Tuesday, December 10, 2019

Palliative Care and the Mental Health of the Elderly

At 11:30am local time this morning (5:30am EST), at the Holy See Press Centre located at Via della Conciliazione 54 in Rome, there was a Press Conference held for the presentation of the International Symposium entitled Religion and Medical Ethics: Palliative Care and the Mental Health of the Elderly which has been organized by the Pontifical Academy for Life and the world Innovation Summit for Health (WISH, an initiative of the Qatar Foundation), which is taking place in Rome, at the Augustinianum from 11 to 12 December 2019.

Present at the Press Conference were His Excellency, Vincenzo Paglia, President of the Pontifical Academy for Life; Doctor Sultana Afdhal, Chief Executive Officer of WISH, Qatar; and Doctor Kamran Abbasi, Executive Editor of the British Medical Journal (BMJ).

Intervention prepared by His Excellency, Vincent Paglia
President of the Pontifical Academy for Life

The two themes chosen for this Congress are Palliative Care and Mental Health in Aging. These are two important areas for the future of our societies and not only for health care, because the sick and the elderly are considered people who no longer have anything to offer. They are not productive, they are not useful, they are a burden for our societies that make efficiency an absolute myth. This is an attitude denounced by Pope Francis who uses, as you know, the effective expression throw-away society.

The Pontifical Academy for Life is committed to promoting a culture of Palliative Care at the level of the Catholic Church throughout the world. We have already held various Congresses on this subject both in Italy and in Europe; in the United States with the signing of a joint declaration with the Methodist Church; in Brazil, Lebanon and Qatar, where in January 2018 I signed a joint declaration with Doctor Sultana Afdhal. Not to be forgotten is the Position Paper on the themes of end-of-life and palliative care, signed in the Vatican on October 28th with representatives of the three Abrahamic Religions. (The texts of these documents are on our website, where there is a well documented page dedicated to the commitment of the Academy on Palliative Care www.academyforlife.va).

We have published a White Paper for the Promotion and Dissemination of Palliative Care in the world, prepared by an international group of experts. The text is available in English, German and Italian - it is also on our website - and Catholic Universities and Catholic Hospitals in the world are receiving it in order to increase not only knowledge, but above all the practice of Palliative Care. We share the desire to promote a palliative culture, both to respond to the temptation that comes from euthanasia and assisted suicide, and above all to develop a culture of care that allows us to offer a company of love until the death's passage.

The Symposium that we are beginning tomorrow - as I said - combines two important issues for the future of health policies in many countries in the world and not only in the West. On the one hand, we are witnessing a growing aging population; on the other hand, the spread of a culture of euthanasia, because terminally ill and elderly persons are considered to be discarded in a world that is centred on profit and economy, and health policies often yield to an accounting mentality. Instead we know well how Palliative Care is the protagonist of the recovery of an integral accompaniment of the patient in the context of contemporary medicine. And we know that we can heal, even when we can no longer heal, balancing attention to the person with economic benefits. The experts tell us this is true and we will talk about it during the work of this Congress.

But I would also like to highlight a further aspect, which concerns a very important border camp. If in fact the men and women of our time need integral accompaniment at the time of fragility, even more so is this true when it comes to minors. A specific section of our work is dedicated to a very delicate and painful area: paediatric palliative care. When suffering affects children, we are even more shaken.

Here then are the fields in which religions identify a common perspective: an accompaniment that looks at the physical, emotional and spiritual dimensions of each person. A reading of human existence and of the reality that values ​​religious experience allows us to see and affirm a good that goes beyond the mere measure of calculation. The recognition of constitutive openness to the transcendence of the person allows us to affirm that in human life, even when it is fragile and apparently defeated by illness, there is an intangible preciousness. Beginning with the encounter with the Creator, it is possible to identify in finiteness an aspect of the human condition that, while arousing rebellion and transgression in mankind, it can open us up to another reading: this same limit can be rediscovered as a place of relationship and Communion. And this applies not only to other human beings, but also to nature and the earth. The I finds its most complete expression in the relationship, that is, in us: two realities that cannot be separated from each other. We must patiently return evidence to the dynamic of the mutual bond between the ego and the we. Humanism is constitutively supportive.

This is why the Pontifical Academy for Life is committed to these frontiers. Reinventing a new fraternity is the anthropological and social challenge of our day. And it is precisely in this line that Pope Francis delivered a specific mandate to the Pontifical Academy for Life, on the occasion of the twenty-fifth anniversary of its institution, which was celebrated on 11 February this year. Overcoming the prevaricating and predatory attitude that we so often practice, we are given the task of guarding others and all of creation, without which the very life of the human family is deprived of what makes it possible.

Thank you.
Testo originale nella lingua italiana
More information about the Conference

Intervention prepared by Doctor Sultana Afdhal
CEO of WISH, Qatar

Hello. On behalf of the World Innovation Summit for Health, I want to thank you all for giving your valuable time to join us at this press conference today.

