Palliative care as a Fundamental Human Right: where are we at in Italy?

Abstract: The right to live with dignity during the final stages of existence, enshrined in national and supranational Charters of Rights, represents a significant step towards humanizing medicine and is integral to the right to health. Palliative Care, rooted in health, dignity, and therapeutic self-determination, has emerged as a fundamental human right and a moral imperative within health systems. It seeks to alleviate suffering, emphasizing the holistic well-being of patients with life-limiting illnes-ses. This paper provides an analysis of the current situation of Palliative Care in Italy and examines its critical aspects, also in relation to the issues found in other European and non-European countries. In Italy, although laws have been enacted to ensure the provision of Palliative Care, its availability remains inconsistent across different regions. Financial constraints and insufficient support hinder the comprehensive dissemination of these services. Recognizing the significance of Palliative Care, the Catholic Church also endorses its implementation as a response to human suffering and an approach to end-of-life care. Efforts to strengthen Palliative Care are critical to meeting the rising demand and ensuring access to compassionate and dignified care for all individuals in need. Through legislative advancements and adequate resources, Italy can make significant strides in advancing the provision of Palliative Care.

Catholic religious agency during the Covid-19 emergency: the issue of vaccines.

The Catholic Church's reflection on and assessment of the Covid-19 pandemic has developed in several areas. Inspired by the tradition of its social teaching, specifically by the values of the dignity of the human person, justice, solidarity, and the common good, a strong sense of responsibility-on the part of all to prevent the spread of the pandemic and care for the affected sick-was called for. This resulted in a series of interventions and documents on the various medical and spiritual issues involved, particularly concerning the vaccines again Covid-19. In this short article, I draw out these insights from the official and universal reference point of the Catholic Church (i.e., Vatican sources in their various expressions and expertise). Interventions from other religions have also played a significant role during the Covid-19 pandemic as exemplified by the close relationship between certain religious actors and the World Health Organization. However, these alternative viewpoints, while important in and of themselves, do not find a suitable place within this work, which focuses on the Catholic Church's perspective.

No Strings Attached: How Catholic Institutions Prospered at the Expense of the Administrative State and Patient Autonomy.

Catholic hospitals and health systems have proliferated and succeeded in American healthcare; they now operate four of the largest health systems and serve nearly one in six hospital patients. Like other religious entities that Wuest and Last write about in this issue, in their article Church Against State, they have benefited by and supported the long reach of conservative efforts to undermine the administrative state.

Channeling Erasmus in Communist Poland: Leszek Kolakowski, Vatican II, and the Reinvention of "Counter-Reformation".

Polish intellectual historian Leszek Kolakowski proposed in the 1960s an innovative, now virtually forgotten, reimagining of a crucial concept in the history of Roman Catholicism: the idea of "Counter-Reformation." Kolakowski's lifelong affinity for early modern Europe's Catholic dissidents led him into dialogue in the era of Vatican II with Tadeusz Mazowiecki, the leader of a movement of young Polish reformers who styled themselves "Catholic socialists." Seeing them as the bedrock of a new Catholic Counter-Reformation, Kolakowski sketched the role he hoped Poland might play in reinventing not only Catholicism, but religious life in the modern world.

["God for us!": Catholic festivals and rites in times of epidemics, Salvador-BA, Brasil, 1918-1919]. / "Valha-nos a Providência!": festas e ritos católicos em tempos epidêmicos, Salvador-BA, Brasil, 1918-1919.

This article analyzes the reactions of Catholics linked to lay associations in the city of Salvador, in the period of the Spanish flu (1918) and smallpox (1919). Newspapers were the main sources used to identify the festivals and rites, both those practiced to ask for the intercession of the saints, and those that were suspended due to the need for social isolation. In spite of both diseases being transmissible and the short interval between the two epidemics, the analysis of the sources showed different reactions from the faithful regarding the measures of protection and the search for a cure.

O artigo analisa as reações dos católicos vinculados às associações leigas na cidade do Salvador, no período da gripe espanhola (1918) e da varíola (1919). Os jornais foram as principais fontes utilizadas para a identificação das festas e dos ritos, tanto dos praticados para pedir a intercessão dos santos quanto daqueles que foram suspensos em função da necessidade de isolamento social. Apesar de ambas as doenças serem transmissíveis e do curto espaço de tempo entre as duas epidemias, a análise das fontes evidenciou diferentes reações dos fiéis quanto às medidas de proteção e busca da cura.

The safeguarding capability of adults in Catholic Church ministries: A global perspective.

