Another Identity Crisis
Cochran, Clarke E.
ANOTHER IDENTITY CRISIS Catholic hospitals face hard choices Clarke E. Cochran ase One. James Michener reports a conversation Arguably, the sacramental and...
...Moreover, real change is taking place in Catholic institutions...
...For extive, admirable, and generous about the Catholic way of ample, in the future hospitals should restructure intensivedoing things...
...Signs and symbols-tangible, visible, and autensions stem from friction over Catholic labor teachings dible-tell Catholics who they are and identify the church to and the response of Catholic institutions to labor organizing non-Catholics...
...Crucifixes surely...
...We might ask: If the faThe church you can trust...
...Just as Catholic colleges and universities opted for lay boards and administrators in the 1960s and 1970s, so, some years later, did the religious orders that had established and maintained Catholic health-care institutions relinquish their control...
...Imagine being admitted to a Catholic hospital for serious surgery...
...Tell dors, patient rooms, admission offices, and surgery suites me, would sensible men trust politicians to run a hospital...
...But medicine itself, as therapy regimes...
...Principles like justice, freedom, respect for life, human Second, the more committed Catholic health care is to de- dignity, and the common good are vital to Catholic faith...
...Catholic hospitals still supply significant bishops, to well-informed lay persons, or to patients...
...Residents family-centered and less "medical...
...Still, they have left many people chronG ensure its Catholic quality and character...
...Seat belts, air bags, and level-one trauma centers Catholic health care in the new century do to have all saved lives...
...efenders of Catholic health care argue that Catholic hospitals are a vital part of the medD ical system, providing the highest quality of care to patients, funding substantial charity care for the uninsured, and furnishing advocacy leadership for universal health-care coverage...
...Will the words spoken on admission differ from those in a secular institution...
...Catholic health-care institutions now have alliances with housing, youth and family, educaCommonweal 1 3 February 25, 2000 tion, and anticrime initiatives, often in association with illusion of life without suffering, the denial of death, the Catholic Charities agencies or with other Catholic and non- pipe dream of pharmacological or surgical solutions to aging, Catholic community organizations...
...As Catholic hos• First, internal reform of the Catholic hospital should move pitals have established or affiliated with rehabilitation centers, it away from strict adherence to the culture of medical tech- it is not at all clear that they have successfully integrated nology...
...They must "find flesh," become in- ticular should practice a studious skepticism about technocarnate, in words, gestures, and ambiance...
...Catholicism worships elsewhere...
...In August ception and sterilization services in newly created systems...
...Commonweal 1 2 February 25, 2000 institutions' fidelity to the church's moral teachings and for the question of whether the values of the marketplace and the medical profession, rather than Catholic ideals, control the institutions...
...Yet they are Healthcare West, the fifth largest Catholic hospital system, held accountable by Rome and in the public mind for these after an aggressive market-based expansion strategy brought losses of hundreds of millions of dollars...
...Catholic institutions, and with controversies over contraProphetic statements sometimes are ignored...
...Bishops in Saint Louis, integrity" of the ministry, including "market forces that Chicago, Austin, and other cities have wrestled with plans gauge the effectiveness of health-care delivery solely in terms for mergers and affiliations between Catholic and nonof profitability...
...James Michener reports a conversation Arguably, the sacramental and incarnational aspects of in Spain some decades ago...
...Now take away your sense of sight...
...Clarke E. Cochran is a professor of political science at Texas Tech University in Lubbock, and a deacon of the Diocese of Lubbock...
...1999, Modern Healthcare, the health-care industry weekly, As with colleges and universities, local bishops seldom reported the departure of top executives from Catholic own the health-care institutions in their dioceses...
...Modpaigns against assisted-suicide initiatives, and they commit em medicine worships at the altar of research, development, themselves to measurable goals for indigent care and assis- and the market...
...Of course, in many parts of the cilities are not clearly sacramental, might it not be time to United States at that time, Catholic hospitals did serve as transfer the resources invested in them to more distinctivethe primary health-care providers, offering free or low-cost ly Catholic healing missions...
...Just as colleges and universities abandoned doctrinal requirements and hired lay, often nonCatholic, faculty attuned to the principles and incentives of national academic disciplines, so too Catholic hospitals now hire lay and non-Catholic administrators whose professional ethos is the business culture that pervades their profession...
...Catholic services (about 15 percent of all community hospital beds), identity is as hot a topic in health care as in higher education, but at prices as high as-and in settings often indistin- the arena where this issue is most prominently addressed in guishable from-their public and other private counterparts...
...livering high-quality, advanced medical care, the more it Nevertheless, they are both too abstract and too generic to must wrestle with medicine's technological ambitions-the form a distinctive Catholic identity, whether in health care, Commonweal 14 February 25, 2000 education, or parish life...
...They ops have been drawn into hospital identity questions as also call attention to "forces which imperil the identity and surely as college campus issues...
...In June 1999, the assembly of the Catholic Health Association (CHA), for example, featured panels on Catholic identity, "sponsor leadership," relationships between bishops and laity, and "sustaining identity in other-than-Catholic partnerships...
