Journal of Moral Theology, Volume 8, Number 1
152 Pages

Journal of Moral Theology, Volume 8, Number 1


152 Pages


Catholic Health Ministry
Edited by Rachelle Barina, Nathaniel Hibner, and Tobias Winright
Repair Work: Rethinking the Separation of Academic Moral Theologians and Catholic Health Care Ethicists
Paul Wojda
Catholic Bioethicists and Moral Theologians Drifting Apart?: A Sequela of Specialization and Professionalization
Becket Gremmels
Equally Strange Fruit: Catholic Health Care and the Appropriation of Residential Segregation
Cory Mitchell and Therese Lysaught
Hospital and Health System M&A: Is It Good for Community Health?
Michael Panicola63
Accompaniment with the Sick: An Authentic Christian Vocation that Rejects the Fallacy of Prosperity Theology
Ramon Luzarraga76
Grace at the End of Life: Rethinking Ordinary and Extraordinary Means in a Global Context
Conor Kelly89
A Voice in the Wilderness: Reimagining the Role of Catholic Health Care Mission Leader
Michael McCarthy114
Theologians in Catholic Healthcare Ministries: Breaking Beyond the Bond with Ethics
Darren Henson130



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Published 17 January 2019
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VOLUME8,NUMBER1 JANUARY2019 CATHOLICHEALTHMINISTRYEdited byRachelle Barina Nathaniel Hibner Tobias Winright
Journal of Moral Theology is published semiannually, with regular issues in January and June. Our mission is to publish scholarly articles in the field of Catholic moral theology, as well as theological treat-ments of related topics in philosophy, economics, political philosophy, and psychology. Articles published in theJournal of Moral Theologyundergo at least two double blind peer reviews. Authors are asked to submit articles electronically to Submissions should be prepared for blind review. Microsoft Word format preferred. The editors as-sume that submissions are not being simultaneously considered for publication in another venue. Journal of Moral Theologyis available full text in theATLA Religion Database with ATLASerials® (RDB®), a product of the American Theological Library Association. Email:, www: ISSN 2166-2851 (print) ISSN 2166-2118 (online) Journal of Moral Theologyis published by Mount St. Mary’s Univer-sity, 16300 Old Emmitsburg Road, Emmitsburg, MD 21727. Copyright© 2019 individual authors and Mount St. Mary’s Univer-sity. All rights reserved. Except for brief quotations in critical publications or reviews, no part of this book may be reproduced in any manner without prior written permission from the publisher. Write: Permis sions. Wipf and Stock Publishers, 199 W. 8th Ave., Suite 3, Eugene, OR 97401. Pickwick Publications, An Imprint of Wipf and Stock Publishers, 199 W. 8th Ave., Suite 3, Eugene, OR 97401. 13:978-1-5326-7922-3
EDITOR EMERITUS AND UNIVERSITY LIAISON David M. McCarthy,Mount St. Mary’s University EDITORJason King,Saint Vincent College SENIOREDITOR William J. Collinge,Mount St. Mary’s University ASSOCIATE EDITOR M. Therese Lysaught,Loyola University ChicagoMANAGING EDITOR Kathy Criasia,Mount St. Mary’s University BOOK REVIEW EDITORS Kent Lasnoski,Quincy University Christopher McMahon,Saint Vincent College EDITORIAL BOARD Jana M. Bennett,University of DaytonMara Brecht,St. Norbert College Jim Caccamo,St. Joseph’s University Meghan Clark,St. John’s University David Cloutier,The Catholic University of AmericaChristopher Denny,St. John’s University Matthew Gaudet,Santa Clara University Mari Rapela Heidt,Waukesha, WisconsinKelly Johnson,University of Dayton Andrew Kim,Marquette University Warren Kinghorn,Duke University John Love,Mount St. Mary’s Seminary Ramon Luzarraga,Benedictine University, MesaWilliam C. Mattison III,University of Notre Dame Christopher McMahon,Saint Vincent College Mary M. Doyle Roche,College of the Holy Cross Joel Shuman,Kings CollegeMatthew Shadle,Marymount UniversityChristopher P. Vogt,St. John’s UniversityBrian Volck,University of Cincinnati College of MedicinePaul Wadell,St. Norbert CollegeGreg Zuschlag,Oblate School of Theology
