CHARTER FOR HEALTH CARE WORKERS 21
21 The application to humans of biotechnology learned from animal fertilization has made possible various interventions in human procreation, giving rise to serious questions of moral lawfulness. "The various <techniques of artificial reproduction>, which would seem to be at the service of life and which are frequently used with this intention, actually open the door to new threats against life."
The evaluative ethical criterion must take account of the originality of human procreation, which "derives from the originality itself of the human person." "Nature itself dictates that the transmission of human life be a personal and conscious act and, as such, subject to the most holy laws of God: immutable and inviolable laws which must be acknowledged and observed." This personal act is <the intimate union of the love of the spouses who, in giving themselves completely to each other, give life>. It is a single, indivisible act, at once unitive and procreative, conjugal and parental.
This act—"an expression of the reciprocal gift which, in the words of Scripture, brings about a union 'in one flesh"'—is the source of life.
61. John Paul II, Encyclical <Evangelium vitae>, March 25, 1995, EV 14.
62. Cong. Doct. Faith, Instruct. <Donum vitae>, Feb. 22, 1987, in AAS 80 (1988) 76. 63. John XXIII, Encyclical <Mater et Magistra>, III, in AAS 53 (1961) MM 447. Cf. Pius XII, <To the participants at a congress of the Italian Catholic Union of Obstetricians>, Oct. 29, 1951, in AAS 43 (1951) 850.
64. Cf. John Paul II, <General Audience>, Jan. 16, 1980, in <Insegnamenti> III/1 (1980) 148-152.
65. Cf. Pius XII, <To the participants at a congress of the Italian Catholic Union of Obstetricians>, Oct. 29, 1951, in AAS 43 (1951) 850.
22 Humans are not at liberty to be ignorant of and to ignore the meanings and values intrinsic to human life from its very beginning. "And therefore means cannot be used nor laws followed which may be licit in the transmission of animal or vegetable life." The dignity of the human person demands that it come into being as a gift of God and as the fruit of the conjugal act, which is proper and specific to the unitive and procreative love between the spouses, an act which of its very nature is irreplaceable.
Every means and medical intervention, in the field of procreation, must always be by way of assistance and never substitution of the marriage act. In fact, "the doctor is at the service of people and human procreation: he has no authority to do as he wills with them or to make decisions about them. Medical intervention respects the dignity of the persons when it aims at helping the marriage act.... On the contrary, sometimes medical intervention replaces the conjugal act.... In this case, the medical action is not, as it should be, at the service of the marriage union, but it appropriates the procreative function and thus is contrary to the dignity and inalienable rights of the spouses and of the expected child."
66. John XXIII, Encyclical <Mater et Magistra>, III, in AAS 53 (1961) MM 447.
67. Cong. Doct. Faith, Instruct. <Donum vitae>, Feb. 22, 1987, in AAS 80 (1988) 96.
23 "The use of such artificial means is not necessarily forbidden if their function is merely to facilitate the natural act, or to ensure that a normally performed act reaches its proper end." This is <homologous artificial insemination>, that is, within matrimony with the semen of the partner, when this is obtained through a normal marriage act.
68. Pius XII, <To the participants at the IV International Congress of Catholic Doctors>, Sept. 30, 1949, in AAS 41 (1949) 560.
24 But homologous FIVET (<Fertilization in vitro with embryo transfer>) is illicit because conception is not the result of a conjugal act—"the fruit of the conjugal act specific to the love between the spouses"—but outside it: in vitro through techniques which determine the conditions and decide the effect. This is not in accord with the logic of "donation," proper to human procreation, but "production" and "dominion," proper to things and effects. In this case the child is not born as a "gift" of love, but as a laboratory "product."
Of itself, FIVET "separates the acts which are destined for human procreation in the conjugal act," an act which is "indissolubly corporeal and spiritual." Fertilization takes place outside the bodies of the spouses. It is not "actually effected nor positively willed as an expression of and fruit of the specific act of conjugal union," but as a "result" of a technical intervention. "[Man] no longer considers life as a splendid gift of God, something 'sacred' entrusted to his responsibility and thus also to his loving care and 'veneration.' Life itself becomes a mere 'thing,' which man claims as his exclusive property, completely subject to his control and manipulation."
