Catholic Health Care in Canada Maintaining Catholic Identity in an Evolving Context

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Catholic Health Care in Canada Maintaining Catholic Identity in an Evolving Context Sister Bonnie MacLellan, csj, PhD, JCD bmaclellan@csjssm.ca 705-493-7874 (Cell) 8/12/2018 1

Agenda Identity Definition Lenses Code of Canon Law Common & Constant Opinion of Learned Persons Identity in Context World transitions Church transitions Catholic Identity of sponsored apostolates Essential Elements Value-Added of Catholic Health Care Internal Criteria External Criteria Leadership Requirements Questions

What is Identity? Sameness of essential characteristics Merrimam-Webster.com 9/20/2018 3

Catholic Identity Defined in the Code? Can. 19 If a custom or an express prescript of universal or particular law is lacking in a certain matter, a case, unless it is penal, must be resolved in light of laws issued in similar matters, general principles of law applied with canonical equity, the jurisprudence and practice of the Roman Curia, and the common and constant opinion of learned persons.

Laws Issued in Similar Matters Can. 216 Since they participate in the mission of the Church, all the Christian faithful have the right to promote or sustain apostolic action even by their own undertakings, according to their own state and condition. Nevertheless, no undertaking is to claim the name Catholic without the consent of competent ecclesiastical authority. Can. 222 1. The Christian faithful are obliged to assist with the needs of the Church so that the Church has what is necessary for divine worship, for the works of the apostolate and of charity, and for the decent support of ministers.

Laws Issued in Similar Matters Can. 300 No association is to assume the name Catholic without the consent of competent ecclesiastical authority according to the norm of can. 312. Can. 803 3. Even if it is in fact Catholic, no school is to bear the name Catholic school without the consent of competent ecclesiastical authority. 9/20/2018 6

Constant Opinion of Learned Persons Cannot be legislated (Morrisey 2011) Self-engaging-in-context (Fitzgerald, 1993) It might be wise to speak of Catholic identities in the plural (Steinfels, 2003) Catholic Identity or Identities? (Arbuckle) No longer can we view a culture as a unifying, unchanging, and homogenizing force [hence] individuals have a multiplicity of potential identities because the context in which they are living, working and recreating is continually changing (Arbuckle, 2013, loc. 394) 9/20/2018 7

Can Catholic Identity be Defined? Not in concrete Flexible yet rooted Solid Foundation Responding to the real world Our Context 8/12/2018 8

Contextual Lenses 9/20/2018 9

Changing Canada: Changing Health Care 1639 L Hȏtel-Dieu de Québec(Augustinian Sisters) 1947 Saskatchewan - First Universal Hospital Care 1957 Federal/Provincial Funding for health care 8/12/2018 10

Pre-Vatican II Hospitals Nursing Homes Religious Institutes Orphanages Schools 8/12/2018 11

Post Vatican II Identity Rooted in Baptism Shared by all Holy People of God share also in Christ s prophetic witness ( LG, no. 12) 8/12/2018 12

Fulfilling the Church s Mission As you go, preach this message: The kingdom of heaven is near. Heal the sick, raise the dead, cleanse the lepers, drive out demons. Freely you have received; freely give. (Matt. 10: 7-8) 8/12/2018 13

Catholic Faith in the World Context Catholic Population Shift Europe & N America Africa, Asia, & Latin America Aging Population in 1 st and 2 nd World countries Laity ministry in response to fewer religious/clergy Scientific Advances which strain the Church s moral teaching 9/20/2018 14

Place of Religion in our Lives 8/12/2018 15

Self-Identified Religions in Canada Statistics Canada, National Household Survey, 2011 Population Christian Buddhist Hindu Jewish Muslim Sikh Indigenous Spirituality Other Religions No Religious Affiliation 8/12/2018 16

Canada s Religious Composition, 1971-2011 http://www.pewforum.org/2013/06/27/canadas-changing-religious-landscape/ 17

