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Life and death in the daily: reflections with the professional of health was written with the purpose of contribute with the project of the State Politics of Humanization of the assistance and of the Health Management of the State of the Ceará, that defines in your guidelines " to provide the appropriate preparation to the experience of losses, of suffering, of dying and of the death ". The work is organized in thematic about of the senses of the death and of dying in the occident. It presents four chapters that talk about the life and the death in a valuable contribution about the understanding of the death as indispensable part of the life and your inclusion in the cares offered by the professionals of the health. The authors provoke in a competent and sensitive way the rethinking about the subjects of the death and of the dying, starting from the reality lived by the professionals. They put in evidence an indispensable theme for taking care humanized in the practices of health and not give the reference to the patients and your relatives, which in some way share with the professionals of the process of taking care. The first chapter: the death and the dying in the life and your senses, contains teachings retired of the poets that through your music and poems portray the death in the most different ways, but recognizes it as part of the life in your fullness. They present an abbreviation revision about the death´s history, the transformations happened along of the time and your several meanings. Concluding the chapter the authors reminds the fact that the man is the only animal that knows that will die and this conscience provokes fear and solitude feelings. They also portray importants subjects as the aging, the losses and your implications, that are going happening along the life, and last they talk about the science´s power, that tries to postpone the death considering that in this moment the biggest part of die´s process is the professional's of the health responsibility.The second chapter: the professional of the health before the death, treats of the professional's unpreparedness, it presents some basic concepts as euthanasia, medical futility, to discuss to subjects of the emotion, of sense of the life and of the death for each person, of the need of moments for that the professionals can to reflect on the own death. To think in the own death means to reflect about the life as not as a group of vital signs that have to be monitored. The reading invites us to consider the death as not as enemy, but as a complement of the life, in that life and death form the totality of being. The third chapter: the appeal to the re-humanization of the death. The authors reflect about the technological progress of the Medicine that at every cost tries the prolongation of the life and that not always those actions are accompanied of help for a good death. They point out, in this context, the solitude, the impersonal and the inhumanization of the Being that is dying. In this same chapter is discussed still the relevance of the palliative cares and the twelve beginnings for a good death published in England.>In the fourth chapter, practical application: like this in the life as in the death, the authors propose a series of practical activities for be developed in groups, with the objective of to sensitize the professionals to share, in wheels of chats in the services of health about the life and the death. The organization of this activities is in the workshop format meddled by appreciation of poems, music and support texts.In the final considerations the prominence is given for the fact that the most important seems to be a solidary attitude together to the Being that is dying. Besides, the authors also consider important the invigoration of the Public Politics and the consolidation of the Palliative Cares.It is treat of a work with clear style, objective, easy reading, that maintains us in the expectation of reaching the end. We recommend the reading of this book is recommended to the teachers of the courses of the health, professionals of health, students, as well as for people that are interested in enlarging knowledge about the subjects of the death and of the dying. ; La vida y muerte en el periódico: las reflexiones con el profesional de la salud fue escrito con el propósito de contribuir con el proyecto de la Política Estatal de Humanización de la Atención y de la Gestión en la Salud del Estado del Ceará, que define en sus directrices "proporcionar la preparación apropiada a la vivencia de pérdidas, de sufrimiento, de el morir y de la muerte."La obra es organizada en temáticas sobre los sentidos de la muerte y de el morir en el occidente. Presenta cuatro capítulos que abordan cuestiones sobre la vida y la muerte en una valiosa contribución sobre la comprensión de la muerte como la parte imprescindible de la vida y su inclusión en los cuidados dados por los profesionales de la salud. Los autores provocan de una manera competente y sensible o repensar sobre las cuestiones de la muerte y de el morir, a partir de la realidad vivieron por los profesionales. Ponen en la evidencia un tema imprescindible para el cuidar humanizado en las prácticas de salud y no si da la referencia a los pacientes y sus parientes que en alguna manera comparten con los profesionales del proceso de cuidar.El primer capítulo: la muerte y el morir en la vida y sus sentidos contiene las enseñanzas retirados de los poetas que a través de sus músicas y los poemas retratan la muerte de las más diferentes maneras, pero a reconoce con la parte de la vida en su plenitud. Presentan una breve revisión sobre la historia de la muerte, las transformaciones pasaron a lo largo del tiempo y sus varios significados. Concluyendo el capítulo los autores recuerda el hecho que el hombre es que el único animal que sabe cuando se morirá y esa conciencia provoca sentimientos de miedo y soledad. Retratan también asuntos importantes como el envejecimiento, las pérdidas y sus implicaciones, que van pasando a lo largo de la vida, y último abordan el poder de la ciencia, que intenta posponer la muerte considerando que en este momento la mayoría del proceso del morir es responsabilidad el profesional de la de salud.El segundo capítulo: el profesional de la salud enfrente de la muerte trata de el desarreglo de los profesionales, presenta algunos conceptos básicos como la eutanasia, el distanasia, para discutir los asuntos de la emoción, del sentido de vida y muerte para cada persona, de la necesidad de momentos para que los profesionales puedan reflejar sobre la propia muerte. Pensar en la propia muerte significa reflejar sobre la vida no como un conjunto de señales vitales que se debe supervisar. Considerar la muerte no come al enemigo, pero como un complemento de la vida. La vida y la muerte forman la totalidad del ser.El tercer capítulo: la apelación para la re-humanización de la muerte. Los autores reflejan sobre el progreso tecnológico de la Medicina que a todo costo los intentan la prolongación de la vida y que no siempre esas acciones se acompañan de ayuda por una buena muerte. Resaltan la soledad, la impessoalidad y el deshumanización de el Ser que está muriendo. Presentan la relevancia de los cuidados paliativos y los doce principios para una buena muerte publicados en Inglaterra.En el cuarto capítulo, la aplicación práctica: así en la vida como en la muerte, los autores proponen una serie de actividades prácticas para sean desarrolladas en los grupos, con el objetivo de sensibilizar los profesionales a compartir, en las ruedas de conversas en los servicios de salud sobre la vida y la muerte. Los talleres son organizados con la apreciación de poemas, música y textos de apoyo.En las consideraciones últimas los autores creen que el más importante parece ser una actitud solidaria junto al Ser que está muriendo. Considera ser importante también al fortalecimiento de las Políticas Públicas y la consolidación de los Cuidados Paliativos.Se trata de una obra con el estilo claro, objetivo, fácil lectura, mantiene la expectativa de alcanzar a lo fin. Se recomienda la lectura de este libro a los maestros de los cursos de la salud, a los profesionales de salud, a los estudiantes. Es recomendado también para las personas se interesen en agrandar el conocimientos sobre los asuntos de la muerte y de el morir. ; Vida e morte no cotidiano: reflexões com o profissional da saúde foi escrito com a finalidade de contribuir com o projeto da Política Estadual de Humanização da Atenção e da Gestão em Saúde do Estado do Ceará, que define em suas diretrizes "proporcionar a preparação adequada à vivência de perdas, de sofrimento, do morrer e da morte."A obra está organizada em temáticas sobre os sentidos da morte e do morrer no ocidente. Apresenta quatro capítulos que versam sobre a vida e a morte numa valiosa contribuição sobre a compreensão da morte como parte imprescindível da vida e sua inclusão nos cuidados prestados pelos profissionais da saúde. Os autores provocam de forma competente e sensível o repensar sobre as questões da morte e do morrer, a partir da realidade vivida pelos profissionais, colocando em evidência um tema imprescindível para cuidá-lo humanizado nas práticas de saúde e não se da referência aos pacientes e seus familiares, que de alguma forma compartilham com os profissionais do processo de cuidar.O primeiro capítulo: a morte e o morrer na vida e os seus sentidos, contém ensinamentos retirados dos poetas que por meio de suas músicas e poemas retratam a morte das mais diferentes formas, mas a reconhece como parte da vida em sua plenitude. Estes apresentam uma breve revisão sobre a história da morte, as transformações ocorridas ao longo do tempo e seus diversos significados. Finalizando o capítulo os autores lembram o fato de que o homem é o único animal que sabe que vai morrer e essa consciência provoca sentimentos de medo e solidão. Retratam também questões importantes como o envelhecimento, as perdas e suas implicações, que vão ocorrendo ao longo da vida, e por último abordam o poder da ciência, que a todo custo tenta adiar a morte considerando que neste momento a maior parte do processo de morrer é responsabilidade do profissional da saúde.O segundo capítulo: o profissional da saúde diante da morte trata do despreparo dos profissionais, apresentando alguns conceitos básicos como eutanásia, distanásia para discutir a questões da emoção, do sentido de vida e morte para cada pessoa, da necessidade de momentos para que os profissionais possam refletir sobre a própria morte. Pensar a própria morte significa refletir sobre a vida não como um conjunto de sinais vitais que se deve monitorar. A leitura nos convida a ponderar a morte não como inimiga, mas como um complemento da vida, em que vida e morte formam a totalidade do Ser.No terceiro capítulo: apelo à re-humanização da morte, os autores refletem sobre o avanço tecnológico da Medicina que a todo custo tentam o prolongamento da vida e que nem sempre essas ações são acompanhadas de ajuda para uma boa morte. Ressaltam, nesse contexto, a solidão, a impessoalidade e a desumanização do Ser que está morrendo. No referido capítulo é discutida ainda a relevância dos cuidados paliativos e os doze princípios para uma boa morte publicados na Inglaterra.No quarto capítulo, aplicação prática: assim na vida como na morte, os autores propõem uma série de atividades práticas para serem desenvolvidas em grupos, com o objetivo de sensibilizar os profissionais a compartilhar, em rodas de conversas nos serviços de saúde sobre a vida e a morte. A organização de tais atividades é no formato de oficinas mediadas pela apreciação de poemas, músicas e textos de apoio.Nas considerações finais o destaque é dado para o fato de que o mais importante parece ser uma atitude solidária junto ao Ser que está morrendo. Além disso, os autores consideram importantes também, o fortalecimento das Políticas Públicas e a consolidação dos Cuidados Paliativos.Trata-se de uma obra com estilo claro, objetivo, fácil leitura, que nos mantém na expectativa de chegarmos ao fim. Recomendamos a leitura deste livro aos docentes dos cursos da saúde, profissionais de saúde, estudantes, assim como para pessoas que se interessam em ampliar conhecimentos sobre as questões da morte e do morrer.

Life and death in the daily: reflections with the professional of health was written with the purpose of contribute with the project of the State Politics of Humanization of the assistance and of the Health Management of the State of the Ceará, that defines in your guidelines " to provide the appropriate preparation to the experience of losses, of suffering, of dying and of the death ". The work is organized in thematic about of the senses of the death and of dying in the occident. It presents four chapters that talk about the life and the death in a valuable contribution about the understanding of the death as indispensable part of the life and your inclusion in the cares offered by the professionals of the health. The authors provoke in a competent and sensitive way the rethinking about the subjects of the death and of the dying, starting from the reality lived by the professionals. They put in evidence an indispensable theme for taking care humanized in the practices of health and not give the reference to the patients and your relatives, which in some way share with the professionals of the process of taking care. The first chapter: the death and the dying in the life and your senses, contains teachings retired of the poets that through your music and poems portray the death in the most different ways, but recognizes it as part of the life in your fullness. They present an abbreviation revision about the death´s history, the transformations happened along of the time and your several meanings. Concluding the chapter the authors reminds the fact that the man is the only animal that knows that will die and this conscience provokes fear and solitude feelings. They also portray importants subjects as the aging, the losses and your implications, that are going happening along the life, and last they talk about the science´s power, that tries to postpone the death considering that in this moment the biggest part of die´s process is the professional's of the health responsibility.The second chapter: the professional of the health before the death, treats of the professional's unpreparedness, it presents some basic concepts as euthanasia, medical futility, to discuss to subjects of the emotion, of sense of the life and of the death for each person, of the need of moments for that the professionals can to reflect on the own death. To think in the own death means to reflect about the life as not as a group of vital signs that have to be monitored. The reading invites us to consider the death as not as enemy, but as a complement of the life, in that life and death form the totality of being. The third chapter: the appeal to the re-humanization of the death. The authors reflect about the technological progress of the Medicine that at every cost tries the prolongation of the life and that not always those actions are accompanied of help for a good death. They point out, in this context, the solitude, the impersonal and the inhumanization of the Being that is dying. In this same chapter is discussed still the relevance of the palliative cares and the twelve beginnings for a good death published in England.>In the fourth chapter, practical application: like this in the life as in the death, the authors propose a series of practical activities for be developed in groups, with the objective of to sensitize the professionals to share, in wheels of chats in the services of health about the life and the death. The organization of this activities is in the workshop format meddled by appreciation of poems, music and support texts.In the final considerations the prominence is given for the fact that the most important seems to be a solidary attitude together to the Being that is dying. Besides, the authors also consider important the invigoration of the Public Politics and the consolidation of the Palliative Cares.It is treat of a work with clear style, objective, easy reading, that maintains us in the expectation of reaching the end. We recommend the reading of this book is recommended to the teachers of the courses of the health, professionals of health, students, as well as for people that are interested in enlarging knowledge about the subjects of the death and of the dying. ; La vida y muerte en el periódico: las reflexiones con el profesional de la salud fue escrito con el propósito de contribuir con el proyecto de la Política Estatal de Humanización de la Atención y de la Gestión en la Salud del Estado del Ceará, que define en sus directrices "proporcionar la preparación apropiada a la vivencia de pérdidas, de sufrimiento, de el morir y de la muerte."La obra es organizada en temáticas sobre los sentidos de la muerte y de el morir en el occidente. Presenta cuatro capítulos que abordan cuestiones sobre la vida y la muerte en una valiosa contribución sobre la comprensión de la muerte como la parte imprescindible de la vida y su inclusión en los cuidados dados por los profesionales de la salud. Los autores provocan de una manera competente y sensible o repensar sobre las cuestiones de la muerte y de el morir, a partir de la realidad vivieron por los profesionales. Ponen en la evidencia un tema imprescindible para el cuidar humanizado en las prácticas de salud y no si da la referencia a los pacientes y sus parientes que en alguna manera comparten con los profesionales del proceso de cuidar.El primer capítulo: la muerte y el morir en la vida y sus sentidos contiene las enseñanzas retirados de los poetas que a través de sus músicas y los poemas retratan la muerte de las más diferentes maneras, pero a reconoce con la parte de la vida en su plenitud. Presentan una breve revisión sobre la historia de la muerte, las transformaciones pasaron a lo largo del tiempo y sus varios significados. Concluyendo el capítulo los autores recuerda el hecho que el hombre es que el único animal que sabe cuando se morirá y esa conciencia provoca sentimientos de miedo y soledad. Retratan también asuntos importantes como el envejecimiento, las pérdidas y sus implicaciones, que van pasando a lo largo de la vida, y último abordan el poder de la ciencia, que intenta posponer la muerte considerando que en este momento la mayoría del proceso del morir es responsabilidad el profesional de la de salud.El segundo capítulo: el profesional de la salud enfrente de la muerte trata de el desarreglo de los profesionales, presenta algunos conceptos básicos como la eutanasia, el distanasia, para discutir los asuntos de la emoción, del sentido de vida y muerte para cada persona, de la necesidad de momentos para que los profesionales puedan reflejar sobre la propia muerte. Pensar en la propia muerte significa reflejar sobre la vida no como un conjunto de señales vitales que se debe supervisar. Considerar la muerte no come al enemigo, pero como un complemento de la vida. La vida y la muerte forman la totalidad del ser.El tercer capítulo: la apelación para la re-humanización de la muerte. Los autores reflejan sobre el progreso tecnológico de la Medicina que a todo costo los intentan la prolongación de la vida y que no siempre esas acciones se acompañan de ayuda por una buena muerte. Resaltan la soledad, la impessoalidad y el deshumanización de el Ser que está muriendo. Presentan la relevancia de los cuidados paliativos y los doce principios para una buena muerte publicados en Inglaterra.En el cuarto capítulo, la aplicación práctica: así en la vida como en la muerte, los autores proponen una serie de actividades prácticas para sean desarrolladas en los grupos, con el objetivo de sensibilizar los profesionales a compartir, en las ruedas de conversas en los servicios de salud sobre la vida y la muerte. Los talleres son organizados con la apreciación de poemas, música y textos de apoyo.En las consideraciones últimas los autores creen que el más importante parece ser una actitud solidaria junto al Ser que está muriendo. Considera ser importante también al fortalecimiento de las Políticas Públicas y la consolidación de los Cuidados Paliativos.Se trata de una obra con el estilo claro, objetivo, fácil lectura, mantiene la expectativa de alcanzar a lo fin. Se recomienda la lectura de este libro a los maestros de los cursos de la salud, a los profesionales de salud, a los estudiantes. Es recomendado también para las personas se interesen en agrandar el conocimientos sobre los asuntos de la muerte y de el morir. ; Vida e morte no cotidiano: reflexões com o profissional da saúde foi escrito com a finalidade de contribuir com o projeto da Política Estadual de Humanização da Atenção e da Gestão em Saúde do Estado do Ceará, que define em suas diretrizes "proporcionar a preparação adequada à vivência de perdas, de sofrimento, do morrer e da morte."A obra está organizada em temáticas sobre os sentidos da morte e do morrer no ocidente. Apresenta quatro capítulos que versam sobre a vida e a morte numa valiosa contribuição sobre a compreensão da morte como parte imprescindível da vida e sua inclusão nos cuidados prestados pelos profissionais da saúde. Os autores provocam de forma competente e sensível o repensar sobre as questões da morte e do morrer, a partir da realidade vivida pelos profissionais, colocando em evidência um tema imprescindível para cuidá-lo humanizado nas práticas de saúde e não se da referência aos pacientes e seus familiares, que de alguma forma compartilham com os profissionais do processo de cuidar.O primeiro capítulo: a morte e o morrer na vida e os seus sentidos, contém ensinamentos retirados dos poetas que por meio de suas músicas e poemas retratam a morte das mais diferentes formas, mas a reconhece como parte da vida em sua plenitude. Estes apresentam uma breve revisão sobre a história da morte, as transformações ocorridas ao longo do tempo e seus diversos significados. Finalizando o capítulo os autores lembram o fato de que o homem é o único animal que sabe que vai morrer e essa consciência provoca sentimentos de medo e solidão. Retratam também questões importantes como o envelhecimento, as perdas e suas implicações, que vão ocorrendo ao longo da vida, e por último abordam o poder da ciência, que a todo custo tenta adiar a morte considerando que neste momento a maior parte do processo de morrer é responsabilidade do profissional da saúde.O segundo capítulo: o profissional da saúde diante da morte trata do despreparo dos profissionais, apresentando alguns conceitos básicos como eutanásia, distanásia para discutir a questões da emoção, do sentido de vida e morte para cada pessoa, da necessidade de momentos para que os profissionais possam refletir sobre a própria morte. Pensar a própria morte significa refletir sobre a vida não como um conjunto de sinais vitais que se deve monitorar. A leitura nos convida a ponderar a morte não como inimiga, mas como um complemento da vida, em que vida e morte formam a totalidade do Ser.No terceiro capítulo: apelo à re-humanização da morte, os autores refletem sobre o avanço tecnológico da Medicina que a todo custo tentam o prolongamento da vida e que nem sempre essas ações são acompanhadas de ajuda para uma boa morte. Ressaltam, nesse contexto, a solidão, a impessoalidade e a desumanização do Ser que está morrendo. No referido capítulo é discutida ainda a relevância dos cuidados paliativos e os doze princípios para uma boa morte publicados na Inglaterra.No quarto capítulo, aplicação prática: assim na vida como na morte, os autores propõem uma série de atividades práticas para serem desenvolvidas em grupos, com o objetivo de sensibilizar os profissionais a compartilhar, em rodas de conversas nos serviços de saúde sobre a vida e a morte. A organização de tais atividades é no formato de oficinas mediadas pela apreciação de poemas, músicas e textos de apoio.Nas considerações finais o destaque é dado para o fato de que o mais importante parece ser uma atitude solidária junto ao Ser que está morrendo. Além disso, os autores consideram importantes também, o fortalecimento das Políticas Públicas e a consolidação dos Cuidados Paliativos.Trata-se de uma obra com estilo claro, objetivo, fácil leitura, que nos mantém na expectativa de chegarmos ao fim. Recomendamos a leitura deste livro aos docentes dos cursos da saúde, profissionais de saúde, estudantes, assim como para pessoas que se interessam em ampliar conhecimentos sobre as questões da morte e do morrer.

Both healthcare systems were structured as universal access and comprehensive care attention, hierarchized by the level of care, politically and administratively decentralized. To measure the effectiveness of the Brazilian healthcare system, a comparison with another country is desirable. The French healthcare system is considered to be one of the best in the world, the following hypothesis has been developed: Is the French health system more effective in terms of results than the Brazilian in terms of strategies and care in stroke? The general objective was to compare the effectiveness of the Brazilian and French healthcare systems related to stroke care. It was sought to identify the commonalities and discrepancies between both national health policies related to stroke care through the specific objectives that sought to describe health strategies and clinical practice for stroke care in both healthcare systems; to research and to describe the number of acute hospitalizations, the average length of stay in the hospital, hospital mortality rate, deaths and the cost of in-hospital stroke treatment. Methods: Comparison and description of the similarities, differences, or relationships between the data regarding policies, risk factors, and health indicators about stroke care, from 2010 to 2017. The data were obtained from both countries (publicly accessible information or on request) from the respective Ministries of Health or international agencies. As a result, about acute stroke hospitalizations, the in-hospital mortality rate in Brazil was 163 per 1.000 hospitalized people versus 263 in France. The average length of stay of acute hospitalizations was 7.6 days in Brazil versus 12.6 in France. The prevalence of strokes by age group shows from 0 to 39 years old the rate did not show any significant growth or decrease and it can be considered stable; from 40-59 years it was increasing in both countries; from 60-79 and 80+ years this average rate has been increasing in France and decreasing in Brazil. Regarding the acute stroke hospitalizations costs from 2010 to 2017, Brazil had an average expenditure of Power Purchasing Parity 79.579.810.78 dollars per year. France had 446.919.476.40 dollars. The hypotheses discussed are not sufficient to explain the difference in acute hospitalization costs by stroke between Brazil and France. In conclusion, the initial hypothesis seems refuted. Compared to the French healthcare system, the Brazilian healthcare system is more efficient, and it is more effective in terms of in-hospital average stay and in-hospital mortality rate. To conclude, both healthcare systems are constantly changing to meet new needs and obtain sufficient financial resources to provide a quality service to their population. No major differences were found about the health care policies and the National Health Plans related to stroke. However, the data directly linked to the period of hospitalization differed substantially between countries. Subsequent studies can be implemented to identify the explanatory factors, notably among the risk factors and actions in primary care and the moments after hospital care, such as secondary prevention and palliative care. ; Les systèmes de santé brésilien et français ont été structurés comme d'accès universel et une prise en charge globale, hiérarchisés par le niveau de soins, décentralisés politiquement et administrativement. Comme le système de santé français est considéré comme l'un des meilleurs au monde l'hypothèse suivante a été élaborée : Est-ce-que le système de santé français est-il plus efficace en résultats que le brésilien en matière de stratégies et soins de santé en cas d'accident vasculaire cérébral ? L'objectif général était de comparer l'efficacité de résultats entre les systèmes de santé brésilien et français liés aux soins de l'Accident Vasculaire Cérébral. L'étude a cherché à identifier les points communs et les divergences entre les deux politiques nationales de santé liées aux soins de l'accident vasculaire cérébral à travers les objectifs spécifiques qui visaient à décrire : les politiques de santé et la pratique clinique pour les soins de l'accident vasculaire cérébral dans les deux systèmes de santé ; de rechercher et de décrire le nombre d'hospitalisations aiguës ; la durée moyenne de séjour à l'hôpital ; le taux de mortalité hospitalière ; les décès et le coût du traitement des accidents vasculaires cérébraux à l'hôpital. Méthodes : Comparaison et description des similitudes, des différences ou des relations entre les données concernant les politiques, les facteurs de risque et les indicateurs de santé concernant les soins de l'accident vasculaire cérébral, de 2010 à 2017. Comme résultats, les données ont été obtenues des deux pays auprès des Ministères de la Santé ou des agences internationales respectifs. Les résultats ont montré que les données directement liées à la période d'hospitalisation entre 2010 et 2017 différaient considérablement d'un pays à l'autre. Par rapport aux hospitalisations dues à un AVC aigu, le taux de mortalité hospitalière au Brésil est de 163 pour 1.000 hospitalisés contre 263 en France. La durée moyenne de séjour des hospitalisations aiguës était de 7.6 jours au Brésil contre 12.6 en France. La prévalence des accident vasculaire cérébraux par tranche d'âge entre 2010 et 2017 montre que pour les 0 à 39 ans le taux n'a pas montré aucune croissance ou diminution importante et peut être considérée comme stable ; des 40-59 ans, il a augmenté dans les deux pays et que de 60-79 ans et 80+ ans, le taux était en augmentation en France alors qu'en baisse au Brésil. Concernant les coûts d'hospitalisation pour AVC aigu de 2010 à 2017, le Brésil avait une dépense moyenne de Parité de Pouvoir d'Achat de 79.579.810.78 dollars par an et la France 446.919.476.40. Les hypothèses discutées ne sont pas suffisantes pour expliquer la différence des coûts d'hospitalisation aiguë pour cause d'AVC entre le Brésil et la France. En conclusion, l'hypothèse initiale semble réfutée. Le système de santé brésilien par rapport au système de santé français est plus efficient et il est plus efficace en résultats en ce qui concerne le séjour moyen à l'hôpital et pour le taux de mortalité hospitalière. Les deux systèmes de santé sont en constante évolution pour répondre aux nouveaux besoins et obtenir des ressources financières suffisantes pour fournir un service de qualité à leur population. Aucune différence majeure n'a été trouvée concernant les politiques de santé et les plans nationaux de santé liés à l'AVC. Des études ultérieures peuvent être mises en œuvre pour identifier les facteurs explicatifs, notamment parmi les facteurs de risque et les actions en soins primaires, et la prise en charge après les soins hospitaliers aigus en termes de prévention secondaire, de réhabilitation, voire en soins palliatifs.

Both healthcare systems were structured as universal access and comprehensive care attention, hierarchized by the level of care, politically and administratively decentralized. To measure the effectiveness of the Brazilian healthcare system, a comparison with another country is desirable. The French healthcare system is considered to be one of the best in the world, the following hypothesis has been developed: Is the French health system more effective in terms of results than the Brazilian in terms of strategies and care in stroke? The general objective was to compare the effectiveness of the Brazilian and French healthcare systems related to stroke care. It was sought to identify the commonalities and discrepancies between both national health policies related to stroke care through the specific objectives that sought to describe health strategies and clinical practice for stroke care in both healthcare systems; to research and to describe the number of acute hospitalizations, the average length of stay in the hospital, hospital mortality rate, deaths and the cost of in-hospital stroke treatment. Methods: Comparison and description of the similarities, differences, or relationships between the data regarding policies, risk factors, and health indicators about stroke care, from 2010 to 2017. The data were obtained from both countries (publicly accessible information or on request) from the respective Ministries of Health or international agencies. As a result, about acute stroke hospitalizations, the in-hospital mortality rate in Brazil was 163 per 1.000 hospitalized people versus 263 in France. The average length of stay of acute hospitalizations was 7.6 days in Brazil versus 12.6 in France. The prevalence of strokes by age group shows from 0 to 39 years old the rate did not show any significant growth or decrease and it can be considered stable; from 40-59 years it was increasing in both countries; from 60-79 and 80+ years this average rate has been increasing in France and decreasing in Brazil. Regarding the acute stroke hospitalizations costs from 2010 to 2017, Brazil had an average expenditure of Power Purchasing Parity 79.579.810.78 dollars per year. France had 446.919.476.40 dollars. The hypotheses discussed are not sufficient to explain the difference in acute hospitalization costs by stroke between Brazil and France. In conclusion, the initial hypothesis seems refuted. Compared to the French healthcare system, the Brazilian healthcare system is more efficient, and it is more effective in terms of in-hospital average stay and in-hospital mortality rate. To conclude, both healthcare systems are constantly changing to meet new needs and obtain sufficient financial resources to provide a quality service to their population. No major differences were found about the health care policies and the National Health Plans related to stroke. However, the data directly linked to the period of hospitalization differed substantially between countries. Subsequent studies can be implemented to identify the explanatory factors, notably among the risk factors and actions in primary care and the moments after hospital care, such as secondary prevention and palliative care. ; Les systèmes de santé brésilien et français ont été structurés comme d'accès universel et une prise en charge globale, hiérarchisés par le niveau de soins, décentralisés politiquement et administrativement. Comme le système de santé français est considéré comme l'un des meilleurs au monde l'hypothèse suivante a été élaborée : Est-ce-que le système de santé français est-il plus efficace en résultats que le brésilien en matière de stratégies et soins de santé en cas d'accident vasculaire cérébral ? L'objectif général était de comparer l'efficacité de résultats entre les systèmes de santé brésilien et français liés aux soins de l'Accident Vasculaire Cérébral. L'étude a cherché à identifier les points communs et les divergences entre les deux politiques nationales de santé liées aux soins de l'accident vasculaire cérébral à travers les objectifs spécifiques qui visaient à décrire : les politiques de santé et la pratique clinique pour les soins de l'accident vasculaire cérébral dans les deux systèmes de santé ; de rechercher et de décrire le nombre d'hospitalisations aiguës ; la durée moyenne de séjour à l'hôpital ; le taux de mortalité hospitalière ; les décès et le coût du traitement des accidents vasculaires cérébraux à l'hôpital. Méthodes : Comparaison et description des similitudes, des différences ou des relations entre les données concernant les politiques, les facteurs de risque et les indicateurs de santé concernant les soins de l'accident vasculaire cérébral, de 2010 à 2017. Comme résultats, les données ont été obtenues des deux pays auprès des Ministères de la Santé ou des agences internationales respectifs. Les résultats ont montré que les données directement liées à la période d'hospitalisation entre 2010 et 2017 différaient considérablement d'un pays à l'autre. Par rapport aux hospitalisations dues à un AVC aigu, le taux de mortalité hospitalière au Brésil est de 163 pour 1.000 hospitalisés contre 263 en France. La durée moyenne de séjour des hospitalisations aiguës était de 7.6 jours au Brésil contre 12.6 en France. La prévalence des accident vasculaire cérébraux par tranche d'âge entre 2010 et 2017 montre que pour les 0 à 39 ans le taux n'a pas montré aucune croissance ou diminution importante et peut être considérée comme stable ; des 40-59 ans, il a augmenté dans les deux pays et que de 60-79 ans et 80+ ans, le taux était en augmentation en France alors qu'en baisse au Brésil. Concernant les coûts d'hospitalisation pour AVC aigu de 2010 à 2017, le Brésil avait une dépense moyenne de Parité de Pouvoir d'Achat de 79.579.810.78 dollars par an et la France 446.919.476.40. Les hypothèses discutées ne sont pas suffisantes pour expliquer la différence des coûts d'hospitalisation aiguë pour cause d'AVC entre le Brésil et la France. En conclusion, l'hypothèse initiale semble réfutée. Le système de santé brésilien par rapport au système de santé français est plus efficient et il est plus efficace en résultats en ce qui concerne le séjour moyen à l'hôpital et pour le taux de mortalité hospitalière. Les deux systèmes de santé sont en constante évolution pour répondre aux nouveaux besoins et obtenir des ressources financières suffisantes pour fournir un service de qualité à leur population. Aucune différence majeure n'a été trouvée concernant les politiques de santé et les plans nationaux de santé liés à l'AVC. Des études ultérieures peuvent être mises en œuvre pour identifier les facteurs explicatifs, notamment parmi les facteurs de risque et les actions en soins primaires, et la prise en charge après les soins hospitaliers aigus en termes de prévention secondaire, de réhabilitation, voire en soins palliatifs.

Introduction.The article is devoted to the topical issues in the area of ensuring the right of the older persons to health, taking into account modern realities. In particular, it focuses on the existing problematic aspects through the prism of the right to decent treatment and autonomy. The issue of abuse of the elderly, which negatively affects their physical and mental health and providing palliative care, which helps to improve the quality of life of patients with diseases that limit life expectancy have been analyzed; it focuses on the problem of dementia, which is one of the leading causes of disability and dependence among older people around the world; given the fact that older people are at high risk during COVID-19, the focus is on protecting this category of people during a pandemic. The main results of the study. An analysis of the existing legal framework for cooperation between states to overcome the negative trends in the provision of health care to the elderly, in particular: the Toronto Declaration on the Global Prevention of Elder Abuse, the Council of Europe Convention on preventing and combating violence against women and domestic violence, the European Social Charter (revised), the Inter-American Convention on Protecting the Human Rights of Older Persons, the Global action plan on the public health response to dementia 2017-2025, the "Towards a Dementia Plan" Guide , World Health Organization Guidelines for Reducing the Risk of Cognitive Function and Dementia. In addition, attention is paid to the recommendations of the main bodies of international intergovernmental organizations, in particular the Committee of Ministers of the Council of Europe, and international treaty bodies in this field - the Committee on Economic, Social and Cultural Rights, the Committee on the Elimination of Discrimination against Women (General recommendation № 24, General recommendation № 27) etc. Relevant conclusions and recommendations have been made. Conclusions.It should be noted that the existing tendency of the population to age is a reality of today and encourages society to seek new ways of life in these circumstances. Aging is no longer seen as a problem, but rather as a challenge and an opportunity for society to respond and take timely adaptation measures. The international community is making significant efforts to create a legal framework, develop standards, and develop international cooperation to ensure a decent old age for the elderly. The task for governments is to implement international norms into national legislation and to optimize national measures in this area. The field of healthcare for the older personsis the most sensitive, as it is a question of a decent standard of living, so it needs a balanced strategy, which should include: disease prevention (diagnosis, medical care, etc.); development, improvement, introduction of an affordable and inexpensive system of long-term care with the involvement of the elderly themselves in this work and training of specialists who will work in this field; training of persons who informally care for the elderly; regular independent monitoring of long-term care services, based on clear principles and rights that older people can exercise on their own; giving preference to home care; creation of appropriate services to provide advice, psychological, legal assistance to the elderly. It is also important for society to be aware of aging in order to understand the problems and not to cause repeated psychological trauma to the older persons so they don't feel like a "burden" for society, rather than full members. ; Статья посвящена актуальным вопросам в области обеспечения права на здоровье пожилых людей с учетом современных реалий. В частности, в ней акцентируется внимание на существующих проблемных аспектах сквозь призму права на достойное обращение и автономию. Исследована проблематика жестокого обращения с лицами пожилого возраста, которое негативно влияет на состояние их физического и психического здоровья; оказания паллиативной помощи, способствующей улучшению качества жизни пациентов с заболеваниями, ограничивающими продолжительность жизни; сосредоточено внимание на проблеме деменции, являющейся одной из основных причин инвалидности и зависимости среди пожилых людей во всем мире; учитывая то обстоятельство, что пожилые люди находятся в группе высокого риска в условиях COVID-19, акцентировано на защите этой категории лиц. Проведен анализ существующей правовой основы сотрудничества государств по преодолению негативных тенденций в оказании помощи пожилым людям в области здравоохранения, в частности: Торонтская декларация о глобальном предотвращении жестокого обращения с пожилыми людьми, Конвенция Совета Европы о предотвращении насилия в отношении женщин и домашнего насилия и борьбе с этими явлениями, Европейская социальная хартия (пересмотренная), Межамериканская конвенция о защите прав пожилых людей, Глобальный план действий сектора общественного здравоохранения по реагированию на деменцию 2017-2025 гг., документы Всемирной организации здравоохранения в отношении деменции. Кроме того, сосредоточено внимание на рекомендациях, принятых главными органами международных межправительственных организаций, в частности, Комитета министров Совета Европы, и международных договорных органов в этой сфере – Комитета по экономическим, социальным и культурным правам, Комитета по ликвидации дискриминации в отношении женщин (Общая рекомендация № 24, Общая рекомендация № 27) и др. Сделаны соответствующие выводы и рекомендации. ; Вступ. Стаття присвячена актуальним питанням у галузі забезпечення права наздоров'я літніх людей з урахуванням сучасних реалій. Зокрема, в ній акцентованоувагу на існуючих проблемних аспектах через призму права на гідне поводження й автономію. Досліджено проблематику жорстокого поводження з особами похилого віку, що негативно впливає на стан їх фізичного і психічного здоров'я; надання паліативної допомоги, яка сприяє поліпшенню якості життя пацієнтів із захворюваннями, що обмежують тривалість життя; зосереджено увагу на проблемі деменції, яка є однією з основних причин інвалідності і залежності серед літніх людей в усьому світі; зважаючи на ту обставину, що літні люди знаходяться у групі високого ризику під час COVID-19, зосереджено увагу на захисті цієї категорії осіб під час пандемії. Основні результати дослідження.Проведено аналіз існуючої правової основи співпраці держав щодо подолання негативних тенденцій в наданні допомоги літнім людям у галузі охорони здоров'я, зокрема: Торонтська декларація про глобальне запобігання жорстокого поводження з людьми похилого віку, Конвенція Ради Європи про запобігання насильству стосовно жінок і домашньому насильству та боротьбу з цими явищами, Європейська соціальна хартія (переглянута), Міжамериканська конвенція про захист прав людей похилого віку, Глобальний план дій щодо заходів громадської охорони здоров'я у відповідь на деменцію на 2017-2025 рр., Керівництво «На шляху до плану по деменції», Керівні принципи Всесвітньої організації охорони здоров'я щодо зниження ризику когнітивних функцій і деменції. Крім того, зосереджено увагу на рекомендаціях головних органів міжнародних міжурядових організацій, зокрема, Комітету міністрів Ради Європи, та міжнародних договірних органів у цій сфері – Комітету з економічних, соціальних і культурних прав, Комітету з ліквідації дискримінації щодо жінок (Загальна рекомендація № 24, Загальна рекомендація № 27) тощо. Зроблено відповідні висновки і рекомендації. Висновки.Слід констатувати, що існуюча тенденція населення до старіння, є реаліями сьогодення і спонукає суспільство до пошуків нових шляхів існування за цих обставин. Старіння вже не розглядається як проблема, а скоріш за все, як виклик і можливість суспільства зреагувати та прийняти своєчасні заходи по адаптації. Міжнародним співтовариством докладаються суттєві зусилля щодо створення правової основи, розробки стандартів, розвитку міжнародної співпраці задля забезпечення літнім людям гідної старості. Завдання для урядів полягає в імплементації міжнародних норму у національне законодавство та оптимізація національних заходів у цій сфері. Галузь охорони здоров'я для літніх людей є самою чутливою, оскільки мова йде про гідне існування, тому вона потребує виваженої стратегії, складовою якої повинна стати: профілактика захворювань (проведення діагностики, медичного догляду тощо); розробка, удосконалення, запровадження доступної і недорогої системи довгострокового догляду із залученням до цієї роботи самих літніх осіб і підготовка фахівців, які працюватимуть у цій сфері; здійснення навчання осіб, які неофіційно доглядають за літніми людьми; здійснення регулярного незалежного моніторингу послуг з довгострокового догляду, побудованому на чітких принципах і правах, які літні люди можуть реалізовувати самостійно; надання переваги догляду на дому; створення відповідних служб з наданням консультаційної, психологічної, правової тощо допомоги літнім людям; суттєве значення має й поінформованість суспільства про старіння з метою розуміння проблематики і незавдання повторної психологічної травми літнім людям у результаті якої вони відчуватимуть себе «тягарем» для суспільства, а не повноцінними його членами.

ISSUES OF ECONOMIC AVAILABILITY OF MEDICAL DRUGS IN AFRICAO. Ievtushenko, Osama Abuzayid Mohamed Nur AhmedNational University of Pharmacy, Kharkiv city INTRODUCTIONCurrently Africa with its highest index of diseases in the world maintains a serious dependence of imported medical drugs. Imported production comprises from 80 to 100% in some African countries, despite the fact that the incomes of population and medical support system doesn't correspond completely with the consumption of expensive medical drugs (further MD). There is an extremely severe problem of physical and economical availability of MD in theEastern Mediterraneancountries. OBJECTIVE STATEMENT OF THE ARTICLEIn connection with the above mentioned, the purpose of the work is the analysis of economic availability of MD in theEastern Mediterraneancountries, and also the comparison of the received indexes with the indexes of European countries. In the researches it has been participated such countries as Sudan, Egypt, Lebanon, Uganda and Ethiopia. To compare the received indexes of availability and their level determination it has been made the comparison of indexes among themselves and also with the indexes of the developed country of the European continent. As a standard it has been taken Germany as a country with one of the most developed pharmaceutical markets in the world and the strongest health care system, which finances medical and pharmaceutical assurance among all the EU countries.RESEARCH METHODSIn this work it has been taken into account the pharma-economic methods of analysis and methodology of the World Health Organization (WHO) and Health Action International (HAI) «Prices determination of MD, their availability and price of components ", data obtained during this methodology examination [1, 4, 6-11]; information from regional and national sources [12]; and also the scientific publications on this topic [2,3,5]. Data concerning prices for medicines and the cost of treatment course were obtained in studying of retail prices in pharmacies of the above mentioned countries. In the total examination it has been studied the MD which are used for the treatment of chronic diseases and which are included in the international list recommended for the continuous monitoring (study) by the World Health Organization . RESULTS AND IT DELIBERATION According to WHO recommendations, it has been selected the basic MD for the treatment of 14 the most common diseases, which will allow to make the international research. Also it is allowable to include in this list of MD the most important for the treatment of specific diseases in certain countries. Yes, for the African countries such drugs are the remedies for the malaria treatment.In the study it has been participated the generic MD sold at the lowest price. Further it has been determined the economic availability of studied MD, taking into account the ratio of the treatment cost by this drug (according to the international treatment protocols) and the daily wage of unskilled low paid public officer in these countries.During the determination of economic accessibility of medicines it has been used the paying capacity adequacy ratio, which includes the lowest retail price of the drug (or the treatment course price), and the average salary for a certain period of time.The analysis shows that the availability of MD in some African countries is situated at the unsatisfactory level. Regarding the indicators of availability general perception, the lowest indicators hasSudan, the highest accessible indexes has Egypt. By comparison of the availability of MD in African countries and in Germany, for the diclofenac treatment course in Germany it is necessary to spend 0.24 of one day wages, and in Sudan - 5.3, which is higher in 22 times; for the paracetamol treatment the Sudan patients spend more in 10 times.Thus, the availability economic analysis of basic MD confirms thatEgyptandLebanonassist a relatively low cost of basic MD, which is close to the level of the European countries. Especially in Egypt, the major part of economic availability indicators of medical drugs corresponds to parameters of the country with the developed pharmaceutical market and a strong health care system and this is Germany. Thus, the indicators ofEgyptare almost identical with those ofGermanyat the prices of Diclofenac, Atenolol, Captopril, Glibenclamide, Ceftriaxone, Diazepam, and even lower - with Salbutamol, Amitriptyline, the antimalarial medical drugs.Thus, in Sudan is marked with the rather high prices and, consequently, low availability on a number of medical drugs such as Diclofenac, Paracetamol, Captopril, Simvastatin, Amitriptyline. Thus, patient inSudanneed spend in 22 times more of money to the diclofenac treatment than patients inGermany. A treatment will paracetamol will be in10 times more expensive, treatment with captopril will be in 7 times more expensive. Comparison of availability indexes in theSudanwith the African region countries is also accompanied by a situation where the indicators availability of MD are in 3 - 10 times worse than in other countries with similar health care system. The necessity of generic MD availability analyses, especially for the countries with the health care systems which are forming will help to make the fast and low priced determination of the availability level of medicines for the population, the timely reaction in case of indexes deterioration, the regulation of public policy of countries in the pricing field on MD as well as coordination of original and generic drugs use, which allow to reduce the budgetary costs of medical assistance without the quality loss.References1. Vyvchennya spozhyvannya likarsʹkykh zasobiv za anatomo-terapevtychno-khimichnoyu klasyfikatsiyeyu ta vstanovlenymy dobovymy dozamy (AT·S/DDD – metodolohiya): metod. rek. / A. M. Morozov, L. V. Yakovlyeva, A. V. Stepanenko ta in. – Kharkiv: Stylʹ-Yzdat. – 2013. – 34 s.2. Hromovyk B.P. Farmatsevtychnyy marketynh: teoretychni ta prykladni zasady / B.P. Hromovyk, H.D. Hasyuk, O.R. Levytsʹka. – Vinnytsya: Nova Knyha, 2004. – 464 s.3. Dovhun S. S. Otsenka stoymosty y ékonomycheskoy dostupnosty nootropnykh preparatov, naznachaemykh bolʹnym s ynsulʹtom / S.S. Dovhun // Sovremennye problemy nauky y obrazovanyya. – 2012. – № 2. – S. 33-39.4. Dumenko T. M. Vyvchennya dostupnosti osnovnykh likarsʹkykh zasobiv v Ukrayini: rezulʹtaty spilʹnoho proektu VOZ, NAI ta MOZ Ukrayiny / T. M. Dumenko, V. D. Pariy, L. B. Yakovleva, A. B. Zimenkovsʹkyy // Farmakoekonomika v Ukrayini: stan ta perspektyvy rozvytku: materialy VI naukovo-praktychnoyi konferentsiyi (m. Kharkiv, 22 lystopada 2013 r.) / redkol.: V.P. Chernykh ta in. – Kharkiv: Vyd-vo NFaU, 2013. – S. 180-181.5. Perehinetsʹ I. B. Dostupnistʹ osnovnykh likarsʹkykh zasobiv v Ukrayini: rezulʹtaty farmakoepidemiolohichnoho doslidzhennya (spilʹnyy proekt VOOZ, NAI ta MOZ Ukrayiny) / I. B. Perehinetsʹ, T. M. Dumenko. – Kyyiv, 23-24 zhovtnya 2013 roku. [Élektronnyy resurs]. – Rezhym dostupu: http://old.dec.gov.ua/site/file_uploads /ua/sem/7_rac_farm/4.pdf 6. Measuring medicine prices, availability, affordability and price components – 2ND edition. World Health Organization and Health Action International. – [Élektronnyy resurs]. – Rezhym dostupa:http://www.who.int/ medicines/areas/access/OMS_Medicine_prices.pdf 7. Database of medicine prices, availability, affordability and price components. [Élektronnyy resurs]. – Rezhym dostupa: http://www.haiweb.org/MedPriceDatabase/8. Medicine prices, availability, affordability & price components.Ukraine. Palliative care. [Élektronnyy resurs]. – Rezhym dostupa: http://www.haiweb.org/ medicineprices surveys/200709UAP/sdocs/EMP_Ukraine%20palliative%20Final.pdf9. Medicine prices, availability, affordability and price components. Ukraine. Survey date: March 2012. [Élektronnyy resurs]. – Rezhym dostupu: http://www.haiweb.org/medicineprices/surveys/201203UAE/sdocs/Summary_report_ukraine_mar2012.pdf 10. Medicine Prices, Availability, Affordability and Price Components in Sudan. Survey date: March 2012, Report date: April 2014. [Élektronnyy resurs]. – Rezhym dostupu: http://www.haiweb.org/medicineprices/surveys/201203SD /sdocs/Sudan_report_2012_FINAL.pdf 11. Medicine Prices, Availability and Affordability in Sudan. Report of a survey conducted in February – March 2013. [Élektronnyy resurs]. – Rezhym dostupu: [Elektronnyy resurs]. – Rezhym dostupu: http://www.haiweb.org/medicineprices /surveys/201302SD/sdocs/Sudan_survey_report_2013.pdf 12. Salah Ibrahim Kheder. Evaluating medicines prices, availability, affordability and price components inSudan / Salah Ibrahim Kheder, Hassan Mohamed Ali // Sudan Medical Monitor. – 2014. – Vol. 9, Issue 1. – P. 19-30.

