Gary Gutting, Endowed Chair in Philosophy, argued that the will of many Catholics who choose to use contraceptives is paramount to the teaching of the bishops.

…haven’t the members of the Catholic Church recognized their bishops as having full and sole authority to determine the teachings of the Church?  By no means.  There was, perhaps, a time when the vast majority of Catholics accepted the bishops as having an absolute right to define theological and ethical doctrines.  Those days, if they ever existed, are long gone.  Most Catholics — meaning, to be more precise, people who were raised Catholic or converted as adults and continue to take church teachings and practices seriously — now reserve the right to reject doctrines insisted on by their bishops and to interpret in their own way the doctrines that they do accept.  This is above all true in matters of sexual morality, especially birth control, where the majority of Catholics have concluded that the teachings of the bishops do not apply to them.  Such “reservations” are an essential constraint on the authority of the bishops.

The bishops and the minority of Catholics who support their full authority have tried to marginalize Catholics who do not accept the bishops as absolute arbiters of doctrine.  They speak of “cafeteria Catholics” or merely “cultural Catholics,” and imply that the only “real Catholics” are those who accept their teachings entirely.  But this marginalization begs the question I’m raising about the proper source of the judgment that the bishops have divine authority.  Since, as I’ve argued, members of the church are themselves this source, it is not for the bishops but for the faithful to decide the nature and extent of episcopal authority.  The bishops truly are, as they so often say, “servants of the servants of the Lord.”

It may be objected that, regardless of what individual Catholics think, the bishops in fact exercise effective control over the church.  This is true in many respects, but only to the extent that members of the church accept their authority.  Stalin’s alleged query about papal authority (“How many divisions does the Pope have?”) expresses more than just cynical realpolitik.  The authority of the Catholic bishops is enforceable morally but not militarily or politically.  It resides entirely in the fact that people freely accept it.

The mistake of the Obama administration — and of almost everyone debating its decision — was to accept the bishops’ claim that their position on birth control expresses an authoritative “teaching of the church.”  (Of course, the administration may be right in thinking that the bishops need placating because they can cause them considerable political trouble.)  The bishops’ claim to authority in this matter has been undermined because Catholics have decisively rejected it. The immorality of birth control is no longer a teaching of the Catholic Church.  Pope Paul VI meant his 1968 encyclical, “Humanae Vitae,” to settle the issue in the manner of the famous tag, “Roma locuta est, causa finita est.”  In fact the issue has been settled by the voice of the Catholic people.

Gutting’s argument would seem to have Jesus telling Peter, “upon this poll I will build my Church.”

Gutting teaches courses to first year Philosophy students at Notre Dame and includes the writings of radical philosopher Peter Singer.

On Friday evening, February 10—several hours after President Obama unveiled his “compromise” proposal—the US Conference of Catholic Bishops (USCCB) released an official statement signed by five leading prelates. The bishops said that the revised plan “continues to involve needless government intrusion in the internal governance of religious institutions, and to threaten government coercion of religious people and groups to violate their most deeply held convictions.”

That clear statement of opposition contrasted with an earlier response from the USCCB, in which Archbishop Timothy Dolan of New York had described the revised plan as “a first step in the right direction.” While that initial reaction was ambiguous, the bishops’ 2nd statement left no doubt that the USCCB would continue to oppose the Obama mandate.

Unfortunately, before the bishops released their second statement, leaders of two of the largest Catholic employers in the country—the Catholic Health Association and Catholic Charities USA–had released their own statements indicating that they were satisfied with the Obama administration’s “compromise” proposal. So while the political battle continues, the Catholic forces are already split.

In a perceptive analysis of the political debate, reporter Laurie Goodstein of the New York Times said that in its decision to amend the original HHS mandate, the Obama administration was “never really driven by a desire to mollify Roman Catholic bishops, who were strongly opposed to the plan.” She explained:

Rather, the fight was for Sister Carol Keehan–head of an influential Catholic hospital group, who had supported President Obama’s health care law–and Catholic allies of the White House seen as the religious left. Sister Keehan had told the White House that the new rule, part of the health care law, went too far.

