BEND — The ongoing discussion surrounding health care in America has caused me once again to reflect on what it means to be a Catholic health care facility. This is an important question for its answer may be the same as the answer to the question about what constitutes a Catholic school, college or university. It also touches, at least to a small degree, the question of what it means for an individual teacher, physician, politician or lay person to be “Catholic.” From a strictly canonical point of view what it means to be Catholic is defined in Canon 205. There we read, “Those baptized are fully in the communion of the Catholic Church on this earth who are joined with Christ in its visible structure by the bonds of the profession of faith, the sacraments, and ecclesiastical governance.” In general, a baptized individual who views himself as believing what the Church believes, accepts the teaching about the sacraments and submits himself to ecclesiastical authority is Catholic. The Church does not normally make individualized assessments about the authenticity of an individual’s Catholicity unless the greater good of the People of God requires this to be done. As we discussed last week, public servants whose public views, expressed and held, seem to be diametrically opposed to the clear teaching of the Church may be out of communion with the Church even if that lack of communion is not officially declared. In some serious instances that lack of communion is so explicit and so public that it demands an official response.

A similar situation arises with Catholic institutions, particularly universities and hospitals. Here, too, it is not uncommon for faithful Catholics to question the Catholicity of these public institutions especially when they seem to be expressing and holding public views which are, or strongly appear to be, contrary to the clear teachings of the Church. At what point are these Institutions no longer “in the communion of the Catholic Church on this earth?”

Here it is important to make a very important distinction and that is the distinction between those who are de facto no longer Catholic because of their rejection of creed, sacrament or authority and those who have been declared so by an official act of the Church. There are, in fact, countless numbers of lapsed Catholics who are no longer Catholic in the practical reality of their lives. These men and women, whether they follow the commandments or not, do not use the sacraments, do not attend Mass regularly and do not strive to deepen their communion with the Church. They are still Catholic since their names remain in some Catholic baptismal register and perhaps even on the roster of some parish but their interior Catholicity, their communion with the Church, is deficient. They may still identify themselves as Catholic but there is more to being Catholic than having one’s name on a roster.

In terms of medical facilities, the concept of Catholicity covers a very broad spectrum. One of the things which it includes is an overall atmosphere and attitude of respect on the part of medical practitioners for patients whether they or their patients are Catholic or not. This could be classified as the virtues or values of Catholicism and they are very important to the notion of the Catholicity of an institution. In addition to the broadly defined virtues and values, there are also particular practices which those virtues and values require and which exemplify them. Translating those virtues and values into concrete action is also a part of what it means to be a Catholic institution. There are some medical practices, for instance, which are mainstream in terms of the medical community, but which are contrary to Catholic values and principles. A Catholic Institution must not only uphold the principles, it must align all of its internal practices, including medical practices, with those principles. These specific practices, as well as a summary of the principles, are contained in a document published by the Catholic bishops of the United States titled: Ethical and Religious Directives for Catholic Health Care Services or, as they are commonly known, ERDs. An institution may be historically Catholic but the interior test of authenticity is whether it abides, as an institution, by the teachings of the Church and, in the case of medical facilities, with the ERDs.
In the case of individuals the bishop may speak to the question of Catholicity when public good demands it but in the case of public institutions that bear the name Catholic it is the bishop’s responsibility to positively affirm the Catholicity of the institution and its practices. This is the meaning of Canon 216, which states, in part, “Nevertheless, no undertaking is to claim the name Catholic without the consent of competent ecclesiastical authority.” Thus, an institution is identified as Catholic precisely because the bishop has given his consent for the use of that title. This giving of consent, however, is not only a one-time event. It is rather the establishment of an ongoing consensual relationship and persists only as long as the bishop continues to give his consent. That consent is conditioned on the actual Catholicity of the institution and, in the case of medical facilities, on the actual implementation of the ERDs and other Catholic principles.

The withdrawal of consent to use the name Catholic is equivalent to declaring that the institution is no longer in communion with the Catholic Church. This is a drastic step, but when it is clear that the medical practices of the institution are contrary to the ERDs in very important matters and that there is little hope of reform, then true catholicity is absent and it is proper that such an absence be acknowledged publicly.

When an institution is Catholic, measured by its fidelity to the Church and its adherence to the ERDs, the bishop’s approval affirms that it is fitting also to identify it as Catholic. The bishop’s official relationship with the institution affirms that he believes that the medical practices there are consistent with the teachings of the Catholic Church and the Ethical and Religious Directives for Catholic Health Care Services.