By PAM SCHAEFFER
ANAHEIM, Calif. — In an overview of the first year of a three-year study to determine membership criteria for CHA — specifically, to determine whether for-profit and non-Catholic organizations can be CHA members — theologian M. Therese Lysaught told participants in a June 3 Innovation Forum during the 2013 Catholic Health Assembly here that several key areas calling for further theological development had emerged. These include:
- Refining understanding of what it means for Catholic health care to be "in communion with" the Catholic Church.
- Updating the principle of moral cooperation in light of recent papal teaching on collaboration for the common good.
- Exploring new ways in which both nonprofit and for-profit organizations might better reflect Catholic social teaching and the call to serve the common good.
Traditionally, CHA bylaws have required that member organizations be Catholic and nonprofit, but after several CHA members entered new partnerships and business structures, the association embarked on the in-depth study of membership criteria that will be rooted in Lysaught's review of the theology underlying Catholic health care and the evolving marketplace. "These are changes that affect us very deeply, at the root of our Catholic identity," said Sr. Patricia Talone, RSM, CHA's vice president of mission services, in an introduction to Lysaught's talk.
White paper
Lysaught's presentation focused on highlights of a just-released CHA white paper, "Caritas in Communion: Theological Foundations of Catholic Health Care." The white paper is based on a year of research and reflection during which Lysaught undertook an extensive review of relevant literature and solicited ongoing feedback from a working group of scholars and theologians, both inside and outside of CHA.
The CHA Board of Trustees reviewed and accepted the 63-page white paper at their April 2013 meeting. That paper, along with a 12-page summary by freelance writer Karen Sue Smith, are available at www.chausa.org on the assembly handouts page. Sr. Talone urged that both the summary and the longer paper be "read and used."
The white paper examines theological foundations of three pivotal issues: Catholic identity as it relates to Catholic health care; the principle of moral cooperation as it applies to developing health care partnerships; and Catholic social and economic thought as it pertains to for-profit health care organizations.
Regarding Catholic identity, Lysaught said its meaning, while incomplete, is evolving, with consensus emerging around seven characteristics. The first three are: Catholic health care is rooted in, and continues to make present to the world the healing ministry of Jesus; the stories of the founding congregations; and the church's social teaching.
Additionally, Lysaught said, Catholic identity is rooted in an understanding that Catholic health care is a ministry of the church; a sacrament, or a sign of Christ's presence; a way of being in communion with the church; and a means of witnessing to the faith.
All of these characteristics are woven together by the theological notion of "caritas," which refers to the way God interacts with the world, she said.
Catholic works
The theology underlying at least two of these areas is, however, incomplete, Lysaught said. Particularly in an era when leadership is shifting from consecrated religious men and women to lay persons, Catholic health care does not neatly fit into historic definitions of "ministry," she said. Also incomplete is the theology underpinning the way Catholic health care signifies its communion with the church. Historically, the sign of that communion has come through validation by the local bishop, but that expression may be insufficient at a time when health systems often extend across several diocesan borders, Lysaught said. Further, she proposed more attention to the distinction within canon law between "Catholic works" — works undertaken in the name of the church — and "works of Catholics," or activities undertaken by Catholics with no official link to the church.
Regarding the principle of moral cooperation, a tool historically used by theologians and ethicists to reflect upon the relationship of a Christian's actions and his or her relationship to another's possible wrongdoing which has recently been used to analyze partnerships between Catholic and other-than-Catholic institutions, Lysaught said her study suggests that this understanding conflicts with a more recent "broad theological mandate," based on the developing theology of Vatican II, and recent papal exhortations, calling for Catholics to cooperate with non-Catholics to further the common good.
People before profits
Lysaught noted an insufficient body of authoritative church teaching and well-developed Catholic economic thought on the concept of profit. She said CHA members' concerns about for-profit organizations mostly relate to the matter of shareholder primacy. Yet, she said, "that reality has started to shift" with the emergence of for-profit structures that have a social purpose at their core. She cited four examples of "hybrid" corporations that put people before profits: the Mondragon Corp., a federation of worker co-operatives in Spain; the worldwide Economy of Communion in which business owners use retained earnings to grow the business and employ more people and directly help people in need; the Grameen Bank, a micro lender; and the "B-Corps," and "Benefit Corporations," both of which strive to create value for society and shareholders.
The deeper question about for-profit organizations and Catholic identity, Lysaught said, involves neither yes, nor no, but how. Both Catholic social teaching and commitment to the common good require Catholic health care to develop "profoundly new ways of understanding the health care enterprise," she said.
Sr. Talone said that during this the second year of the CHA study, the membership task force will examine the "lived experience" of those CHA members that have made changes to their organizational structures that do not fit the current CHA membership criteria.
Regarding theological questions on cooperation, relationship of Catholic health care and the church, and Catholic teaching vis-à-vis economic structures of U.S. health care, Sr. Talone said these are important questions, but outside the scope of the task force's work. "It is our hope that theologians and ethicists, both within and beyond the Catholic health ministry, will reflect upon and respond to these questions, which are so vital to the ministry," she said.