God "now sends you out, thousands upon thousands strong, to do your part in forming a vibrant mosaic on behalf of life," he added. "You must be the 'rich color' he created you to be. You must play your role in his overarching design, and be patient with others as they seek to do the same."
The earlier start of the vigil Mass -- one hour earlier than in past years -- appeared to make not one bit of difference in the numbers attending, as people squeezed into every pew, aisle, vestibule and side chapel in the basilica's main church.
The number of participants in the sanctuary was similarly large, as the entrance procession -- featuring seminarians, deacons, priests and more than 40 bishops who were concelebrants -- took 30 minutes to complete.
END
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January 12, 2008 10:57 AM
National Review Book Review Wesley J. Smith on Embryos
Rock-Solid Logic
WESLEY J. SMITH
This book is bigger than the sum of its parts. The pro-life apologist and Princeton professor Robert P. George and his co-author, University of South Carolina philosopher Christopher Tollefsen, don’t just make a compelling and rational case — no religious arguments here — for the biological humanity and personhood of embryos. They also demonstrate convincingly that human life matters morally at every stage of existence, simply because it is human. And despite the high academic credentials of both authors, Embryo is no scholarly tome. Instead, while George and Tollefsen write very intelligently and mount their case with impeccable logical precision, the book is highly readable and their argument readily accessible to the average reader.
Their topic could not be more important. Across a broad spectrum of philosophies and ideologies, the unique moral importance of human life is under dedicated siege. Animal-rights advocates, for example, reject human exceptionalism, claiming that according human life unique value is “speciesism,” a perceived wrong asserted to be as odious as racism. What really matters, they insist, is the ability to feel pain. Hence, since both cows and human beings experience that sensation, bovines are our moral equals and cattle ranching is akin to slavery.
The concept of speciesism is also accepted in the field of utilitarian bioethics, which might be described as essentially an anti-humanism movement. According to the likes of Peter Singer and the British bioethicist John Harris, being human does not convey value. Rather, what matters is “personhood”: a moral status that must be earned by possessing sufficient cognitive capacities, such as being self-aware or valuing one’s own existence. Supporters of personhood theory argue that human beings who are not persons do not have the right to life and can be treated ethically as mere natural resources. And this is held to be true at both ends of life’s spectrum. Thus, articles in medical and bioethics journals around the world have urged that human beings diagnosed as being in a persistent vegetative state can ethically be harvested for their organs because they have permanently lost their personhood, while creating embryos through cloning for the purpose of stem-cell research is acceptable ethically because embryos have not yet attained personhood.
Meanwhile, many philosophical materialists deny that species distinctions are even real, given that most of our genes are shared by other mammals, opening the door in some minds to using the most weak and vulnerable people in place of animals in medical research. Then there are the so-called deep ecologists who misanthropically claim that we are a vermin species infecting the living Gaia, the solution to which is a radical reduction of human population to fewer than 1 billion.
It is into this ethical wind shear that George and Tollefsen jump in defense of the moral value of all human life. They do this powerfully by openly asserting the absolute moral equality of what many consider the least of human organisms: the early embryo.
Their apologia begins with proof of the biological humanity of the embryo from the moment it comes into being at the conclusion of fertilization. (The fertilized egg is actually not an egg at all: It is a one-celled embryo known as a zygote.) At one time such a defense would have been unnecessary. Embryology and basic biology textbooks clearly taught the simple scientific truth that human life begins at conception. But then along came the abortion debate and the potential to garner medical and scientific benefits from the instrumental use of the earliest embryos, and that which was once deemed biologically uncontroversial suddenly became the subject of heated debate.
After discussing the mechanics by which the sperm and egg merge and in the process are subsumed into the embryo, George and Tollefsen identify the biological nature of the new entity that has thus come into existence:
A human embryo is not something different in kind from a human being, like a rock, or a potato, or a rhinoceros. A human embryo is a whole living member of the species Homo sapiens, in the earliest stage of his or her natural development. Unless severely damaged or denied or deprived of a suitable environment, an embryonic human being will, by directing its own integral organic functioning, develop himself or herself to the next more mature developmental stage, i.e. fetal stage. The embryonic, fetal, child, and adolescent stages are just that — stages in the development of a determinate and enduring entity — a human being — who comes into existence as a single-celled organism (a zygote) and develops, if all goes well, into adulthood many years later.
