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.     

The Importance of Begging Earnestly

The author focuses on the potential for many healthcare institutionscurrently called ‘Catholic’ to lose their genuineRoman Catholic identity, and he offers suggestions for the futureof the Catholic identity of Catholic healthcare institutions.The author then considers one particular task of the Catholichospital, that of showing a preferential option for the poor.Some of the threats to this task are highlighted. The authorconcludes with some suggestions for the renewal of Catholicidentity in Catholic healthcare institutions.     

In the world but not of it: managing the conflict between Christian and institution.

Christian physicians, nurses and other health care workers must manage a daily conflict of conscience between their Christian faith and predominantly secular health care institutions. This essay examines various efforts for managing these conflicts: a turn towards social justice or a seeking of holiness. Seeking social justice, however, is theologically empty. Traditionally, the Christian requirement that we be "in this world but not of it" requires a journey along a narrow path to holiness. Christian medical morality must, therefore, be understood within this light. However, just as there cannot be generic health care, but rather health care for a particular person's needs and problems there cannot be generic holiness, but only a holiness grounded in worshiping God rightly. In so worshiping the Christian will be assisted in negotiating the inescapable and perilous vocation of being in the world but not of it.     

Publicly Accessible Intuitions: "Neutral Reasons" and Bioethics

This article examines Leon Kass's contention that a choice forphysician-assisted suicide is "undignified." Although Kass isJewish rather than Christian, he argues for positions that mostChristians share, and he argues for these positions withoutpresupposing the truth of specific religious claims. I arguethat although Kass has some important intuitions, he too readilyassumes that these intuitions will be shared by his audience,and that this assumption diminishes the force of his argument.An examination of the limitations of Kass's argument is helpfulinsofar as it illustrates the real challenge faced by religiousbelievers who wish to defend their beliefs in the "public forum."For it illustrates that what needs to be made "accessible" isthe Judeo-Christian understanding of man and his place in theworld. While I do not wish to claim that this task is impossible,I do think that it is far more difficult than most realize.Like all important tasks, however, unless we wrestle with thedifficulties it raises, our arguments will strike many as unconvincing.     

The Role of Christian Belief in Public Policy

It seems intuitive to the believer that God intended throughinstruction in the Law to define morality, intended to leadhumankind to "the right and the good." Further, God's love forhumankind, exemplified by the incarnation, atonement and teachingsof Jesus, and empowered by the Holy Spirit, should lead to abetter world. Indeed, the Christian worldview is a coherentand valid way to look at bioethical issues in public policyand at the bedside. Yet, as this paper explores, in a pluralisticsociety such as the United States, it is neither possible nordesirable for Christians to try to force their views on others.Still, it is obligatory for Christians to stand up and articulatetheir views in the public square. We should try to persuadeothers using either prudential or moral arguments. While wemust be willing to live with "the will of the people," at thesame time, we must not be intimidated into accepting the positionthat our voice is not valid because it has a religious basis.     

The Role of Christian Educational Institutions in Improving Economic Self-Reliance

This article argues that Christian educational institutions in Africa can play a major role in improving economic self-reliance within the continent, if those who establish Christian universities there take time to plan the programs and activities in those institutions. Specifically, it argues that with proper planning of quality education–the curriculum, the choice of extra-curricular activities, the teaching methods, and proper assessment–Africa's situation, especially its economy will improve. The paper insists that God gave a mandate to Christians to lead out in the world when He called them the light of the world (Matthew 5:14-16) as well as promised that they would be the head and not the tail (Deuteronomy 28:13). Finally, it ends with several recommendations that will help leaders of Christian universities in Africa to plan education in such a way to improve the economy of the continent. While the paper addresses Christian institutions of higher learning in general, it focuses its attention on Seventh-day Adventist educational institutions of higher learning in Africa and draws its examples from Babcock University in Nigeria, West Africa.     

Secular humanism and "scientific psychiatry"

The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility ... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of mental diseases. Black's Law Dictionary states: "Every confinement of the person is an 'imprisonment,' whether it be in a common prison, or in private house, or in the stocks, or even by forcibly detaining one in the public streets." Accordingly, I maintain that Secular Humanism is incompatible with the principles and practices of psychiatry.     