ISSUES OF ECONOMIC AVAILABILITY OF MEDICAL DRUGS IN AFRICAO. Ievtushenko, Osama Abuzayid Mohamed Nur AhmedNational University of Pharmacy, Kharkiv city INTRODUCTIONCurrently Africa with its highest index of diseases in the world maintains a serious dependence of imported medical drugs. Imported production comprises from 80 to 100% in some African countries, despite the fact that the incomes of population and medical support system doesn't correspond completely with the consumption of expensive medical drugs (further MD). There is an extremely severe problem of physical and economical availability of MD in theEastern Mediterraneancountries. OBJECTIVE STATEMENT OF THE ARTICLEIn connection with the above mentioned, the purpose of the work is the analysis of economic availability of MD in theEastern Mediterraneancountries, and also the comparison of the received indexes with the indexes of European countries. In the researches it has been participated such countries as Sudan, Egypt, Lebanon, Uganda and Ethiopia. To compare the received indexes of availability and their level determination it has been made the comparison of indexes among themselves and also with the indexes of the developed country of the European continent. As a standard it has been taken Germany as a country with one of the most developed pharmaceutical markets in the world and the strongest health care system, which finances medical and pharmaceutical assurance among all the EU countries.RESEARCH METHODSIn this work it has been taken into account the pharma-economic methods of analysis and methodology of the World Health Organization (WHO) and Health Action International (HAI) «Prices determination of MD, their availability and price of components ", data obtained during this methodology examination [1, 4, 6-11]; information from regional and national sources [12]; and also the scientific publications on this topic [2,3,5]. Data concerning prices for medicines and the cost of treatment course were obtained in studying of retail prices in pharmacies of the above mentioned countries. In the total examination it has been studied the MD which are used for the treatment of chronic diseases and which are included in the international list recommended for the continuous monitoring (study) by the World Health Organization . RESULTS AND IT DELIBERATION According to WHO recommendations, it has been selected the basic MD for the treatment of 14 the most common diseases, which will allow to make the international research. Also it is allowable to include in this list of MD the most important for the treatment of specific diseases in certain countries. Yes, for the African countries such drugs are the remedies for the malaria treatment.In the study it has been participated the generic MD sold at the lowest price. Further it has been determined the economic availability of studied MD, taking into account the ratio of the treatment cost by this drug (according to the international treatment protocols) and the daily wage of unskilled low paid public officer in these countries.During the determination of economic accessibility of medicines it has been used the paying capacity adequacy ratio, which includes the lowest retail price of the drug (or the treatment course price), and the average salary for a certain period of time.The analysis shows that the availability of MD in some African countries is situated at the unsatisfactory level. Regarding the indicators of availability general perception, the lowest indicators hasSudan, the highest accessible indexes has Egypt. By comparison of the availability of MD in African countries and in Germany, for the diclofenac treatment course in Germany it is necessary to spend 0.24 of one day wages, and in Sudan - 5.3, which is higher in 22 times; for the paracetamol treatment the Sudan patients spend more in 10 times.Thus, the availability economic analysis of basic MD confirms thatEgyptandLebanonassist a relatively low cost of basic MD, which is close to the level of the European countries. Especially in Egypt, the major part of economic availability indicators of medical drugs corresponds to parameters of the country with the developed pharmaceutical market and a strong health care system and this is Germany. Thus, the indicators ofEgyptare almost identical with those ofGermanyat the prices of Diclofenac, Atenolol, Captopril, Glibenclamide, Ceftriaxone, Diazepam, and even lower - with Salbutamol, Amitriptyline, the antimalarial medical drugs.Thus, in Sudan is marked with the rather high prices and, consequently, low availability on a number of medical drugs such as Diclofenac, Paracetamol, Captopril, Simvastatin, Amitriptyline. Thus, patient inSudanneed spend in 22 times more of money to the diclofenac treatment than patients inGermany. A treatment will paracetamol will be in10 times more expensive, treatment with captopril will be in 7 times more expensive. Comparison of availability indexes in theSudanwith the African region countries is also accompanied by a situation where the indicators availability of MD are in 3 - 10 times worse than in other countries with similar health care system. The necessity of generic MD availability analyses, especially for the countries with the health care systems which are forming will help to make the fast and low priced determination of the availability level of medicines for the population, the timely reaction in case of indexes deterioration, the regulation of public policy of countries in the pricing field on MD as well as coordination of original and generic drugs use, which allow to reduce the budgetary costs of medical assistance without the quality loss.References1. Vyvchennya spozhyvannya likarsʹkykh zasobiv za anatomo-terapevtychno-khimichnoyu klasyfikatsiyeyu ta vstanovlenymy dobovymy dozamy (AT·S/DDD – metodolohiya): metod. rek. / A. M. Morozov, L. V. Yakovlyeva, A. V. Stepanenko ta in. – Kharkiv: Stylʹ-Yzdat. – 2013. – 34 s.2. Hromovyk B.P. Farmatsevtychnyy marketynh: teoretychni ta prykladni zasady / B.P. Hromovyk, H.D. Hasyuk, O.R. Levytsʹka. – Vinnytsya: Nova Knyha, 2004. – 464 s.3. Dovhun S. S. Otsenka stoymosty y ékonomycheskoy dostupnosty nootropnykh preparatov, naznachaemykh bolʹnym s ynsulʹtom / S.S. Dovhun // Sovremennye problemy nauky y obrazovanyya. – 2012. – № 2. – S. 33-39.4. Dumenko T. M. Vyvchennya dostupnosti osnovnykh likarsʹkykh zasobiv v Ukrayini: rezulʹtaty spilʹnoho proektu VOZ, NAI ta MOZ Ukrayiny / T. M. Dumenko, V. D. Pariy, L. B. Yakovleva, A. B. Zimenkovsʹkyy // Farmakoekonomika v Ukrayini: stan ta perspektyvy rozvytku: materialy VI naukovo-praktychnoyi konferentsiyi (m. Kharkiv, 22 lystopada 2013 r.) / redkol.: V.P. Chernykh ta in. – Kharkiv: Vyd-vo NFaU, 2013. – S. 180-181.5. Perehinetsʹ I. B. Dostupnistʹ osnovnykh likarsʹkykh zasobiv v Ukrayini: rezulʹtaty farmakoepidemiolohichnoho doslidzhennya (spilʹnyy proekt VOOZ, NAI ta MOZ Ukrayiny) / I. B. Perehinetsʹ, T. M. Dumenko. – Kyyiv, 23-24 zhovtnya 2013 roku. [Élektronnyy resurs]. – Rezhym dostupu: http://old.dec.gov.ua/site/file_uploads /ua/sem/7_rac_farm/4.pdf 6. Measuring medicine prices, availability, affordability and price components – 2ND edition. World Health Organization and Health Action International. – [Élektronnyy resurs]. – Rezhym dostupa:http://www.who.int/ medicines/areas/access/OMS_Medicine_prices.pdf 7. Database of medicine prices, availability, affordability and price components. [Élektronnyy resurs]. – Rezhym dostupa: http://www.haiweb.org/MedPriceDatabase/8. Medicine prices, availability, affordability & price components.Ukraine. Palliative care. [Élektronnyy resurs]. – Rezhym dostupa: http://www.haiweb.org/ medicineprices surveys/200709UAP/sdocs/EMP_Ukraine%20palliative%20Final.pdf9. Medicine prices, availability, affordability and price components. Ukraine. Survey date: March 2012. [Élektronnyy resurs]. – Rezhym dostupu: http://www.haiweb.org/medicineprices/surveys/201203UAE/sdocs/Summary_report_ukraine_mar2012.pdf 10. Medicine Prices, Availability, Affordability and Price Components in Sudan. Survey date: March 2012, Report date: April 2014. [Élektronnyy resurs]. – Rezhym dostupu: http://www.haiweb.org/medicineprices/surveys/201203SD /sdocs/Sudan_report_2012_FINAL.pdf 11. Medicine Prices, Availability and Affordability in Sudan. Report of a survey conducted in February – March 2013. [Élektronnyy resurs]. – Rezhym dostupu: [Elektronnyy resurs]. – Rezhym dostupu: http://www.haiweb.org/medicineprices /surveys/201302SD/sdocs/Sudan_survey_report_2013.pdf 12. Salah Ibrahim Kheder. Evaluating medicines prices, availability, affordability and price components inSudan / Salah Ibrahim Kheder, Hassan Mohamed Ali // Sudan Medical Monitor. – 2014. – Vol. 9, Issue 1. – P. 19-30.

Cette thèse de doctorat est composée de trois chapitres distincts et indépendants qui ont pour objectif d'analyser certaines politiques de santé au Québec notamment les incitatifs financiers, les délais d'attente et les soins à domicile sur la santé des patients et l'utilisation de services hospitaliers. Le premier chapitre porte sur l'impact des incitatifs financiers sur la santé des patients, spécialement le cas des soins spécialisés. Il faut noter de prime abord que la demande de soins de santé a beaucoup augmenté au Québec ces dernières années pour certains types de chirurgies. Cette augmentation, dont les causes sont multiples notamment les changements démographiques, a entraîné des temps d'attente plus élevés que les temps médicalement requis pour ces chirurgies. Pour résorber ce problème, le gouvernement québécois a mis en place en 2004 le Programme d'Accès à la Chirurgie (PAC), afin d'inciter financièrement les hôpitaux à pratiquer plus de chirurgies pour lesquelles les délais d'attente étaient plus importants. Ce programme a permis de diminuer la durée moyenne d'attente pour ces chirurgies, mais a aussi entraîné une augmentation des dépenses liées à ces chirurgies. Ces dépenses accrues étaient également dûes à certaines lacunes du programme. Une réforme majeure, qui consistait essentiellement à la modification des incitatifs financiers, a eu lieu en avril 2011, afin que le financement vienne appuyer la bonne pratique et le choix du plateau technique le plus adéquat. Notre étude, constituant une première évaluation de cette réforme, a pour but d'analyser l'impact de cette réforme sur la santé des patients, notamment les durées de séjour à l'hôpital après l'opération chirurgicale et les réadmissions après la sortie de l'hôpital. Notre application porte sur les chirurgies thoraciques et cardiovasculaires. Les résultats montrent une diminution significative des durées de séjour après l'introduction de la réforme et un impact non significatif sur les réadmissions urgentes. Dans le premier chapitre, les différentes politiques mises en places ont été initialement motivées par des délais d'attente excessifs. Pourtant, peu d'études ont analysé les impacts des délais d'attente sur la santé des patients au Québec. Tel est l'objectif du deuxième chapitre de la thèse, analyser si un délai d'attente élevé est associé à un risque de détérioration de la santé des patients. Nous utilisons des modèles empiriques pour analyser cette problématique. Nous introduisons le différentiel de distance du domicile du patient à l'hôpital le plus proche relativement à l'hôpital le plus proche parmi les hôpitaux avec de faibles délais d'attente comme variable instrumentale pour tenir compte de l'endogénéité potentielle des temps d'attente. Dans ce chapitre, nous analysons les variables de santé en termes de probabilité de réadmission urgente et de durée de séjour excédentaire (durée de séjour supplémentaire après la durée de séjour maximal recommandée). Les résultats montrent que les longs temps d'attente augmentent la probabilité d'être réadmis en urgence pour les patients qui ont eu une chirurgie de l'arthrose du genou, une chirurgie thoracique ou cardiovasculaire, une neurochirurgie, ou une chirurgie pour une tumeur de l'utérus. Il n'y a pas d'effet significatif des temps d'attente sur la probabilité de réadmission pour les chirurgies de l'arthrose de la hanche et des tumeurs de la prostate. Les longs temps d'attente augmentent également la durée de séjour à l'hôpital et les coûts d'hospitalisation après une chirurgie de l'arthrose du genou ou de la hanche. Le vieillissement de la population québécoise entraîne plusieurs enjeux cruciaux pour les services de soins de santé notamment les soins à domicile pour les personnes âgées (OIIQ, 2017). Les soins à domicile sont composés de tous les soins de santé que les établissements publics ou privés offrent aux individus à leur domicile. Ces services sont souhaitables pour toute personne qui a besoin de soins pour maladies chroniques, de soins palliatifs, de soins de réadaptation, de soins de fin de vie, ou des soins pour perte d'autonomie liée au vieillissement. Les soins à domicile pourraient constituer une alternative sécuritaire, à moindres coûts, aux soins de santé dans les hôpitaux. Les soins à domicile contribuent donc au maintien à domicile des personnes en offrant des services paramédicaux des infirmières, des aide-soignantes, coordonnés avec ceux des autres intervenants à domicile comme les kinésithérapeutes, les aides-ménagères, les auxiliaires de vie. Nous analysons dans le troisième iv chapitre, dans quelles mesures les services hospitaliers et les soins à domicile pour les personnes âgées sont substituables. Nous analysons également l'impact des soins à domicile sur l'admission dans les centres d'hébergement de soins de longue durée (CHSLD). Notre analyse montre que l'augmentation des soins à domicile pour les personnes âgées réduit la probabilité d'admission et la durée de séjour en urgence. L'effet des soins à domicile est plus prononcé chez les personnes âgées avec des pertes d'autonomie plus légères. Les résultats montrent également qu'une augmentation des soins à domicile réduit la probabilité d'être admis en CHSLD. ; This doctoral thesis is composed of three separate and independent chapters that aim to analyze certain health policies in Quebec, including financial incentives, waiting times and home care on patients' health and the use of hospital services. The first chapter focuses on the impact of financial incentives on the health of patients in Quebec, especially the case of specialized care. It should be noted, first of all, that the demand for health care has increased significantly in Quebec in recent years for certain types of surgery. This increase, which has many causes, including demographic changes, resulted in higher waiting times than the medically required times for these surgeries. To solve this problem, the Quebec government implemented in 2004 the Access to Surgery Program (ASP) to financially encourage hospitals to perform more surgeries for which waiting times were longer. This program allowed to reduce the average waiting time for these surgeries, but has also led to an increase in expenses related to these surgeries. These increased expenditures were also due to some weaknesses in the program. A major reform, which consisted mainly of modifying the financial incentives, took place in April 2011, so that the funding would support good practice and the choice of the most appropriate technical platform. Our study, which is a first evaluation of this reform, aims to analyze the impact of this reform on the health of patients, including the length of stay in hospital after surgery and readmissions post-discharge. The results show a significant decrease in length of stay after the introduction of the reform and a non-significant impact on urgent readmissions post-discharge within 30 days. In the first chapter, the various policies were initially motivated by excessive waiting times. Yet, few studies have analyzed the impact of wait times on patient health in Quebec. This vi is the purpose of the second chapter, to analyze whether a high waiting time is associated with a risk of deterioration of the patients' health. We use empirical models to analyze this problem. We introduce the differential distance from the patients' home to the nearest hospital relative to the nearest hospital among hospitals with low wait times as an instrumental variable to account for the potential endogeneity of the waiting time. In this chapter, we analyze health variables in terms of the probability of urgent readmission post-discharge within 30 days and excess length of stay (additional length of stay after the maximum recommended length of stay). The results show that long waiting times increase the likelihood of emergency readmissions for patients who had a knee surgery, a thoracic or cardiovascular surgery, a neurosurgery or a surgery for a tumor of the uterus. There is no significant effect of waiting times on the probability of readmission for hip and prostate surgeries. Long waiting times also increase the hospital length of stay and costs of hospitalization for knee and hip surgeries. The aging of the Quebec population is leading to many crucial issues for health care services, particularly home care for the elderly (OIIQ, 2017). Home care is composed of all health care that public or private institutions provide to individuals in their homes. These services are desirable for anyone who needs care for chronic illnesses, palliative care, rehabilitation care, end-of-life care, or care for loss of autonomy linked to aging. Home care could be a safe, low-cost alternative to health care in hospital. Home care, thus contributes to people to stay at home and receive paramedical services from nurses and care assistants, coordinated with those received from other home care providers such as physiotherapists, housekeepers and carers. In the third chapter, we analyze the extent to which hospital services and home care for the elderly are substitutes. We also analyze the impact of home care on admission to long-term care facilities (LTCFs). Our analysis shows that increased home care for the elderly reduces the probability of admission and the length of stay in emergency. The effect of home care is greater for seniors with less disabilities. The results also show that an increase in home care reduces the probability of being admitted to LTCFs.

La Bioética nos enseña que la medicina no solo debe comprometerse con la búsqueda del mayor beneficio para el paciente sino también a tener en cuenta sus intereses, respetando su identidad y su cultura, sin tratar de imponer opiniones de terceros, ya sean de carácter filosófico, moral, religioso o político. El considerable aumento en la expectativa de vida de nuestra población latinoamericana en los últimos 40 años y la creciente incidencia de enfermedades neurológicas que comprometen las funciones mentales como la enfermedad cerebrovascular y las demencias, han traído consigo la aparición de un nuevo e importante problema: ¿Cómo se deben tomar decisiones médicas en pacientes que han perdido la capacidad para tomar sus propias decisiones? El presente trabajo analiza los problemas bioéticos que surgen alrrededor de las decisiones médicas en sujetos con compromiso de sus funciones mentales o con deterioro cognitivo. Primero, en el MARCO DE ANTECEDENTES, se realiza una revisión de la literatura acerca de los problemas bioéticos encontrados en torno a las decisiones médicas en sujetos con compromiso de sus funciones mentales. Posteriormente, en el MARCO TEÓRICO CONCEPTUAL, se analizan los conceptos filosóficos relacionados (ser humano, persona, autonomía, dignidad humana y calidad de vida) con un enfoque al sujeto con compromiso de las funciones mentales, revisando las funciones mentales y su compromiso desde la medicina y la neurología, el proceso de toma de decisiones en medicina y su enfoque desde la neurociencia, así como también algunas propuestas de mejora actuales. Se revisa aquí también el abordaje bioético a la toma de decisiones en medicina, examinando este proceso desde varios aspectos bioéticos fundamentales y a través de los principales problemas que presentan estas decisiones en el sujeto con compromiso de sus funciones mentales al final de la vida, como la limitación del esfuerzo terapéutico, la eutanasia, el cuidado paliativo y la muerte digna, así como el abordaje actual que propone la medicina en estos casos, sus críticas y posibles alternativas desde una bioética integral. En tercer lugar, con el fin de intentar comprender mejor estos problemas, se realizó una investigación de tipo cualitativa interpretativa con enfoque de estudio de caso para explorar la percepción de los principales actores involucrados en el proceso, los médicos, mediante un trabajo de campo en un hospital general. En el MARCO METODOLÓGICO, se presenta en detalle el proceso metodológico empleado para el estudio, sus fundamentos, su diseño, la implementación del proceso y los aspectos éticos y bioéticos de la investigación. En el MARCO DE ANÁLISIS Y RESULTADOS se presenta el plan de análisis, el perfil de los médicos entrevistados y el análisis detallado de toda la información obtenida. Estos resultados se ilustran mediante un mapa conceptual que muestra una unidad hermenéutica con familias y categorías, las cuales se describen e interpretan a profundidad. La investigación realizada permitió establecer que existen factores relevantes que influyen en la toma de decisiones médicas en pacientes con compromiso de sus funciones mentales y que hay algunos problemas importantes en este contexto que fueron percibidos por los profesionales entrevistados. Algunos de estos factores se consideraron relevantes, ya que pueden influir marcadamente en la toma de decisiones médicas en estos pacientes. Entre ellos, fue notable la presencia del paternalismo médico. Finalmente, en CONCLUSIONES Y RECOMENDACIONES, se discuten los resultados a la luz de la investigación teórica efectuada y se comparan con hallazgos y conclusiones de estudios previos. Algunos de los factores encontrados en este estudio, que inciden en la toma de decisiones médicas en estos pacientes, se encontraron reportados en estudios previos, pero otros no. El proceso de toma de decisiones respecto al tratamiento médico en pacientes con compromiso de sus funciones mentales debe principalmente garantizar el respeto a la autonomía del paciente; este estudio demuestra que este es el núcleo fundamental del problema bioético en torno a las decisiones médicas en ellos. Se encontró que este problema bioético se origina tanto en factores dependientes de los profesionales de la salud y del sistema de salud, como en factores dependientes del propio paciente, de su familia y de la cultura. Se concluye que se deben promover medidas que permitan que las decisiones médicas se adhieran lo más posible a la voluntad del paciente, ya sea ésta obtenida por indagación a sus familiares o por conocimiento de las voluntades anticipadas. Es necesario crear espacios que permitan discutir las políticas existentes en el manejo de estos pacientes y buscar formas alternativas desde las cuales se puedan tomar decisiones en casos particulares, considerando una visión más holística del paciente. ; INTRODUCCIÓN _________________________________________________ 11 PLANTEAMIENTO DEL PROBLEMA, JUSTIFICACIÓN Y ALCANCES ______ 17 PROPÓSITO DEL ESTUDIO ________________________________________ 19 PRESUPUESTOS Y OBJETIVOS ____________________________________ 20 Objetivo General _____________________________________________________ 20 Objetivos Específicos _________________________________________________ 20 1. MARCO DE ANTECEDENTES ____________________________________ 21 1.1. ACERCA DE FACTORES NO MÉDICOS QUE INFLUYEN EN LA TOMA DE DECISIONES MÉDICAS _______________________________________________ 21 1.2. ACERCA DE LA TOMA DE DECISIONES MÉDICAS EN SUJETOS DE EDAD AVANZADA _________________________________________________________ 25 1.3. ACERCA DE LA TOMA DE DECISIONES MÉDICAS EN SUJETOS CON COMPROMISO DE SUS FUNCIONES MENTALES __________________________ 27 1.3.1. La Evaluación de la capacidad del paciente para tomar sus propias decisiones ___ 28 1.4. ACERCA DE LAS DECISIONES MÉDICAS CUANDO SE CONOCEN LAS PREFERENCIAS PREVIAS DEL PACIENTE _______________________________ 31 1.5. ACERCA DE LA INTERVENCIÓN DE LA FAMILIA EN LA TOMA DE DECISIONES MÉDICAS EN SUJETOS NO COMPETENTES __________________ 32 1.6. ACERCA DE LA PERCEPCIÓN DE LOS PROFESIONALES DE LA SALUD SOBRE LA TOMA DE DECISIONES MÉDICAS EN SUJETOS CON COMPROMISO DE SUS FUNCIONES MENTALES _______________________________________ 33 1.7. ACERCA DE LA ENSEÑANZA DE LA TOMA DE DECISIONES ÉTICAS EN MEDICINA __________________________________________________________ 34 1.8. ACERCA DE LA LEY EN LAS DECISIONES MÉDICAS EN PACIENTES CON COMPROMISO DE SUS FUNCIONES MENTALES __________________________ 38 1.8.1. La protección a la autonomía y a la discapacidad __________________________ 38 1.8.2. El Decálogo de los derechos de los pacientes de 1991 ______________________ 42 1.8.3. El consentimiento informado ___________________________________________ 43 1.8.4. Las voluntades anticipadas ____________________________________________ 45 2. MARCO TEÓRICO CONCEPTUAL _______________________________ 49 2.1. LOS CONCEPTOS DE SER HUMANO, PERSONA, AUTONOMÍA, DIGNIDAD HUMANA Y CALIDAD DE VIDA _________________________________________ 49 2.1.1. Los conceptos de ser humano y persona _________________________________ 49 2.1.2. El concepto de autonomía ____________________________________________ 52 2.1.3. Autonomía y Dignidad ________________________________________________ 53 2.1.4. La dignidad desde otras perspectivas ____________________________________ 55 2.1.5. El concepto de Calidad de vida _________________________________________ 57 2.2. LAS FUNCIONES MENTALES Y SU COMPROMISO ___________________ 59 2.2.1. El sujeto con compromiso de sus funciones mentales _______________________ 61 2.2.2. La vulnerabilidad ____________________________________________________ 61 2.2.3. La irreversibilidad ___________________________________________________ 62 2.3. EL ABORDAJE DEL PACIENTE EN MEDICINA _______________________ 63 2.3.1. El modelo médico tradicional __________________________________________ 63 2.3.2. La propuesta holística al abordaje del paciente ____________________________ 68 2.3.3. El abordaje holístico al paciente con compromiso de sus funciones mentales ____ 69 2.3.4. El abordaje al paciente neurológico desde la perspectiva de Oliver Sacks _______ 73 2.4. LA TOMA DE DECISIONES _______________________________________ 77 2.4.1. El proceso de Toma de decisiones desde la Neurociencia ___________________ 79 2.4.2. Las emociones y la toma de decisiones __________________________________ 79 2.4.3. Neurobiología de la toma de decisiones __________________________________ 81 2.4.4. Las decisiones morales _______________________________________________ 84 2.4.5. La toma de decisiones en medicina _____________________________________ 85 2.5. LA BIOÉTICA Y EL PROCESO DE TOMA DE DECISIONES MÉDICAS ____ 88 2.5.1. Ética, Bioética y Neuroética ___________________________________________ 88 2.5.2. Problema y Dilema Bioético ___________________________________________ 90 2.5.3. La ética hipocrática __________________________________________________ 90 2.5.4. Los principios bioéticos _______________________________________________ 91 2.5.5. El cambio de paradigma en bioética _____________________________________ 94 2.5.6. Los comités de bioética clínico-asistenciales ______________________________ 96 2.5.7. Problemas bioéticos más importantes asociados a la toma de decisiones médicas en sujetos no competentes _____________________________________________________ 96 3. MARCO METODOLÓGICO ____________________________________ 107 3.1. DISEÑO METODOLÓGICO DEL ESTUDIO DE CAMPO _______________ 109 3.2. LUGAR DEL ESTUDIO __________________________________________ 109 3.3. DESCRIPCION Y SELECCIÓN DE LOS SUJETOS PARTICIPANTES ____ 110 3.4. TÉCNICAS DE RECOLECCIÓN DE LA INFORMACIÓN _______________ 111 3.4.1. La observación ____________________________________________________ 111 3.4.2. Entrevista semiestructurada __________________________________________ 112 3.4.3. Recolección de la información ________________________________________ 117 3.5. CONSIDERACIONES ÉTICAS ____________________________________ 118 4. MARCO DE ANÁLISIS Y RESULTADOS _________________________ 119 4.1. PLAN DE ANÁLISIS ____________________________________________ 119 4.2. PERFIL DE LOS ENTREVISTADOS _______________________________ 119 4.3. PROCESAMIENTO DE LAS ENTREVISTAS ________________________ 121 4.4. ANÁLISIS DE LAS ENTREVISTAS ________________________________ 122 4.4.1. Mapa conceptual de la unidad hermenéutica _____________________________ 123 4.4.2. Primera familia: Relación e interacción entre actores involucrados ____________ 124 4.4.3. Segunda familia: Factores generadores de problemas _____________________ 133 4.4.4. Tercera familia: Factores relevantes en la toma de decisiones _______________ 146 5. DISCUSIÓN DE LOS RESULTADOS DE LA INVESTIGACIÓN DE CAMPO 162 6. CONCLUSIONES Y RECOMENDACIONES _______________________ 169 6.1. Acerca de los antecedentes revisados ____________________________ 169 6.2. Análisis conceptual ____________________________________________ 171 6.3. Análisis de los resultados de la investigación ______________________ 175 6.4. SIGNIFICACIÓN, APORTES Y LIMITACIONES ______________________ 177 7. ANEXOS ___________________________________________________ 178 7.1. ANEXO 1: CONSENTIMIENTO INFORMADO ________________________ 178 7.1.1. Explicación consentimiento informado __________________________________ 178 7.1.2. Hoja de Consentimiento informado para el profesional _____________________ 180 REFERENCIAS BIBLIOGRAFICAS _________________________________ 181 ; Bioethics teaches us that medicine must not only commit itself to the search for the greatest benefit for the patient but also to take into account their interests, respecting their identity and culture, without trying to impose the opinions of third parties, whether of a philosophical nature, moral, religious or political. The considerable increase in the life expectancy of our Latin American population in the last 40 years and the increasing incidence of neurological diseases that compromise mental functions such as cerebrovascular disease and dementias, have brought with it the appearance of a new and important problem: ¿¿ How should medical decisions be made in patients who have lost the ability to make their own decisions? The present work analyzes the bioethical problems that arise around medical decisions in subjects with compromised mental functions or cognitive impairment. First, in the BACKGROUND FRAMEWORK, a review of the literature is carried out on the bioethical problems found around medical decisions in subjects with compromised mental functions. Subsequently, in the CONCEPTUAL THEORETICAL FRAMEWORK, the related philosophical concepts (human being, person, autonomy, human dignity and quality of life) are analyzed with a focus on the subject with commitment to mental functions, reviewing mental functions and their commitment from the medicine and neurology, the decision-making process in medicine and its approach from neuroscience, as well as some current proposals for improvement. The bioethical approach to decision-making in medicine is also reviewed here, examining this process from several fundamental bioethical aspects and through the main problems that these decisions present in the subject with compromise of their mental functions at the end of life, such as limitation of the therapeutic effort, euthanasia, palliative care and dignified death, as well as the current approach proposed by medicine in these cases, its criticisms and possible alternatives from a comprehensive bioethics. Thirdly, in order to better understand these problems, a qualitative interpretive research was carried out with a case study approach to explore the perception of the main actors involved in the process, the doctors, through field work in a general hospital. In the METHODOLOGICAL FRAMEWORK, the methodological process used for the study, its foundations, its design, the implementation of the process and the ethical and bioethical aspects of the research are presented in detail. The ANALYSIS AND RESULTS FRAMEWORK presents the analysis plan, the profile of the doctors interviewed and the detailed analysis of all the information obtained. These results are illustrated by a conceptual map that shows a hermeneutical unit with families and categories, which are described and interpreted in depth. The research carried out allowed to establish that there are relevant factors that influence medical decision-making in patients with compromised mental functions and that there are some important problems in this context that were perceived by the professionals interviewed. Some of these factors were considered relevant, since they can strongly influence medical decision-making in these patients. Among them, the presence of medical paternalism was notable. Finally, in CONCLUSIONS AND RECOMMENDATIONS, the results are discussed in light of the theoretical research carried out and compared with the findings and conclusions of previous studies. Some of the factors found in this study, which influence medical decision-making in these patients, were reported in previous studies, but others were not. The decision-making process regarding medical treatment in patients with compromised mental functions must mainly guarantee respect for the patient's autonomy; This study shows that this is the fundamental nucleus of the bioethical problem around medical decisions in them. It was found that this bioethical problem originates both in factors dependent on health professionals and the health system, as well as in factors dependent on the patient herself, her family and culture. It is concluded that measures should be promoted that allow medical decisions to adhere as closely as possible to the will of the patient, whether it is obtained by inquiring their relatives or by knowledge of advance directives. It is necessary to create spaces that allow the discussion of existing policies in the management of these patients and seek alternative ways from which decisions can be made in particular cases, considering a more holistic view of the patient. ; Doctorado

The background study for the national strategy on social inclusion and poverty reduction 2015-2020 was produced under a RAS agreement with the Ministry of Labor, Family, Social Protection, and Elderly of Romania. The report is a companion volume of the strategy, adopted by the Romanian Government in May 2015, and summarizes the diagnostics and analyses carried out by the World Bank team to provide a sound empirical base for the strategy. Given the multi-dimensional nature of poverty, the report includes diagnostics and policy recommendations on employment, social protection, education, health, housing, social participation, as well as regional and rural development policies. The document is based on a combination of desk research, qualitative data analysis, new data collected by the World Bank team and analyses of administrative, census, and survey data. This included qualitative research (for example, case-studies in two counties, interviews with representatives of central governmental bodies, interviews with recipients and eligible potential beneficiaries of means-tested benefits and with social workers), and quantitative data collection and analysis (a census on social housing stock; census of frontline social workers; a consolidated database of physicians, representatives of the pharmacies, community nurses, and health mediators; administrative dataset with social services for elderly, social services for people with disabilities and specialized child protection services; analysis of poverty. The book is organized in four parts. The first part starts with an analysis of the trends in poverty and social exclusion over the past few years and with a poverty forecast for the next five years (2015 to 2020). The second part analyzes the sectoral policies that must be implemented to tackle the problems identified in the first part of the volume. The third part turns its focus to area-based policies and discusses regional disparities, urban-rural differences, and specific problems in small towns and villages, rural, and urban marginalized areas, and Roma and non-Roma communities. The fourth part discusses the actions needed to strengthen the capacity of the public system to reduce poverty and increase social inclusion.

Jamaica has made many notable achievements in the fight against HIV/AIDS, which include a robust treatment program and improved HIV prevention programs that increasingly focus on the key drivers of the HIV epidemic and which are based on evidence. These attainments have resulted in a sustained decline in the estimated incidence of HIV and in a reduction in AIDS mortality. The national response to HIV/AIDS in Jamaica is currently financed by the Government as well as by several external sources, including the World Bank, the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and the United States government. It is expected, however, that external financing will cease or be significantly reduced in the next two years. As a result, a substantial increase in domestic financing for the national HIV/AIDS response will be needed. However, public debt levels are high, and the country is feeling the repercussions of the global financial crisis, thus the availability of domestic resources is and will be very tight. Any shortfall in financing whether domestic, external or both will have serious implications for the delivery of HIV services. The Government of Jamaica requested this study so as to inform its future HIV/AIDS policy response. This study is one input in a series of actions that the Government will undertake to formulate a future sustainability plan and investment framework for the National HIV Program. This study was led and financed by the World Bank and conducted in collaboration with the Government of Jamaica and United Nations Programme on HIV/AIDS (UNAIDS). The study aimed to assess the sustainability of Jamaica's National HIV Program from a fiscal perspective. Specifically, the purpose of the study was to: 1) review current spending on HIV/AIDS and the sources of financing; 2) estimate the fiscal burden of the national HIV/AIDS response and assess the outlook for external financing of the HIV program; 3) project how the epidemic will unfold as well as what the costs would be under different potential scenarios; and 4) provide recommendations to inform policy decisions.

Issue 61.2 of the Review for Religious, 2002. ; Examen .Living with God Growing Older Religious Eife Perspectives MARCH APRIL 2002 VOLUME 61 NUMBER 2 Review for Relig4ous helps people respond and be faithful ~ to God's universal call to holiness by making available ~to them the spiritual legacies that flow from the charisms of CathOlic consecratea life. Review for Religious (ISSN 0034-639X) is published bimonthly at Saint Louis University by the Jesuits of the Missouri Province. Editorial Office: 3601 Lindell Boulevard ¯ St. Louis, Missouri 63108-3393 Telephone: 314-977-7363 ¯ Fax: 314-977-7362 E-Mail: review@slu.edu ¯ Web site: www.reviewforreligious.org Manuscripts, books for review, and correspondence with the editor: Review for Religious ¯ 3601 Lindell Boulevard ¯ St. Louis, MO 63108-3393 Correspondence about the Canonical Counsel department: Elizabeth McDonough OP Mount St. Mary's Seminary; Emmitsburg, Maryland 21727 POSTMASTER Send address changes to Review for Religious ¯ P.O. Box 6070 ¯ Duluth, MN 55806. Periodical postage paid at St. Louis, Missouri, and additional mailing offices. See inside back cover for information on subscription rates. ©2002 Review for Religious Permission is herewith granted to copy any material (articles, poems, reviews) contained in this issue of Review for Religious for personal or internal use, or for the personal or internal use of specific library clients within the limits outlined in Sections 107 and/or 108 of the United States Copyright Law. All copies made under this permission must bear notice of the source, date, and copyright owner on the first page. This permission is NOT extended to copying for commercial distribu-tion, advertising, institutional promotion, or for the creation of new collective works or anthologies. Such permission will only be considered on written applicatign to the Editor, Review for Religious. L VING OUR CATHOLIC LEGACIES Editor Associate Editors Canonical Counsel Editor Editorial Staff Advisory Board David L. Fleming SJ Clare Boehmer ASC Philip C. Fischer SJ Elizabeth McDonough OP Mary Afin Foppe Tracy Gramm Judy Sharp ~Adarmiaens G~.nadu dJoinan S. CFelling Sr. Raymond Marie Gerard FSP Eugene Hensell OSB Ernest E. Larkin OCarm Bishop Carlos'A. Sevilla SJ Miriam D. Ukeritis CsJ MARCH APRIL 2002 VOLUME 61 NUMBER 2 contents 118 feature Examen: Persons in Relationships Joseph A. Tetlow sJ provides new insights by focusing examen on our many personal relationships in daily life. 129 137 living with God No Rapine in the Holocaust: Eremitical Life Today Karen Karper Fredette surveys some of the different forms eremitical life has taken in a fresh flowering in church life today. Metaphysical Self in Other Mystical Traditions James J. Magee defines metaphysical self as one's self residing in God and God residing in it and then examines this term as it appears in Christian, Buddhist, Hindu, Jewish, and Muslim (Sufl) mysticism. 146 growing older Aging: Spiritually Present to the Burning Bush Geraldine M. Wodarczyk CSFN reflectively enters us into her six-year experience of living among her own congregation's aging and prayerful sisters. Review for Religious 166 Coping with Repetition: A Spirituality for Ministering to the Elderly Helen Jean Novy HM proposes some spiritual considerations to guide our responses to the repetitiousness of sick/elderly people. 169 religious ~i~e perspectives Medaille's "Means" and Religious Life's Renewal Joan Wagner ssJ focuses on six "means" derived from Father Medaille's writings that nourish religious community life. 183 The Decline of Religious Life: A Success Story Michael Dominic W. Ledoux OFM asks whether the next task for religious congregations is to let go of our hold on institutions and ministries and allow them to find a charism based upon their own stories and histories rather than being too strongly attached to religious communal stories. " 191 Membership and Leadership: An Organic Whole Beatrice M. Eichten OSF sketches out the patterns of interworking between leaders and members that enhance effective leadership in community life. flepar men s 116 Prisms 202 Canonical Counsel: Exclaustration: Further Considerations 211 Book Reviews March-April 2002 115 prisms Jesus' transfiguration was a favorite passage of the Jesuit paleontologist Pierre Teilhard de Chardin. With his own description of evo-lution progressing by crossing thresholds, he found the transfigured Jesus giving promise of crossing the threshold from being Jesus a marginal Jew to being the risen Christ Pantocrator. Whatever our response to evolutionary theory, the crossing of thresholds gives insight into words and images used to describe the mysteries of our Catholic faith. We seem to be unaware that in faith we have crossed a .threshold between commonsense language and language bursting with faith realities. For exam-ple, our scripture and prayer language in the Lenten and Easter seasons describes redemption as our being purchased at a price. Sometimes this has led to the preaching and imaging of God paying off the devil by Jesus' passion and death. So we--the human race-- were bought at the cost of Jesus' death in order to release us from the grip of the evil one. At other times, it seems that our language has seen God as being appeased or satisfied by the pain and suffering and blood shed by his Son. And we have wondered: What kind of God is this? The New Testament writers built upon the imagery of the Hebrew Scriptures and presumed a poetic under-standing of the religious world. Following Scripture and inspired by their own culture and times, theolo-gians, artists, and spiritual writers over the centuries have all contributed, with mixed results, to various ways of understanding and celebrating the central mystery of our salvation/redemption. In the United States, with R~view for Reli~o~s our sometimes sanitized religious worship removing us from devotional or emotional involvement, we still tend to slip back to a rather morbid focusing on physical pain and the shedding of blood in Lenten prayer and especially in the Holy Week triduum. Perhaps we find ourselves praying with an unhealthy fixation on pain and suffering as the way to God. We need to acknowledge that Holy Thursday has more than just a chronological precedence to Good Friday. The Eucharist is key to a solidly Christian approach to the Passion and Cross, one that is psychologically and spiritually sound and healthy. As St. Ignatius Loyola points out, Jesus' institution of the Eucharist is "the greatest mark of his love." We may be surprised that it is not Jesus' passion and death that help us to understand the Eucharist, but it is the other way around. The Eucharist shows us that Jesus holds nothing back from us in his love. He gives all that he is, sacramentally, to be the food and drink of our life, a life in the same bloodline as God. The word redeemer from its Hebrew derivation points to one taking on the obligations of blood or familial relationship. In itself redeemer does not imply pain or suffering. In the Hebrew Scriptures redeemer describes God in this familial relation to his chosen people. In Jesus we see God fulfilling the redemption of all peoples. By instituting the Eucharist, Jesus intends that the sacramental "nowness" of a blood relationship--the reality of our being adopted as God's sons and daughters--is to be celebrated in our daily living. We have the saying that "love costs." On Holy Thursday Jesus is showing sacramentally that he pays whatever it costs. That is how much he loves us and loves his Father. All our scrip-tural words about payment--ransoming us with his blood, pur-chasing us for a price, and so on--are images, sometimes confusingly used, looking towards the heartfelt truth that "love costs." But God is not paying off anyone. Jesus is not buying us back from the devil. It is the reality that "love costs." Jesus shows us the face of the God who does not count the cost to show his love. The Eucharist is our key to all the events of the Passion and Death. The key presents itself to us every time we look at the crucifix, every time we come forward for Communion. We are invited to cross a faith threshold, thereby experiencing anew God as Love and our identity as beloved. David L. Fleming SJ II7 March-April 2002 JOSEPH A. TETLOW feature Examen: Persons in Relationships You are likely to take account of your relationships with others whe'never you make the examen that St. Ignatius Loyola recommends. But why? Deep down in our own hearts, is there not plenty for God and me to do, without distractions from all sides? Actually, no, and for good reasons. The first reason comes from revelation. The human person is created in the likeness of a God who is One only and also Three Persons. This impenetra-ble mystery reveals to us that each of the Persons has identity only in and through the relations among the Three. It is in that likeness that your own "person" is modeled: you are a person only in your relationships. You will always be your mother's child and your father's offspring, always your siblings' brother or sis-ter. Moreover, it is in and through those relationships and others--teachers, neighbors, friends, even ene-mies- that you have become the person you are. To tell who Jesus of Nazareth is, Matthew begins with a genealogy. After telling about incarnation and birth, he goes right to Jesus' relationship with John the Baptist. Joseph A. Tedow SJ last wrote for us in September-October 1998. His address is Secretariate for Ignatian Spirituality; C.P. 6139; 00195 Roma Prati; Italy. Review for Religious Here is the second reason, closer to the everyday, for doing this exercise. You are always relating to your family, where per-sonhood (self) takes early shape and within which you continue to develop throughout life. You work with others, creating another set of day-to-day relationships. You may belong to a religious community, requiring you to develop a subtle lifelong set of relationships with persons whom God has chosen for you. You may belong to an apostolic team--parish, school, center, hospital, program--which requires cooper-ation and planning. All of these relation-ships require attention and prayer, since "we are all parts of one another" and together we make up the Body of Christ (Rm 12:5). As a very practical matter, this exercise might be a regular part of the prayer of those who work in apostolic partnerships. These are not simple in the church today, and a lot of "personality conflicts" disguise rather dis-orderly emotions and affects. Moreover, a lot of apostolic planning and community planning gets scuttled because of unre-flected- upon personal relationships. Teams and communities commonly blame "the process" for failed planning, when the actual problem is the relationships among the members. This examen, besides helping you know whom to thank God for, helps reveal and even heal such dysfunctional relationships. There are reasons why everyone would benefit from this special exercise. Every life today is plagued in some measure by individualism and alienation. One consequence affects the examen. Even when examining how you are getting along with others, you tend to focus on your own part in the relationship-- "How am I doing?"mand less on the other or on the relation-ship itself. This exercise challenges that focus on the self. It draws you to appreciate, for the right reasons, the people whom God has put into your life. "Each of us should think of our neighbors and help them to become stronger Christians" (see Rm 15:2). You enact individualism by thinking about yourself in isolation rather than in relationships with others. This examen asks you to look directly at the others in your life and the relationships that hold you together in Christ. Every life today is plagued in some measure by individualism and alienation. 119 March-April 2002 Tetlow * Examen Your relationships are where, and the deepest reason why, you exercise the virtues of prudence, justice, fortitude, and tem-perance and a host of others that are needed in order to love the way Jesus loves. Relationships, especially your family and community relationships but also your apostolic and job rela-tionships, are where you give in to sins of pride, covetousness, lust, envy, anger, gluttony, and sloth. If you find this hard to believe, perhaps you really need to do this exercise for a while. Here is the last and ultimate reason to use an examen specif-ically about your relationships: to make sure you are loving the way Jesus loves. Ignatius's Contemplation on Love--the more descriptive title would be "Contemplation to learn to love the way God loves"--begins with two prenotes. The first is that love "ought to manifest itself in deeds rather than in words," and the second is that love consists in constantly sharing, the lover and the beloved giving and receiving in open generosity (SpEx §231). This is how Jesus loves, always in relationship with the Other and the others. This exercise takes you directly to the issue whether you are loving as Jesus loved or are, in actu-ality, doing something else. Practicing the Exercise What is recommended here can be used as a single exercise, in which case it will require a long period of quiet time. It has been used profitably as the material for an eight-day retreat. Once you have gone through it for a while, however, you will know which parts of it to apply on a given day or occasion. You will know that sometimes you need to run through and examine all of your relationships: family, friends, work, community mem-bers, parish council, and so forth. At other times you will want to examine something that has happened, like a disagreement that left you far more unsettled than the matter deserved, or a deci-sion not to phone someone. This exercise will help you to uncover your true purposes, responses, and responsibilities. You can think about one partner or colleague; you can look at one group or committee or team. And so on. (The exercise as it is given here is divided into five sections, following its Ignatian inspiration.) First, taking time to thank God for those whom the Spirit has put into your life. A good way to do this is by making three columns Review for Religious on a sheet of paper. In the first, write some names (parent, sibling, friend, coworker), choosing those who belong to the period you are covering. If you are moving historically through your life, you would begin with parents or grandparents; if you are covering your life situation today, you would name the people with .whom you relate regularly. In the second column, across from each name, write the relationship you have with this person. You might want to add some details beyond a mere title. For instance, to "childhood friend" you might add "first date"; to parent, "died too young"; to colleague, "real partner." This assigning of titles may not be entirely simple. Choosing the appropriate title for a sibling.who is also a lifelong inti-mate friend and a business partner would take some thought--thought precisely about the relationship that you are given and choosing. Then, in the third column, for which you will need plenty of space, describe the relationship you have with this person. How has this person helped shape your self and your life, in the past or more recently? For instance, "rooted me in Christ" about a deeply religious and well-informed parent who established you in your faith. A trust-worthy friend may have told you the truth about yourself and your opinions and decisions, bringing you to know yourself before God. This step will give you grounds for a good deal of thanksgiving. Someone taught you to read and write. Someone showed you how to play your favorite sport. Someone intro-duced you to the Scripture.s. Someone challenged you to for-giveness because he or she not only hurt your feelings but did you harm. Someone may have betrayed you as Judas betrayed your Master. In this examen you probe how you relate to these people, not only how you feel about them, but especially what you have done and are doing in this relationship. In every instance your Creator and Lord is giving you an array of gen-erous gifts, sometimes surprising ones, freely and constantly, gifts for you to be thankful for. There is no gift as great as the gift of a faithful friend or lover who means only good for you. 12I March-April 2002 Tetlow ¯ Examen People know that there is, no gift as great as the gift of a faithful friend or lover who means only "good for you. So here is occasion to name the influences that such persons have had on your values and choices. You may well have adopted a friend's special perspective on the church or on parenting. You may become a member of a solid program because a friend invited you into it. You may have made a life-shaping choice under his or her influence. This point is well worth dwelling on, because through these relationships God is moment by moment creat-ing us as persons. Whom has God put into your life to give it shape? How have they shaped it? How do you relate to them? Here is the core of this exercise. Thanking God for these friends and relations will be incom-plete- and perhaps impossible--unless we consciously approve of how God is even now creating us and those we relate with. If you have an elderly parent who is still clear and keenly interested in your life, that is a great gift. An equally great gift is an elderly parent who depends entirely on you. If you have colleagues who depend on you, that is a gift. So is it when there are colleagues on whom you can depend. And sons or daughters will be their parents' sons or daughters forever, however they may be doing just now. The members of a religious community--real persons--are the living environment of each religious's living, growing, and dying. This exercise asks that you grow conscious of a reality we take so much for granted that we do not think about it at all. How often do you note that the sun rose this morning? How much do you value the water that comes from your tap? We treat our relationships rather like that. They are just there. They do not take thinking about except in special circumstances like an argument or a celebration. But every day each relation is a gift greater than today's sun, and each person given you to love and to be loved by is as indispensable to your thriving as the pure water that you drink without giving it a thought. Prayer Lord Jesus Christ, when you walked this earth you lived a family life with neighbors and friends. When you began to spread the Good News, You gathered around you seventy-two, and twelve, and three, who were precious to you, each in a special way, because Review for Religious the Spirit of Love gave them to you. Never has there been a companion better than you, a colleague more trusting and compassionate, a partner more giving and generous. Help me to know those many, those most special ones whom the Spirit of Love has given me in my life, and, with you, to thank the Father for the gift of them. Amen. Second, asking for attention, insight, and courage. Call on the Holy Spirit to let you pay attention to the others in your life. Ask to feel real interest in others, to get outside yourself and your interior concerns to see the people around you as they are. Ask to pay this attention in the way that God does, who hates nothing he has created and lets rain fall on just and unjust alike. Ask for insight into each person and into your relationship. Some are growing more important in your life, and perhaps some are growing away from you. Ask to know how. Ask the Spirit to let you see what you are looking at, and also to let you hear what you are listening to--from and about those whom the Spirit has given you. Finally, beg for the courage to see clearly and to affirm your connections to others, to feel how they have grown into your life and yourself. How have you reached out to them and perhaps risked something to know and love them? Ask boldness to assert your attachments to others, or your detachment and distanc-ing. Ask to be able to see how another or others are calling you to grow or, alternatively, how another or others are inviting you to be less authentic. Prayer Spirit of the risen Lord, who moved the Holy One to care for friends with his still-wounded hands and pierced heart, make me attentive to my friends even with my fearing toudh and wearing spirit. Open my eyes to see what gifts they really are; open my ears to hear what good they really mean to say. Brace my spirit to feel what they need me to feel. And, as you steeled the heart of Jesus while he lived misunder-stood and then betrayed, brace me now--while I find how I have fared in risking my self--to remain true to who I am ~and to be open in giving and receiving love. Amen. March-April 2002 Tetlow ¯ Examen Third, examining how relationships are doing. To begin with, stay with relationships that are going well. Simply look down the three columns you have written and note the name, relation-ship, and influence, and let yourself be contented in Christ with this love that falls into his pattern of loving. Using the columns is an effective way of examining relationships, but there are other ways. You could begin with the persons most closely related to you by blood and move out through extended family to friends. Or begin with the people you spend most of your daytime with, colleagues, coworkers, and so on. You could begin with superiors and move to those who answer to you. All of these steps could be limited to a smaller set of people if that would be useful at this time. Then come to those relationship that are not going well. Possible failures are sometimes glaring, like anger or blatantly selfish action, and sometimes quite subtle and complex. For every relationship is triune: one person, the relationship, and another person, and all three matter. Honestly and exactingly lay five templates (to be described below) over each conflicted or faltering relationship. As you con-template your relationship with each person under each tem-plate, demand an account of yourself, for failures in relationships show up in many ways and manifest many personality limitations or flaws, or simple sins. For instance, perhaps you find yourself saying negative things about an old friend's character. What has happened in this r~lationship and what is your responsibility for it? What are you doing or failing to do that damages the rela-tionship, or the mission you share with this person (or persons)? These failures or dysfunctions can be variously accounted for. One way is by looking at them under five categories (which I borrow from Roberta Gilbert's Extraordinary Relationships). The categories will help you look clearly and honestly at any fal-tering relationship. They will demand that you take your respon-sibility for what you have done, what you are doing, what you must do, to make this relationship a strong and holy one. The Templates 1. Conflict. You cannot come to agreement with another in some serious matter. You have never got- Review for Religious ten over a rancorous argument. You answer each other with "yes, but." You are losing respect for the person. You question whether you can ever work together again. Any of these suggests a relationship of conflict, which is often a hot relationship. 