New and novel definitions of embryos exist, of course, and the authors rebut them all. For example, some claim that the embryo doesn’t arise until it implants in a uterus. But this is, biologically, nonsense. Implantation doesn’t make a new entity that did not exist previously; fertilization does. Implantation merely enables the embryo to remain in a suitable environment for continued growth via the soon-to-come creation of its first vital organ — namely, the placenta. Nor is the embryo merely a bunch of cells equivalent to a mole before implantation, as other advocates assert. It’s a fully integrated and self-sustaining organism that begins developing from the moment it comes into being.
Having proved that the human embryo is indeed human life, the authors readily acknowledge that the biology of the matter does not settle the moral question. Indeed, establishing moral worth is not a job for science, but belongs rightly in the realms of philosophy and morality, areas of analysis to which they devote the balance of the book.
In tackling these matters, the authors present a good mini-seminar on “dualism,” which holds that “the kind of being we are” is “substantially different from the human organism” itself. For example, the authors explain that the beliefs of utilitarian bioethicists assert a “person-body” dualism, that is, they separate the biological human organism from the moral entity — the person — with only the latter having true value. Others, following in the intellectual footsteps of Plato, perceive a soul-body dualism. Descartes and his philosophical progeny assert the presence of a mind-body dualism (I think, therefore I am). And some distinguish the brain from the body, with the moral value of our beings centered in our frontal lobes.
The authors reject dualism in all its forms. And this leads them to their moral conclusion, which can be very briefly summarized as follows: “We are by nature,” they write, “human animals,” by which they mean to say that we are “bodily beings.” This means we have a unitary, not dual, nature. This nature is, among other attributes, rational. As a consequence, unlike any other species, we also are persons from the moment we come into existence. And it is our intrinsic personhood that gives each of our lives intrinsic value from its beginning until the very end. The authors write:
It seems to us that the natural human capacities for reason and freedom are fundamental to the dignity of human beings — the dignity that is protected by human rights. The basic goods of human nature are the goods of a rational creature, a creature who, unless impaired or prevented from doing so, naturally develops capacities for deliberation, judgment, and choice. These capacities are godlike (in a limited way, or course) . . . the power to be an uncaused causing. This is the power to envisage a possible state of affairs, to grasp the value of bringing it into being, and then to act by choice, and not merely impulse or instinct, to bring it into being.
To which their detractors will sniff: So what? While most human beings exhibit these capacities at any given time — and hence have the moral value that George and Tollefsen attribute to all human beings — not all members of the species Homo sapiens are so capable. Early embryos have no brain or nervous system, for example, and fetuses are not consciously aware. Some human beings who have lived personal existences lose these capacities. And when they do, they lose the value conveyed by personhood.
Not so fast, George and Tollefsen rejoin. Our value is objective, not subjective. Each of us possesses a “human nature,” as a “rational animal.” Our dignity doesn’t depend on the capacities of the individual, and personhood is not something we acquire along the way. It comes with the package, meaning our entire species is steeped in dignity and moral value, attributes that are intrinsic to our very nature as human beings. The fact that some of us have not yet developed, or have lost, our natural capacities is thus irrelevant to our moral status.
Moreover, understanding and accepting this philosophical point is the condition precedent to the recognition of universal human rights. This seems incapable of refutation. After all, if each of us has to earn his value moment-by-moment — as personhood theorists would have it — then universal human rights become oxymoronic, since our respective value is relative to our capacities at any given time.
Having demonstrated forcefully that the human embryo is biologically a human being from the moment of conception, and having strongly argued that every human being is ipso facto a person, the authors draw some important conclusions: All innocent human beings have a right to life; destructive embryonic-stem-cell research and human cloning are wrong, because they violate the bodily integrity and right to life of the nascent human person. Even though these biotechnological techniques could lead to scientific advancement and potential medical treatments, the authors assert (quoting Kant) that each of us must always be considered an end, never a means.
There remains the question of abortion. Some readers may be disappointed to learn that the authors generally leave it alone; but sufficient for each day are its own troubles. The emotional and incendiary nature of the abortion debate — the arguments on both sides of which everyone knows by heart — would have simply overwhelmed the delicately nuanced and generally neglected philosophical territory explored in Embryo. The authors were wise to leave that discussion for another book.
