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Posts by David Clayton

Why Population Medicine is Anti Human – a Review of a New Book Pontifex University Professor, Michel Accad

Moving Mountains – A Socratic Challenge to the Theory and Practice of Population Medicine, by Dr Michel Accad (available from Amazon.com andd movingmountainsthebook.com

This small book is an accessible and readible account of the philosophical basis of public policy relating to medicine, which has dominated government health policy for the last 30 years at least. It arises from a branch of medicine called epidemiology, which studies the possible control of disease by statistical analysis of human behaviour and the frequency of the occurance of symptoms and disease in population groups and any population as a whole.

The writer, Dr Michel Accad is a medical doctor who regularly publishes peer-reviewed articles on the philosophical aspects of healthcare and medicine and a Catholic who is concerned especially about the de-personalization of healthcare in the US. In this book, by reference to real policies and their effects, and with analysis backed up by scientific research, he explains why, in his opinion, it has gone so wrong. He does so through the vehicle of a conversation in the style of a dialogue that one might read in Plato’s works. It is an imagined conversation between the ancient Greek philosopher Socrates and Geoffrey Rose, an Englishman who died in 1993 and who was one of the intellectual founders of population health medicine.

I would urge all doctors and anyone involved in the formulation of public health policy to read this book and consider its implications.

The starting point for our consideration is the bell curve showing the links between particular behaviour and risk of a particular in the population. In the examples given, which one assumes are typical, they appear to indicate that a certain proportion of the population is always at risk. So far so good.

The public policy that is implemented as a result of this analysis is based on an assumption that if the overal pattern of the symptoms or behaviours  of risk in the population can be controlled so that a smaller proportion of the population appear to be at risk, the rate occurance of the disease of individuals will go down too and therefore, the general health of the population will go up. So for example, blood pressure can lead to heart disease so, the argument runs, if you reduce the average blood pressure of the whole population, you reduce the rate of heart disease in the population as a whole because fewer people are at risk.

By adopting this assumption, government directs public health policy therefore to controlling, not the desease, but the shape of the bell curve – and so the signs of risk to the disease or the behaviours that is felt lead to this disease. (Public policy cannot ever control disease directly because diseases, microbes are not subject to legal penalty or taxes only human beings are.)

At first sight this seems reasonable, but in fact there are a number of problems with this method and the assumptions behind it.

Most important first: however strong the argument in advance of implementing such policy, in practice there is little evidence that it actually works in helping people. Where there have been improvements in, for example, heart disease rates, it is as easy to demonstrate that these would have occured anyway due to improvements in other treatments or better advice delivered from the doctor, with people freely choosing to adopt them rather than being influenced by government actions directly – legal or financial regulation – to behave in the desired fashion.

Second, there seem to be a number of flawed assumptions that arise from bad philosophy – a wrong understanding of society, of man and even of the scope of natural science that lead to unanticipated detrimental effects as a result of implementing such policies.

Contrary to the assumption of those who create public policy, society is not an entity that can necessarily be controlled by the laws of cause and effect of classical physics in the way that a physical process can. Attempts to do so always involve centrally planned policies that attempt to direct behaviour either through incentives (usally tax) or legal penalties and thereby direct behaviour by restricting the freedom of all individuals for the sake, supposedly, of the few within the population who might have been at risk befoe and will not be now. We can’t test this properly, because we never precisely who was at risk before and who will be saved by this policy because the figures that apply to the whole population are derived from statistical sampling of a small part of that population, not by looking at every person in the population. We are not looking at Fred or Mary and saying previously you were at risk and now you are not because we can measure how your health has improved. We are looking at a small sample of the population and looking at the statistics of that sample perhaps a thousand people and then applying the numbers to the whole population. This makes it a hypothesis that is very difficult to test even if it works and produces the desired bell curve because at best we can suggest that as a result some unkown people are at less risk. The difficulty with this is that we cannot then check for unforeseen secondary effects in the particular people who are apparently saved that might be worse than if the policy had never been implemented. We will come back to this.

In practice, though, we don’t always get the desired bell curve that public policy seeks to create. society as a whole rarely behaves as the policy intends. People cannot be controlled in this way because even if they stop doing one thing, it is almost impossible to predict what they will do instead.

Furthermore, risk of disease is rarely connected to one condition only and so the alternative behaviours that are induced by our policy might lead some people into greater risk of ill health, perhaps arising from some other unconnected disease. The mechanisms are always more complex than the picture used to describe them. This is the effect that free market economists know well – unintended consequences.

It gets worse. The recieved wisdom of what is good and bad for people changes over time and public policy, even if perfectly effective in controlling behavious, will always be behind the times as it is very slow to implement policy and change behaviour. Many will be aware that the behaviours percieved as good change as times goes on – eating butter used to be a good thing , then it was bad thing and now it is good again; saccharine was good and now is bad etc.
Nevertheless, one might argue, the science will very likely get better in time and at some point perhaps public policy could catch up and reflect it. But here’s the point: even if we understood perfectly what patterns of behaviour were best, and even if we understood how to control the pattern of behaviour and the symptom levels in population as a whole, as indicated by statistical sampling, – in other words even if the problems so far mentioned did not exist – this approach would still not help us to promote health. This is because we do not know directly how the pattern in the society as a whole relates to the effects and behaviours of any given individual in that society.
So, while we might show how a public policy might affect the public, we have very little idea how it affects each person within the public.