Priesthood and the Epistle to the Hebrews

Current controversies about the ordination of women have shown the need for a re-examination of what the Christian Church means by priesthood. This article looks at the Epistle to the Hebrews' contribution to our understanding. To that end it focuses on the institution of priesthood in its first-century Jewish context and shows the use made of it by the author of Hebrews in his presentation of Christian faith.
Section 1 emphasizes some all-important differences between the NT's use of the language of priesthood and ours. Not least, it nowhere uses "priest" to designate Christian ministers. All the more striking, therefore, is Hebrews' depiction of Jesus as "high priest".
Section 2 discusses Judaism' Day of Atonement ceremonies – Hebrews' dominant cultic model. In the comparison drawn between Christ's death and exaltation with these rites, he becomes not only the high priest but also the expiatory victim.
As far as Judaism' cultic institutions are concerned, however, Jesus was not and never could be a priest, since he was of the tribe of Judah rather than Levi. Hence Hebrews appeals to Melchizedek. How this non-Israelite model is used by Hebrews to subvert the whole notion of priesthood as caste is discussed in section 3.
Finally, in section 4 Isaacs concludes that for Hebrews there is no longer a role for an ongoing priesthood, since Jesus has definitively achieved access to God, which was its raison d'être . Melchizedekian high priesthood is unique to Christ; neither inherited nor transmitted. Hence, unlike other NT authors, for Hebrews even the church as a corporate body is not a priesthood. As its closing chapters show, in this Epistle the cultic model gives way to the more inclusive one of pilgrimage.     

Holiness, virtue, and social justice: contrasting understandings of the moral life.

Being a Christian involves metaphysical, epistemological, and social commitments that set Christians at variance with the dominant secular culture. Because Christianity is not syncretical, but proclaims the unique truth of its revelations, Christians will inevitably be placed in some degree of conflict with secular health care institutions. Because being Christian involves a life of holiness, not merely living justly or morally, Christians will also be in conflict with the ethos of many contemporary Christian health care institutions which have abandoned a commitment to Christian spirituality. In this regard, managed care raises the special question of how Christian institutions can act morally under financial constraints and maintain their character while under the control of secular managers. This question itself raises the further question as to why health care institutions need even pose this query when there are Christian physicians and nurses who could work for less, or Christian men and women who could become sisters and brothers and work for nothing. Contemporary challenges to Christians to maintain their integrity in a post-Christian world have much of their force because Christians have failed to maintain traditional Christian sprituality. In the face of that failure, Christian physicans and nurses will find themselves in greater conflict with health care institutions, because few will any longer understand the requirements of traditional Christianity. In its place, they will have put a generic spirituality, a value-neutral understanding of the role of the health professional, and an anonymous commitment to social justice.     

近五十年来台湾地区士林哲学之研究与前瞻

根据祁尔松（Etienne Gilson）的说法,中世纪哲学,尤其是十三世纪的思想,是基督宗教哲学。本文按其在台湾发展时所袭用的名词,称之为士林哲学。士林哲学之传入中国,虽然早在利玛窦时期（1550—1610）已经开始,但真正成为学术思想之主流之一,是最近五十年来在台湾地区的发展。20世纪初士林哲学初传入台湾时,当时的思想环境,对基督宗教哲学并不十分友善,这种种情况,与中世纪的思想家,面对信仰与神学之挑战相似。当时的思想家,融合各种不同的思想派系,对柏拉图与亚理斯多德的观念,重新诠释与批判,批判与诠释是创新的基础。所以,中世纪可说是哲学的第二春,而中世纪哲学之精华,即全盛期的士林哲学。十四世纪唯名论之后,士林哲学逐步式微,于十九世纪末再兴。本文认为,士林哲学在台湾发展之过程,与其在中世纪之盛行,及十九世纪末之再兴,背景虽异但有不少相似之处,而这些相似之处,正是士林哲学之基本思想与立场。本文对台湾士林哲学之发展,从四方面探讨：（1）回到形上学之根以面对新的挑战;（2）形上学基本立场与概念之说明;（3）反思与批判;（4）未来发展之方向。本文所参考之资料,一是已发表之学术文献;其二是与学者们之正式交谈——如学术演讲、座谈会等,及非正式之谈话、访问等。     

The Decent Care Movement: Subsidiarity,Pragmatic Solidarity,and Cross-Cultural Resonance

Decent Care is the World Health Organization and The Ford Foundation’s joint effort to articulate a healthcare paradigm that makes a patient’s voice equal to the voice of the healthcare provider. In this article, the six tenants of Decent Care are outlined with particular emphasis on subsidiarity. Liberation theology’s preferential option for the poor maxim is presented and compared with other major world religions to demonstrate the cross-cultural focus of “decency.” The power of this paradigm is in its emphasis and proclamation of human flourishing in a healthcare setting, generally speaking, and more specifically, human flourishing in the presence of affliction from chronic disease or dying cross-culturally.     

"Men of Stone and Children of Struggle": Latin American Liberationists at the End of History

This article critiques the political theory of Latin American liberationists and suggests a theological source of resistance to the regnant capitalist order. Drawing on the work of Raymond Williams, the liberationists' commitment to "politcs as statecraft," manifest originally in the hopes of seizing the state and more recently in the praise of an emergent civil society, is shown to be unable to resist "paranational hyper capitalism." Instead, liberationists should reconsider the church as a "public", as a social, political, economic formation in its own right. Toward this end they might learn from the Christian base communities.     

