- A Mother Teresa post is long overdue on r/badhistory sheerly for the vast amount of misinformation circulating around the figure on the Redditsphere. 
- There are certain aspects of Mother Teresa that are taken as absolute facts online when they lack the context of Mother Teresa\u0027s work and beliefs. 
- Much of these characterizations originate from Hitchen\u0027s documentary \u0027Hell\u0027s Angel\u0027 and his book \u0027The Missionary Position’[1] neither of which are academic and are hit pieces, which like a telephone game, have become more absurd online. 
- I intend this neither to be a defense nor a vindication of Teresa; rather, adding some much needed nuance and assessing some bad-faith approaches to the issues. 
- My major historical/ sociological research here deals with the state of medical care in Teresa\u0027s charities.
- Criticism of Mother Teresa\u0027s medical care
 - "Teresa ran hospitals like prisons, particularly cruel and unhygienic prisons at that"
 - It is crucial to note here that Teresa ran hospices, precisely a "home for the dying destitutes", not hospitals. 
 - Historically and traditionally, hospices were run by religious institutions and were places of hospitality for the sick, wounded, or dying and for travelers. 
 - It was not until 1967 that the first modern hospice (equipped with palliative care) was opened in England by Cicely Saunders.[2] 
 - It wasn\u0027t until 1974 that the term "palliative care" was even coined and not until 1986 that the WHO 3-Step Pain Ladder was even adopted as a policy[3] (the global standard for pain treatment; the policy is widely regarded as a watershed moment for the adoption of palliative programs worldwide).
 - Mother Teresa began her work in 1948 and opened her "home for the dying and destitutes" Nirmal Hriday in 1952,[4] 15 years before the invention of the modern hospice and 34 years before the official medical adoption of palliative medicine. 
 - Mother Teresa ran a traditional hospice, not a modern medical one. 
 - As Sister Mary Prema Pierick, current superior general of the Missionaries of Charity, colleague and close friend of Mother Teresa said "Mother never had hospitals; we have homes for those not accepted in the hospital. We take them into our homes. Now, the medical care is very important, and we have been improving on it a lot and still are. The attention of the sisters and volunteers is a lot on the feeding and bandaging of the person. It is important to have them diagnosed well and to admit them to hospitals for treatment."[5]
 - Mother Teresa\u0027s charism was not in hospitals and medicine, it was in giving comfort to the already dying and had stated that that was her mission. 
 - Neither is the MoC principally engaged in running hospices; they also run leper centers, homes for the mentally challenged, orphanages, schools, old age homes, nunneries among many other things around the world. 
 - And note, this leaves out the state of hospice care in India at the time, which is not comparable to England.
- Which brings us to:
 - "Mother Teresa\u0027s withheld painkillers from the dying with the intent of getting them to suffer"
 - This is one of the bigger misconceptions surrounding Mother Teresa. It originates from Hitchens lopsidedly presenting an article published by Dr. Robin Fox on the Lancet.[6]
 - Dr. Fox actually prefaced his article by appreciating Mother Teresa\u0027s hospice for their open-door policy, their cleanliness, tending of wounds and loving kindness (which Hitchen\u0027s quietly ignores). 
 - Dr. Fox notes; "the fact that people seldom die on the street is largely thanks to the work of Mother Theresa and her mission" and that most of "the inmates eat heartily and are doing well and about two-thirds of them leave the home on their feet”.
 - He also notes that Mother Teresa\u0027s inmates were so because they were refused admissions in hospitals in Bengal. 
 - Only then does Dr. Fox criticise the MoC for its "haphazard medical care" which were the lack of strong analgesics and the lack of proper medical investigations and treatments, with the former problem separating it from the hospice movement. 
 - The latter is largely due to the fact that Teresa ran hospices with nuns with limited medical training (some of them were nurses), with doctors only voluntarily visiting (doctors visited twice a week, he notes the sisters make decisions the best they can), that they didn\u0027t have efficient modern health algorithms and the fact that hospitals had refused admissions to most of their inmates.
 - Most importantly, Mother Teresa did not withhold painkillers. 
 - Dr. Fox himself notes that weak analgesics (like acetaminophen) were used to alleviate pain; what was lacking were strong analgesics like morphine. 
 - The wording is important, Fox only noted \u0027a lack of painkillers\u0027 without indicating it\u0027s cause, not that Teresa was actively withholding them on principle.
 - What Hitchens wouldn\u0027t talk about is the responses Dr. Fox got from other palliative care professionals. 
