Fr Billy Swan
The headline of an article recently published in a local newspaper caught my attention: ‘Church has no Business Running Hospitals, Schools, Society’ (Wexford People, 4th May 2022).
I have been a priest now for 24 years. None of those who were part of my training or anyone since then has ever told me that the Church claims the right to run hospitals, schools or society. There is no official Church teaching anywhere that claims such a right. In fact, the opposite is true. In 1965, the Second Vatican Council affirmed the autonomy of States and the distinction between the religious and political spheres (cf. Gaudium et Spes, 76). This distinction has been recognized by the Church as something that belongs to the inheritance of contemporary civilization.
However, what the Church does not accept is the prospect of such autonomy understood as independence of the moral law. This moral law is grounded in the respect for the truth and justice. According to the Compendium of the Social Doctrine of the Church, ‘a sincere quest for the truth using legitimate means to promote and defend the moral truths concerning social life – justice, freedom, respect for life and for other human rights – is a right and duty of all members of a social and political community’ (Compendium, 571).
Therefore, while the Church has interests in the welfare of people in the fields of healthcare, education and the kind of society we inhabit, it does not seek to run them. The Church believes that the areas of education and healthcare are domains that require the highest standards of moral integrity, ensured by an ethos and values that uphold the dignity of all. Policies, curricula and decisions made in schools, hospitals and governments do not take place in a moral vacuum or a morally neutral space. Rather they are informed by and shaped by some values and ought to be directed to some good.
The recent controversy about ownership of the National Maternity Hospital brought the issue of Catholic ethos sharply into focus. The central issue played out in the media and on social media was that medical procedures in the hospital should not be influenced by Catholic ethos. Why? Because Catholic ethos, it is assumed, is an imposition, irrational and unscientific. It is, in the article mentioned above: ‘the slavish following of another’s opinions without questioning’.
As the debate blazed out in public, the dominant issue quickly became that of control. Who controls our hospitals and schools, Church or State? There was a chorus of loud arguments that employed the tactic that in order for the State to ensure control, it needed to demonize Catholic ethos as irrational and dangerous, turning public opinion against it. Catholic ethos was unfairly portrayed as being opposed to fundamental values of healthcare such as compassion and based on mythical beliefs.
The curious thing was that few bothered to find out what Catholic ethos is and the values it stands for. What are the values that uphold a Catholic ethos and can we debate them? This did not happen. The other curious anomaly in the controversy was the assumption that in a State controlled healthcare institution free from religious influence and ethos, medical personnel would be suddenly free to operate in total freedom and independence. But in such a hospital, there are always values that underpin decisions. There is no such place as an ethos free environment. One ethos simply replaces another. And if there is a new ethos, what are those values and principles in operation and who decides what they are? Should we not allow these ‘modern values’ and new ethos to dialogue with older values and a Catholic ethos? Sadly, this engagement and dialogue of values didn’t happen.
So what is a Catholic ethos in healthcare and why are so many trying so hard to tarnish it? A Catholic ethos is a prevailing value system and culture of wholistic care that serves the good of the people concerned. It seeks to enshrine core values that are based on an understanding of the human person with unalienable rights that must be acknowledged rather than conferred. It seeks to uphold those rights with the principals of justice, mercy, compassion and respect for both faith and reason. It acknowledges, protects and cares for the essential physical and spiritual dimensions of the human person – their physical welfare but also their emotional and overall wellbeing. When there is a clash of rights, or a dilemma faced by medical staff, a Catholic ethos provides a series of principals and guidelines that adhere to truth and the pursuit of justice. One example of this would be the principle of double-effect whereby an unintended evil is morally permissible as a direct consequence of trying to attain the good.
A Catholic ethos also includes the principle of non-maleficence which refuses to acknowledge the doing of harm as part of healthcare. Such is the dignity of the human person that a Catholic ethos is always guided towards the good and avoidance of evil or harm. This principle not only stands at the foundation of Catholic ethos in healthcare but remains at the heart of ethics and law, founded on justice and rights. The Church believes this principle to be so important that if it decays within a culture, then it is inevitable that the rest of ethics, justice, rights and law will fall along with it.
This is the component of a Catholic ethos that is the greatest reason for its opposition and is the reason why the Church refuses to acknowledge abortion as part of healthcare. This she does for good reason. Look at America and the legalization of abortion there in 1973 with Roe vs Wade. Almost 50 years later and after about 70 millions deaths, there are reports that it may be overturned – not because of religious reasons but because there continues to be serious legal and moral problems with the initial ruling that has led to the deaths of so many. At the time of the ruling, the question arose of when human life begins. Since then, scientific advancement in sonogram technology has served to strengthen the case of the Church’s position, namely that life begins at conception. So in this case, scientific progress has strengthened the Church’s case, not weakened it.
Here in Ireland, we scramble to normalize abortion as part of health care and justify it under the slogan of ‘clinical independence’. America tried to do this in 1973. Almost fifty years later, there is more doubt than ever that this or any slogan can ease the disturbed conscience of a nation around this issue and the ethical and moral problems that simply won’t go away.
We would do well to remember the examples from history when States who sanctioned practices and laws while silencing opposing voices, have been humbled by their own arrogance in the fullness of time. Just because something is legal does not mean it is moral. It is also a red flag when the public debate around such issues moves away from truth and towards control, as it did in the case of the National Maternity Hospital controversy. A civilization based on who decides what’s true rather than what is actually true, is build on sand and will inevitably fall. This is true even if it is the State who decides what is true or the majority of citizens within that State who have voted away the rights of others. Morality based on majority opinion does not guarantee that it is ethical or just. This was the lesson from history and totalitarianism in places like Russia in the last century which forced people to accept, or at least not oppose, falsehoods and propaganda that were based not on truth but control.
One man who resisted this movement was Aleksandr Solzhenitsyn (1918-2008). In his final message to the Russian people before his exile to the West in 1974, he urged the Russian people to ‘live not by lies!’ Such focus on truth became the core of the anti-totalitarian resistance. For Solzhenitsyn and others, living within the truth is an attempt to regain control over our freedom and responsibility. It is the first step at re-building a culture where rights are relative to who decides them and who confers them.
In the recent controversy over the National Maternity Hospital, Catholic ethos was sullied and tarnished without fully engaging with the values of what it enshrines. The conversation took and dangerous and worrying turn towards the issue of control and away from the foundation of truth. As Solzhenitsyn reminds us, this is the slippery slope towards totalitarianism. So while the Church does not seek to control healthcare, she defends her ethos in the welfare of people at the most vulnerable time of their lives. I hope this article has helped Catholics appreciate better what a Catholic ethos looks like. I hope it articulates and gives concrete shape to our vision of healthcare as essentially a humanising endeavour characterised by love, hope, justice and the pursuit of all that is good and true.