2. Distancing. You hold each other at arm's length. You have become very polite to each other and a lit-tle standoffish. You rarely talk about anything serious; instead, you chat. You would deal as openly and warmly with a stranger. You would simply rather not have to pay attention to this person anymore. You are uncomfortable around him or her. This is distancing, and, though it seems to suggest that you have no relationship with this person, you have--a special one. 3. Cutting Off. You stay out of each other's way. You do not communicate even when you have to convey some information. You simply do not like this per-son. Your judgment is that this person is harming the family, community, apostolate. You would like to be rid of this person. This is a cutoff, and it is an intense relationship. 4. Excessive Mutual Dependency. You depend on each other, too much or far too much. One of you makes the decisions. One of you needs the emotional support of the other, and the other needs to give it. Others see you as a pair. You are cutting others out of this relationship, emotionally or practically. This is excessive dependency--in a way, too much of a relationship. 5. Triangling. You have an issue with another and, instead of going to the other, take it to a third person. You find yourself saying things about this person, not to him or h~r, but to others. You gossip about this person. You complain about his or her shortcomings to others, never to the person. Alternatively, you passively allow others to tell you things about this person which they ought to be saying to him or her. 6. Could there be another template? You may find a March-April 2002 Tetlow ¯ Examen better term for a ~elationship in your life that is faltering, a term that clarifies for you what you are doing and might do. The Applications When you are on a team with another, you are not free to remain unrelated. The only issue is how you will choose to relate: whether well or badly, creatively or destructively, and, indeed, holily or unholily--all the more, of course, within your own family or among those who have somehow become your friends. Each of the five templates names a relationship--dysfunc-tional, but a relationship. It is crucial to accept that you are related to a person even when you cut him or her off, or are constantly arguing and debating with him or her, or when you are triangling. Humility demands--since it is truth--that you affirm your own contribution to making a relationship bad, or your cooperation in any dysfunctional relationship. Each of your relationships will have its own intensities, its own occasions, its own mixture of the apostolic, social, intel-lectual, affective, and so on. Each lays on you the light yoke of responsibility to accept the relationship as a gift from God, who is giving you freedom and the chance to love as God loves. When you find that one of the templates describes a current relationship, you will have to look into your heart more deeply to find out what is going on. At the same time, you will have to keep aware that the relationship has its own life and tempo, and that there is always "the other" or "the others." Prayer Jesus of Nazareth, my good brother, you worked with many and loved many. You loved aging laborers and the idle rich. You loved holy sisters and disrep-utable women. You worked with tax collectors and scribes. You chose partners who doubted and one who betrayed. You chose them, accounted for your choices to the Father, and stood by your friends to the end. Let me find my way in sureness and in risk, and give me courage to name those I relate to and clarity to know our shared responsibility. Help me to Review for Religious give my account to the Father and to stand by my friends to the end. Amen. Fourth, asking forgiveness for your sins and healing for those you have wounded and for yourself. "Forgive us our trespasses as we forgive those who trespass against us." This is the only condi-tion in the prayer Jesus taught. You cannot overestimate the weight of forgiving others. Yours, after all, is "the ministry of reconciliation," for you are in mission with Jesus Christ. You cannot expect forgiveness and the experience of reconciliation, except to the extent that you have forgiven and become recon-ciled with others. This is no trivial matter, and as good a reason as any to make an examen something like this one. Pray for those whom you have failed, or offended, or hurt. You need to beg the Spirit of Love to make up for your short-comings. Prayer Holy Triune God, in you, giving and taking barely differ since both are done as love. I have taken and not given. I have given what I did not mean to give and not given what I wish I had, so far, so very far, am I from loving as you love. Grant'me to be close to you in this, at least: that I forgive wholeheartedly those who wound me, as Jesus forgave those who wounded him. And then I ask that you forgive me and make up for all that I have left undone. Amen. F~h, choosing to do one thing tomorrow. You are wise to choose a single act to do, a concrete act like making a phone call (some-times the hardest thing you will do that day) or writing a note. Your discernment brings you to see how you can enact your gratitude to God for the people in your life. You take responsi-bility for your part in the relationship, not trying to redeem, but only to help the other and to bring him or her closer to Christ. You may need to focus on one person: to reconcile, to praise or thank, to enjoy being with. You may need to focus on one group of people like your family or community or colleagues. You may need to focus on yourself: to accept that God is making you a unique lover, to accept others' acceptance of you as you are; or, alternatively, y6u may need to address some habit that you see aggravates others or turns them off. Or you may I27 March-~tprll 2002 Tetlow ¯ Examen need to see that you really have entered into in a new relation-ship. Or you may need to get ready for a meeting by spending precious time really preparing for it or praying that you.do well. Finally, you may need to focus on some concrete event that is coming up: an interview, a meeting, a confrontation. Or you may need to focus on some long-term development in a relarionship--unsettling conflict, growing distance, emotional-ities-- so that you can take some concrete action. In all of these focuses, you are trying to keep Jesus' own commandment, "Love one another the way I have loved you." Prayer 0 Lord, reconciler of us to ourselves, the whole world and all rime would barely hold all the acts that love demands of us. I beg you to accept the little act that for this time is what I can and would do to learn to love like you. Amen. Annunciation Holy one, favored one, the Lord is with you. Be it bright angel's word or voices in the dark or cannonball or caress, any manner of invitation is prelude to Yes Holy ones, favored ones, the Lord is with us. Eugene Cartier Review for Religious KAREN KARPER FREDETTE No Rapine in the Holocaust: Eremitical Life Today '~e what you are called to be--a passionate seeker of God through continual prayer that allows 'no rapine in the holocaust,'" declares a woman in her seventies dwelling in a rural hermitage in Massachusetts. She emphasizes the total dedication she deems necessary for her chosen vocation--that of a hermit. This apo-dictic statement is culled from 140 responses to a ques-tionnaire sent to 600 hermits and solitaries. The survey was circulated by an international newsletter for her-mits, "Raven's Bread: Food for Those in Solitude." Replies flowed in from such diverse places as New Zealand, French Canada, the Philippines, Bavaria, Ireland, Mexico, and forty of the fifty United States. This twenty-three percent response rate is con-sidered a phenomenal return on a survey and, of itself, says something significant about eremites. Interviewing a single hermit is a rare event; taking the pulse of large enough numbers to determine trends would be an impossible task if eremites themselves were the aloof, people-hating individuals portrayed in popular literature. This survey reveals, however, that Karen Karper Fredette writes from 18065 Highway 209; Hot Springs, North Carolina 28743. 129 March-April 2002 Fredette * No Rapine in the Holocaust a lifestyle seasoned by hours of solitary prayer produces human beings distinguished by hospitality of spirit and a rare compassion. The essential hiddenness of eremiticat life is achieved by blending into one's surroundings. Recent History of Eremitism Even before Vatican Council II, a movement toward solitude and eremitical living had been noted. An historical but almost forgotten intervention at the council by Bishop Remy de Roo initiated a process that resulted in a new canon (c. 603) being written into the revised'Code of Canon Law that appeared in 1983. Bishop de Roo expressed his con-viction that the renewed vitality of the eremitical calling "indicates a special influence of the Holy Spirit, who inspires initiatives beneficial to the church and the modern world." Additionally, de Roo made the prophetic point that recognition of hermits would correct the impression that the practice of poverty, chastity, and obedience is limited to those living communal religious life. The myriad forms of hermit life reported in the recent survey prove the validity of this forecast. When an ancient vocation is recovered, old modalities often prove inadequate and new styles are fashioned. But can one devise a single expression for a call that transcends definitions of religious groups and flourishes among a devout and' occa-sionally unchurched fringe of society? What demographics, if any, can be assigned to an amorphous and largely hidden sub-culture that owns no common affiliation--nor desires any? In an effort to assess the state of eremitical life in the 21st century, the recent questionnaire invited hermits to draw their own demo-graphics. The results have been illuminating and inspiring. ¯ For some of us, a hermit may be living in the next apartment or down the street. Contrary to the caricature of hermits in their far caves, only three out of 140 reporting solitaries live in the "wilderness." A large number (31 percent) dwell in rural areas, but even more (43 percent) are to be' found in urban or Review for Religious suburban settings. Eight of those responding to the survey have chosen a site in the inner city. The essential hiddenness of eremitical life is achieved by blending into one's surroundings in such a way as,~to pass unnoticed even by one's neighbors. Many hermits abhor being singled out and so avoid any identifying sign of their inner dedication to solitude. Others, however, accepting the value of witnessing to a transcendent Reality in our midst, choose a simple habit and seek a recognized status within the church. Their countercultural stance is not militant, but rather a silent encouragement to others that a dif-ferent life is possible from that preached by an all-pervasive consumer society. When and to Whom Does the Call Come? A woman living in the southeastern United States writes: "I first heard the 'call' when I was four years old. I did not know What it meant--I only knew that it shook me to my founda-tion. I married, bore two children, and became a single mother. In my studies for clinical psychology, I discovered the works of Carl Jung. My inner life began shouting for attention. I listened. I shut down my practice, moved, got the children on their feet, and became a solitary. That was twenty years ago." A woman in the Philippines says, "Friends thought I was a fool to give up a secure full-time teaching position in a univer-sity, which sadly didn't leave me space and energy to pursue contemplative living--the one thing that gave meaning to all the rest." A married hermit living in California says, "I was a Hindu monk for five years, but the community did not support my attraction to hermit life." Ninety-eight women and forty-two men responded to the Raven's Bread survey. One-third of these are in their fifties. One-fourth are in their sixties. Only six persons responding are in their thirties. Further data confirms that most received the eremitic call later in life rather than earlier. Twenty-seven percent of those responding said they entered an eremitic lifestyle in their fifties, and twenty percent in their forties. Only eighteen percent followed the call to solitude while in their twenties or thirties. Maturity and life experience are necessary before a person 131 March-April 2002 Fredette * No Rapine in the Holocaust can launch into the rigors of solitary living, though the desire may have been planted much earlier in life. This fact of mid-life transition is an echo of the ideal life-pattern espoused by many Eastern cultures. A person joins a monastery or becomes a monk, not at the beginning of life (except for a brief training period), but only after one has fulfilled family obligations and achieved a certain financial success that one then freely leaves behind. The initial results from the survey indicate that in the Western world the call to solitude replicates this wise rhythm. Good physical health and fitness are the norm among solitary dwellers. Forty-seven percent describe their health as "good," and thirty-eight percent claim "excellent" health. Mental and emotional stability radiate from the responses to the reflec-tion questions that accompanied the survey. For example, a Catholic priest in his fifties writes from an urban hermitage in California: "The grace and essence of solitary living is the abil-ity to live in and be continually conscious of the Presence of God, to become more aware of who one is, to become enlight-ened to see more and more with the vision of God, to struggle to live the compassion of God, to grow in serenity and peace-- in a word, to live the freedom of the children of God." Religious Affiliation and Status The largest number of respondents (92 of 140) are Roman Catholic, but the Anglican, Episcopal, Lutheran, and Baptist churches are also represented. Among the respondents we also find persons from the Society of Friends and Orthodox churches and from various Eastern mystical traditions as well. Of the Christian denominations, Catholicism has the most hermit-friendly atmosphere, but even here eremites frequently mention lack of support and outright discouragement of their aspirations. Of the ninety-two Catholic respondents, only seventeen had been recognized as hermits under canon 603; an additional six had professed a state of consecrated virginity under canon 604. The obstacle to canonical recognition most frequently cited by respondents was the indifference of bishops. Many local ordi-naries were suspicious and expressed unwillingness to allow per-sons to pursue church-sanctioned hermit life in their dioceses. Review for Religious In the United States, only three dioceses are reported in this sur-vey to have more than one hermit living according to canon 603. A woman living in an inner-city neighborhood in England says: "The one and only meeting I had with my present bishop (a Benedictine monk) lasted only a few minutes. I had pressured him into giving me an appointment and had waited eight months to see him. I asked if he would help me become publicly pro-fessed, and he said no. That was it, a monosyllable, no expla-nation, no hesitation, no interest, no concern. I had been living as a hermit for twelve years at that time." Sheila Richardson, who is working on her master's degree in canon law at the University of St. Paul in Ottawa, inquires pointedly: "Are bishops aware of canon 605? This canon requires diocesan bishops to strive to discern new gifts of consecrated life, assist promoters of such lifestyles, and protect these new forms by appropriate statutes." Eremitical life is flourishing without much active support from the establishment. This may well be a blessing, allowing persons seeking to live as hermits or solitaries freedom to devise the form of life that best expresses their aspirations without concern about standards only a select few can meet. Exploring the various categories of individuals who choose a predominantly solitary life, we find 67 single lay persons, 24 married people, 38 members of religious congregations, and 15 ordained ministers, male and female, from six different denominations. Catholic priests who are living as hermits often exercise a limited ministry among people living nearby. They have the permission of their local ordinaries to live in retirement from most of the demands of pastoral ministry and devote the larger portion of their time to the "works" of eremitical life in solitude. Others have established a rhythm of part-time ministry with a certain number of days each week spent in solitude. Another priest is searching: "I am now at the point of decision. I am looking for a hermit-loving bishop where I might support myself by celebrating weekend Masses and confessions, perhaps in some priestless parish. Beyond that, I would be free to live in my own cabin following my own hermit schedule." Being a member of a religious community, whether active or contemplative, does not guarantee understanding of or support March-April 2002 Fredette * No Rapine in the Holocaust for an eremitic calling--something which, incidentally, may arise after a person has faithfully pursued religious life for many years. Thirty-seven of the hermits responding to the survey are still members of religious congregations. But, of the laypersons now living as hermits, sixty percent were members of a religious con-gregation at an earlier stage in their journey. Half of the former religious women claim they left their community so they could follow their attraction to solitude. Many said they were deeply grieved by this "necessity" of departure. Only two of the male religious say that their reason for severing connections with their religious order was in order to pursue solitary life. In other words, twenty-five percent of the men who left religious life did so because they were unable to live solitary life within their com-munities; fifty percent of the women left for the same reason. The most surprising category to surface from an analysis of survey responses is that of married hermit. Strictly speaking, this is a contradiction in terms and one that is hard to justify. But, for those who so identify themselves, the vocation is real and valid. Of the twenty-three respondents who are married, not all claimed to be hermits, but more than half did so. In an effort to understand this phenomenon, the following question was posed: "If you are married and are attracted to solitude, how do you work this out with your spouse?" In reply a woman in Arizona said: "The working out of mar-riage and solitude contains., every contradiction that one can experience in making oneself vulnerable in love to God and the unfolding of God's call in another. Two people can be authen-tically called to solitude and to solitude with each other, but the expressions of it can be so very different. The sharing of phys'ical space has been of great pragmatic concern for us recently--how to arrange our home so it can facilitate simplic-ity of life, prayer, and solitude." A man in Connecticut said: "I decided to separate my own liturgy commitments from my marriage by rising each morning at three for my prayer schedule. Also, I go to bed a little before my spouse to be alone once more in prayer." A woman married to a permanent deacon said: "He shares my attraction to silence and solitude although his ministry is pastoral and mine is mainly prayer. Our small country parish requires very little contact with the people for me. I work qui- Review for Relig4ous etly and prayerfully in the background while he ministers to the people. Everyone seems to understand and accept this arrangement." A woman frankly confesses: "It [attraction to solitude] cre-ated great problems. The marriage ended because we could not work it out. We remained friends." Daily Lifestyles, Daily Problems One hundred and one of the 140 respondents to the sur-vey describe themselves as living alone with significant periods of solitude and prayer. Forty-four of these have a written sched-ule incorporating prayer, work, reading, and relaxation. Eighty-seven of the 140 respondents live an informal mix of these elements. Some of these noted that they had begun with a written schedule that gradually became a more flexible routine. Seventy-eight of the 140 re-spondents pray with others one or more times a week. The most frequent prayer-form cited was meditation. Almost ninety percent find daily periods of meditative prayer a necessity. Nearly as many include Eucharistic Liturgy as part of their daily or weekly prayer routine. Most respondents find special periods of retreat important. Almost half arrange for an "annual r~treat; some manage monthly or even weekly periods of retreat. Penitential practices preferred are fasting and vigils. Almsgiving is important, with forty-three percent giving either in cash or in kind. Thirty-six eremites have made public profession of the evan-gelical counsels. Thirty-eight have committed themselves pri-vately, their vows or promises witnessed by a church-related person. Almost all respondents (103) value spiritual direction, though many said that finding a spiritual guide has been diffi-cult. Forty-seven hermits function as spiritual guides for others. One hundred and one of the 140 respondents to the survey describe themselves as living alone with significant periods of solitude and prayer. 135 March-April 2002 Fredette ¯ No Rapine in the Holocaust The survey listed six areas that could prove problematic for eremites: housing, income, spiritual guidance, relationships with church representatives, physical health, and personal fears and insecurities. The most frequently cited problem is difficulties with church representatives; the next, finding adequate spiri-tual guidance. The expected difficulties of locating a suitable site and generating enough income had proved less trouble-some. In this third millennium of Christianity, eremitical life is experiencing a fresh flowering, with new blooms appearing on the ancient vine. Butthe essence remains the same: "For me, the grace of solitary living is Emptiness," a married hermit member of an oblate Benedictine community states categorically. "No rapine in the holocaust" continues to be the stark demand of solitary life. Lake's Edge At night I hear the motion of the lake. It sighs to its own heart. Foam frosts the weight of wetness flung toward the house where my light burns. I am waiting for the wind to bring the message that I long for, the meaning of breath and motion, and who it is that sends waves pulsing toward this empty shore. Kate Martin OSC Review for Religious JAMES J. MAGEE Metaphysical Self in Other Mystical Traditions Ion an article in this journal (1994), I examined the devel-pment of metaphysical self in the writings of eight Christian mystics, concluding with Thomas Merton's definition (1966, p. 180) referring to "the depths of people's hearts where neither sin nor desire nor self-knowledge can reach, the core of their reality, the person that each one is in God's eyes." In short, metaphysical self is the term for one's self residing in God and God residing in it. Respondents to the article took the occa- ¯ sion to point out that metaphysical se/fappears also in the writ-ings of mystics from other religious traditions and recommended that I enlarge the presentation by incorporating some of them. Since these correspondents were women religious more famil-iar than I with these various mystical traditions, I asked them to participate in a monthly online chat room to examine meta-physical self as it appears in Buddhist, Christian, Hindu, Jewish, and Muslim (Sufi) mysticism. Our group of nine has met for the past five years, and this article presents some of the riches these mystical traditions brought to our understanding of meta-physical self. Each month we decided upon two primary sources we would examine in common, one Christian and one from another James J. Magee has written nine articles for our journal, the last in 1994. He is professor of counseling and gerontology at College of New Rochelle; New Rochelle, New York 10805. March-April 2002 tradition. In addition, each of us read the historical and con-textuai introductions preceding the texts or a monograph explaining their specific themes and imagery. At the conclusion of this article is a bibliography of the sources that we found particularly fruitful. Each tradition has its own style, some directly didactic and others more metaphorical. Each elabo-rates upon metaphysical self with novel, arresting paradoxes and engaging imagery that invigorated our familiarity with our own Christian mystics. Each, too, emphasizes the following components of metfiphysical self: the relational, nondualistic rootedness of self in God; transcendent individuality; engaged detachment as an expression of metaphysical self. Throughout this endeavor we dealt with paradoxes and found the most exhil-arating paradox in the power of other traditions to confirm our Christocentric perspective. Residing in God's Unconditional Acceptance This brief sampling of Christian mystics illustrates the con-tinuing emphasis they placed on the-self-residing-in-God: From Meister Eckhart: The soul is so completely one with God that the one cannot be understood without the other. One can think heat easily enough without fire and the shining with-out the sun, but God cannot be understood without the soul nor the soul without God, so utterly are they one. (p. 309) It is God's pleasure and rapture to discover iden-tity, because he can always put his whole nature into it--for he is this identity itself. (p. 167) From Julian of Norwich: Our soul sits in God in true rest, and our soul stands in God in sure strength, and our soul is naturally rooted in God in endless love. (p. 188) Between God and our soul there is neither wrath nor forgiveness. For our soul is so wholly united to God that nothing can interpose . Though we find in ourselves anger, contention, and strife, still we are all mercifully enclosed in God's mildness and meekness. (p. 189) Review for Religious From Catherine of Genoa: My being is God;. my me is God. (W'ilber, p. 72) From Thomas Merton: We know God insofar as we become aware of ourselves as known through and through by him. We "possess" him in proportion as we realize ourselves to be pos-sessed by him in the utmost depths of our being . Our knowledge of God is paradoxically a knowledge not of him as the object of our scrutiny, but of our-selves as utterly dependent on his saving and merciful knowledge of us. (1969, pp. 103-104) Note how this same emphasis appears in the following excerpts from Jewish and Muslim mystics: From the Maggid of Mezhirech: Man's essence is only the soul that is within him, which is a portion of God above. Thus, there is nothing in the entire world except the Holy One. (Uffenheimer) From the Kabbalah: There is nothing that is not pervaded by the power of divinity. God is everything that exists, though every-thing that exists is not God .Nothing is devoid of its divinity. (Matt, 1995) From Rumi: Remember God so much that you are forg9tten, until you are lost in the Call, without distinction of caller and called. (Breton and Largent, p. 23). You are my face. No wonder I can't see you. (Breton and Largent, p. 168) From 'Abd Allah Ansari (Kwaja 'Abdullah Ansari): One went to the door of the Beloved and knocked. A voice asked, "Who is there?" He answered, "It is I." The voice said, "There is no room for Me and Thee." The door was shut. Mter a year of sOlitude and depri-vation, he returned and knocked. A voice from within asked, "Who is there?" The man said, "It is Thee." The door was opened for him. (p. 94) O God, I possess that mirror in which you are reflected. Rather, I am that mirror. You are not sepa-rate from me. (p. 196) From Fakhruddin 'Iraqi: 139 MarchoApril 2002 The EternalOcean spews forth new waves. "Waves" we call them, but there is only. the Sea. (p. 77) From Ibn Al'Arabi: As in the case of a mirror and the beholder, he sees the form in it, but does not see the mirror itself. In your seeing your true self, He is your mirror and you are His mirror in which He sees nothing other than Himself. (p. 65) Through the intimate imagery and ecstatic directness that pervade these writings, the mystics of three monotheistic traditions seem to strain the point that, while human beings par-ticipate in the divine nature, they never become the essence of God. Their mystical reach, on the other hand, does touch upon that mystery which "no eye has seen, nor ear heard, nor the human heart conceived, what God has prepared for those who love Him" (1 Co 2:9). The mystics intuit that persons are not dualistically separated from God, but "closely united with God in a love that is always moving toward oneness" (Johnston, p. 124). Transcending Individuality The Christian Scriptures address a second characteristic, the quality of relationships that proceed from metaphysical self. This characteristic also reappears in the mystical literature of other traditions, and our group members were able to find these paraphrases about metaphysical self-transcending indi-viduality: "Love is not self-seeking; it is not prone to anger; neither does it brood over injuries" (1 Co 13:5) becomes, in Rumi, the Sufi mystic, "Love has no calculating in itT' (Breton and Largent, p. 9) "Thanks be to God, who unfailingly leads us on in Christ's triumphal train, and employs us to diffuse the fragrance of his knowledge everywhere" (2 Co 2:14) occurs in Rtimi as "Vv~hether they know You or not, all creatures bend but toward You. M1 love for some-one else is but a whiff of Your perfume." (Breton and Largent, p. 141) "For I was hungry and you gave me food; I was thirsty and you gave me drink" (Mt 25, 35) appears; Review for Religious in the Bhagavad Gita, as "Any offering--a leaf, a flower, or a fruit, a cup of water--I will accept it if given with a loving heart." (Mitchell, 2000, p. 118) "Let us profess the truth in love" (Eph 4:15) is, in the Bhagavad Gita, "Speak the truth with kindness, honesty that causes no pain." (Mitchell, 2000, p. 178) These mystical sources echo the scriptural message that in human beings metaphysical self is inherently relational. Each of us is a seat of consciousness and an experiencing agent with-out being independent of others. Aitken and Steindl-Rast go so far as to say: "Underlying 'Love thy neighbor as thyself' has to be the experience that the other is no other than myself" (p. 113). Engaged Detachment During our years of meetings, members recognized a third characteristic, engaged detachment, as the way metaphysical self conducts itself in the world. This oxymoron refers to the readiness to invest ourselves in causes, tasks, and relationships while remaining ready to foi'go achieving our goals. It focuses upon process, both the deservingness of the activity at hand and the affirmation that we shall die unfinished, our potential only partly realized, and that completion is ultimately God's work and not our own. The different traditions of mystical writings repeatedly express this theme: From Julian of Norwich: God does not want his servants to despair because they fall often and grievously; for our falling does not hin-der him in loving us. (p. 188) From Paul Tillich: You are accepted, accepted by that which is greater than you . Do not seek for anything; do not intend anything. (Church, p. 180) From Anthony de Mello: There is no clinging to a classical symphony and no hastening it. One does not wait till the end to enjoy . it, but takes in every note, every chord as it comes and lets it go to welcome the next uninterrupted flow. Any attempt to stop the performance, any "attachment" to 14! March-April 2002 Nlagee ¯ Metaphysical Self a single note, will ruin the symphony. (p. 164) From the Tao Te Ching: A good traveler has no fixed plans and is not intent upon arriving. (Mitchell, 1988, p. 27) The Tao gives birth to all beings, creating without possessing, acting without expecting, guiding without interfering. (Welch, p. 41) From the Bhagavad Gita: With no desire for success, no anxiety about failure, indifferent to results, surrendering all thoughts of out-come, unperturbed, he does nothing at all, even when fully engaged in actions. There is nothing that he expects. (Mitchell, 2000, p. 75) From Fakhruddin 'Iraqi: Give up desire. Think that whatever you get is what you want, and in this acceptance find ease and joy. Renounce desire a hundred times. (p. 114) Engaged detachment, like the other characteristics of meta-physical self, is paradoxical. It invites a response of passive atten-tiveness wisely expressed in this admonition from the poet Rainer Maria Rilke: Be patient toward all that is unresolved in your heart. . Try to love the contradictions themselves. Do not now seek resolutions, which cannot be given because you would not be able to live them, and the point is to live everything. Live the contradictions now. Perhaps you will then gradually, without noticing it, live along some distant day into the resolutions. (p. 97) Imagery, Paradox, Complementarity, Love The imagery, metaphors, and paradoxes which other mys-tical traditions use to illuminate the nature of mystical se/famplify and complement the attention Christian mystics center upon on this theme. The artfulness of these other sources can help sustain us both in the apophatic ~loud through which Christian mystics typically view mystical self and in the relaxed tena-ciousness of our commitment to love others as ourselves. Review for Religious References 'Abd Allah Ansari, 1978. Intimate conversations. New York: Paulist Press. Aitken, R., and D. Steindl-Rast. 1996. The ground we share. Boston: Shambala. Breton, D., and C. Largent. 1998. Love, soul, and freedom: Dancing with Rumi on the mystical path. Center City, Minn.: Hazelden. Church, E 1987. The essential Tillich. New York: Macmillan. de Mello, A. 1992. One minute nonsense. Chicago: Loyola University Press. Fakhruddin 'Iraqi. 1982. Divine flashes. New York: Paulist Press. Ibn Al'Arabi. 1980. The bezels of wisdom. New York: Paulist Press. Johnston, W. 2000. "Arise, my love . . .": Mysticism for a new era. Maryknoll, N.Y.: Orbis Books. Julian of Norwich. 1978. Showings. New York: Paulist Press. Magee, J. 1994. "Shame, mystical writers, and a spirituality of self." Review for Religious 53, no. 5 (September-October): 746-752. Matt, D. 1995. The essential Kabbalah. San Francisco: HarperSanFrancisco, p. 25. Meister Eckhart. 1986. Meister Eckhart: Teacher and preacher, ed. B. McGinn. New York: Paulist Press. Merton, T. 1966. Conjectures of a guilty bystander. New York: Doubleday. Merton, T. 1969. Contemplative prayer. New York: Herder and Herder. Mitchell, S. 1988. Tao te ching. New York: Harper and Row. Mitchell, S. 2000. Bhagavadgita. New York: Harmony Books. Rilke, R. 1978. When silence reigns: Selected prose. New York: New Directions. Uffenheimer, R. 1993. Hasidism as mysticism. Princeton: Princeton University Press, p. 74. Welch, H. 1966. Taoism: The parting of the way. Boston: Beacon. Wilber, K. 1983. Up from Eden. Boulder, Colo.: Shambala. Bibliography of Easily Accessible Sources Sources in Christian mysticism appear in the series Classics of Western Spirituality (Paulist Press). Sources for Buddhist and Taoist mysticism Da Liu. 1986. Tai chi ch'uan and meditation. New York: Schocken Books. Deng Ming-Dao. 1990. Scholar warrior: An introduction to the tao in everyday life. San Francisco: HarperSanFrancisco. 143 March-April 2002 Magee ¯ Metaphysical Self Kohn, L. 1993. The taoist experience: An anthology. Albany: State University of New York Press. Merton, T. 1968. Zen and the birds of appetite. New York: New Directions. Mitchell, S. 1988. Tao te ching. New York: Harper and Row. Reps, P. 1957. Zen flesh, Zen bones: A collection of Zen and pre-Zen writ-ings. Rutland, Vermont: C.E. Turtle. Thich Nhat Hanh. 1987. The miracle of mindfulness: A manual on med-itation. Boston: Beacon. Watson, B. 1968. The complete works of Chuang Tzu. New York: Columbia University Press. Wei, H. 1987. The authentic I Ching. North Hollywood, Calif.: Newcastle. Sources for Hindu mysticism Dehejia, V. 1994. The legend of Rama: Artistic visions. Bombay: Marg Publications. Heehs, P. 1998. The essential writings of Sri Aurobindo. New York: Oxford University Press. Jack, H. 1989. The Gandhi Reader. New York: Grove Press. Krishnamurti, J. 1994. On conflict. San Francisco: HarperSanFrancisco. Mitchell, S. 2000. Bhagavadgita. New York. Harmony Books. Ramakrishna Vedanta Centre. 1972. Women saints of East and West. London: Ramakrishna Vedanta Centre. Shukla, S. 1999. The Upanishads. Fremont, Calif.: Asian Humanities Press. Sivaraman, K. 1989. Hindu spirituality. New York: Crossroad. Vetter, H. 1997. The heart of God: Prayers of Rabindranath Tagore. Boston: C.E. Tuttle. Sources for Islamic mysticism 'Abd Allah Ansari. 1978. Intimate conversations. New York: Paulist Press. Breton, D., and C. Largent, C. 1998. Love, soul, and freedom: Dancing with Rumi on the mystic path. Center City, Minn.: Hazelden. Chittick, W.C. 1983. The Sufi path of love: The spiritual teachings of Rumi. Albany: State University of New York Press. Ernst, C. 1984. Words of ecstasy in Sufism. Albany: State University of New York Press. Fakhruddin 'Iraqi. 1982. Divine flashes. New York: Paulist Press. Ibn Al'Arabi. 1980. The bezels of wisdom. New York: Paulist Press. Review for Religious Ibn A1-Sabbagh. 1996. Mystical teachings of Al-Shadhili. Chicago: Kazi Publications. Ibn 'Ata' Illah. 1978, The book of wisdom. New York: Paulist Press. Massignon, L. 1982. The passion of A1-Hallaj, mystic and martyr of Islam. Princeton: Princeton University Press. Schimmel, A. 1987. As through a veik Mystical poetry in Islam. New York: Columbia University Press. Sharafuddin Maneni. 1980. The hundred letters. New York: Paulist Press. Sources for Jewish mysticism Ben Joseph, A. 1987. Book of formation (Sepheryetzirah). San Francisco: Holmes. Ben Zion, R. 1984. Anthology of Jewish mysticism. Brooklyn, N.Y.: Judaica Press. Cohn-Sherbok, D. 1995. Jewish mysticism: An anthology. Rockport, Mass.: Oneworld. Jacobs, L. 1997. Schocken book of Jewish mystical testimonies. New York: Schocken Books. Kamenetz, R. 1998. Stalking Elijah: Adventures with today's Jewish mys-tical masters. San Francisco: HarperSanFrancisco. Kook, A. 1978. The lights of penitence, New York: Paulist Press. Matt, D. 1983. Zohar: The book of enlightenment. New York: Paulist Press. Matt, D. 1995. The essential Kabbalah: The heart of Jewish mysticism. San Francisco: HarperSanFrancisco. Nahman of Bratslav. 1980. The tales. New York: Paulist Press. Scholem, G. 1995. Major trends in Jewish mysticism. New York: Schocken Books. NEW ON OUR WEBSITE Searchable indexes of Review for Religious articles from January 1970 to the current issue Abstracts of the lead articles of the January 1997 isshe to the current issue and summaries of the others Complete text of A Spirituality for Contemporary Life: The Jesuit Heritage Today edited by David Fleming SJ and containing articles by J.J. Mueller SJ, Walter Burghardt SJ, David Fleming SJ, Monika K. Hellwig, Jon Sobrino SJ, Elizabeth Johnson csJ, and John W. Padberg SJ www.reviewforreligious.org -4 45 larch-, Jpril 2002 GERALDINE M. WODARCZYK Aging: Spiritually Present to the Burning Bush growing older For months now I have written multiple reflections on aging. They are connected with a book by Jane Marie Thibault2 She says that in later life people are invited to contemplation and that there should be contem-plative communities for the elderly. My congregation is 127 year old, and I have lived among aging and prayerful sisters for decades. I sought to formulate a theology of aging based on the spirituality of our foundress, Frances Siedliska. But, in spite of a wealth of material, no formulation presented itself. And so, with encouragement from Sister Judith Nero OSB, my local mentor for the gerontological program, I decided on a different focus, simply writing about my ministry experiences at Holy Family Manor. What are those experiences, and what are they calling me to in my own life? Perhaps, like Moses, I have discovered a "burning bush" and here, on holy ground, I learn of God. Geraldine M, Wodarczyk CSFN wrote this paper originally in a gerontological pastoral care program at Luther Seminary in St. Paul, Minnesota. Her address is Sisters of the Holy Family of Nazareth; 285 Bellevue Road; Pittsburgh, Pennsylvania 15229. Review for Religious Years ago Sister Mary Paul Krasowski gave me a copy of a poem by an unknown author: The Moses in my heart trembles not quite willing to accept the prophet hidden in my being wondering how much it will cost to allow the prophet to emerge. O child of unnecessary shoes cast them off and stand in readiness on this awfully holy ground! For the Egypt in people's hearts demands that you see the burning bushes all around you aflame and burning wildly calling you forth away from the comfort of well-protected feet. The ground you stand on is holy! Take off your shoes believe in your Moses and go. Sister Mary Paul gave.me a copy a second time, when I was the superior at the Manor, my "holy ground" for the past six years. I realized that during this time I had been called to accept the prophet in me, and in others, as we search for God in our every-day realities. I have seen the Egypt in the hearts of sisters and heard their cry for freedom sung in many ways. Within the evening solitude that these days provided me, I discovered the Egypt within my own heart and heard a call to let go of false securities of my own and to find new freedoms within me. I have been present to "burning bushes" of experience with seasoned older sisters. In ways I never expected, God touched my life and called me from the comfort zone where I was six years before. 147 March-April 2002 Wodarczyk ¯ Aging With Fear and Trepidation In 1990, when first asked to consider being superior of the Manor, I flatly refused. I was already superior of a small convent of four sisters. I was engaged in full-time ministry as the province councilor for formation, and together with my brother, who was just beginning a family in Wisconsin, I was sharing long-distance care of our widowed father in Erie, Pennsylvania, who was steadily moving to a new stage of frailty in his life. These were the reasons I gave my provincial, but another rea-son was that I had never been present at anyone's death. Terrified, I could not imagine living where I would need to be present to sisters as they died. Time passed. In 1993 our father's condition became worse. When notified, I knew the seriousness of Dad's condition, but did not realize that, with the physician, my brother and I would be making decisions that Dad was not able to make about his failing life. As Divine Providence would have it, I was in Erie when decisions about the breathing and cardiac machines needed to be made, and I was present during Dad's last hours and death. I learned that a broken heart is a real experience. I was changed, and so in 1994, when a new provincial asked me about being superior of Holy Family Manor, I said I would be willing. The provincial was taking seriously the choice of the superior. First, after asking the sisters living in the Manor for suggestions and reviewing the list, she and her council had three sisters come to a mandatory day of reflection in a small cottage on our motherhouse grounds. Our retirement home had sixty-nine beds and sixty-six sisters at various stages of aging. The retreat director, Sister Ann Winschel CDP, invited us to consider our gifts and what might be our stumbling blocks in accepting the ministry. I went to my room in the cottage and prayed with open hands, letting God put there what I needed and giving God the freedom to take away any drawbacks to my willingness to accept this ministry. For most people, praying with open hands is a simple gesture, but for me--with hands affected by rheumatoid arthritis--the gesture spoke of my own human brokenness. Could God really want me, already a broken vessel, to shep-herd these senior religious in their last days? At the end of the retreat, after sharing our personal reflec- tions, we were asked to express our final decision in a letter to the provincial. I wrote of openness to the ministry, my aware-ness of my gifts in working with the elderly, and my recognition that I could use them only in the context of my own brokenness. I qualified my openness by saying that, if I had an incapacitating flare-up of the arthritis, I would take it as an indication that this service was not appropriate for me. Three months later my provincial telephoned me, saying that the council had unani-mously chosen me the next Manor superior. She wanted me to take some preparation time with the current superior, attend the upcoming American Society of Aging conference, and offi-cially begin on the first of May. On Sunday, 30 April 1995, in the early afternoon, I arrived at the Manor. I was scheduled to be in the chapel for a wel-coming prayer and commitment service at four o'clock. The previous superior had already left. Three sisters were waiting for me at the door, welcoming me with one breath and asking with another, "You will take us to the festival at Mr.Assisi, won't you?" Barely gathering my belongings from the auto-mobile and putting them in my room, I welcomed the excur-sion (a five-minute trip) to the Franciscan sisters' festival. Though a busy place, it was a respite where I could amble with-out any focus on the fears and anticipation that were part of me at this transition moment. We returned home and soon four o'clock came. In the presence of the retired sisters, the provincial asked me several questions: Will you accept this responsibility [to be local leader] which the sisters have confided in you? Do you promise to serve the sisters in kindness, compassion, and charity, in the spirit of our blessed foundress, Frances Siedliska? Will you strive to be faithful to the Covenant of Love [our constitutions] and the directives of your general and provincial superiors? Responding affirmatively, I was given a bouquet of roses by the provincial and was told: "Your ministry as servant leader will be a mixed blessing. Both joy and sorrow, possibility and I could not imagine living where I would need to be present to sisters as they died. !49 ~¥larch-April 2002 Wodarczyk ¯ Aging impossibility, success and failure will accompany you. These roses, themselves offering both beauty and pain, are given to you with our gratitude for accepting this mission." After the sisters voiced their support, I recited the following: As I approach this ministry of servant leadership, I pray: Hollow out in me, O God, a space in which I will find myself, find peace and a whole heart, a for-giving spirit and holiness, springs of laughter, and the will to reach boldly for abundant life for myself, this local community, and the whole human family. Grant me your peace, instill in me such awe of you as will make me wise, and such quiet courage as will enable me to make hope visible, forgiving delight-ful, loving contagious, faith liberating, and peace-mak-ing joyful. Shape my weakness into compassion and help me to make myself open and present to my sisters, to oth-ers, and to your kingdom. Amen.2 And so I began my sojourn as the convent superior of our retire-ment community. Except for my Franciscan festival invitation, my first encounter with one of the sisters came that evening, when Sister Maura3 told me, "On behalf of the entire community here at Holy Family Manor, .I want to tell you it is too cold in this build-ing." "Temperatures!" I thought; "after that profoundly religious service, I am supposed to adjust thermostats!" And so it was-- God was inviting me to listen to the concerns of everyday life, the little things that are so important in these sisters' lives. The Power of the Word The next morning I had an announcement to make in the first-floor dining room, where forty sisters sat. Besides some trembling, my voice did not carry well, especially for the good number with impaired hearing. Finally I got the message across. Shortly thereafter, a sister from the second-floor dining area came complaining that I did not give the sisters there any message. What was I to do? The next day I typed out some items of common interest and posted them in the elevator, Review for Religious thereby causing traffic jams. Sisters would ride up and down until they finished reading the note. I realized that we needed copies of the newsletter posted in various places, including the elevator. This simple arrangement, providing this large num-ber of sisters direction for the coming day, also informed them about what was happening in our home. Was this communication episode a "burning bush" in which I found God? At least I learned how impoytant the communi-cated word is to people, and that it could promote love and caring in this household. It calmed the fears of the sisters who wondered about who was in the house: other sisters, guests, contractors, maintenance work-ers. The daily newsletter included a prayer request list and kept the sisters informed about the health progress of the sisters in the hos-pital. The newsletter invited the sisters to share a joke as well as to request prayer for themselves I learned how important the communicated word is to people, and that it could promote love and caring. or others. It became their newsletter. It provided a source of unity and dismantled some rumors that institutions readily give rise to. It hung for twenty-four hours at eight places in the building. Each of us had plenty of time to return to it to get the news of the day. There is a power in the written word. It is a way love can be communicated. Isn't the Word the way God communicates the greatness of Divine Love? And did the Word not become incarnate in the most simple and humble way? Perhaps in some small way the newsletter really was a "burning bush." The Joy of the Resurrection After living a short while in the Manor, I noticed a heavi-ness- sadness in the sisters' demeanor, depressive postures; even the daily Masses were in remembrance of the deceased. Although all the bedrooms are quite alike, some were considered "dying rooms," and sisters shuddered at the thought of being placed there. March-April 2002 V~odarczyk * Aging When I arrived at the Manor in the midst of spring, I was still flesh with the message of the Easter season's life-giving liturgical readings. One reading kept coming back to me, the one about the women returning to the tomb who were asked, "Why do 3iou search for the Living One among the dead?" (Lk 24:5). One day these words, stirring in my h.eart, became reversed. I heard, "Why do you search for the dead among the living?" Something changed within me, and I realized how alive, even with some physical limitations, these sisters were. I knew that I needed to foster that life of theirs. I knew that I should help them help each other to build a happy life within this retirement community. By Pentecost I looked for the evi-dence of the Spirit as we tried new things and reviewed old practices. What brought the gifts of "love, joy, peace, patient endurance, kindness, generosity, faith, mildness" (Ga 5:22-23) that Paul spoke about? The things that brought such results to the majority of the community would be fostering and increas-ing in the sisters the new life of Easter. How else does God speak to us and affirm our actions except by the gifts of the Holy Spirit? In late May 91-year-old Sister Ellen was rushed to the hos-. pital in excruciating abdominal pain. "A perforated bowel," the doctor told me and asked, "What do you want me to do? I don't think that Sister could survive the surgery." Asking Sister, who was fully conscious, was to me the obvious thing to do. The doctor explained the options: surgery or palliative care. Sister Ellen looked at me with the most trusting eyes. "You are my superior," she said. "Whatever you decide will be God's will for me." I could not believe my ears, nor was I prepared for this responsibility she placed on me. She remained adamant. "I trust that your decision is God's will for me." I had not been reared in religious life with that degree of surrender put into a supe-rior's hands. Mine was a formation toward dialogue, toward coming to a mutual decision. She, however, simply continued to insist. From her primary-care physician, I learned that Sister Ellen had specifically said a few weeks earlier that she never wanted another surgery. When I managed to contact our provin-cial superior, who was traveling in Europe, she concurred with the decision for palliative care. Review for Religious I remain humbled by the trust Sister Ellen placed in me. I learned that being an instrument of God in these sisters' lives is something very serious indeed. I learned of my own need for prayer and intimacy with a God who, though transcendent, is immanently present to us and our decisions. Second Floor: 0 God, Are You There? A visitor to our Manor told me happily that her little boy would be three years old in a couple of weeks. On hearing that, he began to cry, "I don't want to be three, Mommy." Holding her tearful child, she said to me: "When he turns three he has to go to the next room in the day care. He doesn't want to take that step." It can be like that with the elderly, too. In conversations with oth-ers who deal with the elderly, I have found that there is always some place where res-idents do not want to go. It may be called the A wing or Mary's Corridor or something sim-ilar. In our convent it is simply called "the second floor." It is where those needing the most care live. Agreeing to live on the second floor is, for some of us, accepting death--even though, in reality, it may be years away. When I came to the Manor, the frailest sisters on the sec-ond floor would sit or recline in geri-chairs in a semicircle in what was called the solarium. These sisters were clean and well kept, but some would randomly yell out a prayer, a request, a humorous remark, or something incoherent. When people passed by Sister Lynnette--her parochial school teaching over and end-stage Alzheimer's drawing near--she would insist, "Line up for the fire drill, without talking!" If you did not do so, your misbehavior called for discipline. Although humorous, these moments were also sad, for Sister Lynnette had been such an excellent teacher. Many sisters shied away from the second floor, and espe-cially the solarium, where these frail sisters spent long days, I have found that there is always some place where residents do not want to go. March-April 2002 Wodarczyk ¯ Agigg still as icons. This comparison struck me as I read some words of Henri Nouwen: Icons are not easy to "see." They do not immediately speak [appeal] to our senses . They do not reveal themselves to us at first sight. It is only gradually, after a patient, prayerful presence, that they start speaking to us. And, as they speak, they speak more to our inner than to our outer sense. They speak to the heart that searches for God.4 The frailest sisters on the second floor "do not reveal them-selves," or the Holy, immediately. It is only after I become prayerfully present to them that their presence, in their dimin-ished physical or mental condition, speaks to my heart. They tell me about life's brevity, about our dependence on God, and show that we are only pilgrims here. One day I took a visiting priest acquaintance to see our treasured sisters on the second floor. He began preaching to them about their duty to contemplate. With blank faces they just looked at him. A confused embarrassment seized him, and he became speechless. There was nothing more to say. Later I wondered if these sisters are in the contemplative state of being in God's wordless embrace. One cannot know such secrets. These sisters, and we ourselves, spend lives desiring such