JO U R N A L O FMO R A LTH E O L O G YVO L U M E8 ,NU M B E R1 JA N U A R Y2 0 1 9 CO N T E N T SA Note from the Editors  Rachelle Barina, Nathaniel Hibner, Tobias Winright .................1 Repair Work: Rethinking the Separation of Academic Moral Theolo-gians and Catholic Health Care Ethicists  Paul J. Wojda .............................................................................4 Catholic Bioethicists and Moral Theologians Drifting Apart?: A Se-quela of Specialization and Professionalization  Becket Gremmels..................................................................... 22 Equally Strange Fruit: Catholic Health Care and the Appropriation of Residential Segregation  Cory D. Mitchell and M. Therese Lysaught............................ 36 Does Hospital and Health System Consolidation Serve The Common Good?  Michael Panicola ....................................................................63 Accompaniment with the Sick: An Authentic Christian Vocation that Rejects the Fallacy of Prosperity Theology  Ramon Luzarraga.....................................................................76 Grace at the End of Life: Rethinking Ordinary and Extraordinary Means in a Global Context  Conor Kelly.............................................................................89 A Voice in the Wilderness: Reimagining the Role of Catholic Health Care Mission Leader  Michael McCarthy ................................................................114 Theologians in Catholic Healthcare Ministries: Breaking Beyond the Bond with Ethics  Darren M. Henson..................................................................130 Contributors.................................................................................... 145
A Note from the Editors
Rachelle Barina, Nathaniel Hibner, and Tobias Winright HIS SPECIAL ISSUEof theJournal of Moral Theologybrings moral theologians and health care ethicists together to ex-Tprecedented size, complexity, and power, and the ethicists plore current topics in Catholic health care ethics. Catholic health care organizations have grown into ministries of un-and mission leaders that they employ are enmeshed in clinical and or-ganizational questions that have theological importance. Throughout the development of organized U.S. health care, moral theologians have been fruitfully engaged in scholarship and dialogue about medico-moral matters, and moral theologians have moved between the acad-emy and mission and ethics roles in health ministry. In bringing schol-ars and ethicists together, this issue explores the evolution of their re-lationship and opportunities to further partner in serving the Catholic moral tradition and the church’s health ministry. It also highlights a number of papers that are of topical relevance to the changing health care landscape today. As editors, we hoped that this issue would include papers from both moral theologians and health care ethicists, and we did achieve some balance. (Although we wish we had more balance with regard to the gender of authors, as well as experience and seniority.) The issue opens with two papers that explore the roles of each group and the opportunities to partner together, one written by moral theologian Paul Wojda and the second by ethicist Becket Gremmels. The issue contin-ues with four papers that explore topics of moral significance in Cath-olic health ministry: Cory Mitchell and Therese Lysaught on residen-tial segregation, Michael Panicola on the impact of mergers and ac-quisitions, Ramon Luzarraga on prosperity theology, and Conor Kel-ley on global solidarity in end of life decision-making. Finally, the issue concludes with papers from Michael McCarthy and Darren Hen-son, both of whom assess the current professional landscape and point towards the vast opportunities for theologians to contribute to health ministries. On the whole, we hope that this issue will increase our mu-tual interest in and understanding of one another. We also want to note some of the shortfalls we experienced in the process of collecting these essays. First, we were not overwhelmed by
2a large number of submissions or vast amount of interest in writing for this issue. Perhaps this substantiates the need for dialogue and in-creased collaboration that prompted us to organize the issue in the first place. We hope that this issue might encourage more interest in health ministry during the vocational exploration of theologians as well as more literature that engages Catholic medico-moral matters and moral questions about health care systems and organizations. Second, some topics we hoped to include were not covered. For example, we hoped to include an in depth examination of the im-portance and necessary scope of theological training for mission/eth-ics leaders in health ministry. We also hoped for interest in the topic of academic freedom and the roles of academic theologians and Cath-olic health care leaders in negotiating controversial moral matters. There has long been discussion about the role of theologians in con-troversial moral matters, but there is no scholarship on the experiences of ethicists and mission leaders, whose writing is sometimes being constrained or censored. There is need for further discussion about how academic theologians and ethicists might collaborate on ensuring there is a healthy level of theological discourse and scholarship on the controversial