69. Cong. Doct. Faith, Instruct. <Donum vitae>, Feb. 22, 1987, in AAS 80 (1988) 92.
70. "Homologous FIVET takes place outside the bodies of the partners through the actions of third parties whose competence and technical activity determine the success of the intervention; it entrusts the life and identity of the embryo to the power of doctors and biologists and gives technology dominion over the origin and destiny of the human person" (ibid., p. 93).
71. Cf. ibid., AAS 80 (1988) pp. 85-86,91-92,96-97. "The origin of a human person is really the result of a donation. The conception should be the fruit of the love of its parents. It cannot be desired nor conceived as the product of the intervention of medical or biological techniques: this would be to reduce it to becoming the object of scientific technology. No one can subject the arrival of a child into the world to conditions of technical efficiency which can be evaluated according to parameters of control and dominion" (ibid, p. 92).
72. Cf. ibid, AAS 80 (1988) pp. 91, 92-94.
73. John Paul II, Encyclical <Evangelium vitae>, March 25, 1995, EV 22.
25 The desire for a child, sincere and intense though it be, by the spouses, does not legitimize recourse to techniques which are contrary to the truth of human procreation and to the dignity of the new human being.
The desire for a child gives no right to have a child. The latter is a person, with the dignity of a "subject." As such, it cannot be desired as an "object." The fact is that the child is a subject of rights: the child has the right to be conceived only with full respect for its personhood.
74. Cong. Doct. Faith, Instruct. <Donum vitae>, Feb. 22, 1987, in AAS 80 (1988), p. 93.
75. Cf. ibid., p. 97. "A child is not something <owed> to one, but is a <gift>. The 'supreme gift of marriage' is a human person. A child may not be considered a piece of property, an idea to which an alleged 'right to a child' would lead. In this area, only the child possesses genuine rights: the right 'to be the fruit of the specific act of the conjugal love of his parents,' and 'the right to be respected as a person from the moment of his conception"' (CEC 2378).
26 Besides these intrinsic reasons of the dignity of the person and its conception, homologous FIVET is also morally inadmissible because of the <circumstances and consequences> of its present-day practice.
In fact, it is effected at the cost of numerous embryonal losses, which are procured abortions. It could also involve congealment, which means suspension of life, of the so-called "spare" embryos, and often even their destruction.
Unacceptable is "post mortem" insemination, that is, with semen, given during his lifetime, by the deceased spouse.
These are aggravating factors in a technical procedure already morally illicit <in itself>, and which remains such even without these factors.
76. Cf. ibid., p. 85 and 84. The "so-called 'spare embryos' are...used for research which, under the pretext of scientific or medical progress, in fact reduces human life to the level of simple 'biological material' to be freely disposed of" (John Paul II, Encyclical <Evangelium vitae>, March 25, 1995, EV 14).
77. Cf. Cong. Doct. Faith, Instruct. <Donum vitae>, Feb. 22, 1987, in AAS 80 (1988), p. 94. "Certainly homologous FIVET is not burdened with all the ethical negativity which is to be found in extra-matrimonial procreation; the family and the marriage are still the ambient of the birth and education of the child." However, it is at variance with the dignity of human procreation, depriving it of the dignity which is proper and connatural to it.
27 <Heterologous techniques> are "burdened" with the "ethical negativity" of conception outside of marriage. Recourse to gametes of people other than the spouses is contrary to the unity of marriage and the fidelity of the spouses, and it harms the right of the child to be conceived and born in and from a marriage. "<Procreation> then...expresses a desire, or indeed the intention, to have a child 'at all costs,' and not because it signifies the complete acceptance of the other and therefore an openness to the richness of life which the child represents."
These techniques, in fact, ignore the common and unitary vocation of the partners to paternity and maternity—to "become father and mother only through one another"—and they cause "a rupture between genetic parenthood, gestational parenthood and educational responsibility," which, from the family, has repercussions in society.
A further reason for unlawfulness is the commercialization and eugenic selection of the gametes.
