Barragán on Future of Health Care
"Putting Technology at the Service of Man"
ROME, OCT. 6, 2007 (Zenit.org).- Here is the address delivered by
Cardinal Javier Lozano Barragán, the president of the Pontifical
Council for Health Care Ministry, during a conference co-sponsored by
the Vatican dicastery and the Acton Institute, titled "Health,
Technology and Common Good." It was held at the Pontifical Gregorian
* * *
My Dear Friends, Ladies and Gentlemen,
I have been honoured to welcome all of you into this one-day conference
which reflects themes based on Health, Technology, and Common Good.
Well, I shall do this duty with pleasure, on behalf of the joint
organizers of this Conference: The Acton Institute and the Pontifical
Council for Health Pastoral Care.
First of all, it is my duty to welcome all the distinguished speakers
of the day. We have a wide spectrum of topics as well as experts for
each session. So let us give all of them a hearty welcome and wish that
they will enlighten us throughout the day. Then, to all the
participants so that the reflections of today will lead us to more
fruitful action in the future.
I have been asked to present "The Future for Health Care: Putting
Technology at the Service of Man." Well, I am to do that presentation
in two divided sessions, one in the beginning as I am doing now, and
the other at the end of the day as closing remarks.
Part I: Introduction
Therefore, at this moment I shall try to introduce briefly the day's
theme: Health, Technology and the Common Good. First of all, there
needs to be a clear understanding of what health is; because technology
must be oriented to health, and to the future of care health. I am sure
Monsignor Jean Laffite is an expert to explain it to us in detail. It
has been my experience as the president of the Pontifical Council for
Health Pastoral Care that there is a lot of confusion regarding health,
even among political leaders as well as Church leaders. Many bishops
from all over the world, when they come to visit the Pontifical
council, had asked me to present for them what does it mean health
today, especially when there are lot of technological developments. So
I prepared especially for them a short volume called "Metabioethics and
My point is there are people who seriously want to understand clearly
what health is, especially at this period of globalization, when they
are bombarded with partial or unclear information, especially from
various international organizations, NGOs and other associations who
are involved in health care. There is clearly a paradigm shift in the
ethical reflection on health. This so called "New Paradigm" is supposed
to be the official thought of the United Nations and its various bodies
like WHO and UNESCO. It is supported by four NGOs in particular:
"Women's Environment and Development Organization," "Earth Council,"
"Green Peace" and "International Planned Parenthood Federation."
According to its proponents the objective of the new global ethics is
to achieve global well-being within the confines of sustainable
development. This global well-being is what forms the target also known
as World Health Organization Quality of Life (WHOQOL) and is defined
as: "the perception by the individual of his position in life, within
the context of the culture and system of values in which he finds
himself, and in relation to his goals, expectations, models and
It covers six areas: 1. Physical health, 2. Psychological health, 3.
Level of independence, 4. Social relations, 5. Context (economy,
freedom, security, information, participation, environment, traffic,
climate, transport…) 6. Spirituality. Aside from social duties, the
basic factors are autonomy and self-determination.
One of the precepts of this new paradigm is "Health For All". Health
for all is defined as at Alma Ata: "the state of complete physical,
mental and social well-being and not merely the absence of disease or
It requires ten aspects: health education, adequate nutrition, clean
drinking water, basic health care, maternal infant care, immunization
against the major contagious diseases, prevention and control of local
endemic diseases, suitable treatment in the event of common disasters
and illnesses, access to basic medicines and reproductive health.
Although apparently there are values in this new paradigm shift what is
basically wrong is an ideology that is "closed to the transcendent."
First of all, there is an ethical subjectivism and relativism. Since
there no objective validity in their argument those who hold to this
thinking concentrate their activities above all in "lobbies," to seek
or buy consensus. Their thinking is based on a distinction made between
the human being or individual and the person. In any case, there are
only rights for the person, not for the human being or the individual.