moral matters that ethicists are often experiencing in real time, long before broader discussion in the public or church. As a final note, we want to be so bold as to acknowledge that in our personal experiences as well as in discussing this special issue with both theologians and mission/ethics leaders, we have been sur-prised by the strong sentiments held by some members in each group about the other. We sense a suspicion from some theologians about whether the academic and practical work of Catholic health care ethics is in fact a rigorous application of the theological tradition. We also have encountered more than a few ethicists who criticize moral theo-logians for not being more engaged in Catholic health ministry or more attuned to the practical realities of clinical care, organizational affairs, and health policy. Neither point was made explicitly in any of the articles, but these sentiments loom in subtle, unspoken, yet influ-ential ways in perceptions of theologians and health care mission/eth-ics leaders. These sentiments illustrate the need for ongoing dialogue so that each group can understand and support the work of the other. The two roles are different ways of living the vocation of the theolo-gian, and both are important in the life of a healthy and vibrant church that has large educational and healing ministries. As theologians and mission/ethics leaders, we all have our existing interests and commitments, and we all tend to remain focused in those areas where we are comfortable and knowledgeable. Catholic univer-sities, starting with theologians, and Catholic health ministry, starting with mission/ethics leaders, have an opportunity to improve and max-imize our collaboration. The opportunities are vast, stemming from university programs preparing people for health professions, the many
3PhD trained theologians who struggle to find adequate employment, and the sincere challenges of health care today that would benefit from the attention of people committed to social justice and the common good. Catholic universities and health ministries can support and feed one another, ensuring a vibrancy in our intellectual traditions as well as our service traditions. As theologians and mission/ethics leaders, let’s lead the way with this collaboration in shared service of our Cath-olic moral and social vision. We also would like to thankgraduate student Addison Tenorio for her assistance with this project.
Journal of Moral Theology, Vol. 8, No. 1 (2019): 4-21 Repair Work: Rethinking the Separation of Academic Moral Theologians and Catholic Health Care Ethicists Paul J. Wojda ESPITE CONSIDERABLE OVERLAPrequisite knowledge, in skills, and even job responsibilities, moral theologians haveDtendedIt is a division of labor into operate in parallel worlds. working in Catholic colleges and universities and health care ethicists working in Catholic health care organizations 1 many ways both old and new, but one whose wisdom has recently been called into question. Ought there to be a closer relationship be-tween academic moral theologians and Catholic health care ethicists? If so, what form might that relationship take? The following essay takes up both questions. Its concluding section roughly outlines one possible form such closer collaboration might take, using as a model the ACE (“Alliance for Catholic Education”) program established in the early 1990s at the University of Notre Dame. The intervening sec-tions constitute the necessary historical and theological prolegomena to that proposal.Any proposal for closer collaboration between the worlds of aca-demic moral theology and Catholic health care ethics must answer three distinct but related questions. First, in the current division of la-bor between academic moral theology and Catholic health care ethics, what is essential and what is accidental? Second, in what respects would closer collaboration be beneficial to both sides of this relation-ship? Put somewhat differently, what does academic moral theology have to teach Catholic health care ethics, and conversely, what does Catholic health care ethics have to teach academic moral theology? Third, can adequatetheological groundsfor such a collaboration be articulated, and if so, what might they look like?
1 In what follows I use the term “academic moral theologian” to refer to persons work-ing primarily in departments of theology within Catholic universities. I use the term “health care ethicist” to refer to those working in Catholic health care organizations. I use the term “Catholic health care organization” to refer to any structure, e.g., hos-pital, clinic, long-term care facility, insurer, management office, etc., that is part of a Catholic health care system.