78. John Paul II, Encyclical <Evangelium vitae>, March 25, 1995, EV 23.
79. Cf. Cong. Doct. Faith, Instruct. <Donum vitae>, Feb. 22, 1987, in AAS 80 (1988), pp. 87-89.
28 For the same reasons, aggravated by the absence of the marriage bond, artificial insemination of the unmarried and cohabitants is morally unacceptable.
80. Cf. ibid, p. 88; see also John Paul II, Encyclical <Evangelium vitae>, March 25, 1995, EV 23.
29 Equally contrary to the dignity of the woman, to the unity of marriage and to the dignity of the procreation of a human person is "surrogate" motherhood.
To implant in a woman's womb an embryo which is genetically foreign to her or just to fertilize her with the condition that she hand over the newly born child to a client means separating gestation from maternity, reducing it to an incubation which does not respect the dignity and right of the child to be "conceived, borne in the womb, brought to birth and educated by its own parents."
81. Cf. ibid, p. 89.
30 The verdict of moral unlawfulness obviously concerns the ways by which human fertilization takes place, not the fruit of these techniques, which is always a human being, to be welcomed as a gift of God's goodness and nurtured with love.
82. Cf. ibid, pp. 92-94.
31 Artificial insemination techniques nowadays could open the way to attempts or projects of fertilization between human and animal gametes, to gestation of human embryos in animal or artificial wombs, of sexless reproduction of human beings through twinning fission, cloning, parthenogenesis.
Such procedures are contrary to the human dignity of the embryo and of procreation, and thus they are to be considered morally reprehensible.
83. Cf. ibid, p. 95.
32 Medicine directed to the integral good of the person cannot prescind from the ethical principles governing human procreation.
Hence the "urgent appeal" to doctors and researchers to give "an exemplary witness of the respect due to the human embryo and to the dignity of procreation."
84. Cf. ibid, pp. 95-96.
33 Medical service to life accompanies the life of the person throughout their whole life-span. It is protection, promotion and care of health, that is, of the integrity and psycho-physical well-being of the person, in whom life "is enfleshed."
It is a service based on the dignity of the human person and on the right to life, and it is expressed not only in prevention, treatment and rehabilitation but also in an holistic promotion of the person's health.
85. Cf. John Paul II, <To the staff of the new 'Regina Marghenta' hospital>, Dec. 20, 1981, in <Insegnamenti> IV/2, p. 1179, n. 3.
34 This responsibility commits the health care worker to a service to life extending "from its very beginning to its natural end," that is, "from the moment of conception to death."
86. Cf. John Paul II, <To the participants at the 35th General Assembly of the World Medical Association>, Oct. 29, 1983, in <Insegnamenti> VI/2, 917-923, AAS 76 (1984) 390]; <To the Catholic health organizations of the United States of America>, Sept. 14, 1987, in <Insegnamenti> X/3 (1987) 500-507; <To the participants at the VII Symposium of European Bishops>, Oct. 17, 1989, in <Insegnamenti> XII/2, p. 947, n. 7.
35 "From the time that the ovum is fertilized, a life is begun which is neither that of the father nor of the mother; it is rather the life of a new human being with its own growth. It would never be made human if it were not human already.... Right from the fertilization the adventure of a new life begins, and each of its capacities requires time—a rather lengthy time—to find its place and to be in a position to act."
Recent advances in human biology have come to prove that "in the zygote arising from fertilization, the biological identity of a new human individual is already present." It is the individuality proper to an autonomous being, intrinsically determined, developing in gradual continuity.
Biological individuality, and therefore the personal nature of the zygote is such from conception. "How can anyone think that even a single moment of this marvelous process of the unfolding of life could be separated from the wise and loving work of the Creator, and left prey to human caprice?" As a result, it is erroneous and mistaken to speak of a pre-embryo, if by this is meant a stage or condition of pre-human life of the conceived human being.
87. Cong. Doct. Faith. <Declaration on Procured Abortion>, June 18, 1974, in AAS 66 (1974) 738.
88. Cong. Doct. Faith, Instruct. <Donum vitae>, Feb. 22, 1987, in AAS 80 (1988) 78-79.
89. Even the theory of the fourteenth day—the day when the primitive streak appears, in which the cells lose their toti-potentiality and twin divisions are no longer possible—cannot ignore and deny the fundamental and decisive biogenetic fact of the human and individual nature of the fruit of the conception.