close-ness. But, because they and we have also spent years seeking responsible and prudent control of our lives, such vulnerability, such complete dependence on God and on others, is likely to be fraught with fear as well. On a recent visit to Pittsburgh, Trappist monk Thomas Keating, founder of Contemplative Outreach, spoke to an ecu-menical group gathered at another Franciscan motherhouse. He spoke of the prayerful consent that is part of Centering Prayer, for fostering contemplative experience. He spoke of the call to follow Christ and to let go of possessions--not external possessions so much as interior ones, the baggage of attitudes that we carry with us (in his phrase, the false self). At one point he looked up at the' choir loft, where the frailest of the com-munity's sisters were. He spoke directly to them, taking note of their willing acceptance of their present frailty, their loss of health, their losses of young self-reliance and of status in the community. He saw their disabilities as precious gifts from God, Review for Religious things to be grateful for. His words reminded me of my own sisters on the second floor. But to accept diminishment with gratitude is not easy. Solidarity with Suffering A few footsteps away from my office, my belief in the cru-cified and resurrected Christ was tested. Suffering is a mystery. We do not want to see others suffer, nor do we want suffering in our own lives. When faced with the suffering of people we love, what is our response? Henri Nouwen says: A friend who was very ill had a great devotion to Mary, the mother of Jesus, and derided to make a pilgrimage to Lourdes to ask for healing. When she left, I was afraid that she would be disillusioned if no miracle happened. But on her return she said, "Never did I see so many sick people. When I came face-to-face with that human suffering, I no longer wanted a miracle. I no longer wanted to be the exception. I experienced a deep desire to be one of them, to belong to these wounded people. Instead of praying for a cure, I prayed that I would have the grace to bear my illness in solidarity with them. And I trust that the mother of Jesus will bring my prayer to her Son."s As for myself, I have never come to the point of wanting "to be one of them." I desire to be well. But so did this dear woman on her way to Lourdes for healing. Is true healing the ability to love so deeply that we long to share others' intense pain and sorrow? That is what Jesus did. When we are young, we find many ways to escape that question and that reality. As we age and see diminishment in ourselves, our families, and our friends, the question returns. That call to solidarity in suffering is a difficult call to hear, especially when the time actually comes for us to visit--or move to--the "second floor." Sacrament of the Present Moment - Even in Dementia "Where am I going?" she asks, her body slumped. The eyes, once sparkling with joie de vivre, now are dim, like smoldering wicks. "I can understand," she says, "why, without faith, one155 March-April 2002 Wodarczyk ¯ Aging could commit suicide. Not that I want to," she says, "but I understand. I know why others would do this." Coming out of my own uncomfortable search for something to say, I ask, "Do you have faith? . Why, yes, I do." But soon she is asking, "What should I do? What is happening to me?" These words rose in her during the initial stages of Alzheimer's. It is easy to agree with the maxim that "a mind is a terrible thing to waste." In a group where many have been educators, the relentless decline of mental acumen is truly frightening. In this place, you can imagine the ardor one brings to reading the "Nuns' Study" !6 In the light (or darkness) of this feared disease, a faith per-spective does not come easy, even in a congregation whose motto is "Thy will be done." I needed to be reverently present to any-one who was concerned about Alzheimer's, just as I did to those showing symptoms of it. I needed to be cautious about explain-ing away dementia-with pious sayings or even a quick quota-tion from Scripture. For many months Sister Mary would stalk me, particularly at sundown. Even when I did not initially see her, I could sense her presence and her foreboding look. I had learned earlier that I should keep touch with my own inner experience when relat-ing to others. With Mary, the more I avoided her physically and psychologically, the more she pursued and pressured me. Her cognitive impairment was becoming worse. I would think, "Oh, here she is, pestering me again!" or "She's got dementia. She doesn't know what she's talking about." One time she was particularly adamant: "How awful to be on the second floo!! How cruel you were to put me there!" And on and on, in a sort of frenzy. I wondered, "What ever happened to that loving and supportive friend I had for so many years?" I thought of relat-ing to her as a simple matter of"how to handle a difficult situ-ation." I thought of Christ being in her, but was far from experiencing it. Worn down by her raving, I was wondering if she had received her medication. I called the nurse to ask. Sister Mary heard me and said, "You think medication is going to take care of this? You are not around and you think medicine is going to cure this? That's not the way! That's not the way!" My "quick and appropriate solution"--so that I could be about more Review for Religious "important" things--stirred up more mistrust in Sister and greater frustration in me. Then my faith invited me to adopt a new perspective. I paused, put aside other matters, sat face-to-face with her, and listened. Soon both of us were at peace. After a while she returned to her room for the evening. This scenario occurred more than once. Afterwards, pondering the healing that took place when I was more present to her, I realized that there is a sacramentality in such moments. Jean-Pierre de Caussade says: There is never a moment when God does not come forward in the guise of some suffering or some duty, and all that takes place within us, around us, and through us both includes and hides his activity. Yet, because it is invisible, we are taken by surprise and do not recognize his operation until it has passed by us. If we could lift the veil and if we watched with vigilant attention, God would endlessly reveal himself to us, and we should see and rejoice in his active presence in all that befalls us. At every event we should exclaim: "It is the Lord!''7 Can I be alert to this potential revelation of God the next time I am stalked by one of my own sisters? When people complain to me about the odd behavior or mental confusion of a dear friend of theirs, can I help them see Christ's presence in the situation? How do I do that? Caussade reminds us of the power of faith: It is faith which interprets God for us. Without its light we should not even know that God is speaking, but would hear only the confused, meaningless bab-ble of creatures. As Moses saw the flame of fire in the bush and heard the voice of God coming from it, so faith will enable us to understand his hidden signs, so that amidst all the apparent clutter and disorder we shall see all the loveliness and perfection of divine wisdom.8 Seeking Life's Deeper Meaning A few years ago Sister Mary Stella came to my office quite excited about the prospect of winning a car or money for the 157 Vlarch-April 2002 Wodarczyk ¯ Aging community. A piece of mail had informed her that she had been "selected to win." I tried to explain to her about the money-maEing ploy of these contests. She insisted: "Fill it out for me. I can't see!" Hoping that somewhere in this experience there would be a teachable moment, I filled out the form and mailed it. A few weeks later she received a "free" watch. "See," she told me, "I am already winning! I will really help the congre-gation when the check arrives." Not long after the watch came, Sister was billed $75 for a magazine subscription. She called me to her room. Obviously upset, she said she did not have the money for this subscription and believed that, if she canceled it, she would be responsible for the salesperson's losing her job. "I should have listened to you," she lamented. My teachable moment had arrived! Though I was angry about companies that exploit senior citizens, I gently explained to her that this is an advertising gimmick, that all she needed to do was write "cancel" on the bill and mail it back; the matter would be over. She listened. I left the room thinking all was well. But within a few days Sister stopped eating. She did not come to morning Mass. She stayed in her room, depressed and despondent. Noticing this, I spent some extended time with her, but she was silent. She wanted to see a priest. I called the Franciscan priest who often served us, and he paid her a pastoral visit. Her depression lingered. I visited her again. She still lamented, "I can't pay the bill, and the poor man will lose his job." Her suffering was evident. Her sheltered and "precomputer" life did not prepare her to understand today's big-business advertising. So I listened, and then I suggested that we write the man a letter with an apology, explain her cur-rent financial situation, and return the watch. Her eyes lit up at the prospect. Together we composed a letter, which she signed and I mailed. In a few days she was back to normal. A few months later her health declined, simply by reason of her advancing age. When I visited, she looked up at me from her bed and with a most peacef~l look said, "I will never forget your gentleness to me when I thought I would win that money. You were so kind." The entire episode showed us God's grace working in both our lives. I continued to see how greatly these older sisters desire to contribute to the congregation. Review for Religqous Supporting the congregation financially gave meaning to the sisters all their lives, even as they themselves led a frugal existence. They had experienced the Depression firsthand and had stories to tell about begging alongside factories, begging h0use-to-house for summer stipends, or asking for funds by writing letters to family and friends. Today, for some, lotteries and various contests appear to be another source of financial support for the congregation. One sister, clear-minded at ninety-nine, had a lucky streak. Although she lived frugally, I heard rumors of her "having money." Family and friends would buy her lottery tickets and then cash them in for her when she mailed back the winning ticket. Although I was "out of the loop" of direct information about these transactions, I somehow always found out about them. Though some might find gambling question-able in light of the vow of poverty, I waited to see what would happen eventually, since Sister's participation connected her to others and caused no harm. Sometimes months would pass between rumors of her winnings and her eventual cash donation of $200 or $300. The happiness she radiated sent the message that even at ninety-nine she could contribute to the community. She rarely wanted anything for herself. Suspicions about a breach of her vow disappeared. I have often noticed with what pride the sisters contribute their Christmas, birthday, Easter, and anniversary donations to the communal kitty, expecting my gratitude as they do so. I appreciate what they do, but I have encouraged them to find meaning in other parts of their lives too. Their very presence in love, patience, and faith is a meaningful gift to the community, to their families, and to all who witness their kindness. I have invited them to look for ways of spreading the Good News in and beyond the community. I have tried to be attentive to the I have often noticed with what pride the sisters contribute their Christmas, birthday, Easter, and anniversary donations to the communal kitty. March-April 2002 Wodarczyk * Aging ordinary things they accomplish or experience, and I have lis-tened affirmingly as they speak about what they did and are doing with their lives. I have learned, too, about meaning that is not initially obvious. Sister Gina was a "collector." Her room was filled with any-thing and everything. Some might call it clutter. One day she said to me, "You know, when I die, people will complain about all the stuff I left behind. Some have already asked me to clean things up. But I want you to know something. Now that I can go nowhere, I have brought into my room all kinds of things that bring to mind the wonderful friends I have had in my life. These things always make me happy, and I pray for these peo-ple as well." When Sister Gina died, I took care of her things quietly, without others knowing, needing to respect the gen-uineness of her words to me. Most of this "junk" humbly con-veyed love and friendship and gave meaning to Sister Gina's last days. An Incarnational Spirituality When our sisters come to the Manor, transportation diffi-culties and their declining health limit their activity. Two things seem to arise in the absence of formal ministry. There is some-times an unhealthy focus on self and on the "world" of the Manor. Small matters become major concerns. Negativity can result. Teresa of Avila saw such problems in her cloistered monastery.9 There is perhaps no one remedy, but I have seen changes for the better when sisters choose other avenues of ser-vice or ministry or other activities compatible with their new status and their personal limitations. The healthiest and happiest in the Manor were those who were able to rechannel their formation-for-ministry in creative ways. Writing letters to friends, family members, and politi-cians and intercessory prayer for the needs of others are integral to the sisters' lives and are a genuine service they render. Decorating the chapel for feasts, participating as readers or Eucharistic ministers during the litu#gies, companioning another to the physician, sending get-well cards to the hospitalized, and visiting the "second floor" are but a few of the ways the sisters incarnate their love for God in service to their neighbor. Their Review for Religious humble acceptance of their limitations and their patient strug-gles day by day become invaluable tools in building up the body of Christ, as those who are touched by their witness can testi@. For the sisters, their personal sufferings take on deeper mean-ing as they offer them for the intentions of people who have requested their prayer and support. Perhaps some ecumenical healing takes place as well, as staff members of different faiths take care of these sisters, who have lived their lives with hearts so attuned to Roman Catholicism. The sisters remain educators, teaching young care-givers about faith, patience, forgiveness, hope, acceptance and nonacceptance of suffering and dying. The sisters, too, are stretched to go beyond the images of a vowed religious life that is past and gone. After fifty years or more of religious life, that is not a small stretch. Sports on television and radio, and movies, books, excur-sions, concerts, and so forth offer relaxation and outreach--for nothing can "separate us from the love of Christ" (Rm 8:35). Some sisters have become mentors or teachers in various spe-cialties. One Sister translated from Polish to English a valu-able book on the foundress of our community, Frances Siedliska. With phones now in every room, telephone ministry to family and friends became possible. Advocacy for human rights and other special interests is also a possible ministry for the sisters. If we live by the truth and in love, we can "grow in all ways into Christ" (Ep 4:15). All these ways of service build the king-dom of love among the family of God; they express the mis-sion of the Congregation of the Sisters of the Holy Family of Nazareth. "Tell Him to Wait!" Several months ago Sister Helen, our 95-year-old, was quite ill. She ceased to breathe during an MRI, and the hospital staff, acting on impulse rather than consulting her advance directive, resuscitated her. The doctor called me and told me Sister had been placed on a breathing machine. Twenty-four hours later the doctor removed the breathing machine, and, staunchly, Sister Helen survived the ordeal. I visited her in the hospital and reminded her gently, "Sister Helen, you are very ill. Perhaps 1K1 March-April 2002 Jesus will call you soon." "Let him wait," she bellowed; "I'm not dead yet!" I was taken aback, slow to see the humor. Later I reflected: "She has been a baptized Catholic for ninety-five years and a member of our religious community for eighty years. She has prayed each day of those years. She has a profound rela-tionship with God. After eighty years of relating, a certain free-dom of relationship must exist between lovers. How free Love can make us!" Sister Caritas died several years ago, and I especially remem-ber her dying. Racked with fever, in great distress, she held my finger tightly--so firmly that it reminded me of what my friend Maureen told me about a birth. Her sister's husband was on a business trip, and Maureen was in the delivery room with her sister. Her sister grasped her hand so tightly during the birth that Maureen needed several weeks of hand therapy afterward. While grasping my finger, Sister Caritas, too, was being born, born into eternal life. I have been with others who have died, not all struggling as did Sister Caritas. Some have gone to the Lord gently. Others have chosen to stop treatment and accepted the palliative care that became part of that choice. Some died after years, months, or a few days of being bedridden; others, while taking a nap. Each "birthing" has been different, each one very final, each one inviting me to deepen my belief in the life hereafter. Here at the Manor--or anywhere, of course--other kinds of dying occur earlier, before that actual moment. Every stage of Elisabeth Kubler-Ross's death-and-dying theory is lived out here: denial, anger, bargaining, depression, acceptance.1° Are some stages more appropriate, more holy, than others? ls the sis-ter in denial less effective in dealing with dying than the one who is angry and displacing it at every available opportunity? And the one who bargains--"If I keep on living on the third floor, I'll never get like those on the second floor"--is she less holy than the one whose depression shows all over her face and in her every bodily move? And is she still less holy than the one who grieves her loss, accepts additional personal help, gently accepts the everyday deaths and dyings that are part of human experience? I think there can be no comparisons here. When one strug-gles in the face of d~ath, regardless of what type, the struggle is Review for Religious real. "It remains true," as Pope John Paul has observed, "that the years pass quickly, and the gift of life, for all the effort and pain it involves, is too beautiful and precious for us ever to grow tired of it." 1, And so we struggle and deny, are angered, bargain, and are depressed. In the end we do accept the reality that has been presented to us by Life. The challenge for me in the Manor community was to have faith in this precious journey and trust that the increasing pains are redemptive. I chose to permit people to be themselves: I challenge, but do not force. Rather, I wait in patience for God's grace to touch hearts and hurts and lead all of us into his sacred presence. My Beloved As we religious grow toward accepting death, the inevitable reality shared by all creation, I believe that a life of prayer sustains us. Deep within us all there is an amazing inner sanctuary of the soul, a holy place, a Divine Center, a speaking Voice, to which we may continuously return . It is a Light within which illuminates the face of God. for the spiritual person is forever bringing all affairs down into the light, holding them there in the Presence, reseeing [sic] them and the whole of the world., in a new and overturning way.12 A life of prayer is different for each of us: some tending to more prescribed prayers, others to a more wordless prayer. What is common about prayer life is the deep relationship with God that is so special and so sacred to each one. Inscribed on each sis-ter's profession ring are the words "My Beloved is mine and I am His," from the Song of Songs (2:16). She not only wears that ring, she lives that reality. Recently I was asked to be the community witness when Sister Ann's casket was closed. Before burial we normally remove from the deceased our congregational cross and ring. On this occasion the undertaker could not remove the ring. I advised him to leave it and close the coffin. Reflecting on this moment afterwards, I considered it to be as symbolic as the ring itself. Sister Ann, orphaned as a child, surrendered herself to God March-April 2002 Wodarczyk * Aging through her vows and eventually, as Alzheimer's disease kept taking its toll, was stripped of family, friends, and even cogni-tion. The one thing that remained was the reality: she was her Beloved's and her Beloved was hers. The sisters at the Manor foster that relationship with their Beloved in many ways, including personal and communal prayer. Communally we have had to vary our prayer style here. Because of impaired hearing and sight and various other physical limi-tations, we no longer say Office in common. But the sisters pray faithfully --in their rooms, in the chapel, at Mass, on the porch, while walking outdoors or in the corridors, and during our spe-cial Friday mornings in the chapel. When they are very ill, they may say they cannot pray, and some are troubled by this. Others say that they are simply united with Jesus in their suffering, which is "nothing compared with His." Still others are quiet, their faith wrapping them palpably like a shawl. At times faith grows in darkness. It is no small discomfort when one who has dedicated her ehtire life to God questions the existence of God. When suffering is too much, "God, O God, why did you abandon me?" becomes the prayer of the day, or week, or even longer. In community, even as we pray in various ways, we journey in prayer together. Just as the psalms pray through the gamut of human emotion, so our lives together become a living psalter. Anlen I cannot think of any richer ministry experience within my thirty-nine years as a member of the Congregation of the Sisters of the Holy Family of Nazareth than the time I spent in service to my sisters at Holy Family Manor. But my two three-year terms as convent superior here have come to an end. "Relieved?" my current provincial superior asked me before announcing my replacement. "Mixed feelings," I mumbled. But I know that this is right and good. My body and my spirit home in on a few words in my Moses poem: "Take offyour shoes, believe in your Moses, and go." Now they have a fuller meaning: ". go, relax awhile, and then, changed by this burning-bush experience of yours, go on and minister to whatever people I, your God, choose for you!" I respond: Amen. Review for Religious Notes l Jane Marie Thibault, A Deepening Love Affair: The Gift of God in Later in Life (Nashville: Upper Room Books, 1993). 2 The welcoming service was composed by Sister Therese Frankowski. 3 The names of most of the sisters in this article have been changed. 4 Henri J.M. Nouwen, Behold the Beauty of the Lord: Praying with Icons (Notre Dame: Ave Maria Press, 1987). s Henri J.M. Nouwen, Our Greatest Gift: A Meditation on Dying and Caring (New York: HarperCollins Publishers, 1994). 6 David Snowden PhD, Aging with Grace: What the Nuns' Study Teaches Us about Leading Longer, Healthier, and More Meaningful Lives (New York: Bantam Press, 2001). 7 Jean-Pierre de Caussade, Abandonment to Divine Providence, trans. John Beevers (New York: Image Books, 1975), p. 34. ~ Caussade, p. 37. 9 The Way of Perfection, chap. 4. ,0 Elisabeth Kubler-Ross, On Death and Dying (New York: Macmillan Publishing Company, 1969). '~ John Paul II, Letter to the Elderly (1 October 1999), §1. ,z C.S. Lewis, as cited in A Step Beyond: Advanced Training in Pastoral Bereavement Counseling (Archdiocese of New York: The Ministry to the Bereaved, November 1994), p. 32. School Day, 1947 I am seven, on my way to school, crisp snow sparkles in the sun. As I walk along, I reflect that some day a man will offer me a diamond ring, but today God himself has hurled thousands at my feet. Mary Hanson ~larch-April 2002 HELEN JEAN NOVY Coping with Repetition: A Spirituality for Ministering to the Elderly ~ehncoeuthneter rds uwriinthg tfhaem eilldye rvlyis iotfst eonr ifnovromlvael mdeianliisntgry w, iothur their habits of repetition. I have overheard "Dad, you say the exact same thing every time I come," and I have heard myself saying "Mom, you ask me that again and again." The proverb "Variety is the spice of life" inclines us to assume variety as a condition of anyone's continuing interest or at least as a lively attention getter. Repetition, however, is a necessary complement to variety. A systematic interplay of repetition and variation is a sine qua non for the arts. Consider the structure of sonatas or the form of songs. Aaron Copland's "Simple Gifts" in Appalachian Spring is an example of theme and variations, as is Max Reger's Variations on "America." In prayer, too, there is repetiton and variation. Christians regularly praying the Liturgy of the Hours, for example, are so accustomed to Morning Prayer's psalms for Week One that most know them by heart. Their predictability provides a rhythm that matches the regularity of breathing. But along with this comes the season's or feast's antiphon, giving a turn to the verses of the psalm and in a sense reinventing them. Helen Jean Novy HM is director of mission effectiveness at Magnificat High School; 20770 Hilliard Road; Rocky River, Ohio 44116. Review for Religious For Sunday of the First Week in Ordinary Time, this antiphon begins and ends Psalm 63: "As morning breaks I look to you, O God, to be my strength this day." The antiphon suffuses the psalmist's words that follow: "O God, you are my God, for you I long; for you my soul is thirsting. My body pines for you like a dry, weary land without water." For the feast of Saints Peter and Paul, a different anti-phon frames the same psalm w"I know the one whom I have trusted"--and gives it a different tinge: "O God, you are my God, for you I long; for you my soul is thirsting. My body pines for you like a dry, weary land without water." The synoptic Gospels, echoing each other in recounting the same events and sayings, do it with small yet significant differences. Compare the healing of Peter's mother-in-law in Mark 1 .'31 ("he came and took her by the hand and lifted her up. Then the fever left her"), in Luke 4:39 ("he stood over her and rebuked the fever, and it left her"), and in Matthew 8:15 ("he touched her hand, and the fever left her, and she got up"). Might these considerations guide our responses to the repetitiousness of elderly people who have debilities of memory or concentration? Each encounter with another person, even though seemingly routine, is a new arid original encounter. Both parties are changed by the passing of time--by the physical, mental, emotional, and spiritual experiences of the intervening time--even if only minutely. Health has improved or declined; the weather has turned warmer or cooler; clothes are brighter or more uniform; the staff has been updated or has had a turnover; the family has been reunited or suffered a loss; a sacrament has been received or a prayer prayed. "No need to recall the past. I am doing a new thing" (Is 43:18-19). Could Yahweh God be doing this new thing daily? God indeed adds yeast to the dough of the soul, lets it work, and gives it the kneading it requires: prayer and contemplation, opportunities for good works and self-sacrifice, active or passive Perhaps the most mutually soothing response to unceasing repetitions is a silent laying on of hands, a gentle and loving touch. I67 March-April 2002 Novy ¯ Coping witb Repetition suffering, or simply love's perpetually re-creating thoughts and deeds and words. Does it take yeoman patience to hear the same questions, the same comments, the same concerns day in and day out, hour by hour, and even minute by minute? Of course, those who minister have to work on themselves, cultivating a reliable equanimity and ideally a blend of knowing tolerance and psychological and spiritual understanding: Thank heaven she can still respond., what a grace that we can still interact., how humbling that he takes his own debility in stride., bow merciful that she is unaware., what a gift.t that I can encounter the very Christ in the simplicity and vulnerability of this person. Perhaps the most mutually soothing response to unceasing repetitions is a silent laying on of hands, a gentle and loving touch. Only by taking the tensions and strains of working with the sick-elderly to prayer again and again will ministers discover each person as an "imago Christi, a living analogue of the crucified Christ. As they do this, the ministers themselves will be molded into other Christs. They may find themselves praying the antiphons and psalms of the Liturgy of the Hours in the persona of Christ in the sick-elderly: "For you my soul is thirsting. My body pines for you like a dry, weary land without water." In the purview of faith, while the soul of the minister is being tuned to a new pitch, the souls of those they minister to become new songs. The Spirit sings through the adaptive constancy of the one and the dulling repetitions of the others, harmonizing both in the mystery of Divine Providence's unfathomable workings. G.K. Chesterton suggested that we should not take for granted the rising of the sun. Such a glorious phenomenon may well depend on the childlike delight of God calling for an encore: "Do it again, Sun!" Ultimately, deepening spirituality will not only expect the unexpected; it will expect the familiar, the recurring, the repetitious. It will perceive even the annoyance of repetition as a melodic refrain within the grand orchestration ¯ of God. Review for Religious JOAN WAGNER Medaille's "Means" and Religious Life's Renewal At our last meeting, in June 1998, I attempted to show that the primitive documents of the Sisters of St. Joseph indicate that apostolic endeavors have deep mystical foundations. In the present paper I examine other aspects of these primitive documents, aspects that pertain especially to the communal life of small communities that undertake apostolic ministry. Because this article focuses on the spiritual and apostolic insights of Father Jean-Pierre Medaille SJ, it is intended especially for those who walk in his tradition, but also for all professed religious who seek the deepening of their community life and their apostolic action. I will focus on six "means" derived from Father Medaille's writings, but first I draw your attention to two Scripture passages that were of major importance for Medaille: Have this mind among yourselves, which was in Christ Jesus, who, though he was in the form of God, did not count equality with God a thing to be grasped, but emptied himself taking the form of a p rspecliv s Joan Wagner ssJ presented this paper in Milwaukee in June 2001 at the fifth triennial meeting of the Conference on the History of Women Religious. Her address is Little Design Community; 171 Schiller Street; Buffalo, New York 14206. March-April 2002 Wagner * Medaille's "Means" servant, being born in the likeness of men. And being found in human form he humbled himself and became obedient unto death, even death on a cross. Therefore God has highly exalted him and bestowed on him the name which is above every name, that at the name of Jesus every knee should bow, in heaven and on earth and under the earth, and every tongue confess that Jesus Christ is Lord, to the glory of God the Father. (Ph 2:5-11) That they may all be one; even as thou, Father, art in me, and I in thee, that they also may be in us, so that the world may believe that thou hast sent me. The glory which thou hast given me I have given to them that they may be one even as we are. one, I in them and thou in me, that they may become per-fectly one, so that the world may know that thou hast sent me and hast loved them even as thou hast loved me. (Jn 17:21-23) I think that adopting Father Medaille's "means" could help contemporary religious to practice the emptying spoken of in Philippians and thereby achieve the unions spoken of in John's Gospel. After discussing these "means," I will offer some concrete proposals for living them. The new community to which I belong, the community of the Little Design, is attempting to establish its communal life on "the means of Medaille." Clarifying the Scope of Medaille's "Means" The six "means" that I will be discussing cannot be found at any one location within the Primitive Documents of the Sisters of St. Joseph. In fact, nowhere in Medaille's writings did he use the term "means" as I use it in this article. It is a concept that was first formed in the latter decades of the 20th century, that is, three hundred years after Medaille, by a commentator on the Primitive Documents, Sister Julie Harkins of the Boston Sisters of St. Joseph. I first encountered Sister Julie's work when I attended a charism retreat that she gave in Wichita, Kansas. In her presentation she referred to "six central means found in the lived experience of our first sisters to maintain unity among themselves and to be apostolic communities of love." Even as I Review for Religious taped her presentation at that conference, I felt that her ideas and concepts about Medaille's approach were truly a treasure. It seemed to me that Medaille had applied St. Ignatius Loyola's Rules for Discernment in a new way, using at the communal level the retreat pedagogy of reflection on experience. He adapted those rules to unlettered and diverse groups of women, to assist them in becoming apostolic communities of love. Other interpreters of the Primitive Documents of the Sisters of St. Joseph such as Sister Vacher and Sister de Vaublanc have analyzed the practices that Medaille proposed for the early sisters. Not all of these commentators would agree that the six "means" identified by Sister Julie Harkins capture the heart of Medaille's approach. Other phrasings and other lists of "means" have been proposed. It has also been suggested that Medaille's approach can be represented by one expansive "means," the sisters' sharing their hearts unreservedly. To shed additional light on whether I-Iarldns's six "means" adequately represent Medaille's approach, I suggest that we consider how difficult it would be to distill the central practices recommended by St. Paul. We know that Paul wrote extensively about the living of the Christian life. (His writings are far more extensive than Medaille's even if we consider all the Maxims and other Primitive Documents to be authentically his.) How then to express the central "means" of St. Paul? One commentator might comb through his writings and identify six "means" as central. Another might determine that there are actually four or eight or one. Obviously there is much room for disagreement. Keep in mind, then, that there are various ways of presenting the essence of Medaille's approach even as I now list Harkins's six "means." I advocate them as the basis of the community life of religious women, today--but always understanding their meaning within the Gospels' call to discipleship. Please note, too, that in Harldns's list there are two dimensions in Means 2 (and perhaps in Means 3 as well). And there is some overlapping among the various "means" since the boundaries among them are not tightly drawn. Finally, note that Means 6 is phrased in such a broad, all-encompassing way that it seems to subsume the preceding five "means." Here, then, is Sister Julie Harkins's list of Medaille's "means": 171 March-April 2002 _Wag~, er ¯ Medaille's "Means" 1. Sharing experiences and feelings in prayer and doing so with candor and simplicity (Reglements, p. 9 par. 6). 2. Sharing the state of the house (outer as well as inner) and sharing the next step to which ofie is called (Reglements, p. 8 par. 4; Primitive Constitutions, p. 16 par. 1; p. 21 par. 4, 5, 6; p. 39 par. 6; p. 51 par. 8). 3. Sharing the dangers (evils) that threaten community life; protesting (promising) to safeguard what will safeguard the common union (Primitive Constitutions, pp. 58-66; Protestations, pp. 67-68). 4. Sharing what is our city and dividing the city among ourselves to discover the evils and to work for their healing (Primitive Constiitutions, p. i1 par. 6; p. 29 par. 9; p. 30 par. 1-3; p. 31 par. 1-2). 5. Sharing with each other how through works of service they are building the kingdom of love among the dear neighbors and the members of the community (Reglements, p. 8 par. 4; Primitive Constitutions, p. 17 par. 2). 6. Fidelity to the core spirituality: being grouped in honor of the Father, Son, and Spirit; Jesus, Mary, and Joseph (Maxims of Perfection, pp. 21-22; Reglements, pp. 4-5; Primitive Constitutions, pp. 12 and 57). Putting Medaille's "Means" into Practice You can see that the first three "means" listed pertain to spiritual bonding within the community; they deal primarily with discernment of spirits as a way of life. The next two "means" pertain to discerning the apostolic and prophetic stance to which the community may be called; these "means" address discernment as a decision-making process. Finally, the sixth "means" stands above the others and informs all of them inasmuch as it focuses upon the mystical relationships that are at the heart of the calling that Medaille identified for the Sisters of St. Joseph. I am keenly excited about having our Little Design community underway. This small community employs Medaille's own term, and it represents the fulfillment of a dream for refoundation that I have had for forty years. (Be it known, however, that at least one other person has called this dream my Review for Religious obsession.) As I write, this house is only three months old and at present has only two members. We have good hopes of attracting other young women who are interested in a life that is based on these six "means" of becoming an apostolic community of love. Let us now consider Medaille's first "means": sharing experiences and feelings in prayer and doing so with candor and simplicity. I will first try to explain why I feel that this is important, and then I will offer some recommendations about how to practice such sharing. The mystery of faith revealed to us in Scripture, particularly in Paul and John, is that all of history is now sacred history. This is the impact of the incarnation on our daily life (note--in Philippians 2:6-11, one of the passages cited above--the relevance of Paul's theology). All of our ordinary daily life is filled with God drawing our human consciousness to God's Self. God desires for us an ever-growing love and participation in the life of Jesus. This goes on in each moment of our human experience, and it registers as a thought, a tendency, a mood, a feeling. (Father George Aschenbrenner SJ has emphasized this approach in his conferences.) It is one thing to believe this. It is another to be deeply aware of it. It is a third step to be keenly sensitive to it. Our response is toward a greater share in living out Jesus' mission (note here the relevance of the John 17 passage on unity). To share within a community (I envision one of three to five sisters) one's experience in prayer presupposes incarnational theology and could move the community from believing to the final stage of responding. Submission to the group mandate for the purpose of growth enables believing, awareness, and sensitivity to develop. And movements of grace obviously become more explicit when inner awareness moves to vocal articulation. Sharing one's prayer experience with candor and simplicity is a demanding endeavor. An emptying is required, but I believe it leads to a new depth of communal unity if it is done in faith, All of our ordinary daily life is f!lled with God drawing our human consciousness to God's Self. --!73 Mt~.rcb-dpril 2002 Wagner ¯ Medaille's "Means" trust, and love. This depth is the mystery of God made more manifest in and among ourselves. We become more conscious of the call to respond and to be accountable. How would this be implemented? A possible scenario would be a biweekly gathering at which community members would relate movements of consolation and desolation during their prayer of the previous few days. Journaling after prayer periods would help members to be more responsibly prepared for the group gathering. Those who have had an Ignatian directed retreat will easily identify with this process. At present our small community enters into Morning Praise with a psalm, quiet time to reflect, and then the citing of a word, phrase, or line that was "given." The Gospel for the day is then read aloud. This is followed by a brief period of quiet and a brief time of communal sharing. All of this is done within half an hour and prepares us for deeper listening at liturgy. The content of our prayer in the future may vary, but the communal sharing is integral. Medaille's second "means" has three aspects: sharing the state of the house (outer as well as inner) and sharing the next step to which one is called. "The state of the house" has two meanings: first, the practical details of the community's living quarters. For harmonious living, responsibility and accountability are expected from every member. Such matters as cleaning, shopping for food, preparing meals, paying bills, scheduling prayer, hospitality, and times for silence are basic elements in a well-ordered "house." Honesty prevailing, the community will be aware of members' overextension or ill health, of things needing repair, and so forth. With solutions to be found, the quality presence of each member is important. The ebb and flow of external harmony is guaranteed by this practical sharing. The other "house" is the inner one, the heart. Teresa of Avila in her Way of Perfection notes that in praying it is essential to recognize and own how one is as one stands before the Beloved: weak, grateful, sinful, needy. This ownership of my incarnate self relates me to the incarnate Jesus. In truth, to articulate that inner state demands honesty, probes causes, and elicits understanding. What a sacred gift to offer my sisters: an emptying for the purpose of union,t My creaturely limitation stands naked before the Christ I trust, and before the Body of Review for Religious Christ in my sisters. Transformation in Christ occurs when I share in Jesus' life--in his being child of God and sharer in created human nature. The next aspect of the second "means," sharing the next step to which one is called, flows out of the group's increasing sensitivity. Articulation of deeper desires was a requirement for Jesuit novices, and this may have influenced Medaille to recommend this sharing to the first sisters. Great desires for God need to be fostered into action or they die. One's next step may be small and subtle or grand and significant. It could be to create a dream, to change a pattern of behavior, to attend to one's health, or to begin a new relationship. Such matters require careful handling with regard to the members' personal and communal mission. They begin in the human heart. It was the sharing that Teresa of Avila had with John of the Cross that enabled them to take the next steps for the refoundation of the Carmelite order. It was the vision that Ignatius shared with Francis Xavier that led to his bringing the faith to south and east Asia. Incarnational theology points out that our deepest desires are God-given. The word God gives us is to be spoken and enfleshed. The emptying required in taking next steps in our lives is attested to in the lives of men and women who accomplished much for God. A Saturday morning once a month could be set aside to ensure Medaille's second "means." Although the focus would vary, all aspects of this "means" would be attended to within this leisurely time together. Community members could take turns facilitating a simple process that might begin with listening to a member describe a project that she feels called to initiate. The listening could be followed b~ quiet reflection, questions, and dialogue. In this way one member's hopeful desire would be gracefully fostered and nurtured or deemed unsuitable or temporarily tabled for deeper discerning. At present our Little Design community gathers in the community room on Saturday mornings for about an hour and a Incarnational theology points out that our deepest desires are God-given. March-April 2002 H~ner * Medaille'~ "Means" half, a time we consider sacred. Because we are a new community, we do this every Saturday unless some special event interferes. We realize, too, that it is easy to spend too much time on the "outer" house, and so we strive to ensure the more interior and bonding elements of this second "means." Medaille's third "means" is sharing the dangers (evils) that threaten community life, protesting (promising) to safeguard what will safeguard the common union. One might ask wh

Issue 12.2 of the Review for Religious, 1953. ; The .Summa, t:or $is :ers Sister Mary Jude, O.P. EVERY good religious longs to perfect herself1 in the technique of that most divine of occupations--the salvation of souls. To that end vacations are sacrificed for "higher studies," precious holidays are spent attending workshops and teachers' meetings, and "free" time is consumed directing co-curricular activities. In this never-ending process the simple religious, as~well as superiors, super-visors, and superintendents may wonder whether they are not losing their perspective, whether the tail is 'not' wagging the dog. Those in authority repeatedly warn the Sister about the "danger" of studies, until she is given the impression that learning is some kind of neces-sary evil, and a uniyersity, an unavoidable occasion of sin. .Although no good religious has entered the convent with the idea of becoming merely a high-powered schoolteacher (or nurse of social worker), by the end of her first year of teaching she finds her-self involved in a complex system of aims and methods, classroom' management and educational devices. If she has time to think, she wonderswhere it all fits in with her longing to, be absorbed in Jesus Christ. The "points" at meditation, the spiritual reading books in the community bookcase, and conferences and retreats are lavish with warnings of all kinds. Sister ~an never say she has not been told the r'ight thing to do, but has anyone ever taught her how? , She marvels afresh at the insight of Pope Pius XII in his Holy Year message to religious: "To harmonize your~exterior work with your spiritual life and to establish a proper balance between the two." The Holy Father knows exactly how she feels. How is this to be accomplished? Sister must teach English and history this year (next year it may be typing and music) the while she longs to make her pupils understand, "If thou didst know the gift of God. the height and deptl'J of Christ's love, the riches of the glory of His in-heritance in the saints." Instead Sister must drill on the rules for capitalization and ex-pound the Monroe Doctrine. In some high schools priests have taken over the teaching of religion. Realizing the importance of training leaders in the secular branches of learning a.ccording t6 Catholic prin- 1The article is. directly concerned with teaching Sisters. But what is said applies equally to teaching Brothers. as well as to religious engaged in social work, nursing, ~7 SISTER MARY JUDE Re~ieu~ [or Religlous ciples, Sister attempts to assimilafe and o~ientate the subject and the child Godward., She suspects that Father bas been given the easier task--that of teaching'religion as religion. Community officials, becoming apprehensive at stories of .Sisters who have lost their vocations or become worldly-minded in pursuit ~f degrees, frequently react by reducirig to a minimum the number of " Sisters engaged in graduate studies, if this reT, ults in a loss of educa-tional standards to their community, many mistresses of studies con-elude that this is the price that must be paid for maintaining the ligious spirit. Unhappily they can neither foresee nor measure in their lifetime the intellectual stagnation effected by this policy. If the senior memb,,er~ .of the congregation remember their own more leisurely days, when summertime meant rest and relaxation: when daily preparation did not include the breadth of background iequired today; when children came to school with respect for au-thority already inculcated at home; when even the lengthier noon period with no police duty allowed sufficient time for slackening emotional tensions and regaining spiritual tranquility; if these thirsts are remembered, they are never brought up in accounts of "the good old days." With higher studies made the privilege of a chosen f~w instead of the constitutional obligation of all, superiors become fearful lest the ~ubjects singled out grow proud. They reason that it is the fault of " the studies if Sisters so favored become complacent. Meanwhile, Sis-ters, being human, continue to substitute emotionalism for true piety and to confuse devotion with devotions. Honor to the Mother of God is frequently a medley of classroom'May-altars and Sodality "activities" fondly imagined to be Catholic Action. On th~ Blessed Virgin's fulness of grace or her other prerogatives they do not expa-tiate much, because they do not know too much about Mariology. Sisters wonder why their students do not turn-out better, why so little that is taught in religion class carries over to daily life. When promising'pupils marry outside the Church or disgrace their faith by misdeeds in public life or in the underworld, their former teachers are bewildered. Have they not done all they can? Have they? Does even Sister's prize pupil know how precious grace really is? Does Sister herself have a proper appreclatlon of what it means to be a member of the Mystical Body of Christ? Has she ever put across to her pupils the beauties of a baptized soul strengthened by. confirma-tion, purified by penance, perfected by the Holy Eucharist, and Mar~h, 1953 .'i SUMMA FOR SISTERS adorned by the gifts of the Holy Spirit? If sl~ has, then Johnny will seek h married partner who will aid in his slSiritual development and will not establish his marriage merely oh emotional grounds. How can Sister teach these things, if she has never been taught them'herself? She has tried to teach children to develop will power, but how well has she emphasized the role of grace in r~sisting temp-tation? How many of her charges know that the grace, of God is theirs for the asking? Or instead have they been. thoroughly indoc-trinated with the idea that the'Jr Guardian Angel is on their right side and the devil on their left? What do they know of the life of grace within themselves? How many children and adults confuse sensible consolation and devotion? lk~ost,Catbolics think that priests and Sisters live in a semi-ecstatic state in which prayer is a series of thrills. They are. consequently, the more horrified when they discoverthat Father and Sister are human. Sister,is such a good teacher that she can mak~ even world history the most gripping subject in the curriculum. She can fiave her pupi_Is laughing merrily at the nineteenth century theory of spontaneous generation.of life. Do any of them know that it is a greater thing for God to raise a soul from mortal sin than to breathe life into a corpse? How different would be her pupils' attitude on leaving the confessional if they believed that they could no more restore grace to their own souls than bring themselves back to life.?_. They are taught to make an act of thanksgiving after confession. Have they ever been "given reasons for awe and wonder at God's mercy in the sacrament of penance? All the dislocations and chaos of the past years have had tre-mendous impact in the classroom. To analyze their cause is not our purpose here. The Korean War and television .are but ancillary to the mental dissipatio.n which teachers must combat. The young peo-ple of today are the offspring of the "Fla'ming Youth" generation .of the 1920's. Greater and " heavier tasks are being placed upon the school. Even so delicate and personal a matter as sex instruction is shirked by parents. Respect for authority is not only not inculc'ated at home; but it is denied to the teache.r,by mother and father.' , Like St. Thomas Aquinas the Sister must accept people as they are. A religious cannot right every wrong in the world, much as she would like to. She must start with that portion of the Lord's vine-yard which the will of God has assigned to her. She does no.t con, clude that the soil is bad becatise she finds weeds thriving in it. Be- SISTER MARY JUDE Re~iew for Religious cause there is so much to be overcome Sister must be equipped with a knowledge of sacred science before she can start to put things in di-vine order. Because the problem is of such complexity, Sister must first see things as God sees them. This wisdom can come from a study of the Summa Theologica. Time was when those entrusted with forming educational poli-cies of communities would have ridiculed the idea of theology for Sisters. Today, however, with the movement of theology for the laity sweeping the country as it has in the last fifteen, years, with* the butcher, the baker, and the candlestickmaker enthusiastically ~d[scus-sing their ultimate end and distinguishing between the moral and in-tellectual virtues at study ,clubs, no excuse is needed for a study of divine trtith by those whose life is dedicated to God by public pro-fession. No longer do people consider the study of theology a pre-requisite only for those who hear confessions. I~ she is going to God-center the'life of her students, a Sister must know. the science of God. "This is eternal life : That they may know thee. the only true God, and Jes~s Christ, whom thou hast sent" (John, 17:3). In order to convince her pupils of the very purpose of their existence she must first develop within herself a reasoned conviction and understanding of the great mysteries of faith. She must learn to distinguish emotionalism from true love of God, and yet evaluate the place of the emotions in the spiritual life. To meet ,the intellectual needs of th~ mid-twentieth centt~ry a scientific knowledge of God is needed. Unless Sister herself believes that "the least knowledge of divine things is greater than hny amount of knowledge about material, things," she will lose ground. Anyone who puts a degree in chemistry, or language, credits in litera-ture or education before a deeper knowledge, of God cannot be suc-cessful in connecting the life of the day and the life of God within the human soul. She is laboring "for the roost thaf perishes," and not for "that which endureth unto everlhsting life." Teaching, according to Saint Augustine, is the highest form of charity. For the religious teacher, then, the study and quest of wis-dom for the development of her vocation is absolutely necessary. Study undertaken for love of God increases her sanctity. The holier she, becomes, the greater is herdesire for a kngwledge of truth. Be-cause in the convent cemetery there lie the remains of Sisters who achieved sanctity without the study of theology, it does not follow that Sister Anno Domini does not need theology. To those who had 60 March, 1953 SUMMA FOR SISTERS not the opportunity for the study of theolo~gy God undoubtedly supplied. He fits each one with the grace needed for the task He wishes her to do. Theology was not ava~labie for those Sisters, nor had they the same problems to face that the Sister of 1953 has: St~ch an excuse will not hold today. The separation of study from. prayer is not a new problem. But the brilliant patron of Catholic schools has left a method by which study can be employed to direct the interior life to God. St. Thomas Aquinas in his Summa Theologica has synthesized the whole rela-tionship 'between God and man in the most perfect harmony. Courses in the Summa Theologica have been opened for Sisters at various centers. Seven of these summer schools'stem from the one at Provi-dence College, Providence, Rhode Island, where the" Summa is stud-ied article by article in courses specially adapted to religious women. Other schools use Father Walter Farrell's Companion to the Summa as a text and the great classic itself as a reference. In accord with the spirit of Saint Thomas and in fulfillment of the spirit of the Do-minican Order the spiritual formation of the religious teachers at-tending Providence College transcends the intellectual. Otherwise the real purpose of the stud~ of theology would be subverted. There is not a mother gener~l anywhere who would grope for an answer if asked whether she would rather gend but in September good religious or good teachers. However~ the study of theology on a graduate level, although enthusiastically endorsed by all the Sisters who have t~iken the courses, is not yet as widespread as it should be. Many consider other educational requirements more pressing. That these members of rel.igious communities may eat their cake and have it too--with icing--Providence College also offers a course in the Summa and additional intensive study of special questions with a master's degree in religious education upon its completion. Theology is the antidote for those who fear that higher studies will~make the Sisters proud, just as it is the preventative for worldli-ness in secular subjects. No one who has learned the Catholic teaching on grace: thai it is "God Who moves in you both to will and to accomplish;" that you cannot even want to be good unless God gik, es you the grace bf that holy desire; no one who has learned the glories of the gifts and fruits in- the soul can find it in her heart to be proud. A man must walk to God by steps of the will, but the mind must tell him tb Whom beis walking and what road he should take. 61 SISTER MARY JUDE Review [or Religious The mind was created for truth, the' will for good. To know the truth and to choose the good a man must have grace. "Not that we are sufficient to think anything of ourselves, as of ourselves: but our sufficiency is from God" (II Cor. 3:5). Humility, St. Thomas teaches, is truth. A distinctive phenomenon of the "active" orders today is the !number of religious seeking to change to a p'urely~contemplative life. Although their final profession is far enough behind them that they should have arrived at some proficiency in the delicate balance between praye.r and work, they now seek to transfer to a cloister. While God. for His own reasons may thus call a Sister, such a voca-tion is unusual. Eor every Sister who makes such a change there are many who for a variety,of reasons never effect the transit. They ar-dehtly desire this transit because they, presume it will bring closer union with God. The Sister who would exchange classroom or hos-pital corridor for cloister, has not yet been brought to a realization of the fulness of her vocation. She is willing to settle for less than th~ overflow of contemplation which needs to find an outlet in lifting her neighbor to God. The author of the.Summa, a high-octane teacher if ever there was one, could, without diminishing any of the power of his spiritual life, give himself to the service of his neighbor, for his compass was ever pointed toward truth. Thomas of Aquin had a list of accom-plishments no superior would dare .assign one person today. He t~ught school, preached, wrote something like 36 volumes, carried on an enormous corresponder~ce, traveled back and forth a~ross Eu- ¯ rope on foot several times and was at every'one's beck'and call. The: religious who resents teachers' meetings which take 'up her valuable time can recall the Angelic Doctor laying down fiiS pen in the middle of an article ("Just when I 'got a good start!") when summoned by the Pope to a General Council. To 'the man who was to become the Patron of C;itholic Schools, action and contemplation were inter- 'woven, interdependent. "Goodness diffuses itself," St. Thomas wrote, and the religious woman who has enough spirituality~will externalize her love of God no matter what she is teaching, which--if her congregation runs true to form--will be something outside her "teaching field." If a Sis-ter's community'has been progressive enough to send her to on.e of 'the summer schools of sacred theology for religious women, she has a lever which can move the dead weight of secula.rism considered l~y 62 , March, 1953 SUMMA FOR SISTERS the Bishops of the United States as l~he number one problem. Be she art or music instructor, baby teacher or cbllege professor, she needs the lever of theology. With ,Thomistic thoroughness and spiritual benefit both to herself and her pu.pils the religious who has met and mastered the order and harmony of the Summa Theologica can fit the most important thing~ in life intb her curriculum. Observant of the world's needs but not preoccupied by them, a Sister who has studied theology can immerse herself in algebra and chemistry without fear of losing the sense of the presence of God. In Him she will live and move and have h~r convent and school life. She will share with her pupils the fruit~ of her contemplation, be it in her presentation, of invertebrates or by .means of geometry theorems worked out in units and lesson plans. After a study of the Summa Sister reaches her peak performance. She can teach about God through, every medium because she has first learned to know God herself. Thrilled as by high altitudes, Sister has become acquainted with the science of God, has learned what~aan is, has studied the~ principles of human acts in relation to God. She has an appreciation" of the role of grace in the soul and has studied the life of Him who is the Way, the Truth, and the Life. Now that she has analyzed the means utkl-ized by the perfect Teacher, the Divine~Physician, the Greatest of all social workers--the means He has ordered for her and her pupils to share His life--now that she. ha~ this equipment, she can gear every moment of her day to the perfect love of God. A survey of Sisters with graduate training in secular subjects will reveal that few have used more than a small p6rtion of the knowl-edge acqutred in Home Economics or Art or Latin at a university. The training in research, the materials, bibliography, the mental con-centration, the technique of organizing knowledge all are invalu-able. These, however, could be acquired and better orientated after a mastery of the queen of the sciences. If Sister has studied only the first twenty-s, ix questions 6f Prima Pars which treat of the nature and attributes of God, hers is a breadth of vision so vast as to leave her untroubled by all the petty things which disturb conventual peac~ of soul. Placed beside the majesty, t~e b~auty, the simplicity of God; what are the annoying manner-isms of Sister Alpha, the inconsiderateness of Sister Beta, the impru-dence of Sister Ghmma ? As~o.the.Holy Eucharist is the great, divinely-ordered means ~f 63 SISTER MARY JUDE transforming.the human soul into the likeness of Christ, so theology lifts convent life above the narrowest of confines, the most ov'~r- ~rowded horarium, the most pQorly systema'tized routine. From the study of the first part of the Summa Sister learns how great God and from the third part of the same work how much He loves her. No spiritual reading book can grip her soul with the irrefutable logii: of Saint Thomas Aquinas. Once these truths have become part of her life, what difference does it make if Sister Delta leaves most of the work for her, or if Sister Epsilon is congenitally unable to mind her own business? No unctuous sermon whose .resultant glow will be chilled by the first reprimand of a superior can fill her with the peace and joy which a knowledge ~f sacred doctrine brings. Theoiogy is thus definitel); needed by all members of our educa-tional system. There is not a Sister in the Catholic Church who feels :satisfied with the results of her teaching. "Ask Father in confession," ¯ will no longer sufficb. Problems brought to Sister by pupils and ex- ¯ pupils by parents and friends should ordinarily be solved by her. .All too frequently.' those turned away will lose their nerve long be-fore they reach the confessional. Many, many people have never :asked a question in confession in all their lives. They would not know at what part of the confession to interject their request for in- .formation. Besides, they feel th.at, knowing SiSter's sympathy and good sense, they would get an answer which would take into tic-count all the circumstances peculiar to their own situation all of which would call for an autobiography in the confessional. As for asking Father outside--oh, no, he's too busy--even though Father, like Sister, is eager to help them. Moreover, there is small danger that Sister is presuming to answer questions and pass judgment in matters requiring.a trained physician Of souls. One of the biggest and surest and most lasting lessons Sis-ter carries away from her study of the Summa is how mu~h she doesn't know! And as she packs a trunk bulging with all the "teaching materials" Sisters tend to accumulate, she doesn't wonder anymore if the v~orld is sneaking up on her, for if she could, she would fill her arms with the world that she might 'give it all back to Christ. IEDITORS' NOTE: Although we would not entirely agree with some points in tml arti_cle, we believe that it calls for careful consideration and perhap~ for some a~o~- sion. Communications on any of the points, pro or con. woUld be welcome.; 64 The blidden Life Michael Lapierre, S.J. T lif~ HE of Our Lord falls into two distinct parts--the hidden life and the active life. The one is predominantly a life o~ .