Powerful forces seek to knock human life off of the pedestal of exceptionalism. Many who stand against the resulting cultural riptide have too often struggled to mount a scientifically valid, entirely secular, and philosophically coherent rebuttal. This important task just became much easier with the publication of George and Tollefsen’s Embryo, an important and powerful contribution in “defense of human life.”
Mr. Smith is a senior fellow at the Discovery Institute, an attorney for the International Task Force on Euthanasia and Assisted Suicide, and a special consultant to the Center for Bioethics and Culture. He is currently writing a book about the animal-rights movement.
December 9, 2007 10:43 AM
A unique forum in California discusses connecrtion between mental health and spiritual convictions
Mind and soul
Psychiatry has typically shunned religion, but a unique forum at one university has them talking to each other - for the sake of the patient.
Since its inception in the middle of last year, the Psychiatry and Spirituality Forum at the University of California, Irvine, has grown from about 20 members to 130. The forum, unique in America, if not the world, has attracted an unusual following of Buddhist monks, Catholic priests, rabbis, psychiatrists, physicians, social workers and scientists. Founder and director of the forum is Dr Aaron Kheriaty, assistant clinical professor of psychiatry at UC Irvine. In this email interview with MercatorNet he talks about the connection between mental health and spiritual convictions.
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MercatorNet: There seems to be an awful lot of mental illness around the world: the WHO attributes a third of all disability to psychiatric conditions, and there are 800,000 suicides a year. Is it just coincidental that these numbers coexist with increasing material prosperity and diminishing religious faith?
Aaron Kheriaty: The burden of mental illness worldwide is indeed tremendous. Because of the social stigma against the mentally ill, their suffering and disability often remain hidden. There does seem to be a relationship between rising rates of certain mental illnesses and broad social and cultural changes-including diminishing religious observance. Despite our material prosperity and recent technological advances, rates of suicide, depression, substance abuse, and other mental and behavioural disorders are paradoxically rising. In his observations on America, the nineteenth century thinker Alexis de Tocqueville observed that we have this strange propensity to remain anxious and dissatisfied, even amidst the most abundant material prosperity. Modern technology has provided many good things, but it has not delivered greater mental health or happiness. We have advanced in terms of medication treatments for some mental illnesses, but solutions at the medical or biological level address only one aspect of very complex problems, in which psychological, social, and spiritual factors also play an important role.
I am a physician who has the highest respect for the benefits offered by modern science, modern medicine, and the other healing methods of psychiatry such as psychotherapy. I believe that because God created the world, all truth is one. Therefore, the truths of science can never contradict the truths of revealed religion, when both are properly understood and interpreted. Therefore, I am a "both-and", rather than an "either-or" thinker. When a patient who is a religious believer asks me whether they should pray more or take a medication to help with an episode of major depressive disorder, my answer is "yes" to both.
The uniquely human tragedy of suicide illustrates this phenomenon. A hundred years ago, the great sociologist Emil Durkheim wrote a classic study on the subject, in which he observed that high suicide rates are a key indicator of social disintegration. He found an inverse relationship between suicide and social connectedness. Durkheim also recognized that religious institutions fostered social solidarity in ways that reduced suicide risk among religious believers. He found that suicide rates were significantly lower in those countries with more robust religious observance. Predominantly Catholic countries also seemed to have lower rates than Protestant countries, which he attributed to Protestantism's relative stress on individualism, as compared to a Catholic emphasis on corporate forms of worship that shaped culture differently.
Durkheim's findings have been replicated in several studies since his day. It is now widely accepted among psychiatrists that religious belief and practice lowers the risk of suicide. In addition to the social support provided by religious institutions, other recent studies show that religious belief and flourishing religious institutions protect against suicide in ways that go beyond providing non-specific social support. Other factors include moral prohibitions against suicide found in Judaism, Christianity, and other religious traditions. In addition, religion often protects against despair and demoralization in the midst of suffering, through fostering meaning, hope, and a sense of one's personal vocation. So there are several factors that lower the risk of suicide among religious believers. Research on substance abuse, impulsivity, and violence also show that religious belief and practice lower the risk of these behavioural disorders.