One is a person only when he acts as such in the complex world of
interrelationships of sensorial, mental, conscious, social activities,
symbolic gestures, etc. If, at any given moment, someone is not capable
of acting as such, he ceases to be a person and is simply a human being
or an individual, deprived of any right that could be described as
human right. This gives rise to questions related to health issues of
the individual in relation to technological advancement, especially
concerning the right to life of the fertilized egg, the human state of
the "pre-embryo" or the embryo, the right to abortion, the ban on
eugenics, euthanasia, etc.
As background of this way of thinking we find the confusion between
well-being and happiness. And also the concept of liberty as something
absolute and closed in itself.
In contrast with the position of the New Paradigm, we can approach to
the authentic concept of health such as is described by the servant of
God John Paul II: According him health is a tension towards harmony at
the physical, psychological, spiritual and social level, and not mere
absence of illness, and which enables man to fulfill his God-given
mission in the stages of life he finds himself.
Part II: The Future of Health-Care: Putting Technology at the Service
Following this pontifical description of health, what will be the
future of the technology in the field of health, if it will be
Addressing the participants of the Plenary Assembly of the Pontifical
Council for Health Pastoral Care, Pope Benedict XVI said: "The health
of the human being, of the whole human being, was the sign chosen by
Christ to manifest God's closeness, his merciful love, which heals the
mind, the soul and the body…. Going to the aid of the human being is a
duty: both in response to a fundamental right of the person and because
the care of individuals redounds to the benefit of the group. Medical
science makes progress to the extent that it is willing to constantly
discuss diagnosis and methods of treatment, in the knowledge that it
will be possible to surpass the previous data acquired and the presumed
limits. Moreover, esteem for and confidence in health-care personnel
are proportionate to the certainty that these official guardians of
life will never condemn a human life, however impaired it may be, and
will always encourage endeavors to treat it. Consequently, treatment
should be extended to every human being, meaning throughout his or her
entire existence. The modern conception of health care is in fact human
advancement: from the treatment of the sick person to preventive
treatment, with the search for the greatest possible human development,
encouraging an adequate family and social environment."
Therefore, when we speak about putting technology at the service of man
we are considering humanity as such and for the common good in general.
As the Second Vatican Council had observed, "Every day human
interdependence grows more tightly drawn and spreads by degrees over
the whole world. As a result the common good, that is, the sum of those
conditions of social life which allow social groups and their
individual members relatively thorough and ready access to their own
fulfillment, today takes on an increasingly universal complexion and
consequently involves rights and duties with respect to the whole human
race. Every social group must take account of the needs and legitimate
aspirations of other groups, and even of the general welfare of the
entire human family."
In today's globalized world we need to think in terms of human
connectivity. Some of the modern technologies in health care themselves
are connecting human race. An example is "eHealth" or health-care
delivery supported by information technology, of digital data --
transmitted, stored and retrieved electronically -- in support of
health care, both at the local level and at a distance.
Internet has helped connect so many medical personnel by providing
information on the latest achievements in health technologies, thanks
to servers installed by medical faculties and medical journals. Another
example would be "Telemedicine."
When the patient and doctor are in far away places, they could use
modern communication technologies (two way interactive consultation and
digital image/data transmission) to send radiology images, laboratory
reports, medical records, etc.
Telemedicine has proven very efficient, especially in emergency
situations like NASA (The National Aeronautics and Space
Administration) intervening in the 1985 Mexico City earthquake, or the
1988 earthquake in Armenia. In 1994 they have improved it into ACTS or
Advanced Communication Technology Satellite.
In 1996 TIP (Portable Telemedicine Instrumentation Pack) was made
available for easy transportation by health care personnel. Today we
can speak of telesugery, teleradiology, teledentistry, teledermitology,
telepathology, teleoncology, telepsycology, telecardiology,
teleneurology, telenursing, etc.
The European Health Telematics Observatory's (EHTO) assertion is
illustrative: health telematics activities are used by hospitals (34%),
telephone utilities (14%), academic institutions (12%), clinicians
(12%), governments (7%) and social services (4%).
