Catholic health care faces many challenges today: a culture that often is hostile to Catholic values on the dignity of human life; inconsistent interpretation of the U.S. bishops’ “Ethical and Religious Directives for Catholic Healthcare Services”; professional pressure on medical personnel to provide immoral services; and the erosion of the conscience rights of Catholic health care institutions, health care workers and consumers of health care.
To address these challenges, nearly 200 people from 16 states attended the “Make Straight the Pathway” conference last month in Livonia, Mich., organized by the Christus Medicus Foundation, the Detroit Guild of the Catholic Medical Association and One More Soul to discuss an inte-grated and unified solution for Catholic health care reform.
Bishop Robert F. Vasa, coadjutor bishop of Santa Rosa, Calif., episcopal adviser to the Catholic Medical Association (CMA), said in his opening remarks that Catholic health care must be reclaimed as a ministry, not an industry.
“The Catholic Church needs to have a substantial place in discussions about health care in the United States,” he said, and he gave four specific reasons: The Church brings an eternal perspective to the debate; has an understanding of suffering that is linked to the redemptive suffering of Christ; understands and defends true compassion; and has a philosophy of the human person that correctly shapes caregiving.
“One of the things we tend to lose sight of today in modern medicine is that the Church is not an opponent to health care, but rather its best and most consistent proponent,” Bishop Vasa said. “Our approach, however, is not willing to accept any vague concept of what constitutes health care, but will accept and foster only that which is consistent with the best good of the entire person, as well as the ... common good of all.”
Richard Doer-flinger, associate director of the U.S. Conference of Catholic Bishops’ Secretariat of Pro-Life Activities, told the conference that current federal laws to protect the rights of conscience for Catholic health care look good on paper, but have many “loopholes and inconsistencies.”
For example, the Hyde-Weldon Amendment (2004) forbids discrimination by federal agencies and programs, as well as state and local governments that receive federal funds under the Labor/HHS appropriations bill. But it must be approved in each appropriations bill, and the only penalty provided is denial of funds to the entity involved, a penalty that is unlikely to be imposed, Doerflinger said. Further, the law does not provide for health care entities or individuals to be able to go to court to sue for their rights.
“The biggest recent threat,” he said, is the Patient Protection and Affordable Care Act (PPACA). The “overall general problem” with the act is that it would require taxpayers to fund abortions, he said. None of the new government entities set up by the law are covered by the Hyde-Weldon conscience protection because new dollars are appropriated outside the regular appropriations bill.
Doerflinger urged support for federal bills that have been introduced in Congress to address the conscience protection and abortion funding problems with PPACA (see sidebar below).
Marie Hilliard, director of bioethics and public policy at the National Catholic Bioethics Center (NCBC), said she increasingly gets calls from young people asking if they can go into health care, given the threats to conscience rights.
“It’s very tragic, because the very government born out of a need for freedom ... is not only saying that human life is not going to be protected, but wants to discriminate against those of us who are trying to protect human life,” said Hilliard, who also has degrees in nursing and canon law.
William Saunders, senior vice president of legal affairs for Americans United for Life (AUL), told the conference that conscience rights are under “vicious attack” all around the country. He gave several examples, including California and New York rulings that Catholic Charities must either include contraceptives in employee health care coverage, or offer no coverage whatsoever.
The people opposing conscience rights are “ruthless,” Saunders said, for they want certain procedures to be legal and then force others to participate. If you refuse to do so, he continued, their answer is to say, “Then don’t go into medicine as a career.”
People “in the trenches” of Catholic health care, including Drs. John Bruchalski of Fairfax, Va., and Michael Parker of Columbus, Ohio, both obstetrician/gynecologists, told their stories about the difficulty in establishing medical practices that offer only moral services in a culture where contraception and sterilization are expected. Some of those difficulties include lack of support from fellow Catholics, but both men have developed successful practices by offering their patients health care that is not only spiritually beneficial, but also better for their bodies.
Franciscan Sister Renée Mirkes, director of the Center for NaProEthics at the Pope Paul VI Institute in Omaha, Neb., struck the same theme, that moral health care is successful health care. She told the conference how NaProTechnology, developed at the institute, enables couples to achieve or avoid pregnancy in a moral way and helps doctors diagnose and treat reproductive health problems.
Eugene Diamond, chief executive officer of the Northern Indiana Region of Sisters of St. Francis Health Services, Hammond, Ind., told the conference about the need to consistently express and protect the Catholic identity of health care institutions.
“There is no incompatibility between our faith and business success,” Diamond said, stressing that the “Catholic” way of providing health care attracts patients. Additionally, his system’s charity percentage is high, he said, yet the system is financially sound, demonstrating that “God rewards generosity.”
Diamond said his health system does not support the PPACA as it is written, and the system withdrew from the Catholic Health Association when the CHA supported PPACA in spite of the U.S. bishops’ concern about lack of conscience protection and the funding of abortion in the law.
Internal, external threats
Leonard Nelson III, professor at Cumberland School of Law and author of “Diagnosis Critical: The Urgent Threats Confronting Catholic Healt Care” (Our Sunday Visitor, $29.95), said that the contemporary struggle between the culture of life and the culture of death puts Catholic health care in great danger.
The threats are both external and internal, Nelson said: Internal threats are from prominent Catholics and Catholic institutions whose version of social justice is devoid of objective moral norms. A major internal threat comes from the “incremental erosion” of commitment to the U.S. bishops’ ERDs. The external threats are based on the contemporary view that conscience is “a psychological idiosyncrasy” that must be dismissed, and Nelson said PPACA adds to those threats.
Charles Donovan, a senior research fellow with the Heritage Foundation, said “this is the Hippocratic moment,” a time for “fresh hope for authentically Catholic medicine.” The Hippocratic oath is a “remarkable” oath crafted in a pagan world that became infused in all the canons of Western medicine and adopted in a nonsectarian context, he said; but that has changed, with a new version of the oath that basically says to abstain from all that is illegal.
Instead of succumbing to this level, Donovan urged Catholic health care to remain steadfast in Catholic values and be resourceful in exercising its ministries, which he said are influential and strong, with a guiding philosophy that values the person and offers hope for eternal life. He also noted that the American public is becoming more educated on life issues, and that progress is showing up in state legislative challenges to Roe v. Wade that were unimaginable 10 years ago.
“There is an unwritten law on the human heart in this country where we keep coming back to hope for life,” Donovan said. “We underestimate what we’re able to do as a nation, as Christian people with God on our side, and we really need to recognize that we have a Hippocratic moment to change.”
Ann Carey writes from Indiana.