BACKGROUND: In the wake of historical sexual abuse across the Catholic Church globally, the Church continues to develop policies and processes to prevent and respond to child sexual abuse, including supporting the skills, knowledge, and confidence of members of the Church. OBJECTIVE: We investigated the safeguarding capabilities of a range of people with different roles within Catholic Church ministries in various countries. PARTICIPANTS AND SETTING: Our 184 participants included lay people, religious men and women, school staff, safeguarding officers and tertiary students associated with the Catholic Church. Data were collected across seven different countries. METHODS: We measured the awareness, confidence, attitudes, and knowledge of participants and examined differences between participants in different roles within the Church and different countries through General Linear Models. RESULTS: We found varying levels of awareness, confidence, attitudes, and knowledge regarding sexual abuse prevention and safeguarding. We pinpointed the significant differences in three of these domains (confidence, attitudes, and knowledge) both between people with different roles in the church worldwide, but also between the countries from which participants came from. CONCLUSIONS: We found that people in various countries and roles within the Church are at different stages of their safeguarding journey. Some are still understanding their roles (attitudes), some are still learning about how it is operationalised (awareness), and others are acquiring skills that will prepare them for enacting safeguarding policies and practices (confidence).

Catholic Hospital Affiliation and Postpartum Contraceptive Care and Subsequent Deliveries.

Importance: In recent years, the number of Catholic hospitals has grown, raising concerns about access to contraception. The association between living in an area in which the closest hospital is Catholic and the probability of postpartum contraception and subsequent deliveries is unknown. Objective: To assess whether living in an area in which the closest hospital was Catholic was associated with the probability of postpartum contraception and subsequent deliveries. Design, Setting, and Participants: This cohort study used data from the Healthcare Cost and Utilization Project's State Inpatient Databases, State Emergency Department Databases, and State Ambulatory Surgery and Services Databases for 11 states (California, Florida, Georgia, Missouri, Nebraska, Nevada, New York, South Carolina, Tennessee, Vermont, and Wisconsin). Female patients with a delivery from 2016 to 2019 who lived within 20 miles of a nonfederal acute care hospital were included, with patients followed up for 1 to 3 years. Coarsened exact matching was used to match patients based on the county-level percentage of the population affiliated with Catholic churches and urbanicity, and the zip code-level number of hospitals within 5 and 20 miles, median household income, and percentage of the population by race and ethnicity. Data were analyzed from April 2022 to November 2023. Exposures: Residence in a zip code in which the closest hospital was Catholic. Main Outcomes and Measures: Probabilities of delivery at a Catholic hospital, surgical sterilization within 1 year of delivery, receipt of long-acting reversible contraception at delivery, and subsequent delivery within 3 years. Results: The sample consisted of 4 101 443 deliveries (1 301 792 after matching), with 14.5% of patients living in exposed zip codes (ie, where the closest hospital was Catholic). Living in exposed zip codes was associated with a 21.26-percentage point (pp) increase in the probability of delivery at a Catholic hospital (95% CI, 19.50 to 23.02 pp; 237.3% relative to the mean in unexposed zip codes; P < .001). Additionally, comparing exposed vs unexposed zip codes, the probability of surgical sterilization at delivery decreased by 0.95 pp (95% CI, -1.14 to -0.76 pp; P < .001) and the probability of sterilization in the year after discharge further decreased by 0.21 pp (95% CI, -0.29 to -0.13; P < .001). Subsequent deliveries within 3 years increased 0.47 pp (95% CI, -0.03 to 0.97 pp; 2.3% relative to the mean in unexposed zip codes; P = .07). Conclusions and Relevance: This cohort study finds that living in a zip code in which the closest hospital was Catholic was associated with a modest decrease in the probability of postpartum surgical sterilizations and a modest increase in the probability of subsequent deliveries.

Healthcare Chaplaincy for Geriatric Patients: A Quasi-Experimental Study into the Outcomes of Catholic Chaplaincy Interventions in Belgium.

The present non-randomized clinical trial examined the short-term outcomes of one-on-one chaplaincy interventions with 416 geriatric patients in Belgium. Participants were interviewed one or two days before a potential chaplaincy intervention (baseline measurement), and one or two days after a potential intervention (post-measurement). Patients in the non-randomized intervention group received an intervention by the chaplain, while the non-randomized comparison group did not. Patients in the intervention group showed a significant decrease in state anxiety and negative affect, and a significant improvement in levels of hope, positive affect, peace, and Scottish PROM-scores, compared to the comparison group. Levels of meaning in life and faith did not significantly change after the chaplaincy intervention. This study suggests that geriatric patients may benefit from chaplaincy care and recommends the integration of chaplaincy care into the care for older adults.

A war against the natural order: Joseph Nicolosi, Reparative Therapy, and the Christian Right.