Accad points to this and explains how, in contrast, the promotion of personal free choice made in conjunction with advice from doctors that takes into account personal needs is still the only way we know of actually achieving greater health.

This approach to medicine doesn’t just lead to policy that tries to control the behaviour of doctors and patients. It affects too the organisation and funding structure of healthcare systems directly and, Accad argues, detrimentally. A healthcare system geared towards this end of personal freedom and the common good, in the way that Catholic social teaching describes it, would look very different from any of the systems for providing health that have existed in the US and Europe over the last 50 years.

The health insurance model (including Obamacare) in the US and the single payer systems of European countries each have this philosophical flaw built into them to detriment of both patients and doctors. So the benefits that arise from these systems are there despite the systems, not because of them. And however, much those in Europe might argue that their system is better than the America (or vice versa) each is worse than what a system could be if Catholic social teaching based upon a right anthropology were taken into account. The drawback is that the person paying is not directly involved in the provision of care ie doctor or patient, but rather is an insurance company or government department. This means that they direct policy according to trends in overall expenditure without reference to individuals and so the same problems occur. All those aspects of healthcare to which a price can be attributed are governed by this bell curve mentality. As a result the provision of healthcare becomes bureaucratic and politicised, pressures are put on doctors to change ethical practices, and even leads to the redefinition of terms such as health and disease to validate government policy to the detriment of patient and doctor.

This is not to say that we should expect no limitation on funds, clearly monetary considerations must come into play or else insurance company, or state would go bankrupt. Rather, it says that we should look for the most efficient form of distribution of a scarce commodity with alternative uses to which a price can be attached. That is the free market. Where freedom is greatest prices are cheapest and availability is greatest. Furthermore, because this encourages free choices by the main protagonists – health care providers and patients – it allows also for the greatest flourishing of those aspects to which a price cannot be attributed, for example personal care and attention and a genuinely fruitful personal relationships between those involved.

I hope very much that doctors and those who influence health policy will read this book and think about how things could be improved.
You can order it online from movingmountainsthebook.com

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Dr Michel Accad is a medical doctor with a practice in San Francisco who regularly publishes peer-reviewed articles on the philosophical aspects of healthcare and medicine. He has also has a strong interest in the philosophy of nature and philosophical anthropology and has published in The Thomist. He gives lectures around the country on these topics and on medical ethics, medical science and healthcare economics. He is a committed Catholic and faculty member of Pontifex University, for whom he is currently creating a course on the Philosophy of Nature and Philosophical Anthropology as part of the Masters in Sacred Arts program. You can contact him directly through his blog AlertandOriented.com

On ‘Strangers in a Strange Land’. A Review by Bishop James Conley

Bishop Conley, Bishop of Lincoln, Nebraska writes:

In his new book, Strangers in a Strange Land, Archbishop Charles Chaput of Philadelphia, writes that we are now living in a post-Christian world.  He suggests that we, as a culture, have not embraced atheism, but we go about our daily lives as if God doesn’t exist. We live a kind of “practical atheism,” even though large numbers of Americans would still profess a belief in God.

In the time since America’s founding, the primacy of God—God’s sovereignty—has all but disappeared from our cultural landscape.  American law and culture has distanced itself from the Gospel’s truths about abortion, contraception, immigration, poverty, technology, and education. And our views on marriage, the family, and, in fact, the very nature of the human person reflect a serious departure from the truth of God’s creation. All of us know that the impact of our cultural worldviews make our lives harder, lonelier, and more vulnerable than God wants them to be.

But the changes in our world, Archbishop Chaput claims, are not just about something happening outside of us—like the imposition of secular values from profane invaders or conquerors  Our world’s changes are also about a transformation in American hearts—a willingness, in generation after generation of American Christian believers, to choose comfort, and security, social prestige and power, even when that requires compromising the Gospel. 

To be sure, the past few decades of American life have been characterized by the imposition of a “new orthodoxy” on all Americans—a forceful expectation that all people will accept the nihilistic worldview at the heart of the sexual revolution. But even that transformation has not happened in a vacuum. And, in his new book, Archbishop Chaput says that in order to bring a renewal of joy and peace to our world, we need to understand how we got here.

In modern America, Archbishop Chaput writes that, “instead of helping the poor, we go shopping. Instead of spending meaningful time with our families and friends, we look for videos on the Internet. We cocoon ourselves in a web of narcotics, from entertainment to self-help gurus to chemicals. We wrap ourselves in cheap comforts and empty slogans, and because there are never enough of them, we constantly look for more. We enjoy getting angry about problems that we can’t solve, and we overlook the child who wants us to watch her dance, or the woman on the street corner asking for food.”

To bring renewal to our nation, Archbishop Chaput says, Catholics, and all believers, need to make a change.  We need “to be healthy cells in society. We need to work as long as we can, in whatever way we can, to nourish the good in our country and to encourage the seeds of renewal that can enliven our young people.”

To live our Christian vocation, Archbishop Chaput claims, we need to have hope.  Hope, he says, is belief “in a God who guides human affairs and loves each of us personally as a Father,” and believes that through God, we can work to make the future better than the present. Hope is not a naïve sense that everything will get better on its own, but it is the firm belief that God really cares about each one of us, and that he can redeem, and strengthen, and renew the world. Hope, Archbishop Chaput says, “is despair overcome.”