MercatorNet: From his experience as a Jew in a concentration camp, Victor Frankl came to the conclusion that suffering can have meaning. This is an idea common to religious traditions but not very popular today. Do we need religion or something similar to cope with suffering, which is unavoidable in human life?
Aaron Kheriaty: I hesitate to speak of "religion" in the abstract. In a sense, there is no such thing as religion; there are only religions, each of which has different answers to questions about suffering and meaning. I have never met anyone who believes in "religion", but I have met a lot of Jews, Christians, Muslims, Hindus, and Buddhists. These religions may very well have some elements in common, but to group them all under one abstract term can be somewhat misleading.
Consider the different approaches to suffering found in different religions. For a Buddhist, suffering is actually an illusion -- in the last analysis, it is not real. The solution to suffering, according to Buddhism, is to detach oneself in such a way that one frees oneself from the illusion of suffering. Contrast this with Judaism, which offers the figure of suffering Job, who hopes in God in the midst of his suffering. Nowhere is it suggested that Job's suffering -- or the suffering expressed by the Psalmist, or the suffering of the Israelites while enslaved in Egypt -- nowhere is it suggested that this suffering is, at bottom, an illusion. It is real, and because it is real this suffering calls forth hope in God's deliverance, hope in the promises made by the Prophets, and an expectation of a future Messiah. Finally, we can contrast these views of suffering with that proposed by Christianity. For Christians, as for Jews, suffering is real. It not only calls for hope of future deliverance, but it sees suffering itself as redemptive. The Christian's suffering takes on meaning when it is united to the suffering of Jesus Christ on the Cross; it is precisely here that one's salvation is found. So it should be clear from these contrasts that there is no single "religious" answer to coping with suffering. On the other hand, it seems that all religions attempt, in their own way, to address the universal problem of human suffering.
It seems to me that it is the religions of the world that have grappled most deeply with the question of suffering, and have offered the most compelling answers to coping with suffering (some more compelling than others). I think, in the end, we do need religious faith to adequately endure suffering. Consider the approach to suffering currently on offer from secular humanism, whose proposal is to someday eliminate all suffering through purely technological means. While this is not possible (and it will never be completely possible), the backup plan seems to be to eliminate the one who is suffering, by means of euthanasia or assisted suicide. This seems to me to be a rather primitive form of denial; it pales in comparison to notions of redemptive suffering found among many religious believers. If we are looking for pragmatic ways to "cope", non-religious answers to suffering appear rather pale and thin compared to religious responses that do not shrink from or ignore the reality of human suffering.
MercatorNet: Does religious faith, or any belief system, guarantee that a person will remain free of mental illness?
Aaron Kheriaty: Absolutely not. Unfortunately, this is a mistaken idea that circulates among some religious believers. It is a notion that needs to be put to rest. Just as with physical illnesses, sometimes a person's behaviours (e.g., overeating or smoking) can contribute to their disease (e.g., lung cancer). But it certainly does not follow that all physical illnesses can be prevented with the right behaviours or beliefs. So also with mental illnesses. Some of the entities currently classified as mental disorders are best understood as diseases in the strict sense of the term; they result from disordered biological or genetic factors that lie outside one's control. Disorders like schizophrenia or bipolar disorder (formerly called manic-depression), although manifested at the psychological or behavioural level, have very strong genetic and neurobiological causes, and cannot be prevented or cured through belief or will power alone.
Other mental illnesses result from being at the far end of a normally distributed trait-like low intelligence, or personality traits that lie on the extreme end of a spectrum. Again, these traits are influenced by factors like genetics and early environmental influences, which lie outside one's control or are not dependent upon religious faith. Other mental disorders are the result of trauma, terrifying life experiences, or injuries to the brain -- none of which can be prevented by any belief system. Throughout history, many saints and people of heroic virtue suffered from mental illness of one sort or another. If we do not recognize this, we run the risk of uncharitably and unjustly stigmatising those who suffer from mental illness.
MercatorNet: In some people, mental illness expresses itself partly as religious mania. What is happening here, and is there a remedy?