~ prayer, the other predominantly a life of activi.ty. The one comprises a period of thirty years, the other a period of only three. Tile life 'of Mary His Mother'and of His Foster-Father St. Joseph. was, moreover, scarcely ever in the public eye. As .a root supports and steadies the stalk and flower, so they supported and prepared, their Son for His future ministry. So in the hidden life of prayer, penance, and silence led by many in the world today whether in or out of religious orders and congregations, whether with or without vows, we find the root fixed in the good ground by the bank of living waters. This root supports and helps to energize the vast apostolic enterprise of the Church of Christ in the vast chaos called ~ the modern world. It may seem strange, in an age when there seems so much need of active work in the Church and outside of it, that the Church leaves. thedoors of.her monasteries sealed up, does not send a trumpet call to her monks and nuns to rise from their benches of prayer, to doff the robe of elected silence, to step forth from'the monastery wall and cry forth, like the Baptist, the words of light, of life, and of salva-tion. It may seem strange that the Church chose a contemplative as a patron for that most active 0f her activities. For over her intense as well as.extensive mission activity the ChurCh has placed the Car-melite contemplative, St. Thir~se, the Little Flower. And it makes us re~flect a little too when we read of Plus XI singling out a monastery of Trappist monks in the vast mission field.of China for special praise ¯ and commendation. "What can these do in the mission field?" we are tempted to ask. Missioners must instruct, preach, baptize, con-firm, perform marriages,.absolve, be at the ready call of the sick and ¯ the infirm. And how can a monk do this! Yet it is not too strange after all, if we reflect for a few moments upon a few salient truths. Only let us not forget that we are speaking , now as men possessed of the precious treasure of the faith wherein so many things are made clear to us at which unaided reason might~ fumble and endlessly stumble. Yet it is not out of place to mention MIdHAEL LAPIERRE Ret~iew for Religious that¯ pagans in their higher moments did not fail to set abundant stress, upon thefimportance of contemplation. 3apart had her bonzes; China had her monks. , And whatever the motives and intentions of these religious d(votees were, nevertheless there was somewhere.in the depths of their minds, a realiz, ation, dim and distant perhaps, that the better part in the life of man was, after all, contemplation. We are all familiar with the episode .in the Old Testament where-in Abraham is asked by God to sacrifice his Isaac, his only bqgotten and beloved son. It ~vas a hard test of faith and God meant it to 'be so. Abr~ih'am bent his mind to the trial and prepared to carry out God's injunctiofi. But as he raised the sacrificial knife which was to spill:his son's blood upon the altar of holocaust, an angel stayed his hand, saying: "Lay not thy hand upon the boy, neither do thou any thing to him: now I know that thou fearest God, and hast not spared thy only begotten son for my sake'." "At once ~e see that God was pleased with Abraham's intention. And God blest Abraham because in the strength of. his faith'he had bent his mind to the ful-fillment of God's will, though it seemed to Contradict one 6f the promises a~lready made to him. We are not so familiar per.haps.with that passage in Psalm 49, ¯ where God so emphatically insists through the mouth of His P~alm- "ist that internal holiness must accompany external worship. Here i~ the passage--"Listen my people and I will speak, Israel; and.I Will bear witness.against thee: I afi~ God, thy God. Not for thy sacrifices do I chide thee, for thy burnt offerings are always before me. I will not take a, bullock f~om th3~ house, nor he-goats .from thy flocks: For all the wild aniinals of the forest.are mine, the thousands of beasts on my mountains. I know all the birds of the air, and what moves in the field is~known to me. If I were hungry I'would not tell you: for mine is the world and what'fills it. Shall I eat the flesh of bulls? or drink the blood of he-goats? Offer to God the sacri/ice of praise, and pay thy vows to the Most High. And call upon me in the day of trouble; I will deliver thee, and thou shalt glorify me." From this we gather then, that all our external activity, all our efforts ha~'e little or no ,value bdfore God, if our ~minds and hearts ire ,no't in harmony with Him, if we are not seeking him in all "our doings. - We recall too how Gabriel responded to Daniel the Prophet who with prolonged piayer-lnterceded for his people: "From. the ~begin- " ning of thy prayers the word came forth: and I am come to shew it to. thee,, because thou art a man of desires: therefore do thou mark 66 March, 1953 ., THE HIDDEN LIFE the word and understand the vision"~ (Dan. 9:22). Because he was a man of desires, a man of prayer, therefore a man with his mind turned towards God, Daniel's prayer is heard and God reveals him-self to him in pra~yer. Many, many tim~s we have heard repeated or have used ourselves the words of Our Lord to Martha concerning Mary Magdalene: -"Mary has chosen the better part which shall not be taken away from her." And to this saying of Our Lord we. may add another less familiar, spoken to His disciples who asked Him why they could not drive the devil out of the boy: "This kind goeth not out but. by prayer and fasting." All these instances show that God fin~Is as much'delight if not more in the 'supreme effort of man to keep his thoughts subject to God as He does in the supreme effort of man to plant the divine truth in other souls. When we bow before the Will of God. when we strive to extend our mind into God's breadth of view, when we b~nd the whole energy of our being into praising, reverencing, and serving God then we are practicing the Apostolate of intention. All*men must practice this to some degree. For all rrien are by -nature reflective animals. They like to turn in upon.the truth ~hich they have discovered---if they are action-inclined, with a vie~- gen-erally to further action: if they are contemplation-inclined, for sheer love and'joy. The missioner and the contemplative each c~rries on a warfare for souls his own soul and the souls of others. While the missioner works in the macrocosm, we magi say that the contem-plative works in the microcosn~. The contemplative finds God in the' depths of his own thoughts, the missioner finds God in the souls for whom he is spending himself. The contemplative is constantly employed in tapping the source of supplies whence flows the grace of God; the missioner ,is directing this supply" to souls. In the redemptive plan of' God each has his activity, each his definite purpose. Nor are.these 6perations opposed to one" another, but rather they are complementary. In the words of St. Paul, "There ar~e diversities of graces, but the same Spi.rit; and there are diversities of ministries, but the same Lord: and there are diversities of opera-tions, but the same God, who worketh all in all" (I Cor. 12:4-.7). Nevertheless because we are human clay equipped with senses easily and quickly captivated by creatures, perhaps 'because we are a fallen race filled .with the pride of life, caught by the glory of re-nown. haunted by the eclat of reputation, thrilled to be. in the public 67 MICHAEL LAPIERRE Ret~ieto for Religiot~s eye and to have our name trumpeted on the lips of men, we rush for-ward, or set high in our estimation the active phase of apostolic en-deavor: For when all is said and done, has not St. Paul received abundant glory through the ages for his ceaseless journeyings in the cause of Christianity? Think of St. FranCis of Assisi, the troubador "of God singing his way into the hearts of the sinners a'nd of the poor of the Middle Ages; think of St. Catherine being the counselor of kings and popes; St. Francis of Sales winning the stern Calvinists by his disarming evenness of temper and charming good humor; St. Philip Neri entrancing the stolid Romans by his laughter and even saintly jocularity; St. Teresaof Avila, a real Napoleon in her struggles for the reform of the Carmelites. There is a strong appeal in this active apostolate; an appeal enhanced by the passage of time and by the softening of the cross's painful outline in the blaze of .after-glory. "They are the heroes," we say. "How I would like a career like that," or "@hat's the'life for me." "If only we could set the world on fire as they did. If we could cast our lives in such a mould." The supreme success of it dazzles us indeed! Two Apostlesj bad the-same thought that we have had when they sat near Our Lord one day and brazenly asked Him, "Lord may we sit, the one on Thy right hand and the other on Thy left in Thy Kingdom? , And Our Lord replied, "Can you drink of the Chalice of which I shall drink?" As they, so we overlook or forget to see th~ pain and the penance~ paid for such renown. The.glory came only after the crown was. won. If we wish to be realistic we must concentrate on the prelude to alFthis glory. We should see St. Paul, ','preaching not ourselves, but Jesus Christ' Our Lord; . . . in all things suffering tribulation,-but not distressed; straitened but not destitute; persecuted but not forsaken; cast down but not pe~rishing: always.bearing about in our bod~, the mortification of Jesus, that the life Of Jesus may be made manifest in our bodies" (II Cot, 4:5, 8- 10). Hear him cry, "Let us exhibit ourselves as the ministers of God in much patience, in tribulation, in necessities, in distresses, in stripes~ in prisons, in seditions, in labors, in Watchings, in fa~tings, in chastity, in knowledge, in long-suffering, in sweetness, in the Hol~ "Ghost, in charity unfeigned, in the wo~d of truth., as dying, :and behold we live; as chastised, and not killed; as sorrowful, yet always ¯ rejoicing; as n~edyl yet enriching many; as having nothing: yet pgs-sessing all things" (II Cot. 6:4-10). We should hear him say, "God forbid that I should glory save in the cross of Our Lord Jesus Christ 68 March. 1953 THE HIDDEN LIFE by Whom theworld is dead to me and I to the world." We should picture to ourselves St. Francis of Assisi contem-plating and praying to God on the lonely and solitary slopes of Mount Alvernia: St. Catherine drawn' from h~r loving contempla-tion of her °Saviour into the world of turmoil and dissension: St. Francis of Sales pouring out'his soul in prayer to God: St. Philip Neri as the "Hermit of the Streets" whose "little room l~ad a bed in it but that was not always used. Many nights Philip stayed,,up praying or wandering in the Campagna. When he did sleep it was as like as not on the floor. He hung what few clothes he had on a cord stretched from wall to wall." (T~ Maynard. M~cstics in Mot-le~ . page 25.) These are a few indications of the lives of prayer and penance led by men and women whom we know to have been extremely active in the work of spreading God's Kingdom on earth~ Their days and hours of contemplation are concealed beneath the radiance of their active lif~. But just as the sun's rays blind us to the sun, so the glory of these saints' public l~fe shields from us the depth and the richness of their hidden life. And yet, as' ~ith the sun, so with them the brilliance of their renown takes its splendors from the ~ullness Of their prayerful nights and silent days wherein the energy of their souls and bodies spent itself upon God and upon His truth. With their whole souls they sought God: and loving Him with all the fire of their whole being enriched by grace, they loved other men and all things in this one all-consuming love. They set in order and tried to keep aright, the creatures in the little world of self before and even wh~le venturing among the creatures of the larger world of God's creation. In all they strove for God--in everything they sought to live the morning offering made to the Sacred Heart. ' This was-the, hidden life behind, shall we say, the feverish activity: this was the wellspring that on no account they allowed to run dry. If in the earthly life of Jesus we find such a startling proportion between the 'years spent amid the hills of Nazareth and years spent on the stage of public life; if ia the lives of the saints we find the sami~ preponderating inclination to slip into prayer, penance, and seclusion, surely we have a truth to learn and a lesson to practice in imitating Him and His chosen souls. The Church, the Body. of Christ, has caught this lesson; there-fore she cherishes with a jealous love and guards with zealous ca~e those of her members°taking Nazareth for their ideal and the prayer-z 69 MICHAEL LAPIERRE ful life of Mary and Joseph. f6r their model. Fbr she is quite aware that they carry on a very vital, though, unseen activity, just as Mary and Joseph performed a very important task in ~uarding, feeding; cI~thing, and teaching the Son of God. For they, walking in the footsteps of Joseph and Mary, guard, feed. c'l~)the, and'enrich today the Mystical Body of Christ. As consecrated workers of Jesus Christ. we need their intercession and support. Furthermore we need to strengthen the life of grace and of union with God ~n our own souls. If we have, a realization of the value of the Hidden Life we shall go ab6ut this with a wil!. To the degree to which we have formed in ourselves a knowledge and a love of J~sus Christ. to that degree even in the midst of the heaviest .and the most annoying work we shall find our minds and our hearts stealing back to taste and to relish the sweetness of the Lord. To Him our desires will fly as to a'harbor and a refuge; for Him our. whole soul will yearn: 'Who will give me wings like a dove and will fly and be at rest." "I have sought him whom my soul loveth . I have found him and I. will not let him go." "I have loved O lord the beauty ofThy house and the place Where Thy glory dwelleth." "How lovely are Thy tabernacles O Lord of hosts! My soul longeth and fain,teth for the courts of the Lord." It is the v,r-" rues of the Hidden Life that we must sow'and make to take root and flourish in. our souls. The better we succeed in this planting the more contemplative our lives will become. And the ,more contem-plative our lives become the.deeber and richer will be our knowledge of God and of His. love. The deeper and richer our knowledge and love of God becomes, the fuller and livelier becomes our Apostolate of Intention. For then we shall move about our daily tasks, then we. shall face our duties, then we shall ac'cept the disaplSointments of each day, then we shall welcome the joys of our pilgrimage, With one thought, with all the ene.rgies of body and soul, senses~and mind concentrated on one object, ,the seeking and the serving of God in each and everything that we think and say and do. For, "Many Waters cahnot quench charity, neither can the fl.oods.drown ,it. If a man sh6uld give all" the substance of his house for love he shall despise it as nothing." ' ' PROCEEDINGS: SISTERS' SECTIONOF CO'NGRESS Religious Comrnunitg Life in the United States. The Proceedings of the Sis-ters' Section of the First National Cgngress. Of Rel!gioUs' of .the United States, which was.held at Notr, e Dame, Indiana, last August, can now; be obtained from the Pau!- ist Press, 411 W. 59tbSt., Ne~, Ysrk 19, New York. $2.50. 70 I:::at:her bler!:ling on I nt:usefl Cont:empla!:ion Jerome Breunig. S'.J. 44~UT do not think you are mystics just because you have read ~ Garrigou-Lagrange's Three Ages of the Spiritual Life," said the rector of a major seminary who had been urging all to buy and read the book. The laudable prOmotion of books on the :mystical life often produces two very different reactions. Some are inclined to make too little of the possibility or desirability of mysti-cal graces, while others tend to be enthusiastically over-optimistic and. after some quickl.y digested reading, imagine they are in the "fifth mansion" as soon as they experience a few moments of serene prayer. In his manual, Theologica Ascetica. Louis Hertling, S.3., presents the basic, element.ary facts of mysticism b¥iefly and concisely, and in a way that 'inculcates respect in those iiaclined to be cynical or slighting and prudent reserve in those who would seem to expect to attain to infused contemplation in ten easy lessons. Father Hertling taught a course in ascetical theology at the Uni-versity, of Innsbruck and later at the Gregorian and Athenaeum Pon-tifical Universities in Rome. He first published his lectures in 1930 under the title, Lehrbuch clef Ascetischen Theologie. His lectures in Rome were published in 1947 by the Gregorian University Press as Theologia Ascetica. The present a'rticle is drawn from the section in the latter which treats of the way of the perfect, numbers 327-367. It does not attempt to reproduce the entire content but rather some of the more practical directives found in the treatise. Father Hertling's ideas about the theoretical problems of mysticism, the essential nature of it, and so on, are not accepted by many other theologians, but still ~they are well worthy of consideration and respect. His practical directions seem. very sensible and excellent. A mystic is defined as one who has infused contemplation, and infused contemplation as a perception of God orof the mysteries of faith wbii:h is beyond human powers. This perdeption is not miracu-lous as the vision the shepherds in Bethlehem-received, as bearing a voice from heaven, or as a prophet's infused knowledge.of, future events:~:. It is not necessarily altogetbe~ new knowledge, bur"it is a new way of knowing as the beatific vision is a new way of knowing. 71 JEROME BREUNIG Revieu.~ for Religious In fact, infused contemplation is in. the same order as beatific knowl-edge, but it lacks the clarity, extension, and permanence of the oter-hal vision. In the natural order, some of our knowledge is proper, some analogotis. We have proper knowledge of what we perceive through our senses. Of spiritual, suprasensible, and supernatural reality, such as, of God and of the, mysteries of faith, we can have only analogous knowledge naturally. But' supernaturally, through the mystical grace of infused contemplation, the favored soul receives more than that: it receives a proper, that is, a sort of immediate, experimental knowledge of the things of God. The definition 'of infused con-templation can therefore be stated: an experimental or at least quasi-experimental perception of God and of the divine mystdries. In simpler language, the mystic might be said to "sense," "touch," "experience" God. In the beatific vision we shall see God face to face, we shall know God as we are known by Him. This description by St. Paul (I Cot. 13) is magnificent and clear, but he does not explain how the finite mind attains the infinite. Theologians have proposed theories, .but all agree that the beatific vision is a~mystery in the strict sense of the word. Infused contemplation presents a somewhat parallel case. A mystic is said to "experience" God, and theologians propose theories to explain this divine experience. Such investigation is challenging and serves to increase the awe of the searcher before the grandeur of the divine, but it does little to unveil the mystery of the divine opera-tion. Father Hertling merely mentions a few of the theories and then quotes from his former colleagi~e at the Gregorian University, the late 3oseph de Guibert, S.3. "Many place the essence of infused contemplation in the soul's becoming directly and immediately con-scious of the supernatural gifts which it has received from God, and in these gifts attaining God Himself and through them His presence and action in themselves. There is no immediate intuition of God but an intuition in ~ mirror, in some objective medium . Nor must it be thought that the object of contemplation is not God Him-self but only his gifts. For these gifts are not only a mirror or medium in which the soul attains God, not by a dialectic process or reasoning, but intuitively, as when I see an object in a mirror, my attention does not stop with the mirror but is wholly taken, with the object that is seen in the mirror." (Theologia Spiritualis Ascetica et Mgstica, 399,401.) 72 March, 1953 I N FUS ED CONTEMPLATII21~I Some Questions Is the grace of infused contemplation ordinary or extraordinary, relatively rare or frequent? Do all have a vocation to it or only a few? Is infused contemplation the normal goal and crown of the spiritual life or not? There is a difference of opinion among theo-logians on these questions. In general, Father Hertling's position is. that ~he grace of infused contemplation is extraordinary and rela-tively rare, that not all are called, and that it is not the crown and 'goal of the spiritual life. He is careful, however, to make proper distinctions on each qiiestion. ~ Is the grace of contemplation extraordinary? It is if understood simply as not customary. But it is not in the sense that it' would be rash to wish it for oneself, to pray to,receive such a grace, to prepare dispositions as occasion offers, as it ,would be imprudent to seek visions or the gifts of miracles. Is it relatively rare? Those who deny that contemplation is rela-tively rare say that all who are in the state of grace possess it because it is the specific effect of the gifts ,of t,he Holy Ghost, which are in-fused with sanctifying grace. Sin~e it seems contrary to experience that all in grace have infused contemplation, those who hold this opinion say that the contemplation in the imperfect is still below consciousness, and, as perfection increa.ses, or as the soul is more and more freed from inordinate affections, the infused contemplation enters more and mo~e into consciousness. After agreeing that infused contemplation is an effect Of the gifts, or rather that it is a special gift of th~ Holy Spirit, the author gives this ~refutation. Infused contemplation is an act of the intellect or~ at least, it is to be considered in the category of actions and not of qualities, or habits. Now, an unconscious act of the intellect, or an illumination of the mind that is not perceived, seems to be a contra-diction. For this reason, it seems more correct to say tl~at the.gifts infused at the time of justification place in the soul a remote disposi-tion to receive contemplation, but contemplation itself is had only when it enters into consciousness. It would not be necessary for the favored soul to know this rdflectively,, for he could have infused con-templation without knowinlg it was such, or knowing that it wa~s something that others did nbt have. The point is, if it is perceived I in no way~ it is not present.] Are all called to contemplation or only some? This. call can be compared to the call to perfection. There is a remote call for all, if 73 JEROME BREUNIG': ~ Review }'or Religious the reception of sanctifying grace with the ~ifts of the Holy Spirit is considered, sufficient for such a Vocatioh. The author denies a,proxi-mate vocation for all. God does not promise .this grace to. all ',who to-operate as well'as they can with the grace they receive, for God does. not lead all by" the same way, nor does He want to.' God can ~ompensate for the absence of infused contemplation by giving :othei: graces to. help ~i'man attain perfection. Of course, 7the man with in-~ 'fused contemplation will advance more easily and can more re~idily advance .higher on the w.ay of perfection. The not-unrelated question of whether infused contemplation the goal and crown of the spiritual life is answered in the same way. Perfection, or. the goal of the spiritual life, is judged l~y the heroic ~,irtue of a man rather t-ban by his method of prayer. As said above, o ] a, man can attain.perfection without co, nterflplation. Contempl.ation, then. is rather a very efficacious means to reach the goal than the goal .itself. On" the Value of Contemplation The author steers a: middle course between the two extremes found among spi~i.tual directors. On the conservative side arethe spiritual directors who fear infused contemplation in souls hndet ~heir direction, are always afraid of illusions, and try severely the sbuls who may show signs of" contemplative graces. On 'the ovef-enthusiastic side are those who woul~l urge a.nd persuade all novices and young religious that they al~eady have ~or may soon expect in-fused contemplation. These 'men are often deceived by the theories spoken of above, such as the universal call to contemlSlation. Even the theologians do not understand these theories as some dir~ectors would wish to apply them, In this way they~le.ad souls, a~'S~. The-resa says; to'intrude themselves into mystical paths where ihey carry on as fools. On the other hand, infused Fontemplation is not as rare as many b~lieve. The highbst levels are very rare but not the qesser grades which are still 'true mystical states. It would not be tOO much to expect tofind one Or 6ther true contemplative in a large~ religi.ous community, and this not only ~m0ng':'jubilarians. Norneed such religious'be parii~ularly conspicuousbr riecessari.ly revered a~ tibly by '~'11. When a spiritual director meets,such a soul, he need not be filled witl~ dismay. I~ is not too urlusual or da,ngerou~: 'Generally speaking, graces are not dangerous. Illusions appear when there is question~ of something other than contempI'ation itself, such as visions, revelations, supernatural commands.' Of such phenomena March, 1953 INFUSED CON:FEMPLATION Father.i-iertling says: "'I would not believe one in a hundred or even one in a thousand." It can happen that one believes he has infused contemplation when he only has affective prayer. But even this is not harmful if it has the effect of f6stering.,the practice of virtue. When the diredtor investigates too much in these matters, intro~- duces.special trials, and especially when he talks too much about them, he may not only disturb but even cause ,the person he is directing to form too high an opinion of himself. The effects of ihfused'contemplation are ve, ry powerful and most desirable, especially when they occur ~ frequently. Success in living a life of virtue depends on,holy thoroughly the Interior life is pene-trated with the truths of faith. A man will constantly practice heroic virtue 0nly when he is completely penetrated with the truths so they.hold sway in his heart and mind over all else. This interior state can be acquired with labor by ordinary means such as medita-' tion. but it can be attained more quickly and efficaciously with the help of thatspecial light sent from above. In" an ordinary-state, the truths of faith, known only analogously and not directly, have less psychological efficacy, and this must be renewed continually by un-ceasing laboi. In infused contemplation, a man acquires a qug~i-experimental knowledge of divine trutbs so that supernaturalrrib: tives have the same or even greater cogency than natural ones. There is real danger when a man leaves the ordinary way iore: maturely and on his own. thinking he already has contemplation when he does not have it. This happens especially when be assumes privileges. True mystics do not have ' privileges." Such a ofiehears that contemplatives find discursive rheditation difficult a-nd. in time. impossible, and mistakenly thinks be is a m)istic when. because"~'of sloth or lack of training, he finds no delight in mental 15~?ayer anal does not m~ike any progress. Infused contemplation is not attainiid by'leaving off meditation: thi? would rather cut short an~ hope whatever of acquiring it. Since even authentic mystics are not always illumined by contemplation,~ they must in the in~erveni'ng time return tirelessly to ordinary ways of prayer. Again, an immature ~eligious he~ars that contemplatives ~re under the direktion of the Holy Spirit, as though contemplation would act )is a spiritual director, and therefore thinks that he'can now act freely and without'the counsels of older me'n. These illu-sions and dangers do not rise from contemplation itself, but from the error of those who do not have it. It can be seen that out-of.'seasdri 75 ,JEROME BREUN[G admonitions that all are called and must tend to contemplation could do more harm than good. Conditions and Dispositions Since contemplation is a. gratuitous gift of. God, it is not easy to determine the conditions or dispositions that would be more favor-able to the reception of this grace. The best natural dispositions for infused contemplation would seem to be a clear mind, seriousness of purpose, and a simplicity or harmony of character. Contrary. dispo-sitions would be genius and a highly imaginative or emotional na-ture. Too much versatility and talkativeness would also seem to be hindrances. In general, mystics are not reformers, innovators who blaze new trails, or critics. A youthful exuberance would also seem unfavorable. A maturer age (after 40 or 50) and a more tranquil outlook are required. Ordinarily, mystics are men with few ideas, but these are sublime ones. Sometimes their writings tend to be monotonous, continually presenting the same round of thought in the same style. Universal spirits such as St. Bernard and St.Theresa of Avila are the exceptions rather than the type of the true mystics. The ~study of mystical theology, association with mystics, and reading their books does not help directly. It can help indirectly by stirring up. interest in the study of the things of the spirit. Infused contemplation is not "contagious." There is no such thing as a mystical movement in the Catholic Church. Collective mysticism is almost certainly a sign of false mysticism. The best deoeloped dispositions for infused contemplation are magnanimity, the spirit of sadrifice, separation from the wbrld, self-denial, and an intense application to prayer. Without the greatest' diligence in cultivating mental prayer, persevered in over the years, there is hardly any hope of attaining to contemplation. The need for chastity and mortification is clear from the examples of the saints. As it is the best way to sanctity, so the religious life provides the most suitable form of life for the cultivation of a life of prayer. Con-templativeorders are particularly.adapted to help their members at-tain this higher state of prayer. It is not going too far to see in a vo-cation to a contemplative order a proximate vocation to infused con-templation. Still, the membe~ of a contemplative order who does not have this conten~plation is not on that account a poor religious, for the purpose of the religious life is always Christian perfection, which can be had without contemplation. But even those who live an active life dedicated to works of charity for others can attain contempla-tion as is attested frequently in the lives of, missionaries. , Xavier t:he Missionary J. J. De~ney, S.J. ALTHOUGH more than ten years elapsed from the time Xavier landed in India on May 6, 1542, until his death on Decem-ber 3, 1552. less than four years and ten months.were spent in the Indian phase of his apostolate, and even this time was very much broken up by movements from one place to another. The field in which he v~orked longest was the Tamil-speaking sections along the Fishery Coast and the southern coast of Travancore, and even there his stays totalled less than two years and were spread over a coastline considerably more than a hundred miles long. Making liberal allowances we can admit that Xavier ma~ have spent seven-teen months in Goa, but these months were diyided over the whole ten years of his stay in the East, and much of the time here was spent in working with the Portuguese and in administrative work. The time Xavier spent in mgving from one part of India to another. usually by sea, certainly totalled up to many weeks and probably months. The remaining time~ includes stays in Cochin (at least seven different times). Quilon, Bassein, Negapatam, and Mylapore. We must remember too that Xavier's work in Goa and the coastal towns of the Por,tuguese was much different from that among~ the Tamils of the south. Yet in spite of such a sho'rt-lived and diversified apostolate Xavier was to become the "Apostle of the Indies," and to be known and revered as such throughout the world. Few saihts are better known and loved than Saint Francis Xavier. and no country is more closely associated with the name of Xavier than India. How did Xavier merit such a close association with India in these few years of work in our country? Since Xavier's most typical missionary work was in the South. we will first consider his work done there. ~ In late October'of the year 1542 Xavier arrived on the Fishery Coast as the ~only priest among twenty thousand recently baptized Paravas in desperate need of religious instruction and speaking a language which he did not know. He set to" work energetically: studying the language, in-structing the people, and baptizing their children. " In a country where the birth-rate is high and life-expectancy is J. J. DEENE¥ Review for Relioious low. we can easily imagine that the unbaptized children who had ~been born since.the priest was last present among .the Paravas num-bered at least four or five thousand, for it is not likely that the unin-stru. ci~d Paravas baptized their children. Besides this. Xavier bap-tized many,dying babies of pagan parents: in one letter he tells us that bebaptized over one thousand babies who died soon afterwards. Thes~ facts alone would explain Xavier's great preoccupation with baptisms, which is reflected in his letters. However. be also baptized great numbers o'f pagan adults, first of all on-the Fishery Coast whe're he tells us his arm often becfime tired from baptizing new converts to the faith: and finally in Travancore where he himself testifies that be baptized ten thousand in one mon(b among a people who 'bad never before been introduced to Christianity. ° ,It is true that Xavier did not requird a prolonged catechumenate prior to baptizing, and that his "'quick" .baptisms of~ pagan adults wot~ld surprise us of a more exacting age, but we must realize tile cir-cumstances in which Xavier worked. When be came to ~heFishery Coast be was confronted with the immense task of instructing twenty thousand new Christians. baptizing their ~hildren. and gaining new converts. Necessarily the instructions had to be on a limited scale. The people were uneducated and Xavier had to rely for the far greater part on formulas memoi?ized in probably defective Tamil. To bring new converts to the same low'level of instruction witb"tbe rest~would not take much time. Xavier just bad to keep working, trusting in God, begging for more helpers so that be could raise the level of all. old and new Christians. and at least he had the cgnsolation of knowing that those Who died had been baptized." could be fairly sure of the stability of his new converts. The oppor. tunism which had led the greater number of these people to the faith would be a-strong inducement for all of them to remain Christians. for this would be their surest guarantee of protection against the Muslims. Meanwhile Xavier would work hard to supernaturalize their motivation and deepen their religious knowledge and their life of grace. ~ The whole movement among the fishermen of Travancore is but an application, on a grand scale of the same attitudes. Xavier had a sudden'opening, an invitation from a grateful local king to enter his territory and work among the fishermen who lived a!ong the coast. Xavier seized the opportunity and went swiftly from village to village briefly instructing and baptizing the people before 78 XAVIER THE MISSIONARY, the moment would pas.s: alrea'dy he-had .some help,.on tl~e Fishery. Coast when this new opportunity presented itself, and'he was confi-dent that new recruits for the mission would soon arrive from. Europe. These would have to consolidate the work. A modern missionary would perhaps be more cautious, and even some of his fellow missionaries;held a stricter view. Surely-one element which we cannot, excliade'in Xavjer's case is the prompting of divine grace, and We ha.ve, nogreater proof of this than the, strong Catholic .faith which still exists among .these peoples. Xavier's work in Goa and the Portuguese ,centres" wa~ cast in a different.mould, but was no less taxing on his energies. The Goa of Xavier's day was far frbm being a model of strong, religious life. Many of the Portuguese were soldiers of fortune away from the. type of family life that might promote even a modicum of decency. For their own sake of course these souls were important to Xavier: more; over, he saw that unless the life of the Portuguese presented a favourable picture of Christianity,.~tbe Indians would havi~ no inter-est in it. So ~a large amount of Xavier'.s attention was given to the Portuguese, preaching to them, hearing, their confessions, visiting the sick and those in prison, using every means of personal contact by ¯ .which be thought he could bring individuals around to'a better way of living. But the Indians were in no way neglected, and Xavier frequently put-aside special time for them and considered it his° greatest glory when he could find time. to.be with their children. - In all these .activities Xavier followed a very exacting time schedule. We know from the eloquent testimonies of Xavier's contemporaries that his presence infused a renewed spirit into the city- of Goa. In all fields of his activity Xavier's form of apostolate was ~tarkly dire~t. He could not afford to spend his time .producinig plays or organizing boys' ball clubs; there was too much to be done. Rather he approached the people ~ immediately off a highl.y spiritual level. He, tried to imbue everyone he contacted with a sense ofthe importance of .the part they must play in the work of. the apostolate. He considered the children ideal co-apostles, and frequently mentions, working through tl~eir instrumentality. His-letters to the King of Portugal find to the'local officials are ferven,t pleas-that they may do all they can~ to eradicate the abuses which are such.a hindrance to the work, a~nd:that~they may render every positive help they can. In his" numerQus.letters to his fellow ,Jesuits working.in India he constantly guides, and ~ncourages them. and we. know, from the testimony of 79 d. d. DEENEY Review [or Religious these Jesuits that his personal contact was a source o~ great inspira-tion to all of them. Even the letters which Xavier sent back to his companions in Europe produced great good for the work of the mis-sion in India, for each new letter was dagerly sought and widely cir-culated in the Jesuit colleges, and they captured young imaginations and set generous hearts on fire. Thus besides what Xavier did him-self in ministering to the good of souls, he gave a tremendous impetus to the work in India by imparting to others some of the warmth of the flame that burned within him. ~ But isn't there a negative side of Xavier's work in India which we should .not overlook if our picture is to be complete? It is very likely that the modern missiologist would not always find~ in Xavier's life the best exemplar of present:day mission theory." We find in Xavier's life no serious attempt at a sympathetic approach to the cultural life of the India of his day, nor do we see signs of his taking those means of adapting his ways to the ways of the people such as would later prove so effective in De Nobili's apoitolate. Xavier occasionally met Brahmins, but from the start he brands them as being "as perverse and wicked a set as can anywhere be found," and when he had one long talk about Indian religion with a learned Brahmin, he considered the fruits of the ~discussion not worth recording. Xavier knew that Indian literature is largely con-tained in a "sacred language," but there is no indication that Xavier ever considered learning this language. The fact that he started to use the vernaculars immediately is surely a strong point in his favour, but we have indications in Xavier's letters that his knowledge of the vernaculars was quite limited. After a year and a half of the two years spent in the South where Tamil was spoken, Xavier wrote, "I am among these people without an interpreter. Antonio is sick at Man'apar, and Rodrigo and Antonio (a different one)'are my interpreters. Thus you can imagine the life I lead, and the sermons I give, since they do not understand me, nor do I understand them. And you can imagine my efforts to talk with these people!" (29 Aug. 1544). / Also as we read Xavier's letters we feel that he did not seem to realize the importance, or at least the feasibility, of influencing 'the lower classes of India through the~intelligentsia. His own apostolate was carried on almost entirely among people of lower class, which can be explained perhaps, but it is harder 'to explain the fact that in his letters to Europe he regularly minimized learning as a requisite 80 March. 19~ XAVIER THE MISSIONARY for. the new missionary to India. Moreover, not only did Xavier fail to take positive means to identify himself with the chhUral life 6f India, but on the contrary Xavier, as we see him in his letters, is thoroughly identi~fied with the Portuguese; he was in continuous torrespondence with King John III of Portugal, and with the local officials, and had constant recourse to the Portuguese for. financial, legislative, and even military aid, nor was he slow to let this be known. He also required that all the new missionaries who did not know Portuguese should learn it immedi-ately upon coming to India. These might be considered limitations in Xavier's approach, but we must remember the sphere of action in which Divine Providence set Xavier's efforts in India. Si'nce Xavier's apostolate was either among the usually extremely poor fishermen or else in cities within the sphere of Portuguese influence, it' is natural that his attitudes s~hould he largely fashioned' by these environments. In the South he was absorbed in work for a people who were in constant danger of attacks, and for the sake of his people he had to be in close harmony with the Portuguese. In-the coastal cities ~ontroIled by the Portu-guese he had no other choice. Portuguese power would intrude itself whether Xavier wanted it or not. Actually much of Xavier's inter-~ vention with the Portuguese authorities was exerted in order t6 keep the Portuguese from hindering his work. Also we must realize that Xavier lived at a time, when Church and State were still very closely linked together, for good and for evil, and that he was working in a sphere where the State was actually willing to do much to aid the spread of religion, so it is natural that he availed himself of this aid as much as he could. This can explain Xavier's failure to adapt his ways to a more typically Indian society. It explains his failure to. consider learning as a necessary requisite for the new missionary. The apostolate of the Fishery Coast and along the southern coasts of Travancore re-quired practical men of robust health and solid virtue; for'the sea-towns controlled by the Portuguese he required good preachers also, apparently mostly for the benefit of the Portuguese, who were, for tl~e greater part, not so'much"in need of priests who could explain the fine points of dogma, as of priests who could shock them out of their attachment to sin. This brief description of Xavier's works helps us understand something of the accomplishments of.Xavier, and also something of 81 SUMMER: SESSIONS Review [or Religious the limitationk in his techniques, but it does not show us positi3~ely the tremendous force which,was Xavier. This can be gotten only by a direct personal study of Xavier. the man. the saint. Happily it is a study to which we have often applied our minds and hearts. Xavier is above all a marl entirely dedicated to God and absorbed in the work of winning s'0uls to God's love and life. Every line of his letters breathes this whole-soul absorption: nothing else matters: there is never a thought of his co~fort nor of rest: always the work to be done: .He is a man of intense activity, but the action never gets in the way of his deep union with God. His trust in God is unbounded i he fears only not to trust. 'Grace and nature gave him a heart with a great capacity for loving l~is fellowmen, and gave him great powers in influencing his. fellowmen. Indeed, although Xavier may not have made much contact with the higher cultural elements in India. he certainly, showed forth qualities which appealed strongly to all that was finest and typically ¯ Indian in those among whom he worked. For Xavier radiated forth a~ spirit, of profound union with God and of utterpoverty and detachment such as none of the Indian holy men could equal, and Xavier's deep sympathy for his people and willingndss to expend himself in their behalf was something unknown to their holy men, but appealing no less s~trongly on that account to the hearts of his people. Summer Sessions At Marquette University, Father Gerald Kelly, S.3. will con, duct a 5-day institute on Medico-Moral Problems, ~dune 15-!9. This instittite, which, covers all the provisions of the Catholic Hospital code, is for cfiaplains, Sisters, and other hospital personnel. Also, this summer M~rquette will inaugurate a program of studi.es leading to a degree of Master of Arts in the_ology. The program extends through,five summers, and provi~les two plans for the Master's de- .gree: one including a thesis,, the other without a thesis. The. intro~ ductory courses will be given in 1953, ,lune.22LJuly 31, by Fathers Augusti~ne Ellard, S.3., and Cyril Vollert, i.3. Among those who will conduct courses in subsequent years are: Fathers Cyril P. Dono-hue, S.,J., Gerald Ellard, S.3., Gerald Kelly, S.d., and Gerald F. Van 82 Mar¢~, ! 9~ 3 F~R YOUR INFORMATION Ackeren, S.J. For further information ,wi~te to: Rev. Eugene H. Kessler, S.J., Marquette University, Milwaukee 3, Wisconsin. The Institute for Religious at College Misericordia, Dallas, Pennsylvania (a three-year summer course of twelve days in canon law arid :iscetical theology for Sisters), will be held this year August 19-30. This is the first year in the triennial coursd. The course in canon law is given by the Reverend Joseph F. Gallen, S.J., that in ascetical theology by the Reverend Daniel J. M. Callahan, S.J., both of Woodstock College, Woodstock~ Maryland. The registration, is restricted to higher superiors, their councilors, mistresses of novices, and thosein similar positions. Applications are to be :;ddressed to Rev. Joseph F. Gallen, S;J., Woodstock College, Wood~tock, M& For Your Inrrorma ion " Scholarships for Librarians Mary.wood College, an ALA accredited library school, will offer three 'scholarships in librarianship for 1953-54 to graduates of ap-proved colleges. .Two of these scholarships are full tuition, $450, and the third; $350. The course of study for which' these scholar-shops are available le~ids to the, Master of Arts in LilSraria.nship. "They are competitive and are based on scholarship and background. Dead-line for application is May" 1. Address~ Marywood College, De-partn~ ent of Librarianship, Scranton 2, Pa. Futuramic Convention A Futuramic Convention will be held at Central Catholic High S~hool, Canton, Ohio, on March 31 and April I, 1953. Religious ~orders, colleges, business, industry, and branches of the service are in-vited to participate. Those interested can write for more information to Futuramic Cowcention Headquarters, Central Catholic High School, 4824 Tuscarawas Street, West, Canton 8, Ohio. Transparencies for .Vocational Project : A priest, wqrking on a project to foster interest in vocations to the Sisterhood, is: anxious to contact any priest or Sister who has a selection of 35 mm color transparencies depicting the everyday life of the Sister in th~ novitiate, the convent, the school and hospital, and in the missions at home and abroad. Write to. Fr. B. Megannet~, O.M.I., St. Patrick's College, Ottawa, Ontario, Canada. 83 Divided Attention P. De Letter, S.J. ONE of the most common forms of inattention during prayer is divided attention. Who does not know from experience what this means? We go to pray and sincerely try to apply our-selves to prayer. We pray the beads or the Divine Office, make our. meditation, say or hear Mass. But while the deliberate application of our mind goes to and stays on the prayer, another half of our mind, subconsciously or half-deliberately, is taken up with thoughts completely foreign to our prayer, Our interest, worry, preoccupa-tion, Our plans for the day or the week, are at the back of our minds, struggling to come to the fore and divert our attention. Even when we do not. wilfully give in, but strive as best we can, the play of the unwanted thoughts and images carries on ,in the background of our mind like another actor on a second stage. The "intruder" succeeds at times in drawing our attention away from prayer and lessening our application by fifty per cent or more. The resulting prayer looks superficial and shalIow. Our mind and heart seem to have little grip on the subject of\our medi.tation. Prayer is not exactly mere lip service. We still give a half-hearted advektence to the matter of our meditation. But neither vocal nor mental pra)'er is thorough, satisfactory. They do. not occupy us fully. No wonder we feel ,small and draw little profit from them. Could it be other-wise when our prayer is half-hearted? ,Can nothing be done? Is there little hope that sorhe day, with the help of His grace, things maY improve ? Human minds are naturally fickle and prone to divide attention among many objects. This is particu~larly true when they are at-tracted to things other than uninteresting duty. But what makes matters worse is that we train ourselves to divide our attention. The inevitable amount of' ~outine occupation, both Spiritual and tempo-ral, found in regular life a~tually fosters this division. Besides, the advice of spi'ritual authors often tends to emphasize this training for a "double life." Some routine work develops a mechanical Way of acting which demands and generally takes little attention. Without allowing itself to slip into inattention ~hat harms the work, the mind can pursue a different train of thought on its own. How many ideas originate in this twilight zone! While we are performing routine 84 DIVIDED A'VFENTION tasks, oar real intere, st follows up its own spe.culations. In regular community life, moreover, we are positively encour-aged to divide our attention. When we do manual work, we are " to keep our mind occupied with spiritual thoughts that can keep us united with God. When at meals, we are not to be too much en-grossed with the material occupation but "to let the soul have her food" in the reading at table or in pious reflections. We are definitely asked to train ourselves to divided attention. Nor is this practice to be cofifined to exterior occupations. 