I speak with many Catholics who are tempted to despair over the state of the world. I also talk with Catholics who are tempted to give up the fight to build a just and hopeful Christian society—who would rather flee from the world, instead of believing that God can use us for extraordinary things. Strangers in a Strange Land is a testament to the fact that God cares about each one of us, and that God transforms our hearts, and can transform the world through us.

It seems as though we are living in a post-Christian world. But ultimately, Archbishop Chaput writes, “there’s really no such thing as a post-Christian world as long as the Gospel lives in our hearts and shapes our actions.” Strangers in a Strange Land is a blueprint for Christian hearts and Christian actions in contemporary American culture.

Each one of us is called to “make disciples of all nations.”  We are called to help our own nation know the Lord, honor him, and live in freedom, according to his plan. I recommend Strangers in a Strange Land to every Catholic who believes that God can heal and renew our culture, our families, and our hearts.

This article first appeared in the  Southern Nebraska Register. This is the newspaper for the Diocese of Lincoln, Nebraska. Bishop Conley has a strong interest in the connection between the practice of the Faith, with the worship of God in the sacred liturgy at its heart, and its impact on every aspect of the culture. This is further indicated by the beautiful new church at the Newman Center at the University of Nebraska and the Great Books programs that he has intiated at the Newman Institute there and which focus on the how the beauty of a Christian culture draws us to the Faith.

David Clayton writes: 

I would like to add an additional note of hope to what Bishop Conley writes.

Church of England parish church of St Mary, Studley Royal, North Yorkshire, built in the 1870s

 

In his book How to Be a Conservative the English philosopher Roger Scruton talks of the culture as the binding force for society that simultaneously reflects and reinforces the core values of that society. He argues that we should strive for a culture of beauty that reflects Christian values, the beauty of which ‘tells us that we are at home in the world’.

Sint Petrus en Pauluskerk, Ostend, Belgium

Many Americans I speak to come to look to Europe, where I come from, as a place of greater cultural beauty than America. This may be so in some ways (although I think many Americans don’t see a lot of the genuine value that is still present in American culture), but what they are thinking of are the historical remnants of a past life and culture. For the most part, the lived culture of most modern Europeans is detached from this past life even more radically than in America. One of the reasons I came to America is that it is where I think it is the place where there is greatest chance of a transforming change, that could in turn affect Europe. In this life we are never fully at home and to some degree always strangers, always pilgrims in passage to a better place; but all of us, are most at home in a culture that that reflects the beauty of God and that is a Christian culture. My personal belief is that we have all the elements that make for the transformation of the culture today into one that potentially not only equals the wonders of historical Europe but even surpasses. Those elements are man open to inspiration, God who can inspire us and his Church, the matter with which we incarnate that inspiration.

University of Richmond, VA

In a small way the gothic architectural movement that can provide some inspiration for this. It began as a deliberate reestablishment of Christian architecture in harmony with the liturgy by Catholics in England (with AW Pugin at the forefront). So beautiful and so powerful was the style he developed that within 100 years it was adopted by faithful and non-faithful alike across the globe. In fact gothic revival had an even greater impact than the original. We see its influence in buildings both grand and humble – churches, civic architecture, college architecture, homes and businesses from Moscow and across Europe, India, and the Americas. It was sheer beauty that caused this. There is no reason why we should not aim to surpass this in the 21st for the good of mankind and the glory of God in the culture as a whole, starting here in the US!

Victoria terminus, Mumbai, India By fish-bone – originally posted to Flickr as Victoria Terminus, Mumbai, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=6922596

 

 

It’s Not Just Illuminations! Inspiring Historical Examples of the Gothic School of St Albans in Wall Paintings

Recently, I suggested that Matthew Paris and other artists of the 14th gothic illuminations (which I have called the ‘School of St Albans’ after the town where Paris lived and worked) might be a model for the reestablishement of a liturgical style for the Roman rite, in the way that the Eastern Church so successfully reestablished the iconographic tradition for the Byzantine liturgy in the middle of the 20th century. Here.

One reader wondered if it would really be possible to adapt a style that is known largely as one for illumination (ie in books and on a small scale) to full-scale liturgical art. This was a very good point. I responded that I thought that it was possible and speculated as to how I might do it. Two people have seperately reminded me of the existence of wall paintings in British churches from the 15th and 14th centuries that bear the essential characteristics of the School of Saint Albans and perhaps demonstrate to artists today some way in which a modern style that comes out of this foundation might be done on a large scale. So, thanks to Deacon Lawrence Klimecki (my fellow blogger here at Beauty of Catholicism) and Gina Switzer for this (both of whom are working artists who are taking the Pontifex University Masters in Sacred Arts).

We have seen many of these images before on this site, but it wasn’t until recently I made the connection with the stylistic connection of the illuminations of the time. It is for this reason that I represent them. The most famous church is St Cadoc’s in Glamorgan in Wales.

So just to remind you here is an illumination of shepherds being informed of the birth of Our Lord:

What characterizes this style for me is the heavy emphasis on line to describe form (rather than tonal variation); restraint in the use of color so that often the surface that is painted on eg parchment – shows through and plays a part in the image; a higher degree of naturalism in the drawing than Romanesque or other iconographic art; but like iconographic art is lives in the plane of the painting – there is little perspective and depth in the image so that it has an other-worldly and symbolic feel to it.

