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BY: KATHLEEN A. KALB, Ph.D., RN

"Person-centered" has always been a Catholic concept. Indeed, the body of the human person is a surpassing gift which must be received as a gift from God, a gift which must be respected and reverenced. This is the dignity and vocation of health care professionals, to be guardians and servants of the dignity of the human person, and to bear witness to the inherent dignity of every human person in and through the body.

As health care professionals, we do not often talk about the body as a witness to Love. Indeed, the bodies of our patients often seem to be witnesses of illness and infirmity, of weakness and vulnerability, of distress and dependency. Yet Pope John Paul II challenges us to see the body of the human person as a "witness to Love" and a manifestation of the spiritual and divine. In his Man and Woman He Created Them: A Theology of the Body, John Paul II teaches us that "only the body is capable of making visible what is invisible: the spiritual and the divine. It has been created to transfer into the visible reality of the world the mystery hidden from eternity in God, and thus to be a sign of it."¹

This is the gift that John Paul II offers to health care professionals. In Theology of the Body, his catecheses on human love in the divine plan, John Paul II describes the meaning of the body as a "theological anthropology" of the human person. He proposes that the human person, created in the image and likeness of God, is a gift who is called to be a gift to others and to receive others as a gift. This gift of self is manifested through, with and in the body. By reflecting on the words of Jesus in the Gospels about the gift of our creation as human persons "from the beginning," John Paul II invites us to return to the "source" of our human dignity and our vocation to love.

THEOLOGY OF THE BODY DEFINED
John Paul II's Theology of the Body contains a profound reflection on the meaning of the human body and the greatness of the vocation to love.² The essential elements of Theology of the Body emanate from Scripture, are connected with the patristic and theological tradition of the church and reflect an organic development of the church's perennial teachings about the dignity of the human person, human sexuality, marriage, virginity and our vocation to love.

"Ever ancient, ever new," Theology of the Body has a long history and rich tradition in the church. Early fathers and doctors of the church wrote about the body and its relation to the soul, created by God in his image and destined for bodily resurrection (e.g., St. Augustine, St. Thomas Aquinas and St. John of the Cross). More recently, Catholic theologians and philosophers have written extensively about human dignity and the meaning of the human body in the context of morality, marriage and the vocation to love. All recent popes have also contributed significantly to the development of Theology of the Body and our understanding of the dignity of the body in light of its divine origin, vocation and destination, including our current Holy Father, Pope Benedict XVI.³

From the very beginning of his priesthood, John Paul II had a "special love for love" and committed himself "to the service of 'fair love,' because love is fair, it is beautiful."⁴ Even before his election as pope in 1978, Karol Wojtyla consistently focused on the essential themes addressed in Theology of the Body in his poetry, plays and major philosophical and theological writings. In his first major catechesis as Pope, John Paul II presented Theology of the Body to the world in a series of 129 "general audiences" (brief talks) from September 1979 to November 1984. As John Paul II explains, the concept "theology of the body" emanates from reflecting on the ancient text of Genesis which describes the creation of the human person, and therefore, the beginning of theology of the body:

"We find ourselves, therefore, within the very bone marrow of the anthropological reality whose name is 'body,' human body. Yet, as can be easily observed, this marrow is not only anthropological, but also essentially theological. The theology of the body, which is linked from the beginning with the creation of man in the image of God . . . has its point of departure here in Genesis.⁵

"The fact that theology also includes the body should not astonish or surprise anyone who is conscious of the mystery and reality of the Incarnation. Through the fact that the Word of God became flesh, the body entered theology — that is, the science that has divinity for its object — I would say, through the main door." ⁶

John Paul II describes Theology of the Body as a specific, evangelical, Christian pedagogy that unfolds and explains the revelation of the body by reflecting on human experience. "Pedagogy seeks to educate man by setting the requirements before him, giving reasons for them, and indicating the ways that lead to their fulfillment," he says.⁷ This pedagogy of the body, according to John Paul II, provides the focus and fulfills the purpose of the Theology of the Body as a whole, that is, to provide an "adequate anthropology" of the human person and to propose a response to questions about the church's moral teachings related to human life and marriage described in the encyclical Humanae Vitae, promulgated by Pope Paul VI in 1968. Indeed, John Paul II's Theology of the Body enables us "to rediscover the full treasure of biblical anthropology and the great Christian tradition ... and to integrate it into a vision consonant with lived experience grasped with new vividness," writes Livio Melina, president of the Pontifical John Paul II Institute for Studies on Marriage and Family, in the preface to Called to Love: Approaching John Paul II's Theology of the Body, by Carl Anderson and Jose Granados (New York: Doubleday 2009).

