BY: JUDY CASSIDY
The concept of the common good seems, on the face of it, as simple as a seemingly white diamond. But as a diamond held to the light sparkles with many colors, so the common good, when examined critically, reveals its many facets. As one tries to analyze how an action affects the common good, suddenly the questions flash brightly: Why does concern for the common good matter, especially to those in Catholic healthcare? How can we balance the individual's rights with those of the broader population? In a pluralistic society, how can we reach a consensus on the meaning of the common good?
Ronald F. Thiemann, PhD, and Rev. Charles E. Bouchard, OP, STD, helped Catholic healthcare ethicists grapple with these questions at the Catholic Health Association's invitational Theology and Ethics Colloquium in March.
Thiemann, dean of the Harvard University School of Divinity, Cambridge, MA, disagrees with cultural critics whose predictions indicate that Americans are slipping away from interest in society's common good. Some analysts say that American society is fragmenting into hostile enclaves polarized by disputes over such issues as abortion, welfare reform, gay rights, and race relations. But American democracy, Thiemann pointed out, was built on a framework in which immigrants identified with their native culture while at the same time forging an American identity. American citizens of all ethnic origins valued liberty, equality, and mutual respect. The current stridency in arguments among opposing groups may be a sign that democracy is robust and not weakening, he said. Research Thiemann cited indicates that Americans are tolerant of others' views in most areas of disagreement.
Religion Offers Hope for America
Unlike writers who stress the polarizing of groups in America, Thiemann is hopeful that the nation can succeed in developing citizens "capable of living in conflicting worlds of meaning" while maintaining an American identity. He believes communities of faith can contribute to that task by developing a theology of pluralism.
Religious people, he said, bring a set of convictions and principles to the public debate and provide a context for critiquing any democratic regime. They are well equipped to deal with the conflicting commitments among which pluralistic values may force them to choose, he said. For example, people of faith know that love of a spouse, a child, a job, or a nation cannot substitute for love of God.
Thiemann insisted that pluralism does not mean that an individual must embrace another's beliefs — only that one must be open to the ideas and views of others. If people begin to question their own beliefs, they should turn to activities that renew their faith, rather than turning absolutist, Thiemann advised. "The risk of not questioning is greater than the risk of questioning," he warned.
Making It Real
"How can society live out the values it shares?" a meeting participant asked. Thiemann said that living out values "requires practices that have decayed and that people of faith need to restore." For example, Harvard's Center for the Study of Values in Public Life, which Thiemann founded, brings together religious and secular scholars to discuss society's obligations and how to meet them. Local communities need opportunities to talk about issues such as the impact of closing a hospital, Thiemann added. He suggested churches as places where people can discuss issues and learn how to work with others with whom they disagree.
Value of the Catholic World View
Fr. Bouchard also stressed faith's practical impact on society and the delivery of healthcare in a pluralistic, market-driven arena. He said the Catholic view of the world and of the social nature of the person can further the notion of the common good. According to Fr. Bouchard, president of the Aquinas Institute of Theology, St. Louis, we need to find effective ways to help both patients and providers see themselves as part of society and develop the ability to understand others' views.
Seeking to define the common good, Fr. Bouchard traced the Catholic tradition. He cited a helpful definition of the concept in the 1994 Catechism of the Catholic Church, which says that to serve the common good, authority's function is to arbitrate between various particular interests and to make accessible to people what they need "to lead a truly human life" (e.g., food, clothing, health, work, education, and culture).
But three factors — the economic prosperity of the United States, its citizens' growing indifference to politics, and its emphasis on controlling one's own destiny — "render American cultural soil inhospitable to most notions of the common good," he said. In healthcare, for example, patients, providers, and insurers all defend their own competing interests.
Theological Elements of the Common Good
An understanding of Catholic tradition can help overcome these impediments, Fr. Bouchard said. He explained the theological elements that form the foundation for Catholic social thought regarding the common good:
- Belief that people are created into the image of God. Fr. Bouchard said the word "into," as used by St. Thomas Aquinas in the Summa, suggests that "the moral life is a dynamic movement into the image of God, who has revealed himself through Scripture and human experience." Bouchard said this view implies that "God's plan for us is planted deeply within us," and we can take steps to achieve that plan. "We are able to participate intelligently in our own destinies."
Although this belief suggests that God has endowed each person with "an exquisite, unfettered freedom," it must be tempered by an understanding of the diversity and unity within the Trinity, Bouchard said. The Trinity analogy reminds us that "we are called to achieve our goal and purpose — but with one another," he said. The tendency to act in community "is essential to what it means to be human," he added. - Belief in human beings' supernatural destiny. If we believe that we were created to know, love, and serve God in this world and to be happy with God forever in the next world, Bouchard said, we must be willing to acknowledge, "happily," that there are limits to healthcare.
- The conviction that grace perfects nature. This element, Fr. Bouchard said, suggests that human nature can be perfected by God's grace. Further, despite original sin, human actions, including healing, are not just goods in themselves; they also are sacramental because they mediate God's grace. "Healing touches us at both a social and spiritual level, and bears the possibility of redemption," he said. Acts of healing can actually make grace present, Bouchard suggested. "Would Catholic healthcare be different if we — and our employees — really believed that?" he asked.
Implications for Management
If healthcare leaders are convinced of the theological basis and truth of the notion of the common good, they must address implications for management. Their management styles must contribute to the good of employees and patients. Fr. Bouchard said mission education must be a top priority for employees so that they can participate fully in the organization. Patients, physicians, and staff need education in their responsibility to choose appropriate medical care in light of what is best not only for the individual but for society as a whole.
Managers must learn to conduct their organizations in a manner that recognizes broader interests than their company's. The need to do so is especially imperative for Catholic healthcare because it is a huge public presence, Bouchard noted. "Catholic healthcare systems must gently but persistently bring the values of community, rooted in the Trinity and in our belief in a supernatural destiny, into the larger public debate."
Judy Cassidy is editor, Health Progress.