Franciscans and Healthcare: What is the Future?

THE HEALTHCARE INSTITUTION AND FRANCISCAN IDENTITY

99 THE HEALTHCARE INSTITUTION AND FRANCISCAN IDENTITY Thomas A. Nairn, O.F.M. As I began to work on this paper, I soon realized that the deceptively simple title (and the related questions posed in the brochure) created all sorts of problematical questions. On the one hand, it raises questions about the meaning of Franciscan identity—an issue that many Franciscan controversies have not yet resolved. On the other hand, it raises questions about the relationship between Franciscans and Church institutions, an area in which Franciscans may feel less than comfortable. Yet in the context of what is happening both in the Church and in healthcare today, we can no longer avoid either question. Regarding the latter question, for example, J. Bryan Hehir has issued the following challenge: If one seeks to influence, shape, direct, heal, elevate, and enrich a complex industrial democracy, it cannot be done simply by the integrity of individual witness. It is done by institutions that lay hands on life at the critical points where life can be injured or fostered, where people are born and die, where they learn and teach, where they are cured and healed, and where they are assisted when in trouble. In a large, complex democracy like ours, institutions ultimately always make a difference for good or for ill. 1 But how are our institutions affected not merely by Catholic identity, but by Franciscan identity? How do we engage the largest not-for-profit healthcare system in the United States not only as Catholics but as Franciscans? Do we, as Franciscans, have available to us a spirituality that can speak to institutions as well as to individuals and that can add something substantive to the myriads of words that have been used in discussing the Catholic identity of healthcare institutions? 1 Bryan J. Hehir, “Identity and Institutions” Health Progress, 76.6 (Nov.-Dec., 1995): Internet version. 100 THOMAS A. NAIRN, O.F.M. I am not really sure that I am able to answer these questions in an adequate manner, but I would like to try by looking at the ways in which not only our Catholic tradition but more especially our Franciscan tradition may be available to us. It is part of the genius of the Catholic moral tradition that when dealing with new issues and problems we seldom need to re-invent the wheel. Rather, we depend on what I often refer to as the “three Rs”—not reading, ‘riting. and ‘rithmatic but “reacting, retrieving. and reconstructing.” Our tradition affords us a means of moving forward by using the past. First, as we react to the immediate past, we are able to retrieve from our tradition a larger, more dynamic past. Yet, we never merely repeat this past but in fact reconstruct as we move the tradition forward. When I saw the questions on the brochure: “For what will we put ourselves at risk? What is non-negotiable?” this way of proceeding came to mind. Reacting To discover what we are reacting to, let us take a look at some elements of the present experience of those involved in Catholic healthcare in the United States. We are part of the largest not-forprofit healthcare system in the United States, but many of us do not necessarily see in this fact an object of pride. The questions raised in the brochure—For what will we put ourselves at risk? What is non-negotiable and must remain constant?—seem to express not pride but rather the frustration that sponsors and administrators currently feel. Our healthcare systems began as agencies to serve the needs of often neglected poor immigrant Catholics and others requiring such services. For a very long time it was simply supposed by many communities within the United States that hospitals were the responsibility of religious congregations, especially congregations of women religious—they were their means of rninistry. But in the past two or three decades, as the place of medicine became more critical in American life, healthcare—especially healthcare technology—may have become a run-away train. We cannot get off the train, but we don’t know where it is going, and we’re really not sure if we are going to like where it is taking us. THE HEALTHCARE INSTITUTION AND FRANCISCAN IDENTITY 101 Those in Catholic healthcare remain uneasy. Where does Catholic healthcare fit in American life? in American Catholic Church life? Despite the...