Among the proudest achievements of American Catholic history was its pioneer efforts in founding hospitals in difficult times, staffing them with dedicated religious and laity, and providing medical care to the poor and needy, often against great odds. The evangelizing power of the Catholic hospital in America has been enormous and the source of great goodwill on the part of many non-Catholics toward the Catholic Church.
But Catholic hospitals are in a state of crisis. Many of the religious congregations that founded them are sadly dying, and the pool of talented religious capable of running and staffing hospitals is being depleted. Slowly the leadership of Catholic hospitals is moving to boards of trustees with a lesser commitment to the religious tradition of the hospital. The process of Catholic hospitals being sold off to secular interests is increasing.
The Catholic identity of hospitals is also being eroded from within. Clergy and religious no longer maintain their once visible and pervasive presence in the institution. The Catholic chaplaincy has been marginalized in recent years as interdenominational pastoral care and social work departments, founded on the clinical pastoral care education model (about which I have considerable reservations), have taken over.
The Eucharist and the sacraments no longer hold pride of place. The centrality of the hospital chapel, the daily semi-public devotions, and the symbols of Catholic faith are vanishing. The faith identity of doctors, nurses, and support staff has become a virtual non-issue.
Is this situation reversible? I believe it is. But the solutions necessary will have to be dramatic. On the part of shrinking religious congregations, the way forward will require the prophetic sacrifice of entrusting their hospitals to local bishops. Many bishops will balk at this suggestion, but there appear to be few acceptable alternatives.
The bishops, in turn, will need to undertake a rigorous review of the secularizing direction Catholic hospitals have taken in recent decades and devise a fairly massive and comprehensive effort to restore Catholic identity.
Because hospitals involve massive administrative and financial resources, the bishops will have to enlist the assistance of talented and industrious lay leaders deeply committed to the Catholic faith and capable of providing for the future the exceptional administrative and financial skills that over 200 years have built up the Catholic institutional infrastructure in the United States.
Some might suggest that I am advocating a sectarian model of Catholic hospitals. I would answer that the Catholic hospital in the United States has never been sectarian. It has always combined strong and visible Catholic identity with conscious service to all segments of society. This combination has been the formula for its success.
The restoration of the Catholic character of hospitals is not an end in itself. It is a key to the very possibility of Catholicism making a distinctive contribution to the world of modern American health care. Hospitals represent one of the principal means by which Catholicism can continue to evangelize the increasingly secularized world of illness, health and death, as well as have an effective voice in the areas of medical ethics and social policy.
This is crucial at a time when our culture is increasingly uncaring about the unborn, the poor, the old and the dying, and is willing to experiment with human life in very troubling ways.
The Catholic hospital can again become a city on a hill. The alternative is the slow death that presently looms large, despite the protestations and genuine goodwill of the present Catholic health care leadership in the United States.
Msgr. Mannion is pastor emeritus of St. Vincent de Paul Parish, Salt Lake City.