Now here is St Cadoc’s in Wales and then some paintings from the interior.

What strikes me about this styles also is that they will be practically slightly easier to produce as wall paintings. An artist who know what he is doing could fresco or paint on panel such paintings quickly and easily and well. This will help to bring down costs for commission and increase sales for artists who are looking to make a living.

Here are two more from different churches in England. First St Catherine in the Church of St Peter and St Paul in Pickering, Yorkshire.

And the following are at St Mary, Lakenheath, Suffolk, England.

East and West Working Together – St Gregory Palamas and St Thomas Aquinas

Two different but complementary interpretations of the Transfiguration

Those who read the previous piece about the Melkite Greek Catholic liturgy with Bishop Nicholas at the Gesu chapel on the Berkeley tomorrow at 5pm will have read this already, but it was buried away at the bottom of the piece and it occured to me that some who don’t live in California would be interested to read this, so here we go.

In the Melkite Church, The Divine Liturgy for Sunday, March 12th, is a commemoration of theologian St Gregory Palamas. St Gregory was Orthodox and he lived in the 14th century. I became aware of him through various icon painting classes where he would be referred to in connection with the theology of icons, in which the argument concerning the light of the sanctity – the ‘uncreated’ light of Christ – was attributed to him. This is the basis for example, for the painting of the halo, a symbolic representation of the light on holiness; and of the fact that there is no cast shadow when the saints are painted, for they are the course of the light that obliterates shadow caused be external light sources.

Very often Palamas and Aquinas are pitched against each other on the doctrine of deification. There has been work to reconcile the work of the two, for example this book by AN Williams. Here is my own perception of this in very simple terms and it relates to an interpretation of the Transfiguration.

Years ago, I was told of a difference between East and West in the interpretation of the event of Mt Tabor. St Thomas Aquinas, I was told, argued that Christ changed when he shone with light and this was an anticipation of the beatific vision.

St Gregory Palamas, on the other hand argued that the apostles changed spiritually and they were able, temporarily to see the uncreated light of Christ – their climbing of the mountain was a metaphor for their spiritual upwards movement towards a greater purity in heart. Furthermore, through the sacramental life of the Church it is possible for all of us, by degrees to grow in purity and be transformed so that we can both witness and shine with the uncreated light of Christ. As Our Lord told us, blessed are the pure in heart for they shall see God.

As I thought about this, I raised this point, which I thought was a contradiction, with a Benedictine monk at Pluscarden Abbey in Scotland when I was on retreat there once. He told me that I should ‘think liturgically’; and suggested that these two interpretations were not mutually exclusive. There might be a dual motion taking place in some way in that just as God comes down to us, so to speak, as Christ is present in the Eucharist, so in taking communion we are supernaturally transformed, potentially, and so are raised up to meet Him.

So that’s my little pitch for East West unity and two lungs breathing as one etc…..

Learn to Paint Icons in the Holy Land with Palestinian Christians, And Earn Studio Credit for Pontifex University’s Masters in Sacred Arts

Icon painting classes at the Bethlehem Icon Center.

Pontifex University is offering its students a chance to earn studio credit on its Master in Sacred Arts Program through icon painting classes at the Bethlehem Icon Center. Yes, Bethlehem – in the Holy Land! This is one of a number of such partnerships in which by offering credit we bring traditional arts back into the mainstream. The Bethlehem Icon Center teaches in English and a large proportion of its students are local Palestinian Christians. You can read about our developing institutional connections here.

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With a series of classes with the highest standard of tuition, this is a great way to earn studio credit for the studio classes of the Masters in Sacred Arts. Each residential class earns credit for an additional fee paid to Pontifex University of just $150 per credit. You simply register for their courses as you would otherwise, paying the Bethlehem Icon Center direct for tuition.

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The school offers two 7-day short courses for paying customers, which cost £200 (GBP) for seven days tuition and lunches. Accomodation can be arranged, typically $20-$50 (USD). The next one is in April – ending the day before Holy Thursday. Then after that there is one in the Fall, in about a year’s time.

The two-year certificate is full time. It is three 8-week terms (Oxbridge timing) during the year. This means that someone from abroad could do this on a tourist visa, travelling in and out of the country. It costs 1,200NIS (New Isreali Schekels) per year, plus of cost of materials and some tools.

In addition you can arrange just to come for personal tuition for up to a month by negotiation with Ian.

Classes and tuition are offered by its founding director, Ian Knowles and its leading patron is the Melkite archbishop – His Beatitude Gregory III, Greek Catholic Patriarch of Antioch, Jerusalem, Alexandria and All the East.

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As a measure of the esteem with which Ian and his students are held, those who do the 2-year diploma program are guaranteed work as iconographers afterwards through the icon studio which has a steady stream of commissions from around the world.

Furthermore, this has to be one of the best value art schools around. Tuition is offered at a price that is in accord with the local market and so is a fraction of the cost of equivalent classes in America or Britain. These savings alone would pay for a huge proportion of travel. The Centre can offer help in sourcing accomodation, which again will be at local prices which are substantially lower than London or the East Bay in California!