Aaron Kheriaty: Psychotic states found in schizophrenia, or manic states found in bipolar disorder, can often be characterized by "hyper-religious" delusions (fixed false beliefs) or hallucinations (perceptions without external stimuli). A manic person may claim to hear the voice of angels, or to be a prophet sent on a mission to save the world. What is happening here is that the unfortunate person suffering from these mental disorders is in a state where their mental life is disintegrating. They are experiencing intense and very unusual thoughts, emotions, and perceptions, which others around them are not experiencing. It is terrifying to believe that one's own mind may be coming unglued -- that one is hearing or seeing things that others do not see or hear, for example. The mind has a tendency toward attaining unity, integration, and meaning. We try to make sense out of our experiences, even when these experiences are pathological or terribly bizarre.
So a person who has grown up in a culture with religious or supernatural concepts readily available will often reach for these concepts to make sense out of these terrifying, highly unusual experiences. "I'm hearing a voice that no one else hears -- so I must be receiving special messages from God." A person who grows up in a non-Christian culture, or who knows little about Christianity, will not develop the delusional belief that he is Jesus or John the Baptist. Rather, the content of his delusion will be drawn from his own religious or cultural concepts, which might appear to explain his experiences. With these illnesses, it is the form of the thinking that is disordered; the particular content of the thinking is dependent on one's own cultural or religious upbringing, knowledge, or background. It is quite clear to anyone that talks to a person with hyper-religious psychosis or religious mania that something has clearly gone wrong with this person's thinking and behaviour. It is not simply a matter of someone suddenly becoming more religious, but of a person losing their capacity for rational thought, which may be expressed in terms and ideas borrowed from religion.
Is there a remedy? Yes, fortunately modern medical science has developed antipsychotic and mood stabilizing medications that can often be remarkably effective in correcting and stabilizing even these dramatic thought and mood disorders. With the right medication treatment, and a stable, supportive environment, someone with severe mania or psychosis (religious or otherwise) can be helped to a remarkable degree.
MercatorNet: You have undertaken a three-year study of the history of psychiatry and the attitudes of its leading figures towards religion and spirituality. We might guess they would be largely negative. Is that what you expected to find?
Aaron Kheriaty: I expected to find negative (or indifferent) attitudes in general, and with a few exceptions, this is what I have found so far. The founding father of psychoanalysis, Sigmund Freud, taught that religion was not only false, it was an illness, a form of psychopathology -- the "universal obsessive neurosis of mankind". For Freud, religion was a childish regression; God was simply a wish-fulfilling projection from our unconscious. Most other psychoanalysts during the first half of the 20th Century followed Freud in thinking that religious faith was pathological, though they may have been too polite to unmask their patient's religious beliefs. One exception would be Freud's heterodox disciple, Carl Jung, who appeared on the surface to be less hostile toward religion. But Jung strongly opposed Judeo-Christian beliefs, and proposed a Gnostic system in which God and man are ultimately indistinguishable. For Jung, God and other sacred ideas were housed in the collective unconscious of humanity. So his psychology became an attic where spiritual dilettantes could search for religious knick-knacks that suited their temperament.
In mid-century, psychoanalysis began to lose influence. Behaviourism, led by John Watson and later B.F. Skinner, began its ascendancy, and influenced psychiatry in other directions. The research findings of the behaviourists were interesting, so far as they went, but the theory was reductionist in the extreme: all mental concepts were done away with. Mental health and illness were nothing but the result of environmental inputs that, in a completely deterministic way, produced behavioural outputs. Obviously religion was thrown out here, along with all other concepts that did not fit within the extremely narrow paradigm of what was considered "behavioural science".
The humanistic psychology movement of the 1970's tried to remedy some of the perceived deficiencies both in psychoanalysis and behaviourism. But it was led by therapists disaffected with religion, who offered their own theory of human flourishing characterized in large part by hostility toward religious values and morals. A cult of the self grew out of the theories of Rogers, Maslow, Fromm, and others. Concepts like "self-esteem," or goals such as "peak experiences," replaced virtues cultivated by religious or ascetical practices. Western culture was influenced by these movements from psychoanalysis to so-called humanistic psychology, in what has been dubbed the triumph of the therapeutic: psychological man (who carefully counts his satisfactions and dissatisfactions) has replaced religious man (who sacrifices himself for a noble ideal) as our dominant character type.