Growth of the Religiously Unaffiliated in Canada & the USA 18

Trends in Canadian Disaffiliation, by Generation 8/12/2018 19

Trends in Canadian Disaffiliation, by Region 20

Religious Composition of Immigrants in Canada By Decade of Arrival 8/12/2018 21

Share of Canadians Belonging to Other Religions By Region 8/12/2018 22

8/12/2018 23

8/12/2018 24

8/12/2018 25

Internal Criteria: Beyond Leadership & Management Preserving unique Catholic ID in larger secular culture Requires Formation Passing on the faith to the next generation Evangelizing a modern and sceptical culture Inspiring individuals to serve 8/12/2018 26

Defining Formation Needs 8/12/2018 27

Call to Ministry 9/20/2018 28

Sponsored Apostolates 9/20/2018 29

PEARL OF GREAT PRICE Tools to Quantify Catholic Identity (Morrisey 2011) Juridic criteria Mission Focus Administration Reserved Powers Institutional Commitment Criteria Criteria based on established & agreed-tovalues 9/20/2018 30

Catholic Identity: Mission Focus Can. 114 2. The purposes [of juridic persons] are understood as those which pertain to works of piety, of the apostolate, or of charity, whether spiritual or temporal. 3. The competent authority of the Church is not to confer juridic personality except on those which pursue a truly useful purpose and, all things considered, possess the means which are foreseen to be sufficient to achieve their designated purpose. 9/20/2018 31

Catholic Identity: Administration Can. 1282 All clerics or lay persons who take part in the administration of ecclesiastical goods by a legitimate title are bound to fulfill their functions in the name of the Church according to the norm of law. 9/20/2018 32

Catholic Identity: Understanding Reserved Power (Hite, Holland, Morrisey, 2012) Approval of the ministry s philosophy and mission as well as any changes to these. Changes in the canonical statutes and bylaws governing the ministry. Vigilance over fidelity to the teaching and laws of the Catholic Church. Approval of acquisitions by whatever means of new works for the public juridic persons. Approval of alienation and debts over the canonical threshold. ($5,473,686 CDN. - Mar 23, 2018) Approval of the admission of new participating entities in the public juridic person. Petitioning for the suppression or dissolution of the public juridic person. 9/20/2018 33

Catholic Identity: Reserved Powers (Morrisey, 2011) Reserved Powers Paper Personnel Property 9/20/2018 34

Catholic Identity: Reserved Powers (Morrisey, 2011) Paper Mission & Philosophy Bylaws Mergers Dissolutions 9/20/2018 35

Catholic Identity: Reserved Powers (Morrisey, 2011) Personnel Board CEO 9/20/2018 36

Catholic Identity: Reserved Powers (Morrisey, 2011) Property Temporal Goods Audits Sale (Alienation) Lease 9/20/2018 37

Catholic Identity: Institutional Commitment Ongoing formation (Can. 774) 9/20/2018 38

Understanding 8/12/2018 39

Catholic Identity: Measuring Against Agreed-upon Values Is a form of Catholicity permeating the establishment? 9/20/2018 40

Agreed-upon Values Beyond Leadership & Management Skills Nature & structure of the Church Authority for mission Role of Diocesan Bishop Catholic social teaching: Foundation for ministry Cultivating fertile soil : formation for canonical governance Application of Health Ethics Guide 8/12/2018 41

8/12/2018 42

Internal Criteria: Authority for Mission 8/12/2018 43

Internal Criteria Role of Diocesan Bishop Can. 394 1. A bishop is to foster various forms of the apostolate in the diocese and is to take care that in the entire diocese or in its particular districts, all the works of the apostolate are coordinated under his direction, with due regard for the proper character of each. 8/12/2018 44

Internal Criteria: Diocesan Bishop All apostolic activity in a particular diocese must be carried out in communion with the diocesan bishop of the place with the ministry is exercised. See F. MORRISEY and S. HOLLAND, Ministerial Juridic Persons and Their Communion with Diocesan Bishops, in Health Progress, vol. 97, no. 6 (2016), 68 Ensure: Ongoing Communication Invitation to Sponsor-forums & Educational events 8/12/2018 45

Internal Criteria: Catholic Social Teaching Key Themes: Life & Dignity of Human Person Call to Family, Community & Participation Protection of Right & Responsibilities of all Preferential Option for the Poor & Vulnerable Dignity of Work and the Rights of Workers Solidarity: We are One Human Family Care for Creation 8/12/2018 46

