Medicine is an art more than a science, says Dr. Bernard Ars.
Waiting lists, financial speculation, depression, pressure to promote euthanasia, surrogate motherhood … The challenges facing doctors today are numerous and, for some, unusual. Aleteia talked with Dr. Bernard Ars, new president of the International Federation of Catholic Medical Associations, about living his profession today.
As the head of the International Federation of Catholic Medical Associations (FIAMC, from its name in French) for the last few months, Dr. Bernard Ars, associate professor of higher education (Ph.D) and specialist in otorhinolaryngology and head and neck surgery, has set three priorities: “To stimulate the particular compassion that we, Catholic doctors, must develop in the face of vital and social precariousness; to spread a Christian concept of man and morality as well as the proper dialogue between faith, reason, and the sciences while remaining faithful to the Church and her Magisterium; and increase our interior lives.” And what interior lives!
FIAMC comprises 80 associations representing some 120,000 members worldwide. It has a dual mission: first, to strengthen the doctors who get involved with their faith in Jesus Christ to help them apply the Gospel message in their daily practice; and second, to inform the Holy See of the realities and developments in medicine concerning the clinic and research.
Aleteia: Catholic doctors are more and more often in situations where they have to claim the right to conscientious objection, because health systems force them to undertake practices contrary to human dignity: genetic manipulation, euthanasia, and abortion. What do you recommend to these doctors?
Dr. Bernard Ars: I advise them, on the one hand, to always ensure that a conscience clause is included in all their contracts with an institution or a collaborator, as well as in the legislation of their country, and on the other hand, to form their own moral conscience well throughout their lives, studying Christian anthropology and taking time to renew their interior life.
What does a conscience clause mean for you?
The duty of conscientious objection manifests the grandeur of human dignity. A man can never bring himself to commit moral evil. He cannot consciously and deliberately adhere to an action that destroys his own dignity. The freedom of the human being is a reflection of the image and likeness of God that He has imprinted in each person’s heart. No person can use his freedom to tarnish the reflection of God’s presence in himself. That is why he must resist unjust human laws.
This has been the case at times in history with racial discrimination and apartheid, and this is the case today with abortion, euthanasia and other acts that are irreconcilable with the dignity of the person. If a Catholic doctor opposes certain practices, it is not first because he is Catholic but because he is a person, a being who listens to the voice of his conscience, enlightened and confirmed by the Church’s teaching.
We all know the anecdote of Cardinal Newman, who was asked if he raised his glass first to his conscience or to the pope. When he said that he first lifted his glass to conscience and then to the pope, he did not want to oppose Christians to the Church, but to honor the unique voice of truth whose first echo resounds in the conscience and is confirmed, if necessary, by the ultimate judgment of the Church.
The pope and the Holy See have recourse to your association to learn about the problems of bioethics. How is your relationship with the Vatican structured?
Our exchange of information is not just about bioethical issues. Medicine is involved in many areas of the human being: scientific research, culture, family … The problems of bioethics are essentially the responsibility of the Pontifical Academy for Life, which depends on the dicastery of the Laity, the Family, and Life. As for FIAMC, it depends on the Dicastery for Promoting Integral Human Development.
What are the ethical issues facing Catholic doctors today?
The ethical problems encountered by Catholic doctors vary in intensity, according to the practice and the regions of the world. For example, general practitioners face ethical and deontological challenges in their person-to-person relationships with patients. Specialist hospital doctors are confronted with ethical difficulties in the face of the domination of technosciences, industry (especially pharmaceutical companies), and the consumerism of care. Finally, medical researchers face ethical difficulties in choosing objectives, working strategies, and also financial constraints.
Often, in recent years, bioethics has been interpreted and exploited ideologically in a way that is inconsistent with its original objectives, which were the defense of life and the human person, as well as with the Christian vision of man. In order to give bioethics its deepest meaning, it is important to form a moral conscience based on an up-to-date Christian anthropology, striving towards the common good.
Contemporary medicine, which is based on the hospital and big data, risks losing the doctor-patient relationship. How is it possible to restore a doctor’s role in our society?
Apart from the real ethical problem of big data, the robotic collection of patient data allows for a rapid diagnosis and precise, targeted therapy. While it is a certain progress in the management of diseases, the technical nature of scientific medicine tends to reduce the contact between the doctor and the patient to an inventory of the objective performance of essential biological functions. But the patient expects something else from the doctor. While he is certainly not indifferent to the pains and sufferings of his body, and to the threat that an illness poses to his future and that of his loved ones, he also expects the doctor to teach him to live with the disease.
