The Perspective of the Theology of Suffering

1. The Perspective of the Theology of Suffering in the Vatican’s “Charter for Health Care Workers” <www.ewtn.com/library/CURIA/PCPAHEAL.HTM> 1

2. Varying Perspectives on Suffering 2

3. <http://jppr.psychiatryonline.org/cgi/reprint/10/3/187> 3

4. Putting Suffering Into Perspective • “The meaning of pain defines suffering. An athlete may expect and even embrace pain during a game but may suffer if his injury disables him or causes his team to lose. A person who is injured intentionally and ignored is likely to suffer more than one who is hurt accidentally and treated with care…. • “The task of putting profound suffering into perspective can require grappling with larger questions. For example, serious physical illness often prompts individuals to reassess what gives their lives significance. Survivors of childhood sexual abuse may need to rebuild their shattered assumptive worlds so as to achieve a new take on themselves, on their hopes, and on reality…. • “in recent years mental health professionals have increasingly recognized the clinical relevance of spirituality…. However, relatively little attention has been directed to the implications of different belief systems embraced by patients for accomplishing basic psychotherapeutic tasks such as integrating suffering.” 4

5. Putting Suffering Into Perspective The Relationship Between Suffering & World View • “A person’s world view helps to shape the meaning of her painful experience. • “An individual who trusts in God as a protector of good people may feel cheated, if not punished, by a dx of cancer. • “A believer with a different understanding of God may wonder if the same illness is intended to discipline him or bring him closer. • “Cancer may remind a Buddhist of the need to transcend desire & attachment, • “an atheist of his most important accomplishments or values. • “suffering can also influence one’s world view….In a survey of 350 members of the American Association for the Advancement of Atheism, they found that ½ of the younger atheists had lost one or both parents before the age of 20. A large # of this group also described themselves as unhappy in childhood & adolescence.” 5

6. Putting Suffering Into Perspective The Therapist’s Role • “Jews can find in the Psalms & in the story of Job precedent for the sufferer to call out to and question God. • “Christians can also see in Christ’s suffering evidence that God cares about their suffering because he has taken it on himself—thus dignifying suffering on behalf of others. • “Buddhists find in the dharma support for detaching from the desire that leads to suffering. • “Atheists faced with suffering may instead take pride in their own integrity, intellectual honesty, or stoicism…. • “Individuals with a spiritual or theistic world view often feel that someone cares about their pain and that they are not ultimately alone. However, • they may also be struggling with the concept that a God who is powerful enough to have spared them illness did not choose to do so…. • “Clinicians will usually find that believing patients (like nonbelievers) …most often want a chance to be heard & to talk about their concerns….They may also need to reflect on, & to think through, their own beliefs & doubts. The account by the Christian apologist C. S. Lewis of his experience of his wife’s death, A Grief Observed, is a compelling description of this process…. 6

7. Putting Suffering Into Perspective The Therapist’s Role • “Individuals with a naturalistic or atheistic world view consciously reject a purposeful explanation for the universe….they may feel ultimately alone and anxious in bearing pain….they see illness as no one’s fault, except perhaps their own through mistakes they made in bringing it on or failing to detect it in its early forms. Instead, they often struggle to achieve a kind of Eriksonian integrity, or ability to live and die consistent with who they are…. • “Suffering makes many patients realize that they are uncertain or ambivalent about their philosophy of life. They may consider themselves as ‘lapsed’ churchgoers or skeptics who have rejected organized religion but retained a strong sense of personal spirituality. • A number of challenges face clinicians in attempting to help agnostic patients clarify their beliefs about what matters most, think through their questions, and consolidate their values so as to live in accord with their deepest commitments…. • “Perhaps the most difficult challenge is presented by those agnostic patients (often character-disordered, with narcissistic traits or substance abuse) who lack both a framework of meaning and the insight that they need direction. The psychologist and philosopher Søren Kierkegaard would have diagnosed them with ‘the sickness unto death,’ or ‘the despair that does not know it is in despair’…. 7