JOHN PAUL II: THEMES
Multiple themes emerge as central to John Paul II's Theology of the Body and are emphasized in his magisterial catecheses on human love in the divine plan. One of these themes addresses the dignity of the human person and is based on a key text from Vatican Council II's Gaudium et Spes:

The truth is that only in the mystery of the incarnate Word does the mystery of man take on light. For Adam, the first man, was a figure of Him Who was to come, namely Christ the Lord. Christ, the final Adam, by the revelation of the mystery of the Father and His love, fully reveals man to man himself and makes his supreme calling clear.

This text emphasizes that Christ, in becoming incarnate as a man and assuming a human body, reveals "man to himself" precisely in and through the human body. A second text, also from Gaudium et Spes, reflects the ultimate meaning of the human person: to recognize oneself as a gift and to become a gift to others,

Indeed, the Lord Jesus, when He prayed to the Father, "that all may be one . . . as we are one" (John 17:21-22) opened up vistas closed to human reason, for He implied a certain likeness between the union of the divine Persons, and the unity of God's sons in truth and charity. This likeness reveals that man, who is the only creature on earth which God willed for itself, cannot fully find himself except through a sincere gift of himself.

This text emphasizes the human person's relationship to others and solidarity with others "in truth and charity," specifically by becoming a "sincere gift" for others. Indeed, because "God is love" (John 4:8) and assumed a human body in the Incarnation, John Paul II states that the body is "a witness to Love." These key themes, focusing on human dignity, solidarity and charity, have fundamental importance for understanding Theology of the Body and have specific implications for health care professionals.

In Theology of the Body, John Paul II offers a pedagogy of the body that addresses the integral and total vision of what it means to be a human person. In health care, this pedagogy of the body has particular importance for why health care professionals are called to respect human dignity, and more importantly, how health care professionals are called to respect human dignity in solidarity with others by practicing with charity.

DIGNITY: THE HUMAN PERSON AS A BODY-PERSON
The source of our dignity as human persons is our creation in the image and likeness of God. Respect for human dignity is addressed in all codes of ethics in the health professions. In the Ethical and Religious Directives for Catholic Health Care Services, human dignity is the focus of Directive 23: "The inherent dignity of the human person must be respected and protected regardless of the nature of the person's health problem or social status." Human dignity is also the foundation of the church's social doctrine. In fact, the whole of the church's social doctrine develops from the principle that affirms the inviolable dignity of the human person.

In Theology of the Body, John Paul II emphasizes that the body is integral to human dignity because the body is integral to the person; the body reveals the person. As John Paul II asserts, the human person is a body, and not merely has a body, "Man, formed in this way, belongs to the visible world; he is a body among bodies."⁸ We are body-persons; embodied spirits who are created in the image and likeness of God who is Love. Our body speaks a language, the "language of the body," which must be spoken in truth and with love. In and through the body, the person becomes a sacrament, that is, a visible sign of the economy of truth and love.⁹ This fundamental theme reflects our dignity as human persons and reveals God's plan for the human person.

In health care, respect for human dignity and the meaning of the person as a body-person reflect a holistic view of the human person with physical, psychological, social and spiritual dimensions. This holistic view of the person inspires the practice of health care professionals and the goals of healing, health promotion and the compassionate care of the dying. These goals must always be achieved in the context of interpersonal patient-professional relationships that respect the dignity of the patient and the health care professional, for the ability to practice with respect of human dignity for others is predicated on recognizing one's own moral worth and dignity. Indeed, Theology of the Body provides the basis for why health care professionals are ethically obligated to respect their own dignity. It is precisely this self-respect which enables health care professionals to engage in relationships which demonstrate respect for the dignity of others in and through the body.

