BY: FR. MICHAEL D. PLACE, STD
What follows is a summary of remarks prepared for CHA's first Sponsorship Institute. I was asked to reflect on the theological underpinnings of sponsorship and its relationship to the Church's healing (health care) ministry. I quickly became excited by the assignment because it required me to reflect on previous teaching and writing in a new way. What follows is more of an essay than a theological treatise. Some of what I propose is more descriptive than definitive, and all of it is in need of significant development. In that light, I offer it for review and critique.
To address the theological underpinnings of sponsorship, we must consider the topic from a theological perspective that includes sponsorship, ministry, and the healing ministry. My approach is somewhat novel. I will "back into" an understanding of these interrelated concepts by reflecting on what I consider to be the theological concepts that are the intellectual infrastructure for a full appreciation of sponsorship, ministry, and the healing ministry and by reflecting on the historical evolution of health care from an apostolic work to an ecclesial ministry.
Obviously I will move through them quickly, highlighting what will be of help and "shortchanging" a great deal of theological richness. I hope that, by exploring the theological roots of this ministry as well as the historical evolution of sponsorship, we will be able to better describe sponsorship today and begin to develop a theology of sponsorship that can assist its transition into the 21st century.
Triune God Understanding of sponsorship and ministry must start with an understanding of God as a triune God—one who is in community and in relationship. As John Paul II often reminds us, we human beings take spiritual nourishment from our sense of a communitarian God who also is in a relationship with us.
Human Beings Next we need to understand who we are as human beings. As children we learn to say that God made us in his own image and likeness. To understand who we are and how we are to live, we must understand what those words mean. God's creativity is expressed in our humanity by our capacity to think and be creative in the stewardship of life. God's freedom is reflected in the exercise of our will, which allows us to order our lives and pursue our destinies. God's love, which is so great that it is a Divine Person, is reflected in our ability to love and to enter into community. So we are human beings in the image and likeness of a triune God who is communal in nature; like that God, we have a capacity for creativity; a freedom of decision making, expression, and articulation; and an ability to enter into relationships and be loving and sociable.
Sense of Mystery To the understanding of ourselves as human beings, we bring a five-fold prism of a Catholic vision of the foundational mysteries of faith. The first mystery is creation, which is God's gift to us of a universe that is fundamentally good. Second, into that basic goodness came sin, which did not destroy the goodness, but disordered it and moved us off target. Third, through the incarnation, the same God who freely created the world chose to return the gift we had rejected by giving of himself—by the Son freely becoming human and "like us in all things but sin." Although by sin we lost our ability to fully understand and live as humans made in God's image, through the humanity of Jesus we once again find our direction and the power to move toward it. The fourth mystery, redemption through the cross, broke the bonds of sin—but breaking the bonds was not enough. The final mystery, the gift of the Spirit, orders and empowers us to work for the realization of the reign of God in this world.
Catholic tradition lives within all aspects of the prism. The Catholic theological tradition is one that is "both-and." It is hyphenated; it lives with complexity. We are both sinner and saved, free and dependent on God, bound in time and living in a future. Indeed, the Catholic world is not a simple one.
Sacramentality In the Catholic understanding, we know Jesus to be like a sacrament, an outward sign that expresses an inward reality. From this ultimate foundation of our faith, we thus are constituted as a people with a "sacramental imagination." Encountering the sacrament, Jesus, whose humanity is the outward sign that reveals the inner mystery that is the Godhead, we encounter the possibility of transformation, change, and ultimately grace.
If Jesus is the sacrament of an encounter with God, we meet with the full meaning of that sacrament in the mission of Jesus, which was to proclaim the reign of God. But Jesus both proclaimed the reign and responded to the mission. Jesus' response to the call of the mission was his ministry, which was three-fold: Proclaiming the Word, or evangelizing; bringing holiness and sanctification; and providing an ordering of life, or an ethic. In other words, Jesus did more than proclaim the mission. In his life he showed us what it means to live the mission. Through his free response to the Father's call, he engaged in a life of ministerial service.
Church In fulfillment of his mission and ministry, Jesus called disciples. They did not choose Jesus; he called them. The invited were gathered into a community, into a fellowship whose purpose was to go forth to preach and baptize, and by doing so make real both mission and ministry.
That fellowship of beloved disciples was sent forward to be the foundation of what was to become the church, the universal gathering of God's disciples. To those with a sacramental imagination, the church is a fellowship of the baptized that is the sacrament of Jesus to the world through which the triune God is made visible. So the church, in its foundational reality as a community, is meant to be sacramental. Those who meet the church encounter the mystery of God. And through that encounter, they experience the gift: the opportunity of salvation.