8. Suffering from a Hindu Perspective 8

9. Suffering from a Hindu Perspective • Hinduism encourages “ a resigned attitude based upon the belief that there is nothing much one can do about what happened in the past or what is happening now & what is going to happen in the immediate future…. • [It] “provides an opportunity to every individual to shape his future & he is inclined spiritually, to liberate himself from the world of births & deaths…. • “True liberation comes when one achieves self realization and becomes free from the cycle of births and deaths.” 9

10. Suffering from a Buddhist Perspective 10

11. Suffering from a Buddhist Perspective “’….The essence of life is suffering, said the Buddha. At first glance this seems exceedingly morbid and pessimistic….Take any moment when you feel really fulfilled and examine it closely. Down under the joy, you will find that subtle, all-pervasive undercurrent of tension, that no matter how great this moment is, it is going to end. No matter how much you just gained, you are either going to lose some of it or spend the rest of your days guarding what you have got and scheming how to get more. And in the end, you are going to die. In the end, you lose everything. It is all transitory.’ Henepola Gunaratana, from 'Mindfulness in Plain English'. “The reason that we experience suffering comes ultimately from our mind. According to Buddhism, our main mental problems or root delusions are: attachment, anger and ignorance. Because of these delusions, we engage in actions that cause problems to ourselves and others. With every negative action (karma) we do, we create a potential for negative experiences….If we can control our body and mind in a way that we help others instead of doing them harm, and generating wisdom in our own mind, we can end our suffering and problems. “The Buddha summarised the correct attitude and actions in the Eight-fold Noble Path: (The first 3 are avoiding the 10 non-virtues of mind, speech and body:) Correct thought: avoiding covetousness, the wish to harm others and wrong views (like thinking: actions have no consequences, I never have any problems, there are no ways to end suffering etc.) Correct speech: avoid lying, divisive and harsh speech and idle gossip. Correct actions: avoid killing, stealing and sexual misconduct Correct livelihood: try to make a living with the above attitude of thought, speech and actions. Correct understanding: developing genuine wisdom. (The last three aspects refer mainly to the practice of meditation:) Correct effort: after the first real step we need joyful perseverance to continue. Correct mindfulness: try to be aware of the ‘here and now’, instead of dreaming in the ‘there and then’. Correct concentration: to keep a steady, calm and attentive state of mind.” 11

12. Suffering from the Perspectiveof Confucianism 12

13. Suffering from the Perspectiveof Confucianism • “In all the greatest cultures of the world, there have been prominent teachers, leaders and reformers who are still honoured and revered to this day. From amongst those of the Chinese tradition, one man stands foremost, and that is Confucius, the great sage, teacher & reformer…. • “In his teaching he emphasised righteousness - correct behaviour based on duty, which in turn is based on one's situation in society….Confucius was the rare combination of an idealist and practical business man…. • “earthly minded, [He] never acknowledged a personal God. Confucius was neither interested in where man came from or where his soul departed to after death. • “Of himself he said, ‘I have striven to become a man of perfect virtue and to teach others without weariness,’ His ideal was ‘the superior man carrying out in his conduct what he professes’…. • “Since the death of Confucius, a whole school of philosophy has developed from his teachings, and his fame and reputation have spread throughout the world. To some he was a God, to others a remarkable administrator, a great reformer, the first teacher or the supreme teacher.“ 13

