To the First International Conference

of the Pontifical Council for Pastoral Assistance to Health Care Workers

A VERY STRICT MORAL CODE IS NEEDED

FOR THE USE AND EXPERIMENTATION WITH medicines

24 October 1986

1.It is with joy that I greet you, participants in this International Conference, which witnesses once again to the importance the Church accords to the service of the sick, the suffering, and to those who labour in the vast domain - delicate and complex - of health and hygiene. This field of apostolate is an integral part of the mission of the Church. This Conference is well representative of the activity of the Pontifical Commission for the Apostolate of Health-Care Workers, and I am happy to take this opportunity to congratulate and thank its President, Cardinal Eduardo Pironio, its Pro-President, Archbishop Fiorenzo Angelini, and their collaborators. In a world where the very understanding of social and health services is evolving considerably, and where it is becoming apparent that they have ever more complex implications, it has become indispensable to coordinate and to promote the Church's presence. This Conference is proof of this presence, as are also the other initiatives which have been undertaken or which are in the process of implementation. Among these, I would like to mention the vast revision of all the Church's health establishments; we are thus becoming more aware of the extension and capillary ramifications of her presence and service on behalf of the human person, now subject to the particular trial of psycho-physical illness.

2.The choice of the main theme of this Conference also seems very appropriate to me. Medicines are in fact the means by which the doctor is not only able to cure diseases, but also to prevent them. A great number of those which, in the past, decimated populations have largely disappeared today; others can be treated for more effectively. Children are more rarely afflicted by the terrible deformation of polio and rickets. Surgery, thanks to an ever more satisfactory contribution of pharmacology, has been able to make extraordinary advances. The average life span has notably increased. All of this we owe above all to serums, vaccines, and so many other forms of medication at our disposal today. This applies at least to the developed countries.

Benefits and problems

3.Nevertheless, if it is true that medicines have brought immense benefits to humanity, they have also raised serious and partially unresolved problems with regard to their development, diffusion, their use and accessibility to all sick persons, regardless of their class or nationality. The preparation and manufacture of medicines is increasingly complex and costly, and this has obvious economic and social consequences. Medicines can stimulate or impair the function of various organs or tissues, or even mental activity. These characteristics make them useful for increasing resistance to certain diseases, or for checking the development of others. It is true that one may occasionally question the opportuneness, for the balance of the human organism, of an excessive consumption of these artificial products, in certain countries and according to the tendency of certain practitioners. But, above all, medicines can also be employed for purposes which are no longer therapeutic, but rather alter the laws of nature to the detriment of the dignity of the human person. It is clear, then, that the development, distribution, and use of medicines should be subject to a particularly strict moral code. Respect for this code is the only way to prevent the demands connected with the production and cost of medicines, in themselves legitimate and important for their distribution, from deflecting them from their meaning and their end.

4.During this congress you also considered the problem of experimentation with medicines. In the present state of scientific knowledge, it is not possible to predict with sufficient accuracy the properties and the characteristics of new medical preparations. Before being used in treatment, they must be tested on laboratory animals. In my address to the participants in the Study Week on biological experimentation which took place in 1982 at the Pontifical Academy of Sciences, I have already pointed out the delicate character of this type of experimentation, stressing that it should be conducted with respect for the animal, not subjecting it to unnecessary suffering. In a second stage, before being made available for general use, medicines should be tested on the human being, on the sick and sometimes even on a person in good health. Clinical experimentation is subject to strict laws and norms which regulate it and aim at offering all possible guarantees. We may at least hope that the day will come when, thanks to the progress of scientific knowledge, the risk and the unknowns in the area of experimentation with medicines will be notably reduced. However, in any event, great prudence is necessary to prevent man from ever becoming a mere object of experimentation, and at all costs avoiding danger to his life, sanity, equilibrium, and health, or worsening his condition.

5.At the same time it is urgent to promote real international collaboration, not only on the normative level, but also to reduce and eliminate the differences among countries. Among the problems that still remain unsolved, I would like to mention those which concern the situation of certain developing countries. Although access to health care is recognized as a fundamental right of man, large sections of humanity are still deprived of even the most elementary medical care. The problem is one of such dimensions that individual efforts, valuable and irreplaceable as they may be, are insufficient. At the present time, it is absolutely necessary for us to try to work together, and to coordinate, at the international level, policies of aid and thus of concrete initiatives. We know that the World Health Organization is engaged in this, as well as other associations and initiatives which show solidarity without frontiers.

Developed countries have the duty to place their experience, their technology and a part of their economic wealth at the disposal of those that are less so. However, this can be done only with respect for the human dignity of others, without ever wishing to obtrude. The protection of health is closely bound up with the different aspects of life: whether they be social or economic, or related to environment or culture. For this reason it requires a prudent and responsible approach, with open and mutual collaboration. It frequently happens that local traditions offer invaluable points of support which should be taken into account and improved. Christians understand that there is excellent ground for fraternal assistance and for humble and respectful service.

The Church's contribution

6.In this context, we cannot forget that there are still medicines which, for almost exclusively commercial reasons, have not been given serious attention and are not benefiting from research and scientific progress. These are often necessary not only for the treatment of certain rare diseases, but also for those which strike millions of people in the poorer tropical zones. In this respect, it in necessary in the first place to discern the objectives and their order of priority, then to see how the economic and political barriers which impede the research, development, and production of such medicines might be overcome.

7.To all those who work in health care and who must confront these difficult and complex problems I would like to reiterate here the encouragement of the Church. Christian doctrine - of this we are convinced - makes a very important contribution to these areas. It offers sure principles to point the way towards solutions which guarantee the dignity of the person, sustain his moral and social progress, and develop solidarity. In this sense, it brings light and hope to those who experience doubts, questions which cause anxiety or discouragement at the sight of the painful condition of the sick and infirm.

On the one hand, the Church shares with the sick their desire for healing and relief and their hope for a fullness of life. She also respects the mystery of their suffering and invites them, above all if they have faith, to situate their trial in the plan of God, in the plan of the Redemption, in union with Christ the Savior, who offers them an opportunity for spiritual elevation and offering in love, for the salvation of the world. This is a mystery that can also benefit those who take care of them. I have often had occasion to speak of this to the sick.

On the other hand, this immense world of sickness is at the same time a challenge offered to your capacities as doctors, pharmacists and scientists, to see if you can find a scientific and humane solution to the problem of health, in all its different aspects. Recently, while visiting the sick and those who care for them in the cathedral of Saint-Jean, in Lyons (5 October 1986), I encouraged scientific research in this sense and I congratulated all those who, like the Good Samaritan of the Gospel, are cooperators with God in the defense of the lives of their brothers and sisters. Yes, not only has the Church constantly urged forward, in the spirit of the teaching of Jesus, the creation of works of mercy for the sick, but she is also anxious to support technological progress, the spread of knowledge, and their wise use in the service of man. Far from closing itself to the legitimate desires of the contemporary world, Christianity strengthens them, and helps to fulfill them.

May this assurance accompany you always and strengthen your commitment, whatever the area of your activity within the health services! It is God who has given us the intelligence and the heart to better discover and implement whatever supports and develops the life of the human being, the expression of the person: may he affirm you in your research, in your professional service, and may he fill you with his blessings - yourselves, your families and those who are dear to you!