Do the bishops have it right on health care reform?

The National Conference of Catholic Bishops has argued for significant government involvement in health care in order to assure respect for what they regard as the right to health care. Critics charge that the bishops are wrong because health care is not a right. In this article, it is argued that these critics are correct in their claim that health care is not a right. However, it is also argued that the premise that health care is not a right does not imply that the market is the most equitable and just system for providing health care. Natural law arguments in the tradition of Roman Catholic social teaching lead to the conclusion that a just and prosperous society has a moral obligation to provide health care even if there is no such right. Further, there are strong moral grounds for concluding that the bishops are correct in their claim that health care ought not to be considered a market commodity. It is argued that if health care ought not to be considered a commodity, then national health insurance is the best available alternative for fulfilling the social obligation to distribute health care resources justly and fairly at this time in American history. The bishops' case for government involvement can be made on the strength of the Catholic tradition in theological argumentation, independent of the claim that health care is a right.     

A blessing in disguise? Empowering Catholic health care institutions in the current health care environment.

Health care institutions, including Roman Catholic institutions, are in a time of crisis. This crisis may provide an important opportunity to reinvigorate Roman Catholic health care. The current health care crisis offers Roman Catholic health care institutions a special opportunity to rethink their fundamental commitments and to plan for the future. The author argues that what Catholic health care institutions must first do is articulate the nature of their identity and their commitments. By a renewed commitment to the praxis of health care on their own distinctive terms, Roman Catholic health care institutions may reestablish a vision of human nature and human service in an increasingly secular society. Health care could then reclaim its place as a powerful setting for the expression of Roman Catholic faith, life and witness.     

A memo from the central office: the "Ethical and Religious Directives for Catholic Health Care Services"

In 1994, the National Conference of Catholic Bishops revised the "Ethical and Religious Directives for Catholic Health Care Services." A goal of the Directives is to maintain the moral integrity of Catholic health care institutions and to address controversies in bioethics and health care. The Directives represent a shift to an exclusively principle-based approach to moral reason. This shift threatens to undermine the very tradition that the bishops seek to protect.     

Managed Care, Catholic Vision, and the Claims of Justice

There are numerous challenges posed to Roman Catholic healthcare institutions by recent developments in health care delivery.Some are practical, involving the acceptable limits of accommodationto and collaboration with secular networks of health care delivery.Others, quite often implicated in the first set, are explicitlytheological. What does it mean to be a distinctively Roman Catholichealth care institution? What are the nature and the scope ofRoman Catholic institutional identity? More broadly, what isthe moral relevance of themes in Roman Catholic social teachingto the provision of health care? This issue of Christian Bioethicsaddresses these questions with a spirited exchange among itsauthors. They offer noticeably different perspectives on thegeneral cogency of Roman Catholic social teaching and differentstrategic recommendations for Roman Catholic institutions tomaintain, or recover, their distinctive presence in health caredelivery.     

From ashes to fire 2002: Introduction

Abstract

The Lutheran, Anglican, and Roman Catholic Bishops in the Commonwealth of Virgina     

Catholic hospitals and Catholic identity.

Catholic hospitals seek to offer health care in accord with the example of Christ. They have several models to assist in this effort. The first model is the values portrayed in the Gospels. The Catholic Church has sought to embody these Gospel values in specific teachings. These teachings have been further specified for hospitals in the United States by the National Conference of Catholic Bishops in the Ethical and Religious Directives. Finally, the Gospels values are also expressed for individual Catholic health care systems in mission statements and statements of Catholic identity. This article examines the worth of mission and identity statements, and explains that the statements must be put into practice through a process of internalization before they will be able to be of worth to the Catholic health care apostolate.     

Ireland’s economic crisis and austerity: the response of the Irish Catholic Bishops

The Irish Roman Catholic Church has been a dominant institution in Irish society for generations but this dominance has declined in recent decades due to modernisation and secularisation. Since the mid-1990s, the Church has been rocked by scandals of clerical and religious sex abuse of children, which has had a negative impact on its moral standing in Irish society. As a result of the economic crash in 2008, a programme of severe austerity was introduced by the Irish government. In this article, the response of the Irish Catholic Bishops to the recession and austerity measures is assessed through the analysis of their public statements which are available through the news archive of the Irish Bishops’ Conference. The findings show that the Bishops did criticise the socio-economic policies of the Irish government but this was limited due to a range of institutional barriers.     