'When reciting our rosary or saying the Office, there is no need. to try to pay attention to every word. While saying the 'Hail Marys, we are to reflect either on the mystery, on the person to whom we pray, or on our special intention. While reciting a psalm, we need not follow the meaning of every word (who could do that?), but we may keep ¯ our attention on its main idea or on some striking phrase or thought. In that manner we expressly foster, in our very prayer, a psychology of divided attention. Is it surprising that something similar happens when we do not look for it and wish to give ourselves fully to prayer. After developing the habit of dividing our attention, both outside of and during prayer, we must not be surprised to find the habit coming into play even when we are not planning on it. Obviously, divided attention is not all wrong. We cannot help dividing our attention. A spiritual life that is not confined to chapel or prie-dieu but penetrates into our day's work is not possible with-out it. The spiritual advice we are given about attenti6n in spiritual and temporal duties is certainly right. We do ~ell in following it. There is nothing wrong with that divided attention which we foster deliberately. It is a means of saturating our action in contemplation, of making our vocal prayer approach ever closer to mehtal prayer. It is a fact, nevertheless, that the habit of deliberately dividing our attention is not without harmful consequences. We suffer from these when we turn our minds to set period~ of prayer. The habit is prone to act in an indeliberate manner. Such is the mechanism of every habit or second nature. This may evidently hinder our pur-poseful action. Trained to divide their application, our minds often do 'so spontaneously just when we wish to concentrate on one sub-ject. A special effort is required, to counteract this natural and de-veloped propensity. To know ,the factor~ that favor the indeliberate activity of the divided-attention habit is the first step we can take to oppose them 85 'P. DE L~TTER Review ~,or Religious effectively and neutralize their influence., The~se may be divided into three groups: affections that occupy one's emotional powers, such as, desire and hope, fear and anxiety: thoughts and memories steeped in emotional content: new sense-perceptions which we are permitting or seeking here and now. These are factors to be reckoned with. ¯ The shallowness of prayer that is,caused by the habit of divided attention cannot be remedied completely. 'There is no need ~o at- ¯ tempt the impossible. To prevent every surprise of divided attention would require a vigilance so sustained that it could not be demanded in. our every day duties. The power of the habit can be lessened and controlled, but the habit itself can hardly be rooted out'altogether. We can go far in learning to control its spontaneous activity by fol-lowing the wise rules given by the masters of Catholic spirituality. Our emotions, desires, hopes, anxieties, fears are among the chief causes of the thoughts and images that disturb our prayer. A two-fold effort can check the noxious action of these worries and preoc-cupations. First is the long-range strat.egy. By personal effort and with the help of gr.ace we can train ourselves, to control our emotions. We can prevent them from upsetting our peace of soul. The measure of success in this effort varies for different temperaments, characters, ai~d graces. Some are easily excited, preoccupied, worried. Others can take things more evenly. Not all have th~ same will power~ Not ail receive the same graces. But those called to a state of perfection or to the priesthood should possess this self-control to a marked de-gree: this is part of the vocational fitness and they are in a position to inirease'it steadily. .This self-mastery and habituai'peace of mind is-nothing else than the remote preparation for pra3ier which spiritual authors, without exception, recommend. Secondly, spiritual authorities also insist on immediate prepara-tion. -This consists in arranging for a psychological transition-stage from exterior occupations to prayer. This transition must be gradual, It must allow a peaceful and organic switch-over from the .one to the other. It may not be mechanical. Our psychological make-up is such that sudden transitions c6mmanded by sheer will power or whim rarely succeed. What occupied the mind before prayer stays on and continues to hold us" half-consciously. We must allow the hold to decline gradually. Before prayer we must give our mind and heart a chance to shift from @hat occupied them before, and to turn peacefully but definitely to prayer. To make this mgve :effective, motivation is important. We may find. motives by asking 86 March, 1953 DIVIDED.ATTENTION the traditional preparatory questions': "What ain I ,about todo?" "To Whom am I going to speak?" The better we manage this trari-sition, the greater the chance for success in forestalling divided atten-tion. The same twofold effort for remote and. immediate preparation l~elps to ,redu.ce the harmful influence of the thoughts and memories steeped in emotional cbntent that stay on in the mind during prayer. They are reduced as a cause of distraction by habitual union with God, habitual self-control, and a determined immediate l~reparation for prayer. The third source of divided attention is easier to"dr~/up." ¯ It is ~w~at we'see and hear around us during prayer. To allowthe eyes and ears to prey for .new sensations is evidently looking for trouble. Why invite images to enter, when they have to be dismissed at once? A suitable place for prayer should eliminate most divided attention from this source. It may happen that remote and proximate preparation for pra~,er meet with 0nly partial success, for instance, on occasions of marked emotional disturbance, whether of great joy or of great anxiety" When we have been half-hearted in our effort and are paying the price in half-distracted prayer, can we still do something? Can we go agains~ distractions and salvage a little of our prayer? A: condition for success is to nouce the distraction and to desire to overcome it. We are able to notice it, for our mind.is not fully~ taken .up by the distracting thoughts. We can also desire to remedy the situation. Our very dissatisfaction is a first step towards im- -provement. With the help of grace we can rouse ourselves to effecliive volition. '.The following considerations might prove of help in con-trolling and counteracting divided attention. A.first means is to arouse a desire for,.real prayer, for real union with God. We can desire, or at~ least desire to d~sire, this deeper contact with God. We can express this desire by asking for grace. Unless we really wish to pray, we are not likely to make ~he needed effort. In prayer, our effort and God's grace go hand in hand. The desire must be rooted in the awareness of our need for contact w~th God who.is our strength and happiness. A life dedicated to God has no meaning without real union with Him. The awareness of what we are and do should excite a genuine desire of actual union with God. Aided by grace, this desire should grow strong enough to tin-saddle distracting affections. This will .not always succeed. Our worries may be too pervading 87 P. DE LETTER and penetrating~ When it fails, it might be useful to pray about°our distractions. One way of unifying divided attention is to bring the troublesome care to the fore and to center our attention on it under God'~ eyes. We can prayerfully reflect before God on what worries us, on our plans and ideas, hopes and apprehensions, and entrust these to His Providence. What can be better than this? When we beg Him to enable us to do what He demands, our very worries' may unite us closer to Him in genuine prhyer. This use of our distrac-tions is not without danger. Unless we.be fully sincere about ex-ploiting them, we may be !ed into far-away considerations and for- .get about prayer. , But if we are sincere, and if our first effort in tackling distracting worries has failed, there is a good chance that this second means may prove more helpful. At any rate, this prayer will likely be better than a half-distracted and desireless resignation. Lastly, we can insist on the self-surrender we make in prayer. Even under surface inattention this can be genuine. In spite of some unwanted and repelled wandering of the mind, prayer can really be raising of the heart to God. Prayer indeedis more a matter of inten-tion than of attention. Attention, of course, is always required, but the intention of surrendering to God is the heart of prayer When this is thorough, distracting thoughts easily lose" their interest and their grip. Le[ se.lf-surrender 15e sincere: shall we not be'straightfor-ward in setting aside what does not tally with it? Passing and un- '~ccepted wandering of the mind does not seriously break our contact with God. And the more pervading our surrender, the rarer also and less lasting our distractions. This last consideration suggests the radical remedy for divided attention in prayer. But it is not a quick device or a palliative for passing ill. It is a whole attitude of life. Our minds will easily concentrate on God in prayer when our lives are centered in Him, when He is our all?embracing~love and "worry." Then othdr wor- ties and preoccupations shrink into unimportance. They lose their hold on our minds and hearts. The more we grow in that one iove, the higher~ we rise above temp~ral occupations. That growth is the work of a lifetime. In its unfinished stages we are likely to exper,- ence. the trouble of divided attention in prayer now and again. No grave harm will come from it if we sincerely keep up the, struggle T1fiere are no magic or mechanical devices to rid us of this evil. It the simplicity and unity of one Love which ~must rule our' lives that will also bring unity and stability to our naturally wandering minds. 88 The I:ucharis :ic APOSTOLIC CONSTITUTION OF HIS HOLINESS POPE PIUS XI[ ON LEGISLATION TO BE OBSERVED REGARDING THE EUCHARISTIC FAST. PIUS, BISHOP, SERVANT OF THE SERVANTS OF GOD FOR AN EVERLASTING REMEMBRANCE ~i~HR, IST Our Lord, on the in which He was betrayed" Cot. 11 :23), when for the last time He celebrated the Pasch of the Old Law, took bread and, giving thanks, broke and gave it to His disciples after the supper was finished (cf. Ldke 22:20), saying: "This ,is My body which shall be delivered for you" (I Cot. 11:24). Ir~ the same way He handed the chalice to them, with the words: "This is My blood of the New Testament, which shall be shed for many" (Matt. 26:28); and He added: "This do for the commemoration of Me" (cf. I Cot. 11:24 f.). These passages of Sacred Scripture clearly show' that our Divine Redeemer wished to substitute, in place of that last celebration of the Passover in which a lamb was eaten according to the Hebrew rite, a new Pasch that would endure until the end of time. This is the Pasch in which we eat the Immaculate Lamb that was immolated for the life of the.world." Thus the new Pasch of the New Law brought the ancient Passover to an end, and,truth dispelled shadow (cf. the hymn Lauda Sion in the Roman Missal). The relation between the two suppers, was designed to indicate the transition from the ancient Pasch to the new. Accordingly, we can easily see why the Church, in renewing the Eucharistic Sacrifice to commemorate our Divine Redeemer as He had commanded, could relinquish the conventions prevailing at the older Love Feast and introduce the practice of the Eucharistic fast. From the earliest times the custom developed of distributing the Eucharist to the faithful who were fasting (cf. Benedict XIV, De Synodo diocesana, VI, cap. 8~ no. 10). Toward the end of the fourth century fasting was prescribed in a number of Councils for those who were to celebrate the Eucharistic Sacrifice. Thus ir~ the year 393 the Council. of Hippo decreed: "The Sacrament of the Altar shall not be celebrated except by persons, who are fasting" 89 POPE PlUS XII Revieu., for Religious (Conc. Hipp., can. 28: Mansi, III, 923). Not long after, in the year 397, the same prescription, phrased in the vgry same words, was issued by the "Third Council of Carth.age (Conc. Carthag. IlI, cap. 29:'MansL III, 885). By the beginning of the fifth century this practice was quite universal and could be said to be immemorial. Hence St. Augustine asserts that the Holy Eucharist is always received by persons who are fastihg and that this usage is observed through-out the whole world (cf. St. Augustine, Epist. 54, Ad Ianuarium, cap. 6: Migne, PL, XXXIII, 203). Undoubtedly this practice was based on very' weighty reasons. Among them may be mentioned, first of all, the situa.tion deplored b'y the Apostle of the Gentiles in connection with the fraternal Love Feast of.theCbristians (cf. I Cot. !1:21 ft.). Abstinence from food and drink is in accord with the deep reverence we owe to the supreme m~jesty of 3esus Christ when we come to receive Him hid-den' ufider the Eucharistic veil. Moreover. when x~e consume His precious body and blood before we partake of any other food. we give clear evidence of our conviction that this is the, first and most excel!enf nourishment of all, a refreshmen.t that sustains our very souls and increases their holiness. With good reason, then, St. Au-gustine reminds us: ".It has pleased the Holy Spirit that. in honor of so great a sacrament, the Lord's body should enter the mouth of a Christian before food of any other kind" (St. Augustine, loc. c~t.). The Eucharistic fast not only pays a tribute of honor due to our Divine Redeemer, but also fosters our devotion.' Therefore it can help to increase the salutary fruits of holiness which Christ, the source and author of all good, desires us who have been enriched with His grace, to bring forth. ' Besides; everyone who has had experience of the laws of human nature knows that when the body is not sluggish with'food, the mind is aroused to greater activity and is'inflamed ro meditate more ferventl}; on that bidden and sublime mystei'y which unfolds within the temple of the soul, to the growth of divine love. The importance ,which the Church attaches to the observance of the Eucharistic fast can also be gathered from the gravity of the pen-alties imposed for its violation. The Seventh Council of Toledo, in the year 641, threatened with excommunicstion anyone who qcould offe,r the HolyI Sacrifice after having broken his fast (Conc. Tole-tanum VII, cap. 2: Mansi, X, 768). In the year 572 the Third Council of Braga (Conc. Bracarense III, can. 10: Mansi, IX. 841.), 9O March: 1953 THE EUCHARISTIC FAST 'and in 585 'the Second Council of Macon (Conc. Matisconense II, can. 6: Mansi, IX, 952) bad previously decreed that ahyone~ who incurred this guilt should be deposed from office and deprived of his dignities. As the centuries rolled on, however, careful attention was paid to the consideration that expediency sometimes required, because of special circumstances, the introduction of some measure of mitigation into the law of fasting as it affected the faithful Thus in the year 1415 the Council of Constance, after reaffirming the venerable law, added a modification: "The authority of the sacred~canons and the praiseworthy customs approved by the Church havre prescribed and do now prescribe that the Hol~; Sacrifice should not be offered after the celebrant has taken food, and that Holy Communion should not be received by the faithful who are not fasting, except in the case of illness or of some other grave reason provided for by law or granted by ecclesiastical superiors" (Cone. Constantiae, sess. XIII: Mansi, XXVII, 727). We have desired to recall these enactments ~o mind that all may understand that We, although granting not a few faculties and per-missions regarding this matter in view of the new conditions arising from the changing times, still intend by the present Apostolic Letter to retain in full force the law and usage respecting the Eucharistic fast. We also wish to' remind those who are able to observe the law that they must continue to do so carefully. Consequently only they who need these concessions may avail themselves of the same accord-ing to the measure of tbelr need. We are filled with joy--and We are glad to express Our satis-faction here, if only briefly--when We perceive that devotion to the Blessed Sacrament is increasing day by day in the souls of Christ's' faithful as well as in .the splendor surrouhding divine worship. This fact emerges whenever the people gather for public congresses. The paternal directives of Sovereign Pontiffs have undoubtedly contrib-" uted much to the present happy state of affairs. This is particularly true of Blessed Plus X, who called on all to revive the ancient usage of the, Church and urged them to 'receive the Bread of Angels very frequently, even daily if possible (S. Congr. Concilii, Decree Sacra Tridentina S~tnodus, Dec. 20, 1905: Acta S. Sedis, 'XXXVIII~ 400.ft.). At the same time be invited children to this heavenly Fbod, and wisely declared that the precept of sacramental confession and of Holy Communion extends to all without exception who have 91 POPE PIUS XII Review [or Religious attained the use of reason (S. Congr. de Sacramentis, Decree Quam sir~gula~:i, Aug. 8, 1910: ttcta Apostolicae Sedis, II, 577 ft.). This prescription was later confirmed by.Canon Law (C. I. C., canon 8d3; cf. canon 85zL § 5).-In generous and willing response to the desires of the Sovereign Pontiffs, the faithful have been receiving Holy Communion in ever greater numbers. May this hunger for the heavenly Bread and the thirst for the divine Blood burn atidently in the hearts of all m~n, whatever their age or social condition may be! Yet allowance must be made for the fact that the extraordinary circumstances of the times we live in have introduced many modifica-tions into the habits of society and the activities of our workaday life. Consequently serious difficulties may arise to prevent people from participating in the divine mysteries, if the law of Eucharistic fast should have to be kept by.all with the strictness that has ipre-vailed up to the present time. In the first place, priests in our day, owing to insufficient num-bers, ate clearly unequal to the task of dealing with the constantly growing needs of Christians. On Sundays and holydays, particu-larly, they are often overburdened with work. They have to offer the Eucharistic Sacrifice at a late hour, and not rarely twice or even three tim~s the same day. They are frequently obliged to travel a considerable distance that large portions of their flocks may not be deprived of Holy Mass. Apostolic toil of this exhausting kind un-questionably undermines the health of our clergy. The difficulty mounts when we reflect that, besides celebrating Mass and explaining the Gospel, they have to hear confessions, teach catechism, and take care of the manifold tither duties of their ministry which" is more exacting and laborious than ever before. In addition to all this, they must prepare and adopt measures to repel the relentless attacks that in our day are craftily and savagely launched on many fronts against God and His Church. But Our thoughts and Our heart go out most of all to those who are laboring in distant lands far from their native soil, because they have nobly answered the invitation and command of the divine Master: "Going, therefore, teach ye all nations" (Matt, 28:19). We have in mind the heralds of the Gospel. They endure the most crushing burdens and overcome every imaginable obstacle in their travels, with no other ambition than to wear themselves out that the light of the Christian religion may dawn for all men, and that their flocks, many of them but recently received-into the Catholic faith, 92 Ma~h. 1953 THE EUCHARISTIC FAST may be fed with the Bread of Angels which nourishes virtue and re-. kindles love. A similar situation arises amofig those Catholics who live in many of the districts committed to the charge of missionaries or in other places that lack the services of a resident priest. They have to wait hour after bou~ until a priest arrives that they may assist at the Eucharistic Sacrifice and receive Holy Communion. Furthermore, with the development of machinery in various in-dustries, countless workers employed in factories, transportation, sbipping,'or other public utilities, are occupied~ day and night in al-ternate shifts. The exhausting hature of their work may compel them to take periodic- nourishment to restore their energies, with the result that they are unable to observe the Eucharistic fast and hence are kept away from Holy Communion. Mothers of families, likewise, are often unable to go to Holy Communion until they have finished their household duties. Such tasks usually require many hours of hard work. Again, the case of school children presents a problem. Many boys and gibls are eager to take advantage of the divine invitation: "Suffer the little children to come unto Me" (Mark 10:14). They put all their trust in Him "who feedeth among the lilies" (Cant. 2:16: 6:2), knowing that He will guard the purity of their souls against the temptations which assail youth and will protect the in-nocence of their lives from the snares which the world sets to trap them. But at times it is extremely difficult to arrange to go to church and receive HoI~ Communion, and after that to re~urn home for the breakfast they need before setting out for school. Another matter of frequent occurrence today is that large num-bers ~f people c~oss from place to place during the afternoon hours to be present at religious functions or to attend meetings on social questions. If pe.rmis~ion were given on such occasions to offer the Holy Sacrifice, which is the living fountain of divine grace and in-spires wills to desire growth in virtue, there is no doubt that all could draw upon this source of strength to think and act in a thor-ougbly Christian manner and to obey just laws. These specific considerations may well be augmented, by others of a more general kind. Although the science of medicine and the study of hygiene have made enormous progress and have contributed greatly to the reduction of mortality, especially among the young, conditions of life at the present time and the hardships brought on 93 POPE-PlUS XII Review for Religious by the frightful wars of 6ur century have seriously impaired bodily constitutions and public health. For these reasons, and especially for the purpose of promoting reawakened devotion toward the Eucharist, numerous bishops of v~irious, nationalities have requested, in official letters, that the law of fast might be somewhat mitigated. The Apostolic See had previ-, ously shown itself favorably disposed in this regard .by granting special faculties and dispensations both 'to priests and to the faithful. As an e.xample of such concessions, the Decree entitled P. gst'Editum may be mentioned; it was issued by the Sacred Congregation of the Council, December 7-, 1906, for the benefit of the sick (Acta S. Sedis, XXXIX, 603 ffl). Another is the Letter df May 22, 1923, sent by the SacrM Congregation of the Holy Office to local Ordinaries in favor of priests (S.S. Congregationis S. Officii Litterae locorum Or-dinariis datae super ieiunio euc,haristico ante Missam: Acta Ap. Sedis, XV, 151 ft,). ~ In these latter times, the petitions of the bishops hav.e become more frequent and urgent. Likewise the faculties granted have been more liberal, partcularly those that were conferred because of war c6nditions. All this clearly discloses the existence of new, serious. coniinuing, and widely prevailing reasons which, in the diversified circumstances brought to light, render the cdebration ~f the Holy Sacrifice by priests .and the reception of Communion by the faithful ex_ceedingly difficult, if the la~, of fasting has to be observed. ¯ .Accordingly, to alleviate these grave hardships and incOnveni-ences, and to eliminate the possibility of inconsistent practice to which the variety of: indults previously granted may lead, We deem it n.ecessary to mitigate the legislation governing the Eucharistic fast ~to such an extent that all may be able more easily to fulfill the law as perfectly as possible, in view of particular circumstances of time, place, and person. By issuing this decree, We trust that We may contribute substantially to the growth of Eucharistic devotion,, and thus more effectively persuade and induce all to sharc in the An-gelic! Banquet. This will surely redound to the glory,of. God and will enhance the holiness of the Mystical Body of Christ. By our Apostolic authbrit~r, therefore, we enact and decree ihe folio.wing; I. The law of Eucharistic fast, to be observed from midnight,. cgntijaues in force for all those who do not come under the. special Mar~l~. 1953 THE EUCHARISTIC FA ST conditions which We shall set forth in this Apostolic Constitution. In the futuie, however, this general principle, valid for aIl ,, alike, whether priests or faithful, shall prevail: plain water does not break the Eucharistic fast: II. Those who are ill, even though not confined to bed, may, on the advice of a prudent, c.onfessor, take something in the form of drink or of true medicine: but alcoholic beverages are excluded. The same faculty is granted to priests who are ill yet desire to celebrate MASS. ~. III. Priests who are° to offer the Holy Sacrifice at a late. hour or after onerous work of the sacred ministry or after a long journey, may take something in the form of drink, exclgsive of alcoholic.bev-erages. However, they must abstain from such refreshment for the period Of at least ~one hour before' they celebrate Mass. I~r. 'Priests who celebrate Mass twice or three times the ~ame day. may. consume the ablutions at each Mass. In such cases, how' ever, the ablutions must be restricted to water.alone, and mu~t not include, wine. ~ V. Likewise the faithful, even though they are not ill, who are unable to observe a. complete fast until the tiine of Communion, be-cause of some grave inconvenience--that is, because of fatiguing work, or the lateness of the hour at which alone they can receive the Holy Eucharist, or the long distances they have to travel--may, on the, advice of a prudent confessor, and as ,long as such state of necessity lasts, take something in the form of drink, to the exclusion of alco-holic beverages. However, they must abstain from refreshment of this kind for the period of at least one hour before they receive Holy Communion. VI. If circumstances indicate a necessity, We grant to local Or-dinaries authorization to permit the celebration of Mass at. an eve-ning hour, as We have said, but with the restriction that Mass shall notbegin before four o'clock in the afternoon. This evening Mass may be celebrated on the following days: on Sundays and h61ydays of dbligation which are obseived at the present time or were formerly obserged, on the first Friday of each month, and on days delebrated With solemn functions which the people attend in great numbers; finally, in addition to these days, on one day a week~ The pries,t who offers Mass.on these occasions must observe a fast of .three hours from solid f6od and~alcoholic beverages, and of one hour from non- March. 1953 ~ THE EUCHARISTIC FAST alcoholic beverages. At such Masses the faithful may receive Holy Communion, ob, serving the same rule r~garding the Eucharistic fa.~st, but the prescription contained in canon 857' remains in force. In mission territories, after due consideration of the extraordi-nary con(~itions there prevailing; which for the most part prevent priests from v.isiting their distant stations except rarely, local .Ordi-naries may grant to missionaries faculties to celebrate evening Mass also on other days of the week. ' Local Ordinaries are to exercise care that any interpretation en-larging on ~he faculties here granted is precluded, and that all danger of abuse and irreverencein this matter is removed3 In granting these faculties, which circufiastances of person,place, and time make impera-tive in our day, We decidedly intend to reaffirm ~he importance, binding force, and good effects of the Eucharistic fast for those° who are to receive our Divine Redeemer dwelling concealed underneath the Eucharistic veils. Besides, whenever bodily discomforts are re-duced, the soul ought to do~ what, it can to restore equilibrium, either by interior'penance or in other ways. This is in harmony with the traditional practice of the Church, which is accustomed to enjoin other pious works when it mitigates the obligation to fast. Accordingly, they who are in a position to take advantage of the faculties here granted, should offer up more fervent prayers to adore God, to thank Him, and above all to expiate their sins and implore newgraces from on high. Since all must recognize that the Eucharist has been ins[ituted by Christ "as an everlasting memorial of His Passion" (St. ~Fhbmas, Opusc. LVII, Office for the Feast of Corpus ChristL lesson IV, Opera Omr~ia, Rome, 1570, Vol. XVII), they should stir up in their hearts those sentiments of Christian hu-mility and contrition which meditation on the sufferings and death of our Divine Redeemer "ought to arouse, Moreover, let all offer to our Divine Rddeemer, who keeps fresh the greatest proof of His love by uiaceasingly immolating Himself on our altars, ever more abun-dant fruits of their charity toward their fellow men. In this way, surely, all Will do their part, better and better every day, toward alizing the words of the Apostle to the Gentiles: "We, being many, are one bread, one body~ all that partake of one ,bread" (I Cor 10:17). We desire that all the decrees set forth in this Constitution shall be. firmly established, ratified, and valid, an~ything to the contrary 96 March. 1953 THE EUCHAILISTIC FiST notwithstanding, even what "may seem to be deserving of special men-tion. All other privileges and faculties granted in any form by the Holy See are abolished, that this legislation may be duly and uni-formly observed throughout the ;¢ orld by all men. All the decrees herein enacted shall become operative from the date of their publication in the Acta Apostolicae Sedis. Given at St. Peter's in Rome, in the year of Our Lord nineteen hundred and fifty-three, the sixth day of January, on the Feast of. the Epiphany, in the fourteenth year of Our Pontificate. POPE PIUS XlI Instruction ot: Holy OJ:t:ico SACRED CONGREGATION OF THE HOLY OFFICE INSTRU'~TION ON THE LEGISLATION TO BE OBSERVED CONCERNING THE EUCHARISTIC FAST The Apostolic Constitution Christus Dominus, issued this day by the Sovereign Pontiff, Pius )~II, gloriously reigning, grants a number of faculties and dispensations concerning the observance of the law of Eucharistic ~fast. At the same time. it substantially con-firms most of the norms which the Code of Canon Law (canons 808 and 858, § 1) imposes on priests and the faithful who are able to observe the law. Yet these persons are likewise included in the favor conferred by the first prescription of the Constitution, according to which plain water (that is, ordinary water without the admixture of any other substance whatever), no longer breaks the Eucharistic fast (Constitution, n. I). With regard to all the other concessions, however, only those priests and faithful may take advantage of them who find themselve~ in the particular conditions specified in the Con-stitution, or who celebrate evening Masses or receive Holy Commun-ion at evening Masses which are authorized by Ordinaries within the limits of the new faculties granted to them. Accordingly, to secure throughout the world a uniform observ-ance of the norms pertinent to these concessions and t0 forestall every interpretation that would enlarge on the faculties granted, as well as to obviate any abuse in this matter, this Supreme Sacred Congrega-" .97 INSTRUCTION OF HOLY OFFICE Reoietu for'Religious tion of the Holy Office, by order and command of the Sovereign Pontiff, lays down the following directives: Concerning the sick, whether the faithful or priests (Constitution, n~ II) 1. The faithf~ul who are ill, ~ven though not confined to bed. may take something in the form of drink, with the exception of al-coholic beverages, if because of their illness the); are unable, without grave inconvenience, to observe a complete fast until the r.eception of Holy Communion. They may also take something' in the form of medicine, either liquid (but not alcoholic drinks) or solid, provided it is real medicine, prescribed by a physician or generally recognized as such. However. as must be noted, solid foods taken a's mere nour, ishment cannot be regarded as medicine. 2. ,The conditions that must be verified before anyone may use a dispensation from the law of fasting, .for which no time".limit pre-ceding Holy Communion is set down, are to be pru, dently weighed by a confessor, and no one may avail himself of the dispensatior~ without his approval. The confessor may give his approvai either in ¯ sacramental confession or outside of confession, and once and for all so that it holds good as long as the same conditions of illness endure. 3. Priests who are ill, even though not confined to bed, may likewise take advantage of the dislbensation, whether,they, intend to celebrate Mass or wish only to receive Holy Communion. Concerning priests in special circumstances (Consti'tution, nn. III and IV) 4'. Priests who are not ill and who are :to celebrate Mass (a) at a late hou'r (that is,-after nine o'clock in the morning), or (b) after onerous work of the sacred ministry .(beginning, for example, early in the morning or lasting for a lbng time), or (c) after a long jour-ney (that~is, at least a mile and a quarter or so :on fogt, or a propor-tionately greater distance in accordance with the "means of. travel em-ployed, allowance being made, too, for difficulties of the journey and personal~considerations), may take something in the. form of drink, exclusive of alcoholic beverages. 5. The three cases enumerated' above are,formulated .in-such a way'as to embrace all the circu'mstances for which the legislator in-tends to grant the aforesaid faculty. Therefore any interpretation that would.extend the faculties granted must :be avoided~ 98 March. 1953 , THE EUCHARISTICF.AST 6. l~riests who find themselves in these circumstances may take. something in the form of drink once or several times,, but must serve a fast of one hour prior to the celebration of Mass.:. 7. Furthermore, all priests who are to celebrate" tWO . or; three Masses the same day may, at the first Mass or Masses, .take the two ablutions pr~escribed by the rubrics of the Miss.al, .hut using only water. This is merely an application of the new principle that-water does not break the fast. However,. priests who celebrate three Masses without interval on Chrismas or on All Souls' Day are obliged to observe the. rubrics regulating ablutions. 8. Yet if the priest who is to celebrate two or three Masses should inadvertently take wine in'the ablutions', he is not forbidden to celebrate the second and third Mass. Concerning the faithful in special "circumstances (Constitution, n. "V) 9. Similarly the faithful who are unable to observe the Eucha,. risti¢ fast, not because of illness but because of some other grave in-convenience," are allowed to take something in the form of drink, with the exception of alcoholic beverages. But they must keep the fast for one hour prior to the reception of Holy Communion. 10. ,The causes of grave inconvenience, as it is here understood. are three in number, and they may not be extended. a) Fatiguing wbrk undertaken before~ going to Holy ,com-munion. Such is the labor performed by workers employed in suc-cessiv. e shifts, day and night, in. factories, transport and- maritime services, or other public utilitieS; likewise b~ those who, in .virt~ue of their .position or out of charity, pass the hight'awake (for example, hospital personnel, policemen on night duty, and the like). The same.is: true of pregnant women and mothers of families who must spend a long t.ime in household tasks befo~.e, they can go to church :etc. : b) The lateness of the hour at whicb:"Holtj Communior~ ceived. Many of the faithful cannot have Mass until late in the day, because no priest is able to visit them earlier. Many children,find it excessively burdensome, before .sett.ing out for school,'to go to church, receive Communion, and then to return home again for breakfast; etc. c)" A. long distance to travel on the way" to chu.rch. As was explaiped above (n. 4), a distance of at least a~ mile and a quarter or INSTRUCTION OF H~)LY OFFICE Reuieua for Religious so, to be covered on foot, is tb be regarded as a long journey in this connection. The distance would have to be proportion.ately longer if conveyances of various kinds were us~ed, and allowance has to be made for difficulties of travel or the condition of the person .who makes the trip. 11, The reasons of grave inconvenience that may be alleged must be'carefully evaluated by a confessor either in sacramental cofifession or outside of confession; and without his approval the faithful may not receive Holy Communion while not fasting. The confessor, however, may give this approval once and t:or all so that it holds good as long as the same cause of grave inconvenience exists. Concerning evening Masses (Constitution. n. VI) By authorization of the Constitution, local Ordinaries (cf. canon 198) enjoy the power of permitting the celebration of evening Mass in their own territory, if circumstances indicate its necessity, not-withstanding'the prescription of canon 821, § 1. The common good sometimes requires the celebration of the Holy Sacrifice in the after-noon: for example, for those in certain industries who work in shifts even on Sundays and holydays: for those classes of workers Who must be at their jobs on the mornings of Sundays and holy-days. such as those who are employed at ports of entry;' likewise for people who have come in great numbers from distant places to cele-brate some event of a religious or social character; etc. 12. Such Mhsses. however, are not to be celebrated before four o'clock in the afternoon, and are limited exclusively to the following specified days: a) Sundays and 'holydays of obligation which are now in force, according t,o the norm of canon 1247, § 1 : b) Holydays of obligation that have been suppressed, as listed in the Index published by the Sacred Congregation of the Council, December 28, 1919 (cf. A./l.$,, Vol. XII [1920], pp. 42- 43): ) First Fridays of the month: d) Other days that are ~elebrated with solemn functions and are attended by the. people in great numbers: e) In addition to the days mentioned above, one other day during the w.eek0 if the good of particular classes of persons requires it. 100 Ma~h. 1953 THE EUCHARISTIC FAST 13. Priests "who celebrate Mass in the evening, and likewise the faithful who receive Holy Communion at such a M~ass. may, during a meal which is permitted up to three hours before the beginning of Mass or Communion, drink al~c;holic beverages that ate customary at table ifor instance, wine, beer. and the like), but they must observe becoming moderation, and haid liquors are entirely ruled out. How-, ever, with regard to the liquids whi(h they are allowed to take before or after such a meal up to one, hour before Mass or Communion, alcoholic beverages of any kind whatever are excluded. 14. Priests may not offe? the Holy S,acrifice in the morning and afternoon of the same day, unless they have e~xpress permission, to celebrate Mass twice or three times, according to the norm of canon 806. The faithful, similarly, may not receive Holy Communion in the morning and afternoon of the same day, in conformity with the prescription of canon 857. 15. The faithful, even though they/are not included in the number of those for whose benefit evening Mass has been instituted, are. free to receive Holy Communion during such a Mass or directl~ before or immediately after it (cf. canon 846, § 1). If they do so, they must observe the noims prescribed a~ove, relative to the Eucha-ristic fast, 16. In places that are not subject to the general law [ius com-mune] but are governed by the-special law for the missions [ius.mis-sionum], Ordinaries may authorize evening Mass on all days of the week, under the same conditions. Cautions regarding the execution of these norms 17. Ordinaries are to exercise great care that all abuse and irrev-erence toward the Most Blessed S~icrament are completely avoided. 18. They must also see to it that the riew legislation is uniform-ly observed by all their subjedts, and must notify them that all fac-ulties and dispensations, whether territorial or personal, heretofore granted by the Holy See, are abrogated. 19. The interpretation of the Constitution and of the present Instruction must adhere faithfully to the text, and must not in any way extend the faculties that are already so generous. With regard to customs that may be at oddswith the new legislation, the abroga-ting clause is'to be borne in mind: "Anything to the contrary not-withstanding, even what may seem td be worthy of special men-tion." 101 BOOK NOTICES Review ~or ReligioUs 20. Ordinaries and priests who are to avail themselves of the faculties granted by the Holy ,See should zealously exhort the faith-ful to assist at the Sacrifice of the Mass and ~recei~ve Holy Commun-ion frequently. " By initiating appropriate measures and especially by their preaching, they should promote that spiritual good for the sake of which the Sovereign Pontiff, Plus XII, has been pleased to issue t.he Constitution. In approving this Instruction, the iHoly,Father has ordered that it should be promulgated by publication in the Acta Apostolicae Sedis along with the Apostolic Constitution Christus Dominus. From the,Palace of the Holy Offic.e, danuary 6, 1953'. ~ JOSt~PH CARDINAL PIZZARDO, Secretaql A. OTTAVIANI Assessor. [EDITORS' NOTE: The foregoing translations "*'ere made by Father "Cyril Vollert. S.J. professor of sacramental theology at St. Mary's College, St. Marys, Kansas. The - translations wer~ prepared 'from the texts as published in L'Osservatore Romano, January I 1, 1953, and were carefully checked with the official texts published in ,Acta Aoostolicae Sedis, 45 (Jan. 16. 1953), 15-24. 47-51. For our purposes a somewhat free translation, rendering the sense of the documents as accurately as pos-sible, seemed preferable to a strictly literal translation.] ¯ BOOK NOTICES Those who want a life of Our Lord that is scholarly, without the more distracting trappings of scholarship, and very readable, will find what they desire in the popular edition of Giuseppe Ricciotti's LIFE OF CHRIST. By means of careful editing the former large edi-tion has been reduced to a little more than half its size. The popular edition has a 70-page critical introductibn and a :good index. A very good book.f0r either spilitual reading or meditation, i(Milwaukee: The Bruce Publishing Company, 1952. Pp. xiii + 40.2. $3.50.) Every Sister will smile, laugh, and cry as she catches some glimpse, s of herself in EVERYNUN, a, novel and. play by Daniel A. Lord, S.3. Written originally for th~ One Hundredth Anniversary of the-Sisters of St. 3oseph xn Canada, the play is ideal for a similar celebrfftion, for Vocation Week Programs, and for private reading. Many passages seem to glow like grace itself. This "morality play" is a tribute and a consolation to Sisters, and should open the vistas of the religious life to Sisters-to-be as well as to others who have to live outsid~ convent walls] No royalty is charged for the productions of 102' March. 195'3 BOOK NOTI.CES Eoer~mun. If admission is charged by those producing theplay, Father Lord asks a gift ~f ten per cent of the return for his work for the Knights and Handmaids of the Blessed Sacrament. (St. Louis, Missouri: KHBS, 3115 S. Grand Blvd., 1952. Pp. 162. $3.00.) ST. VINCENT DE PAUL, by Mgr. Jean Calvet (translated by Lancelot C. Sheppard), is a l-volume, well-documented biography, as fascinating as good historical fiction. The many aspects of the saint's life--his interior life, his apostolate of charity, his power of organization, his spiritual direction of nobility and especially of his companion saint. Louise de Marillac, and so forth all blend into the picture of an unt~orgettable character. One flaw in the book is ISerbaps a too-evident nationalism on the part of. the biographer. _Bibliography and index are both useful. (New York: David McKay Company, 1952. Pp. 302. $5.00.) RETURN TO THE FOUNTAINHEAD contains the addresses given at the Tercente,nary Celebration of the Sisters, of St. Joseph, Le Puy, France. in July, 1950. by His Eminence, Cardinal Gerlier, and .other French Churchmen. The book is edited and translated into the- American idiom by the Sisters of St. Joseph at Fontbonne College, St. Louis, Missouri. All Sisters of St. Joseph (others, too) will . draw inspiration and strength for today from this return to and consideration of the evidently blessed origins of their congregation. The address, "The Spirit of the Congregation," is particularly de-serving of prayerful attention. (St. Louis 5, Mo.: SistErs of St. Jo-seph of Car, ondelet, Wydown and Big Bend Blvd., 1952. Pp. xi, + 143. $3.00.) Great things might be expected from the girl who was late for school because she had stopped to pick up broken pieces of glass to protect the' feet of the children of the poor from the young lady who preferred the care of blin~t children to the attractive social life her position guaranteed. WHOM LOVE IMPELS, by Katherine Bur-ton, tells her story in another excellent biography., the life of Pauline yon Mallinckrodt, the foundress of the Congregation of Charity. While her brother Hermann .yon Mallinckrodt helped lead 'the growing Center Party t+ ultimate victory over Bismarck in the Reich-stag, Mother Pauline guided a still-growing crusade of charity that began in Paderborn, Germany, in 1849 and now motivates over "2,000 religigus laboring in schools, orphanages, and hospitals in Eu-rope~ throughout the United Sthtes, and in South America. (New York: Kenedy 24 Sons, 1952. Pp. x + 234. $3.00.) ¯ 103 Search t:he Script:ures Henry Willmering, S.J. | N THE ENCYCLICAL Diuino Agtante' Spiritu. published Sep- | .tembet 30, 1943. Pope plus XII remarked "that the condition of biblical studies and their subsidiary Sciences has greatly changed .within the last fifty years." and "after enumerating the various helps which are at the disposal of modern exegetes the Holy Father con-tinues: "All these advantages which, not without a special design of Divine Providence. our age has acquired, are, as it were, an invitation and inducement to interpreters of the Sacred Literature to make dili-gent use of this light, so abundantly given, to penetrate more deeply explain more clearly and expound more lucidly the Divine Oracles." This invitation of His Holiness was promptly accepted by the m~mbers of the British Catholic Biblical Association. After appoint-ing an editorial committee, they drew upa plan to produ.ce a one-volume commentaryI on the whble Bible. In addition to a thorough exposition of the text of all the books of the Old and New Testa-ments, it would include a complete manual of biblical introduction Their ambitious plan has been successfully realized, and the firm of Thomas Nelson and Sons, Edinburgh, has produced their labors in a quarto volume of 1312 pages, double column to a page. clearly printed on excellent paper, and,strongIy bound in buckram. The price is eighty-four shillings (about twelve dollars). The volume includes a condensed, yet adequate and up-to-date commentary on the forty-five books of the Old, and" the twenty-seven bqoks of the New Testament. There' are introductory articles for every book, and also on groups of literature, namely, on the Pentateuch, the historical books, the poetical and Wisdom literature, the prophetical literature, and the Epistles of the New Testament. The place of the Bible in the Church, the formhtion and history, of the canon, the languages, texts and versions, the geography of the'Holy ~.Land,.the history of Israel, chronology of Old and New Testaments, archaeology and the Bible, and many other informative and fascinating articles enable the IA CATHOLIC COMMENTARY ON HOLY 'SCRIPTU'RE." Editorial Committee: Dom Bernard Orchard, Rev. Edmund Sutcliffe, S.J., Rev. Reginald'Fuller, Dora Ralph Russell. Thomas Neldon ~ Sons. Pp. 1312. 4 guineas. The reviewer, Father Willmering, a p~cofessor of Scripture at St. Mary's College. St. Marys. Kansas. has written the commentary on the Catholic Epistles for this volume. 104 March, 1953 SEARCH THE SCRIPTURES reader to obtain a solid background for the proper understanding ot the sacred text. In all there are seventy-two commentaries andthirty-eight separate articles. The commentary is designed to be read with the Douay version of the Bible, which is the version still in widest circulation among Catholics yet every commentator had before him the original text of the book he interpreted, and he faithfully noted any important vari-htion of the English v~rsion from the original. Throughout the book ¯ each paragraph is distinctly marked in the margin for .purpose of reference, and very many paragra~phs have appropriate headings indi-cating their contents. The commentaries on individual books are a positive expos, ition of Catholic interpretation, not directly apolo-getic, but so worded as to provide answers to current unorthodox views. The explanation meets the needs of all who desire to have in limited compass a clear exposition of the sacred text. which is schol-arly, accurate, and thoroughly ~Catholic. Frequently we desired to have at hand a ready answer book to the many perplexing questions which ,the Old Testament poses. Let us take a few examples from Genesis. The opening chapters of this book narrate the story of creation and the origin of the human race. The world was formed by Divine Omnipotence on six successive days. Darkness yielded to light, the firmament unfolded, the waters under it assembled in one place, and dry land appeared. Then God placed the sun, moon, and stars in the firmament, filled the waters with fishes and the air withbirds; gave the land as the habitat for beasts and reptiles, and finally, created man in His own image and made him ruler of the visible world. How must we understand this unscientific account of the development of the earth and its inhabi-tants? What is the meaning of the six days of creation? Recent discoveries have found human bones .and artifacts in sl~rata that .greatly antedate the four thousand years B.C. which was formerly assigned as the age of the human race. To what extent, therefore, are the early narratives of Genesis historical? For what purpose did the sacred writer introduce them? What are we to think of the great ages of the patriarchs? What part of the earth was covered by the flood? We used to look for the answer to these questions~ in the Catholic Enc~Iclopedia or the Catholic's Ready Answer Book: yet these books of reference are nearly a half century old, and exegetical opinion has passed through radical changes since that time. The new Commentary offers satisfactory solutions to these and several hun- 105 HENRY WILLMERING dred other difficulties that have often puzzled us in the past. As the preface ~tates: "it' is a critical survey of modern biblical knowledge-from the standpoint of all those, Catholic and non;Catholic alike, who accept the full doctrine of biblical inspiration" (p. vii). At the end of the volume is a topical index, which lists nearly ten thou'- sand titles and refers directly to the paragraph in which the answer to our difficulties is given. ' But the Commentary,, is not primarily a "question settler." St. Paul reminds .Timothy: "All Scripture, inspired of God, is profitable to teach, to reprove, to correct, to instruct in .justice: that the man of God may be. perfect,, furnished to every good work" (2 Tim, 3: 16f.). Hence, "in the commentaries on individual books a special endeavour is made to give adequate treatment to the doc-trinal and spiritual con.tent." ~pecial articles, which emphasize the spiritual nature of the Bible and are therefore of particular interest to religious, are the following: :'The Place of the Bible in the Church," by W. Leonard and' Dom B. Orchard, which stresses the Church's love for the Bible, and what she has done to preseive and propagate it;' "The Interpretation of Holy Scripture," by, R. C. Fuller, an ac-count full of valuable information: "Our Lady in the Scriptures, by E. C. Messenger, explaining the prophecies relative to the Mother of God, and her tJrerogatives; "The meaning of the Old Testament," by E. F. Sutcliffe, S.J., what it meant for the. israelites, and what is its meaning and value today; "The Religion of Israel," by the same author; "The Person and Teaching of Christ," by Dom Aelred Gra-ham; "Christianity in Apostolic Times," a long and interesting article by M. Bevenot, S.J. and Dom Ralph Russell; and finally "The Life of St. Paul," by D. J. O'Herlighy. Besides the articles mentioned above, there are thirty others, all-well written and abounding with valuable and interesting information. Anyone who digests all these wil

