Introduction
Allow me once again to welcome all of you to the annual White Mass sponsored by the Baltimore Guild of the Catholic Medical Association. In this Holy Mass we honor those who care for the sick and ask God’s blessings on their daily service to their brothers and sisters. And let me remind you that it’s called a “White Mass” because of the white uniforms which healthcare workers typically wear.
Healthcare, of course, is constantly in the news. We have only to think about the tragic spread of Ebola in West Africa and the deep concern in our own country that it be contained. Let us pray for those who are victims of this deadly disease and also let us pray for those who care for Ebola patients with courage, generosity, and dedication. We entrust them to the intercession of St. Luke, Patron of Physicians, whose feast day we celebrated only yesterday.
Render Unto Caesar
Whether we are talking about preventing the spread of Ebola or about the implementation of the Affordable Care Act, we also recognize that our government and allied organizations play an important, if sometimes debatable, role in the delivery of healthcare. I mention the role of government in healthcare in light of today’s Gospel. As you recall, Jesus’ enemies were trying to trap him with a trick question. They asked him whether or not it was lawful for a Jew, living under the oppression of the Roman empire, to pay the census tax to Caesar, the emperor. If, on the one hand, Jesus said it was lawful to pay taxes to Caesar, they would condemn him for complicity with the Roman occupiers. If, on the other hand, Jesus answered it was not lawful to pay taxes to Rome, then Jesus’ enemies would have accused him of lawlessness, of being a brigand, a revolutionary, a disturber of the public order.
‘Innocent as a dove and wise as a serpent,’ Jesus gave a response that baffled his enemies and continues to challenge us: “Render unto Caesar the things that are Caesar’s & to God the things that are God’s.” Jesus’ answer, of course, applies not only to taxes but to the entirety of our relationship with our leaders and our government. What belongs to Caesar? And what belongs to God? How we answer those questions helps shape our understanding of our daily work and the decisions we make. Let us spend a moment reflecting on these two questions.
To begin with, Catholic social teaching recognizes a role for government and various intermediate organizations in the delivery of healthcare. It is appropriate for the government and its partners to strive to provide healthcare to as many citizens as possible, especially those who are the poorest and the most vulnerable. So too, the government has a role to play in ensuring that high standards of medical practice be maintained so that the safety of healthcare professionals and their patients will be protected. Similarly, the government should promote the health and well-being of the general population. And, at times the government itself provides healthcare services. The precise role of the government in these and other facets of healthcare will no doubt continue to be the subject of vigorous debate. And with shifting political fortunes, that role will expand or contract.
But in his answer to the Pharisees in today’s Gospel, Jesus relativizes the role of government, all governments. None of them play an absolute role in society & in our individual lives, and all of them receive whatever authority they have from God. They exercise a limited power, subordinate to God’s power. What does this mean in the case of the delivery of healthcare? It means that human life, human dignity, and human freedom are given to us ‘not by the generosity of the state but by the hand of God’ (cf. JKF Inaugural). Every good gift – all that we are and all that we have – comes from God and in the final analysis we owe everything to God. We are the recipients of his blessings and the stewards of his gifts. No earthly power “owns” human life, sickness, and death; no human tribunal or legislature has “patented” human dignity; no one has bestowed on us the gift of human freedom and the rights of conscience – except God, ‘the giver of every good and perfect gift’ (cf. James 1:17).
Answering to a Higher Power
But, of course, that observation alone doesn’t entirely settle the question. Both healthcare institutions and individual practitioners must answer in some detail the question of what is legitimate government regulation of healthcare and what should be left to the realm of religious freedom and the rights of conscience.
A faith-based healthcare facility does not have unlimited freedom in deciding which services it will offer and which it will not – Its decisions truly must be rooted in the faith, teachings, and values that inspired the religious body to found and sponsor the facility in the first place and its positions must be carefully thought out and coherently presented, with the goal of protecting the dignity of human life and fostering the common good of society. In reaching such decisions, however, faith-based healthcare facilities, such as Catholic medical centers and clinics, must seek for themselves wide latitude, not because they are looking for special treatment from the government but rather because they are seeking the freedom to serve those in need and the freedom to bear witness to their core faith and values. How important that we heed the warning of Pope Francis that our Catholic institutions of healthcare & service maintain their religious identity, and not become mere N.G.O.’s – non-governmental organizations — that are mere private sector extensions of government policy.
Individual healthcare professionals, especially those who work in non-faith based settings, sometimes face delicate moral decisions in which they must assess how intimately they are being asked to cooperate in procedures that are contrary to church teaching & to their well-formed consciences. The Church’s moral teaching on the question of cooperation with moral evil & the guidance of experts in medical-moral issues can often help answer questions about what belongs to Caesar and what belongs to God: “What can healthcare & government authorities legitimately demand of a practitioner and what is the reserve of religious freedom and the rights of conscience?”
Conversely, the power of a just government over faith-based institutions and the consciences of healthcare professionals is limited. Government should not treat faith-based institutions that serve the common good as if they were somehow less religious than parishes and houses of worship, and, absent a compelling interest, should not try to force their hand in providing so-called “services” deemed immoral. Recently some state governments, & now the federal government, seem determined to force religiously based individuals and individual healthcare professionals to become entangled in providing so-called services which our faith teaches violates the inviolable dignity of innocent human life, whether at its beginnings or now, more and more, at the end of life. Today’s Gospel alerts us to be more vigilant about such questions and sheds light upon the efforts of the Church in the United States to teach more vigorously about religious freedom and the rights of conscience while seeking to vindicate in court and protect them through just legislation & policy.
Conclusion
Not everyone here in this Basilica this morning is a healthcare professional but all of us love our faith and we love our country. Let us ask the guidance of the Holy Spirit and the intercession of St. Luke that we might engage in our daily work with integrity and compassionate love while at the same time exercising that eternal vigilance that is the price of freedom.
May God bless us and keep us always in His love!