I want to thank Archbishop Paglia and his team at the Pontifical Academy for Life for being open to co-hosting a symposium on Religion and Medical Ethics with us, and Kamran and The BMJ for working with us to ensure that the medical perspective is present during our discussions. Tomorrow’s symposium has been developed to shine a light on ethical questions around palliative care and on the mental health of the elderly, and whether participants in the event are healthcare policy makers, representatives of faith groups, or are carrying out the vital role of providing day-to-day patient care, we want them to find value in our event.

As the CEO of the World Innovation Summit for Health – WISH – which is a part of the Doha-based non-profit Qatar Foundation for Education, Science and Community Development, I was absolutely delighted and honoured to announce earlier this year that we would be co-hosting this week’s event with our very special friends from the Pontifical Academy for Life.

In 2018, WISH published a report on Islamic ethics and palliative care, which was discussed at length at our biennial global summit last November in Doha – an event that attracts more than 2,000 healthcare leaders. Early this year, we signed a declaration on palliative care with the Pontifical Academy for Life that in October was used as the basis for a positioning paper around palliative care that was endorsed by a large group of Abrahamic faith leaders and was subsequently presented to His Holiness the Pope by Archbishop Paglia.

Since WISH was launched, at the World Global Health Policy Summit in London in 2012, our mission has been to build a healthier world through global collaboration. It is therefore a natural progression for us to be here in Vatican City to actively promote dialogue between people of faith and medical experts around issues that have such a profound effect on individuals, their families, their communities, and healthcare workers.

WISH sees itself as providing a solid platform that enables the meeting-up of global experts and stakeholders to discuss key healthcare matters. Our parent organization, Qatar Foundation, now has almost 25 years of experience working in education, science and community development both at home in Qatar and around the world. While here in Vatican City we want to initiate conversations that have the genuine potential to benefit humanity as a whole, regardless of individual beliefs.

The interfaith nature of this event, and the involvement of experts from both a faith and a medical background, will provide a priceless opportunity to gain a deeper understanding of the very real ethical dilemmas experienced by healthcare practitioners from different spiritual backgrounds across our world when dealing with these sensitive, and yes, difficult subjects for a great many of us.

There is no doubt in my mind that sharing knowledge from different religions and medical healthcare perspectives enriches and expands our thinking. I also believe we will all gain something from learning about how other faiths respond to these issues, and perhaps discover some fresh approaches to follow, both medically and spiritually.

In-depth interfaith and medical interdisciplinary dialogue about palliative care and the mental health of older members in our communities is essential in helping to establish a common ground. This will aid our task in finding more effective ways to bridge differences in ethical approaches based on faith, whether actual or perceived. Without wanting to pre-empt the discussions that we will have, I anticipate that we’ll end up finding more commonalities than differences.

By seeking to provide more uniform approaches to dealing with ethical challenges, we can be more effective in our efforts to help those in need. We can also be united in our efforts to advance the idea that to treat people holistically and in a way that alleviates suffering requires a willingness to consider a person’s spiritual needs, as well as their physical and mental needs.

We will be discussing some very emotive matters over the next two days, such as suicide among older members of society and end-of-life care for children. I realize that these will be very difficult and upsetting areas for us to debate. However, it is both right and important that we do not shy away from these topics, and I believe our discussions can only benefit those who are affected and afflicted by such issues, as we take back our shared knowledge and understanding to our respective communities around the world once the symposium comes to a close.

Intervention prepared by Doctor Kamran Abbasi
Executive Editor of the British Medical Journal

Good morning. I’m delighted to be here to represent BMJ.

This conference is perfectly in line with our core values: Transparent, open and trusted; Patient-centred; Evidence-based – and our vision for a Healthier World.

We aim to bring a medical perspective to these discussions.

If we do believe in being patient-centred, which we all of us here do, then we must find common ground for a constructive conversation that recognizes that people’s beliefs play an important and central part in their decision making about their health.

For over two decades, The BMJ has championed evidence-based approaches to care, and it is important now, in the era of shared decision making in health, in the age of patient partnership, that we find ways to make sure that people from all faiths and backgrounds are able to draw on the evidence and science to live long and healthy lives.

Crucially, on the issues that we will be discussing over the next few days, end of life care and mental health in the elderly, religious beliefs and evidence must work in harmony to help patients and their families face these complex challenges.

BMJ encourages open/balanced debate that reflects medical, legal, ethical, and religious views. We help inform clinicians, based on the latest evidence, so they can make decisions in the best interests of their patients. And we support shared decision making – taking account of patient/family values and beliefs.

We’d like to thank the editors of the Journal of Medical Ethics (Prof John McMillan, Prof Julian Hughes, Prof Kenneth Boyd) for their paper, which is available for you to read today. We hope it will inform and prompt debate. The Islamic and Catholic case studies are designed to prompt discussion over the next two days and will form the basis for Prof Julian Hughes' presentation tomorrow. The paper raises some of the key issues in religion and medicine, from decision making to the role of advance directives.

We, the BMJ, intend to feature the discussions we will have here in a follow paper which we'll share in the new year.

Finally, we’d very much like to thank Sultana Afdhal and Archbishop Paglia for organising and hosting this important meeting.

At a moment of global discord, disharmony, and danger, it is symbolic that we are gathering here at The Vatican to show the power of people from all faiths and backgrounds in coming together to solve the world's problems.

Thank you.

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