90. John Paul II, Encyclical <Evangelium vitae>, March 25, 1995, EV 44.
36 Prenatal life is fully human in every phase of its development. Hence health care workers owe it the same respect, the same protection and the same care as that given to a human person.
Gynecologists and obstetricians especially "must keep a careful watch over the wonderful and mysterious process of generation taking place in the maternal womb, to ensure its normal development and successful outcome with the birth of the new child."
91. John Paul II, <To the participants at a congress for obstetricians>, Jan. 26, 1980, in <Insegnamenti> III/1, p. 192, n. 1.
37 The <birth> of a child is an important and significant stage in the development begun at conception. It is not a "leap" in quality or a new beginning, but a stage, with no break in continuity, of the same process. Childbirth is the passage from maternal gestation to physiological autonomy of life.
Once born, the child can live in physiological independence of the mother and can enter a new relationship with the external world.
It may happen, in the case of premature birth, that this independence is not fully reached. In this case health care workers are obliged to assist the newborn child, making available to it all the conditions necessary for attaining this independence.
If, despite every effort, the life of the child is at serious risk, health care workers should see to the child's baptism according to the conditions provided by the Church. If an ordinary minister of the sacrament is unavailable—a priest or a deacon—the health care worker has the faculty to confer it.
92. Cf. <Code of Canon Law>, CIC 862/2.
38 The respect, protection and care <proper> to human life derives from its singular dignity. "In the whole of visible creation it (human life) has a unique value." "The human being, in fact, is the 'only creature that God has wanted for its own sake. Everything is created for humans. The human being' alone, created in the image and likeness of God (cf. Gn 1,26-27) is not and cannot be for any other or others but for God alone, and this is why he exists. The human being alone is a <person>: he has <the dignity of a subject and is of value in himself.>"
93. John Paul II, <To the participants at a congress for Obstetricians>, Jan. 26, 1980, in <Insegnamenti> III/1, p. 192, n. 2. Cf. John Paul II, Encyclical <Veratatis splendor>, VS 13.
94. Ecum. Coun. Vat. II, Past. Constit. <Gaudium et spes>, GS 24.
39 Human life is irreducibly both corporeal and spiritual. "By virtue of its substantial union with a spiritual soul, the human body cannot be considered merely an amalgam of tissues, organs and functions, nor can it be measured by the same standards as the body of animals, but it is a constitutive part of the person who by means of it manifests himself and acts." "Every human person, in his unrepeatable uniqueness, is made up not only of spirit but also of a body, so that in the body and through it the person is reached in his concrete reality."
95. Cong. Doct. Faith, Instruct. <Donum vitae>, Feb. 22, 1987, in AAS 80 (1988) 74.
96. John Paul II, <To the participants at the 35th General Assembly of the World Medical Association>, Oct. 29, 1983, in <Insegnamenti> VI/2, 917-923, AAS 76 (1984) 393]. "The human person, created in the image of God, is a being at once corporeal and spiritual. The biblical account expresses this reality in symbolic language when it affirms that 'then the Lord God formed man of dust from the ground, and breathed into his nostrils the breath of life; and man became a living being' (Gn 2,7). Man, whole and entire, is therefore willed by God" (CEC 362).
40 Every intervention on the human body "touches not only the tissues, the organs and their functions, but involves also at various levels the person himself."
Health-care must never lose sight of "the profound unity of the human being, in the obvious interaction of all his corporal functions, but also in the unity of his corporal, affective, intellectual and spiritual dimensions." One cannot isolate "the technical problem posed by the treatment of a particular illness from the care that should be given to the person of the patient in all his dimensions. It is well to bear this in mind, particularly at a time when medical science is tending towards specialization in every discipline."
97. Cong. Doct. Faith, Instruct. <Donum vitae>, Feb. 22, 1987, in AAS 80 (1988) 74-75. "The unity of soul and body is so profound that one has to consider the soul to be the 'form' of the body: i.e., it is because of its spiritual soul that the body made of matter becomes a human, living body; spirit and matter, in man, are not two natures united, but rather their union forms a single nature" (CEC 365).
