Catholic healthcare
In an Italy with over 22 different healthcare systems, Catholic institutions are faced with the challenge of combining the charism of the founder, the sustainability of the system, with requests for treatment to poor and indigent people. Mental disability is the primary emergency. Father Carmine Arice, newly-elected Superior General of the Society of Priests of Saint Joseph Benedict Cottolengo and Father of the Little House of the Divine Providence, has no doubts
Father Carmine Arice, Director of the national Office for Health Pastoral Care of the Italian Bishops’ Conference – CEI – since 2012, member of the Pontifical Commission for the activities in the healthcare sector of public legal persons of the Church since 2016, was elected General Superior of the Society of the Priests of Saint Joseph Benedict Cottolengo and Father of the Little House of Divine Providence, de facto President of the institution present worldwide. Follows our interview.
Father Arice, what will you bring with you of your five years of service in Rome? I am deeply grateful to the CEI presidency, in the person of the Cardinals Bagnasco and Bassetti, and to the General Secretariat of Mons. Crociata and Msgr. Galantino. I have always perceived their constant trust and support. These past five years were a beautiful experience of Church, of ecclesial communion. I am grateful to Benedict XVI for having given renewed thrust to the theological foundations of anthropology. With Francis I felt I had been called to interpret the reality that I was confronted with through the lenses of Evangelii Gaudium. Becoming aware that reality is greater that the idea led me to start by focusing on personal situations to put hope into practice, giving a name and a voice to the victims of the throwaway culture, to the faces and the suffering underlying the numbers. Another gift I received during these years was to experience the Church’s presence at local level, from the north to the south of the Country.
What is your perception of Italian healthcare, including Catholic healthcare? I unfortunately came to realize that the Country’s scenario is markedly uneven in terms of interest and resources, starting with Catholic healthcare that is less present in the south than in the north; this situation should prompt in-depth reflection. It could be said that there are 22 different healthcare systems, one per region, plus the two autonomous Italian regions. As concerns Catholic healthcare, the extent of the managerial burden of its many structures is such that in some cases it leads to overlook the global mission of initiatives that in the most part were developed with the purpose of assisting the poor but which are often deficient in terms of ensuring the wholesome treatment of the sick person. In fact, without a comprehensive approach to the therapeutic programme patients risk feeling worthless and that they are a burden, thereby requesting to die prematurely.
It is necessary to create the conditions so that nobody will want their lives to be terminated. But it is equally necessary to support the fatigue, the tiredness, in some cases the desperation, of family members assisting the patient.
Fifteen days ago I heard the family members of a patient, asking, with a broken heart, to accompany their dear one to death with sedation and through the suspension of nutrition and hydration. It isn’t only an anthropological crisis. This situation is also a result of exhaustion caused by lack of help. This should make us think.
In your capacities as President of the Cottolengo institution worldwide, what is the challenge faced by Catholic healthcare institutions? First of all we should interpret reality and ask ourselves, as Catholic structures, what we have, why we have it and how we care for it. Why should we strive to ensure the performance of institutes that offer nothing different compared to public structures? A situation where patients that can afford accessing private healthcare receive immediate treatment as compared to the poor, penniless person forced to wait for months – typical of public healthcare structures. Thanks God, this is not the case of the Cottolengo, in fact it’s not a widespread situation. However, it is a risk that some Catholic healthcare structures are exposed to in order to survive. The risk is to reverse the goals whereby the service to the poor is overlooked to the benefit of “substantial” services dictated by financial motivations. Pope Francis gave clear indications: look at reality, and with creative faithfulness to the charism of the founder be open to reconvert your structures if they should no longer correspond to the original charism.
It’s a courageous endeavour: it means facing the challenge of combining the charism of the founder with the sustainability of the system whilst providing treatment to poor and indigent persons.
What is the key-word of your first 100 days?
To listen. I wish to be open to learn about a situation that I am less familiar with compared to when I left it to come to Rome. To listen to my predecessors, to the many collaborators of the Little Home. It’s a significant challenge also because the religious staff is decreasing while lay personnel is increasing, with remarkable financial costs (considering shifts and paid holidays). We are expected to provide high-level treatment, but regulations should take into account practical implications as well as available resources and the variable known as the integral health care of the human person. To me, pastoral direction has the same value as health – technical, administrative direction… The Institution has a global scope. We want to preserve the preferential option for the poor: a distinctive trait of our identity. Another aspect is the important role of networking. All sister-institutions which, notwithstanding their specific identity, carry out a service inspired by the charism of mercy and of assistance comparable to ours, should intensify reciprocal communication.
In collective imagination the Cottolengo Institute is famous for its … Monsters. Don’t be afraid to use the term “monsters”, for that is how they were once defined. The Institute is known for having welcomed – in time and in the course of its history – creatures considered unworthy of life, with serious physical and cognitive forms of disability combined. When I entered the structure we had what we called the “guardian angels” ward, with hydrocephalus, macrocephalos patients, physically undeveloped adolescents. In Turin, where we have high requests of elderly patients, there are almost none left, but they didn’t disappear completely. Patients affected by these pathologies are found especially in the south of the Country, albeit not as many as in the past. Overall health has certainly improved, but it is mainly due to prenatal diagnoses that allow to prevent the birth of the child. Mothers who accept to continue with their pregnancy decide to keep their child with them at home.
From your position has the social sensitivity towards people with disabilities increased? It increased towards people with mobility disabilities, but not towards cognitive forms of disability.
Today mental disability is the major form of poverty, an emergency which I feel especially called to address in my capacities as Superior of the Cottolegno and which Italy will need to address.
Nobody has a magic wand, but our ears and our hearts must remain open. As CEI Office, with the mental health department we promoted the conference “Italian Church and mental health” to be held at the Palazzo della Cancelleria on December 2. It will be a wake-up call to civil society, and especially to the ecclesial community, to say that these people are citizens with equal rights and that art.32 of our Constitution applies to them too.