Now that Sister Keehan has endorsed the Obama “compromise” (along with Father Larry Snyder of Catholic Charities USA), the Obama administration can claim that many Catholics, including some who had originally opposed the plan, now see the wisdom of his ways. President Obama does not intend to persuade the American bishops to support his proposal; he intends to siphon off support for the bishops among American Catholic voters, driving a political wedge further into the country’s Catholic community.

Isn’t this always the technique that subtle politicians use to attack the power of the Catholic Church? King Henry VIII set himself up as supreme ruler of the Church in England, superior to the bishops; the Chinese Communist regime urges the faithful to take their guidance from the Catholic Patriotic Association rather than the stubborn bishops of the “underground” Church; the Chavez regime in Venezuela boasts that the “people’s Church” supports the president even while the bishops warn against the dangerous expansion of his powers. Only rarely do brutal tyrants attempt a frontal assault; much more frequently, Machiavellian leaders attempt to draw invidious comparisons between the “unreasonable” bishops who cling to traditional Catholic teaching and the more accommodating Catholics—never in short supply—who will accept the authority of the state.

In their later statement, USCCB leaders reveal that they were not consulted in advance about President Obama’s proposed “accommodation.” The bishops who have been most heavily involved in this battle apparently now recognize that they are unlikely to reach an agreement with the White House. In their official statement, they said:

We will therefore continue—with no less vigor, no less sense of urgency—our efforts to correct this problem through the other two branches of government. [emphasis added]

Still, despite its clear rejection of the proffered compromise, the bishops’ second statement left the door open to the possibility that some future compromise could secure their acquiescence. Their statement said that the proposal required further study and “careful moral analysis,” and said that the compromise plans presented at the White House on February 10 “appear subject to some measure of change.” These measured words might give some readers the impression that the bishops are hoping to amend the Obama proposal, rather than to defeat it.

The Catholic bishops have long supported access to life-affirming healthcare for all, and the conscience rights of everyone involved in the complex process of providing that healthcare. That is why we raised two serious objections to the “preventive services” regulation issued by the U.S. Department of Health and Human Services (HHS) in August 2011.

First, we objected to the rule forcing private health plans –nationwide, by the stroke of a bureaucrat’s pen –to cover sterilization and contraception, including drugs that may cause abortion. All the other mandated “preventive services” prevent disease, and pregnancy is not a disease. Moreover, forcing plans to cover abortifacients violates existing federal conscience laws. Therefore, we called for the rescission of the mandate altogether.

Second, we explained that the mandate would impose a burden of unprecedented reach and severity on the consciences of those who consider such “services” immoral: insurers forced to write policies including this coverage; employers and schools forced to sponsor and subsidize the coverage; and individual employees and students forced to pay premiums for the coverage. We therefore urged HHS, if it insisted on keeping the mandate, to provide a conscience exemption for all of these stakeholders –not just the extremely small subset of “religious employers” that HHS proposed to exempt initially.

Today, the President has done two things.

First, he has decided to retain HHS’s nationwide mandate of insurance coverage of sterilization and contraception, including some abortifacients. This is both unsupported in the law and remains a grave moral concern. We cannot fail to reiterate this, even as so many would focus exclusively on the question of religious liberty.

Second, the President has announced some changes in how that mandate will be administered, which is still unclear in its details. As far as we can tell at this point, the change appears to have the following basic contours:

• It would still mandate that all insurers must include coverage for the objectionable services in all the policies they would write. At this point, it would appear that self-insuring religious employers, and religious insurance companies, are not exempt from this mandate.

• It would allow non-profit, religious employers to declare that they do not offer such coverage. But the employee and insurer may separately agree to add that coverage. The employee would not have to pay any additional amount to obtain this coverage, and the coverage would be provided as a part of the employer’s policy, not as a separate rider.