Finally, in our own day, the cognitive and neuroscientific turn has rescued the brain from the behaviourists, but has focused on human mental life from a purely biological perspective. This can also tend toward reductionist and materialistic interpretations, if its limits are not appreciated. Great benefits have come from our rapidly expanding knowledge of the brain at the cellular and molecular level. I am involved in research of this kind, and there is no doubt that biological psychiatry has much to offer in terms of treatments for mental illness. But we humans are more than biological beings. And if we continue to ignore the psychological and spiritual dimensions of the human person, our perspectives in psychiatry will remain truncated and incomplete.
MercatorNet: What about today's psychiatrists -- do they approve of your initiative?
Aaron Kheriaty: So far, the response to the Psychiatry and Spirituality Forum has been nothing but positive. I imagine there must be some critics out there, but so far, my colleagues in psychiatry have been very supportive of this project, even if they have no interest in participating themselves. The University of California, Irvine, and our Department of Psychiatry, have been tremendously helpful, and the Templeton Foundation and its affiliate institutes have been very generous in assisting this project. I have been approached by psychiatrists, scientists, scholars, clergy, and religious leaders from our University, the local community, and beyond, who tell me that they have been interested in the relationship between psychiatry, religion, and spirituality for many years, and are delighted to find others who share their professional and personal interests. We have psychiatry residents applying here who are attracted to our program because of this project. Other schools in the United States have expressed interest in starting similar programs, and researchers from as far away as Iran have contacted me to collaborate on research projects. The time seemed to be right for this project, and the positive response has been surprisingly edifying.
MercatorNet: You say that modern psychiatry has much to offer religious believers. Could you unpack that idea for us?
Aaron Kheriaty: I am a physician who has the highest respect for the benefits offered by modern science, modern medicine, and the other healing methods of psychiatry such as psychotherapy. I believe that because God created the world, all truth is one. Therefore, the truths of science can never contradict the truths of revealed religion, when both are properly understood and interpreted. Therefore, I am a "both-and", rather than an "either-or" thinker. When a patient who is a religious believer asks me whether they should pray more or take a medication to help with an episode of major depressive disorder, my answer is "yes" to both. This is an illness whose causes may be a complex combination of biological, psychological, social, and spiritual factors. Therefore, the treatment should encompass all of the above.
So modern psychiatry has much to offer religious believers in the same sense that modern cardiology has much to offer religious believers-we have medical remedies for disease, illness, and suffering that afflict people, including people of devout religious faith. Beyond this, I think, psychiatry and its related psychological sciences have insights gleaned through research, clinical experience, and careful observation, that shed light on perennial questions about human nature. These are questions addressed by the great religious and philosophical traditions, and the answers to these questions can be enriched by insights from modern science and medicine.
MercatorNet: Members of your forum are also doing a study on the long-term effects of prayer and meditation on the brain. What is already known from research on this subject? What does your own experience suggest?
Aaron Kheriaty: Most of the research so far has looked at state-dependent brain activity during times of prayer or meditation. This basically means that we take a snapshot of the brain, typically through functional imaging techniques like SPECT, PET, or functional MRI scans, to see what is happening in the moment when one is praying or meditating. Aside from the obvious challenge of entering into a state of mystical contemplation while lying in a loud and claustrophobic MRI machine, it is not yet clear exactly what wisdom is gained from such studies. That such-and-such area of the brain (e.g., the temporal lobe) is active during times of prayer or meditation tells us very little about such religious or spiritual activities. This research has also been subjected to the corrosive acid of reductionist interpretation along purely materialist lines: "Contemplative prayer is nothing but discharges in this parietal region of the brain," or "Religious mystics like Teresa of Avila must have suffered from temporal lobe epilepsy." I have very little patience for this sort of thing. This is not to say that such scientific research must be interpreted in this way, nor does it deny that there may be valuable insights gained from these studies.
Our own proposed brain research project, led by Dr Adrian Preda, takes a somewhat different approach, which may be more fruitful. We plan to study not just state-dependent snapshots of what is happening during periods of mediation or prayer. Rather, we will try to measure structural changes of the brain, which result from many years of engaging regularly in such practices. Our hypothesis is that habitual prayer and meditation may have integrating effects on various parts of the brain. These structural integrations have been associated (in other research) with superior mental and emotional health and functioning.