Charismatic Element From the earliest days within the community, some have felt a call to a radical way of holiness that involves a lifelong commitment to the evangelical virtues of poverty, chastity, and obedience. These people were called not as a witness against the world but as a witness to the world of its potential for holiness. At its origin this "white martyrdom" of the individual hermit's retreat to the desert was experienced by the church as a poor substitute for the witness of the martyrs' blood. In time this solitary life was complimented by various more communal expressions that were ordered in accord with the Spirit-driven inspiration of a foundress or founder. The charismatic response of an individual foundress or founder to an invitation to be a radical witness to holiness became the "way" for others. Known today as the charism of a community, this particular ordering of the baptismal call is directed toward holiness or personal sanctification by living a uniquely ordered life conformed to the three evangelical virtues or commitments.
Looking at this way of life in the family of faith, we can quickly distinguish the charismatic from the more institutional dimension of church life. With the sacramental vision noted earlier, the charismatic dimension is essential to church life because, by way of analogy, this component is like a continuing sacrament to the family of faith—one reminding the church of its call to holiness and sanctification.
Obviously this essential part of the family of faith has been expressed in different ways over the centuries. Following the singular way was the monastic expression, and then the mendicant expression. As Europe became more urban, the communities of apostolic life were formed and carried on their apostolic works inside the new urban ghettos, places of poverty and human loss. Reaching out to and touching those whom no one else would, the apostolic communities bore witness in the daily movement of life. In the everydayness of their lives, they mirrored the "sacrament" of a call to holiness to newly industrial Europe and to the emerging missions in the New World, Africa, and Asia. And they did this through the instrumentality of apostolic works such as teaching and healing.
Today the rise of secular institutes is another way of engaging in a world with a different set of experiences. The call, however, is still to holiness so that the community may see, experience, and follow that same call.
Ministry At least in theory, ministry is not the same as apostolic work, which can be an expression of the call to holiness that is associated with the charismatic dimension of the community of faith. Ministry is carrying on the mission of the church in the name of, and on behalf of, the community of faith. Ministry also differs from what baptized Christians do when they carry on the mission of Jesus. The nature of ministry involves an official call, preparation, and deputation by the community through the church's pastors.
Just as Jesus engaged in ministerial service, so too does the church because the "sacrament of Jesus" is a ministerial community. Among the ministries of the church is the ordained ministry, the sacramental priesthood. Those in the ordained ministry are ordered by divine institution. Like baptism and confirmation, ordination transforms an individual's very being for the purpose of becoming the deputed steward of mission and ministry on behalf of the church. Continuing with this sacramental imagery, just as the charismatic life is the "sacrament" to the family of faith of its call to a life of holiness, so the ordained ministry is the "sacrament" to the family of faith of its call to carry on publicly, and in an ordered way, the mission and ministry of Jesus.
Within this conceptual framework, we can argue that at least four sacramental-type moments occur in the ordering of church life. The sacrament of baptism witnesses to the world its call to holiness. The "sacrament" of the charismatic dimension witnesses to the family of faith its call to radical holiness. The sacrament of the ministerial priesthood witnesses to the family of faith its call to carry on the ministries of Jesus. The sacrament of matrimony witnesses to the families' call to be the domestic church.
With the emergence of lay ministry, we are rediscovering the fact that the richness of ministry is greater than ordination. The challenge is to distinguish the ministry of the laity from the ministry of the ordained as well as from the baptismal call and service of all believers. Failure to do so could, on one hand, lead to the development of a new clerical caste that is as hierarchical, in the worst sense of the word, as clerics and, on the other, lead to the diminishment of the vocation of the baptized. Like the ministry of the ordained, lay ministry carries forward the official ministries of the church in the name of and on behalf of the church.
Healing Ministry The healing ministry of the church has its beginning in Jesus' life. In the Gospel stories, the most frequent image of Jesus is as healer, reaching to those who are broken in body, mind, and spirit. As Fr. Donald Senior, CP, has suggested, Jesus acts as healer in multiple ways. First he is the liberator who comes to free us from our brokenness. Second, through solidarity, Jesus stands as one with those who suffer from physical and spiritual brokenness. Jesus suffered and died. Jesus' solidarity with humankind remains through his resurrection. Even transformed into a body made perfect, Jesus still bore the signs of his wounds. Finally, through this solidarity with our brokenness and through the power of the resurrection, Jesus brings a profound sense of hope to those who suffer. The healing ministry follows the ministry of Jesus. It seeks first to liberate from suffering; it stands in solidarity with those who suffer, especially the marginalized and oppressed; and, most fundamentally, it is a sign of hope. Joseph Cardinal Bernardin described this hope as rooted in God's love for us in Christ:
"As Christians, our hope relies on the fact that God's love for us in Christ Jesus is permanent and unchanging. Trusting that we are so loved, we face life, with all its sorrows and joy, with hope. However, it is not enough that we be comforted in our affliction. St. Paul tells us that our own consolation enables us to bring comfort to others in their need. As Christians, we are called, indeed empowered, to comfort others in the midst of their suffering by giving them a reason to hope." (From Card. Joseph Bernardin, A Sign of Hope, October, 1995.)