SOLIDARITY AS A COMMUNION OF PERSONS
According to Theology of the Body, the human person is created in the image and likeness of God who is a trinity of divine persons, a "communion of persons" (communio personarum), an eternal exchange of love. John Paul II explains,

"Man becomes an image of God not so much in the moment of solitude as in the moment of communion. He is, in fact, 'from the beginning' not only an image in which the solitude of one Person, who rules the world, mirrors itself, but also, and essentially, the image of an inscrutable divine communion of Persons."¹⁰

In the church's social doctrine, the communion of persons is related to the principle of solidarity. In health care, solidarity emphasizes our relationships with patients and families, professional colleagues and communities of practice. In Catholic health care, solidarity is manifested specifically "by a spirit of mutual respect among caregivers that disposes them to deal with those it serves and their families with the compassion of Christ, sensitive to their vulnerability at a time of special need."¹¹

This interprofessional practice, enacted in solidarity with others and for others, enables health care professionals to place the interests, dignity and respect of patients at the center of health care delivery. In communion and solidarity with others, health care professionals interact with individuals, families and communities in and through the body to promote healing and health. Because the human body is a mode of self-communication, donation and a means of entering into communion in solidarity with others, the actions and interventions of health care professionals should communicate caring and be enacted with charity.

CHARITY: THE HUMAN PERSON AS GIFT
The human person is the only creature God willed for its own sake. This means that the body, as an integral part and visible expression of the person, can never be treated as an object or used as a means to an end. According to John Paul II, "we cannot consider the body as an objective reality outside of man's personal subjectivity."¹² Indeed, John Paul II states that the only proper and adequate response to the human person is love. This fundamental theme reflects our vocation as health care professionals to love and to respond to others with charity, the principle of Catholic social teaching that is at the heart of the church's social doctrine.

Charity is love received and given as a gift. Caring, that is, charity, finds its fullest expression when health care professionals become a "sincere gift" for others and promote healing by offering themselves as a gift and by receiving others as a gift entrusted to their care. As John Paul II explains,

"The communion of persons means living in a reciprocal 'for,' in a relationship of reciprocal gift. ... In fact, the gift reveals, so to speak, a personal characteristic of personal existence, or even of the very essence of the person [which is realized] only by existing 'with someone' — and put even more deeply and completely, by existing 'for someone.' "¹³

The human person is created as a gift and called to be a gift to others. This vocation of self-giving is inscribed in our nature as human persons and described by John Paul II as the "spousal meaning" of the body, that is, to be a gift to others and to receive others as a gift. This spousal meaning of the body applies to all authentically human relationships and interactions. Health care professionals offer themselves as a gift to their patients by engaging in relationships characterized by caring and sensitivity, extending their knowledge and expertise to promote healing. Patients, by allowing themselves to be cared for and entrusting themselves to health care professionals, offer themselves as a gift, giving their vulnerability and revealing their sickness, infirmity and weakness.

According to John Paul II, the vocation of all human persons is ultimately "the vocation to love. Love, as a sincere gift of self, is what gives the life and freedom of the person their truest meaning."¹⁴ For health care professionals, the sincere gift of self in the conduct of practice expresses what is most essential to health care, that is, compassion that promotes healing, and what is most universal to being a human person, that is, charity.

THE MEANING FOR HEALTH CARE
At the heart of health care is respect for the inherent dignity of the human person. This respect for human dignity is manifested in and through the body. In Theology of the Body, John Paul II challenges us to respect human dignity by recognizing the body as a "witness to Love" and by speaking the truth with our own bodies as we provide health care that honors, protects and promotes human dignity. This means that health care professionals are called to be guardians of human dignity, servants of human dignity and witnesses to human dignity.

