Excerpts from Church Documents

Table of Contents

Catechism of the Catholic Church

The Charter for Health Care Workers

The New Charter for Health Care Workers

Ecclesia in America

Centesimus Annus

Catechism of the Catholic Church

2288. Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them, taking into account the needs of others and the common good.

Concern for the health of its citizens requires that society help in the attainment of living-conditions that allow them to grow and reach maturity: food and clothing, housing, health care, basic education, employment, and social assistance.

2289. If morality requires respect for the life of the body, it does not make it an absolute value. It rejects a neo-pagan notion that tends to promote the cult of the body, to sacrifice everything for its sake, to idolize physical perfection and success at sports. By its selective preference of the strong over the weak, such a conception can lead to the perversion of human relationships.

2290. The virtue of temperance disposes us to avoid every kind of excess: the abuse of food, alcohol, tobacco, or medicine. Those incur grave guilt who, by drunkenness or a love of speed, endanger their own and others' safety on the road, at sea, or in the air.

2291. The use of drugs inflicts very grave damage on human health and life. Their use, except on strictly therapeutic grounds, is a grave offense. Clandestine production of and trafficking in drugs are scandalous practices. They constitute direct co-operation in evil, since they encourage people to practices gravely contrary to the moral law.

The Charter for Health Care Workers

Dependency

92. Dependency, in medical-health terms, is an addiction to a substance or product—such as drugs, alcohol, narcotics, tobacco—for which the individual feels an uncontrollable need, and the privation of which can cause him psycho-physical disorders.

The phenomenon of dependency is escalating in our societies, which is disturbing and, under certain aspects, dramatic. This is related, on the one hand, to the crisis of values and meaning which contemporary society and culture[189] is experiencing and, on the other hand, to the stress and frustrations brought about by the quest for efficiency, by activism and by the high competitiveness and anonymity of social interaction.

Doubtless, the evils caused by dependency and their cure are not a matter for medicine alone. But it does have a preventive and therapeutic role.

Drugs

93. Drugs and drug-dependency are almost always the result of an avoidable evasion of responsibility, an aprioristic contestation of the social structure which is rejected without positive proposals for its reasonable reform, an expression of masochism motivated by the absence of values.

One who takes drugs does not understand or has lost the meaning and the value of life, thus putting it at risk until it is lost: many deaths from overdose are voluntary suicides. The drug-user acquires a nihilistic mental state, superficially preferring the void of death to the all of life.

94. From the moral viewpoint "using drugs is always illicit, because it implies an unjustified and irrational refusal to think, will and act as free persons."[190]

To say that drugs are illicit is not to condemn the drug-user. That person experiences his condition as "a heavy slavery" from which he needs to be freed.[191] The way to recovery cannot be that of ethical culpability or repressive law, but it must be by way of rehabilitation which, without condoning the possible fault of the person on drugs, promotes liberation from his condition and reintegration.

95. The detoxification of the person addicted to drugs is more than medical treatment. Moreover, medicines are of little or no use. Detoxification is an integrally human process meant to "give a complete and definitive meaning to life,"[192] and thus to restore to the one addicted that "self confidence and salutary self-esteem" which help him to recover the joy of living.[193]

In the rehabilitation of a person addicted to drugs it is important "that there be an attempt to get to know the individual and to understand his inner world; to bring him to the discovery or rediscovery of his dignity as a person, to help him to reawaken and develop, as an active subject, those personal resources, which the use of drugs has suppressed, through a confident reactivation of the mechanisms of the will, directed to secure and noble ideals."[194]

96. Using drugs is anti-life. "One cannot speak of 'the freedom to take drugs' nor of 'the right to drugs,' because a human being does not have the right to harm himself and he cannot and must not ever abdicate his personal dignity which is given to him by God,"[195] and even less does he have the right to make others pay for his choice.

Alcoholism

97. Unlike taking drugs, alcohol is not in itself illicit: "its moderate use as a drink is not contrary to moral law."[196] Within reasonable limits wine is a nourishment.