• Finally, we are told that the one-year extension on the effective date (from August 1, 2012 to August 1, 2013) is available to any non-profit religious employer who desires it, without any government application or approval process.

These changes require careful moral analysis, and moreover, appear subject to some measure of change. But we note at the outset that the lack of clear protection for key stakeholders –for self-insured religious employers; for religious and secular for-profit employers; for secular non-profit employers; for religious insurers; and for individuals –is unacceptable and must be corrected. And in the case where the employee and insurer agree to add the objectionable coverage, that coverage is still provided as a part of the objecting employer’s plan, financed in the same way as the rest of the coverage offered by the objecting employer. This, too, raises serious moral concerns.

We just received information about this proposal for the first time this morning; we were not consulted in advance. Some information we have is in writing and some is oral. We will, of course, continue to press for the greatest conscience protection we can secure from the Executive Branch. But stepping away from the particulars, we note that today’s proposal continues to involve needless government intrusion in the internal governance of religious institutions, and to threaten government coercion of religious people and groups to violate their most deeply held convictions. In a nation dedicated to religious liberty as its first and founding principle, we should not be limited to negotiating within these parameters. The only complete solution to this religious liberty problem is for HHS to rescind the mandate of these objectionable services.

We will therefore continue –with no less vigor, no less sense of urgency –our efforts to correct this problem through the other two branches of government. For example, we renew our call on Congress to pass, and the Administration to sign, the Respect for Rights of Conscience Act. And we renew our call to the Catholic faithful, and to all our fellow Americans, to join together in this effort to protect religious liberty and freedom of conscience for all.

You and I believe with all our heart and soul that Christ and His Church are one.

That truth has been passed on to us from our predecessors, the apostles, especially St. Paul, who learned that equation on the Road to Damascus, who teaches so tenderly that the Church is the bride of Christ, that the Church is the body of Christ, that Christ and His Church are one.

That truth has been defended by bishops before us, sometimes and yet even today, at the cost of “dungeon, fire, and sword.”

That truth — that He, Christ, and she, His Church, are one — moistens our eyes and puts a lump in our throat as we whisper with De Lubac, “For what would I ever know of Him, without her?”

Each year we return to this premier see of John Carroll to gather as brothers in service to Him and to her. We do business, follow the agenda, vote on documents, renew priorities and hear information reports.

But, one thing we can’t help but remember, one lesson we knew before we got off the plane, train, or car, something we hardly needed to come to this venerable archdiocese to learn, is that “love for Jesus and His Church must be the passion of our lives!”

Perhaps, brethren, our most pressing pastoral challenge today is to reclaim that truth, to restore the luster, the credibility, the beauty of the Church “ever ancient, ever new,” renewing her as the face of Jesus, just as He is the face of God. Maybe our most urgent pastoral priority is to lead our people to see, meet, hear and embrace anew Jesus in and through His Church.

Because, as the chilling statistics we cannot ignore tell us, fewer and fewer of our beloved people — to say nothing about those outside the household of the faith — are convinced that Jesus and His Church are one. As Father Ronald Rolheiser wonders, we may be living in a post-ecclesial era, as people seem to prefer
a King but not the kingdom,
a shepherd with no flock,
to believe without belonging,
a spiritual family with God as my father, as long as I’m
the only child,
“spirituality” without religion
faith without the faithful
Christ without His Church.
So they drift from her, get mad at the Church, grow lax, join another, or just give it all up.

If this does not cause us pastors to shudder, I do not know what will.

The reasons are multiple and well-rehearsed, and we need to take them seriously.