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This would be a great chance to make a visit to the Holy Land. You could combine it with the pilgirmage led by Pontifex University professor, Fr Sebastian Carnazzo who teaches Scripture and Theology. Fr Caranazzo, who is also a Melkite Greek Catholic, always incorporates the study of the traditional icons of the Church (East and West) into his classes. You can earn studio credit through the pilgrimage too – if you submit a paper at the end of the 10 day program, you will qualify for 3 credits too.

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We will be blogging regularly about the Bethlehem Icon Centre and the work of Ian Knowles. He has created a unique place of learning and beauty that unites us with the prayer of the Church. There are so many wonderful features to this that we cannot hope to give you the full picture in one short blog piece. Watch this space! Or investigate yourself at bethlehemiconcentre.org.

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Follow up on Medicine and Beauty – Hospital Gardens and Healing

Thank you to reader AH who pointed out to me, after reading the recent article about Pontifex University’s Dr Michel Accad, Hope for Catholic Healthcare, that there is scientific research that backs up the idea that beauty and spirituality aid physical healing, not just mental health. It was hearing of such research in regard to meditation taking place in cardiac wards that inspired me to start a regular Vespers group in the Veteran’s Hospital in Manchester NH. You can read about it here in Send Out the L-Team, Making a Sacrifice of Praise for American Veterans. The L in the title, by the way stands for liturgy.

Here is another link that AH gave to me, about how the beauty of gardens aids healing. How Hospital Gardens Help Patients Heal.

What is interesting in all the research about gardens, transcendental meditation and public policy on this is that the engagement between the beauty or spirituality is always passive. All policies assume that there is no underlying, objective truth, it simply rests in the personal beliefs of the patient, which are purely subjective. I do not propose aggressive evangelization that makes cures conditional upon accepting Christ, for example (if that were possible). However, if the underlying assumption were of objective truth and that spiritual therapies might work because they are true, then a greater harmony of science and faith will be possible in which the possibility of a health community that not only restores, but also offers ongoing support that maintains health is more likely. There is no contradiction in maintaining human freedom and presenting as a health choice faith based support groups, for example, that assume that Christian practices rest in fullest expression of truth; and that they work because God exists and loves us.

Furthermore, this suggests to me that the greatest potential for health care delivery that has the patients genuine health at its core is one that works in harmony with the free choices of patients in every respect, including those aspects of health care upon which a price can be placed. This is why I feel opening of the free market would be preferential to a single -payer government system.

Furthermore, a care system that is founded in Christian tradition would not only for more beautiful hospitals, it might allow for better and more powerfully healing gardens. You can make your mind up, but here is an ‘award winning’ modern garden in Maryland

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And here is the garden in the museum of a medieval cloistered garden at the museum of the Order of St John in London. I ask you, where would you rather be after open heart surgery (other things being equal?).

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And here is a garden in a former city hospital in Barcelona, below.

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Blessed John Henry Newman and Lent, by Bishop James Conley

The Palazzo di Propaganda Fide sits at the south end of the Piazza de Spagna in Rome. The building has housed the Vatican’s offices for evangelization around the world since the 17th century. It is a beautiful baroque building, designed by the great Gian Lorenzo Bernini, and designed to evoke the Church’s mission to proclaim the Gospel to every human heart, to every people, to every nation.

In 1847, Blessed John Henry Newman, was ordained a Catholic priest in a small chapel just off the entrance of the Palazza di Propaganda Fide. The next day, he celebrated his first Mass in another small chapel, on the second floor, overlooking the street. It is a beautiful symbol that Newman was ordained a priest in this building: as a famous convert to Catholicism, he represents the Church’s mission of evangelization, and, as a Catholic priest, he was responsible for the evangelization of hundreds of souls. In the 19th century, England was considered, once again, to be missionary territory and Newman would return to England as a Catholic priest of the Oratory of St. Philip Neri, to bring souls back to Holy Mother Church.

I had the privilege of celebrating Mass last week at the altar where Newman offered his first Mass. Several priests of the Diocese of Lincoln joined me, and our Lincoln seminarians who are studying at the North American College in Rome served the Mass. It was a moment of joy for me, and also a moment of humility. I was reminded, in that Mass, of the great responsibility each one of us carries: to proclaim the Gospel, to witness to truth, to know, love, and serve the Lord such that others will take up the mission of doing the same.

This week, we begin the holy and penitential season of Lent; a season designed to help us remember the mission of the Christian life, and to recommit ourselves to serving the Lord and his Kingdom. The wisdom of Blessed John Henry Newman can offer us important guidance this Lent.

“At Christmas,” Newman once wrote, “we are born again with Christ [in baptism]; at Easter we keep the Eucharistic Feast. In Lent, by penance, we join the two great sacraments together.” Lent is the time, Newman taught, in which we might do penance, asking the Lord for forgiveness for our sins against the grace of baptism, so that we might receive the Eucharist more worthily.

To have a fruitful Lent, Newman taught, we should examine our hearts and consciences, to be honest about the places in our lives where sinfulness abounds. And then we should offer penances and sacrifices, mortifications and fasts, to be freed of those sins, to bring ourselves more humbly and honestly seek God’s mercy.

