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.     

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.     

Understanding the Diversity of Catholic Higher Education: A New Empirical Guide for Evaluating the Influence of Catholic Identity

Although scholars have often described faith-based universities in America as “church-related,” we argue this classification tells us virtually nothing about how the Catholic identity influences the mission, rhetoric, curriculum, or policies of Catholic institutions. Although Morey and Piderit (2006, Catholic higher education: A culture in crisis) created a more sophisticated four-part typology of Catholic institutions, we find that students, parents, administrators, and scholars, particularly scholars interested in institutional secularization, need a better means of empirical analysis to determine the degree to which the Catholic identity of an institution influences key administrative decisions of the university. Thus, we propose a method of content analysis that can quantify how the Catholic identity shapes key administrative, curricular, and cocurricular decisions and thereby places Catholic institutions upon a continuum. We then apply our new Operationalizing Faith Identity Guide (OFIG) to Catholic institutions in the United States to demonstrate the helpfulness of its application. Replication : The data needed to duplicate and replicate the findings in the paper will be made available immediately following publication.     

Institutional identity; sacramental potential: Catholic healthcare at century's end.

Government and market forces have fundamentally transformed the religious healthcare sector. Religious healthcare organizations are struggling to define their identities and determine what it is that makes them different and what implications the differences have for the delivery of social services and for public life. In response to these questions, the defenders of traditional Catholic healthcare make a variety of responses that first defend the continued relevance of the major institutions of Catholic healthcare, especially its hospitals, and second, specify reforms to make these institutions even more relevant to the new healthcare system. This essay argues that these defenses are inadequate to that challenge and that the reforms proposed are too timid. Catholic healthcare needs a better theoretical account of its mission and more creative institutional adaptations.     

Catholic Social Teaching and Healthcare: Some Reservations

The author considers the capacity of Catholic Social Teaching(CST) to contribute to the public debate about health care andthen remarks on the capacity of CST to assist in the formationof "intentionally Christian institutions." The author arguesfor two main points. First, there are some serious obscuritiesin CST's account of the derivation and interrelation of variousrights. Hence, it is not altogether clear what ideal CST isseeking to promote in the public order. Second, the author arguesthat there is a serious political conflict in CST's commitmentto both subsidiarity and the preferential option for the poor.He also claims that it does not follow from these criticismsthat CST is useless as a guide for the formation of "intentionallyChristian institutions." Reflection on financing in the lightof subsidiarity and the preferential option suggests that thereis a need for Christian wealth-producing institutions and schemesof investment that will provide subsidium for healthcare enterprises.In the final portion of the paper, the author sketches out afew dimensions of that sort of vision.     

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.     

The Difference Catholic Makes: Catholic Faculty and Catholic Identity

This study examines, for the case of Catholics, the thesis that a "critical mass" of devoted faculty members—50 percent or more, according to the papal document Ex Corde Ecclesia—serves to promote or preserve the religious character of religiously affiliated institutions of higher education. Factor analysis and structural equations are employed to analyze a random sample of faculty members ( n = 1,290) and institutional profiles ( n = 100) of American Catholic colleges and universities. Catholic faculty show higher support for Catholic identity in latent structures of aspiration for improved Catholic distinctiveness, a desire for more theology or philosophy courses, and longer institutional tenure. Institutions having a majority of Catholic faculty exhibit four properties consistent with stronger Catholic identity: a policy of preferential hiring for Catholics ("hiring for mission"), a higher proportion of Catholic students, higher faculty aspiration for Catholic identity, and longer faculty tenure in the institution. These latter two characteristics are not due simply to aggregation, but are stronger, on average, for Catholic faculty when they are in the majority. Preferential hiring marks Catholic identity, but is ineffective to increase the proportion of Catholic faculty. I conclude that the prediction of the critical mass thesis is correct.     

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.     

