When I first saw mention of “Diagnosis Critical: The Urgent Threats Confronting Catholic Health Care” by Leonard J. Nelson III on Amy Welborn’s blog I knew this was a book I wanted to read. The issue of Catholic Health Care has certainly emerged on this blog as I have covered stories regarding this important subject. There are plenty of comparison between Catholic health care and the Catholic education system with the decline of so-called Catholic identity. But as this author points out in his conclusion the Catholic health care system has faired better in this regard for the most part. Not that there are not major ethical problems which are certainly pointed out.
The title of the book certainly gives it an urgency about the seriousness of some of the real problems. Though this is not a book containing chapter after chapter of horror stories of bad things going on in Catholic health care. The author who is a professor in a school of law and an expert surrounding healthcare law goes way beyond just detailing problems.
In fact the book take as systematic approach and starts with moral theology and especially the Catholic natural law tradition. He gives a good overview of this in regards to health care along with a history of the applicable theology. As you would expect there is coverage of the theologians who have departed from traditional moral theology into relativism, proportionalism, and consequentialism which has caused damage to the culture of life in this area.
In the area of bio-ethics they have tried to create a system apart from natural law that develops a consensus in the secular world. There is of course no such consensus and this area of ethics has turned more and more into defending the indefensible. The Pope in his latest encyclical addressed the problem in this area where ethics has come to mean something entirely unethical
Eventually, those who dissented from Humanae Vitae realized that the traditional natural-law approach did not approved a satisfactory basis for their dissent and began to develop alternative approaches. Building on the principle of double effect, they developed a new approach that deemphasized the application of absolute moral norms.
This paragraph is a very good synopsis of what has happened in theology by dissident theologians throughout the world and not just in health care. Once you separate theology from absolute moral norms than it is no surprise they find reasons that evils such as abortion, contraception, euthanasia, doctor-assisted suicide, and sterilization
He spends five chapters on moral norms that ends with a discussion and history of Ethical and Religious Directives (ERDs) used in Catholic health care settings. The discussion of ERDs is actually very interesting to see how they responded to changing medical technology. They have remained consistent with the teaching of the Church. What has not been consistent is personnel in health care following them.
Again and again throughout the book we are treated to the history behind Catholic health care and I thought this was one of the most important parts to understanding how we got to where we are today. He devotes some time to talking about the transition from hospitals mainly run and staffed by a religious order to the situation we see today where there is some connection to the founding order, but is mostly run by lay people who often are not even Catholics. Plus you have all the mergers and takeovers by Catholic health care systems of secular assets and the problems that has occurred. A couple of chapters detail specific Catholic health care systems and problems that resulted when local bishops and/or the Vatican complained about evils such as surgical sterilization and even abortion occurring at these acquired assets.
There is much in the state of Catholic health care that frankly angers me. Often it seems that some are seeking loopholes instead of following the moral law. While surgical abortion is for the most part not occurring in Catholic hospitals, it has in the past along with other morally dubious practices. But in the area of surgical sterilization they seem to be gaming the system by referring people to other centers or in one case having a hospital within a hospital on the fifth floor of one institution that did it for them. Sterilization is mutilation and destroys a functioning part of the body. There is no medical need for direct sterilization. But it seems like this is a wink-wink situation where “Hey we don’t do this because we are not suppose to, but we will help you out in getting it done.” So much for teaching the Gospel and an actual teaching opportunity of explaining why sterilization is gravely evil. The same goes for contraception and euthanasia where some Catholic health care have formally cooperated with evil.
As this book and in fact the daily news demonstrates is that we are being attacked both from without and within. No we aren’t ready to run to the catacombs, but the government and other outside groups are doing what they can to make Catholic health care not a whit different from secular health care. From within we are being attacked by dissident theologian and those who follow them. Some specific cases of government interference is also covered in this book and goes through some famous cases where legislatures tried to force their will on Catholic institutions by mandating contraceptive coverage or in myriad other ways. Increased pressures by the Culture of Death are certainly trying to force Catholic hospitals into gravely evil areas and the same goes for individuals with the attacks on conscience clauses.
I think we will only see more of these problems especially with the push for national health care. The author makes note of how these mandates for services not allowed under the ERDs is moving ahead and says “Despite these possibilities, Catholic organizations have continue to be strong advocates of a governmental system of universal health care.” When it comes to providing for our neighbor in terms of the Gospel – the government is not our friend. The USCCB calling for national health care even with the caveats they mention is very shortsighted in my opinion. This is not subsidiarily in any way and only funnels our health care dollars through the government so that there will be even less to pay for actual health care. It also opens up our non-profit hospitals for even more attacks at they try to standardize everything. It would be rather ironic if Catholics were forced out of the hospitals considering we were the ones that created them in the first place.
Well I don’t want my review to be longer than the book. But the subjects covered and the thorough way they are covered really makes me want to write about them. This is such and excellent book in so many ways and is not just gloom and doom. There is a lot covered even interesting information about Catholic health care in regards to canon law. For anybody wanting to learn more about Catholic health care from the morality and history on I can’t think of a finer book to recommend. This book is quite well researched and footnoted and the notes take up over a hundred pages at the end.