Newman taught that Lent should be the time in which we remember that we will face judgment, and that nothing in this life is worth losing eternal happiness with God. He said that Lent is a time to give up some of the comforts of our lives, so that our comforts and luxuries won’t lead us into sin. “Let not the year go round and round, without a break and interruption in its circle of pleasures,” he wrote. “Give back some of God’s gifts to God, that you may safely enjoy the rest. Fast, or watch, or abound in alms, or be instant in prayer, or deny yourselves society, or pleasant books, or easy clothing, or take on some irksome task or employment; do one or other, or some, or all of these, unless you say that you have never sinned… Ever bear in mind that Day which will reveal all things, and will test all things ‘so as by fire,’ and which will bring us into judgment ere it lodges us in heaven.”

Finally, Newman taught that during Lent, especially, we should pray for one another. Newman believed that intercessory prayer was a fundamental obligation of Christians, especially during Lent. Newman wrote that “the privilege of Intercession is a trust committed to all Christians who have a clear conscience and are in full communion with the Church.” He kept long lists of people to pray for, and committed to asking the Lord for specific things for each one of them. During Lent, he spent as much time as he could praying for others.

The lessons of Newman for Lent are simple: each one of us will be judged someday, and we should act accordingly. During Lent, we should confess our sins, so that we can live out our baptism more fully, and receive the Eucharist more worthily.

During Lent, we should give up some of our comforts, and take up some acts of charity, so that our comfortable lives don’t distract us from our Christian mission, or lead us into sin.

During Lent, we should spend as much time as we can in prayer for other people, asking the Lord to grace them in real and particular ways. During Lent we should try to spend more time in quiet prayer before our Eucharistic Lord in adoration.

Newman’s lessons can instruct us this Lent to become more holy, as he was holy. My prayer is that each one of us will grow closer to the Lord during these hallowed weeks of Lent; that all of us will become holier through our Lenten practice, because God made each one of us for holiness. And I pray that the lessons of Blessed John Henry Newman will be helpful to you during this holy season of Lent.

This article first appeared in the the Southern Nebraska Register.

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Afterword by David Clayton:

Newman, one of the great Catholic thinkers of the 19th century is one of the people whose writing inspired the ethos that shaped Pontifex University. His Idea of a University has become almost mandatory reading for anyone who is interested in educating Catholics today to engage constructively with the modern world. It is for this reason that so many Catholic chaplaincies at American universities are called Newman Centers. Bishop Conley has done much to make the University of Lincoln’s Newman Center a place of beauty and a place of beautiful liturgy that draws us in to drink from the source of the flowing waters so that we might benefirt from that which all Catholic education is forming us for – an encounter with God in the Eucharist. For those who cooperate with God’s grace this is the source of divine wisdom and supernatural transformation in Christ that equips us for and guides us to our personal vocation in this life and the next. It is what every student clamours for, if they are honest, and so few realise where it is offered to them. It is through the beauty of St Thomas Aquinas Catholic Church at the Newman Center in the University of Nebraska-Lincoln that this truth is communicated to them.

In my book, the Way of Beauty, I quote Newman who describes his time at Oxford as a young student in the early 18th century. He describes how in his opinion, the tutorials, lectures, exams and books (however great) were not the most important aspect of an education. He says that the educational community is the most powerful forming influence in the young men of Oxford. In short, the students teach each other and form their characters, for good or ill.

The question then is how do you create community? The answer, in my opinion, is most powerfully, the prayer of community, which is a liturgically oriented piety. The Oxford college that Newman attended was Oriel. The Liturgy of the Hours, in the form of the Anglican Office would have been prayed daily in those days and will still be prayed regularly today. It is no accident that the place that formed one of the great intellects of the post-Enlightenment Church should have worshipped in a place of such beauty. How much more if Mass were celebrated here too.

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Pontifex University offers online classes. How, one might ask can we build community? Well it is more difficult but it is possible. The answer is that we build community through personal communication, of course, and all other practial ways we can think of. But also we create one that is mediated by the Church through prayer. This is why we encourage all Pontifex students to develop a liturgically oriented piety and also to pray for each other and for us.

And this brings us back to the Bishop’s Ash Wednesday message. We will pray for you and we ask that you pray for us, that we may all participate in a community that might contribute steadily more to the common good and the greater glory of God.

I would encourage all to visit the website of the  Southern Nebraska Register. This is the newspaper for the Diocese of Lincoln, Nebraska. Bishop James Conley, the Bishop of Lincoln, contributes regularly and his writings are worthy of study. He has a strong interest in the connection between the practice of the Faith, with the worship of God in the sacred liturgy at its heart, and its impact on every aspect of the culture. This is further indicated by the beautiful new church at the Newman Center at the University of Nebraska and the Great Books programs that he has intiated at the Newman Institute there and which focus on the how the beauty of a Christian culture draws us to the Faith.

 

Melkite Bishop Nicholas to Celebrate Divine Liturgy on Berkeley Campus, March 11th

The third in the monthly liturgies of the Melkite Outreach of Berkeley will be on March 11th, 5pm, at Gesu Chapel of the Jesuit School of Theology, 1735 Leroy Ave., Berkeley, CA. This is a week on Saturday.

The liturgy is usually celebrated by Fr Christopher Hadley (who teaches at the Jesuit School) and Fr Sebastian Carnazzo who is pastor of St Elias Melkite Church in Los Gatos, CA has told me: ‘This time we will be honored to host his Grace, Nicholas Samra, bishop of the Melkite Diocese of the United States, who will be celebrating the Divine Liturgy and giving us his episcopal blessing and exhortation.’

Hope to see you there.

