Catholic Culture Podcasts
Catholic Culture Podcasts

Bishop Aquila on Health Care

by Archbishop Samuel J. Aquila, D.D.


In an Aug. 28, 2009, letter, Most Rev. Samuel J. Aquila, Bishop of the Catholic Diocese of Fargo, encouraged priests, deacons, religious sisters and parishioners to “become engaged in promoting genuine health care reform” and presented four principles upon which the “moral value and justice of a given plan to provide health care” should be evaluated.

Publisher & Date

Diocese of Fargo, August 29, 2009

 August 28, 2009

Dear Priests, Deacons, Religious and Faithful of the Diocese of Fargo,

At this time in our nation’s history, we continually face new challenges as we witness to the Gospel in an ever increasing secularized society. Currently our civil leaders are discussing different proposals to provide greater access to health care in our country. Indeed, the Church has officially manifested her teaching, since Pius XI to Benedict XVI, in the recognition of the great importance of ensuring that all peoples have access to health care.

In principle, the Church ought to always promote wider and more complete access to health care; however, that does not mean that in practice the Church ought to support each and every plan which is proposed by civil leaders. At this time, I want to offer you some key principles that should always be used when evaluating the moral value and justice of a given plan to provide health care. The following is a brief summary of these principles, after which I will offer further explanation and application:

  1. Any provisions for actions which deny the dignity of human life, especially abortion, euthanasia, whether passive or active, and embryonic stem-cell research must be excluded from all health care plans.
  2. The freedom of consciences must be safeguarded. The moral voice of individual doctors, nurses, health professionals, as well as the general public, deserve reverence and respect.
  3. Access to health care ought to be available to all people, including the poor, legal immigrants, the handicapped, and especially the elderly and unborn members of society.
  4. The means of providing access to health care should be governed by the principle of subsidiarity, being reasonably and equitably distributed among members of society.

The Dignity of Human Life
Made in the image and likeness of God, each and every human person bears the mark of the Trinity’s own character and life. Because of this inherent dignity, each man and woman is to be reverenced with great care from the moment of conception through every stage of their life. From the right to life flow all other human duties and rights, including the duty to preserve and protect one’s own life and health with the right to the means of achieving this goal.

Any attempt to provide greater access to health care without safeguarding human life from the moment of conception is inherently inconsistent. Pope Benedict XVI shares this great wisdom of the Church in his latest encyclical letter, Caritas in Veritate, when he recalls the words of John Paul II, “A society lacks solid foundations when, on the one hand, it asserts values such as the dignity of the person, justice and peace, but then, on the other hand, radically acts to the contrary by allowing or tolerating a variety of ways in which human life is devalued and violated, especially where it is weak or marginalized” (Caritas in Veritate, 15; Evangelium Vitae, 101). True health care begins with the unborn child in the womb. When a given plan to provide care fails to protect that life, it is no longer animated by a source of truth and justice, thus it will not, and cannot, flourish. The killing of unborn children through abortion or as a means to do research has nothing to do with promoting health. Both encyclicals make clear the teaching of the Church that the destruction of human life by abortion and other evils can never be a neutral question or one that is promoted by any faithful Catholic.

Conscience Rights
One of the important developments that resulted from the Second Vatican Council is found in the document on religious freedom, Dignitatis Humanae. “Nobody may be forced to act against his convictions, nor is anyone to be restrained from acting in accordance with his conscience in religious matters in private or in public” (DH 2-1). In the arena of health care, this statement applies both to those who work directly in health care, as well as to the general public who participate in health care plans through insurance premiums and taxes.

The practice of medicine is a tremendous gift whereby the seemingly endless illnesses and maladies that afflict the human body can be studied, known and healed. This in-depth knowledge which serves the progress of human health can also be used to promote death and destruction. The doctors, nurses and health care professionals who possess such medical expertise are prime candidates for coercion from those who would destroy the most vulnerable human lives. The right to follow one’s conscience, as informed by God, must be guaranteed. It is imperative that health professionals and institutions have the freedom to refuse to perform unethical procedures and even to refuse to refer a patient to another professional or institution for treatments they believe, according to the natural law, are immoral.