We are quick to add that good news about the Church abounds as well, with evidence galore that the majority of God’s People hold fast to the revealed wisdom that Christ and His Church are one, with particularly refreshing news that young people, new converts, and new arrivals, are still magnetized by that truth, so clear to many of us only three months ago in Madrid, or six months ago at the Easter Vigil, or daily in the wonderfully deep and radiant faith of Catholic immigrants who are still a most welcome — – while sadly harassed — – gift to the Church and the land we love.
But a pressing challenge to us it remains . . . to renew the appeal of the Church, and the Catholic conviction that Christ and His Church are one.
Next year, which we eagerly anticipate as a Year of Faith, marks a half-century since the opening of the Second Vatican Council, which showed us how the Church summons the world foreward, not backward.

Our world would often have us believe that culture is light years ahead of a languishing, moribund Church.

But, of course, we realize the opposite is the case: the Church invites the world to a fresh, original place, not a musty or outdated one. It is always a risk for the world to hear the Church, for she dares the world to “cast out to the deep,” to foster and protect the inviolable dignity of the human person and human life; to acknowledge the truth about life ingrained in reason and nature; to protect marriage and family; to embrace those suffering and struggling; to prefer service to selfishness; and never to stifle the liberty to quench the deep down thirst for the divine that the poets, philosophers, and peasants of the earth know to be what really makes us genuinely human.

The Church loves God’s world like His only begotten Son did. She says yes to everything that is good, decent, honorable and ennobling about the world, and only says no when the world itself negates the dignity of the human person . . . and, as Father Robert Barron reminds us, “saying ‘no’ to a ‘no’ results in a ‘yes ‘!”

To invite our own beloved people, and the world itself, to see Jesus and His Church as one is, of course, the task of the New Evangelization. Pope Benedict will undoubtedly speak to us about this during our nearing ad limina visits, and we eagerly anticipate as well next autumn’s Synod on the New Evangelization. Jesus first called fishermen and then transformed them intoshepherds. TheNew Evangelization prompts us to reclaim the role of fishermen. Perhaps we should begin to carry fishing poles instead of croziers.

Two simple observations might be timely as we as successors of the apostles embrace this urgent task of inviting our people and our world to see Jesus and His Church as one.

First, we resist the temptation to approach the Church as merely a system of organizational energy and support that requires maintenance.
As the Holy Father remarked just recently in his homeland of Germany, “Many see only the outward form of the Church. This makes the Church appear as merely one of the many organizations within a democratic society, whose criteria and laws are then applied to . . . evaluating and dealing, with such a complex entity of the ‘Church’.”

The Church we passionately love is hardly some cumbersome, outmoded club of sticklers, with a medieval bureaucracy, silly human rules on fancy letterhead, one more movement rife with squabbles, opinions, and disagreement.

The Church is Jesus — teaching, healing, saving, serving, inviting; Jesus often “bruised, derided, cursed, defiled.”

The Church is a communio, a supernatural family. Most of us, praise God, are born into it, as we are into our human families. So, the Church is in our spiritual DNA. The Church is our home, our family.

In The Power and The Glory, when the young girl asks him why he just doesn’t renounce his Catholic faith, the un-named “Whisky Priest” replies:
“That’s impossible! There’s no way! It’s out of my power.”
Graham Greene narrates: “The child listened intently. She then said, ‘Oh, I see, like a birthmark’.”

To use a Catholic word, Bingo! Our Church is like a birthmark. Founded by Christ, the Church had her beginning at Pentecost, but her origin is from the Trinity. Yes, her beginning is in history, as was the incarnation, but her origin is outside of time.

Our urgent task to reclaim “love of Jesus and His Church as the passion of our lives” summons us not into ourselves but to Our Lord. Jesus prefers prophets, not programs; saints, not solutions; conversion of hearts, not calls to action; prayer, not protests: Verbum Dei rather than our verbage.

God calls us to be His children, saved by our oldest brother, Jesus, in a supernatural family called the Church.

Now, and here’s number two: since we are a spiritual family, we should hardly be surprised that the Church has troubles, problems . . . to use the talk-show vocabulary, that our supernatural family has some “dysfunction.”

As Dorothy Day remarked: “The Church is the radiant bride of Christ; but her members at times act more like the scarlet woman of Babylon.”