98. Cf. John Paul II, <To the participants at the 35th General Assembly of the World Medical Association>, Oct. 29, 1983, in <Insegnamenti> VI/2, 920, n. 5.
41 Revealing the person, the body, in its biological make-up and dynamic, is the <foundation and source of moral accountability>. What is and what happens biologically is not neutral. On the contrary it has ethical relevance: it is the indicative-imperative for action. The body is a properly personal reality, the sign and place of relations with others, with God and with the world.
One cannot prescind from the body and make the psyche the criterion and source of morality: subjective feelings and desires cannot replace or ignore objective corporal conditions. The tendency to give the former pride of place over the latter is the basis for contemporary psychologization of ethics and law, which makes individual wishes (and technical possibilities) the arbiter of the lawfulness of behavior and of interventions on life.
The health care worker cannot neglect the corporeal truth of the person and be willing to satisfy desires, whether subjectively expressed or legally codified, at variance with the objective truth of life.
99. "The body reveals the human being, expresses the person and is the first message of God to the human being himself' (John Paul II, allocutions of Jan. 9 and Feb. 20,1980, in <Insegnamenti> III/1, 8895 and 428-434).
100. The moral law, in which biological meanings take shape, "cannot be seen as a merely biological norm" but as integrally human: in it is expressed "the rational order according to which the human person is called by the Creator to direct and regulate his life and his actions and, in particular, souse and dispose of his own body": Cong. Doct. Faith, Instruct. <Donum vitae>, Feb. 22, 1987, in AAS 80 (1988) p. 74; Paul VI, Encyclical <Humanae vitae>, in AAS 60 (1968) p. 487, HV 10.
101. Cf. John Paul II, Encyclical <Evangelium vitae>, March 25, 1995, EV 23.
42 "The inviolability of the person, a reflection of the absolute inviolability of God himself, has its first and fundamental expression in the inviolability of human life." "The question: 'What have you done?' (Gn 4,10), which God addresses to Cain after he has killed his brother Abel, interprets the experience of every person: in the depths of his conscience, man is always reminded of the inviolability of life—his own life and that of others—as something which does not belong to him, because it is the property and gift of God the Creator and Father."
The body, indivisibly with the spirit, shares in the dignity and human worth of the person: <body-subject> not body-object, and as such is indisposable and inviolable. The body cannot be treated as a belonging. It cannot be dealt with as a thing or an object of which one is the owner and arbiter.
Every abusive intervention on the body is an insult to the dignity of the person and thus to God who is its only and absolute Lord: "The human being is not master of his own life: he receives it in order to use it, he is not the proprietor but the administrator, because God alone is Lord of life."
102. John Paul II, Apost. Exhort. <Christifideles laici>, Dec. 30, 1988, in <Insegnamenti> XI/4, p. 2133, CL 38.
103. John Paul II, Encyclical <Evangelium vitae>, March 25, 1995, EV 40.
104. Cf. Pius XII, <To the participants at the Congress of Italian Catholic Obstetricians>, Oct. 29, 1951, in AAS 43 (1951) 838: John Paul II, <To the participants at the 54th updating Course of the Catholic University>, Sept. 6, 1984, in <Insegnamenti> VII/2, p. 333. "The human body shares in the dignity of the 'image of God': it is a human body precisely because it is animated by a spiritual soul, and it is the whole human person that is intended to become, in the Body of Christ, a temple of the Spirit" (CEC 364).
105. John Paul II, <To the participants at a congress of the "Movement for Life,>" Oct. 12, 1985, in <Insegnamenti> VI/2, 933-936, n. 2. Cf <To scientists and health care workers>, Nov. 12, 1987, in <Insegnamenti> X/3 (1987) 1084-1085, n. 2. Cf. Pius XII, <To the members of the First International Congress of Histopathology of the Nervous System>, Sept. 14, 1952, in AAS 44 (1952) p. 782.