We must remember that, in his own healing ministry, Jesus healed not as an end in itself but as an opportunity for faith. Although infrequently recounted in the Gospel, Jesus' healing failed when faith was not present in a very profound way in the one afflicted. The healing ministry at its very foundation, then, is an outward sign, a sacramental-type expression that makes the triumph of God's reign present in this world. For this reason, Pope John Paul II described the continuing expression of Jesus' healing ministry as an essential ministry of the church.
As described in the Acts and in the letters of Paul, the ministry of healing was largely an individual work that eventually became somewhat organized. In time it became primarily associated with the sacrament of the sick, reminding people of the sacramentality of healing and the essential place it has in the life of the church.
Because the ministry of healing was so essential to the life of the church, the apostolic work of healing service became associated with the charismatic life of the church. Monasteries had infirmaries, and the mendicants touched the lepers and the sick of their age. Later, for those called to the apostolic form of religious life, involvement in the healing work of the church was a natural external expression of their various charisms.
Transformation In modern times a transformation gradually occurred as the apostolic and mendicant communities carried on apostolic works of healing that were expressive of their various charisms. Accomplishing their work more often began to require structures and institutions. For example, when poverty was so extreme that apostolic works of expressing Jesus' solidarity with the poor could not occur in the home, the sisters took the poor to the convent. When the sick began to outnumber the sisters, the sisters built a second building alongside the convent. In time, carrying on the healing work of Jesus became almost a constitutive expression of the charismatic life, of being a sacrament of holiness in the world, for many religious communities. We must remember, however, that the healing ministry began in the Mediterranean basin in Europe and in this country with touch, with caring for the dying, with carrying the sick up the stairs. A personal encounter, it corresponded to the personal nature of carrying forward a commitment to the apostolic works associated with the charismatic dimension of the church.
Gradually, however, external forces developed that were more powerful than those that motivated the aggregation of individualized apostolic works into the collective environment of a hospital. Transforming the practice of medicine were various internal forces, such as penicillin and antibiotics, and external realities in the United States such as the Hill-Burton Act and the inauguration of Medicare and then Medicaid. What had begun as an expression of a charismatic work in the life of the church became more and more institutional and businesslike.
Simultaneously, as noted earlier, our theological understanding was evolving and we began to see that being in the ministry was more than being a cleric. The concept of "lay ministry" emerged even as the demographics of religious life began to change.
When this increasingly public, institutional, and businesslike expression of the apostolic work of healing met the emerging theology of ministry, a change occurred—the significance of which we are still discovering.
Over the course of time, speaking of health care as an apostolic work evolved into being described as a ministry of the church. This evolution was given "ecclesiastical endorsement" when John Paul II, speaking in Phoenix in 1987, declared that "health care is an essential ministry of the church." As logical and appropriate as this evolution was, it did complicate matters. The apostolic works, which are an expression of the charism of a religious community, have always enjoyed a certain autonomy from the hierarchical dimension of church life. The ministerial life of the church has been closely associated with the episcopal office. Clearly, we had moved into uncharted territory.
Sponsorship Emerges Concurrent with this evolution, the same complexity required that religious congregations reconsider their relationships with Catholic health care. New organizational structures were needed to manage and protect the patrimony of religious communities and the assets of health care institutions. The concept of sponsorship emerged as a uniquely American way of preserving the gifted presence of the religious congregations that had established and sustained Catholic health care and of allowing Catholic health care to adapt to changing circumstances. As helpful as it has been as a pragmatic tool to organize and delineate responsibilities (e.g., reserved powers) and ensure health care a place in the life of the church, we have not been able to find a suitable theological explanation or description of sponsorship.
Why is that? I suggest the origin of that difficulty is that sponsorship is not an end in itself, but a mediating category that brings together the charismatic (religious) dimension of church life with what more often corresponds to an expression of the public ministerial life of the church. Although both are valid and essential dimensions of church life, they are quite distinct. Returning to my earlier, rather simplistic analysis, I suggest that sponsorship has been the instrument connecting the sacrament of the church's call to holiness to the sacrament of the church's call to formally carry on the ministries of Jesus. Not surprisingly, capturing this complexity in a few words is not easy. Also not surprising is that this "ecclesiastical coupling" would find it difficult to maintain balance between these two distinct "sacramental modes." Depending on circumstances, either charismatic life or ministerial life would naturally tend to be more influential on sponsorship.