It might seem, brother bishops, that the world wants us to forget every Church-teaching except for the one truth our culture is exuberantly eager to embrace and trumpet: the sinfulness of her members! That’s the one Catholic doctrine to which society bows its head and genuflects with crusading devotion!

We profess it, too. With contrition and deep regret, we acknowledge that the members of the Church — starting with us — are sinners!

One big difference: we who believe in Jesus Christ and His one, holy, Catholic and apostolic Church interpret the sinfulness of her members not as a reason to dismiss the Church or her eternal truths, but to embrace her all the more! The sinfulness of the members of the Church reminds us precisely how much we need the Church. The sinfulness of her members is never an excuse, but a plea, to place ourselves at His wounded side on Calvary from which flows the sacramental life of the Church.

Like Him, she, too, has wounds. Instead of running from them, or hiding them, or denying them, she may be best showing them, like He did that first Easter night.

As Monsignor John Tracy Ellis used to introduce his courses on Church history, “Ladies and gentlemen, be prepared to discover that the Mystical Body of Christ has a lot of warts.”

And we passionately love our bride with wrinkles, warts, and wounds all the more.

We bishops repent as well. At least twice a day — at Mass, and at compline — we ask Divine mercy. Often do we approach the Sacrament of Penance.
One thing both sides of the Catholic ideological spectrum at last agree upon is the answer to this question: who’s to blame for people getting mad at or leaving the Church? Their unanimous answer?
. . . nice to meet you! We’re the cause, they never tire of telling us.
Less shrill voices might comfort us by assuring us that’s not true. Nice to hear . . .
But we are still sincere in often praying “mea culpa, mea culpa, mea maxima culpa.”

As Gregory the Great observed fifteen centuries ago: “the Church is fittingly pictured as dawn . . . dawn only hints that night is over. It does not reveal the full radiance of the day. While it indeed dispels the darkness and welcomes the light, it presents both of them . . . so does the Church.”

Bishops, thanks for listening.
I look out at shepherds, fishermen, leaders, friends.
I look out at 300 brothers each of whom has a ring on his finger, because we’re spoken for, we’re married.
Our episcopal consecration has configured us so intimately to Jesus that He shares with us His bride, the Church.
There’s nothing we enjoy doing more than helping our people, and everybody else, get to know Him and her better. That’s our job description.
Because . . . “Love for Jesus and His Church is the passion of our lives!”

Conducted by International Communications Research (ICR) from September 16-20, 2009, the phone survey of 1,043 U.S. adults found that 60 percent favor – and only thirty percent oppose – “efforts to pass health care reform to provide affordable health insurance for all.” Focusing on that sixty percent, the survey found that:

• Sixty percent of those favoring reform oppose – and only 25 percent support – “measures that would require people to pay for abortion coverage with their federal taxes.”
• By a 49-39 percent plurality, those who favor reform oppose “measures that would require people to pay for abortion coverage with their health insurance premiums”; and
• Among those favoring reform, those who favor maintaining “current federal laws that protect doctors and nurses from being forced to perform or refer for abortions against their will” outnumber those who oppose keeping such laws in place by a margin of two to one (60-30).

Opposition to abortion coverage was somewhat stronger in the total sample of U.S. adults – for example, 67 percent of the total sample opposed requiring people to pay for abortion coverage through their taxes and 56 percent opposed making them do so through their insurance premiums.

The survey also asked: “If the choice were up to you, would you want your own insurance policy to include abortion?” Sixty-eight percent of U.S. adults said ‘No’ and only 24 percent said ‘Yes.’

“The USCCB survey confirms other recent polls conducted by Public Opinion Strategies (August 30-September 1) and Rasmussen Reports (September 14-15) on health care policy and abortion,” said Deirdre McQuade, Assistant Director for Policy & Communications at the USCCB’s Secretariat of Pro-Life Activities. “With each passing week it gets clearer: The American public generally does not want to pay for abortion coverage and does not want health care reform used to promote abortion,” she said.