Some of the technologies enhance the past groundbreaking achievements
in health care science: the concept about "public health", Epidemiology
and its branches like Neuron Epidemiology, Cardiovascular Epidemiology,
Cancer Epidemiology, etc., Health Economics and Health Management and
so on. This last one branch has helped form health policies where there
is awareness that spending on health care "is not an expenditure but an
investment." This has also helped strategies of preventive and
promotive measures in health care.
During my pastoral visits around the world, it is very heartening for
me to see dozens of immaturely born children being cared in the
incubators by well-trained, diligent and gentle health care personnel;
or hundreds of children born to HIV infected mothers saved due to the
timely administration of AZT. In the same way the news coming from a
country in Africa that the death toll could be reduced to 1 from an
average of 26 every month, thanks to the assistance they are getting
from the Good Samaritan Foundation for the purchase of anti-retroviral
medicine as well as basic nutrients.
Technology and Bioethics
What are the main principles that must lead the future of health
technology? We try to answer regarding the biomedical field. As a
general principle we can establish this; that which builds man is good,
and that which destroys him is bad.
We know that Biomedical technology holds a great deal of promise in the
areas of diagnosis and treatment of diseases. Strong health care
systems invariably rely heavily on access to and use of health
technologies. But we must also be aware of the fact that technology and
medicine are only a part of the health care system and undue insistence
on their capabilities may give more emphasis in meeting the demands of
the providers than that of the human persons. The ultimate criterion in
the use of all technologies must be the good of man. Everything
technologically possible need not be ethically oriented. For this,
ultimately we need a bioethics that is open to the transcendent.
In discussing the sciences of life and reflecting on the experimental
sciences that manipulate life, one wonders about correct human
behaviour in relation to human life, deficiency in human life, increase
in human life, improvement in human life, procedures to be followed to
obtain this improvement and deviations to be avoided. As a final
condition, we find ourselves before the binomial
necessity-satisfaction. This means that there is a living subject that
aspires at improving himself, to do this he must journey along a path,
and to do this he must plot the path, and to do this he must first know
where he is heading for. Within the context of life, it is necessary to
know what life is, what is the better life that one desires, the path
to be followed and the path to be avoided in this journey, for instead
of donating life, it could be taken away. In other words, biotechnology
appears as a project for the building of man through the life and
health sciences, that can build or destroy.
The horizon for Ethics in itself is finality. The horizon of Technology
is only the possibility. The technology itself, is neuter, can build or
destroy man. All depends from its direction, and the direction is given
to Technology by Ethics. Therefore, in order to have a true code of
bioethics, which provides us with rules of behaviour in the area of
health and life, the first, question we must ask ourselves concerns the
project for man, which involves the manipulation of life and health.
Authentic Bioethics must appear as the project to improve human life
and includes all the life and health sciences as its base, as that
"intus legere" (inte-lecto, reading from inside) which in any analysis
always concerns the final synthesis of what cannot be anything other
than the construction of human life.
For a vital project to function (like any other project), it is
necessary to understand the living reality that expects improvement as
much as possible. This is a path that belongs to Bioethics. Here, we
find rules which cannot simply be formulations or imperatives external
to the person, instead they are real constructions of the same person
and which little by little bring it nearer to the "better person",
thereby increasing its density.
This complexity brings him to a consciousness of his reality which
means being relational, open and thus embarking on his journey, that
is, freely opening himself up to the Other, which in this case is the
fulfillment of the Power of Truth and Love, which is precisely God. To
attain freedom, Man in his project for development, opens himself up to
the force of genuine progress in Biotechnology in order to ascertain,
each time ever more that his vital completeness is in constant harmony
with God, with all of humanity and with the whole surrounding
And now, if we try to pass over the natural way of thinking to
Revelation of God, in Catholic thought, this Ethics that is open,
"objective", real, and with no constrictions, opens up to full
communication with God the Almighty Father who brings about in us the
Truth of His Son through His Incarnation, Passion, Death and
Resurrection. He fulfils all our aspirations by bringing us along the
Way that is Christ, in the fullness of the Love of His Spirit. Catholic
Ethics and Bioethics are the Christ's journey within us, to His Father
through His death and resurrection, in the Love of the Holy Spirit. In
this way, Bioethics will be the journeying within us of the Spirit
along the paths of the life and health sciences. "Those led by the
Spirit are the children of God" (Romans 8,14). The Spirit infuses in
man the ability to journey towards the total construction of Christ --
this ability are the virtues -- and directs him into the comprehension
of Christ Himself as a way, by means of the Commandments and the Sermon
on the Mount.