 Repair Work5The importance of articulating the possible theological grounds for a closer relationship between academic moral theology and Catholic health care ethics should not be gainsaid. To do so would risk letting the issue of collaboration be framed in primarily pragmatic terms. For example, it would appear that the need for Catholic health care ethi-cists will soon be dire. According to a recent study by the Catholic Health Association,more than two thirds of currently active Catholic 2 health care ethicists will be retiring in the next ten to fifteen years. Most of these soon-to-be-retired ethicists, as Carl Middleton writes, “have been theologians with doctorates in philosophy or sacred theol-ogy. Most…but not all, are clergy, former clergy, members of reli-gious communities, or have been members of religious communities 3 or seminary-trained.” Since these institutional contexts no longer play the role in theological formation they once did, it is natural to turn to academic moral theologians as a “potential resource,” as Middleton 4 puts it. For its part, academic moral theology, and academic theology gen-erally, might find closer connection with Catholic health care ethics (and Catholic health care organizations generally) to their advantage, as theology departments in many Catholic colleges and universities continue to shrink due to the current reorientation of these institutions away from their historically liberal arts focus and towards professional 5 (i.e., career) preparation. In fact, given current trends, it is not unrea-sonable to think that, over the next two decades, for newly degreed masters and doctors of moral theology, there will be more job oppor-tunities in Catholic health care than in Catholic higher education. If one widens the lens to include jobs in Mission Integration, and not simply positions in ethics, then this is likely already the case. Such pragmatic considerations are not entirely irrelevant, of course, but focusing on them risks obscuring the more fundamental normative questions informing the desire to cultivate closer relation-ships between academic moral theology and health care ethics, ques-tions both vocational and institutional. The vocational question con-cerns the identity of both academic moral theology and health care ethics, what in each case it means and requires to be a Catholic moral theologian or health care ethicist. The institutional question, closely
2 Carl Middleton, “Preparing the Next Corps of Ethicists,”Health Progress97, no. 6 (2016): 62. 3 Middleton, “Preparing the Next Corps of Ethicists,” 65. 4 Middleton, “Preparing the Next Corps of Ethicists,” 66. Middleton recognizes the limitations of a strictly academic background, namely the lack of both clinical expe-rience and (often) spiritual formation. 5 See the recentCommonwealexchange between Massimo Faggioli and Michael Hol-lerich, “Do Catholic Theology Departments have a Future?”Commonweal,May 18, 2018,
6Paul J. Wojda connected to the vocational, concerns the identity of the organizations in which these vocations are practiced. What is or ought a Catholic university to be? What is or ought a Catholic health system to be? These questions are ultimately theological questions. Neither is new, of course, and possible answers to both abound. Whatdoesseem to be new, though, is that academic moral theologians and Catholic health care ethicists are beginning to think afresh about them and are doing so together. SEPARATED ATBIRTH? The current division of labor between academic moral theology and Catholic health care ethics would appear to be justified, in the first place, by essential differences in the nature of the institutions within which each operates and finds its distinctive role, on the one hand the Catholic university, and on the other, the Catholic health care organi-zation. The Catholic university, asEx Corde Ecclesiaputs it,serves “thecause of truth” (no. 4). In so doing, the Catholic university also serves simultaneously the good of both the human person and the Church, for it is among the fundamental tasks of the Church to pro-claim the fullness of the truth about the human person as that is known in the light of faith. Within theuniversitas magistrorum et scholarium,inspired by the love of learning and dedicated to the cause of truth, moral theologians have the specific responsibility of reflecting, from the unique and irreducible “perspective and orientation” of Christian faith, on the specifically ethical dimensions of scholarly research and the implications of its discoveries for human flourishing. This reflec-tion is particularly needed,Ex Cordeadds, where science and technol-ogy are concerned. For [i]t is essential that we be convinced of the priority of the ethical over the technical, of the primacy of the person over things, of the superi-ority of the spirit over matter. The cause of the human person will only be served if knowledge is joined to conscience. Men and women of science will truly aid humanity only if they preserve the sense of the transcendence of the human person over the world and of God over the human person (Ex Corde Ecclesiae, no. 18). Such a task requires of the moral theologian specialized knowledge and skills: knowledge of and ability to distinguish among and interpret the authoritative texts of the tradition, including authoritative interpre-tations of those texts; a sensitivity to and facility with the varying forms of argument on display in those texts and their interpretations; and familiarity with the subject matters, methods, and arguments of