Healthcare is a subject that profoundly touches the lives of us all. For the Catholic hospitals in Kenya the healing apostolate takes special significance because of the Church’s long tradition of involvement in this area. Additionally, the Catholic Church considers healthcare to be a basic human need which flows from the sanctity of human life. All healthcare workers are called to be guardians of the culture of life and, therefore, to be guardians of human dignity and the right to life. This paper argues that, central to Catholic Church’s healthcare ethics are the sacredness of human life. In this perspective, healthcare ethics is essentially intended to make healthcare a pro-life service. This requires a holistic approach to health on the basis of Christian anthropology while considering African values.
We begin by explaining different concepts. First, Roberta Loewy proposes that, “Holistic health is based on the law of nature whereby a whole is made up of interdependent.”[i] Holistic view of health was a common phenomenon in African traditional society. Stan Ilo, in discussing about the African perception of wholeness, succinctly argues that:
This search for wholeness is also understood as quest for abundant life …Abundant life is the ideal state of affair where in person and communal appropriation of the spiritual and material forces out there are working together in bringing about human and cosmic flourishing…sickness according to this world view, is seen as evil for it reduces the participation of the sick person in the very bond of life with oneself, others, nature and with the spiritual world.[ii]
Second, the culture of life is described as a way of life based upon the theological truth that human life at all stages from conception through natural death is sacred.[iii] Constance Bansikiza further proffers a synthesis of what is understood by culture of life. He asserts that “a culture of life entails affirming and defining the right to life, not only of the unborn child or the sick and elderly person, but also of convicted criminals sentenced to death and of the marginalized. It is about accepting the new life, protecting the most vulnerable lives, the survival of the ecosystem, the repudiation of heinous and diabolic killings and finally all that lead to death.”[iv] The culture of life holds that human life at all stages from conception through natural death is sacred. This leads to respect, care, and promotion of dignity and inviolability of the human person. In this respect, the Catholic hospitals in Kenya are called to uphold the culture of life in all aspects of its healthcare ministry and eliminate challenges that hinder it.
Thirdly, healthcare ethics is the field of applied ethics that is concerned with the vast array of moral decision-making situations that arise in the practice of human medicine in addition to the procedures and the policies that are designed to guide such practice.
Today the healthcare system confronts a range of economic, technological, social and moral challenges. As a result, there have been practices that dehumanize human beings and do not promote holistic healing and the culture of life in the healthcare ministry of the Catholic hospitals in Kenya. These practices pose as challenges in promoting the culture of life in healthcare globally and thereby necessitates a quest in finding a solution. The first challenge is the breach of confidentiality. A breach of confidentiality is said to occur when a patient’s private information is disclosed to a third party without his/her consent. Addressing confidentiality breaches is important due to the consequences they have for the doctor-patient relationship. Second challenge is the high cost of the medical care in the Catholic hospitals in Kenya. This was attributed to lack of funding, either by the government or other well-wishers even as cost of medicines and medical equipment keep skyrocketing.
Third, in an effort to offer whole person care, the solidarity between medicine and the spiritual aspect of the patient cannot be overemphasized. This is possible only if the hospitals provide enough professionally trained hospital chaplains to minister to the patient’s spiritual needs and provide private spaces for this encounter. Fourth psychological services and support services were found to be useful for patients and their relatives who due to sickness get depressed and need support to help them cope. Fifth, the healthcare workers in these hospitals expressed a sense of demotivation resulting from work overload, poor salary, lack of opportunities to upgrade, and poor management.
Sixth, the Catholic hospitals must deal with several elements that our research found as drawbacks towards the Church’s effort in promoting the Catholic identity in healthcare. The challenges enumerated were: failure of the Catholic health institutions to explain the core values of the healthcare facilities, Catholic identity and ethics to their employees. Many employees were not familiar with the Catholic ethics of healthcare systems.
Finally, the current Covid-19 pandemic is a huge blow to the healthcare sector in Kenya and the world at large. Consequently, the healthcare sector is overwhelmed. Overall, effects of the discussed challenges have led to lack of quality care due to healthcare workers burn out, hence a rise in patient neglect. The emotional distress that comes along with sickness if not addressed well leads to patients and their relatives getting depressed. However, the question that remains unanswered is what should be done to overcome the challenges highlighted, and how could the culture of life be promoted in healthcare?
Some Proposed Solutions
In order to Promote Holistic Healthcare ethics and culture of life in Catholic hospitals in Kenya, this paper proffers recommendations to different stakeholders. First, the communal participation in an individual’s illness and treatment is an authentication of the ethics behind traditional African respect for life that maintains that the individual experience of suffering is also communal. Second, as the life and health of countless people are committed to healthcare workers’ care, they must take their responsibility seriously. Third, by its very nature, a Catholic hospital in Kenya aims to take on the character of a Christian community. All who work there are participants in the Catholic healthcare apostolate and should be well acquainted with the Catholic identity, ethics and values.
Fourth, Catholic hospitals in Kenya are to ensure that Catholic identity is predicated on commitments around which hospital ministry forms and through which it finds ongoing direction and inspiration. Fifth, there is need for coordinated cooperation among the public, private and faith-based healthcare for wholistic service to the people of Kenya. The Church and the government must work together to prioritize healthcare provision, grassroots health protection and improvement measures. Sixth, there is also need for global solidarity of Catholic healthcare link and pastoral care incorporating African traditional healing and the values of societal concern for the sick. Seventh, the need of personalistic ethics of care is important where the main focus is to argue for the centrality of the human person in the healthcare sector.
The purpose of medicine is to cure the human person. This is by providing holistic healthcare ethics which upholds the dignity of the human person through quality healthcare and human wellbeing. Those are ways of acknowledging personhood, and they are critical elements of any clinical repertoire. This paper recommends holistic healing as a practice that focuses on healing the whole person. Holistic healing addresses the interconnectedness of the mind, body, spirit, social/cultural, emotions, relationships, and environment.[v] Finally, in search of abundant human and cosmic flourishing, the conditions that promote health and wellbeing should become central in the reform of the Catholic hospitals in Kenya.
[i] Roberta Loewy, Integrity and Personhood: Looking at Patients from a Bio/Psycho/Social Perspective (New York: Plenum Publishers, 2000), 63-65.
[ii] Stan Ilo, “Searching for Healing in Miraculous Stream: The Fate of God’s People in Africa,” in Wealth and Hope in African Christian Religion: The Search for Abundant Life, ed., Stan Ilo (New York: Lexington Book, 2017), 44-79, 46.
[iii] John Paul II, Encyclical Letter Evangelium Vitae (25 march 1995), 57: AAS 87 (1995), no.1.
[iv] Constance Bansikiza, “Building a Culture of Life: The Basis of True Peace,” African Christian Studies 24:3 (September, 2008): 28-45, 28.
[v] Tom Hutchinson, “Whole Person Care,” in Whole Person Care: A New paradigm for 21st Century, ed., Tom Hutchinson (New York: Springer, 2011), 1-8, 3.