As if matters were not complex enough, the last decade has seen several religious communities either singularly or in a "cosponsorship" model begin the process of turning "sponsorship" over to the laity. When this happens, I believe the meaning of sponsorship also changes with the absence of any connection to the charismatic dimension. A need for an "ecclesiastical coupling" no longer exists.
In this new arena, sponsorship becomes a category by which the church transforms health care from what was primarily an expression of the apostolic works associated with the charismatic dimension of the church into a more formal expression of the ministerial life of the church. That transmigration is, I believe, a great gift to the church because it provides an opportunity for the baptized to be formally entrusted with stewarding an essential public ministry of the church.
In this modality sponsorship obviously takes on a new identity. Sponsorship is now the instrument by which an institutional or public ministry of the church is carried forth in the name of, on behalf of, and in communion with the family of faith. When that ministry is not a direct expression of the ministry of a particular church, this new form of sponsorship can be carried on in various ways. However organized, these ways are now distinct from the charismatic dimension of church life, where they were born and nurtured.
With this change in sponsorship, the theological foundation will come from the theology of baptism, not the theology of religious life. The "problem" for the church is that we lack a rich theology or experience of the lay ministry on which to build such a theology. Although this lack may cause discomfort, it is also cause for excitement because we are transitioning into a whole new set of opportunities.
This transition does not mean that sponsorship will not remain, in part, associated with the charismatic dimension of church life. The almost natural affinity between the healing work and religious life remains. But sponsorship is not the same as religious life. Sponsorship grew out of a historical need for connectivity. Now we must ask the self-critical question: How will we express that need going forward? Each religious community will ask the question, and answers will vary. Some will decide to move fully in another direction, which is to a lay public juridic person. Others will move into cosponsorship. Still others will maintain their own history and role, at least for the time being.
This transition presents another challenge. When completely uncoupled from the charismatic dimension of church, sponsorship, as a ministry of the church, must have all the elements that constitute ministerial life: call, deputation, and mandate. These elements do not come with baptism. Only the empowerment or the opportunity for the call comes with baptism. Ministry work is not the same as a baptismal work. Ministry requires its own spirituality and accountability. Our challenge is to learn how to prepare people to answer this call and steward well.
Part of that preparation will involve the recognition that as a ministry of a sacramental church, healing also involves working for the transformation of the world to make possible the triumph of God's reign and being a source of evangelization. While accustomed to the transforming role, we have unfortunately become very uncomfortable with thinking about ministry as being an expression of evangelization. Many people inappropriately associate evangelization with the indoctrination and proselytising. Evangelization, however, is much more: it is a healing witness to a broken world of Jesus' gifts of liberation, solidarity, and hope.
In this perspective, analogically speaking, the ultimate criteria of successful charismatic or lay sponsorship of an essential ministry of the church will be whether Catholic health care is a true "sacrament" of Jesus' liberation, solidarity, and hope. The ministry of health care in the family of faith is that agency through which the Holy Spirit works so that the ongoing public expression of God's ecclesial "sacrament" of healing is present to and in the world. Sponsorship is bringing these sacramental elements of liberation, solidarity, and hope to the health care ministry. Sponsors are those who act in the name of, and on behalf of, the family of faith so that all we do in Catholic health care can be a "sacrament of Jesus' healing."
This essay should leave you with a certain sense of incompleteness. Although we have a rich theological and spiritual heritage available to guide and nurture the charismatic call to radical holiness and a fulsome history of Catholic health care as an apostolic work, comparatively speaking little is available on the significance of health care as a ministry of the church, let alone a lay ministry. Similarly, if my hypothesis is correct, sponsorship as a "coupling" category or as an instrument for transference will be defined more by its referents than as a freestanding theological concept.
Whether the newest expression of sponsorship, as the instrumentality through which the laity will steward an essential public ministry of the church, will further evolve is not clear. I would dare to propose, however, that an attempt to develop a theological understanding of this form of sponsorship or of Catholic health care as a lay ministry must be grounded in all the theological categories I have raced through: community orientation, sustained complexity, nurture from a sacramental imagination, an expression of public lay ministry, and support of a ministry that is evangelical in purpose and expressive of Jesus' healing ministry of liberation, solidarity, and hope.
Fr. Place is president and chief executive officer, Catholic Health Association, St. Louis.
Copyright © 2000 by the Catholic Health Association of the United States
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