| |||||||||||||||||||||||||||||||
questions answered
by wm. b. smith
Cooperation Revisited
Question: Your July 1996 Q/A on "Cooperation in Health Care" seems to be at odds with the "Ethical and Religious Directives" on cooperation. Are you with the Church on this or not?
Answer: I certainly hope I am with the Church, if not, I would just as certainly retract my opinion as mistaken if it were truly against Church teaching.
The real question here is precisely what does the Church teach. You mention that the "Ethical and Religious Directives for Catholic Health Care Services" (1994) do have a one page Appendix: "The Principles Governing Cooperation" (p. 29).
This is true. It is also true that I do not believe that that Appendix is either well-stated or well-reasoned. In fact, I think it's a bit misleading.
One reason for saying that is some history of questionable citation. Concerning hospital partnerships, joint ventures, mergers, co-sponsors, etc., we are all in debt to Fr. Russell Smith for his printed contributions to this difficult area; e.g., his article in Linacre Quarterly 63:2 (May 1996) 87-96; and his prior efforts at the Workshop for Bishops, Dallas Texas: (1994) 81-92; (1995) 217-231.
As Fr. R. Smith has correctly pointed out, not all that much has been written about institutional cooperation. While that is true in part, it is not all that's true.
By some curious twist of fate, much confusion can be traced back to great clarity. Back in the early 1970s, the Bishops of the U.S. posed some moral and practical questions to Rome concerning sterilization in Catholic hospitals. Technically, the question then posed was whether Directive #20 (in the 1971 Directives) was correct as it read in view of the fact that some theologians don't accept it or teach it, and that it could raise serious practical problems like closing hospitals, conflicts with personnel, possible polarization, etc.
On March 13, 1975, the Congregation for the Doctrine of the Faith issued an authoritative response: "Sterilization in Catholic Hospitals" (cf. Origins 6 [6/10/76] pp. 33; 35; also in A. Flannery, vol. 2 [1982] pp. 454-455.
To my mind, this official response is a pearl of theological precision and doctrinal clarity. Since it is only 6 or 7 paragraphs in length, it is easily read and should be read since it clearly answers the questions posed. It is so clear it needs no commentary.
In those pre Veritatis Splendor days, it was my opinion (printed in Linacre Quarterly 44 [May 1977] 107-118) that the CDF was clearly correct and that competing and counter voices (C. Curran Ongoing Revision (1975) 210-248; R. McCormick TS 37 (1976) 471-477; and K. O'Rourke, Hospital Progress 57 [May 1977] 68-75; 80) were clearly wrong about cooperation in sterilization.
As above, the CDF Response (3/13/75) was exceptionally clear and to the point. To my personal amazement, after unusual delay, a subcommittee of the USCC on Health Affairs with the approval (35-3) of the Administrative Board of the NCCB published a "Commentary" (September 15, 1977) on the CDF Reply (3/15/75). This Commentary can be found in Origins 7:25 (12/25/77) pp. 399-400 and also as an 11 page pamphlet from the USCC (#B-127).
As clear as the CDF Reply (1975) is, so unclear in parts is the USCC Commentary (1977). For example, the prominent and crucial mention given to "duress" in the understanding of the principles of cooperation in the 1994 Directives (p. 29). However, the term "duress" never appears in the CDF Reply (1975), that term first emerges in the USCC Commentary (1977; #2).
Next, the overly simple distinction re cooperation that the object of the cooperator must be distinguishable from that of the wrongdoer (1994 Directives, p. 29) is a distinction that does not appear in the CDF Reply (1975) but again emerges first in the USCC Commentary: the distinction between the reason for the sterilization and the reason for the cooperation (1977, #4). This reduces the moral question largely to a matter of intentionality only, the justification being: will it do more harm than good? (Commentary [1977] #2).
This more-harm-than-good calculus cries out for clarification. What kind of goods (or evils) are being calculated? Closing a service or a hospital? Loss of revenue or catchment? Are these financial and functioning "goods" to be measured and calculated against moral goods or moral evils? The Commentary (1977) does not say, but it surely opens the way for a "proportionalist" reading and calculation in those pre Veritatis Splendor (1993) days. The USCC Commentary seemed more intent on not offending the McCormick school of "proportionalism" than in faithfully rendering the clear teaching of the CDF Reply.
While I still value the several printed contributions of Fr. R. Smith, it is here that I differ with him and from him. He writes (LQ 63:2 [May 1996] p. 93) that both the USCC Commentary and the CDF Reply address "duress" and then tries to discern the nature of the "duress" both documents have in mind. The CDF Reply never mentioned "duress," let alone spelled out its nature.
Unfortunately, the recent "Ethical and Religious Directives" (1994) in their Appendix on "The Principles Governing Cooperation" relies more heavily on the USCC Commentary (1977) than on the CDF Reply (1975). To me, that is the basic misstep that is no small part of the confusion here.
The traditional doctrine on "Cooperation" was articulated for, developed in and applied to INDIVIDUALS not INSTITUTIONS, especially Catholic INSTITUTIONS! The easy transfer of these principles from individuals to institutions is not easy and rarely legitimate.
Indeed, while the placement of the Appendix on Cooperation in the 1994 Directives was aimed at the current situation of institutional mergers, joint ventures, co-sponsors, etc., the principles as they read there (even misstated) are examples of individual cooperation rather than institutional cooperation. When a Catholic institution ends up owning, sponsoring or otherwise merging their Catholic mission with the delivery or sponsorship of what the Catholic Church forbids, the reality of positive scandal also demands a correct statement of principles rather than a misleading one.
No one can deny the very difficult problems that do arise in these areas today-great challenges both to the viability and identity of Catholic health care institutions. But faulty explanations of "material cooperation" will only preserve viability for a while, then in time, both viability and identity will be compromised.
To Play is to Pray?
Question: A "creative" liturgist keeps telling me that mimes and sacred show are a legitimate part of sacred worship. Is this so?
Answer: Your letter also states that this was done for the Pope at Denver when he visited there. It might be more accurate to say it was done to the Pope rather than for the Pope. Mercifully, the Pope did not have to witness this "creative" version of Sister Act.
By "sacred worship," I take it you mean the celebration of the sacraments and the liturgy of the hours. It seems clear to me that mimes and show plays are not part of the rubrics of the seven sacraments and are contrary to them.
"Masses for Children"-which I take it are not precisely the same as what are now commonly called "Family Masses"-can allow options and adaptations not permitted in regular worship.
Apart from proper worship and sacraments, different questions might arise about the use of a church for concerts or religious plays. Canon 1210 of the Code (1983) distinguishes things that: (1) serve the exercise of worship, piety or religion; (2) secular uses not opposed to the sanctity of the place (which the Ordinary can authorize); and (3) secular uses contrary to the sanctity of the place, which cannot be allowed. On concerts in church, the Letter of the Congregation for Divine Worship (11/5/87) would govern judgments in this regard (cf. Notitiae 24 [1988] 3-10).
History is not entirely silent on "mimes." The IV Lateran Council (1215) in chapter 16 "On the Dress of Clerics" determined, among other things, "[Clerics] should not watch mimes (mimis), entertainers (ioculatoribus) and actors (historionibus). Let them avoid taverns altogether, unless by chance they are obliged by necessity on a journey. They should not play at games of chance or dice, nor be present at such games. . . ." (N.P. Tanner, Decrees of the Ecumenical Councils, vol. 1 [1990] p. 243. Often in morals we don't have to invent new things but simply remember what has been forgotten.
Please address questions to Msgr. Wm. B. Smith, St. Joseph's Seminary, Dunwoodie, Yonkers, N.Y. 10704. n