43 The fact that life belongs to God and not to the human being gives it that sacred character which produces an attitude of profound respect: "a direct consequence of the divine origin of life is its indisposability, its untouchability, that is, its sacredness." Indisposable and untouchable because sacred: it is "a natural sacredness, which every right reason can recognize, even apart from religious faith."
Medical health activity is above all a vigilant and protective service to this sacredness: a profession which defends the non-instrumental value of this good "in itself"—that is, not relative to another or others but to God alone—which human life is. "Man's life comes from God; it is his gift, his image and imprint, a sharing in his breath of life. God therefore <is the sole Lord of this life>: man cannot do with it as he wills."
106. Cf. Pius XII, <Discourses and Broadcasts>, X, Vatican Polyglot Press, 1949, pp. 98ff; <To the "San Luca" Italian Union of Medical Biology>, Nov. 12, 1944, in <Discourses and Broadcasts>, VI cit., 191ff; John Paul II, <To the Pontifical Academy of Sciences>, Oct. 21, 1985, in <Insegnamenti> VIII/2, p. 1081 n. 3.
107. John Paul II, <To the participants at a congress for obstetricians>, Jan. 26, 1980, in <Insegnamenti> III/1, p. 192, n. 2; <To the participants at the congress of the Italian Association of Anesthesiology>, Oct. 4, 1984, in <Insegnamenti> VII/2, p. 750, n. 4; <To the Catholic health organizations of the United States of America>, Sept. 14, 1987, in <Insegnamenti> X/3 (1987) 504.
108. John Paul II, <To the participants at a congress of the "Movement for Life>," Oct. 12, 1985, in <Insegnamenti> VIII/2, pp. 933-936, n. 2.
109. John Paul II, <To the participants at the III Congress of the Association of Catholic Health Care Workers>, Oct. 24, 1986, in <Insegnamenti> IX/2, p. 1172.
110. "Scientists and doctors must not think that they are lords of life, but rather its expert and generous servants" (John Paul II, <To the Pontifical Academy of Sciences>, Oct. 21, 1985, in <Insegnamenti> VIII/2, p. 1081, n. 3.
111. John Paul II, Encyclical <Evangelium vitae>, March 25, 1995, EV 39.
44 This must be affirmed with particular rigor and received with vigilant awareness at a time of invasive development in biomedical technology, where the risk of abusive manipulation of human life is increasing. The techniques in themselves are not the problem, but rather their presumed ethical neutrality. Not everything which is technically possible can be considered morally admissible.
Technical possibilities must be measured against ethical lawfulness, which establishes their human compatibility, that is, their effective employment in the protection of and respect for the dignity of the human person.
112. John Paul II, <To the participants at a congress of the "Movement for Life>," Dec. 4, 1982, in <Insegnamenti> V/3, p. 1513, n. 5, <To the Pontifical Academy of Sciences>, Oct. 23, 1982, in <Insegnamenti> V/3, p. 896, n. 2; <To the participants at the Colloquium of the "Nova Spes" international Foundation>, Nov. 9, 1987, in <Insegnamenti> X/3 (1987) 1050-1051, n. 2.
45 Science and technology "cannot by themselves give the meaning of human existence and progress. Since they are ordained for the human being from whom they receive their origin and increase, it is from the person and his moral values that they draw direction for their finality and awareness of their limits."
This is why science and wisdom should go hand in hand. Science and technology are extremist, that is, they are constantly expanding their frontiers. Wisdom and conscience trace out for them the impassable limits of the human.
113. Cong. Doct. Faith, Instruct. <Donum vitae>, Feb. 22, 1987, in AAS 80 (1988) 73.
114. Ecum. Coum. Vat. II, Past. Constit. <Gaudium et spes>, GS 15: "Our age, more than any of the past, needs such wisdom if all that man discovers is to be ennobled through human effort."
46 The divine lordship of life is the foundation and guarantee of the right to life, which is not, however, a power over life. Rather, <it is the right to live with human dignity,> as well as being guaranteed and protected in this fundamental, primal and unsuppressible good which is the root and condition of every other good-right of the person.