We will compare three groups: Hindu Yoga meditators, Christian contemplatives from religious orders, and a control group of "meditation-naïve" subjects. We are predicting important integrative structural brain differences between the meditators and non-meditators. In addition, we suspect there may be measurable differences between the two meditation groups, rooted in differences of the theory and practice. The Yoga meditators have techniques focused on mental awareness of bodily states such as breathing. The Christian contemplatives have techniques focused on awareness of the presence of a personal God beyond oneself, with whom one engages in an intimate "I-Thou" dialogue. These differences may result in differences at the level of brain structure and functioning.
This is research that may coincide with insights from virtue ethics and related philosophical or theological theories. The ethics of Aristotle or Aquinas, for example, posits that repeated behaviours over a long period of time will result in changes inscribed on our nature that predispose us to virtuous action. Our research may shed light on measurable changes at the biological level which strengthen mental states or behaviours, as they are practiced repetitively over time. We may see that prayer and meditation not only activate certain areas of the brain, but that such activity changes a person at the biological level, and these changes predispose to better mental functioning.
MercatorNet: The forum sponsors lectures covering religious and spiritual issues for all psychiatric residents during the first three years of training. Do they respond well to the subject? Do they bring much personal experience and conviction to it?
Aaron Kheriaty: After medical school, residency training equips the physician for practice in a particular specialty. The residents in our program at UCI have responded very well to the lectures, case conferences, grand rounds, and supervision that we have integrated into training. This curriculum addresses religious or spiritual issues that commonly arise in a clinical context. Most residents have already encountered patients whose thoughts, emotions, and behaviours (the bread and butter of psychiatry!) are profoundly influenced by the patient's religious and spiritual beliefs and practices. Often, patients will seek a psychiatrist who shares, or at least respects and understands, their religious, spiritual, and moral convictions. Residents with clinical experience are already aware that such training is valuable in their clinical work. Many of them have a personal interest in this area, stemming from their own religious or spiritual background.
MercatorNet: Your forum is unique so far -- is this idea going to catch on?
Aaron Kheriaty: I hope so. My experience so far suggests that it might catch on elsewhere. If this happens, this will, I hope, produce mutual benefits for psychiatrists, clergy, and religious leaders who are all dedicated to promoting health, happiness, virtue, and human flourishing.
Dr Aaron Kheriaty is assistant clinical professor of psychiatry at the University of California, Irvine, and director of the university's Psychiatry and Spirituality Forum. He can be contacted at akheriat@uci.edu
Comment (13) | Email | Print | del.icio.us | Technorati | digg Comments (13)
Pete Cook said... Great interview and wonderful, pioneering work by Dr. Kheriaty and his associates.
United States | Friday, 30 November 2007 at 7:45 am
ck :-) said... Religion is so basically defined as “a way of life.” For psychiatry or psychiatrists to shun religion is to uniquely forsake a patient’s mental health thus well-being. Finally! Congratulations to the director-founder and more power to the Psychiatry and Spiritual Forum at UCI.
ck :-)
Philippines | Friday, 30 November 2007 at 10:50 pm
Theresa Kolodge said... Excellant research and presentation!!! Interesting and Powerful insight!
United States | Saturday, 1 December 2007 at 5:38 am
Ann Marie Eckl said... A gift for modern times. Glory be to God!!!
United States | Saturday, 1 December 2007 at 5:42 am
Rosemary Kite said... Thank you for this informative interview. There is certainly much needed work to be done on integrating the biological, psychological and spiritual dimensions of each human person. I wish Dr. Aaron Kheriaty and his forum the best of luck.
United States | Monday, 3 December 2007 at 3:43 am
ecv said... This is one of the best news I’ve heard this year. Imagine the good this will bring to a lot of people. It will also surely help in strengthening the hope of those who suffer from these illnesses.