"It is only the abuse that is reprehensible":[197] alcoholism, which causes dependency, clouds the conscience and, in the chronic stage, produces serious harm to the body and the mind.

98. The alcoholic is a sick person who needs medical assistance together with help on the level of solidarity and psychotherapy. A program of integrally human rehabilitation must be put in place for him.[198]

Smoking

99. With regard to tobacco also, the ethical unlawfulness is not in its use but in its abuse. At the present time it is established that excessive smoking damages the health and causes dependency. This leads to a progressive lowering of the threshold of abuse.

Smoking poses the problem of dissuasion and prevention, which should be done especially through health education and information, even by way of advertisements.

Psycho-pharmaceuticals

100. Psycho-pharmaceuticals are a special category of medicines used to counter agitation, delirium and hallucinations and to overcome anxiety and depression.[199]

101. To prevent, contain and overcome the risk of dependency and addiction, psycho-pharmaceuticals should be subject to medical control. "Recourse to tranquilizing substances on medical advice in order to alleviate—in well-defined cases—physical and psychological suffering should be governed by very prudent criteria in order to offset dangerous forms of addiction and dependency."[200]

It is the task of health authorities, doctors and those responsible for research centers to apply themselves in order to reduce these risks to a minimum through apt measures of prevention and information."[201]

102. Administered for therapeutic purposes and with due respect for the person, psycho-pharmaceuticals are ethically legitimate. The general conditions for lawfulness in remedial intervention applies to these also.

In particular, the informed consent of the patient is required and his right to refuse the therapy must be respected, taking into account the ability of the mental patient to make decisions. Also to be respected is the principle of therapeutic proportionality in the choice and administration of these medicines, on the basis of an accurate etiology of the symptoms and the motives for the subject's requesting this medicine.[202]

103. Non-therapeutic use and abuse of psycho-pharmaceuticals is morally illicit if the purpose is to improve normal performance or to procure an artificial and euphoric serenity. This use of psycho-pharmaceuticals is the same as that of any narcotic substance so the ethical verdict already given in the case of drugs is valid also here.

Endnotes

[189] "At the root of alcohol and drug abuse—taking into account the painful complexity of causes and situations—there is usually an existential vacuum, due to an absence of values and a lack of self-esteem, of trust in others and in life in general" (John Paul II, To the participants at the International Conference on Drugs and Alcohol, Nov. 23, 1991, in Insegnamenti XIV/2 (1991) 1249, n. 2.

[190] Ibid., n. 4.

[191] Cf. John Paul II, To the participants at the VII World Congress of Therapeutic Communities, Sept. 7, 1984, in Insegnamenti VII/2, p. 347, n. 3.

[192] Ibid, p. 350, n. 7.

[193] Cf. John Paul II, Message to the International Congress in Vienna, June 4, 1987, in Insegnamenti VII/2, p. 347, n. 3.

[194] John Paul II, To the participants at the VII World Congress of Therapeutic Communities, Sept. 7, 1984, in Insegnamenti VII/2, p. 347, n. 3.

[195] John Paul II, To the participants at the International Conference on Drugs and Alcohol, Nov. 23, 1991, n. 4. "The use of drugs inflicts very grave damage on human life and health. Their use, except on strictly therapeutic grounds, is a grave offense. Clandestine production of and trafficking in drugs are scandalous practices. They constitute direct cooperation in evil, since they encourage people to practices gravely contrary to the moral law" (CCC 2291).

[196] John Paul II, To the participants at the International Conference on Drugs and Alcohol, Nov. 23, 1991, n. 4.

[197] Ibid, n. 4.

[198] "The present economic conditions in society, as well as the high level of poverty and unemployment, can be contributory factors that increase in your people a sense of unrest, insecurity, frustration and social alienation, leading them on to the illusory world of alcohol as an escape from the problems of life": John Paul II, To the participants at a congress on alcoholism, in Insegnamenti VIII/1, p. 1741.

