Reflections by a Member of the American Catholic Medical Association, part 2

By Thomas W. McGovern, M.D.

In Part 1, Dr. McGovern discussed the first two “pillars” of Catholic Social Teaching: (1) respect for human life and (2) seeking the common good. This month he discusses the last two ”pillars”: (3) solidarity and (4) subsidiarity. As a doctor, he then reflects on how Catholic doctors are implementing these “pillars” during the COVID-19 pandemic

3. Solidarity

Solidarity is a kind of social charity — simply put, we believe that “your good is my good.”

Solidarity becomes especially important now —when the chronically ill, the elderly, the immune-compromised, and other vulnerable populations are at increased risk; all Catholic healthcare professionals and policymakers must recommit to the Catholic vision of the “other” as “another I.”

Whereas most physicians take care of individual patients, public health physicians “care for” populations of patients.

At a Vatican medical conference in 2018, I first learned that clinical care of patients by their doctors only contributes to about 10% of health care outcomes.

Between 20-30% is determined by genetics, and a whopping 60-70% is determined by public health measures — patient behaviors, social circumstances, and environmental exposures — which should reflect “solidarity” between members of society.

We physicians are experiencing greater understanding of our poorest patients through the experience of our own underemployment and limits on social interaction and travel — an experience that can encourage greater solidarity with those we treat.

When will public Masses return? Once public health authorities determine that the risk is low enough to allow large public gatherings: COVID-19 cases and deaths must decrease for several weeks first. 

We only return to “normal social interaction” in one of three ways: herd immunity through natural infection, herd immunity through vaccination, or a blockbuster drug that effectively treats the disease.

Herd immunity happens when enough people in a population are immune to an infectious disease that it can no longer spread. It is estimated that 50-70% of the population will need to be vaccinated or have antibodies from prior infection to stop the spread of COVID-19. Until that happens, we can expect repeat waves of infection as we loosen restrictions.

Blockbuster drugs against viruses are rare, and vaccine development and deployment is expected to take 12-18 months.

That puts the achievement of herd immunity sometime in mid-to-late 2021 — unless researchers determine there are widespread asymptomatic infections occurring, leading to large numbers of people with antibodies. Until then, some form of social distancing will likely remain.

4. Subsidiarity

The principle of subsidiarity teaches that the smallest, most local level of society capable of handling a problem should handle it—beginning with the competent individual and his or her family, and from there proceeding to higher levels of government. This principle should still prevail in times of health crisis.

One example of subsidiarity is being practiced by nursing homes which allow patients to decide if they want to stay put or take a risk by leaving the nursing home to be with family — which many do. 

As we climb the ladder of organizational size, we have seen individual hospitals and practices determine their own policies without undue governmental pressure.

Individual states, and in some cases, municipalities, have issued “shelter-in-place” or “stay-at-home” orders without the force of the federal government.

Finally, with national economic collapse and millions of newly unemployed, only the federal government could have enacted the Payroll Protection Plan that will likely save many small businesses, including medical practices, from closure.

It’s a joy and a privilege for Catholic physicians to bring the healing of Christ to the sick while we strive to uphold Catholic social teaching in our work. Pray for us as we pray for and care for our patients.

Thomas W. McGovern, MD is a Fort Wayne, Indiana Mohs Surgeon who serves on the national board of the CMA and co-hosts Doctor, Doctor, the official podcast and radio program of the CMA. Doctor, Doctor is found on numerous podcast platforms and on EWTNradio and SiriusXM 130 at 11 a.m. ET on Saturdays. More than 25 COVID-related shows are available.

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