14. Suffering from an Islamic Perspective 14

15. Suffering from an Islamic Perspective • “our present life, with all its joys and sufferings, is merely transitory & illusionary…. Death may be the ultimate human suffering in this world, but it is certainly not the end of life….the 2nd phase of human life is reflective of how we conduct ourselves in the first phase of life.  The joys as well as the sufferings shall continue in the life Hereafter…. • “Islam acknowledges that life is full of suffering, starting as early as the very process of human conception in a mother's womb and during the process of childbirth….. • ….the disasters that are caused by natural laws are no reflection of the Creator's cruelty over humans. According to the Holy Quran, the study of natural phenomenon makes us understand that, despite the devastation suffered by some humans, God's Mercy (rahmah) is the most overwhelming attribute in Nature that creates, maintains and evolves all forms of life including human life. • “there are the man-made infliction that cause other humans to suffer….causing suffering, pain and death to others through the misuse and abuse of one's free will, humans remain responsible to God, & not God to humans….to establish, a JUST society is one of the most important obligations taught by Islam. Those who may escape the corporal punishment in this world, for them God's punishment shall be waiting in the life to come….. • “there are acts of ‘self-inflicted suffering’:….The Holy Quran prohibits inflicting self-injuries, specifically committing of suicide…. • “it does not matter how much a person suffers in this world, as long as he or she is engaged, according to his or her capacity, in repelling the evil and doing the good works. The joys and comforts of the life yet to come are far greater, unparalleled and everlasting as compared with human sufferings of this life!….for us Muslims and all others, the important thing should be is to learn how to handle human sufferings retaining full faith in a loving God!” 15

16. Suffering from a Jewish Perspective? 16

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18. “I believe in God. But I do not believe the same things about Him that I did years ago, when I was growing up or when I was a theological student.” “I recognize His limitations. He is limited in what He can do by laws of nature and by the evolution of human nature and human moral freedom.” 18

19. "We could bear nearly any pain or disappointment if we thought there was a reason behind it, a purpose, to it. But even a lesser burden becomes too much for us if we feel it makes no sense…. “Let me suggest that the bad things that happen to us in our lives do not have a meaning when they happen to us. They do not happen for any good reason which would cause us to accept them willingly. But we can give them a meaning. “ 19

20. Not Very Satisfying! 20

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23. (from Peter Kreeft’s web site) 23

24. Reasons to Believe:First Cause Argument Four of Aquinas' 5 proofs are variations. Whether it be • motion, • the beginning of existence; • present existence or • goodness/value, everything needs an explanation. 24

25. Reasons to Believe: Argument from Design • Monkeys could have banged out the greatest musical masterpieces. Common sense instead points us to great composers. • The existence of the universe points to a creator. 25

26. Reasons to Believe:Argument from Desire "Creatures are not born with desires unless satisfaction for these desires exists.... If I find in myself a desire which no experience in this world can satisfy, the most probable explanation is that I was made for another world" (C.S. Lewis) 26

27. Reasons to Believe: Pascal’s Wager • If you've got everything to gain and nothing to lose, why not believe? • If there is a God, don't we want to give Him His due? 27

28. Reasons to Believe:Arguments from History Similar to the argument from design, we could argue • 1st, that humanity's story is meaningful. • 2nd, that God's justice is revealed in this story. • 3rd, that various "coincidences" testify to Providence, • as do miracles (which is 4th). • 5th, that honest examination of evidence forces the question of Christ's identity: • Lord, lunatic, or liar? • 6th , that if not God, what causes martyrs' joy? • 7th, that if not for God, how would Christianity have been so successful at winning converts? • 8th, what happens when you pray the prayer of the sceptic? 28

29. Reasons to Believe: Argument from Conscience Some basic beliefs about right & wrong enjoy universal agreement. Who but God gives the inner "still, small voice" telling us to do good? 29

30. John Haas, Ph.D., STL President of the National Catholic Bioethics Center 30

31. Some Very, Very Basic Beliefs about Right & Wrong Enjoy Universal Agreement Dr. John haas notes that "the ancient Babylonian code, the Code of Hammurabi, [and] .... other ancient pagan religions,... have rules against adultery, murder, theft, & bearing false witness." Because there truly are objective moral standards, Dr. Haas says we can "dialog with other peoples who may not share our...religious beliefs.... basic moral teachings ...apply to everybody.... we all share the same human nature." Traditionally, this has been called the “Natural Law” or “Natural Moral Law.” In his letter to the Romans, the Apostle Paul said the "demands of the law are written in their hearts." The "Natural Law" or "Natural Moral Law" is concerned with universal & unchanging principles of morality. Who but God gives the inner "still, small voice" telling us to do good? 31