But how can they help the sick to develop their resilience?
For patients, resilience is a dynamic and interactive process between himself, his family, and his environment, which allows him to develop a new and fulfilling path, changing the representation of the reality that is harming him. For this, we doctors must show empathy, which is naturally based on good listening. To listen is to give the word of the other all its value. It is through listening that we learn from the patient what his illness is, how he interprets it, and the means he has to face it.
For listening to be successful and beneficial for the patient, it is necessary to respect his rhythm. We must not seek to force confidences and we must also discern the right time to stop listening. Resilience is a long-term process. It is only by allowing time to do its work that a “new” form of life can be born of illness. We must be patient. For the trial of suffering to be bearable, we must live it one day at a time.
Is every day’s trouble sufficient for itself?
Each day we experience an accumulation of trials, but we also have the courage to face them. It is necessary to help the patient to accept what today has to give him as a resource and to abandon, in confidence, the day that is ending. Even in the worst conditions, man has the ability to get away from it all with humor. Let’s be receptive and interactive! “Men stay strong as long as they live for a strong idea,” said Freud. It is around this strong idea, this sense that makes the coherence of his life, that man can build himself, rebuild himself. “That meaning must be found, because it is an object that is sought, but it must never be given. It is the responsibility of the patient to find it for himself,” said neurology and psychiatry professor Viktor Frankl.
In addition, the Catholic physician, beyond his scientific competence and his human empathy, is also a soul who sees the suffering Christ in his patient, and who prays for the man or the woman who suffers.
Many Catholic doctors work in situations of extreme poverty. Is there a message you would like to send to these doctors?
Dear colleagues, you probably lack basic diagnostics and therapies to heal your patients and save lives. Do not hesitate to alert, by all the means at your disposal, the international organizations, as well as your connections, in order to mitigate the gravity of your situation. Nevertheless, know that you are, among our confreres, “the doctors’ doctors.” Your empathy is more developed than that of others, and you understand better than anyone the distress of our patients. Know also that many of us are praying for you. And when we, doctors, have nothing more effective to offer in the face of sickness and suffering, we still have our support, our listening, and our time to offer. We always have Hope to make present. Finally, we also have to offer the powerful help of prayer.
Can you tell us a bit about yourself? Why did you decide to devote yourself to medicine? And as a Christian doctor?
I chose medicine at the age of 17 because it was a profession of human relations — giving and receiving — and I felt that I could be happy by practicing it. I chose otorhinolaryngology because this specialty gave me, in equal proportion, the joys of clinical consultations, surgery, and functional explorations. As for the vocation of a Christian doctor, I didn’t really choose it. It came slowly and sweetly. I have always been a believer and a practicing Catholic. But, faced with the problems and the sufferings of life, it is Christian practice, as well as my life of prayer in front of Jesus, that appeared to me as the true and only way of Life.
Do you have any advice for young Christians who want to become doctors?
Get involved where your heart is calling you! And when you make a commitment, train yourself unceasingly, scientifically, technically, and continuously. It’s a question of professionalism! But do it also on the cultural, artistic, philosophical, and even theological level, to have the greatest possible humanistic openness, while listening to our patients. In fact, the patient who comes to consult us comes to talk about himself, and he expects his doctor to listen to him, and then respond to him. He is distressed. He may feel excluded. The doctor should speak openly to his patient about the disease. This leads the patient to think about himself as much as about the illness he came to report. The rebellious disease, and even more so death, may appear as a limit to medical efficacy. The natural tendency would be to flee from this disease or death. But, the important thing is to be available so that the patient does not feel alone in the face of his experience. The doctor is not the master of life, nor of the death of the patient who confides in him. He does not have complete power over his patient; he is, in fact, at the service of the life of the suffering man. The Catholic doctor lives from Christ. He has a unity of life, a coherence in all the aspects of his life. This involves not only professional and responsible competence, scientific and technical knowledge in collaboration with the other disciplines of care but, above all, a strong daily interior life, as well as a thorough knowledge of the Christian vision of the human being. In short, an updated Christian anthropology, expressed as much in research as in the clinic — in a word, in culture. Medicine is not a science, it is an art. It’s the best job in the world!