Higher Education as Moral Community: Institutional Influences on Religious Participation During College

Borrowing from the literature on religion and deviance, the concept of moral communities is applied to religious and secular postsecondary education to explain institutional influences on student religious participation. Results from nationally representative panel data indicate that students attending Catholic and mainline Protestant affiliated institutions decline in religious participation at a faster rate than students attending evangelical institutions or students attending nonreligious public colleges and universities. This finding is consistent with Catholic and mainline Protestant institutions less successfully providing a shared moral order that legitimates religious language, motive, and behavior when compared to conservative Protestant colleges. At the same time, the religious and ethnic pluralism that activates minority religious identity at nonreligious public institutions is also less likely to be present on Catholic and mainline Protestant college campuses. Additional results indicate that evangelical students' religious participation declines while attending Catholic colleges and universities, while Catholic students increase their participation while attending evangelical institutions. The religious composition of students may act to alter friendship networks, and thus participation rates, on these campuses, although further research is necessary to validate the proposed institutional mechanisms.     

On the impermissibility of euthanasia in Catholic healthcare organizations.

Roman Catholic healthcare institutions in the United States face a number of threats to the integrity of their missions, including the increasing religious and moral pluralism of society and the financial crisis many organizations face. These organizations in the United States often have fought fervently to avoid being obligated to provide interventions they deem intrinsically immoral, such as abortion. Such institutions no doubt have made numerous accommodations and changes in how they operate in response to the growing pluralism of our society, but they have resisted crossing certain lines and providing particular interventions deemed objectively wrong. Catholic hospitals in Belgium have responded differently to pluralism. In response to a growing diversity of moral views and to the Belgian Act of Euthanasia of 2002, Catholic hospitals in Belgium now engage in euthanasia. This essay examines a defense that has been offered of this practice of euthanasia in Catholic hospitals and argues that it is misguided.     

Catholic Social Teaching and the Economics of Health Care Management

The author considers the issue of what it is for a health careinstitution to be intentionally Christian. He begins with areview of Catholic social teaching, and considers how this perspectiveis shaping Catholic thought and action regarding health caremanagement and public policy reform. He then proposes some standardsfor intentionally Christian institutions.     

Gregory the Great’s Metaphor of the Physician of the Heart as a Model for Pastoral Identity

The identity of the Roman Catholic priesthood remains in serious crisis. Scholars have called for a return to traditional sources to find possible solutions, including the Early Church Fathers and the Hebrew Bible. Following Oden, this article further explores Pope Gregory the Great’s The Book of Pastoral Rule and his ideals regarding pastoral identity. Of unique importance is his notion of the pastor as a “physician of the heart,” unrecognized previously as central to his project.     

Catholic health care: rationale for ministry.

This essay attempts to describe contemporary Catholic sponsored health care in the United States and to describe the purpose and structure of these particular Christian charitable organizations within the broader society. As health care has become more complex, critics claim that there is not a need for Catholic sponsored health care any longer. The author attempts to evaluate critically whether Catholic health care has a place in contemporary society. He reviews some salient biblical, ecclesial, and justice teachings of the Church to demonstrate why religious institutional presence is still needed. The author reviews contemporary health care structures to show how this is accomplished. He also uncovers additional issues which need to be addressed in order for these charitable institutions to carry on the ministry of the Church, to shape social structures, and to proclaim the reign of God.     

Merton’s Melancholia: Margie,Monasticism, and the Religion of Hope

In this second successive essay on Merton’s melancholia, the author argues that the period of Merton’s romantic involvement with Margie Smith reflects a desire on Merton’s part to adopt the religion of hope. The author argues that this period of romantic involvement was especially taxing on Merton. In this period, the author argues that Merton developed a conflicted understanding of the Christian God, which manifested itself in confusion over sexual matters and vocational matters among others. Finally, the author points to numerous instances in which the Roman Catholic Church exacerbated Merton’s existing problems.     

Human and institutional transformations: Catholic hospitals becoming 'a light in the the darkness.

Catholic health care institutions in the United States and Canada face internal and external challenges to their continued existence. Confronted by these external and internal challenges, Catholic hospitals in the United States and Canada have been pressed to identify what is distinctive about the Catholic contribution to health care and to consider whether existing institutional structures and partnerships foster what is distinctive. The author looks at the essays in this volume by Dennis Brodeur, Clarke E. Cochran, and Christopher J. Kauffman, and suggests that there is little agreement, even among Catholics, on such fundamental issues. The aim of this article is to highlight three important and often overlooked ideas raised by the authors, to relate them to the Canadian context by means of a story, and to pose questions for further discussion.     