...While the assembly devoted attention to other topics-social justice, meeting the health needs of the poor, and national health-care reform-it is a sign of crisis when identity questions consume so much of an organization's energy...
...The idea of pub- daily experiences in Catholic health-care institutions-may lic hospitals astounds his Spanish friend...
...Commonweal and other journals of opinion...
...None of this is news to Catholic health-care leaders, to Times change...
...Theologian Edward Schillebeeckx contended that the Yet these initiatives have their limits...
...The reputation, medical quality, and financial picture of most remain solid...
...Yet lic hospitals and discovers there are none...
...tation of care between ever more specialized personnel, the task of incarnating Christ's healing becomes more urgent...
...With Vatican II, the church rediscovered in the church itself: divisions between liberal and conserva- its own sacramentality: As Christ is the sacrament of God, so tive Catholics, the phenomenon of "cafeteria Catholicism," the church is the sacrament of Christ...
...Catholic health-care leaders themselves are attuned to the problems these developments pose...
...ANOTHER IDENTITY CRISIS Catholic hospitals face hard choices Clarke E. Cochran ase One...
...Yet there is pervasive anxiety in the hearts and minds of Catholic health-care leaders: They worry whether elegant principles can survive the heat of operating rooms, admitting offices, and nurses' stations...
...Catholic hospitals should can smell the aromas of sizzling bacon and fresh-brewed cof- devote substantial resources to developing similar types of fee from down the hall before they ever see their meal...
...nancially, psychologically, and spiritually...
...You mean the lead us to wonder whether this quality persists in the corrigovernment taxes you for what the church gives us...
...Thus, Catholic hospitals in par- served not only severely damaged infants but also thousands Commonweal 1 5 February 25, 2000...
...medical care...
...or imagine that you are taking your elderly mother to a Catholic nursing home...
...Each floor of the hospice In the last decade, birth care in hospitals has become more has its own kitchen, where breakfast is prepared...
...This care that underscore the Catholic understanding of life and sensitivity to patients' needs expresses something distinc- death, not only for patients but for their families...
...the Institute of Medicine reported last year, can be patho- Similarly, surgical and pharmacological progress has prelogical as well as curative...
...What will you hear, taste, touch, or smell that identifies this hospital or nursing home as distinctively Catholic...
...They cooperate in cam- and the consequent spiraling rise in health-care costs...
...whether institutions that serve largely non-Catholic patient populations and that increasingly rely on precarious Medicare and Medicaid funding can remain committed to a unique Catholic mission...
...All our imagined admission episodes above-and our actual C hospitals are church-operated...
...First, the institu- church is the "earthly representation of the sign of salvations undertaking them harbor all of the internal tensions tion in heaven...
...Will the employees handle your mother physically in any different way...
...Unless such a sense is palpable and routinely care units to allow families more access to their loved ones...
...With tinctly Catholic, even when they meet their medical and eco- trends that include shorter hospital stays and the fragmennomic challenges successfully...
...Case Three...
...Additional internal Catholic life...
...iven these challenges, what should those • Second, technological progress carries unintended consecharged with maintaining and broadening quences...
...Further, Catholic institutions keep vital principles before the public-the protection of life, commitment to social justice and the common good, service to the poor-principles all too likely to be lost in society's contradictory double quest for medical miracles and cost containment...
...In a 1995 statement on the "Rationale of Catholic world parallels higher education in its debate over the 1990 Health Care," the bishops of New Jersey stress its sacra- apostolic constitution Ex corde ecclesiae, and the nation's bishmental character and centrality to the church's mission...
...A case in point: Be- logical "progress" in contemporary medicine, and should cause breakfast is often the only meal cancer patients enjoy, make it clear that they exist to care for the whole person, not Calvary Hospital in the Bronx, New York, goes to great to propagate the latest "medical breakthrough...
...Catholic health-care institutions have ridden out many storms over the last century and a half, and have proved unusually resilient...
...One example is Campaign 2000, the CHA's commitment to place health-care reform at the top of the agenda for the 2000 elections and to develop a national consensus during the next three years on accessible and affordable health care for all Americans...
...What might you see that reassures you, that quickens your spirit in the midst of anxiety...
...Catholics, therefore, are and the assumed irrelevance of the church's moral teach- a sacramental people and the Eucharist is the center of ings to many self-identified Catholics...
...noticeable in Catholic health-care institutions, the institu- Stories about Catholic facilities indistinguishable from their tions fail the "identity challenge" of what makes them dis- secular counterparts, though, are all too common...
...formerly suffused with Catholicity...
...see sidebar...
...He asks about pub- Catholic life inform Catholicism's distinctive quality...
...lengths to insure that patients do so...
...What you will not see are the women religious who formerly dominated the daily life of the institutions they founded and who incarnated its Catholic identity...
...whether increasingly lay and non-Catholic executives and boards can adequately replace the women religious whose orders founded their organizations...
...This is not to deny that millions of persons benefit pastoral care or sacramental environments as part of their from the advances of medical science...
...a chapel...
...tance to local communities...
...The health-care Case Two...
...Here ically disabled and their families ill-equipped to cope, fiis a brief set of recommendations...
...statues of the Virgin or saints quite likely...
Vol. 127 • February 2000 • No. 4
