Catholic Health Care: The Social Face of Compassion

July-August 2008

BY: THOMAS A. SHANNON, Ph.D.

Dr. Shannon is professor emeritus of religion and social ethics, Department of Humanities and Arts, Worcester Polytechnic Institute, Worcester, Mass.

Many people think of compassion as an individual virtue or practice, done by one person to immediately help another. Compassion, sympathy with or feeling for the plights of a particular person is what motivates our action. Even when we think of those who practiced compassion on a rather large scale — Dorothy Day and Mother Theresa are two examples — their compassionate action was directed to individuals in need, not to building institutions or social structures to do this on their behalf. The Catholic Worker philosophy was directed to founding houses of hospitality where guests were welcomed and ministered to individually. And even though Mother Teresa did found a religious community and built various forms of shelter for people with many needs, the focus of the community remains the individual and ministering to his or her specific needs.

Clearly, person-to-person compassion is a key element in Catholicism and brings genuine healing and relief to people. Yet, in another sense, in which we can understand compassion to have a critical social dimension. This article presents a view of social compassion and shows how it can help point to some areas of intervention by those involved in providing Catholic health care.

The Spiritual and Corporal Works of Mercy
The Beatitudes as presented in Matthew 25:34 seem to have an individual tone to them:

"Then the King will say to those at his right hand, 'Come, O blessed of my Father, inherit the kingdom prepared for you from the foundation of the world; for I was hungry and you gave me food, I was thirsty and you gave me drink, I was a stranger and you welcomed me, I was naked and you clothed me, I was sick and you visited me, I was in prison and you came to me.' Then the righteous will answer him, 'Lord, when did we see thee hungry and feed thee, or thirsty and give thee drink?' And the king will answer them, 'Truly, I say to you, as you did it to one of the least of my brethren, you did it to me.'"

The focus of this passage is clearly on an individual, who responded to the specific needs of another. Yet, another question one could ask in relation to this scenario is, "How did this person get in that situation?" Then, a social question arises, or questions about the structuring of society or institutions that generate specific outcomes. A compassionate response to this kind of question will require addressing both the individual and the social situation that brought about this person's condition.

If one considers both the traditional spiritual works of mercy — convert the sinner; instruct the ignorant; counsel the doubtful; comfort the sorrowful; bear wrongs patiently; forgive injuries; and pray for the living and the dead - and the corporal works of mercy — feed the hungry; give drink to the thirsty; clothe the naked; shelter the homeless; visit the sick; visit those in prison; and bury the dead - one can see that to perform these works at all is to have a strongly developed sense of personal compassion. Yet, as one reads these two sets of works together, the inherently social dimension of them emerges, as it did with the Beatitudes. Both the spiritual and corporal works of mercy are directed to others. Inherent in these works is the social dimension that leads one to ask, "Why is this person in this situation and what needs to be done to prevent this?" And here we have the seed bed of a strong social ethic.

The Classic Definition of Justice
There is an analogous individualistic perspective with the understanding of justice. The classic definition of justice — to each his or her own — looks to ensuring that each receives his or her due and focuses on individual acts of restitution or distribution. Also, there is a correspondingly strong sense of justice as procedural. Justice is achieved when the rules have been followed. The concern is not the outcome, but with the correct following of the procedure. This is the basis of our customary image of justice as a blindfolded woman holding a scale: all decisions are evenly meted out, justice plays no favorites, and all are treated exactly the same.

Yet, another image of justice is represented by a statue at the World Court. Here, justice is also portrayed as a woman, but as a woman picking up a wounded bird and protecting it from a wolf. The represents justice as in fact playing favorites - those in need - and in being concerned more about outcome than procedure. This image of justice is more in harmony with the understanding of justice both in the Hebrew and Christian Scriptures and the Roman Catholic social ethics tradition. Justice is a concrete expression of compassion for individuals or groups by intervening in society or social structures to help improve their lives. The following three aspects highlight this perspective of compassion as seeking justice, or what can be called social compassion:

1) In the 1971 document Justice in the World from the Synod of Bishops, we read: "Action on behalf of justice and participation in the transformation of the world fully appear to us as a constitutive dimension of the preaching of the Gospel, or, in other words, of the Church's mission for the redemption of the human race and its liberation from every oppressive situation."1

This sentence sets the context for a lengthy reflection on the demands that justice makes on contemporary Christians. In Chapter 2, we read, "For love implies an absolute demand for justice, namely a recognition of the dignity and rights of one's neighbor. Justice attains its inner fullness only in love."2 Thus achieving justice is not the consequence of a method of calculating obligations but is rather directed to the dignity of one's neighbor and is fully realized in love. This is social compassion in action.

2) The American Catholic Bishops' 1986 document Economic Justice for All gives a sustained examination of justice from scriptural, philosophical and theological perspectives. The bishops begin by noting that "The fundamental moral criterion for all economic decisions, policies, and institutions is this: They must be at the service of all people, especially the poor.3 In discussing social justice, the bishops argue that persons have an obligation to be active and productive participants in the life of society and that society has a duty to enable them to participate in this way. The greatest injustice then is marginalization that violates the dignity of a person by excluding him or her from participating in society and making contributions appropriate to that person's abilities. Such forms of injustice prevent one from practicing social compassion.

Social compassion leads one to go beyond narrow, individualistic understandings of justice, to seeing justice as a way of ensuring that all have a stake in society and can meaningfully participate in it. The sorrow at seeing these kinds of institutional injustice leads to the compassionate response of insuring that all have a place at society's table and are able to bring something to share with the others there.