Merton’s “True Self”: A Resource for Survivors of Sexual Abuse by Priests

The toxic impact of clergy sexual abuse in childhood and adolescence can be complex and enduring. For some, a particularly painful consequence is noteworthy change in one’s personal identity or sense of self. Survivors frequently experience unrelenting grief over the loss of the “self” that was experienced as “real” prior to the onset of abuse. Memories of days and times when this self was “alive” are often accompanied by strong feelings of affection and joy. Despair over the loss of this identity contrasts sharply with the indifference or hostility felt for the self with which they have been burdened as a consequence of sexual abuse by clergy in childhood. Many struggle with the unbearable conviction that they are fated to live “in the skin” of an identity that is not an authentic expression of the person they were meant to be. This article suggests that the writings of Thomas Merton (1915–1968) may offer a hopeful resource for survivors of clergy sexual abuse and for those working in support of survivors’ recovery. Merton has been described as “the most influential Catholic author of the twentieth century” ). His writings touch the “deeper woundedness of spirit and psyche” (Kilcourse, Cross Curr, 49:87–96, 1999, p. 90) and his elegant examination of the true self lies “at the center of his teaching on the Christian life” (Conn, Pastor Psychol, 46:323–332, 1998, p. 327). For Merton, the true self is indestructible and, because it is “rooted in God” (Merton, The inner experience: Notes on contemplation, Harper Collins, New York, 2003, p. 2), always open to discovery, growth, and transformation. This framework may be especially useful for individuals whose personal identity, as a consequence of sexual abuse in childhood by clergy, is experienced as forever poisoned and beyond redemption.     

Human Rights and Pluralism in CatholicSocial Thought

The essay argues that a Catholic tradition of natural law and its conception of human rights depend on the continuing life of institutions that stand apart from and sustain standards of justice independent from the modern state and its corresponding economy. Christians contribute to a defense of human rights precisely as members of their Churches, through their social and institutional presence across the globe. Catholic social thought deals with matters of human rights from within a tradition of natural law that assumes a common human end, a common good. This ecclesiological tradition of the human good is precisely what Catholics have to offer in a context of pluralism. The Church has a task of sustaining institutions where its practical rationality about human goods offers a practical alternative in a world where the self-interest of states and purely economic interests win the day.     

Extending Awareness of Catholic Healthcare Ethics Among Junior Clinicians: A Qualitative Study

Journal of Religion and Health - As Catholic healthcare organizations form a substantive part of healthcare delivery in the USA and Australia, ethical standards for Catholic health care were...     

The role of crosstalk in dual-task performance: evidence from manipulating response-code overlap

The present study examined the role of crosstalk in dual-task interference using a combination of a nonspeeded visual task and an auditory-manual reaction time (RT) task. The potential for dual-task crosstalk was introduced by presenting in the visual task objects (e.g., a cup with a handle), which “afford” associated responses that were either spatially compatible or incompatible with the response in the RT task. Crucially, the degree of crosstalk was varied by instructing participants either to attend to the left–right orientation of the objects, creating explicit cross-task response-code overlap (“strong crosstalk”), or to attend to object identity (no direct overlap; “weak crosstalk”). The data indicated a relative benefit for cross-task compatible trials, which was much greater with strong crosstalk than with weak crosstalk. Crucially, however, even on compatible trials dual-task performance was substantially worse with strong crosstalk than with weak crosstalk. This overall cost of crosstalk suggests interference of response codes even on compatible dual-task trials. This work was presented in August 2007 at the XVth Conference of the European Society for Cognitive Psychology (ESCoP) in Marseille, France. The author would like to thank Peter A. Frensch and two anonymous reviewers for helpful comments, Julia Klotz and Marion Marksteiner for testing the participants, and Lynn Huestegge for helpful discussions.