Philippines | Monday, 3 December 2007 at 11:18 am
m c c ryan said... Dr Aaron Kheriaty of California misleads on C G Jung, saying that Jung ‘strongly opposed Judeo-Christian beliefs’. Take the young doctor back 55 years to ‘God and the Unconscious’ by Victor White,OP. The renowned Dominican scholar (p 272) quoted Jung: “Christ is in us and we are in him! Why should the activity of God and the presence of the Son of Man within us not be real and observable? Every day am I thankful to God that I have been allowed to experience the reality of the Divine Image within me.. Thanks to this act of grace . . my inward eye has been opened to the beauty and the greatness of dogma. I am enabled to see that the Church is my Mother . . “
For ‘psychiatry and spirituality’, consult the great Swiss.
MICHAEL C C RYAN, SOMERVILLE VIC 3912 Australia
Australia | Monday, 3 December 2007 at 12:26 pm
Christopher Canaris said... A lovely synthesis reflecting an authentic humanism encompassing an attitude of respect for faith and the role it plays in our own and our patients’ lives. I especially liked the distinction between religion and faith – religion is a man made construct whereas faith under its many guises is a gift from God. I think it’s equally important to acknowledge the differing insights that different faiths have to offer and their impact on our experience of physical and psychiatric illness.
A five star effort from MercatorNet and Aaron Kheriaty.
Australia | Monday, 3 December 2007 at 9:46 pm
Mariusz Wesolowski said... Michael C C Ryan tries to debunk Dr. Kheriaty’s statement that C.G. Jung “strongly opposed Judeo-Christian beliefs” by quoting Jung using Christian terminology. But Dr. Kheriaty goes on to say that Jung “proposed a Gnostic system in which God and man are ultimately indistinguishable.” The stress is on the term “Gnostic”. Many ancient and modern Gnostics, Jung including, used the Judeo-Christian concepts and terminology while totally rejecting the basic Christian beliefs (viz., the original sin, the Holy Trinity, etc.) This is what Dr. Kheriaty correctly stresses in this excellent interview.
The main problem with Jung is that he travels “downward”, into the substrata of human conscioussness, thus ignoring the upward thrust of the true faith, into the SUPER (i.e., above)-natural region of the Divine.
Canada | Wednesday, 5 December 2007 at 3:29 am
Richard P. Fitzgibbons, M.D. said... For those interested in a deeper understanding of Aaron Kheriaty’s psychologically accurate comments on Jungian thought and practice, I highly recommend Richard Noll’s The Jung Cult and The Aryan Christ from the history of medicine department at the Harvard Medical School.
United States | Thursday, 6 December 2007 at 11:52 am
michael c c ryan said... Readers, please go back and read Jung’s entire quotation closely.
His words sit easily with, “...Christ lives in me”
Mr Mariusz Wesolowski brands Jung a Gnostic.
Like that other Gnostic, St Paul? [Galatians 2:20].
Next negator, Dr Richard Fitzgibbons. Shall we rely on Richard Noll (not Nolls), a secularist sour on Jung’s christian affinity, rather than on Victor White, O P?
I recall an Australian Dominican, now bishop, telling me the English Father White was an honoured philosopher in the Order of thinkers.
- Michael C C Ryan, Somerville VIC Australia 3912
Australia | Thursday, 6 December 2007 at 4:34 pm
Mariusz Wesolowski said... Mr. Ryan chooses to pretend ignorance when he says:
“His words sit easily with, “...Christ lives in me”
Mr Mariusz Wesolowski brands Jung a Gnostic.
Like that other Gnostic, St Paul? [Galatians 2:20].”
Of course, using the name of Christ does not prove anybody’s orthodoxy, and calling St. Paul a Gnostic is just playing with words. There are Gnostics and there are gnostics, as I’m sure Mr. Ryan knows only too well. St. Paul belonged to the second category.
As for Jung’s very clear “downward” direction, toward the chthonic and the demonic, I suggest reading Stephen Hoeller’s “The Gnostic Jung” (Hoeller is entirely sympathetic to CGJ.)
Canada | Thursday, 6 December 2007 at 11:50 pm
Richard P. Fitzgibbons, M.D. said... Richard Noll’s outstanding scholarly research on Jung was actually in History of Science at Harvard University. The Jung Cult and The Arian Christ clarified what few in the mental health field or in the Church realized,that is, that Jung’s theories of the archtypes and the collective unconscious came as much from late nineteenth century occultism, neopaganism and social Darwinian teachings as they did from natural science.
United States | Sunday, 9 December 2007 at 4:47 am
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