[199] There are three categories of psycho-pharmaceuticals. The first is that of neuroleptics, the anti-psychotics which have made possible the closing of psychiatric hospitals, since they overcome agitation, deliria and hallucinations, and so make it useless to confine and isolate patients; in any case, these measures were non-curative. The second category is comprised of sedatives or tranquilizers and the third antidepressives.

[200] John Paul II, To the participants at the International Conference on Drugs and Alcohol, Nov. 23, 1991, n. 4.

[201] Ibid.

[202] Cf. Pius XII, To the International Congress of Neuro-psychopharmacology, Sept. 9, 1958, in Discourses and Broadcasts Vol. XX, pp. 327-333.

The New Charter for Health Care Workers

Forms of dependence

121. Dependence, in the context of medicine and health care, is a habitual reliance on a substance or a product—such as drugs, alcohol, narcotics, or tobacco—for which the individual experiences an irrepressible need, and the deprivation of which can cause mental and physical disturbances.

The phenomenon of dependence in our societies is an increasingly worrisome and in some ways tragic reality. It is related on the one hand to the crisis of values and meaning from which contemporary society and culture suffer[241] and, on the other hand, to the stress and frustrations generated by the relentless demand for efficiency, by activism, and by the heightened competitiveness and anonymity of social interactions.

The evils caused by forms of dependence and the treatment of dependence are not the exclusive province of medicine. Medicine, however, has a preventive and therapeutic approach of its own.

Drug dependence

122. Drug dependence can be an expression of the loss of meaning and of value in life, to the point of putting it at risk: many cases of death by overdose are true suicides, strictly speaking.

123. From the moral perspective, drug abuse “is always illicit, because it implies an unjustified and irrational refusal to think, will, and act as free persons.”[242] A judgment that drug use is illicit is not a judgment that condemns the person, who experiences his own condition of dependence as “a heavy slavery.”[243] Neither emphasizing moral guilt nor applying legal penalties can be the path to full recovery; rather, recovery must be based on the reacquisition of values, without concealing any actual moral responsibilities on the part of the drug abuser, which promote his liberation for the sake of his reintegration into family and society. This means that detoxification is more than a medical treatment: it is an integrally human intervention.[244]

124. Drug abuse is opposed to life. “One cannot speak of ‘the freedom to take drugs’ or of ‘the right to drugs,’ because a human being does not have the right to harm himself, and he cannot and must not ever abdicate his personal dignity, which is given to him by God,”[245] and even less does he have the right to make others pay for his choice.

Alcoholism

125. Alcohol can also have harmful effects on health. In fact, excessive consumption of it tends to result in alcoholism, an expression of the dependence caused by its continuous use, and in ever higher doses. Alcohol abuse and dependence disregard the moral duty to safeguard and preserve health, and with it life. Both, in fact, produce highly deleterious effects for the person’s physical, psychological, and spiritual health. Moreover, alcoholism can also have a social impact, inasmuch as it is frequently the cause of traffic and workplace accidents; it can incite family violence and even affect a person’s descendants. Alcoholism is widespread in some countries and regions, making it a true social plague. Particularly worrisome is the rise of alcohol consumption among women and youth, who start drinking at earlier ages, with destabilizing effects on their growth.[246]

126. This social plague should persuade those responsible for health care activities and policies, and health care workers themselves, to promote detoxification and treatment facilities and prevention strategies, with particular attention to young people. An alcoholic is a sick person in need of medical treatment, along with help in terms of solidarity and psychotherapy. Such an individual warrants the engagement of integrally human recovery measures.

Tobacco dependence

127. By now medical research has confirmed the harmful effects of tobacco smoking on health. It harms the health of the smoker (active smoking) and also of those who breathe the smoke of others (passive smoking). Today tobacco is one of the main causes of death in the world. For this reason alone, tobacco use raises unavoidable moral questions.

Smoking is becoming more widespread among young people and among the female population. In particular, adolescents are more susceptible to dependence and to the physically and psychologically harmful effects of tobacco. Those who are responsible for health care policies and health care workers themselves cannot remain indifferent to these facts. They are charged with the work of prevention and dissuasion, in their respective fields, through appropriate and targeted educational activity.