We Christians know that the only possibility for the true vital
construction of man is the resurrection. Stated in concrete historic
terms, the only possibility for vital construction is union with
Christ, who died and rose from the dead. This is the only Ethics that
is objectively valid and to which all the authentic values found in
non-Christian ethics come close to and as such are indicators of the
sole reality which goes beyond illusions of vital permanence.
According to the Roman Catholic view, the construction of man is a
theandric construction where divine and human actions intertwine. In
translating these actions into principles of valid action for guiding
Biomedicine, we can state the following:
1. The human being is a creation of God, it is from Him he comes and to
whom he must tend as his exemplary and final Cause. The person is in
the image of God, member of the Body of Christ, citizen of the people
2. Human life is received from humanity, not as property but to be
administered. Human life is inviolable from its very conception to its
natural end. The dignity of the human person is inviolable. It is on
this that all Anthropology and Bioethics is based.
3. The origin to human life must lie solely in marriage and solely as
the fruit of the marital act.
4. Spouses are not the cause of human life but the instruments of God in
5. From Christ, the human person is capable of reflection, is an end in
himself and can never be considered as a means.
6. The human person has his freedom and responsibility that he must put
to practice in order to attain fulfillment. There is no freedom without
responsibility that in turn implies respect for the freedom of others.
7. The totality is above the part and sometimes the part must be
sacrificed in favor of the totality. The human person is in solidarity
and must tend towards the common good.
8. The only explanation of life and its single source is Christ who
died and was raised to life. If death and suffering are considered in
unity with the death of Christ they are the only source of life.
9. In this context, the three principles of subjective Bioethics:
autonomy, beneficence and justice, can be accepted and justified.
10. The human person is the synthesis of the universe and is the reason
for everything that exists. Biomedical science and technology must be
at the service of human life and not vice versa, namely, such knowledge
should be used to develop man and never to destroy him.
If then we make an attempt to define Catholic Bioethics and so, try to
synthesize principles that lead the authentic future of health
Technology we can enounce the following as conclusion of this paper:
The Bioethics is "The systematic and detailed study of the conduct that
constructs man through the health and life sciences in order to walk in
Christ towards the Father, the fullness of life, by the power of the
This theological vision implies a profound structural dialogue with all
sciences and technologies involved, with all the unifying ideas from
the analyses, made by the different philosophical and theological
schools, also in dialogue with other religions, bearing in mind that it
is a behavioral study and therefore cannot be solely a line of
reflection but must be concretized as a guiding light to resolve the
difficult problems raised by science and technology.
Javier Cardinal Lozano Barragán
Pontifical Council for Health Pastoral Care
 See Kim Yersu, 1999. "A Common Framework for Ethics of the
Twenty-First Century." UNESCO, Division of Philosophy and Ethics. Cited
Nov. 15, 1999, at www.unesco.or.kr/ethics/yersu_kim.htm.
 See John Paul II, "Message for the World Day of the Sick for the
Year 2000," "Dolentium Hominum," 42 (3, 1999), No. 13.
 Benedict XVI, Address to the Plenary Assembly of the Pontifical
Council for Health Pastoral Care, March 22, 2007.
 "Gaudium et spes," No. 26.
 See Department of Essential Health Technologies (WHO), "Information
Technology in Support of Health Care", p. 2 at http://www.who.int/eht.