This article situates Joseph Nicolosi's first book, Reparative Therapy of Male Homosexuality, in historical context. Nicolosi, a Catholic clinical psychologist, was one of the most vocal practitioners of sexual orientation change efforts (SOCE) from the early 1990s until his death in 2017, and in these decades, the Christian Right became a key supporter of SOCE. In this article, I argue that two features of Nicolosi's book appealed to the Christian Right. First, Nicolosi relied on psychoanalytic thought to pathologize not only same-sex sexual desires but also poor parenting. The use of psychoanalytic thought was of particular interest to conservative Christians who believed that American fathers had forfeited their role as strong patriarchs. Second, Nicolosi's approach to therapy, which included changing one's dress and mannerisms and assertiveness training, stressed that same-sex desires could be eliminated through behavioral reconditioning. Nicolosi's psychological eclecticism, a common feature for mental health practitioners at the end of the twentieth century, has not been emphasized in prior scholarship on reparative therapy. Importantly, the psychological eclecticism practiced by Nicolosi became common within the Christian Right after the publication of Reparative Therapy of Male Homosexuality. By offering a close reading of Reparative Therapy of Male Homosexuality, this article demonstrates the interrelationship between one of the core texts of the ex-gay movement and the psychological and religious thought of the Christian Right at the turn of the twenty-first century. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Catholic Perspective on COVID-19.

It took nearly two thousand years for society to recognize the Hippocratic insistence that "the doctor knows best"1 was an inadequate approach to medical decisionmaking. Today, patient-centered medicine has come to understand that the individual patient has a significant role in the decisionmaking process.2.

Church leader's Interpretation of COVID-19 in Nigeria: Science, Conspiracies, and Spiritualization.

The need for governments across the globe to collaborate with religious leaders in the fight against COVID-19 has been emphasized by international organizations including the World Health Organization (WHO). However, there has not been much discernible scholarly effort to know what religious leaders think of COVID-19. The present study, therefore, explored the interpretations church leaders have about COVID-19 in Nigeria. Semi-structured interviews were conducted with eighteen leaders from Catholic, Anglican and Pentecostal churches in Nigeria. Using a thematic analytical approach, the study found that only few church leaders interpreted COVID-19 as a medical problem in line with science (33%). The rest interpreted the virus as a tool of conspiracies/political manoeuvrings (27%) and as a spiritual event (39%). The study discussed the implications of the findings for policy and research as well as how to address some of the harmful interpretations.

Racial and ethnic disparities in short interval pregnancy following delivery in Catholic vs non-Catholic hospitals among California Medicaid enrollees.

OBJECTIVES: We examined the impact of Catholic hospital delivery on short interval pregnancy in the California 2010-2014 Medicaid population. STUDY DESIGN: We used Cox regression to estimate the association between hospital affiliation and short interval pregnancy, adjusting for patient factors. RESULTS: Catholic hospital delivery had increased the risk of pregnancy within 6 months for Black (hazard ratio [HR] 1.11, 95% CI 1.06, 1.17) and Hispanic (HR 1.07, 95% CI 1.05, 1.09) but not for White women (HR 1.02, 95% CI 0.98, 1.05). CONCLUSIONS: Among California women with Medicaid, Catholic hospital delivery was associated with short interval pregnancy only among women of color.

A Plausible Historical and Forensic Account of the Death of Thomas Aquinas.

Thomas Aquinas (1225-1274) was an influential medieval Christian theologian and arguably one of the greatest scholastic philosophers. He produced more than 60 works in his 48 years, including his magnum opus, the Summa Theologica. The Catholic Church regards him as a canonized saint and one of 37 Doctors of the Church. On his way to an ecumenical council in 1274, he was "struck with sudden illness" requiring rest at a monastery where he was cared for until death several weeks later. An obscure Latin text describes an incident where he hit his head violently on an overhanging branch. Becoming progressively ill, he arrived at a Cistercian abbey where he died on March 7. Through an analysis of his final illness as documented in key Latin and Italian historical texts, and careful observation of the reputed skull relic in Priverno, Italy, the authors postulate that Aquinas may have suffered a traumatic brain injury and that his death at age 48 was occasioned by a chronic subdural hematoma. Examination of the skull was inconclusive; however, the historical textual analysis supports this theory. A more in-depth forensic analysis of the skull may help confirm the diagnosis.

"Valha-nos a Providência!": festas e ritos católicos em tempos epidêmicos, Salvador-BA, Brasil, 1918-1919 / "God for us!": Catholic festivals and rites in times of epidemics, Salvador-BA, Brasil, 1918-1919

Resumo O artigo analisa as reações dos católicos vinculados às associações leigas na cidade do Salvador, no período da gripe espanhola (1918) e da varíola (1919). Os jornais foram as principais fontes utilizadas para a identificação das festas e dos ritos, tanto dos praticados para pedir a intercessão dos santos quanto daqueles que foram suspensos em função da necessidade de isolamento social. Apesar de ambas as doenças serem transmissíveis e do curto espaço de tempo entre as duas epidemias, a análise das fontes evidenciou diferentes reações dos fiéis quanto às medidas de proteção e busca da cura.

Abstract This article analyzes the reactions of Catholics linked to lay associations in the city of Salvador, in the period of the Spanish flu (1918) and smallpox (1919). Newspapers were the main sources used to identify the festivals and rites, both those practiced to ask for the intercession of the saints, and those that were suspended due to the need for social isolation. In spite of both diseases being transmissible and the short interval between the two epidemics, the analysis of the sources showed different reactions from the faithful regarding the measures of protection and the search for a cure.