Psychotropic drugs

128. Psychotropic drugs are a special category of pharmaceuticals designed to alleviate physical or mental sufferings in certain cases. Recourse to such psychotropic substances, when medically indicated, must adhere to very prudent criteria, so as to avoid dangerous forms of habituation and dependence.

“It is the job of health care authorities, physicians, and those responsible for research centers to work to minimize these risks by means of suitable measures of prevention and information.”[247]

129. Psychotropic drugs are ethically legitimate when administered for therapeutic purposes and with due respect for the person. The general conditions for the permissibility of any therapeutic intervention apply to them.

In particular, whenever possible, informed consent should be requested, taking into account the patient’s decision-making capacity. In selecting and administering these drugs, the physician must also respect the principle of therapeutic proportionality, basing it on a careful assessment of the etiology of the symptoms and other reasons for employing these drugs.[248]

130. The nontherapeutic use and the abuse of psychotropic drugs for the purpose of enhancing particular abilities or obtaining an artificial, euphoric serenity is morally illicit. In this way human experience is altered, falsifying the results of the subject’s self-realization, putting his personal identity and authenticity at risk, and promoting a culture of hyperefficiency. The inappropriate use of psychotropic drugs in this way is no different from drug abuse, so the ethical judgments already formulated with regard to drug dependence apply to them as well.

Particular attention must be paid to casual recourse to psychotropic drugs in pediatric patients.

Endnotes

[241] “At the root of alcohol and drug abuse—taking into account the painful complexity of causes and situations—there is usually an existential vacuum, due to an absence of values and a lack of self-esteem, of trust in others and in life in general” (John Paul II, Address to the participants in the Sixth International Conference on Drugs and Alcohol [November 23, 1991], n. 2: AAS 84 [1992], 1128).

[242] Ibid., n. 4: AAS 84 (1992), 1130.

[243] Cf. John Paul II, Address to the participants in the Eighth World Congress of Therapeutic Communities (September 7, 1984), n. 3: Insegnamenti VII/2 (1984), 347.

[244] Cf. ibid., n. 7: Insegnamenti VII/2 (1984), 350.

[245] John Paul II, Address to the participants in the Sixth International Conference on Drugs and Alcohol (November 23, 1991), n. 4: AAS 84 (1992), 1130. “The use of drugs inflicts very grave damage on human life and health. Their use, except on strictly therapeutic grounds, is a grave offense. Clandestine production of and trafficking in drugs are scandalous practices. They constitute direct cooperation in evil, since they encourage people to practices gravely contrary to the moral law” (CCC, n. 2291).

[246] “The economic conditions existing in society, such as high rates of poverty and unemployment, can contribute to a young person’s sense of restlessness, insecurity, frustration and social alienation, and can draw that person to the fantasy world of alcohol as an escape from the problems of life” (John Paul II, Address to the participants in the Thirty-First International Institute for the Prevention and Treatment of Alcoholism [June 7, 1985]: Insegnamenti VIII/1 [1985], 1741).

[247] John Paul II, Address to the participants in the Sixth International Conference on Drugs and Alcohol (November 23, 1991), n. 4: AAS 84 [1992], 1130.

[248] Cf. Pius XII, Address to the participants in the First International Congress of Psychopharmacology (September 9, 1958): AAS 50 (1958), 687–696.

Ecclesia in America

The Drug Trade

24. The drug trade and drug use represent a grave threat to the social fabric of American nations. The drug trade “contributes to crime and violence, to the destruction of family life, to the physical and emotional destruction of many individuals and communities, especially among the young. It also undermines the ethical dimension of work and increases the number of people in prison — in a word, it leads to the degradation of the person created in the image of God”.[64] This devastating trade also leads to “the ruin of governments and erodes economic security and the stability of nations”.[65] Here we are facing one of the most urgent challenges which many nations around the world need to address: it is in fact a challenge which threatens many features of the human progress achieved in recent times. For some American nations, the production, trafficking and use of drugs are factors which tarnish their international reputation, because they reduce their credibility and render more difficult the cooperation which they seek with other countries and which is so essential nowadays for harmonious social development.