The consciences of participants in health care plans must also be respected. In no way should taxpayers or policy holders be forced to participate in plans, whether private or public, which fund procedures that violate the moral precepts of the faith. In his August 11, 2009, letter to the House of Representatives, Cardinal Justin Rigali addresses this very issue as he writes, “By what right, then, and by what precedent, would Congress make abortion coverage into a nationwide norm, or force Americans to subsidize it as a condition for participating in a public health program?” The protection of the freedom of conscience is a concern not only for those directly involved in medicine, but for all members of society. No health care plan managed by our government or funded by taxpayer money may include provisions to provide for abortion or other evils without violating the rights and consciences of citizens. The right of individuals to contest the inclusion of such provisions in privately managed or funded plans must be also safeguarded.

Access to All
One of the basic messages of the Gospel is that the love of God has no bounds or conditions. Many of the parables and actions of Jesus Christ illustrate this foundational truth. We share in this unrestricted outpouring of divine life through the infused virtue of charity in our souls. In friendship with the Father, Son and Holy Spirit, the Christian receives the ability to love all people, especially those in the greatest need.

Therefore, as John Paul II wrote, the love of the Church must “embrace the immense multitudes of those…without medical care” (Solicitudo Rei Socialis, 42). In our day, when many times utilitarian values overlook the most vulnerable, we must ensure that the poor, the elderly, the handicapped, legal immigrants and the unborn, together with all citizens of our nation, have access to health care. Called to be the living presence of Jesus in the world, finding ways to provide medical care to those who have none is a perennial priority for the Church. In fact, health care was a chief concern of the Church in North Dakota when in the 1940’s, Msgr. Anthony Peschel, who wrote extensively on the duties and rights of individuals with respect to health care, played a major role in the establishment of health insurance programs in North Dakota.

Subsidiarity is the principle that states “a community of a higher order should not interfere in the internal life of a community of a lower order, depriving the latter of its functions, but rather should support it in case of need” (Catechism of the Catholic Church, 1883). As a society seeks to bring about any good such as health care, there are many organic and intermediate groups which cooperate together to reach the desired goal. There is a danger in being persuaded to think that the national government is the sole instrument of the common good. Rather, according to the classic principle of subsidiarity in Catholic social thought, many different communities within society share this responsibility. These various strands of community life within society build up a strong and cohesive social fabric that is the hallmark of a true communion of persons. States, towns, fraternal organizations, businesses, cooperatives, parishes and especially the family have not only legitimate freedom to provide the goods they are rightly capable of supplying, but often times do so with far greater efficiency, less bureaucracy and, most importantly, with personalized care and love.

This is especially the case in the tremendous work that the Church has done in successfully bringing health care, from early hospitals to modern research centers, to more and more people. We see this truth vividly in the Catholic health facilities in our rural areas. As our society seeks to achieve the goal of ensuring access to health care for all, the federal government surely has a role to play, but definitely not the only role, or even the primary role. Working together with individual states to foster an environment where greater insurance options are available to all, fostering the formation of new and creative associations and finding ways in solidarity to assist financially and coordinate, when necessary, local and private entities are all desirable starting points for a task of such great scope. Honoring the principle of subsidiarity will enable all men and women to be true participants in contributing to the goal of providing greater access to health care.

These four principles provide a foundation for a fruitful discussion about health care reform and must be considered carefully as changes in health care policy are drafted. I encourage all of our Catholic health care facilities, medical professionals, parishes and lay faithful to become engaged in promoting genuine health care reform. I am sure this debate will not subside soon, so I also encourage you to continue to periodically check the Web sites of the North Dakota Catholic Conference ( and the United States Conference of Catholic Bishops ( in order to stay up to date.

Finally, may we be joined by the Holy Spirit in fervent prayer to the Father with our savior, Jesus Christ, who has said “I came that they may have life, and have it abundantly” (John 10:10). He is the Lord of history who continues to guide and direct our world with the power of his truth and love. May we trust in him who continually inspires us to arduously work for the health, well-being and flourishing of all human life from the moment of conception through natural death.

Sincerely yours in Christ,

†Most Rev. Samuel J. Aquila
Bishop of Fargo

© Diocese of Fargo

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