The theology of prevention between love and responsibility, for a healthy psyche and body
Nothing is more fascinating to our eyes than the immense work of creation that manifests the ineffable intelligence and imagination of the Creator
The progressive investigations of science reveal the extraordinary divine power that everything had hidden in the heart of a star pregnant with life that exploded millions and millions of years ago. What makes up our bodies, bones, flesh and blood, was already there in that precious casket that suddenly opened. Turned on the clock of time, there followed the complex conditions that allowed man to exist. Everything was chaos, and order was conducted with skillful, silent and patient doing. The sublime Potter took millions of years to fashion his masterpiece: man as we are in our day. The seven billion humans living on earth today, not including all those who have gone before us, bear the imprint of uniqueness. Even monozygotic twins, who would be identical with respect to genetic heritage inherited from their parents, are never completely so with respect to external appearance and personality. We are prompted to exclaim with the psalmist, “the glory of God is the living man” (Ps. 144). Awe ravishes us when we reflect on man’s psychic and spiritual faculties, when we explore the infinite meanderings of consciousness, where the invisible artist dialogues with his creature. To understand man identified as body and psyche we must exclude the possibility that everything came about by chance, the whole reduced to a molecular accident. Light on the truth of man is revealed in the holy scriptures, “yet you made him little less than the angels” (Ps. 8:6). The Hebrew word used for man is “basar” which primarily means flesh and, more broadly, body as a human being understood in its totality and completeness. The suggestive vision of Ezekiel 37 imagines a fantastic structuring of the living man starting with the bones on which the nerves are formed, then the flesh, the skin and, finally, the spirit that gives them life. The ancient Jewish believer knew that the human being consists of a multiplicity of elements that are unified and vitalized by the “breath” spirit he imagined circulating in the blood. The body structure in its visibility and physicality characterizes and names the living man. The body is the person as called by God into existence from conception and remains so until its natural demise. Its members and its psychic and physical energies place it in vital and fruitful relationship with others and with things. Jesus himself, the Word made flesh, who takes a body from Mary, is a teacher of life and teaches us to take care of our own bodies and those of others, worries about the lack of food ( Mk 6:37-43), health (Lk 7:21), and invites his friends to get some rest (Mt 6:30-31). The body is also primary medium of expression of human interiority, through the face. Remember the many expressions about the Face of Christ recorded in the Gospels.
To the teacher of the law, who wanted to test him (Lk 10:25-29), Jesus reaffirms what Leviticus teaches: love of neighbor commensurate with love of self. The care and custody, which we must have toward this body given to us by God, must also be directed toward our fellow human beings, our neighbor. It is interesting that it is the same teacher of the law who, in his encounter with Jesus, reduces the two main commandments to one: “You shall love the Lord your God…..love your neighbor as yourself” . To love as oneself can mean that one loves another only if he loves himself, not in a selfish sense, but simply to cherish the gift of God that is us, to give glory to God even while preserving the good health that will enable us to serve others with greater dedication and effectiveness. Anthony the Great would go so far as to say that “no one is more wicked than he who is wicked to himself: he who loves himself loves everyone.” Carefully watching over our physical, mental and spiritual health is therefore a definite moral duty; a better quality of life depends on it; it is like a contribution offered to a better society, to the common good .
Health is the summation of several factors, the so-called “health determinants,” represented by genetic make-up, personal behaviors and lifestyles, social, cultural and economic factors, working condition, ‘accessibility to health services, and environmental context.
These factors weigh differently on the health status of an individual and a community (Institute for the future (IFTF), Health and Healthcare 2010. The forecast, The challenge. Princeton: Jossey-Bass, 2003). Thus health is as much as 50 percent dependent on behaviors and lifestyles, while the environment determines it by 20 percent, as does the genetic component (20 percent). Finally, the remaining 10 percent is attributable to health services.
These aspects explain why it took as many as eight thousand years for the human species to go from an average life expectancy of 20 years to one of 40, while it took not even a century, the last of the last millennium, for a further extraordinary doubling. Thus, in the most advanced countries, average life expectancy is now approaching 80 years. In other words, over the past 170 years, average life expectancy in industrialized countries has increased by 2.5 years every 10 years. That’s more or less than 6 hours a day.
Let us prepare, however, for further leaps forward. Some recent studies on the biology of aging seem to confirm what is asserted in Genesis (6:3): “Then the Lord said, ‘My Spirit shall not abide forever humbled in man, for he is flesh: his life shall be but 120 years.’ ” The Bible on the other hand gives us records of at least 33 people who lived more than 123 years. (Whether these are symbolic or historical numbers escapes us.)
According to research, the human organism would have a genetic make-up, conformed over 150,000 to 300,000 years, that would give it the potential to live well beyond 100 years. This upper limit, however, is 70 to 80 percent conditioned by lifestyle and numerous environmental factors. Therefore, what determines an individual’s lifespan is not so much an unchangeable element such as genetic make-up, but modifiable factors such as behaviors and socio-environmental conditions.