“Abortion is not health care. The bishops of the United States are working hard to ensure that health care reform serves the most vulnerable among us – especially the poor, immigrants, and the unborn,” McQuade said.

For more information on the U.S. bishops’ position on health care reform, visit www.usccb.org/healthcare.

Survey Methodology
ICR / International Communications Research, based in the Philadelphia suburb of Media, PA, is a top-ranked and nationally recognized market research organization. ICR fielded this study in their national, weekly EXCEL Omnibus telephone survey on behalf of the USCCB from September 16-20, 2009, interviewing a nationwide sample of 1,043 adults aged 18 and older. EXCEL is weighted to provide nationally representative and projectable estimates of the population ages 18+. At a 95 percent level of confidence, the margin of error for this sample of 1,043 is +/-3.0 percent. A full methodology and profile of the pollster are available upon request.

Bishop William Murphy’s letter to members of the US House of Representatives endorsing comprehensive health care for every inhabitant of the United States (including illegal immigrants) raises an important question about the involvement of the United States bishops in politics. Granted, the letter comes from Bishop Murphy as chairman of the Domestic Justice and Human Development Committee of the USCCB. It is not, apparently, a mandate of the body of bishops as a whole. Nonetheless, the letter once again raises the critical question: Where is the line between moral principles, which the bishops must enunciate clearly and forcefully, and public policy, which the bishops have neither the charism nor the competence to formulate?

This question has long haunted the Church in America, especially in the heady post-Vatican II years when many bishops apparently believed that Catholic doctrine itself was in the midst of a major reformulation, resulting in episcopal political statements that were sometimes not so very well grounded in Catholic moral principles. But the main issue is not whether the bishops have a firm grasp of Catholic moral principles, but whether they have a superior grasp of how effectively this or that public policy embodies those principles. According to Church teaching, they don’t. In both theory and practice it is up to the laity, formed by Catholic principles, to determine the best prudential response to various public issues.

The episcopal office does not confer any particular special insight into either the feasibility or the effectiveness of proposed public policies; nor is there any historical warrant for suggesting that, in practice, bishops as a body are better at this sort of thing than laymen. In fact, both by training and experience, one would expect politically active lay persons to have a better grasp of the art of the possible in implementing effective public policies, just as one would expect bishops to have a better grasp of Catholic faith and morals.

Social Justice and Social Change

When the Church involves herself in politics, she is wont to talk about “social justice” rather than charity. However, as Pope Benedict XVI clearly stated in his first encyclical, Deus Caritas Est , the special province of the Church is charity. It is the State which has justice as its proper end. This does not mean that the Church should not teach the principles of justice. Justice derives from the moral law, which Revelation helps the Church to enunciate with unmatched clarity. But there is a blurry line between charity and justice in the public context, even when both aim at the same goal.

For example, consider these questions: Is it a matter of charity or justice that free education should be available to all citizens? Or that the poor should receive a high level of housing and food benefits? Or that health care should be free? There is no “right” answer to these questions; the answers depend very much on the social context. In previous eras, nobody would have argued that the State had an obligation in justice to provide these things. The scope of the State was utterly insufficient to the purpose, and economic conditions were such that it simply could not be expected that a very large percentage of citizens could ever have access to such benefits. But if one person denied to another person a benefit to which he was ordinarily entitled—stealing a noble’s inheritance or riding roughshod over a peasant’s right to common acreage and shared equipment—then a matter of justice was clearly present. For the rest, the charity of friends, neighbors and the Church herself was essential to get people through difficult times.