The Drug Problem

61. With regard to the serious problem of the drug trade, the Church in America can cooperate effectively with national and business leaders, non-governmental organizations and international agencies in developing projects aimed at doing away with this trade which threatens the well-being of the peoples of America.[222] This cooperation must be extended to legislative bodies, in support of initiatives to prevent the “recycling of funds”, foster control of the assets of those involved in this traffic, and ensure that the production and marketing of the chemical substances from which drugs are obtained are carried out according to the law. The urgency and the gravity of the problem make it imperative to call upon the various sectors and groups within civil society to be united in the fight against the drug trade.[223] Specifically, as far as the Bishops are concerned, it is necessary — as the Synod Fathers suggested — that they themselves, as Pastors of the People of God, courageously and forcefully condemn the hedonism, materialism and life styles which easily lead to drug use.[224]

There is also a need to help poor farmers from being tempted by the easy money gained from cultivating plants used for drug-production. In this regard international agencies can make a valuable contribution to governments by providing incentives to encourage the production of alternative crops. Encouragement must also be given to those involved in rehabilitating drug users and to those engaged in the pastoral care of the victims of drug dependence. It is fundamentally important to offer the proper “meaning of life” to young people who, when faced with a lack of such meaning, not infrequently find themselves caught in the destructive spiral of drugs. Experience shows that this work of recuperation and social rehabilitation can be an authentic commitment to evangelization.[225]

Endnotes

[64] Propositio 38.

[65] Ibid.

[222] Cf. Propositio 38.

[223] Cf. Ibid.

[224] Ibid.

[225] Cf. ibid.

Centesimus Annus

36. It would now be helpful to direct our attention to the specific problems and threats emerging within the more advanced economies and which are related to their particular characteristics. In earlier stages of development, man always lived under the weight of necessity. His needs were few and were determined, to a degree, by the objective structures of his physical make-up. Economic activity was directed towards satisfying these needs. It is clear that today the problem is not only one of supplying people with a sufficient quantity of goods, but also of responding to a demand for quality: the quality of the goods to be produced and consumed, the quality of the services to be enjoyed, the quality of the environment and of life in general.

To call for an existence which is qualitatively more satisfying is of itself legitimate, but one cannot fail to draw attention to the new responsibilities and dangers connected with this phase of history. The manner in which new needs arise and are defined is always marked by a more or less appropriate concept of man and of his true good. A given culture reveals its overall understanding of life through the choices it makes in production and consumption. It is here that the phenomenon of consumerism arises. In singling out new needs and new means to meet them, one must be guided by a comprehensive picture of man which respects all the dimensions of his being and which subordinates his material and instinctive dimensions to his interior and spiritual ones. If, on the contrary, a direct appeal is made to his instincts — while ignoring in various ways the reality of the person as intelligent and free — then consumer attitudes and life-styles can be created which are objectively improper and often damaging to his physical and spiritual health. Of itself, an economic system does not possess criteria for correctly distinguishing new and higher forms of satisfying human needs from artificial new needs which hinder the formation of a mature personality. Thus a great deal of educational and cultural work is urgently needed, including the education of consumers in the responsible use of their power of choice, the formation of a strong sense of responsibility among producers and among people in the mass media in particular, as well as the necessary intervention by public authorities.

A striking example of artificial consumption contrary to the health and dignity of the human person, and certainly not easy to control, is the use of drugs. Widespread drug use is a sign of a serious malfunction in the social system; it also implies a materialistic and, in a certain sense, destructive "reading" of human needs. In this way the innovative capacity of a free economy is brought to a one-sided and inadequate conclusion. Drugs, as well as pornography and other forms of consumerism which exploit the frailty of the weak, tend to fill the resulting spiritual void.