Jewish and Roman Catholic approaches to access to health care and rationing

In addressing issues of access to health care and rationing, Jewish and Roman Catholic writers identify similar guiding values and specific concerns. Moral thinkers in each tradition tend to support the guarantee of universal access to at least a basic level of health care for all members of society, based on such values as human dignity, justice, and healing. Catholic writers are more likely to frame their arguments in terms of the common good and to be more accepting of rationing that denies beneficial and needed health care to some persons. Jewish writers are more likely to consider individual responsibility for illness in allocation decisions and to accept differences in health care that different members of society receive. The article considers the relevance of both shared and complementary perspectives for deliberations in nations such as the United States.     

The future of Catholic health care: observations from an Orthodox Christian perspective.

The author reflects on the future of Catholic health care by looking at the essays in this volume by Dennis Brodeur, Clarke E. Cochran, and Christopher J. Kauffman. The author argues that (1) Roman Catholic teaching on the Trinity is defective, yielding an inadequate model of society, (2) Roman Catholic teaching on the Incarnation is defective, yielding an impoverished understanding of the "sacramental," and (3) the institutional orientation of Roman Catholicism combined with the lack of true sacramental vision makes it nearly impossible for Roman Catholic theory to criticize the current structure of health care financing.     

Roman Catholic health care identity and mission: does Jesus language matter?

This article examines the current use of Jesus language in a convenience sample of twenty-five mission statements from Roman Catholic hospitals and health care systems in the United States. Only twelve statements specifically use the words "Jesus" or "Christ" in their mission statements. The author advocates the use of explicit Jesus language and modeling. While the witness of Jesus in the Gospel healing narratives is not only the corrective to current abuses in the health care delivery system, it is foundational to the integrity of Roman Catholic health care identity and mission. An analysis of Gospel healing narratives is used to illustrate the prophetic dimension of Jesus' wisdom, word, and witness.     

Institutional integrity in Roman Catholic health care institutions.

Issues of institutional identity and integrity in Roman Catholic health care institutions have been addressed at the level of individual institutions as well as by organizations of Catholic health care providers and at various levels in the Church hierarchy. The papers by Carol Taylor, C.S.F.N., Thomas Shannon, Kevin O'Rourke, O.P., Gerard Magill in this volume provide a significant contribution to concerns of Roman Catholic health care institutions as they face the challenges of providing health care in a secular, pluralistic, market-driven economy. One way to understand institutional integrity is as a measure of the coherence between what an institution identifies as its commitments (its stated moral character), what an institution does (its manifest moral character) and an institution's fundamental moral commitments (its deep moral character). The essays in this volume support this model of integrity. Although it is not their explicit focus, the four essays together provide a vision of institutional integrity for Catholic health care institutions. Each author focuses on one of the three central aspects of integrity: what one identifies as one's commitments (Taylor), how one's actions reflect one's values (Shannon and Magill), and what one is or what one values at a deep level (O'Rourke). I will offer a brief overview of the ways in which the integrity of Catholic health care institutions has been addressed. Then I will consider the four essays and show how each offers an analysis of one of the three critical elements of integrity.     

Living the vision: health care, social justice and institutional identity.

This paper will examine the topic of identity in Roman Catholicism from the perspective of topics contained in or absent from mission statements of 25 Catholic health care institutions. In particular, I will look at these from the perspective of social justice as well as how this and other topics such as human dignity, sanctity of life, stewardship, pastoral care and the likelihood of mergers with other institutions will affect the healing ministry of Catholic health care providers. The article will conclude that there are three key dimensions to Catholic health care: leadership in advocating reform of the current health care system, care for the marginalized and under-insured, and the provision of pastoral care in all institutions.     

Probing The Politics of Difference: What's Wrong with an All-Male Priesthood?

Though it is often taken for granted that feminists necessarily must condemn the exclusion of women from the Roman Catholic priesthood, the author demonstrates that the "politics of difference," if pursued consistently, reopens this question. International feminist arguments for honoring gender differences, the teachings of John Paul II concerning women, and Catholic social justice teachings, taken jointly, suggest that the current Catholic exclusion of women from the priesthood is unjust not because the reservation of a social role to a single sex is inherently unacceptable, but because of the asymmetry in power between the roles accorded men and women in the governance of the Catholic Church. To be just, sex-specific reservation of roles must meet the criteria of balance, proportion, power, and particularity.     

Observations on the rejection of physician-assisted suicide: a Roman Catholic perspective.

