Rooted in charity

Health Progress, Jul/Aug 2002 by Gottmoeller, Doris

Catholic Social Thought Has Shaped the Development of Health Care and Social Service Ministries

The Catholic Church in the United States today can boast of a body of social thought and a body of social works unparalleled by any other denomination. Obviously the development of social teachings-beginning with Rerum Novarum and continuing through the great social encyclicals up through Centesimus Annus, augmented by the documents of the Second Vatican Council, of the synods of bishops, and of the U.S. bishops-is not a distinctively American achievement. But these teachings have been embraced, interpreted, and applied by American bishops and scholars and the faithful in such a way as to make them "our own."

At the same time, the U.S. Catholic Church has founded and continues to oversee a vast array of social service and health care organizations, institutions, agencies, and services. Visits to the Web sites of Catholic Charities USA and the Catholic Health Association (CHA) will reveal the enormous range of services, some of them stretching back into the 19th century, others founded in recent years in response to previously unrecognized or unmet needs.

One might imagine that this evolution of the social teaching tradition, on one hand, and ministerial commitment, on the other, proceeded in a tidy and logical way from principle to practice. In fact, the story is much more complicated. The church launched many of the works that continue to thrive today out of a sense of compassion, with no thought of trying to change the social structures that generated the problems in the first place. At times, the principles enunciated or remedies proposed for social ills were insufficiently in touch with the personal dimensions of human suffering and dysfunction.

We will leave to historians of the U.S. church the task of illuminating all the stages in the rich history of Catholic social thought and ministry development. Today it is probably safe to say that bishops, scholars, ministry leaders, and church members in general-to the extent they think about it-appreciate both the social teachings and the multiple and varied ministries. I would suggest, however, that our appreciation of both dimensions of Catholic life would be enriched enormously by reflecting on five areas of intersection. These are areas in which social principles such as human dignity, concern for the common good, and participation come to life in both the organization and the care it provides, and in which, conversely, the daily work of ministry is renewed and invigorated through the application of principles of social justice.

HUMAN WELL-BEING

The first area of intersection is the interpretation of human well-being. The foundation of Catholic social teaching is that every human being has an inherent dignity as created in the image of God. Because this is so, we believe that all people deserve respect and the opportunity to preserve and enhance their well-being and that of their dependents. When we move beyond this principle into practice, the experience of the helping and healing ministries illuminates what well-being entails. We are keenly aware today of the interdependence of health status, education, housing, and public safety. One's health, in turn, has physical, psychological, and spiritual dimensions. Human dignity and well-being can be threatened or eroded in any of these areas.

This awareness prompts collaboration (such as that exemplified by Phase IV of the New Covenant initiative; see Bishop Joseph M. Sullivan, "Ministering Together," p. 42) among health care providers, social service agencies, schools, and similar service organizations. In health care settings, pastoral care ministers are being integrated into the care-giving team. The ministry is moving away from "silos" of service toward a more integrated approach to the fostering of well-being-which will, in turn, strengthen our understanding of the basic principle.

COMMUNITY BENEFIT

A second area of intersection involves the interpretation of "community benefit." Every health care facility calculates its annual community benefit, using a methodology similar to that promoted by CHA.* The data are then published as an expression of accountability for the tax exemption that not-for-profit institutions enjoy. However, a deeper reason for investment in programs that benefit the community is the desire to live out the principles of human solidarity, participation, and accountability for the common good. Solidarity connotes the interdependence of members of the human community; participation implies involvement in decisions that affect one's well-being; the common good refers to social conditions that allow people to realize their human dignity.

Implementing programs to benefit the community is more difficult than it might seem. It is easy to launch health screening programs that pay a dividend to the hospital in terms of public relations. It is more difficult to involve the community in a needs assessment and design of services-even though needs assessment and design of services, because they require genuine community participation, are likely to be more beneficial in the long run. Helping the needy can be done within a philanthropic, almsgiving framework, without acknowledging or addressing the underlying causes of poverty. Many charitable works were initiated out of benevolent motives that are paternalistic by today's standards. Today we recognize that, to be of lasting benefit to a community, an initiative must take into consideration the social conditions that promote problems-for example, teenage pregnancy, lack of prenatal care, and unemployment-and then address them in partnership with those who experience them.