Catholic Health Care II: The CHA Question
Having examined The ACLU Question, I wish to take up a second argument against Bishop Olmsted’s stand on Catholic health care, an argument we are already hearing from ostensibly Catholic groups such as the Catholic Health Association. These groups hold that an overly strict interpretation of traditional Catholic ethics can only weaken the Church’s ability to provide health care.
In other words, in this view the optimum Catholic position is one which resolves the problems created by difficult cases in ways most people can understand and approve. I grant that this is not exactly how the CHA expressed its position, but I cannot think of any other reasonable interpretation of the CHA’s claim that its commitment to Catholic health care requires it to side with the hospital against Bishop Olmsted, who was without question upholding official Catholic moral teaching.
As Phil Lawler pointed out, this argument that a strict application of Catholic principles in hard cases is detrimental to Catholic health care as a whole makes sense only if it is sufficient to the Catholic purpose to be engaged in the general good of health care as commonly conceived. If, on the contrary, the Church wants to provide truly Catholic health care—by which we can only mean health care characterized by a singular Catholic dedication in accordance with specifically Catholic moral principles—then the argument that it is counter-productive to apply such principles strictly runs into grave problems. For if the principles are not applied strictly, the “Catholic” institution may well be more widely supported, but to precisely the same extent the “Catholic” care will be missing.
Here the argument turns on a profound ambivalence concerning the word “Catholic”. For a great many years now, at least in the United States, we have grown used to describing Church-affiliated institutions (whether currently or originally so affiliated) as “Catholic” as long as they wish to retain the name, and with little or no regard for whether they fulfill either a distinctively Catholic mission or a broader mission in a distinctively Catholic way. But when we discuss Catholic principles, of course, we cannot similarly take Catholicity for granted. Instead our task is self-evidently to articulate how the Catholic Faith must specifically govern our actions in this or that case if those actions are to be rightly described as “Catholic”.
During the years in which we have permitted this wholesale institutional drift, health care has evolved in our society in two ways which make a principled Catholic presence difficult. First, costs have skyrocketed to the point that modern health care cannot really be provided by dedicated Catholics without becoming part of a much larger network of financial and governmental entanglements. Second, a significant bioethicial gap has arisen—particularly in medical issues related to sexuality, birth and death—between government and the general public on one side and the Catholic Church on the other.
The result is twofold. On the one hand, any strict enforcement of Catholic moral norms in Catholic health institutions will often (perhaps always) carry such a high cost in funding and government regulations (and be so repugnant to those now in control) that these institutions will be lost to the Church in name, just as they have already been lost in principle. Thus such a strict enforcement will certainly be counter-productive in the sense that it will reduce the nominal presence of the Church in health care. But on the other hand, this same strictness is the only way—there is no other—to define and ultimately extend the principled presence of the Church in health care.
We are currently unable to sustain a principled Catholic presence on a large scale, and yet the time may not be far off when increasing numbers of people will prefer to avail themselves of principled Catholic health care rather than to entrust themselves to ordinary hospitals. One thinks, for example, of the fear the elderly and the handicapped already have of being hospitalized in some places in Europe.
It is unfortunate that principled Catholic health care must rebuild itself largely from scratch, and that this is unlikely to be accomplished without immense nominal institutional losses. Moreover, principled Catholic health care may well have to rebuild itself initially on the margins of society, among those who are more or less rejected by the larger secular community—the elderly, the infirm, the handicapped, those with large families, those seeking to escape sexual exploitation, those who are committed sacrificially to their Faith, and mothers who wish to be cared for by a pro-life medical staff.
I grant that the alternatives are not pretty, but between principled Catholicism and nominal Catholicism, only one choice is possible—just as only one choice can do any ultimate good.
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