All health care professionals are called to be guardians of human life and, therefore, to be guardians of human dignity. As guardians of human dignity, health care professionals are called to be vigilant advocates for those persons whose dignity is threatened, compromised or violated because of factors including, but not limited to, weakness, disability, illness, age, economic status, culture, ethnicity or perceived lack of quality of life. Health care professionals are also called to advocate for those who are at risk for dehumanizing procedures and technologies that are performed under the guise of health care (e.g. abortion, non-therapeutic embryonic research, assisted suicide, voluntary active euthanasia).¹⁵

As guardians of human dignity, health care professionals must act to change those aspects of social structures that detract from health and well-being by promoting a culture of life that ensures all persons have access to health care which respects their dignity from the moment of conception to the point of natural death. Health care professionals must also distinguish themselves "by service to and advocacy for those people whose social condition puts them at the margins of our society and makes them particularly vulnerable to discrimination"¹⁶ and work to ensure that our health care delivery system provides adequate health care for the poor, the uninsured and the underinsured.

As health care professionals, it may become commonplace to assess the body of our patients without fully appreciating how the body reveals the person. We may fail to recognize the incredible privilege it is to care for others who are exquisitely vulnerable, whether because of illness, age, inability to speak English, lack of health care insurance or disability. How we guard the dignity of those entrusted to our care ultimately reflects our own dignity and our own willingness to enter into a communion of persons with our patients as servants of human dignity.

SERVANTS OF HUMAN DIGNITY
Service is the sign and expression of love; service that respects and promotes the dignity of the human person is an essential task.¹⁷ As servants of human dignity, health care professionals provide care that incorporates and reflects the uniqueness of a person's background, preferences, culture, values, traditions and family. This patient-centered approach promotes a healing relationship that expresses solidarity with the individual patient, family and community, as well as with other health care professionals engaged in caring for the patient. This patient-centeredness facilitates optimal health outcomes by involving patients and those close to them in decisions about their care. Patient-centeredness also supports the respectful, efficient, safe and well-coordinated transition of the patient through all levels of care and across all health care settings.

As servants of human dignity, health care professionals are also called to be servants of life. By serving those entrusted to our care and reverencing the body as the visible manifestation of the person, we are serving the God who is the Creator and Redeemer of all life, in whose image we have been created and in whose service we have been called. As health care professionals, it is instructive to consider the way Jesus served others and respected human dignity in and through his own body: using touch and speech, responding to the expressed needs of the person, extending his healing touch to those who were considered "unclean" and "untouchable" and healing those who were among the most neglected, vulnerable and powerless members of society. By collaborating with others, Jesus promoted the dignity of those who were healed as well as those who participated in his healing ministry.

The service of health care is an act of the love of God, shown in the loving care for the person. It is an actualization of the healing love of Christ. At the same time it is an expression of love for Christ, for Christ is the sick person who assumes the face of one who is in need of our care: "You did it to me." This service of charity is conducted in solidarity through, with, and in Christ, and for Christ and bears witness to human dignity. As witnesses to human dignity, health care professionals embody Christ's healing compassion in the world.

WITNESSES TO HUMAN DIGNITY
As a service that promotes human dignity, health care is a "form of Christian witness" that expresses "a profoundly human and Christian commitment, undertaken and carried out not only as a technical activity but also as one of dedication to and love of neighbor."¹⁸ Called to be witnesses of human dignity, health care professionals need a "formation of the heart"; that is, "a heart which sees where love is needed and acts accordingly."¹⁹ This formation of the heart is predicated on the recognition that "a pure and generous love is the best witness to the God in whom we believe and by whom we are driven to love ... so that by their activity — as well as their words, their silence, their example — they [health care professionals] may be credible witnesses to Christ."²⁰ By seeing the image of God's glory in every child who is born and in every person who lives or dies, health care professionals see with the eyes of the heart and bear witness to the "incomparable and inviolable worth of every human life."²¹

Bearing witness to human dignity means speaking the truth with love. This means that health care professionals choose words that express and promote the transcendent dignity of the human person throughout the lifespan and refuse to use language that denies the humanity of the vulnerable and weak. The words we use to communicate with patients, families, communities and colleagues have the potential to confirm and affirm the dignity of those we care for, especially those who are "at risk for being dismissed as having 'a life unworthy of life.' "²² Our words need to convey an impassioned and unflinching witness to life which is "made flesh" in how we provide health care. Our language needs to bear witness to the uniqueness and inestimable worth of every person. Our voices need to bear witness to human dignity for those who have no voice and for those whose voice has been silenced. In the very act of providing health care, we bear witness to human dignity and the gift of life in all its stages of growth and development.