 - Three prominent palliative care professionals, Dr. David Jeffrey, Dr. Joseph O\u0027Neill and Ms. Gilly Burn, founder of Cancer Relief India, responded to Fox on the Lancet.[7] 
 - They note three main difficulties with respect to pain control in India: 
 - 1) lack of education of doctors and nurses
 - 2) few drugs
 - 3) very strict state government legislation, which prohibits the use of strong analgesics even to patients dying of cancer
 - with about "half a million cases of unrelieved cancer pain in India" at the time.
 - They respond, "If Fox were to visit the major institutions that are run by the medical profession in India he may only rarely see cleanliness, the tending of wounds and sores, or loving kindness. In addition, analgesia might not be available." 
 - They summarise their criticisms of Dr. Fox by stating that "the western-style hospice care is not relevant to India, The situation in India is so different from that in western countries that it requires sensitive, practical, and dynamic approaches to pain care that are relevant to the Indian perspective.”
 - India and the National Congress Party had been gradually strengthening it\u0027s opium laws post-Independence (1947), restricting opium from general and quasi-medical use. 
 - Starting from the "All India Opium Conference 1949", there was rapid suppression of opium from between 1948 and 1951 under the Dangerous Drugs Act, 1930 and the Drugs and Cosmetics Act, 1940. 
 - In 1959, the sale of opium was totally prohibited except for scientific/ medical uses. Oral opium was the common-man\u0027s painkiller. 
 - India was a party to three United Nations drug conventions – the 1961 Single Convention on Narcotic Drugs, the 1971 Convention on Psychotropic Substances and the 1988 Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, which finally culminated in the 1985 Narcotic Drugs and Psychotropic Substances Act, which was ultimately responsible for the drastic reduction of medicinal opioid use in India even for a lot of hospitals. 
 - It is also noted that opium use in Western medical treatments in India was limited during the time (post-Independence), mostly for post-operative procedures and not palliative care. 
 - The first oral morphine tablets (the essential drug of palliative medicine) only arrived in India in 1988 under heavy regulations. [8][9][10][11] 
 - Before 1985, strong analgesics could only be bought under a duplicate prescription of a registered doctor, de facto limiting its use to hospital settings. 
 - Nevertheless, India had some consumed some morphine then, although well below the global mean.[12] 
 - Since the laws prior to 1985 weren\u0027t as strict, the Charity was able to use stronger painkillers like morphine and codeine injections at least occasionally under prescription at their homes, as witnesses have described.[13][14][15] 
 - This essentially rebuts critics claiming she was "against painkillers on principle", as she evidently was not. 
 - Also note, palliative medicine had not even taken its roots at that point.
 - Palliative care only began to be taught in medical institutions worldwide in 1974. [16] 
 - Moreover, palliative medicine did not appear in India till the mid-1980s, with the first palliative hospice in India being Shanti Avedna Sadan in 1986. 
 - Palliative training for medical professionals only appeared in India in the 1990s. 
 - The NDPS Act came right about the time palliative care had begun in India and was a huge blow to it.[17][18]
 - Post-NDPS, WHO Reports regarding the state of palliative medicine in India shows that it was sporadic and very limited, including Calcuttan hospitals.[19] 
 - As late as 2001, researchers could write that "pain relief is a new notion in [India]", and "palliative care training has been available only since 1997".[20] 
 - The Economist Intelligence Unit Report in 2015 ranked India at nearly the bottom (67) out 80 countries on the "Quality of Death Index"[21]. 
 - With reference to West Bengal specifically, it was only in 2012 that the state government finally amended the applicable regulations.[22] 
 - Even to this day, India lacks many modern palliative care methods, with reforms only as recently as 2012 by the "National Palliative Care Policy 2012" and the "Narcotic Drugs and Psychotropic Substances (Amendment) Act 2014" for medical opioid use.[23][24][25][26] 
 - The only academic evidence I could find for the lack of painkillers in the MoC comes from the 1994 Robin Fox paper, post-1985 NDPS act. 
 - Both the evidences that Hitchens provides for the lack of painkillers in their homes, Dr. Fox\u0027s article and Ms. Loudon\u0027s testimony comes post-1985. 
 - Regardless, It is disingenuous of Hitchens to criticise the MoC\u0027s conditions in 1994 when being ignorant of the situation and laws at the time.
- Another criticism faced by Mother Teresa was the reusing of needles in her hospices. 
 - Plenty articles attribute Fox\u0027s Lancet article for reusing unsterilized needles even though Fox did not indicate this in his piece (also, he also did not find anything objectionable with regard to hygiene). 
 - While constantly using disposable needles may seem ubiquitous today, it was not a global standard practise at the time. 