Issue 12.6 of the Review for Religious, 1953. ; A. M. D. G. Review for Religious NOVEMBER 15, 1953 Pracfice Of ÷he H01y See, I I . Joseph F. Gallen Psychological Testing . William C. Bier The Eucharistic Fast . : . Hi~ary'R. Wer~s MOfU Proprio Jubilee . c.J. McNaspy Communications Questions and Answers News a'nd Views Book Reviews Index for 1953. VOLUME XII NUMBER 6 RI::VII::W FOR Ri::LIGIOUS VOLUME XII NOVEMBER, 1953 NUMBER CONTENTS NEWS AND VIEWS . 281 PRACTICE OF THE HOLY SEE, II--Joseph F. ~Gallen, S.'J .2.8.5 BOOK NOTICES . 290, 316, 329 LETTER ON OBEDIENCI~ . . . 290 PSYCHOLOGICAL TESTING OF CANDIDATES AND THE THE-OLOGY OF VOCATION---Willlam C. Bier, S.J2.91 OUR CONTRIBUTORS . 304 THE EUCHARISTIC FAST---Hilary R, Werts, S.J . 305 MOTU PROPRIO JUBILEE--C. d. McNaspy, S.J . 317 COMMUNICATIONS . 321 QUESTIONS AND ANSWERS-- 29. Correction of Subject by Immediate or Mediate Superior 322 30. Guidance of Subjects by Superiors . 322 31. Local Superior at Council Meeting . 323 32. Local Superior at General Chapter . 324 33. General Council and Suggestions to General Chapter . 324 34. Postulancy and Readmission . ." . 325 BOOK REVIEWS-- Religious Men and Women in the Code; Fundamental Psychiatry; Most Reverend Anthony 'j. Schuler, S.J., D.D.; I Want to See God 326 BOOK ANNOUNCEMENTS . 330 INDEX FOR VOLUME XII, 1953", . 333 REVIEW FOR RELIGIOUS, November, 1953. Vol. XlI, No. 6. Published bi-monthly: January, March, May,,July, September, and November at the College Press, 606 Harrison Street, Topeka, Kansas,, by St. Mary's College, St. Marys, Kansas, with ecclesiastical approbation. Entered as second class matter 3anuary 15, 1942 at the Post Oflke, Topeka, Kansas, under the act of March 3, 1879. Editorial Board: Jerome Breunig, S.J., Augustine G. Ellard, S.J. Adam C. Ellis, S.J., Gerald Kelly, S.J., Francis N. Korth, S.J. Copyright, 1953, by Adam C. Ellis, S.J. Permission is hereby granted for quota-tions of reasonable length, provided due credit be given this review and the author. Subscription price: 3 dollars a year; 50 cents a copy. Printed in U. S. A. Before wrlfing to us, please consult notice on Inside back cover. News and Views Psychological Testing When we last published an article on the psychological testing of candidates, a religious superior wrote an indignant letter cancelling his subscription and asserting that such testing interferes with the work of the Holy Ghost. Thatthis is a misconception should be evi-dent to all who read Father Bier's article in the present number and a s~cond article to be phblished in January. Whatever may be said 'for or against the value of psychological tests--and we do not claim to have all the answers--it seems clear enough that their use is no more an attempt to "naturMize" religious vocation than is the use of previous medical examinations. Educating Sisters We have just received a very yaluable brochure entitled Directorg of Catholic Women's Colleges with Facilities for the Education oF Sisters. This brochure gives tabulated i'nformation on colleges and motherhouses accredited to offer degree programs, detailing the par-ticular courses provided, the number of Sisters who could be cared for, and the conditions, financial and otherwise, under which they would be received. The information was gathered by the Commit-tee on the Survey Section on Teacher Education of the N.C.E.A. The reason for gathering the information was the fact that many of the smaller religious congregations of women do not have facilities for educating their own members and find the standard costs of "sending Sisters away" prohibitive. These congregations can obtain help from the larger congregations; and this Directorg will show at a glance where and how the help can be obtained. For further information, or for copies of the Directo~g, piease address: Sister Mary Gerard, O.S.F., Chairman, Directory Project, Alverno College, 3401 South 39th Street, Milwaukee 15, Wisconsin. Poor Clares The Poor Clares of New Orleans have prepared a file of at least one hundred 2-inch slides in .black 'and white for use in a still pro-jector. The photos were taken within the cloister, and every" part of the monastery is included. Also prepared is a brief description of every picture. The nuns will send'this file to any desiring to show 281 NEWS AND VIEWS Reoiew for Religious the slides tO interested groups, particularly, young ladies among whom there might be the possibility of a contemplative vocation. They will also send ~lratis literature for distribution, a set of seven large posters, and 6-inch dolls'd~es~ed as" Poor Clar~s. The remailing of, the small slide file is the only expense they would expect the user to assume. Those interested in this vocational project shQ~Id write to: Monastery of Saint Clare, 720 Henry Clay Avenue, N~w Orleans 18, Louisiana. New Indulgence For the purpose of 'increasing devotion to the Blessed Virgin Mary ever more and more, Ou~ Holy Father, Pope Plus XII, in. an audience given to the Cardinal Major Penitentiary on March 30, 1953, granted in perpetuum an indulgence of fifty days, to be gained once a day, to those who, keeping on their person a duly blessed rosary of Our Lady, have kissed it devoutly.and at the same time have recited with a pious mind the words of the Angelic Salutation: "H~iil Mary, full of grace, the Lord is with thee: blessed art thou among women, arid blessed is the fruit of thy womb, Jesus." (Acta Apostolicae. Sedis, XXXXV [ 19 5 3 ], 31 1.) , Valuable Booklets The Grail Press, St. Meinrad, Indiana, has sent us two booklets of immense value for clerics. Both of them are re-editions. One is Rome and the Study of Scri_pture, which contains a collection of papal enactments on the study of Holy Scripture, together with deci-sions of the Biblica.1 Commission. The price is one dollar. The other booklet is The Popes and the Priesthood, which contains English translations of importgnt statements of the Holy See on the.priest-hoo. d. The price of this booklet is only fifty cents. Rural Parish I, Vorke;'s In our last number (see. p. 242) we promised a more complete account of the Rural Parish Workers of Christ the King. This apostolate was begun by Miss Alice Widmer, a graduate of.Webster College, Webster Groves, Missouri, and Miss LaDonna I-fermann, a graduate of Maryville College of the Sacred Heart, St. Louis. In the summer of 1941 they decided to devote ~heir lives to lay action for the salvation of souls and the extension of Christ's Kingdom by the igractice bf the spiritual and corporal works of mercy. That fall they heard Monsignor (later Bishop) Leo J. Steck speak of the'lick 282 Not~ember, 1953 NEWS AND VIEWS. of priests'in rural.areas, and th'ey: asked him whether they might help in one of these areas. With his assis'tance and that of Father William d. Pe~.old, they began work in the latter's parish of Cottleville, St. Charles Count'/, Mi'ssouri. During that same summer they learned to use the short breviary. The remainder of their story i~ told by tlSemselveL as follows: "Activities ir~ St. Ct~arles County, where we lived in two twelve: by-twelve-foot rooms in a portable schoolbuilding on thechurch grounds, included home visiting, care of the sick, helping the poor, Vacation schools, Sianday school for non-Catholic and pre-s~hool .Catholic children, craft classes for,, dhildren and adults, discussion Clubs in' the homes, w~rk with teen-agers, in'structions of converts'. distribution of Catholic literature and sacramentals, religious and social Welfare work. "Originally we had no thought of a continuing organizatio.n. As'we saw the needs and what could be done we went to see Car-dinal John d. Glennon of beloved memory', who had been a benefac-tor from the first. He encouraged us in our plans to £tevelop a per-manent organization and gave permission to solicit funds for~ p, er-manent home not to be located on parish grounds. Shortly there-after he died. "Sev, enteen months, later we discussed our future with Arch-bishop. Joseph E. Ritter. Three months afterwards he asked us;.to work'among.the miners and farmers of the tiff.aiea in Wash, ington County, the mbst e~ploited region in the St. Louis archdiocese. Through ,his generous assistance and that of Auxiliary Bishop: Charles tt.'Helmsing and Rev. Edward A. Bruemmer of Old Mines, we moved in September, 1949, to Fertile iri the Old Mines parish,of St. Joachim. We entered into parish, activity by beginning the in-struction of ninety-one public-school children and visitation in their homes and began extensive remodeling of an old brick residence eight miles from church. "The Rural Parish Worker program is adjusted to the,.needs of the area and is always pointed to the development of Christian homes and the strength.ening of parish life. In Washington County the following activities take precedence: ~eligiotis and social welfare work: distribution of food and ,clothing; transportation, to church, h.ospitals,_a.nd clinics; Sunday instruction classes; preparation of con-verts: home visiting, and instruction; interpretation of rights and 283. NEWS AND VIEWS duties as citizens; assistance in obtaining State and Federal benefits, doctors' care, hospitalization. "Some assistance is given to a few in adjoining parishes. HOw-ever, since.our home parish of St. ,loachim is one hundred and fifty square miles in size with poor and sometimes no roads,, it occupies most of our time. Attendance at civic meetings and participation in civic affairs are also on the agenda, as are outside works, such as land-scaping, building of small buildings, care of goats, and gardening when we can get to it. "Yearly summer sessions ~nd a year-of-service program are offered to young women thinking of the lay apostolate as a way of life or who wish to give at least part of their lives in. concentrated work for the restoration of Christ in society. "Last fall Rev. Bede Scholz, O.S.B., of Plus X Monastery in Labadie, Mo., was appointed by the Most Rev. Archbishop as our spiritual director. Father Bede, then at Conception Abbey, Concep-tion, Mo., had helped form us in the early days. (We would go for a week of spiritual refreshment to Conception.) Father Bede, Rt. Rev. Monsignor Martin B. Hellriegel, and Rev. Charles P. Schmitt were our spiritual advisers for several years when we lived in St. Charles County. "At the beginning we had literally nothing except a few dollars we had saved when working, a typewriter, phonograph and records ¯ bought for the work, our clothes and personal little belongings. Yet we have neve'r been in want and God has sent everything as it was needed for our neighbors and for us. Today many are assisting by prayer, donations of money and materials. The bills are always with us but we know that Almighty God is also, and we have no fears for the future. We know He will do with us as He wishes and that is all we want. It is with humble hearts that we look back over twelve years of labor in His vineyard and it is with confidence that we invite others--young women from all over the United States--to come to Fertile, to the Center of the Rural Parish Workers of Christ the King, and lend their talents and their labors in this rural aposto-late of service based on the spiritual arid corporal works of mercy for the glory of God and the development of Christian homes; to come to Fertile and help in the world-wide work "of the Church today-- the restoration of Christ to society." The address of the Rural Parish 'Workers of Christ the King is: Route 1, Box 194, Cadet, Missouri. 284 ¯ Pract:iceot: :he l-loly See, II Joseph F. Gallen, S.J. [The first part of this article was published in the September REVIEW, pp. 252- 72.] XII INDULTS OF SECULARIZATION New practice of the Holy See. Secularizati-on is the voluntary de-parture from religion, authorized by an indult of competent ecclesi-astical authority, in virtue of which the subject is separated com-pletely and perpetually from membership in the institute and is freed absolute.ly from all obligations contracted by. religious profession. Since secularization dispenses from all religious vows, even if solemn, it is co~nmonly also called a dispensation from the vows of religion. The Holy See alone may grant secularization in pontifical institutes; in diocesan congregations the Ordinary of the place where the, reli-gious is staying is also competent.34 .Indults of secularization granted by the Holy. See for those who are not priests now contain the following sentence: "This decree ceases to have any validity if not accepted by the petitioner within ten days after being informed of the executorial decree.'qs" It has long been a clea~ principle of canon law .that an indult of seculariza-tion, even ~hou.gh freely petitioned,, may be refused and has no effect until accepted by the religious in question,z6 If within the ten days: (a) the indult is expressly accepted, it becomes effective immediately;37 (b) the induli is neither accepted nor refused, it ceases to have any validity at the end of this period; (~') the indult is definitively refused, all validity of the indult cer-tainly ceases at the end of ten days and. at least more probably immediately upon the definitive refusal.3s In practice a new indult is to be petitioned if the religious repents of his refusal and wishes again 34Can. 638; Bouscaren. II, 173. 3s"Post decem dies a recepta comrnunicatione Decreti exsecutorialis, ex porte Oratoris (ricis), prasens Decretum, si non fuerit acceptatum, nullii~s roboris esto.'" Cf. Gu-ti& rez, CpR, XXIV (1953), 186-197. 36Bouscaren, I; 326. 37Cf. Creusen. ft. 332: Jombart, RCR, II (1926), 151; Piontek, 262 ft.: Ver-meersch, Periodica, XI (1923), 151. a8Cf. Guti~rrez. CpR, XXIV (1953),194-195: Goyeneche, CpR, XVIII (1937). 239-240:.Muzzarelli, p. 172; and Jombart, RCR, II 1926), 150-151, who ap-pears to hold the contrary. 285 ¯ JOSEPH 1:::. GALLEN for Religious to leave during the ten-davy period. ," The practice of the Holy See is not to grant the indult directly to the religious but to give to an intermediary person, for example, the local Ordinary, the f~iculty of granting the indult of secularization to the religious. The actual granting of the indult by this intermedia'ry person is called the executorial decree. The ten days begin to run -from the time the religious is officially notified of the granting of this executorial decree, not from the date of notification of the deciee of the Holy See. The day of notification is not computed. If the no-tification is given on August 1, the ten days expire at midnight of August 1 1-12. This time does not run for any period in which the religious was ignorant of or unable to exercise his right of acceptance and refusal. XII. GENERAL CHAPTER 1. Constitutions rec.ently appro~)ed by the Holy See. One congrega-tion of sisters had difficulty in persuading the S. C. of Religious to approve in a general revision of its constitutions the designation of the Secretary and Bursar General by appointment rather than by election. Appointment was approved about the same time in another general revision without any difficulty and had been permitted in some constitutions approved by the Holy See in the past. The num-ber in the grouping of the smaller houses for the election of delegates. is now rather constantly stated to be at least twelve and not more than twenty-three professed. The S. C. of Religious is consistently including in constitutions an article stating that the duties of the pre-siding local Ordinary or his delegate terminate at the proclamation of the election of the mother general.39 Some recent constitutions con-tain the prescription of the Normae of 1901: "If the Ordinary. is ac-companied by one or more priests, these may in no way take part in the election.''40 The present practice of the Holy See permits not only the secretary general but also the bursar general to be elected a general councillor but neither may be elected as the first councillor. The same practice now rather consistently gives the general chapter the right of declaring matters to be of greater importance and subject to the deliberative vote of the general council. Some recent constitu-tions. also give to the general chapter and council the'right to deter- 39Cf. REVIEW FOR RELIGIOUS, XI (1952), 16-18. 4ONormae of 1901, n. 224. Cf. REVIEW FOR RELIGIOUS, ibid., 17-18. 286 Nooember, 1953 PRACTICE OF THE HOLY SEE. min~ matters as subject to the deliberative vote of-the local council. The S. Congregation corrected one set of constitutions to read~ " . . .the newly elected M6.thfir General shall appoint one or seoeral. committees.to examine and arrange the'proposals to the Gerieral Cfiapter and to furnish a report concerning them." Even if not so' stated in the constitutions, several committees may be appointed be~ cause of the amount of work or for greater efficiency and lack of time, since several committees are not forbidden by the constitutions. 2. Indult's. One congregation of si'sters secured an indult from the Holy Se~ permitting th~ anticipation of its next general chapter by' six months. The principal reason given in the petition was the ex-~ p~nse and extensive travel that would be required foi the' capitulars' to return to the motherhouse two months after all had been present there for the annual retreat. ~ Another congregation of sisters requested a change, in its constitu- ' tions by which the novice mistress would be a member of thegeneral chapter in virtue of her offce. The S. C. of Religious replied: "It is not expedient.'" Canonical authors had stated that such a provision was not in accord with the practice of the S. Congregation,4x but a.~ similar article had been approved in a very small number of constitu-. tions in the past. A congregation of sisters was to hold in the United States an ex-traordinary general chapter,, which the delegates of the provinces be-yond the "iron curtain" would not be able to attend. The S. C. of Religious gave to a local Ordinary the faculty of permitting their votes to be sent by letter or for these provinces to choose delegates here who would cast their votes. 3. Roman meeting. The subjects touched upon at this meeting of superioresses general appear to have been the following: (a) The Holy See is opposed to the immediate re-election, or rather postula-tion., of a mother general beyond the limits prescribed in the consti-tutions. Similarly the Holy See only for serious reasons grants a dispensation permitting a local superior to be given a third successive three-year term in the same house. (b) Two excesses are verified in ~lections, an indifference that results in ignorance of the eligible and' suitable and electibneering. (c) Young religious should not be ex-. cluded from higher offices' if they have the necessary natural and spit-. itual qualifications. ., 41Basticn, n. 246, 2; Battandier, n. 352. 287. JOSEPH F. GALLEN Review/:or Religious These subjects present nothing new,4z but the. light thrown on the abuse of electioneering is very Opportune. Electioneering is the deliberate seeking of votes, directly or indirectly, to elect a particular person, or one person rather than another, or to exclude anyone from being elected. The simple seeking of information concerning the abilities or defects of those eligible and the communication of such information to. others, without any attempt at persjaasion, is not for-bidden, and is very frequently necessary and laudable. It is.:remarkable.how often the matter of elections can blind the moral sense of even very good religious. This reason alone has per-suaded the present writer to hold rigidly to the conviction, that in any general revision of the constitutions elections should, be restricted to those absolutely necessary. Only the offices of the superior gen-eral and of his or her councillors demand election. Every religious should have the permanent resolution of nevei uttering a word about future elections in his institute until after he has meditated daily for at least a week on the will of God. XIII. MONASTERIES OF NUNS I. Federations and Con/¥derations. The only federation or con-fdderation affecting American monasteries of nuns that has been made public is that of the Visitandines. The pohtifical constitution Spon~a Christi and the accompanying Instruction should be carefully studied by all nuns. Unwise and exaggerated changes are to be avoided in any state of life, "but no religious institute can reasonably exclude progress and prudent adaptation to .the times; Federations and con-federations are highly recommended by Plus XII in Sponsa, Christi. 2. Restoration o[ solemn ~ows. In 195 1-52 eighteen monasteries of nuns-in the United States secured permission from the Holy See for the taking of solemn vows.43 The restoration of solemn vows is at least strongly urged on all monasteries of nuns in Sponsa Christi. If serious reasons exist against this restoration in any monastery, such reasons are to be submitted to the S. C. of Religi6us for examina-tion. 44. The form of the decree granting solemn vows is uniform. The provisions are: (a) Papal cloister must be observed as' described in 42Cf. REVIEW FOR RELIGIOUS, X (1951), 187-200. 43Guti~rrez. CpR, XXXIV (1953), 102-115. Cf. the list of monasteries of solemn vows in the United States, as of January, 1950. in REVIEW FOR RELIGIOUS, IX (19~50), 58, note 2. 44Larraona, quoted by Guti~rrez, ibid., 1"07. " '288 November, 1953 PRACTICE O~: THE HOLY SEE canon law, Sponsa Christi and the accompanying Instruction (Inter praeclara), and also the Instruction of the S. C. of Religious of Feb-ruary 6, 1924.4s (b) Nuns at present in simple perpe.tual vows and thbse who have compieted the prescribed time of temporary vows make solemn profession. The local Ordinary or his delegate receives the profession of the superioress, who then receives all the other pro-fessions. (c) Any nun in simp!e perpetual vows who does not wish to make the solemn profession may remain in simple vows but she is obliged by all the prescriptions of papal cloister.46 (d) Future per-petual professions Will be solemn except, of course, those of the ex-tern sisters, who may be admitted only to simple perpetual profession at the expiration of the prescribed peridd of temporary vows. 3. Dowr~ . Modifications in the general constitutions were granted to several monasteries of one order of nuns in the United Sta~es by the S. C. of Religious in 1950. A canonically interesting article of these modifications is: "No dowry is required for the admission of postulants." 4. Induhs concerning papa! clbister. A monastery of nuns in. the United States obtained the follov~ing permissions from the S. C. of Religious: (a) for five years--to admit into the enclosure at the funerals of nuns the clergy, acolytes, and pall bearers required to carry the body to the crypt; (b) fbr three years--to allow those taking out naturalization papers to go out to government offices as often as necessary; (c) for three years--t6 allow a nun to leave the enclosure as companion for a nun obliged to go out for bospltal treatment. Iri the case of another monastery, the local Ordinary whs given the faculty for twenty cases of permitting a nun to leave the enclosure with a companion for the reason of ill health. The rescript contained the clause, that any unbecoming circumstance was to b~ avoided. 5. Concession of Masses. A proper ordo or calendar, and thus dis-tinct from the diocesan ordo, is had by all orders of regulars, and this is to be observed also by the nuns and sisters of these orders. A proper ordo is also had in.religious congregations and societies living in common without public vows, whether of men or women, that have been approved by the Holy See,.[re constituted under one gen-eral superior, and are obliged to the divine office, even if only by 45Bouscaren, I, 314-320; .46Escudero, CpR, XXXIII (1952), 35, nota 39. 289 JOSEPH F. GALLEN reason of major orders.47 Nuns that constitute a second order, such as the Carmelites, will follow the proper ordo of the first order of men. Obviously, there-fore, they may not celebrate in the divine office and Mass feasts granted to dioceses or t6 other institutes. For this reason at least one monastery of nuns in the United States secured from the Holy See an indult permitting the celebration of the feasts of the North American Martyrs on September 26 and that of St. Frances Xavier Cabrini on December 22.48 47,SCR, 4312, ad'l-2; 4403, ad 1. 48The autlqors, documents, and abbreviations not clear from their mere citation are." Acta Apostolicae Sedis (AAS) ; Bastien, Directoire Canonique; Battandier, Guide Canonique; Bouscaren, Canon Law Digest; Cervia, De ProFessione Religiosa; Com-mentarium Pro Rell.qiosis (CpR) ; Creusen, Religious Men and Women in the Code; Decreta Authentica Congregationis Sacrorum Rituum (SCR) ; Muzzarelli, De Con-gregationibus luris Diocesani; Piontek, De Indulto Exclaustrationis necnon Saecular-izationis; Revue des Communautis Religieuses (RCR) ; Schaefer, De Religiosis. BOOK NOTICE AUX SOURCES DE LA TRADITION DU CARMEL, by Jean le Soli-taire, is a work that will be of special.interest and value, not only to Carmelites, but also to all who are concerned with understanding well the essentials and the accidentals of the contemplative life and~ with the problem of adapting it fittingly to the changes that mark modern culture and the present situation of the Church. The book is not primarily historical; rather it is conceived from the ,spiritual point of view, and would like to contribute to the best possible re-vitalization and perfection of the contemplative life in the concrete existe.ntial conditions of today and tomorrow." (Paris: Beauchesne et ses Fils, 1953. Pp. 274.) LETTER ON OBEDIENCE Father William J. Young. S.J., has made a new and very readable translation of St. Ignatius' Letter on Obedience. This translation is published in pamphlet form by the America Press. Single copies are twenty cents; special discounts are allowed on quantity orders. Write to: The America Press, 70 East 45th St., New York 17, N.Y. 290 Psychological Test:ing ot: Candida!:es and t:he Theology oF Vocal:ion William C. Bier, S.,I. [EDITORS' NOTE: This article is an adaptation of 'a paper presented at the Fordham "Institute on Religious and Sacerdotal Vocations, July, 1953. Father Bier's interest in the use of psychological tests as helps in evaluating the suitability of candidates for the priesthood and religious life goes back to graduate work in psychology at The Catholic University under Father Thomas Verner Moore, who encouraged him to plan a doctoral research on some.preliminary phases of this problem. After the completion of his doctoral work in 1948 Father Bier went to Fordham and has been teaching in the psychology department of the graduate school since that time. He developed a program of psychological tests for candidates in the New York Province of the Society of 3esus, which has been in operation for five years. This work is now spreading to other Provinces of the Society and to other religious groups. He thinks that the greatest need at the present time is the development of specific, norms on these tests, not only for religious as distinct from lay persons, but probably also for different religious groups. The development of such norms is of necessity a cooperative undertaking, and Father Bier has been serving as a clearing house for gathering the needed information from the various groups working in conjunction with him. At the present time this work is still in its initial stages, and it will have to be in operation some time longer before publishable results are ¯ available, ] THE present article is the first in a series of two dealing with the use of psychological tests in the selection of candidates for the priesthood and for the religious life. This matter receives clari-fication bydistinguishing and giving separate treatment to the two questions involved. The first concerns the role of psychological tests in the selection of candidates and raises the question of the relation-shiio between testing of this kind and the theology- of vocation. It is evident that this first question is largely theoretical, but testing must first be justified on these grounds before it is feasible to discuss the second question, namely, the practical requirements of such a testing program. The current article, therefore, will consider the theoretical basis for the psychological testing of candidates, and a second article will take up the problems involved in the development of such a pro-gram in practice. Religious Vocation Although in full accord, on theological and psychological grounds, with the modern tendency to extend the term vocation to embrace all states of Christian life, the current consideration is never-theless restricted to vocations to the religious life.and to the priest- 291 WILLIAM C. BIER Reoiew for Religi'ous hood. More specifically still, the explicit treatment is confined mostly to the religious life, leaving the priesthood as matter for reasonably evident inference. A vocation, as the nominal definition of the wor~l implies, ex-presses the action of summoning someone to move toward a definite goal; in a word, it is a call. ~n the case of a divine vocation, it is God who calls the person, and in the matte~ of religious vocation, it is a call to the voluntary practice of the evangelical counsels in an institute.approved by the Church. The question that arises in the case of every vocation is: how can we know in a given case that'God calls? How can it be determined that the vocation is real and not illusory, genuine and not deceptive? This is the question ~vhich must be answered by the candidate himself, by his director, and by the superior who accepts him. In his recent book, The Theolog~I of Religious Vocation, Father Edward Farrell, O.P.,1 indicates that St. Thomas Aquinas distin-guished between internal vocation, or desire on the part of the candi-date for the religious life, and external vocation, or acceptance by a legitimate superior. It will be helpful for our present purpose to consider vocation under both of these aspects, and in so doing we shall 9ttempt to place the psychological testing of candidates in its proper perspective and to indicate what is its legitimate function with respect to the discernment of vocation. Internal Vocation By internal vocation St. Thomas means the intention on the part of the candidate to embrace the religious life. This intention is formed by. a man under the influence of the Holy Spirit. -Such an intention is the result of grace, or rather a series of grace~ consisting of interior'andexterior helps, in virtue of which the individual is led to take the resolution to enter.religious.life. This resolution to enter religion may result from an extraordinary illumination of the mind and incitement of the will toward the reli-gious state. Some of the saints have been favored with such an un-mistakable divine call, but Pope Plus X in his decision on the book of Canon Lahitton on Sacerdotal Vocation made it clear that no such special attraction is necessary for a priestly or religious vocation. Gen-erally, the intention to enter religion is formed under the influence of what theologians would refer to as ordinary grace, i.e., a grace which " 1St. Louis: Herder, 1951. 292 o November, 1953 PSYCHOLOGICAL TESTING works through the reasoning processes. Theologians generally would take this to mean that the decision is the result of deliberation where-by the individual perceives, in the light of the Gospel ~ind from other considerations that, everything being taken into account, the way of the counsels is preferable for him. Consequently be experiences a corresponding rational inclination of the will toward such a life. It is Worth n'oting, however, that the proposal to enter r.eligion must be sufficiently firm considering the difficulties involved in this state of life. It is only a firm resolution which, in the opinion of theologians, is the subjective manifestation of vocation. On philo-sophical grounds it may be shown that a state of mind can be logically firm only when reasonable doubt is.excluded. We may .say, therefore, that what God's grace does in the case of vocation is to make it possible for the individual to see with a clarity which ex-cludes the reasonable fear of error that the way of ~he counsels is the preferable way of life for him. It would seem, therefore, that the applicant, whose state of mind prior to entrance is uncertain, who is not ~ure whether he has a vocation or not, but who applies "in order to give the life a try," does not hav~ a vocation, since he lacks this firm proposal which is the subjective sign of vocation. It is possible that such an applicant would become certain bf his vocation during postulancy or noviceship, but it seems more prudent, when such a doubt is known, .to postpone his acceptance until it is solved, and meantime to encour.age him to'pray and consider the matter more maturely. It is evident that such a firm decision to enter the religious state is the result of grace. "You have not chosen me, but I have chosen you" (Jo. 15:16). This is the essence of religious vocation, and it is clearly its supernatural aspect. Directly, therefore, psychology, which can touch only the natural, has nothing to do with this aspect. of vocation. Yet,. indirectly, even here, it may have something to contribute. Canon 538 indicates that the candidate for the religious life must be inspired by a "right intention." This requirement expresses in another way what has already been discussed. If the intention to enter religion has been formed under th~ influence of grace, it will be a right intention. Therefore, no purely natural motive will suffice, such.as disappointment or disillusionment with the world, or per-sonal happiness, or security; or the desire to escape an unhappy home situation. On the other hand, theologians allow that ar~y super- 293 WILLIAM C. BIER Ret~iew for Religious natural motive will suffice, for instance, the desire, to save one's soul, or to work for the salvation of others, or to serve God more per-fectly, or to render salvation more secure. It is at thi~ point, it would seem, that psychology can enter to make a contribution. Human motivasion, we know now, is a much more complex affair than was previously suspected. Our motives are seldom simple, and seldom single. Conscious motives can sometimes serve as a cloak for hidden and undetected tendencies. In the case of the motives inducing a person to apply for admission to the religious life, it will seldom happen that they are pur~ly supernatural. Natural motives invariably enter as well. What seems to be important, how-ever, is that the dominant motives should be supernatural. Granted that in the.concrete the total motive force will bepartly natural and partly supernatural, the more dominant the role of supernatural motives, the more assurance there would be that the call was truly from God. Let us illustrate the point mad~ here by an example. " Suppose a spiritual director, on inquiring why a girl wants to consecrate her virginity to God, were to discover that it is because she finds things of the flesh repugnant. Marriage would be abhorrent to her, and if ¯ the attraction to the religious lifewere in fact nomore than an adjust-ment to such a psychic inhibition, it would scarcely be genuine. Prob-ably, such a girl would have combined this fundamental motive force with some supernatural intention, but the question is how dominant, and hence how genuine, would a supernatural motive be in such a case? Would it be any more'than a case of self-deception? I can conceive of a director telling sucha young girl to thank God that she feels that way, because she is thus freed from many temptations against chastity. Yet such advice, I think, would be highly questionable. It is true, of course, that such a person would have little or no difficulty with the material observance of chastity, but absence of sin or conflict.is not a proof of virtue. In such a case the brake applied to prevent sin is not the regulating influence of rea-son, which would be the basis for virtue, but is an inhibition of the psychic order. It is God's plan that sex should be attractive, not repugnant, and it is clear from the words of Christ (Math. 19:12) and of St. Paul (I Cor. 7:6-9) that the invitation to the counsels implies.a sacrifice. The girl who finds sex repugnant has no sacrifice to make in dedicating her virginity to God. The suitable candidate for the religious life is not one who is incapable of marriage, but one 294 November, 1953 PSYCHOLOGICAL TESTING who freely surrenders this good for a greater. There is a further consideration in a case of this kind which should not be overlooked. The repugnance felt toward sex expression is, as we have presented it, a psychicinhibition. It is due to some psycho-logical twist or other. Suppose, "perhaps after some years of religious life, that this twist is suddenly straightened out--a not inconceivable happening. Once the psychological brake is removed, the person may, for w.ant of virtue, be defenseless against a passion whose existence she never suspected. Could it not be that something similar to this is the explanation of some of those particularl~- puzzling defections after years in religion? The masters of the spiritual life have always recognized the pos-sibility of self-deception in the service of God, and modern psychol-ogy tends to re-enforce their warnings by supplying instances of the subtle ways in which uncon'scious and undetected influences may in-sinuate themselves into human motivation. When such happens in the case of vocation, the good will of the applicant is not in ques-tion, but the genuineness of his vocation.is. He is, in this supposi-tion, deceived himself, and be may quite easily deceive others. The manifestation of virtue is sometimes ambiguous, and what externally passes for virtue may actually be no more than a cover-up for a psychological problem. Natural submissiveness and deep-seated inferiority can ~asily pass for humility, overly-conscientious strivihgs for perfection can, as a matter of fact, be no more than psy-chological defenses against fear of criticism and inability to tolerate failure, while genuine apostolic zeal is not always ea~sy to distinguish from a paranoid discontent. The discernment of spirits is sometimes difficult, and we have the scriptural warning: "Dearly beloved, be-lieve not every spirit, but try the spirits if they be of God" (I John 4:1). This admonition seems to be particularly pertinent in the matter of the discernment of vocation and especially with respect to. the motives prompting the applicant to apply for admission to reli-gion. It would surely be excessive always to question o~ur conscious motives and to see in them nothing but disguises for hidden tenden-cies, but it must be acknowledged that conscious motives are some-times deceptive, and that the dominant motives for our actions are not always the ones which consciously move us. Unconscious fear of contact with the world, for example, may be concealed by perfectly orthodox motives such as contempt for the world and desire of per-fection. For a long time the individual's actions may seem to be in- 295 WILLIAM C, BIER for Refigious spired by these traditional motives, but it may eventually appear that ~hey were in fact but the effects of neurotic tendencies. Where uhcon-scious factors are at work common sense is hardly sufficient for the discernment of vocation, and the eye of the expert, is needed to detect a latent neurosis artfully Concealed behind normal behavior. External Vocation ~ ~ Let us pass now from internal vocation where psychology has but a limit.ed and indirect contribution to make, to external vocation where its contribution is more direct and more extensive. By external ¯ vocation, as previously mentioned, St. Thomas meant the acceptance of ,'i candidate by a legitimate superior. Thus external vocation com-pletes and perfects the internal call essentially determining it to this particular institute. It is evident that before an applicant can be accepted a judgement must be made on his suitabil!ty for the religious life. Some one must 'pass on such firness, and ultimately this decision is the responsibility of the religious superior. The internal call is always subject to the possibility of self-deception, and finds a certain confirmation, there-fore, in the judgement of suitability passed by a competent superior. The junction of the two gives vocation to the religious life in the concrete. Suitability for the religious life might be treated from various-points of vie~v, but for the purposes of the present discussion it will be considered under qualities of body and mind, which in the words of Canon 538 render the individual "fit to bear the burdens of the religious state." A certain level of physical well'being is required for the exercise of religious life, and it is co~nmon practice, to require of applicafits a doctor's certificate of good health. Pertinent to the present discussion, however, is the fact that mental health is no less necessary for religious life. The idea of "mens sana in corpore san&' (a sound mind in a sound body)' seems to be a p~oper estimate of fitness f?r life in religion. The Contribution of Psychological Tests There would be no real disagreement, I think, on the fact that certain psychological qualities are required in a candidate for the reli-gious life. What these qualities are might be diff,erently expre.ssed as maturity, balance, stability, control, adjustment, but there is at least agreement that some over-all psychological integrity is needed. It might even be clearer and there would, perhaps, be even greater agree- 296 Nouernber, 1953 PSYCHOLOGICAL TESTING ment if the propositi6n were put negatively: certain psychologic.al conditions render an applicant unsuitable for the religious life. Con- .sequently no .superior can accept a candidate for religion without making some judgement of psychological fitness. The trouble is that such a judgement, necessary as it is, is frequently superficial and hap-hazard, because the basis for a more adequate judgement is not avail-able. Here the psychological examination of candidates can enter to make its contribution. Such an examination can offer a more ade-quate foundation for the estimate of psychological suitability which must be made. It may be valuable to point out thus early in the pre~ent discussion that the psychological testing of candidates is new only in its methods; not in its p.urpose. Its function is traditional and inescapable: namely, ~a judgement on the psychological fitness of the applicant. The psychological' examination has a function to perfwor~mth " " respect to all candidates. With the greater n~amber of them its func-tion will be negative hnd w. ill consist simply in affirming the fact that th'ey are psychologically suitable, i.e., that no psychological fac-tors are in evidence which would antecedently make it impossible for them to bear the burden of religious life. Even though the contribu' tion here is negative, it is not to be despised for it is precisely what is needed, namely, a clean bill of mental health. It should be noted that such immunity at the time of application is no necessary guar-antee that psychological difficulty ~might not subsequently ,,develop, any more than the assurance of physical health at the time of entrance is a gua.rantee against subsequent ill health, bht at the time it repre-sents what is needed and is sufficient. With ~espect to the remaining candidates the psychological exam-ination, we assume, will show positive results. Sometimes these re-sults will be extreme, for serious mental disorder cannot be a priori excluded in candidates for the religious life. .In this connection, the work of Father Thomas Verner .Moore on the. rate of insanity in priests and religious2 is pertinent. This ~tudy appeared in The Ec-clesiastical Review for 1936, and still remains the only published work on th,e subject. In connection with the investigation, Father Moore contacted all the Catholic and non-Catholic state and .private sanatoria and asyla for the insane in. the United States. On a basis '-'Thomas Verner Moore. "Insanity in Priests and Religious. Part I[ The Rate of Insanity in Priests and Religioi~s." The Ecclesia t;'ca! Reoic~', 95 (1936). 485- 498. : 297 WILLIAM C. BIER Review for Religious of his returns, Father Moo~e reports the following figures for the year 1935. The ratio per 100,000 population was as follows: for priests 446; for sisters 485; for brothers 418: for the ge,neral popu7 lation 595. He found a notable difference between active sisters with a ratio of 428 and cloistered sisters with a ratio of 1034. On a basis of these findings, therefore, the rate of insanity among priests and religious is less than it is among the general population, but the rate for cloistered sisters is more than twice what it is among the popula-tion at large. One additional point is worth noting. Although it is true that the rate of insanity among priests and religious is less than for the general population, this result is due to the fact that syphilitic types of insanity are almost completely absent among priests and re-ligious. If the latter were eliminated from the figures for the general population, the rate of insanity for priests and religious xvould rise above that for the population at large. One might be tempted at first sight to interpret these figures as meaning that religious life makes reore demands on psychological stability than life in the world, with psychological breakdown conse-quently more frequent. Although there is truth in this interpreta-tion, Father Moore is of the opinion that a more important factor in producing these results is the attraction exerted by the religious life upon certain pre'-psychotic personalities. Schizophrenia, for example, is by far the most frequent psychiatric disorder among institutional-ized priests and religious; and there can be no doubt that a consider-able number of pre-schizophrenic personalities are attracted by the retirement and seclusion of religious life, and of the contemplative life more than the active. Their schizophrenic tendencies blossom out into a full psychosis in religion, but they would undoubtedly have done so just as xvell had these persons remained in the world. Outright psychosis among applicants for the religious life is hardly to be expected, but pre-psychosis and incipient psychosis is ~ problem, as Father Moore's findings and fundamental interpretation indicate. Now, the essential point in term} of the present discussion is that pre-psychosis is not likely to be discovered in an applicant for the religious life, apart from some special testing procedur~ designed to reveal it. Sufficient proof of this statement is found in the number of such persons who secure admission to religious life. As indicated above, cases of severe mental disorder among appli-ca, nts for the religious life are relatively rare, nor do they offer too great a difficulty in evaluation. In such cases the picture is unequivo- 298 Not~erober, 1953 PSYCHOLOGICAL TESTING 6al, and upon examination the applicant is found to exhibit such a wealth of psychopathology as to be clearly unsuitable. There is, however, a larger number of cases in which the degree of psychologi-cal difficulty is considerably less. The evaluation of such cases is more difficult for two fundamental reasons: (1) because the degree of disorder being less it is more difficult to detect; and (2) because it is more difficult to predict the extent to which the disorder is likely to render the applicant incapable bf bearing the burdens of the religious life. It is evident that the reference here is to neurosis in 'general and to the milder forms of mental difficulty which wduld not even qualify as neurosis. Neurosis, referring in general to the non-psychotic forms of mental difficulty, is a broad term, and I am inclined to think that most responsible and informed persons would be reluctant to say that the presence of neurosis, ipso Facto, would render an applicant un-suitable for the religious life. The presence of neurosis would un-questionably create a presumption of unsuitability, but the latter might yield to the contrary fact in a given case. What then is to be taken as the norm? I would, suggest that we might distinguish 'on the basis of the kind of neurosis. It is beyond question that there are certain types of neurotic difficulty which would almost surely be accentuated by the demands of religious life, and it would be my suggestion that the presence of a neurosis of this type would render the applicant unsuitable. At the present time I would prefer to leave open the question as to whether there actually are any neuroses of the second type, i.e., which would not be aggravated by the requirements of life in religion. As an example of a neurosis the presence of which would likely preclude acceptance into' religion, I would mention hypochondriasis, an abnormal pre-occupation with bodily health. This tendency, as is well known, can grow into an exclusive pre-occupation leaving the individual with little thought or energy for religious observance. In its milder forms it s.imply interferes with ~ommunity life and regular. observance; in more advanced stages, it renders the individual com-pletely incapable of foIlowing religious routine. Experience quite well attests that the introspection of the religious life develops a cer-tain number of hypochondriacs as it is, so that the expectation seems justified that this life would aggravate such tendencies if they were already present at the time of admission. An even clearer example, to my mind, of the kind of neurosis the presence of which would 299 WILLIAM C. BIEP~ Re'view [or Religious render an indi~cidual unsuitable 'for the religious life, would be an obsessive-compulsive neur6sis, which manifests itself .in the moral sphere as scrupulosity. I have referenc~ not to an isolated instance of scrupulosity in the life of an applicant, but to scrupulosity of suffi-cient duration to have become habitual. Such a state is aggravated 'by the additional duties of religious life, by the continual self-exam-ination which is an iodispensable condition for progress t~ward reli-gious perfection, andparticularly by the obligation of the vows. In its milder forms, scrupulosity impairs efficiency, in prayer no less than in apostolic work. In its severer manifestations, it makes prayer and religious observance a torture, and any substantial measure of pro-ductive work an impossibility. Attitude to be Assumed in Doubtful Cases In connection with the matter just .discussed, a question arises which must be faced directly, and it is this: do we not go too far in excluding applicants with neurotic tendencies? Would it not be more in accord with the spirit of Christ. and the Church to accept them and to leave something to the healing effect of God's grace? In answer to this sort of a question, I would like first of all to. point out that psychological testing is finished, its work complete; its contribution made, when it has ascertained the facts, in as far as it is possible to ascertain them in the case of the applicant, and has put these at the disposal of the superior. It then becomes the superior's responsibility to act upon the facts as seems best, and, in view of them and all other available sources of information, to accept or to reject the candidate. A prudent superior will not come to a decision', of course, without taking the matter to prayer. Indeed everyone con-nected with the discernment of a vocation must pray; the applicant himself must pray, his director must pray, and the superior who acts on his application must pray. The Gospels tell us that Our Lord spent the .night in prayer before choosing the Apostles. The example. of saints teaches us that we should pray in such an important deci-sion, but also work. It was it. Ignatius' advice, for instance., that we should .work as if the entire l)utcome depended on us, buy pray as though the entire outcome depended on prayer alone. Such advice seems particularly apposite in the selection of candidates. In this case, the importance of the matter requires that the most adequate possible investigation be made, but ultimately such s~lection depends upon a judgement of the superior. This judgement should be founded in fact--as far as it is humanly possib, le to discover the truth--and 300 Noaeraber, 1953 PSYCHOLOGICAL TESTING should be illumined b'y grace, in as far as it is possible to invoke the divine assist~ince through prayer. Even when we have proceeded in: the manner indicated abo,~e,.the decision still remains difficult, for we are attempting in such cases just ¯ about the most difficult task in the .world, namely, to predict the interplay of divin'e grace and human freedom. "If the human mind,'r says a distinguished French contemporary, "cannot probe this mys-terious interplay +yen after the event (for when someone leaves a re-ligious institute it is often impossible to tell.whether it was through infidelity to a. real vocation or simply due to the late discovery that there was no vocation at all) still less can it see it~beforehand.'''~ We are compelled .humbly to admit that there are and will continue to be a certain number of cases which cannot be avoided, but there are others which, with a gr.eater expenditure of human effort and l~ru-dence, could be avoided. Such" is our task. When there, is, doubt about the psychological s~itability of can-didates for the religiou~ life, I would offer it as a general principle that we should be severe rather than lenient in admitting. My fun-damental reason for this recommendation is that the religious life demands more than ordinary psychological stability for. its practice. In the vows, which constitute the essence of religious life, man makes of himself a holocaust to God. owe speak also of the martyrdom of the vows. It is true that "holocaust" and "martyrdom" are meta-phorical expressions in this context, but they serve to emphasize the demands made of human nature in the practice of the religious life, " demands which are to a considerable extent psychological. Certainly the number of psychological satisfactions available to religious are considerably reduced over those possible to people in the world, while the occasion~ for frustration are greater, due to the surrender of deep human wants through the vows of religion, and by reason of the demands of day-by-day community lif~. Hence there is required more than the usual amount of psychological stability and maturity in a religious, and it would seem, therefore, to be imprudent to accet3t in religion applicants with distinctly less than the normal amount of psychological integrity. A further point seems worth) of note in this connection. The attitude is sometimes assumed that doubtful candidates should be ac-cepted in religion because religious life wotild benefit them more than 8A. Pit, O.P., "Unconscious Attraction to the Religious Life." Religious Life: H Vocation. Westminster, Maryland, Newman, 1952, p. 110. 301 WILLIAM (~. BIER Reoiew fo'r Religious it would some better individuals who are less in need of helps reli-gion would prgvide. A ~lightly different way of putting this same objection would be to say that if there is a doubt, we should give the ,applicant the benefit of the doubt. We assume that the doubt is a positive one, i.e., one in which there are positive .reasons for ques-tioning the suitability of the candidate. ¯ In such cases, I do not think that the general principle that the applicant should be given the bene-fit of the doubt is the correct one. It must not be forgotten that the religiouscommunity has rights as well, and it .seems a more funda-mental principle that the good of the community should prevail over the good of an individual, particularly when the latter is not yet a member of the community, as would be the case of an applicant. The doubtfully suitable applicant--if indeed the doubt is well founded--is likely to prove to be a problem from the very day of his arrival in the novitiate. If such is the case, he will require a dispro-portionately large amount of the novice master's time, to the detri-ment of the other novices who would profit more from his counsel and direction. Furthermore, psychologically unstable and neurotic individuals are difficult to live with, and it seems really inequitable that such persons should be permitted to enter and to. disrupt the peace and harmony of community life. One such person can be a thorn in the side of an entire community,, as experience very well at-tests. In God's Providence we shall always have enough 'difficult members of the community to make religious~life a source of virtue and sanctification, but it seems quite another thing knowingly to ¯ contribute to the difficulties of religious life by admitting psycho-logically unsuitable persons. Finally, there is always the distinct possibility, if not probability, that the defiaands of religious life will increase the difficulties of psychologically unstable persons to the point where they will ultimately be compelled to leave religion (and the institute may consider itself fortunate if the p}oblm can be solved in this way), or else they will have to be removed from the commun-ity and institutionalized. The latter can be.a tremendous financia'l burden to a c~mmunity, an, d it would seem an unjust one when the likelihood of such an eventuality could have been foreseen at the time of admission. It might be felt by" some that when there is doubt about the psy-chological suitability of a candidate, he should be admitted with the expectation that his inability to adjust to religious life would soon become evident to him through the actual attempt in a way which he 302 Noaernber, 1953 PSYCHOLOGICAL TESTING would never have been able to accept beforehand, and that he xvill in consequence voluntarily leave. The expectation of k, oluntary with-drawal in a case of this kited is not well founded. Even for the psy-chologically well-integrated and mature personality, readjustment to life in the world is difficult and the courage required to face the un-asked questions of family and friends is considerable. Ability to measure up to such demands is not realistically to be expected of one whose difficulty is weakness precisely in this area. Furthermore, it is assumed that the individual is suffering from personality or emo-tional disorders, and one of the main characteristics of such difficulties is a lack of insight on the part of the individual into his condition.' Hence, if the disorder" increases to a point where the individual should leave, insight is likely to decline as well, so that it is not to be ex-pected that the individual will leave voluntarily. I return, therefore, to my earlier proposition that it is a mistaken charity to accept doubt2 fully mature and questionably stable individuals into religion. In concluding the'present article I should like to refer to two quotations which seem to me to re-enforce the viewpoint presented. The first arises out of*the symposium on religious vocation held in France during the summer of 1949, and consists of the following expression of experience on the part of a religious superior: "Experi-ence has taught us one thing, and that is that when there is a doubt about any.one in the novitiate it is n~arly always confirmed later: the situation does not improve. There may be exceptions but they are few and far between.TM I would simply suggest that, under adequate investigation, we can move the process back one step further, and speak about the doubtful applicant, but that the principle remains the same. The second quotation is from our late Holy Father, Pope Pius XI, xvho expressed himself on the severity to be exercised in admitting candidates to the religious life. The occasion was an audience granted to the Capuchin general chapter after the election of Very Reverend Donatus de Welle as Minister General in June I938, at which time the Pope spoke in part as follows: "This recommendation, for which we take full responsibility, ought to be regarded as a father's instruction to his children, based simply on a desire foi the well being of all religious families. And the instruction is this: Be severe. These may be hard words but they~ 4"An Enquiry about Vocation" in Religious Life: II Vocation, Westminster]Mary-land, Newman, 1952, p. 83. 303 WILLIAM C. BIER are p~ompte~t by love, for true love, love worthy of our L.o~d's' friends, can be satisfied with nothing short of the truth . We are not alluding merely to severity of discipline, in general, but first and foremost to the seyerity v,;hich ought to be shown in accepting postu-lants. If ariyone tells you that there is too much sev.erity even now, we authorize you to reply that the Pope wants it to be that .way, be-cause he clearly sees the, need of it, in virtue of his position and.re-sponsibilities, the more so as Providence has granted him a pontifi-cate of some length and thus allowed him to acquire wide .experience in this field. Indeed, if the religious life is to be kept in all its splen-dour there must be severity, particularly with regard, to vocations, because although divine grace helps nature it does not destroy iF; the necessity fordoing battle remains, and in the religious life the stakes. are higher . "It is no exaggeration to say that whenever people unite to form a group, even in small numbers, deterioration occurs. We learn.this from experience. This does not mean that a religious family ought therefore to reduce the number of its members; quite the contrary-- the tendency should always be to increase. But it should see that its members are carefully chosen, like picked soldiers. This is a difficult task, but essential.