Letter from the Vatican Secretary of State to a congress on palliative care. "Palliative care proves, within clinical practice, the awareness that the limit demands not only to be fought and moved, but also recognized and accepted. And this means not abandoning sick people, but rather being close to them and accompanying them in the difficult test that makes itself present at the end of life".
Vatican City (AsiaNews) - Medicine is not only about defeating diseases, but also taking care of the sick when it is impossible to recover. In this task, palliative care, which is used to combat the pains of the disease, is of particular importance, but if the possibility for the Church to approach the moment of death, sedation, especially when protracted and deep, is also acceptable to the Church , "it is therefore always at least partially unsatisfactory" because "that relational and communicative dimension" that is "crucial in the accompaniment of palliative care" is erased.
The deep sedation, used to alleviate the pains of the terminally ill, "must be considered as an extreme remedy, after having carefully examined and clarified the indications ", writes Cardinal Pietro Parolin, Vatican Secretary of State, in a letter to Msgr. Vincenzo Paglia, president of the Pontifical Academy for Life on the occasion of the opening of the work of the international congress on " Palliative Care: Everywhere and by everyone. Palliative care in every region. Palliative care in every religion or belief”, organized by the same Pontifical Academy. During the event, the PAL-Life Project will be officially presented, conceived and created by the Pontifical Academy for Life for the global dissemination of palliative care.
In his letter, card. Parolin stresses that "these are topics that regard the concluding moments of our earthly life and which confront the human being with a limit that seems unsurpassable for freedom, sometimes causing rebellion and anguish. This is why in today’s society we try in many ways to avoid it and to remove it, neglecting to listen to the inspired indication of the Psalm: “Teach us to number our days, that we may gain a heart of wisdom” (90.12). We thus deprive ourselves of the richness that is hidden in finitude, and of an opportunity to develop a more sensible way of living, both on a personal and a social level.
Palliative care, however, does not support this renunciation of the wisdom of finitude, and here is a further reason for the importance of these issues. In fact, they indicate a rediscovery of the deepest vocation of medicine, which consists first of all in caring: its task is to always care for, even if it is not always possible to heal. Certainly the medical enterprise is based on the untiring commitment to acquire new knowledge and to overcome an increasing number of diseases. But palliative care proves, within clinical practice, the awareness that the limit demands not only to be fought and moved, but also recognized and accepted. And this means not abandoning sick people, but rather being close to them and accompanying them in the difficult test that makes itself present at the end of life".
Accompanying people in the final phase of life, recalls the cardinal, if it aims to combat pain, is something different from euthanasia. "Pope Pius XII had clearly legitimized, by distinguishing it from euthanasia, the administration of analgesics to alleviate unbearable pain that is not otherwise treatable, even if, in the phase of imminent death, they may cause a shortening of life (cf Acta Apostolicae Sedis XLIX [1957 ], 129-147). Today, after many years of research, the shortening of life is no longer a frequent side effect, but the same question emerged with new drugs, which act on the state of consciousness and make different forms of sedation possible. The ethical criterion does not change, but the use of these procedures always requires careful discernment and great prudence. Indeed, they are very demanding for the sick, for the family, and for carers: with sedation, especially when protracted and deep, the relational and communicative dimension that we have seen is crucial in accompanying palliative care is cancelled. It is therefore always at least partially unsatisfactory, so it must be considered as an extreme remedy, after having carefully examined and clarified the indications".