32. So, What is this “Natural Law” (aka, “Natural Moral Law”? 32

33. Norms of Christian Decision Making in Bioethics are consistent with the "Natural Law," that applies to all: "NATURAL LAW" is not the same as the "LAWS OF NATURE" (prescriptive) (descriptive) the road map to true human happiness ("...demands of the law are written in their hearts..." (Romans 2: 15)) "Natural Law“ (prescriptive) is also not the same as the "Might is Right" nor "Morals Are Mores" nor "Right Is What Brings Pleasure" nor "Right is the Greatest Good for the Greatest Number" (Utilitarianism) First Principle of Morality: Choose the goods which will promote the true good of humanity (Do not impede, damage, or destroy a "Basic Human Good.") ("God looked at everything he had made, & He found it very good." (Genesis 1:31)) Life, Knowledge, Skillful performance/ aesthetic appreciation Integrity Authenticity, Friendship, Religion, & Marriage. l l We always choose "goods;" l we are concerned with how l we choose. l l Arguments about how lto choose BHGs l get confused. l 33

34. According to authors/Dominican priests Benedict Ashley & Kevin O'Rourke, "Christian ethics might be specified by the priority it gives to certain values....St. Paul, summarized these Christian priorities as faith, hope, and love(Rm 13).... 34

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37. Norms of Christian Faith & Prudence Principle of Well-Formed Conscience Principle of Free and Informed Consent Principle of Moral Discrimination Principle of Double Effect Principle of Legitimate Cooperation Principle of Professional Communication Norms of Christian Decision-Making in Bioethics Norms of Christian Love Norms of Christian Hope Principle of Human Dignity in Community Principle of Participation (aka, subsidiarity) Principle of Totality & Integrity Principle of Stewardship and Creativity Principle of Inner Freedom Principle of Personalized Sexuality (aka, The Principle of Family-Oriented Sexuality) Principle of Growth through Suffering 37

38. NORMS OF CHRISTIAN FAITH & PRUDENCE (6) • Principle of Well-Formed Conscience Good, decent, well intentioned people can “follow their conscience” and still be objectively wrong. In any ethical decision-making, I have the responsibility to “step to the plate” equipped with facts, as well as a conscience well-formed by the relevant ethical principles. 38

39. NORMS OF CHRISTIAN FAITH & PRUDENCE (6) • Principle of Free & Informed Consent This principle is sometimes misinterpreted as meaning that my health care provider is morally free to perform any procedure which is agreed-to by the patient. 39

40. NORMS OF CHRISTIAN FAITH & PRUDENCE (6) • Principle of Moral Discrimination According to the Natural Law’s “First Principal of Morality,” I should always make my moral choices in a manner which will promote “Integral Human Fulfillment,” the true good of humanity (This should NOT be confused with other types of moral decision-making, such as the notions of "Might is Right," "Morals are Cultural Mores," "Right Is What Brings Pleasure" or "Right is the Greatest Good for the Greatest Number" (aka, Utilitarianism)). In making choices, I should NEVER impede, damage or destroy a “basic human good” (i.e., Human Life, Knowledge, Skillful performance/aesthetic appreciation, Integrity, Authenticity, Friendship, Religion, & Marriage.). Along the lines of this principle, provision of nutrition/hydration (even if via an “artificial” means) would ordinarily constitute obligatory “care,” rather than “treatment” (which MAY not always be obligatory). 40

41. NORMS OF CHRISTIAN FAITH & PRUDENCE (6) • Principle of Double Effect In a situation where I am choosing a good action, but in which my action will have both good & bad effects, my intention must be the good effects and the avoidance of the bad effects. The anticipated good effects must outweigh or at least equal the bad effects; the anticipated good effects must NOT be products of the bad effects. My action must produce those good effects at least as immediately as the bad. This principle would absolutely NOT justify doing an inherently bad action, so that good may come of it. 41