 - Loudon\u0027s account does not seem to be the routine. 
 - We know that Mother Teresa\u0027s hospice had usually used some form of disinfection on their instruments, surgical spirit[27], some accounted boiling[28] and had later switched to using disposable needles (stopping reuse) in the 90s/ early 00s.[29] 
 - Although disposable needles were invented in the 1950s, reuse of needles was not uncommon until the AIDS epidemic scare in the 1980s.[30] 
 - Back then, many Indian doctors and hospitals didn\u0027t shy away from reusing needles, sometimes without adequate sterilization.[31][32][33] 
 - There is also no suggestion that Mother Teresa knew or approved of the alleged negligent practice.
 - India did not have any nationwide syringe program at the time. 
 - WHO estimates that 300,000 people die in India annually as a result of dirty syringes. 
 - A landmark study in 2005, \u0027Assessment of Injection Practices in India — An India-CLEN Program Evaluation Network Study\u0027 indicated that "62% of all injections in the country were unsafe, having been administered incorrectly or “had the potential” to transmit blood-borne viruses such as HIV, Hepatitis B or Hepatitis C either because a glass syringe was improperly sterilized or a plastic disposable one was reused. "[34] 
 - Dirty syringes were a problem in India well into the 21st century in government and private hospitals, with researchers citing lack of supplies, proper education on sterilization, lack of proper waste disposal facilities among other things.
 - While the treatments were substandard to hospices in the west, Navin Chawla, a retired Indian government official and Mother Teresa’s biographer notes that in the 1940s and 1950s, “nearly all those who were admitted succumbed to illnesses. In the 1960s and 1970s, the mortality rate was roughly half those admitted. In the last ten years or so [meaning the 1980s to the early 1990s], only a fifth died.”[35] 
 - There are other positive accounts of their work and compassion by medical professionals as well.[36]
 - The entire point here is that it is terribly unfair to impose western medical standards on a hospice that began in the 50s in India when they lacked the resources and legislation to enforce them given the standards of the country. 
 - To single out Mother Teresa\u0027s hospice is unfair when it was an issue not just for hospices, but hospitals too. 
 - Once this context is given, it becomes far less of an issue focused on the individual nuns but part of a larger problem affecting the area.
- Once this is clear, it ties into the second part of the sentence:
 - " Mother Teresa withheld painkillers because suffering bought them closer to Jesus / glorified suffering and pain. ”
 - A quote often floated by Hitchens was “I think it is very beautiful for the poor to accept their lot, to share it with the passion of Christ. I think the world is being much helped by the suffering of the poor people” with the implication being that Teresa was something of a sadist, actively making her inmates suffer (by “withholding painkillers” for instance). 
 - This is plainly r/badhistory on a theological concept that has been around for millennia.
 - Hitchens relies here on a mischaracterization of a Catholic belief in “redemptive suffering”. 
 - Redemptive suffering is the belief that human suffering, when accepted and offered up in union with the Passion of Jesus, can remit the just punishment for one\u0027s sins or for the sins of another.[37] 
 - In simpler words, it is the belief that incurable suffering can have a silver spiritual lining. 
 - The moral value and interpretation of this belief is a matter of theology and philosophy; my contention is that neither Catholicism nor Teresa holds a religious belief in which one is asked to encourage the sufferings of the poor, especially without relieving them. 
 - The Mother Teresa Organization itself notes that they are “to comfort those who are suffering, to feed the hungry, to give drink to the thirsty, to care for the sick, etc. Telling someone to offer it [suffering] up without also helping him to deal with the temporal and emotional effects of whatever they are going through is not the fully Christian thing to do.”[38]
 - It becomes fairly obvious to anyone that the easiest way for Teresa to let her inmates suffer is to let them be on the streets. 
 - Teresa was not the cause of her inmates\u0027 diseases and reports (eg. Dr. Fox) show that most inmates were refused to be treated by hospitals. 
 - Mother Teresa in her private writings talks of her perpetual sorrow with the miseries of the poor who in her words were "God\u0027s creatures living in unimaginable holes"; contradictory to the image of malice given by Hitchens.[39] 
 - Which also brings into question; why did the MoC even bother providing weaker painkillers like acetaminophen if they truly wanted them to suffer? 
 - They had used stronger painkillers in the past too, so this was not a principled rejection of them.