3) Justice as the Option for the Poor emerged from the Theology of Liberation that was developed in Latin America in the 1970s. It emerged out of church communities, the hierarchy, and theologians reading that was orthopraxis — correct practice — rather than orthodoxy — correct belief. This perspective was utilized by several bishops' conferences in Latin America and was in part the inspiration for the Catholic bishops of the United States in their pastoral letter on economics. The theology was born out of a sense of compassion for the disenfranchised and marginalized in developing countries and this led to seek means of analysis and action that would bring the community together by establishing a more just society. Implementing the option for the poor is a specific way of practicing social compassion.

These orientations toward justice provided by the Catholic tradition are anything but justice carefully weighed out to ensure that each has that to which they are entitled or that procedures are followed with no attention to outcome. Rather, the practice of social compassion leads us to establish justice both as our response to those in need and to correct the structures that create such conditions to begin with. Social compassion fires the heart to engage in the work of justice. Catholic health care has a singular opportunity at the present moment to be the face of social compassion.

The Role of Catholic Health Care
The current U.S. presidential campaign is making abundantly clear the many and pressing political, social and economic problems present in our country. Two specific contributions exist that Catholic care can make to this critical discussion:

1) Promote social compassion as the proper response to the corrosive philosophy of political and economic individualism that is so pervasive in much current political discourse. We know wages are stagnant, jobs are not easily available, costs of health care account for about half of all bankruptcy claims, and children go without decent health care, nourishment, or education. What Catholic health care can do here is promote social compassion as the dominant agenda for any discussion in which individuals representing Catholic health care are involved. We know that negative or problematic social circumstances of what ever kind eventually have negative impacts on one's health. A critical move on the part of Catholic health care is to promote social compassion as the basis for redirecting our priorities. We have seen where eight years of so-called compassionate conservativism has gotten us. Now it is time for social compassion to lead the discussion by changing the framework of both discussion and action.

2) Catholic health care must use the springboard of social compassion to press the implementation of some form of universal health care. And this will be no easy task, even though many seem ready for it. For example, I taught a course on religion and culture for several years. One day, my students and I were discussing a French law that prohibited the wearing of prominently displayed religious symbols in public schools, and the wearing of head scarves by Muslim women was a focal point of the discussion. One of my students observed that such a law was permissible in France because they are socialist — like the communists, the Nazis, and then since you are French, you must have national health care besides! This student was 18 years old and already knew that national health care was communist and socialist! And if he is in any way representative of even a large minority, and if this interesting cast of characters is representative of a mindset, we are in for a long and difficult discussion about health care reform.

Providing some sort of national health care highlights a core theme of social compassion: the preferential option for the poor. The poor and marginalized are to be given preferential treatment precisely because of their vulnerable position. Such preference also affirms the value and dignity of all persons regardless of social status or economic class.

Since the majority of the uninsured and underinsured are poor, they tend to seek medical care only when the problem becomes an emergency or is life threatening. And of course by that time the damage to one's health is already done and while interventions may be somewhat successful, they will certainly be more expensive and will respond only to the problem at hand, not the larger health care needs of the individual. And while it is certainly helpful to have an emergency room (ER) to go to for health care, such a setting is probably the worst place to deal with health problems because of its focus on short-term intervention, its higher costs, and focus on rescue medicine rather than prevention. The ER is not a solution to the health care needs of anyone, much less the poor.

Social compassion is also an exercise of responsible stewardship, which includes, according to Vatican Council II, the mandate "to govern the world with justice and holiness."4 Such governing in health care would focus primarily on prevention and wellness care, ensuring that everyone, particularly children, receive basic preventive care such as vaccinations and appropriate medical examinations and interventions and instruction, as well as preventive dental care. Given the preferential option for the poor and the requirements of responsible stewardship, the marginalized and their needs must be front and center of national policy guided by a social compassion.

Finally, a spirituality emerges from the response of social compassion. The technical name for this spirituality is an inner-worldly spirituality that looks to our transformation through our living out of our faith and through our practice of social compassion. Gaudium et Spes provides a three-fold foundation for this spirituality. First, the council notes that though we have a mandate from the Creator to subject the world to ourselves; we are to "govern the world with justice and holiness."5 We have a profound role but this role is structured by the requirements of justice and the practice of social compassion.

Second, "It is clear that men are not deterred by the Christian message from building up the world, or impelled to neglect the welfare of their fellows. They are, rather, more stringently bound to do these very things."6 Christianity is not a counter-cultural religion, but a religion that mandates that we enter into the very heart of the world and all human activities and bring the transformative message of social compassion with us.

Finally, the council notes that "while we are warned that it profits a man nothing if he gain the whole world and lose himself, the expectation of a new earth must not weaken but rather stimulate our concern for cultivating this one. For here grows the body of a new human family, a body which even now is able to give some kind of foreshadowing of the new age."7 The conclusion the council draws is that "to the extent the earthly progress can contribute to the better ordering of human society, it is of vital concern to the kingdom of God."8

The profound message of social compassion is not only a mandate for deep and critical analysis of social problems, but also a spirituality that challenges us to find our salvation in the dedication of ourselves to the good of others, whether this be in day-to-day acts of kindness and service to others, whether this be through a life in community service, a life in politics, or a life in one of the various trades that benefit all of us. In practicing social compassion in these areas, we are transformed through our contact with the Kingdom of God that is being built through all of the daily actions of our lives.

NOTES

  1. David J. O'Brien and Thomas A. Shannon, Catholic Social Thought: A Documentary History (Maryknoll, N.Y.: Orbis Books, 1992), 289.
  2. O'Brien and Shannon, 293.
  3. O'Brien and Shannon, 583.
  4. O'Brien and Shannon, 185.
  5. O'Brien and Shannon, 185.
  6. O'Brien and Shannon, 186.
  7. O'Brien and Shannon, 189.
  8. O'Brien and Shannon, 189.

 

Copyright © 2008 by the Catholic Health Association of the United States.
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