42. NORMS OF CHRISTIAN FAITH & PRUDENCE (6) • Principle of Legitimate Cooperation This principle concerns “cooperation” with the immoral act of another person. It is really an extension of Double Effect. To “formally cooperate” in an immoral act means to assist without moral reservation; formal cooperation is always wrong. Any other type of cooperation with the immoral act of another is called “material cooperation.” If my material cooperation with the immoral act is “immediate” (i.e., if I am “an instrumental agent of the principal agent”), it is also always wrong. When my my material cooperation is not immediate, it is called “mediate.” If my mediate, material cooperation with the immoral act is “remote” (rather than “proximate”), it may be acceptable – “depending on the degree of the good to be achieved or evil avoided by the cooperation" (Ashley & O’Rourke, pp.193 - 199). Even with remote, mediate material cooperation, I should consider the d danger of scandal that my cooperation may entail. Formal Cooperation v. Material Cooperation (always wrong) immediate v. mediate (always wrong) proximate v. remote Making a referral for a morally excluded service would be an example of formal cooperation or immediate, material cooperation in the immoral act of another. 42

43. NORMS OF CHRISTIAN FAITH & PRUDENCE (6) • Principle of Professional Communication This principle entails trust, and honest/ appropriate sharing of information: “For the Christian ...confidentiality is not only professional; it expresses respect for the dignity of the human person, whom only God has a right to judge (Mt 7:1-5)" (Ashley & O’Rourke, pp. 199, 200). This principle would NOT necessarily exclude sharing information with the Center for Disease Control. 43

44. NORMS OF CHRISTIAN LOVE (3) • Principle of Human Dignity in Community According to the Natural Law’s “First Principal of Morality,” I should always make my moral choices in a manner which will promote “Integral Human Fulfillment,” the true good of humanity In making choices, I should NEVER impede, damage or destroy a “basic human good” (i.e., Human Life, Knowledge, Skillful performance/aesthetic appreciation, Integrity, Authenticity, Friendship, Religion, & Marriage.). 44

45. NORMS OF CHRISTIAN LOVE (3) • Principle of Participation (aka, subsidiarity) This principle seems best understood with an illustrative example: The family is the basic unit of society. The government would be wrong to interfere in a parent's relationship with her/his child, other than for very serious reasons, such as the abuse of the child. 45

46. NORMS OF CHRISTIAN LOVE (3) • Principle of Totality & Integrity “Everyday clinical practice generally accepts a limited form of disposing of the body and certain mental functions in order to preserve life, as for example in the case of the amputation of limbs or the removal of organs. Such practice is permitted by the principle of totality and integrity (also known as the therapeutic principle). The meaning of this principle is that the human person develops, cares for, and preserves all his physical and mental functions in such a way that (1) lower functions are never sacrificed except for the better functioning of the total person, & even then with an effort to compensate for what is being sacrificed; & (2) the fundamental faculties which essentially belong to being human are never sacrificed, except when necessary to save life…. “For the application of the principle of totality & integrity, the following conditions must be met: (1) there must be a question of an intervention in the part of the body that is either affected or is the direct cause of the life-threatening situation; (2) there can be no other alternatives for preserving life; (3) there is a proportionate chance of success in comparison with drawbacks; & (4) the patient must give assent to the intervention” <www.vatican.va/roman_curia/congregations/cfaith/cti_documents/rc_con_cfaith_doc_20040723_communion-stewardship_en.html> 46

47. NORMS OF CHRISTIAN HOPE (4) • Principle of Stewardship & Creativity While Genesis teaches that humans were given dominion over God's creation, we are to have the mentality of a creative steward. We are NOT free to thoughtlessly use worldly resources. 47

48. NORMS OF CHRISTIAN HOPE (4) • Principle of Inner Freedom Obsessions we experience are not simply crosses to bear passively. We have moral responsibility to seek treatment for an obsession. 48

49. NORMS OF CHRISTIAN HOPE (4) • Principle of Personalized Sexuality (aka, Family-Oriented Sexuality) Sexual acts have "unitive" & "procreative" dimensions. Reserved for marriage, they unite a couple. Each act is to be open to the transmission of new life. 49

50. NORMS OF CHRISTIAN HOPE (4) • Principle of Growth through Suffering For the Christian, pain is a sharing in Christ's own suffering and a uniting with Him in His redemptive sacrifice, offered in obedience to His father. This does NOT mean that all suffering/pain must be accepted, & that all efforts to alleviate suffering/pain should be foregone. 50