 - Sister Mary Prema Pierick, current superior general of the Missionaries of Charity, colleague and close friend of Mother Teresa responds; "[Mother\u0027s] mission is not about relieving suffering? That is a contradiction; it is not correct... Now, over the years, when Mother was working, palliative treatment wasn’t known, especially in poor areas where we were working. Mother never wanted a person to suffer for suffering’s sake. On the contrary, Mother would do everything to alleviate their suffering. That statement [of not wishing to alleviate suffering] comes from an understanding of a different hospital care, and we don’t have hospitals; we have homes. But if they need hospital care, then we have to take them to the hospital, and we do that."[40]
 - It is also important to note the Catholic Church\u0027s positions on the interaction of the doctrine on redemptive suffering and palliative care.
 - The Catholic Church permits narcotic use in pain management. 
 - Pope Pius XII affirmed that it is licit to relieve pain by narcotics, even when the result is decreased consciousness and a shortening of life, "if no other means exist, and if, in the given circumstances, this [narcotics] does not prevent the carrying out of other religious and moral duties" [41], reaffirmed by Pope John Paul II responding to the growth of palliative care in Evangelium Vitae.[42]
 - The Ethical and Religious Directives for Catholic Health Care Services notes that "medicines capable of alleviating or suppressing pain may be given to a dying person, even if this therapy may indirectly shorten the person\u0027s life so long as the intent is not to hasten death. Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering".[43]
 - According to the Vatican\u0027s Declaration on Euthanasia "Human and Christian prudence suggest, for the majority of sick people, the use of medicines capable of alleviating or suppressing pain, even though these may cause as a secondary effect semi-consciousness and reduced lucidity." 
 - This declaration goes on, "It must be noted that the Catholic tradition does not present suffering or death as a human good but rather as an inevitable event which may be transformed into a spiritual benefit if accepted as a way of identifying more closely with Christ."[44]
 - Inspecting the Catholic Church\u0027s positions on the matter, we can see that Hitchens is wholly ignorant and mistaken that there is a theological principle at play.
- “Mother Teresa was a hypocrite who provided substandard care at her hospices while using world-class treatments for herself”
 - While a value judgement on Teresa is not so much history as it is ethics, Hitchens deliberately omits several key details about Mother Teresa’s hospital admissions to spin a bad historical narrative in conjunction with the previously mentioned misportrayals. 
 - Mother Teresa was often admitted to hospitals against her will by her friends and co-workers. 
 - Navin Chawla notes that she was admitted “against her will" and that she had been “pleading with me to take her back to her beloved Kolkata”. 
 - Doctors had come to visit her on their own will and former Indian Prime Minister Narasimha Rao offered her free treatment anywhere in the world.[45] 
 - He remembers how when she was rushed to Scripps Clinic that "so strong was her dislike for expensive hospitals that she tried escaping from there at night." 
 - "I was quite heavily involved at the time when she was ill in Calcutta and doctors from San Diego and New York had come to see her out of their own will... Mother had no idea who was coming to treat her. It was so difficult to even convince her to go to the hospital. The fact that we forced her to, should not be held against her like this," says 70-year-old artist Sunita Kumar, who worked closely with Mother Teresa for 36 years.[46]
 - Unlike some tall internet claims, Mother Teresa did not "fly out in private jets to be treated at the finest hospitals". 
 - For example, her admission at Scripps, La Jolla in 1991 was at the request of her physician and Bishop Berlie of Tijuana. 
 - It was unplanned; she had been at Tijuana and San Diego as part of a tour setting up her homes when she suddenly contracted bacterial pneumonia.[47] 
 - Her other hospitalisation in Italy was due to a heart attack while visiting Pope John Paul II and in 1993 by tipping and breaking her ribs while visiting a chapel.[48][49] 
 - Dr. Patricia Aubanel, a physician who travelled with Mother Teresa from 1990 to her death in 1997 called her “the worst patient she ever had” and had “refused to go to the hospital”, outlining an incident where she had to protest Mother Teresa to use a ventilator.[50] 
 - Other news reports mention Mother Teresa was eager to leave hospitals and needed constant reminders to stay.[51]
 - Her treatments and air travel were often donated free of charge. 
 - Mother Teresa was a recipient of the Bharat Ratna, India\u0027s highest civilian award in 1980, which has the additional benefit of getting a lifetime of free first class tickets on Air India.[52] 
 - Many other airlines begged and bumped her up to first-class (on principle Teresa always bought coach) because of the commotion the passengers cause at the coach.[53] 
 - As Jim Towey says "for decades before she became famous, Mother rode in the poorest compartments of India\u0027s trains, going about the country serving the poor. Attacking her by saying she was attached to luxury is laughable."[54]
- “Mother Teresa misused her donations and accepted fraudulent money”
 - There is no hard, direct evidence that Mother Teresa had mishandled her donations other than her critics speculating so. 