~ When a number of men join together in some enterprise, their good qualities, and particularly the highest ones, do not become common property; each man keeps his own. Their weak-ness and. bad qualities,I on the other hand, add up and merge to-gether . " These words, coming from so high an authority, speak for them-selves. The purpose of the present article has been to demonstrate the ~)roposition that psycl~ological testing has a function to perform in theselection of candidates for the religious life, and that such,a pro- . gram is in keeping with the spirit of religious vocation as understood in the Church. The theoretical desirability.of such a program is one thing, its practicality is another, arid the latter question will be con-sidered in a second article. OUR CONTRIBUTORS JOSEPH F. GALLEN is professor of canon law at WoodstockCollege, Wood-stock, Md. HILARY R. WERTS is superior and a professo.r of moral theology at Alma College, Los Gatos, Calif. C. J. McNASPY, an authority on ~cclesiastical music, is on the faculty of St.'Charles College, Grand Coteau, La. Information on WILLIAM C. BIER is given in the prenote to his article. ' 304 \ The F:ucharis :ic Fast: Hilary R. Werts, S.3. THE. new and mitigated law of the Eucharistic fast contained in the Apostolic Constitution, Christus Dorninus; and the accom-panying Instructibn of the Holy Office, whose translations were published in this REVIEV~, last March, is a generous concession of our H01y Father the Pope who wishes to make more humanly possible the frequent and even daily reception of Holy Communion so.much recommbnded by Blessed Pope Pius X and his successors in the chair of Peter. In pro.mulgating the new law His Holiness urge~ bishops and priests to take advantage of its concessions to exhort the faithful to more frequent reception of'the Blessed Sacrament. Religious who have much contact with the faithful in schools and hospitals will find many' opportunities for their zeal to promote frequent Com~ munion by expla.ining this law'and leading people to use its condes-sions. For this purpose it is necessary that they have a clear under-standing of the conditions for the.application of these concessions. It is hoped that this article will help to this understanding. The former law for the Eucharistic fast is retained except for the particular conces~ion~ "granted in the new law. The first concession is that water does not break the fast, Water may now b.e taken at any time by anyone, right up to Communion time. The Eucharistic" fast is no longer concerned with water, and abstinence from it can no long, er properly be called fasting, though it may be an act of mortifi-cation ¯ Water here means plain water, that is, water without the admix-ture of'any other substance whatever. Water as it is found in natural conditions is plain water, even.though it be mineral water from a mineral spring, Qr ocean water with its content of salt. But minerals or salt may not be added artificially to the water that is permitted before Communion. How,ever, the chemical additions to our city water su'pplies are not to be considered, f6r otherwise we would have no water available to drink and the change in the law would be meaningless. Aside from the permitted water, the Pope confirms the former law and says that it must be observed by those who are able to do so. But this does not mean that those who c.ome under the conditions of the new concessions must worr, y as to whethe, r or not they should use .305 HILARY R. WERTS . Revieu~ for Religious them. Norm I of the Constitution says: "The law of the Eucharistic fast, to be observed from midnight, continues in force for all those who do not come under the special conditions, which We shall set forth in this Apostolic Constitution" (italics supplied). Hence there is no requirement that those who come under the concessions should rather fast from midnight if possible. Norm II of the Constitution makes concessions for the infirm. They may, without any time restriction, take something by way of drink or medicine. They may take non-alcoholic liquids and they may take medicine in either liquid or solid form at any time before the celebration of Mass or the reception of Communion. The ini~rm who enjoy this concession are either those who are sick, or thos.e who are infirm because of age. For the sick, no kind or length or degree of gravity of sickness is specified, but it is required that the infirmity be such that it is difficult to observe .the fast from midnight. The difficulty need not be extraordinary; a moderate diffi-culty will suffice. If an infirm person who desires to communicate would omit Communion because of th~ fast from mid.night, then surely he finds this fast too difficult. For example, influenza, stom-ach ulcers, diabetes, asthma, the ills of pregnancy, may be presumed to make fasting from midnight difficult. Any sickness in which the doctor recommends nourishment before Communion, or in which re-covery would be delayed by fasting, or any infirmity which causes the feeling of weakness unless nourishment is taken will suffice to permit liquid nourishment before Communion. Insomnia, severe headache, high or low blood pressure, distressing ~ough, rheumatism, arthritis, a bad cold, hay fever, may frequently make fasting rather difficult, ahd permit liquids. Some kinds of infirmity may last for a long time and permit .liquids daily before Communion; others may be tran.sitory and cause difficulty only for a day or a few days and these latter equally suffice for the use of the concession whenever ~hey occur. Since a moderately serious difficulty in fasting is required for the use of this concession, there are cases of infirmity in which the con-cession may not be used because the fast is no more difficult in these cases than it is for ordinary healthy persons; e.g., a person who has weak eyes or is blind, one who has lost an arm or leg, will have no fasting difficulty arising from his infirmity Unless other circumstances enter into the case. The difficulty in fasting required in order to permit the infirm to 306 November, 1953 THE EUCHARISTIC FAST take liquids before Communion is, according to some commentators, also required in order to permit them to take medicine. However it seems to me that a close reading of the Instruction (n. 1) reveals a distinction between liquid nourishment and medicine. There are two clauses, one concerning liquids, which are permitted fi~nder the con-dition that fasting is difficult; the other cgncerning medicine, which is permitted under the sole condition that it is real medicine. Thus [ conclude that a person with a headache, even though it is not severe enough to make fasting difficult, would still be permitted an aspirin before Communion because he is sick and aspirin is real medicine. ¯ It may happen that someone feels well on rising, but knows from exi~erience that if he fasts until he receives Communion, he will be-come ill. In this case be may take medicine or liquid under the con-cession for the infirm, in order to avoid the sickness. Sometimes a person's sickness is due to his own fault, as when one is ill the morning aft, er an evenir~g of overindulgence in food or d~ink. Nevertheless, he .may use the'concession for the sick, sup-posing that he has the .proper dispositions of body and soul for the reception of.the Blessed Sacrament. We may now examine more .in detail what is meant by liquids and medicines. The liquid permitted to the sick before Communion is anything that can be pour,ed and drunk, except alcoholic bever-ages. Thus milk, tea, coffee, broth, fruit juices, soft drinks, and. heavier liquids like egg hog, milk shake, creamed soup and raw or lightly boiled eggs. The liquid may have some° undissolved solids as lo.ng as it remains a potable liquid; e.g., broth with some bread or cracker crumbs, cereals such as cream of wheat or corn meal when diluted with suffici,ent milk to make them drinkable. But all alco-holic beverages, even with low alcoholic content, are excluded after the midnight preceding Communion. Medicine, either liquid or solid, is permitted so long as it is real medicine, and not merely something nourishing or agreeable. True medicine is somethi,ng curative, palliative, or preventive. Any medi-cine prescribed by a doctor is a true medicine, but there are also many substances that are known to be medicine and used without a pre-scription, such as aspirin, sleeping pills, cold remedie~, etc. Commen-tators dispute whether medicine containing alcohol is permitted. It may safely be said that alcoholic beverages may not be used medici-nally before Communion, but a real medicine, even if it contains alcohol, may be used. This accords with the wording of the law, 307 HILARY R. WERTS ° Review for Relioious and the law hardly requires that a sick person know the chemical con-tent of his medicine, or° be prevented from Communiofi because he must take medicine containing some alcohol. We may also note that some things which are ordinarily considered food and not medicine may in certain diseases be real medicine with curative or preventive value. Thus sugar is prescribed for diabetics who have an insulin reactidn. This concession of the use of liquids and medicines for the infirm is granted to priests or rion-priests, and to p~iests for the reception of Communion or th,e celebration of Mass, and applies whether the ¯ Mass or Communion is in the morning or in the evening. The liquids or medicine may be taken once .or several time~ after midnight, and in any quantity. The use of this concession is not directly open to all the infirm, but those who are not priests are required to first consult a confessor, that he may judge whether they may use the concessio~a. This con- ¯ sultation is required in every case, but need be made only once ,for a given cause of infirmity, and the advice of the cQnfessor maY be fol-lowed as long as the infirmity continues, even if it be life-long. When the infirmity diminishes, as during convalescence, the c6ncession may still be used until it is clear that the infirmity no longer makes fasting difficult. . The time'fo[ this consultation is any time before Comm~ion. The confessor's advice is not required to take liquids or medicines. The advice is required for Communion after having taken these things, and so .it may be asked after taking them ~but before receiving Communion. The gravity of the obligation to consult a confessor is discussed by commentators, and some hold that to use the concession without consultation would be to viOlate the law of the Eucharistic fast and commit a grave sin. Others say that a person who is sure that his case comes under the conditions of the concession would sin'venially by disobedience if he were to omit the consultation and rceive Com-munion; and that in an extra.ordinary case, when it is impossible to. consult a confessor, he could use the concession without consultation. This opinion may be followed unless the Holy See ~olves the question otherwise. Of course, if a person were not qualified to judge the matter, he would sin at least, venially b,y acting imPrudently. There is"also some discussion about the confessor who is t6 be consulted. The strictest o.pinion is that he must be a priest who 308 November, 1953 THE EUCHARISTIC FAST could h~re and now hear the confession of the one consulting, and this would be required if the advice were sbught in confession. But the law does not require that the advice be sought in confession. It may be asked in private consultation outside the confe~si6nal and, according to atenable opinion, from a priest who can hear confes-sions somewhere, even though he .has no faculties to hear confessions in the place of the consultation or of the person consulting. Certainly no one but a priest may give the required advice, though teachers and others may explain the requirements to their charges. Since the advice of the confessor may be asked out of confession, it follows'that it may be asked in personal interview, by phone or by letter, or by an int.ermediary,such as a parent or other relative, a Sister or nurse in a hospital, a teacher, etc. The advice is personal and in-dividual and could not be given to a large group together, such as Ill the people attending Mass; but.if there is a group in which the con- "fessor knows that all those present have the same reason for the use of the concession, he could advise the group together, as when all the nurses present are on night duty, or all the people present must make a long trip to Mass, and thus come under the concessions to be seen later. As seen above, a person who is not a priest must consult a con- . fessor before using the concession for the sick (and also the conces-sions to be seen below). Must the sick priest also consult a confessor before using this concession to receive Communion or to celebrate Mass? "A~ first sight the law seems to requlke this, and some com-mentators thus interpret the law., But many, i~ncluding some who are connected with the Holy Office in Rome, say that the sick priest need not consult a confessor. This seems reasonable, for if the priest can decide for others, he should be able t9 decide ~or himself. With-out entering into all the arguments, it might be well to consider one point, The Instruction of the'Holy Office concerning the sick (n. 3) says: "Priests who are ill., may likewise take advantage of the dispensation." The word likewise is a translation of the.word pariter, meaning "likewise," "in the same way." Many'commenta-tors r~fer this word to what has gone before, and understand the law to gay that priests may use the dispensation in the same way as the faithful, that is, .after consulting a confessor. It seems to be as well or even better to refer the word to what follows, and understand the sentence to mean that priests are given permission to .use the dispen-sation as well for celebrating Mass as for receiving Communion, 309 HILARY R. WERTS Review for Reliqious which is a new and very noteworthy concession, emphasized by the word pariter. The next concession is for priests in circumstances other than sickness which make fasting difficult. Three specific causes of diffi-culty are set down and the concession is grant.ed to piiests in these circumstances, without the need of consulting a confessor, and even incases where the pri, est couId fast without difficulty. The three causes are exclusive, and the concession is not to be extended to other circumstano~s, but actually the three given causes cover most of the difficult cases. The first cause is the late hour of celebrating Mass. The hour is defined as nine o'clock in the morning. If a priest celebrat,~s Mass after this hour he may take non-alcoholic !iquids as explained above, up to one hour before the beginning of Mass, and may take them as often as he wishes. The time in this case must be measured mathe-matically. There must be a full hour of fasting before the beginning of Mass. And the Mass must start after nine o'clock. If the priest leaves the sacristy promptly for a scheduled nine o'clock Mass, it will be after nine when he begin? the Mass at the foot of the altar with the sign of the cross, and he is a proper subject for this concession. When a priest is celebrating more than one Mass, and one of them is after nine o'clock, he fulfills the cbndition and may us~ the dispensation by taking liquids any time after .midnight, and therefore before his. earlier Mass, but he must observe the prescription of fasting from the liquids for one hour before each Mass. Thus if he celebrates at eight and nine o'clock, he could take liquids before seven o'clock; if he celebrates at six and nine o'clock, he could take liquids before five and again after the first Mass but before eight o'clock. The second cause which allows priests the use Of liquids up to one hour before the beginning of Mass is heavy work of the ministry done before Mass. No exact definition of this work is given, but in view of the definition of a late hour given above, and of a long jour-ney given in the next cause, it would seem safe to say that one hour or more of concentrated work, such as hearing confessions, taking~ Communion to the sick, preparing a sermon, participating in solemn ceremonies, and the like, would allow the concession, but not an hour of puttering at odds and ends while waiting for Mass time. The third cause permitting liquids to the priest up to one hour before the beginning of Mass is a long journey, before Mass. A long journey is defined by the Holy Office as a distanoe of a mile and a 310 November, 1953 THE EUCHARISTIC FAST quarter on foot, which is a walk of about 20 or 25 minutes. If transportation is used, the distance must be greater in proportion to the kind of conveyance, the d!fficulty of the road, and the condition of the traveler. The inconvenience of the trip by conveyance should be equivalent to the inconvenience of a walk of a mile and a quarter. For a healthy person and a good road, it would seem that about forty minutes by car, or thirty minutes by bus, or twenty minutes by bicycle, would be a long journey in the sense of this law. Where the road or the weather is bad, or the person old or unwell, this distance may be shortened proportionately. Since water no longer breaks the fast, it is noted that a priest celebrating more than one Mass may take the ablutions in each Mass, but using only water except at the last Mass. However, the Holy Office makes an exception to this in the case of Christmas and All Souls Day, if the priest celebrates three Masses on these feasts without interruption. In this case he should observe the rubrics of the missal which require the omission of the ablutions in the first two Masses. If on these two days the priest should take the ablutions with water, he would not be breaking his fast but he would be violating the rubrics. The Holy Office says that if the binating or trinating priest in-advertently takes wine at the ablutions of a Mass before his last one, he may still celebrate the subsequent Mass or Masses. Some commen-tators hold that this permission is granted only if the priest has some special need to celebrate the subsequent Mass, e.g. because it is a sched-uled Sunday Mass. But others say that the law does not necessarily mean any particular need for the Mass, and that the priest may pro-ceed with his Masses for no greater reason than his own devotion. It would seem that if the priest inadvertently took the wine ablu-tion into the chalice in his earlier Mass, and noticed it before con-suming the wine, he would not be obliged to dispose of it some other ~vay, but could consume it. However, if he deliberately took the wine ablution at Mass, not intending to binate, and later the need for another Mass arose, he could not celebrate again .unless there were sufficient need to allow him to celebrate after breaking his fast. But in view of the present mitigation of the law, one might be less severe than formerly in weighing this need. Having seen the concessions for priests who will celebrate Mass, we come to the concession for communicants. This concession, simi-lar to but somewhat different from the preceding, is the one which 311 HILARY Rz WERTS Re, view/or Reli~lious rules the reception of Holy Communion for all non-priests, even though they be religious or clerics in the major orders of subdeacon or deacon, and it also applies to priests who are to communicate rather than celebrate, as for example, priests who do not c~lebrate Mass on Holy Saturday. The concession is given for three exclusive causes of grave diffi-culty, namel~, fatiguing work ¯before Communion, late hour of. Communion, or a long journey before Commianion. The concession requires consultation of a confessor, as seen ~above for the infirm. When the" concession is allowed, the communicant may take .liquids as often as he wisheL from midnight until one hour b~fore Com-munion, and of course water at any time. No solid food,or alcoholic drink is allowed after midnight. Note that the hour is measured be-fore Communion, while for the celebrant we saw that it is measured before the beginning of Mass. The period of fasting must be a full hour and if in doubt about the exact time of Communion one must leave some margin Of time; or risk arriving at Communion before the full hbur is completed and thus be deprived of Communion, for there m'ust be no diminution of the hour. There are various opinions as to the application of the three causes of grave difficulty. One opinion requires not only the exist-ence of one of these three causes, but also the existence of at I~east a moderately grave difficulty in fasting from midnight for this particu-lar communica.nt, A second opinion holds that if one. of the three, causes exists, we may presume that it is actually difficult for any par-ticular person to observe the fast" from midnight, and so he should be allowed to use the concession unl.ess it is clear that fasting causes him no difficulty. A third opinion holds that the only difficulty required is the actual existence of one of the three given causes. For example, if one must make a long journey to church, he may be allowed to use the concession without inquiry as to the inconvenience he would suf-fer by fasting from midnight. TJae practical application of these¯ different opinions will be the same except in border-line cases in which the third opinion will cre-ate less anxiety in the confessor and the comrrluriicant than will the other two opinions. This third opinion has the fewest supporters,. ¯ but I adopt it'as the easiest to. apply and as defensible according to the meaning of the law. Although the tenor of the law is that it in-tends to relieve those who experience grave difficulty in fasting from midnight, it also states that there is grave difficulty in certain cases 312 November, 1953 ¯ THE EUCHARISTIC FAST given as examples. The C0n~titution also insinuates that some cir-stances which do not ~eem to be serious in a single case may have a serious cumulative effect over an extended period. Thus 'the Consti-tution says that the burden of a priest's Sunday ministry unques-tionably undermines his health; the conditions of work in the mod-ern economy and the conditions of modern living especially after re-cent wars have caused a general decline of health. The Constitution, norm V, grants the concession "because of grave incon.venience-- that is, because Of fatiguing work, or the lateness of the hour . or the long distance." (italics supplied), signif~ring that these three conditions are actually grave difficulties. The introduction to the ¯ Instruction says the concessions may be used by those who find them-selves in the particular conditions specified in the Constitution, which in this.concession are the three given causes. The Instruction states 'the concession to the sick conditionally,."if because of their illness~ they are unable without grave inconvenience, to observe a complete fast," signifying that illness may or may not be a cause of grave in-convenience. But in the concession to communicants who are not ill, it states directly that the three enumerated circumstances are (not rna~] be) causes of grave inconvenience. Furthermore, the spirit of these, documents is very lenient, considering a mile and a quarter as a gravely inconvenient walk and nine o'clock as a gravely inconvenient late horn:, if these are considered as.generally grave, there seems to be little room for a reasonable decision that in some.exceptional cases they are not grave. To draw a line betw,een grave and not grave in this matter seems to be practically impossible and the attempt to do so would lead to anxiety and scruples. So it seems to be in accord' with the meaning and spirit of this law to allow the concession to all communicants who are in one of thd three given circumstances, without trying to measure the gravity of the difficulty of fasting for each communicant. ¯ The first cause given, fatiguing work, is illustrated in the law by the cases of night workers in factories, ships or other transportation, ~hose who spend the night in the'service of the sick or as watchmen, and mothers who must perform domestic duty before going to Com~ reunion. The work may be an all-night occupatign, or it may be work done in the morning for a period long enough to make it fa-tiguing, or it may be work done during some part of the night with some sleep afterwards, as when a nurse is called at night for some emergency. An hour's heavy work in the morning would seem to jus- 313 HILARY R. WERTS Reuieto /:or Religious tify the use of the concession. Work done late in the evening does not seem to be ordinarily included in this cause, but .such work and even work done earlier might sometimes be so fatiguing that it would permit use of the concession. The law also mentions pregnant women,rand probably considers them subjects for the concession in-dependently of any work they must do before Communion, merely by reason of the pregnancy. The second cause is the late hour at which alone the communicant can receive. The late hour is not defined, but since nine o'clock has been defined as a late hour for the celebrant, it must also be a late hour for the communicant. Perhaps it was not defined because it maC/ happen that a time before nine o'clock will be a late hour for those who must rise very early. The Instruction gives the example of Communion in a place where a priest is not able to say Mass early because he must come from some distance, as happens when on.e priest has charge of two or more churches. Although the Constitution says: "The ,lateness of the hour at which alone they can receive," this must not be understood to mean that it is absolutely impossible to receive earlier, but rather that it is difficult to receive earlier, or there is some necessity for waiting until a late hour. The concession could be allowed to these: the parent who must care for the children while the other parent goes to an early Mass and then himself goes to a .later Mass; one who is awake until a very late hour at night and so needs to sleep late in the morn-ing; one who needs a late sleep on Sunday or a holiday to rest from his week's work; one who must choose a late Mass to keep peace in the family; the altar boy who is assigned to serve a late Mass, even if he could go to another earlier Mass; a worker who could.conveni-ently go to noon Mass down town but would find it inconvenient to rise early enough for Mass before work; some special reason for a late Mass, as when the bride and groom wish to receive at a late nup-tial Mass, or the family wishes to receive at a late Requiem Mass; and in general, whenever in view of the person's accustomed rising hour, the time of the first conveniently available Mass is relatively late. But one may not without some necessity freely choose the later of two Masses in order to be able to take liquids before Com-munion. A special case of a late hour, mentioned in the documents, is that of children who would have to go to church, communicate, and then return home for breakfast before school. In order to obviate this 314 Nooernber, 1953 THE EUCHARISTIC FAST difficulty, these children may take liquid nourishment up to an hour before Communion. It must be admitted that this concession is not without its own problems. Although a child could have a sufficiently nourishing breakfast made up entirely of liquids, still it might not be a satisfying breakfast for those accustomed to a more substantial meal, and the liquid breakfast might require that the child and hi~ family rise earlier than usual in order to finish it an hour before Com-munion time. From this case of the school child we may conclude that some-times the hour may be considered late because the available time be-tween Holy Communion and other duties does not permit the com-municant to obtain breakfast, readily after Communion. This may be the case not only for school children, but also for college students, and for people who work away from home and do not have conveni-ent time after Mass to return home for breakfast. The third cause which allows this concession is a long distance to travel to church. The distance in this concession is to be measured in the way explained above for priests, i.e., a mile and a quarter walk, or the equivalently inconvenient ride. Here again there must be some need for the travel. One could not choose a more distant church when there is a nearer one unless there was some fairly serious reason for doing so. Sufficient reason might be some special solemnity at the distant church, e.-g., the first Mass of a member of the family; a group Communion of a family or of the Holy Name Society or the Knights of Columbus; .an alumni or father-son Communion-group at a school; a baccalaureate Mass; the close of a M'ission or novena one has attended; but hardly the mere devotional desire to communi-cate in the distant church rather than in a near one. The final concession concerns evening Masses. These Masses are not directly permitted, but the local Ordinary may permit them on the days specified in the law, and he may permit them in all .the churches of the diocese, or in certain designated churches. He may also permit them in the oratories of religious. There must b~ some need for the evening Mass, for workers who cannot go to morning Mass, or for a gathering for a religious or social festivity such as a Eucharistic Congress, a Sodality Convention, a business, labor or scout convention, etc. The evening Mass may begin at four o'clock or later. Some have thought that an eoenin9 Mass differs from a night Mass, and have tried to assign the latest hour at which this Mass may begin as some hour earlier than midnight, but the law does 315 HILARY R. WERTS not ~eem to set a final hour at any time before midnight, and the hour may be defined by the local. Ordinary according to the need. When evening Masses are permitted, all are free t6 go to the Masses and to receive Communion, but no one may communicate twice on the same day, nor may the priest celebrate morning and evening of the same day unless he may legitimately binate on that day. Neither priest.nor faithful need consult a konfessor under this concession. The Eucharistic fast required for evening Communion is a fast "of three hours from solid food and one hour from liquids, and the time.is measured before Communion for the communicant but before the beginning of Mass for the celebrant. No hard liquor is allow~d ¯ after the preceding midnight.Light alcoholic beverages such as beer and wine are allowed in moderation, but only during a meal. Some commentators hold that these beverages may be taken at only one meal, even if the person ~ats two meals before a Mass late in the evening, But it may I~e admitted with other commentators that the law does not intend to exclude the use of these beverage's from any meal taken before evening Mass or Communion. This new law of the Eucharistic fast is a generous help for the increase of frequent Communion. Priests and other teachers of the faithful can use it effectively, as the Holy Father wishes, to encourage the frequent reception of the Blessed Sacrament, and the faithful should take full advantage of these concessions to increase their re-ception of the'Bread of Life in proportion to the greatlyincreased convenience of its reception. " BOOK NOTICI: Over twenty years ago Father Bernard Hausmann, S.J., first translated from the German a notable book on-the devotion to the Sacred Heart written by Father Christian Pesch, S.J., under the title of OUR BEST FRIEND. World War II and other causes kept the book out of print for some years. Now the publisher has reset the book entirely in very legible type. Its thirty chapters, each acom-plete unit in itself, offer ideal reading matter for daily spiritual reading during the month of June; or for the Fridays of the year. The central thought of this work, that Jesus is t, ruly our best Friend, contains the strongest possible motive for fervent practice of devotion to the Sacred Heart. (Milwaukee: Bruce Publishing Cc~mpany, 1953. Pp. 228. $3.00.) 316 Motu Proprio ,Jubilee C.J. McNaspy, S.J. ~IGH MASS ~nd possibly an added toothsome tidbit, at least for the choir, mark St. Cecilia's feast in many religious com-munities. This year is likely to see a fuller fe.stivity on No-vember 22, the golden jubilee of Blessed Pius X's Motu~Proprio on ¯ sacred music. 'Everything about'this famed document is rwell known to music teachers and chant directors, who often have had to flourish it in defense of their innovations or renovations. But this fiftieth anniversary may be a fit .occasion for all religious, however unmusical, .to recall what the Church has to say about her own music. If the Motu Proprio were a dead letter no one would take the trouble to commemorate it. Blessed Pius himself saw to it that this would not easily happen by enshrining his prescriptions in tt~e pre-paratory draft of canon 1264. His immediate, successor, Benedict XV, not long after stated: "We do not wish that the lapse of time should weaken the force of these wise rules.; indeed, we desire them to have their full force." On the silver anniversary, 1928, Pius XI indeed bolstered them with a new papal document, Diuini Cultus, in which he expr~essed surprise "that some have declared that these laws, though so solemnly promulgated, were not binding on their obedience." .Finally, our present Holy Father devotes several pa.ragraphs to sacred music, alway~ stressing the sameprinciples, in his masterly Mediator Dei. No one, unless wi~h a peculiar axe to grind, can say that the Motu Proprio is out of date. Another unfounded notion one sometimes hears is th~t the Motu Proprio is a bit extreme and not practical enough for us to do anything about it. The full reply to this objection would be simply to read it through. By no means does it. state or imply' that one should use only Gregorian chant in sacred worship. Quite explicitly the Holy Father states that "modern music is also admitted in church, as it also offers compositions of such goodness, seriousness, and grav-ity that they are not at all unworthy of liturgical functions." And if this were not enough, the Holy Father explains that "the Church: has always recognized and favored the progress of the arts, admitting to the service of worship everything good and beautiful that genius has been able to discover throughout the centuries." No, only one 317 C. J. McNAsPY Review for Religious type of music is condemned in the Motu Proprio, and that by indi-. rection: the music that does not possess "the qualities proper to the liturgy, namely holiness, and goodness of form, from which spon-taneously there springs its other mark, uniuersaIit~t.:" It is hard to see how anyone could find this either radical or extreme. So much has been done, especially during recent years, to carry out the requirements of the Motu Proprio that another possible qualm may occur: isn't it all so obvious that we needn't discuss it any more? Mu~n personal contact with religious, younger ones particu-larly, is so encouraging that one is tempted to let down, feeling that the battle has been won. The ever-.widening conquests of the Gre-gorian Institute, Piu; X School, and other liturgical or musical or-ganizations must surely bring added joy to the Blessed Pontiff who so recently launched the whole movement. But when one leaves religious house and seminary to venture forth into parish, or even, in some cases, cathedral, the situation is dismal indeed. True, the more offensive, bumptious Masses usual in the last century will h~rdly now be heard. But in too many instances, what replaced them is little better. In fact, there are parishes, even deaneries, Where .the Motu Proprio would seem never to have been promulgated. Sad indeed would be the Blessed Pastor were he not already in heaven. It was with real poignancy that he had written, fifty years ago, while intro-ducing his great statement, of the "many prejudices so stubbornly held even~among responsible and pious persons"; not all of the stub-bornness is gone .today. Need we recall once again that all.discussion of the role of sacred music in divine worship must be situated in the total context of the very m. eaning of liturgy.? The question cannot be simply decided on a purely musical basis. It cannot be just a matter of aesthetic value, abstractly considered, if that were possible. Much less can it be just a question of "I don't know anything about music but I know what I like." ¯ Music that would ~ank high on some ecclesiastical Hit Pa-rade or even music performed in Carnegie Hall will not necessarily be suitable as worship music. Too often, even now, dubious standards are implicitly set up. A meditative reading of the Motu Proprto could remedy that. "Sacred music as an integral part of the solemn liturgy shares in its general, purpose, which is the glory of God and the sanctification and edification of the faithful." Thus far no cavilling possible. "Its principal function is to adorn with suitable melody the liturgical text 318 November, 1953 MOTU PROPRIO JUBILEE proposed to the understanding of the faithful." Here it becomes clearer that music's place must be secondary, that of a handmaid, as Pius XI would make explicit. If tb? sacred text becomes a plaything, or in any way obscured instead of pointed and intensified, then some-thing has gone askew; this may be good concert music; it is no longer liturgical music. Then the Pontiff enumerates the three qualities of sacred music which we gave above. By "holiness" he means ~hat all profanity must be excluded, "not only in itself but also in the manner in which it is presented by the perfgrmers." Farther on he explains that nothing may be admitted ~hat contains anything "reminiscent of theatrical motifs," or "fashioned even in external pattern on the movement of profane pieces." Music of a romantic or sentimental flavor (aptly called "googaudery") in which the."pleasure directly produced by music is not always kept within bounds," is evi-dently excluded under this heading. Next, music "must be true art, for otherwise it is not possible for. it to have that effect on listeners which the Church intends to achieve in admitting the art of music into bet liturgy." This precept is commonly violated in two ways: either by singing music of low artistic worth, music that would never make its mark in "the world ~vere it not put forth under the aegis of the liturgy; or by singing worth~(music in an unworthy way. The second fault, while often less grievous because prompted by good. intentions, can sometimes do more harm than good. People have frequently grown to dislike Gregorian chant or the Church's great polyphony because they were performed with more good will than skill. For this reason Plus XI insisted that at least seminaries teach "the higher and 'aesthetic' study of plainchant and sacred music, of polyphony and organ, which the clergy should by all means thoroughly know." As the seminaries turn out pastors competent in this field, it is likely that choirs will reflect their understanding of sacred music, artistically and liturgically. The third mark of liturgical music, "universality," means that "though every nation is allowed to admit into its ecclesiastical com-positions those particular forms that constitute, so to speak, the spe-cific character of its own music, still these must be subordinated in such a way to the general character of sacred music that no one of another nation may receive a bad impression-on hearing them." This delicate catholicity, a tension between unity and diversity, is perhaps 319 C. J. MCNASPY the hardest principle to apply. However,. ,the Pontiff goes, ,on. ex-plicitly- to condemn the operatic style of his own country. We wonder~ what he would think of certain rather eccentric efforts to produce Negroid or "western" sacred music for use.in our country. But popes are ever practical, and to prevent us from being too abstract in our approach, the Holy Father immediately gives concrete examples of what the Church does want. "These qualities are found, in the highest degree in Gregorian chant,~'' which "has always been considered the supreme model 'of sacred music." Then he sets down, in italics and as unambiguously as possible, the fol-lowing'rule: "The more closely a composition for church approaches the Gregorian melody in movement, inspiration, and flavor, the more sacred and liturgical it is; and the more it departs from that supreme model, the less worthy it is of the temple." It would" take real in-genuity to misunderstand that. Blessed Pius next forestalls a possible escape. Granted, one might object, that.the chant is so sacred and worthy; but isn't other music really more solemn? No, says the Pope, "it must be held by all as certain that an ecclesiastical function loses none of its solemnity when accompanied by no other music than Gregorian chant alone.'.' How-ever, he adds, "the qualities mentioned above are also possessed in an eminent degree by classical polyphony, especially by the Roman school, which in the sixteenth century reached its highest perfection in the work 6f Pierluigi da Palestrina. . Classical polyphony is quite close to the supreme model of all sacred music, namely Gre-gbrian chant, and for that reason deserved to be received together with Gregorian chant in the most solemn functions of the Church." A fir~al scruple: is this not reactionary,, or at least over-conserva-tive? As an interesting corroboration of the Holy Father's stand I believe we could give quotations from almost every leading con-temporary music historian or theorist. To cite only the most recent,, and surely, one of the most eminent, Harvard's Professor. A. T. Davison, a no/~-Catholic. " His new book, Church Music: Illusion and Reality, could almost be called a commentary on the Motu Pro-prio. After calling our chan~ "the unchallenged example o~t:, worship become music" and speaking of Palestrina and other polyphonic corn- .posers in terms of the highest pr~iise, Dr.Davison states in reference to both: "It may appear to the reader that this music of the Roman Cath-olic Church has been rather aggressively held up as a model.If this 320 November, 1953 COMMUNICATIONS is so, it is only because of a conscientious attempt to deal objectively with the matter; for that particular music, it would seem, fulfills two all-important requisites of true church music: first, in vying with the greatest music in any field, sacred, secular, or instrumental; and second, in creating an atmosphere of worship wherein not man but God appears as the important figure in the transaction." . Surely no fine~ tribute to the sainted Pope and his liturgical work for Christ could be offered. Communications Reverend Fathers: The September issue of the REVIEW FOR RELIGIOUS reached me t£day and I should like" to cl~arify a reference made by WilliamGrem-ley, in his article entitled "Intergroup Relatiohs," pages 231-241. The quotation given by Mr. Gremley from This Is Our Town appeared in the old edition of the book. I have since revised all the Faith and Freedom" Readers and the particular story referred to by Mr. Gremley is no longer in the new edition. Mr. Gremley gives 1952 as the date of copyright which is also in-correct. The story referred t0 in This Is Our, Town appeared in the 1942 edition. The re~;ised book was published last spring and has a 1953 copyright. There is no 1952'edition of this particular volume. --SISTER M. MARGUERITE, S.N.D: Reverend Fathers : His Excellency, Bishop Gonzaga, of the Palo (Leyte) diocese in the Philippines; has asked me, during my brief visit to the United States, to try to interest some American Sisterhoods to undert~ike educational work in his diocese. Will you allow me to publicize his request through your e~teeme'd columns? The Holy See has entrusted to this zealous and schokirly Filipino prelate the spiritual welfare of over 1,000,000 Catholics on the large island of Leyte. During my twenty years in the Philippines, I have had the privilege of. long acquaintance with him, and know well his situation. With only about sixty-five priests (some of whom are old and sickly) and only three schools conducted by Sisters, he is in desperat9 need of spiritual reinforcements and most anxious to obtain American Sisters, and also priests, for his diocese. 321 QUESTIONS AND ANSWERS Reoiew/or Religious Anyone acquainted with our own country realizes that we have many regions at l~ome which need additional laborers in the vineyard of the Lord. It is this situation, no doubt, which is preventing many of our high-minded ecclesiastical, and religious superiors from allow-ing their .American subjects to go to foreign fields. On the other hand, Catholic history from the time of the Apostles is replet~ with examples of how the Church has always been prodigal in sending missionaries to foreign fields, even though their home lands were not yet fully manned nor completely evangelized. And they have been richly rewarded by the Holy Spirit, \Vho has multiplied vocations to their ranks as a blessing for their sacrifices. Those interested in further details will please write .to the under-signed. REV. G. J. WILLMANN, S.J. P. O. Box.510, Manila, Philippine Islands --29~ There are members o~ a commun;ty ~;v;ng ~ogefber who bare not spo-ken to one another over a period of four or five-years. Is the local superior obliged to try to correct this situatlbn or should a higher superior who !~nows of the maffer take a hand? As a general norm local situations as far as possible would be handled by the local superior. For a good reason in a particular case it might be deemed advisable that some other than the local superior take care of the matter; t.he case could then be referred to higher supe-riots. Such a good reasbn could be discrepancy in age between the superior and the subject'.who needs correction, possible lack of ex-perience in a younger superior, a question of tactfulness, a clash of personalities, and the like. In our instance the higher superior is al-ready acquainted with the situation; hence the lotal and higher supe-riors might confer together regarding the more prudent and more efficacious way of handling the case. Is it the mind of the Church tha÷ S~sters who de~re and even ask for correction and guidance from their superiors be left wlthouf it on ÷he ex 322 November, 1953 QUESTIONS AND ANSWERS pressed opinion that the Sisters are grown women and know what they are supposed fo do? Canon 530 strictly forbids all religio~s superiors in any way to indfice their subjects to make a manifestation of conscience to them. It does not, however, forbid subjects to open their minds freely, and of their own accord to their superiors; in fact, it encourages filial trust in superiors and, if the superior is a priest, it also recommends sub-jects to reveal doubts and anxieties of conscience to such a superior. Consequently subjects are free to go to superiors, even those who are not priests,~ with their problems, especially if the problem does not in~rolve a question of sin. Superiors on their part will usually lend a sympathetic ear. But the case might arise in which the superior did not feel competent tO handle a certain problem; or one could, en-visage a particular case in which the superior judged that it would be better for the individual to resolve some simpler difficulty for himself and thereby buiid up self-confidence. In these matters a great deal of tact and Christian charity is required on the part of superiors; but subjects also should practice charity in moderating ~he demands they make upon superiors. Some problems could easily be solved on the individual's initiative after prayer and reflection. A decade ago the REVIEW FOR RELIGIOUS invited discussion on the topic of spiritual direction. In the concluding survey (II [ 1943 ], 187-201) the twofold prong of spiritual direction was indicated, namely instruction and encouragement. On pages 19 I-192 the con-clusion is voiced that need of instruction should certainly decrease with the i~assage of years to such a point that normally the intellec-tual help required of one's spiritual director would be mainly friendly criticism. "In other words, these religious plan their own lives, submit their plans to a director for approval or disapproval,. and then occasionally make a report on the success or failure of the plan." In regard to encouragement, the need is more individual ~nd is usually not lessened with the years. "At various periods in our lives, most of us need sympathetic help or paternal correction lest we lose heart or descend to low ideals." Both superiors and subjects might profit by keeping those considerations in mind. --31-- If a councillor is absent and the local superior, who is not a councillor, is called to a council meeting, does the local superior give her vote ~n ÷l~e order the absent councillor would have or after all the councillors? 323 QUESTIONS AND ANSWERS Review for Religious ¯ Canon 106, n. 5 says in part.that among the members of any college (collegium) the right of precedence shall be determined by the legitim.ate constitutions of the college; otherwise by .lawful custom; in default of that, by the norms of the common law. Hence, the con-stitutions of the institute should be consulted. If they make no pro-vision, then follow whatever has been the legitimate custom (which here means the customary way of acting), in this situation. If neither the constitutions nor custom provide a solution, canon 106, n. 1 states that one who represents another enjoys the precedence'that person has; but anyone who is in a council or similar meeting .as a proxy yields precedence to those of the same rank who are personally present. Accordingly, then, a local superior wl~o is not a councillor but who has been summohed to take the place organ absent councillor would vote after the councillors who are present in person. m32m Acjeneral chapter is held in a branch house. When the time comes for voting, does the local superior who is not a councillor .cjeneral vote before or after the ~ouncillors cjeneral? (It is customary for Junior Sisters 1.o vote first, followed by Senior Sistei-s.I The first answer is, consult your constitutions. If they say. nothing, the.n follow whatever has been customarily done in this matter. If no solution is forthcoming from either of those sources in the order enumerated, it would seem that the local superior in this case would yield precedence to the councillors general since the latter in this instance seem to be acting in their "general" capacity, so to speak. (Possibly some institutes follow a simpler method of having all capitulars vote according to strict seniority, upwards or down-wards, without regard to offices h~ld.) ~33~ Propositions to be presented to our cjenera! chapter are very often sent throucjh some member of our cjeneral council or fhroucjh the cjenera/ council. 'Has the cjeneral, councll the right to discard a proposition that pertains dlrec~ly or indirectly to the cjeneral council itself, since the cjen-eral chapter, wh[le in session, is the highest aufhorlfy ~n the concjrecjatlon? Perhaps your constitutions or legitimate custom indicate that proEositions intended for the genekal chapter are to be forwarded ,dlrough the counciI16rs general, and that these latter have the power to judge the feasibility of presenting any such proposition to the gen- 324 0, November, 1953 QUESTIONS AND ANSWERS eral chapter. Otherwise, an answer (in part) appearing in the RE-VIEW ~:OR RELIGIOUS, XI (1952), 309-310 in response to a similar question .says: "Usually they [requests" or complaints intended for thegeneral chapter] are given to one of the delegates to'the general chapter who, in turn, at the proper time, turns them in to the special committee appointed for the purpose of screening such requests .and complaints. Those that are considered worthy of the attention of the general chapter are proposed to it in due time during the chapter of affairs. At the end of the. chapter, before a vote to adjourn is taken, .any delegate may ask tha~ a request or complaint which has been turned in but has not been submitted to the general chapter 'should now be read, and the chapter will then vote first on whether the request or complaint is to be considered or not. If"it is "rejected, that is the end of the matter. If the majority is for considering it, it will then be 'considered in the same way as .the other requests or com-plaints which Were already submitted to the general chapter." m34.- ~ One of our novices left religious llfe aboufa year ago because of ill health. Now she has fully recovered and would like ÷o re-enter our com-munity. We know she has ÷o make a new novitiate, but does she have to make a new postulancy? Unless your own constitutions require a new postulancy, the ap-plicant does not have to rbpeat the postulancy. There is no special provision in the°Code of Canon Law for this case, but the conclusion is reached by analogy with two other provisions in the Code. Accgrding to canon 640, § 2, if a religious who after making profession obtained an indult of secularization is readmitted later on to a religious institute by virtue of an apostolic indult, he must make a new novitiate and a new profession, but nothing is said about making a new postulancy also. Hence a new postulancy need not be made in that case. ~ Likewise in an institute which has two canonical classes of mem-bers, if a novice or professed passes from one ciass to the other, a new novitiate must be made, but no new postulancy is required (~ee canon 558). Hence by analogy with the above two provisions of the Code, no new postulancy is required in the case proposed in our question. (See also REVIEW FOR RELIGIOUS, I [1942], 357.) 325 Book Reviews RELIGIOUS MEN AND WOMEN IN THE CODE. By Joseph Creusen,'S.J. Fifth Engfish edition, revised and edited to conform wi÷h the sixth Frefich edition by Adam C. Ellis, S.J. Pp. xlv -f- 322. Bruce Publish° ing Company, Milwaukee, 19S~}. $S.S0. Religious superiors and subjects will welcome this latest edition of Father Creusen's vhluable work. In editing the fifth English edi-tion, Father Ellis has painstakingly made the various changes, addi-tions, and omissions found in the latest French edition. These emen-dations, due partly to a constant effort to keep the work up-to-date with recent pronouncements of the Holy See, serve to enhance the undoubted worth of this book. It should be kept handy alike for r~ference shelf and classroom study of the Church's law for religious. Something about the annual report and the new questionnaires for the quinquennial report is included. Appendix III gives an English translation of the questionnaire for the quinquennial report of dioce-san congregations and societies. As the author remarks in his preface: "We have not deemed it necessary to add a chapter on Secular Insti-tutes, since by no title' are they a form of the religious life nor are their members religious." There is a revised bibliography. A larger type has been used for the table of contents.--F. N. KORTH, S.J. FUNDAMENTAL PSYCHIATRY. By John R. Cavanagh, B.S., M.D., ¯ C.P., K.S.G., end James B. McGoldrlck, S.J., S.T.D., Ph.D. Pp. x Jr- 582. Bruce Publishing Company, Milwaukee, 19S3. $S.50. For fifty years psychiatry has drawn man's psychic portrait across the medical horizgn without a spiritual intellect or will, with-out a spiritual soul. For decades the brilliant analytic theories and therapeutic techniques, often investigated with scientific precision, have been built upon a false psychic substructure of practical mate-rialism and ihstinctive determinism. The emerging portrait tends to be a distorted caricature of human nature and psychic life as a mere mixture of matter and determined instinct. As a net result, psychia-trists are now left without adequate goals in life to point out to their patients. To interpret, to correct, to refashion psychiatry on the same old base has long been unsatisfactory. The present authors challenge the jaded materialistic framework at every turn ,and discard it com'- pletely. They have produced a first-rate psychiatry textbook that 326 BOOK REVIEWS turns a new medical page and builds the young ~cience of psychiatry entirely upon the time-tested framework of traditional scholastic psychology. This book is important for its psychological structure and its emphases. Perhaps more than any other psychiatry book today it emphasizes, with scientific precision, the spiritual intellect, will and soul; volitional freedom at the root of mental disorder; character formation based upon intellectual, and moral habits; and .the need of an adequate philosophy of life for true mental balance taken from both reason and revelation. Pervading the book with regard to etiology is the author's insistence upon the psychogenic or nonmaterial origin of mental disorders caused by a misuse of man's spiritual faculties. The high caliber and clear structure of Fundamental Ps~chiatr~ reminds one of Dr. Strecker's excellen~ book Fundamentals ot: Psgt-chiatr~ l. It has seven major sections, thirty-one chapters critically written and well-documented, sixty-five thorough case histories, and rich bibliographical material. Publishers and authors have designed a clear and highly readable book. It opens with intr6ductory con- ¯ cepts, the extent of mental disorders, and a picture of normal per-sonality. Five major sections treat of etiology, the clinical approach to psychiatry, psychoneuroses, psychoses, and borderlands of psy-chiatry. The conclusion is devoted to psychiatry, philosophy, and religion. The growing importance of psychiatry makes thi~ an important and valuable book for Catholic hospitals, doctors, nurses, and coun-selors, and for those engaged .in educational and sociological 'work involving modern psychiatric pkinciples.--CHARLES NASH, S.J. MOST REVEREND ANTHONY 3. SC~HULER, S.J.,D.D.,FIRST BISHOP OF I:L PASO, AND SOME CIATHOLIC~ ACTIVITIES IN THE DIOC~ESE BETWEEN 1915-1942. By Sls~'er M. Lilliana Owens, S.L., Ph.D. Pp. xxiv -J- 584. Revls÷a Clatolica Press, El Paso, 1953. $3.50. This labor of love but also a heavily documented work intro-duces us into the career of another "first l~ishop" in the United States coming from the Society of Jesus. When the diocese of El Paso was erected in 1915, the second choice for this new See was the pastor of ¯ a church in Denver, Colorado. He had seen the southwest in earlier days and knew something of the complicated and almost insoluble problems that would have to be faced. But obedience imposed the task; with confidence in God's help the new bishop put his shoulder BOOK REVIEWS Review for Reliytotts to the task. For more than a quarter of a century he carried on, then handed over a well-established organization to his successor. Less than two years later death carried his soul before his Maker. The volume is prgfusely illustrated and well printed. Six ap-pendixes add materials to those cited in the course of the narrative. Thirty pages.of bibliography give a riotion of the industry that went into the preparation of this work. There is a carefullY-madE index. In the treatment the author in the main f~llows the topical meth-od, giving for each theme the background and carrying it through the whole period of the episcopate. ]3ecause of this we do not get a very clear picture of the growth of the diocese as a whole. In giving the background more is at times given than is needed for the purpose intended. Fo~ the most part the ]3ishop appears before us, not so much initiating projects of his own, but as discreetly promoting and supporting movements set afoot by others and at times making them his own and thus leading'them to a happy solution. In his administration Bishop Schuler faced unique problems with which he had to deal prudently. Such were the bilingual popula-tion in the diocese, its location in t~ro states, the onrush of exiles due to the persecution in Mexico, the dire poverty of a large portion of the faithful, the shortage of priests and of priestly vocations. Some of these themes are treated with some completeness while others are merely touched upon--the title gives warning that the work. is not meant to be exhaustive.--AUGUSTIN C. WAND, S.J. I WANT TO SEE GOD. A Pra~:fical Synthesis of C:armellfe Splritualify. By P. Marle-Eug~ne, O.C~.D. Translated by Sister M. Verda C~lare, C:.S.C:. Pp. xxli -I- $49. F~des Publishers Association, .C:hicag~ .10, 19S3. $S.7S. This is the first of a two-volume work. The. second is to be en-titled, 1"Am a Daughter of the Church. ¯ Their grew out of a series of .conferences on the Carmelite theory and practice of prayer. St. Teresa of Avila, rather than St. John of the Cross, was chosen as the proxi-mate "guide." Of St. Teresa's writings The lnterior Castle, with its seven "mansioias," was taken as basic and typical and it provides .the plan for this exposition. St. John's doctrine is introduced here and there as a confirmation or completion of St. Teresa's, not as something that. is continuous a'nd unified in itself. Very often fu'r-ther confirmation or illustration is sought from St. Th~r~se of Li-sieux. The work as a whole has five principal parts, three of them being 328 November, 1953 BOOK NOTICES in this volume. The first part is called "Perspectives" and serves as a general introduction. "The First Stages" deals with the matter treated in St. Teresa's first three mansions. Therefore it is ascetical. Next follows "Mystica~ Li~e and Contemplation." In this section-- nearly half of volume .one--there is much that one would hardly ¯ think of in simpl~¢ reading the works of St. Teresa or St. John; for example, ch~apter two on the "The Gifts of the Holy Spirit." The two principal parts reserved for the second volun~e are "To Union of Will" and "Holiness for the Church." On the value of this study as a satisfactory synthesis of Carmelite spiritual teaching we' had better let the Carmelites themselves pro-nounce. Besides it would be premature to judge it before the second and much the more important volume appears. --AUGUSTINE G. ELLARD, S.J. BOOK NOTICES Highly recommended is THE NEW EUCHARIS:FIC LEGISLATION, by John C. Ford, S.J. This book contains the original Latin texts of the Christus Dominus and the Instruction of the Holy Office, an English translation of these texts, a stimulating and enlightening commentary on the documents, and some brief summaries that should be very useful for confessors, religion teachers, catechism teachers, and parish priests. (New York: P. J. Kenedy U Sons, 1953. Pp. vii -t- 130. $1.50.) Little less than fascinatir~g is .the story of Louis Brisson as told by Katherine Burton in So MUCH So SOON. Carthusiafi-minded himself, this man founded schools for boys and clubs for girls, and the Oblate Fathers and Sisters of St. Francis de Sales to conduct them. Of rare scientific genius, he planned his own buildings and invented various things to keep his foundations operating efficiently. With profound trust in Providence, he quietly saw most of his great works swept a