Here is a recording of the Hymn of Lent: Open to Me the Gates of Repentance

The Divine Liturgy will be for Sunday, March 12th, which is the Sunday of St Gregory Palamas.

Years ago, I was told of a difference between East and West in the interpretation of the Transfiguration. St Thomas Aquinas, I was told, argued that Christ changed when he shone with light and this was an anticipation of the beatific vision; St Gregory Palamas, on the other hand agued that the apostles changed spiritually and they were able, temporarily to see the uncreated light of Christ. Through the sacramental life of the Church it is possible for all of us, by degrees to be transformed so that we can both witness and shine with the uncreated light of Christ.

I once raised this point, which I thought was a contradiction, with a Benedictine monk at Pluscarden Abbey in Scotland. He told me that I should ‘think liturgically’ and suggested that these two interpretations were not mutually exclusive. There might be a dual motion taking place in some way in that just as God comes down to us, so to speak, as Christ is present in the Eucharist, so in taking communion we are supernaturally transformed, potentially, and so are raised up to meet Him.

Hexaemeron.org and Pontifex University: Earn Credit for the Masters in Sacred Arts through Icon Painting and Icon Carving Worshops

Bring traditional arts into mainstream education!

We are pleased to announce that students on icon painting classes and icon carving classes run by Hexaemeron.org in the US and Canada in the coming year. This is one of a number of such partnerships in which by offering credit we bring traditional arts back into the mainstream. You can read about our developing institutional connections here..

With a series of classes with the highest standard of tuition, this is a great way to earn studio credit for the studio classes of the Masters in Sacred Arts. Each five day residential class earns 1 credit for an additional fee paid to Pontifex University of just $150. You simply register for their courses as you would otherwise, paying Hexaemeron directly for tuition. Then when the Hexaemeron tutor, for example Jonathan Pageau who teaches icon carving, tell us that you have completed the class and the set project to his satisfaction, we will awared you the credit.

You can find out more about their schedule of classes from the Hexaemeron class schedule here.

Starting in May and running through to September locations include Dunlap CA, Bloomfield CT, Hillsdale MI, Anchorage AK, Salem SC.

Here is a video about the work of Jonathan Pageau.

 

 

How a Catholic Understanding of the Human Person Can Revolutionize the Economics of Health Provision (and the Beauty of Hospital Buildings)

I attended a talk on healthcare at Star of the Sea Catholic Church in San Francisco last week given by Pontifex University professor, Dr Michel Accad. Much of the talk was devoted to consideration of the options that Catholics have for affordible healthcare. He spoke in detail about sharing ministries (such as Samaritan); and how many general practitioners are structuring their practices in a new way so that they are employed directly by the patient and act as their advocate. This is in contrast to the usual arrangement where the doctor effectively becomes an agent who sells treatments and drugs for the providers to the payer, who is not the patient, but the insurance company. In his new model, in contrast Dr Accad is motivated to act on behalf of the patient first, and so is an advocate for him, striving for example to bring down the cost of treatments and drugs by negotiating with pharmaceutical companies. He is also able to devote much more time to their care. Furthermore, it enables him to offer treatment that is in accord with Catholic social teaching.

He opened up his talk by asking the question: who here thinks healthcare in this country is going well? No hands went up. He then described how it is possible to have healthcare options that allow for the flourishing of the patient as a human person – body, soul and spirit – and a relationship between doctor and patient that is fruitful for both patient and care provider. In the Q &A session afterwards, it became apparent from the discussion that this was of interest not only to currently disgruntled patients but also to doctors who are frustrated that they cannot give the sort of treament they would like to give. Several spoke of this frustration under the current system.

Dr Accad is a medical doctor (qualified both as a general practitioner and as a cardiologist) who is able to take a broad view of the crucial issues involved. He is one of those rare people who is simultaneously able to analyse the details and to synthesise it all into the big picture. A committed Catholic he writes about medicine and is published in peer reviewed medical journals; he writes about the philosophy of nature and philosophical anthropology and has been published in The Thomist; and he has delivered papers on the economics of healthcare at the Mises Institute. He also has a popular blog on how these issues impact the medical profession called Alertandoriented.com.

Of course, I was interested in the details of how one might have access to affordible health care that is aligned with Catholic social teaching and imbued with genuine consideration of the patient as a person (and if you are interested in this I suggest you contact him through his blog, here). But aside from that what I found fascinating what his description of how so many of the problems associated with healthcare today, even before Obamacare, eminate from a dualistic understanding of the human person as a physical body occupied by a thinking soul; rather than a profound unity of body and soul as a single entity.  This is not a bad thing in itself, a deep understanding of how the physical function fo the body work as has lead to great strides in medicine; but it does place limitations on the scope of treatment through a neglect of the happiness of the person and his spiritual needs. If the underlying problem is spiritual, for example, while treatments might cause the physical symptoms to be alleviated, physical ailments might resurfacing in other forms.