"The subject of this right is the human being in every phase of his development, from conception to natural death; and in every condition, either health or sickness, perfection or handicap, wealth or paupery "
115. Cf. Pont. Coun. "Cor Unum", <Some ethical questions relating to the gravely in and the dying>, July 27, 1981, in <Enchiridion Vaticanum>, 7. <Documenti ufficiali della Santa Sede 1980-1981>. EDB, Bologna 1985, p. 1137, n. 2.1.
116. Cf. John Paul II, <To the Association of Italian Catholic Doctors>, Dec. 28, 1980, in <Insegnamenti> III/2, p. 1007, n. 3; <To a delegation of the "Food and Disarmament International" Association>, Feb. 13, 1986, n. 3.
117. Cf. Cong. Doct. Faith, <Declaration on Euthanasia>, May 5, 1980, in AAS 72 (1980) 544-545; John Paul II, <To the World Medical Association>, Oct. 29, 1983, in <Insegnamenti> VI/2, 918, n. 2; Apost. Exhort. <Christifideles laici>, Dec. 30, 1988, in <Insegnamenti> XI/4, p. 2133-2135, CL 38.
118. John Paul II, Apost. Exhort. <Christifideles laici>, Dec. 30, 1988, in <Insegnamenti> XI/4, p. 2133, CL 38. "Man is not the master of life, nor is he the master of death. In life and in death, he has to entrust himself completely to the 'good pleasure of the Most High,' to his loving plan" (John Paul II, Encyclical <Evangelium vitae>, March 25, 1995, EV 46).
47 The right to life poses a two-fold question for the health care worker. First of all, he must not think that he has a right—power over the life he is caring for, something which neither he nor the patient himself has. and therefore cannot be given by the latter.
The right of the patient is not one of ownership nor absolute, but it is bound up with and limited by the finality established by nature. "No one...can arbitrarily choose whether to live or die; the absolute master of such a decision is the Creator alone, in whom 'we live and move and have our being"' (Ac 17,28).
Here—on the limits themselves of the right of the subject to dispose of his own life—"arises the moral limit of the action of the doctor who acts with the consent of the patient."
119. "The doctor has only the power and rights over the patient which the latter gives him, either explicitly or tacitly. For his part, the patient cannot give more rights than he has" (Pius XII, <To the members of the First International Congress on Histopathology of the Nervous System>, Sept. 14, 1952, in AAS 44  p. 782.)
120. "The patient is bound by the immanent teleology established by nature. He has the right to use—limited by the natural finality—the faculties and powers of his human nature." (Ibid.)
121. John Paul II, Encyclical <Evangelium vitae>, March 25,1995, EV 47.
122. Cf. Pius XII, <To the members of the First International Congress on Histopathology of the Nervous System>, Sept. 14, 1952 in AAS 44 (1952) p. 782.
48 Secondly, the health care worker effectively guarantees this right: "the intrinsic finality" of his profession "is the affirmation of the right of the human being to his life and his dignity." He fulfills it by assuming the corresponding duty of preventive and therapeutic care of the health, and of the improvement, within the ambit and with the means at his disposal, of the quality of life of the persons and their life environment. "On our journey we are guided and sustained by the law of love: a love which has as its source and model the Son of God made man, who 'by dying gave life to the world."
123. John Paul II, <To the participants at a surgery congress>, Feb. 19, 1987, in <Insegnamenti> XI/1 (1987) 374, n. 2.
124. John Paul II, <To the staff of the 'Regina Margherita hospital,> Dec. 20, 1981, in <Insegnamenti> IV/2, p. 1179, n. 3.
125. Pont. Coun. "Cor Unum," <Community health>, in <Enchiridion Vaticanum>, 6. <Documenti ufficiali della Santa Sede 1977-1979>. EDB, Bologna 1983, p. 325, n. 1.2.
126. John Paul II, Encyclical <Evangelium vitae,> March 25, 1995, EV 79.
49 The fundamental and primary right of every human being to life, which is particularized as the right to protection of health, subordinates the trade union rights of health care workers.
This means that any just claims of health workers must be processed while safeguarding the right of the patient to due care, because of its indispensability. Hence, if there is a strike, essential and urgent medical-hospital services for the safeguarding of health should be provided for—even by means of appropriate legal measures.
CHARTER FOR HEALTH CARE WORKERS 21