Roman Catholic moral theology follows a centuries-old tradition of moral reflection. Contemporary Roman Catholic moral theory applies these traditional arguments to the realm of medical ethics, including the issues of active euthanasia and physician-assisted suicide. Unavoidable moral limits on licit medical intervention sometimes require that the moral duty to treat cede to the duty to cease treatment when measures become more harmful than beneficial to the patient. This does not reduce the need for the compassionate use of palliative care in response to suffering. However, it does mean that rather than being excessively committed to maintaining mere biological human life, or actively seeking death, that we learn a sober realism about the limits of human life. Catholic moral analysis examines an act objectively, both in its relation to the agent and as a material event in the world. This allows both the virtuous or vicious intentions of the agent and the effects of the action to be included in its moral evaluation. Thus, Catholic moral analysis is both quasi-deontological and quasi-consequentialist. Objectively, active euthanasia and physician-assisted suicide, as acts of deliberate killing, are seen as repugnant, in that they fail to incarnate a benign inner intention or to form an agent in virtue. Catholic moral theology is extremely skeptical that an act of intending death directly can be consonant with a sincere compassion for the dying, suffering person and views it as a direct negation of the precious gift of human life.     

The impact of Roman Catholic moral theology on end-of-life care under the Texas Advance Directives Act.

This essay reviews the Roman Catholic moral tradition surrounding treatments at the end of life together with the challenges presented to that tradition by the Texas Advance Directives Act. The impact on Catholic health care facilities and physicians, and the way in which the moral tradition should be applied under this statute, particularly with reference to the provision dealing with conflicts over end-of-life treatments, will be critically assessed. I will argue, based on the traditional treatment of end-of-life issues, that Catholic physicians and institutions should appeal to the conflict resolution process of the Advance Directives Act only under a limited number of circumstances. The implications, under the Texas statute, of varied interpretations of Pope John Paul II's recent allocution on artificial feeding and hydration in the persistent vegetative state will also be considered.     

“Never Again War”

This essay addresses the complexities of the Roman Catholic position on war by evaluating recent documentary evidence, attending to the contemporary challenges of terrorism and humanitarian interventions. It presents two arguments. First, attending to traditional Catholic resources for assessing war, papal criticism of recent military action, and debates about a recent shift in Catholic just war logic, this essay argues that Catholic teaching on war has undergone a repositioning in a pacifist direction. Second, it contends that recent critiques of this shift in position by scholars such as George Weigel and James Turner Johnson, however, are wrong to categorize this a “functional pacifism.” Though a development from within just war theory and pacifist reasoning, the Church's new stance does not operate as a type of pacifism, allowing too many possibilities for justified armed conflict to be labeled as “functional” pacifism. The essay concludes by examining the traditional Catholic theological commitments that place limits on any movement toward pacifism, precluding even a functionally pacifist position.     

Catholic social justice and health care entitlement packages.

This paper explores the implications of Roman Catholic teachings on social justice and rights to health care. It argues that contemporary societies, such as those in North America and Western Europe, have an obligation to provide health care to their citizens as a matter of right. Moral considerations provide a basis for evaluating concerns about the role of equality when determining health care entitlements and giving some precision to the widespread belief that the right to health care requires equal entitlement to health care benefits.     

Catholic priests who sexually abuse minors: Why do we hear so much yet know so little?

A tremendous amount of media attention has been directed towards sexual abuse perpetrated by Roman Catholic priests in recent years. While there are countless research studies on both sexual abuse victims and perpetrators in the professional literature, there are very few comprehensive research studies specifically investigating Roman Catholic priests who sexually abuse minors or studies concerning the victims of priests themselves. While the scientific professional community could offer a great deal to this problem, their voice appears silent. The purpose of this article is to examine what is known about sexual abuse among the Catholic clergy and briefly suggest directions for future research and intervention.     

Jesus as an exemplar of faith in the New Testament

Roman Catholic theologians long denied that Jesus had faith in God, and Jesus having faith in God seems in conflict with traditional claims that Jesus is fully divine (Section II). What the New Testament means by “faith” is explored (Section III), and in light of this we consider arguments from orthodox Incarnation theory to the conclusion that Jesus did not have and could not have had faith in God (Section IV). Relevantly, the New Testament clearly asserts in five ways that Jesus had faith in God (Section V). This exposes problems for traditional Incarnation theories, some of which are addressed by recent “Kenosis” accounts. But these too are problematic (Section VI).