CONCLUSION
The Directives state:

"The mystery of Christ casts light on every facet of Catholic health care: to see Christian love as the animating principle of health care; to see healing and compassion as a continuation of Christ's mission; to see suffering as a participation in the redemptive power of Christ's passion, death and resurrection; and to see death, transformed by the resurrection, as an opportunity for a final act of communion with Christ."²³

John Paul II's Theology of the Body offers health care professionals a pedagogy of the body that expresses this mystery of Christ revealed in the essential unity of the human person's mind, body and spirit. This pedagogy of the body enables health care professionals to know the gift of God revealed in themselves and in others as they "share in carrying forth God's life-giving and healing work."²⁴ As John Paul II asserts, it is the body that makes visible the spiritual and the divine; it is the body that makes visible the vocation of the human person to total self-giving love in a communion of persons that images God who is Love. It is the body that enables the health care professional to be a gift to others and to receive the gift of others in caring relationships that promote health, healing and wholeness.

Precisely stated, the essential themes addressed in John Paul II's Theology of the Body reflect the gift of our creation in the image and likeness of God. As a communion of three divine Persons and an eternal exchange of Love, God reveals our dignity as human persons, our call to communion and our vocation to love. By assuming a human body and sharing in our human nature, Jesus teaches us what it means to be a witness to Love and how to be a witness to Love in and through our bodies. For "this is the body ... a witness to Love."²⁵

KATHLEEN A. KALB is associate professor of nursing, Department of Nursing, Henrietta Schmoll School of Health, St. Catherine University, Saint Paul, Minn.

NOTES

1. John Paul II, Man and Woman He Created Them: A Theology of the Body, trans. by M. Waldstein (Boston: Pauline Books & Media, 2006): 203. In quotations from John Paul II's Theology of the Body, the term man is used to refer to an individual regardless of gender to be consistent with the translation of the general audiences delivered by John Paul II and the original written text used by the translator.
2. Benedict XVI, speech at Pontifical John Paul II Institute for Studies on Marriage and Family, May 13, 2011.
3. See, for example, Pope Pius XI, Casti Connubii (1930); Pope Pius XII, Sacra Virginitatis (1948) and Munificentissimus Deus (1950); Pope John XXIII, Mater et Magistra (1961); Pope Paul VI, Humanae Vitae (1968); and Pope Benedict XVI, Deus Caritas Est (2005) and Caritas in Veritate (2009).
4. John Paul II, Crossing the Threshold of Hope (New York: Alfred A. Knopf, 1994): 123.
5. Theology of the Body, 165.
6. Theology of the Body, 221.
7. Theology of the Body, 360.
8. Theology of the Body, 152.
9. Peter Bristow, Christian Ethics and the Human Person: Truth and Relativism in Contemporary Moral Theology (Birmingham, UK: Maryvale Institute and Family Publications, 2009).
10. Theology of the Body, 163.
11. United States Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services, 5th edition (Washington, D.C.: USCCB Publishing, 2009): Directive 2.
12. Theology of the Body, 364-65.
13. Theology of the Body, 182.
14. John Paul II, Evangelium Vitae (1995): para. 96.
15. See, for example, Congregation for the Doctrine of the Faith, "Dignitas Personae" (2008) and United States Conference of Catholic Bishops, "To Live Each Day with Dignity: A Statement on Physician-Assisted Suicide"(2011).
16. Ethical and Religious Directives, Directive 3.
17. Pontifical Council for Justice and Peace, Compendium of the Social Doctrine of the Church (2004): para. 552.
18. Pontifical Council for Pastoral Assistance to Health Care Workers, The Charter for Health Care Workers (1995): para. 1.
19. Benedict XVI, Deus Caritas Est, para. 31.
20. Deus Caritas Est, para. 31
21. Evangelium Vitae, paras. 84, 96.
22. Cardinal Daniel N. DiNardo, "2011 Respect Life Sunday Statement." Retrieved from www.usccb.org/about/pro-life-activities/
23. Ethical and Religious Directives, General Introduction.
24. Ethical and Religious Directives, General Introduction.
25. Theology of the Body, 183.