Internal Criteria: Health Ethics Guides Ethical & Religious Directives Used by Catholic health care in Canada since 1948 Developed & approved by episcopal conferences in Canada USA Australia Framework for health care ministry 8/12/2018 47

Table of Contents Social Nature of Care Dignity of the Human Person Care at the Beginning of Life Care at the End of Life Organ Donation Research Involving Humans Governance & Administration Making Moral Judgements Internal Criteria: Health Ethics Guide 8/12/2018 48

Speaking the Gospel Passing on the faith Evangelizing Inspiring 8/12/2018 49

Beyond Professional Development: Formation Tools Our capacity to sustain Catholic health care as a ministry of the Church depends on our realization that all our activities must flow from the core of who we are, that is, from our spirituality as ministry, we must provide witness as well as service because the call to be mission in the world is also the call to build up the kingdom of God within. (J. DeBlois, The Mission Imperative: Our Foundation and Market Advantage, in Health Progress, vol. 78, no. 2 (1997), 24-27.) Serving as agents of Jesus healing ministry Differentiate Proselytizing and Mission/Values driven ministry

Formation 8/12/2018 51

Catholic Identity: Formation Essentials Human Spiritual Theological Practical pastoral abilities called for in our ministries 9/20/2018 52

Internal Catholic Identity: Faith Under Pressure Ongoing Faith Formation Business Acumen 9/20/2018 53

External Pressures 8/12/2018 54

External Pressures to Maintaining Catholic ID Tensions between faith & political agendas Whoever pays the piper From Charity to Right Affordability Government funding/control Partnerships Chosen or Imposed 8/12/2018 55

External Pressures for Maintaining Catholic ID Mission Margin Tensions Responding with Grace to Scarcity of Access & Funding Public Dialogue Truthful Humble Grateful Canonical Principles 8/12/2018 56

External Pressures for Maintaining Catholic ID Government Funding, Public Demand & Catholic Values Reproductive Services Nutrition & Hydration End-of-life Care 8/12/2018 57

Artificial Nutrition & Hydration Determining when technologies cease being beneficial and become harmful is a major ethical dilemma. Available interventions may not always be morally nor ethically appropriate as part of end-of-life care. Health Ethics Guide Since some pathological conditions experienced by those who are dying prevent normal food ingestion, a decision to forgo or stop medically assisted nutrition and hydration can allow the pathology to run its course without prolonging the dying process. Such a decision is not the same as hastening death. See CHAC, Health Ethics Guide, no. 85, 65. 8/12/2018 58

End of Life Care Physician Assisted Suicide a decision to forgo life-sustaining treatment must not mean abandonment of the person receiving care. Palliative care should always be provided and, the dignity of the person always respected. Health Ethics Guide, no. 78, 62. Treatment decisions can never include actions or omissions that intentionally cause the death of another (euthanasia), or the death of one s self(suicide), as both actions are morally wrong. Health Ethics Guide, nos. 87-89, 66. 8/12/2018 59

Leadership for Catholic Identity 9/20/2018 60

Catholic Identity: Leadership Essentials Commitment to Ongoing Learning/Formation Living our Faith in Context Formation Faith in Culture Prophet Bearers of Hope 9/20/2018 61

New Ways of Embracing Culture Hire for mission Shift from ambivalence about Catholic ministries to a clearer vision of the mission and significance Struggle to define value added Articulate Measure Communicate 9/20/2018 62

Prophets 9/20/2018 63

Bearers of Hope (Bruggemann, W., 2007.) Practicing Hope: Commitment to faith and action Open to newness that will be given by God to us as a gift Interpreting signs of the times 9/20/2018 64

To Heal as Jesus Healed 9/20/2018 65

Leading by Example 9/20/2018 66

Catholic Identity: Mercy in Action "Today we ask the Lord for the whole Church, a conversion towards Jesus, a conversion to Jesus, a conversion to the mercy of Jesus," Francis ended his homily. "And so the law will be fully fulfilled, because the law is to love God and neighbor, as ourselves. (Homily, Pope Francis, Mar 17, 2015) 9/20/2018 67

We live in hope as we continue to serve to bring about the Kingdom of God 9/20/2018 68

Questions/Comments 9/20/2018 69

Thank You 9/20/2018 70