And it runs even more deeply than that. Without a clear picture of what human person is, the idea of a health as a goal for treatment is not clearly defined either. This has lead over the last 100 years or so, to the creation of a  ‘health market’ which has been engineered to serve that idea of a human being as machine – as an object to be repaired; rather than as a person who needs health in order to direct his activity towards his ultimate end, which is union with God. Consequently, the patient occupies a role in this financial model that is more akin to the car in the repair shop, in which the insurance company is the car owner and the doctor is the mechanic. While this model might work well for cars, when the doctor’s surgery becomes a glorified human ‘body shop’ the misalignment and conflict of interests and goals leads to secondary (and more) problems in health care. As soon as the current system, under the guidance of government began to be introduced in the early 20th century, it caused escalating costs because there is no incentive for the key players to keep costs down on behalf of the patient. The doctor seeks to serve first the specialist treatment providers, pharmaceutical companies and insurance companies, rather focussing primarily on the improvement and maintainance of the health of the patient (however we define the word).

Those who wish to know more about the connection between the structuring of the health market and anthropology might be interested in reading (or listening) to Dr Accad’s talk on the subject given to the Mises Institute last year, which can be accessed via his blog, here: From Reacting Maching to Acting Person.

Dr Accad is currently preparing material for his first course for Pontifex University on the Philosophy of Nature and Philosophical Anthropology. He is a wondeful addition to our faculty precisely because of his ability to draw themes from one area of expertise into application in another. This ability to think synthetically is what the whole education at Pontifex is devoted to, and it is why a formation in beauty is right at the heart of what we do. When one apprehends the beauty of something , one is able to see not only how it’s parts are in right relation to the others (due proportion); but also how the whole is in accord with its purpose and in right relationship with all that surrounds it (integritas). In short one is able to look at the detail (analysis) and place it in the bigger picture (synthesis). This is why beauty and culture (which touches every aspect of human life, including economics and health provision) are so intimately related.

As Catholics we must strive always to take that mental step away from whatever field of study we are engaged in and ask ourselves the big question – how does this relate to man’s goal of union with God through worship of Him in the heavenly liturgy, in the next life, and the earthly liturgy in this.

We will hear more about the work of Dr Accad in the future!

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St John of God, by Murillo (Spanish, 17th century). 

Afterword: St John of God, (1495 – 1550) was a Portugese born soldier who founded a hospital in Granada, Spain and whose followers later formed the Brothers Hospitallers of Saint John of God, dedicated to the care of the poor, sick, and those suffering from mental disorders.

How many doctors today are taught of the need for God’s grace in their work for the benefit of both patient and doctor, I wonder? One only has to look at the design of hospital buildings past and present to see how differently the provision of care was considered. Below are photographs of the exterior and interior of the Hospital de Tavera, Toledo, Spain, built in the 16th century (which today is a museum housing many El Greco paintings):

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toledo-hospital-del-cardenal-tavera-patio-renacentista7

and here is a standard National Health Service hospital building, in Darlington County Durham in England:

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The standard criticism of the modern building is that it is only designed for utility, hence its depression appearance. I would argue something different: in my opinion beauty does have a utility, which is to raise hearts and minds to God. That is when a hospital is building is beautiful, it’s beauty helps serve the spiritual needs of tall the people in the care community it houses, and for good of all concerned. Furthermore, just as the person is a profound unity of body and soul, the hospital should be a profound unity of design that aids the function of restoring the health of the all aspects of the human person. Such a hospital will be beautiful and will optimise its functionality of the provision of both spiritual care and physical care. It is no accident that the hospital, just like and educational institution built in this time, has the look of a monastery. Both institutinons have aims that cannot be separated from the supernatural end of the human person and both aim to engender a community in which all work toward this end for themselves and others.

Here’s another example, Broadmoor Hospital was purpose built as a prison for criminally insane and houses some of Britains most violent and notorious convicted criminals.

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Those who are committed to its care are almost certainly going to live the rest of their natural lives behind its walls. The original building was completed in the mid-19th century. It does not have the cloisters and prayerful feel of the 16th century Spanish hospital, I suggest, but nevertheless it is a listed building. The prison/hospital is currently being redeveloped and there has been discussion as to what use the original building will be put to. Newspaper reports suggest that one suggestion is to turn it into a luxury hotel. While I am sure that it was not pleasant to be an inmate there, it seems that in some ways our Victorian forebears had greater insight about the need for the care of the souls of the most reviled members of society than modern society and how to do it.

The Darlington hospital no doubt has dedicated staff and patients receive the best that the National Health Service in the UK has to offer and the National Health Service has its problems too for similar reasons at root, although manifested in different ways (It is interesting to note that while the quality of care in many measures is not a good as that offered by the America system, satisfaction of patients is based upon anecdotal evidence, higher). Regardless, the design of the building tells us something about how the human person who is to be treated is viewed, I suggest. I would argue that it is not even the optimal design if the provision of physical care, for the physical and spiritual cannot be separated. The building of beautiful hosptials is not an extravagance, but ought be considered a necessity that will give us the most highly functional hospitals by any measure. As we can see through Dr Accad’s discussion of the provision of healthcare, care of body and soul cannot be separated, just as body and soul cannot, in reality, be separated in the person being cared for.

Neglecting the spiritual aspects of man will almost certainly affect detrimentally the care of even man-as-machine in ways that cannot always be anticipated. Let us be clear. Wrong anthropology does not suddenly invalidate modern medicine or its methods. It simply allows to locate the source of the problems that remain with the recognition there is more to be done. Once we recognize that man is a single entity that is both physical and spiritual who is made to worship of the God in the sacred liturgy and that this is the activity that all others are ordered to in this life, then we have the greatest chance of restoring all aspects of human health (and having beautiful hospitals once again!).