READINGS AND REFERENCES
John Paul II, Crossing the Threshold of Hope (New York: Alfred A. Knopf, 1994).

Carl Anderson and Jose Granados, Called to Love: Approaching John Paul II's Theology of the Body. (New York, NY: Doubleday, 2009).

Benedict XVI, Caritas in Veritate (2009), Encyclical letter on integral human development in charity and truth. Retrieved from www.vatican.va/holy_father/benedict_xvi/encyclicals/documents/hf_ben-xvi_enc_20090629_caritas-in-veritate_en.html

Benedict XVI, Deus Caritas Est (2005), Encyclical letter on Christian love. Retrieved from www.vatican.va/holy_father/benedict_xvi/encyclicals/documents/hf_ben-xvi_enc_20051225_deus-caritas-est_en.html

J. Brian Bransfield, The Human Person: According to John Paul II (Boston: Pauline Books and Media, 2010).

William Brennan, John Paul II: Confronting the Language Empowering the Culture of Death (Ave Maria, Fla.: Sapientia Press, 2008).

Robert F. Gotcher, "The Theology of the Body: Some Reflections on the Significance for Medical Professionals," The Linacre Quarterly 73, no. 2 (2006): 115-31.

THEOLOGY OF THE BODY: AN OVERVIEW

Theology of the Body is the collective title of John Paul II's 129 general audiences given as a catechesis to the universal church between September 1979 and November 1984. This integrated vision of the human person focuses on the revelation of God's mystery and plan for human life in and through the human body. Theology of the Body:

• Contains the nucleus of John Paul II's teachings about the dignity, meaning and vocation of the human person based on the words of Christ in Scripture
• Unfolds and explains the revelation of the body by reflecting on human experience to propose a Christian, philosophical and theological anthropology which is a specific, evangelical pedagogy of the body
• Addresses the meaning of the body, specifically the "spousal meaning of the body" that focuses on biblical reflections "from the beginning"
• Emphasizes the human person's creation in the image and likeness of God, who is a communion of divine Persons and an eternal exchange of Love
• Describes the power of the human body "to express love: precisely that love in which the human person becomes a gift and — through this gift — fulfills the very meaning of his being and existence"

THEOLOGY OF THE BODY: APPLICATIONS IN HEALTH CARE

DIGNITY OF THE HUMAN PERSON

• Human dignity in health care is based upon a total and integral vision of the human person as a unity of body and soul. This holistic perspective embraces the origin, vocation and destiny of the human person.
• Respect for human dignity is foundational to all codes of ethics in the health professions.
• Health care professionals promote human dignity by ensuring that the human person is always respected as a personal subject and not an "object of treatment."
• The human body is integral to the human person; therefore, health care professionals are called to respect the dignity, bodily nature and interiority and subjectivity of the human person.
• Health care professionals are called to be guardians of human dignity, servants of human dignity and witnesses to human dignity.

SOLIDARITY: THE COMMUNION OF PERSONS

• Health care is conducted in the context of relationships and partnerships, in "communion" with patients, professional colleagues and communities of practice.
• Health care professionals engage with patients in their care by allowing patients to emerge as "personal subjects" and listening to their stories and experiences of health and illness.
• Health care professionals empower patients to be co-responsible for decisions about their health care by providing patient-centered care that respects their dignity and honors their uniqueness as human persons.

CHARITY: THE SINCERE GIFT OF SELF

• Caring is fundamental to the practice of all health care professionals.
• Health care professionals are called to be a gift to others and to give themselves as a gift in the care of others; health care professionals are also called to receive others as a gift entrusted to their care. This mutual gift creates the communion of persons.
• The capacity to express caring in and through the body reveals the meaning of the gift and enables the "finding of oneself in giving oneself [which] becomes the source of a new giving of oneself" and an "even deeper acceptance ... and more intense awareness of the gift itself."