Overcoming Relativism? Levinas's Return to Platonism

Emmanuel Levinas's concept of "the face of the Other" involves an ethical mandate that is presumably transcultural or, in his terms, "precultural." His essay "Meaning and Sense" provides his most explicit defense of the idea that the face has a meaning that is not culturally relative, though it is always encountered within some particular culture. Levinas identifies his position there as a "return to Platonism." Through a careful reading of that essay, exploring Levinas's use of religious terminology and the (some-times implicit) relationships of the essay to the work of other phenomenologists and of Saussure, the author seeks to clarify (1) what Levinas retains and what he rejects in returning to Platonism "in a new way," (2) the sense in which this return constitutes an "overcoming" of relativism, and (3) the nature of the phenomenological warrant that he offers for his position.     

Going As Far As We Can Go: The Jesus Proposal For Stretching Genes and Cultures

The Christian perspective on morality is examined under the rubric of "being like Jesus" and the "Jesus proposal for morality." The Peace People of Northern Ireland are examples of this proposal. Among the features of Christian moral thinking that are emphasized are: Jesus' concern for the future, the transformation that the future requires, human nature interpreted in terms of how it can undergo transformation, and self-giving love as the core of this transformation. Attention is given to the ways in which Jesus both radicalized and relativized the moral conventions of his day. Dialogue with sociobology comes into play when Jesus is viewed as a proposal for cultural evolution and a kind of biocultural mutation. Gerd Theissen's scholarship on Jesus' moral perspectives is given special attention.     

METANOIA AND HEALING: TOWARD A GREAT PLAINS LAND ETHIC

A Great Plains land ethic is shaped by an intimate knowledge of and appreciation for the evolution, ecology, and aesthetics of the plains landscape. The landscape evokes a sense of wonder and mystery suggested by the word "sacrament." The biblical concept of "covenant" points to God as a community-forming power, a creative process that has evolved into the earth community to which we humans belong. In contrast to an anthropocentric ethic which emphasizes human dominion over nature, a Theo-centric land ethic seeks a balance, reflected in Genesis 1–3, between humans who are members of the earth community and moral agents accountable to God for the earth. A land ethic identifies concrete practices of metanoia and healing: agricultural practices to address the loss and degradation of soil; conservation and protection of water sources; utilization of wind and solar energy; and prescribed burning to restore processes vital to the prairie ecosystem. The concept of subsidiarity suggests that practices of metanoia and healing are a combination of wise public policy balanced by personal, family, church, business, and community responsibility.     

The Ohio study in light of national data and clinical experience

The Siminoff, Burant, and Youngner study in Ohio is strikingly consistent with data from a national study. Both suggest that there might be significant public acceptance of future policies that violate the dead donor rule, or that further extend the boundary between life and death to include brain-damaged patients short of "brain death." Experience with donation suggests that many individuals would donate their loved ones' organs when they have concluded that the brain injury is not survivable, even if all the criteria for "brain death" are not met. It would be very helpful to have research on those who have gone through the real-life clinical situation. Based on the findings of this study and the increasing demand for organs, it may be appropriate for public policy to allow for ways to increase organ procurement from individuals who are not fully "brain dead" beyond the current method of procurement after cardiac death, but any change in this area should go slowly and with significant public input.     

Sexual reorientation therapy: an orthodox perspective.

This article evaluates the phenomenon of sexual reorientation therapy from the standpoint of Orthodox Christian theology. It is argued that homosexual desire is the product of the fall of mankind and cannot be considered "normal." At the same time, however, reorientation therapies, whether secular or Christian, are inherently reductionistic and fail to address the underlying spiritual pathologies involved in homosexual desire (or any other deep-seated passion). The purpose of therapeia in the Orthodox Church is the psycho-somatic transfiguration of the whole person into the image of Christ, not merely the cessation of homosexual activity or the "reidentification" of one's "lifestyle."     

Beyond Crucifixion: Remaining Christian after Sexual Abuse

Abstract

Christian survivors have frequently likened their experiences of sexual abuse to crucifixion. While it is understandable that many cannot reconcile their experiences within their faith tradition, the question of how it is possible to move forward within a Christian framework which accommodates the experience of sexual abuse has tended to be overlooked. In doing so, this article considers why identifying with the crucified Christ may be an important step in the process of moving forward, and why the terminology "survivor" may be preferable to "victim." The challenge to move forward may require churches and church personnel to consider whether they need to do some things differently. Above all, this requires integrity for the individuals and communities involved rather than a one-size-fits-all approach.     

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.     

Nurturing Faith for Action: Theological Education and Global Responsibility

Ghana hopes to parlay the financial promises of oil recovery into a better life for its people. If Ghana succeeds, it would be a model for the developing world. But Ghana's capacity to overcome poverty and support human dignity will be stronger if the rest of us who also hold that value commit more truly to it. As people of faith, as leaders of institutions, as educators, we face substantive questions about how our own actions, business decisions, and consumptive practices contribute to the larger issues of oil, consumerism, and planetary health. A course that asks not just Christian scholars and clergy, but leaders of theological institutions, church bodies, businesses, and others, to consider an ethical, paradigmatic shift toward a whole‐world ethic of well‐being is in order.