There is, however, another aspect related to lifespan: the quality of life of those years gained. One indicator, life expectancy in disability-free years, according to 2008 data, is 7.9 years for males and 7.2 for females. As in, we have added many years to life, but less life to years. This consideration implies a reality: the population of industrialized countries is aging and the incidence of chronic-degenerative diseases, that is, those related to modifiable factors, is also increasing due to the lack of preventive interventions. Alcohol consumption, smoking, sedentary living and obesity are modes of behavior that contribute to the increase in chronic-degenerative diseases.
There are three challenges with which the protection system in industrialized society is already measured: the aging population, chronic diseases and non-self-sufficiency.
Chronic-degenerative diseases alone, some of which can be prevented by adopting healthy habits, account for 30 percent of health problems but absorb 70 percent of the resources devoted to it. In this sense, prevention can do much to avoid major consequences such as expenditures that divert resources from other situations that cannot otherwise be addressed.
At least 15 vaccines are effective in controlling infectious diseases. There are screenings that can significantly improve mortality from breast, cervical, prostate, and colon cancer. Organizations, communities, but also individuals carry the responsibility for their own health and the resources committed to protecting it.
Alongside this commitment, so to speak secular, there is another ethical-religious one that, for Catholics in particular, takes on a foundational value, to the point that we can speak of a theology of prevention that investigates and promotes the safeguarding of the body, starting with St. Paul’s admonition, “Do you not know that your body is the temple of the Holy Spirit who is in you and whom you have from God, and that you do not belong to yourselves? For you have been bought dearly. Therefore glorify God in your bodies!” (1 Cor. 3:16).
The Apostle to the Gentiles urges every Christian to decide how to use his or her body: according to the “flesh,” thus not respecting it, or by also involving corporeality in the Christian dimension.
This is specifically addressed by the “Catechism of the Catholic Church” in Articles 2288-2290. In particular, it is the first proposition of Article 2288 that summarizes the relationship between prevention and morality. Indeed, it states, “Life and physical health are precious goods given by God. We must reasonably care for them, taking into account the needs of others and the common good.” At the same time, however, it warns against exasperating this care to the point of turning it into body worship (2289), which has pagan significance.
The Catechism also delves into promoting proper lifestyles when, recalling the virtue of tolerance, it commits Christians “to avoid all sorts of excesses, the abuse of food, alcohol, tobacco and medicines” (2290).
Anticipating in so many ways the advice of international health bodies, the Catechism states, “The care of the health of citizens requires the contribution of society so that they may have conditions of existence that allow them to grow and reach maturity: food and clothing, housing, health care, basic education, work, social security.”
According to bioethicists, failure to take care of one’s own health takes the form of serious ethical misconduct, so taking care of oneself is affirmed as a moral duty and a responsible act of charity toward ourselves and others.
Medicine is increasingly engaged in the area of prevention and the promotion of correct lifestyles, although attitudes not in keeping with the principles of prevention itself cannot be configured as sin. It is true, however, that it is rather a matter of appealing to common sense, or rather to the sense of charity, which in turn confronts us with inescapable duties.
Prevention therefore appeals to individual responsibility with regard to lifestyles and behaviors summarized by the WHO (World Health Organization) indications: do not smoke, consume limited amounts of alcohol, eat an adequate diet, do not expose oneself excessively to the sun, control weight, engage in regular physical activity, and allow oneself adequate hours of sleep, which enhances the beneficial effect of other healthy habits. To these invitations there is another one to be added: undergo screening.
On the doctrinal level, adherence to preventive practices pertains to the exercise of virtues with regard to oneself such as temperance, prudence and charity with regard to others.
While it is true that in economically advanced countries great progress has been achieved with regard to the care of the body, perhaps not equal attention has been paid to the spirit. The news unfortunately places before our eyes cases of murder and suicide, physical and verbal violence that denote deep mental suffering.
Mental and personality disorders are a symptom that in our society there is an evil of living that stems from lack of values, inability to communicate and loneliness. We hear about these problems, but effective prevention is not implemented. The chasm of emptiness, which is being created in and around the individual, often drives him to seek artificial paradises that lead to his total destruction.
In this area, the family, school, and parish must strive to ensure that words such as friendship, solidarity, understanding and love become customary.
Only in this way can contemporary man return to respect himself, his fellow human beings and all creatures.
St. Charles Borromeo in his speech at the last Synod
(Acta Ecclesiae Mediolanensis, Milan 1599, 1177-1178) addressed presbyters with these words, “Do you exercise the care of souls? Do not neglect for this the care of yourself, and do not give yourself to others to the point that nothing remains of you to yourself. You must certainly have in mind the memory of the souls of whom you are pastor, but do not forget yourself.”
Prevention, for a healthy psyche and body, then requires a virtuous attitude (secundum rationem) that avoids excessive fears and disposes people to accept serenely both illness and the aspects of aging and death.
(“The Moral Acting of the Christian,” edited by Licio Melina, vol. 20, p. 162, 2002).
Don Andrea Pio Cristiani
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