 - Neither Teresa nor her institution have luxuries or long-term investments in their names and their vow prevents them from fund-raising. 
 - Hitchens\u0027 source itself asserts that the money in the bank was not available for the sisters in New York to relieve their ascetic lifestyle or for any local purpose, and that they they had no access to it. 
 - Her critics have no legal case to offer and haven\u0027t bothered to follow up on their private investigations. 
 - Cases filed by the MoC\u0027s critics in India in 2018 probing their financial records were investigated by authorities in India and have not resulted in any prosecution (to the best of my knowledge).[55] 
 - The case as offered rests on rumours and anecdotes with little precise details. 
 - Again, I am not vindicating Teresa, just pointing out how the case as offered is lacking.
 - What is claimed as a misuse is but an objection as to Mother Teresa\u0027s choice of charitable objects, coupled with an allegation that she personally failed publicly to account for the donations she received. 
 - The former is absurdly self-referential and goes nowhere near substantiating a claim of "misuse" of charitable funds. 
 - Unless it can be established that the money was donated specifically for the relief of poverty (as opposed to having been given as a general accretion to the funds of MoC), the allegation is fundamentally misconceived. 
 - As for the latter objection, unless it can be established that Mother Teresa was in effective direct control of the finances of MoC and that MoC are under an obligation to make their accounts public, it, too, is misconceived. 
 - Indian charities are not obligated by the government to publish their accounts publicly and are audited and filed to the relevant authorities by law. 
 - If it is to be alleged that MoC are in breach of any statutory norms for publishing accounts (as distinct from lodging them with the appropriate body with oversight of charities in any given jurisdiction), then the fact should be asserted in terms. 
 - It also seems that most charities in Bengal do not publicly publish their accounts, again contradicting Hitchen\u0027s.[56] 
 - The claim of "7% fund utilisation for charity" originates from a 1998 article in Stern Magazine. 
 - However, no details are given how they arrived at this figure either. This figure only amounts for a single home in London from a single year, 1991. 
 - Wüllenweber writing in 1998, had to go back to 1991 to find even one example to provide what is more cover than support for his case.
 - Fraudulence is a substantial claim which requires very good evidence. On inspection, these are at best, insinuations, and at their worst, conspiracies. 
 - Like Hitchens said, that what can be asserted without evidence can be dismissed without evidence. 
 - For example, Navin Chawla, government official/biographer, penned that Mother Teresa said “[She] needed money to use for her people,” not for investment purposes. 
 - “The quite remarkable sums that are donated are spent almost as quickly on medicines (particularly for leprosy and tuberculosis), on food and on milk powder”.[57] 
 - There are no calculations done on the cost of maintaining all her 517 homes across the world accounting for the deficiencies in resources in third-world countries. 
 - Hitchens also openly admits that he does not know if the Duvaliers donated any money.[58]
 - There are also insinuations expressly reliant on guilt by association. 
 - The large donation of Charles Keating was prior to their offense. 
 - While her assessment of Keating is dubious, there is no suggestions that Mother Teresa knew of his thefts beforehand and there is no indication when the donations were made – the date would have been foundational for any legal claim that Teresa was accountable for the money on the ground that she knew or had constructive knowledge of a fraud. 
 - It\u0027s likely that the donations were spent by the time they were convicted. 
 - Too late for the book, the convictions against Keating were overturned on a non-technicality in April 1996,[59] nullifying Hitchens\u0027 censures against Teresa under this head, which Hitchens fails to mention elsewhere.
- Bonus r/badhistory on Mother Teresa:
 - “Her nuns refused to install an elevator for the disabled and handicapped in their homeless shelter in New York to make them suffer”
 - While the news itself is true, it omits a key detail. 
 - By refusing an elevator, the touted implication that they’d let the inmates suffer is mistaken; the nuns stated that “they would personally carry all of them up the stairs”[60] since they don\u0027t use elevators. 
 - While it is valid to criticise her asceticism on ethical grounds, it is dishonest to leave out the detail that they pledged to personally carry the handicapped, giving a false historical narrative implying malicious intent.
 - There also were some communal issues involved in the Bronx home. 
 - The nuns estimated the costs to be about $500,000 in repairs and had already spent $100,000 to repair fire damages. 
 - There were also reports about "community opposition" and "vandals undoing the repairs", raising the price of the home beyond what they could handle. 
 - They found that a $50,000-150,000 elevator was above their budget. 
 - It seems like their asceticism might not have been the only factor as to why they left the project.
- I have also contacted some past volunteers of the charity, some who are medical professionals, to get their experiences as well. They are posted as an addendum in the comments. Fin.