In Western affluent mass societies, the general level of material well-being is far higher, and it is not (in theory) based on rank or class. Universal public education is a fact of life, and in a non-agrarian society education is seen as a key to making one’s livelihood. We tend to think, therefore, that everyone has a right to be educated; hence it is a matter of justice if someone is denied schooling. But we carry this only so far. It does not apply to college or graduate school. In other words, a moment’s reflection reveals to us that issues of justice are not always absolute. Instead, many issues take on a dimension of justice by virtue of the conventions of the social context in which the issues are raised. The most important point to recognize here is that the term “social justice” is very malleable; it is what the ancients recognized as distributive justice, and it must take circumstances into account. Thus it depends only partly on the natural law and to a much greater degree on the expectations, customs and capabilities of the society in question. (In contrast, charity faces no such conceptual problems: It is always a personal response to another’s need out of love.)

Health Care

Health care is an excellent case in point. The very dream that all people should have access to a high level of professional health care depends on the peculiar features of particular societies: the widespread availability of competent professional care; a generalized familiarity with such care throughout the social order; a high percentage of persons already enjoying the advantages of this care; a significant understanding of public health; the advancement of medicine to the point that the difference between those who have medical care and those who do not is both significant and predictable; and of course tremendous affluence.

But for this dream to be the proper province of the State, we must somehow translate it from the sphere of desire to the sphere of justice. One would expect that the special gift of bishops would be to articulate the principles which make a given potential benefit a matter of justice; the case needs to be made because there is very little absolute about this sort of social claim. Thus the bishops might suggest (as I believe they would be right to do) that the claim to health care (or any other social benefit) becomes a matter of justice in a given society when that society begins to perceive, in its own context, that health care is unnecessarily unavailable to defined groups of people who—again, in the culture’s own particular context—would ordinarily be expected to have access to it.

The example of education may again prove useful. At a certain point in Western history, it became a feature of our common Western culture that the vast majority of people could be educated. A variety of philosophical, social and economic circumstances led to this cultural shift, and it took a very long time for the availability of education to reach anything like what we might call critical mass. Once critical mass was reached, it became the norm that all persons should be educated in a certain way (so much so that people gradually lost a great deal of personal control over the matter). Once this became the norm—and not before—society was in a position to judge it an injustice if anyone was prevented from going to school. Health care is perhaps now on a similar trajectory. However, it is not a matter of absolute principle but of socio-economic-political judgment whether, in fact, our culture is in a position to demand a certain level of health care as a matter of justice.

Problems

Once again, the primary role of bishops is not to endorse a particular policy proposal or a particular demographic result, but to explain the various principles and related considerations which might be sufficient to make health care a justice issue. Such a case may well be worthy of serious consideration, given the current characteristics of our society. Moreover, I would suggest that the bishops ought to be uniquely qualified to make this case—just as they are generally unqualified to endorse any particular method of embodying such principles of justice in public policy.

After all, there are grave problems with any specific implementation of these principles in health care. Costs, quality of care, and personal liberty in determining the nature and scope of one’s medical treatment are among the more obvious. But the very involvement of the public order in medical care raises problems of its own, just as it has in education. It is no secret that a very large number of bishops were reared in the social traditions of modern liberalism. Perhaps as a result, many bishops assume that if a social problem exists, the Federal government must be put in charge of solving it. But he who lives by the Federal government may well die by it, for the Federal government is deeply involved in and supportive of quite a few grave moral evils in the realm of standard health care.

Bishop Murphy recognizes this difficulty, sort of. He warns that “no health care legislation that compels Americans to pay for or participate in abortion will find sufficient votes to pass.” But this is only another political judgment that no bishop is qualified to make. The smart money, I think, suggests that a universal medical system, if it were to pass all the other objections, would not be long subverted by such “petty” concerns as contraception, abortion and the use of aborted embryos in medical treatments—or even by assisted suicide, should that become the secular norm. One needs only to consider how we have fared in keeping such things out of insurance coverage. In any case, the main point is that Bishop Murphy, who only “sort of” sees the problem, does not see it as something that would deter him from demanding that the Federal government institute comprehensive health care now. The same ideological problems that undermine the values of the American citizenry in public education will be at work in the actual giving and taking of life in public medicine.

It probably isn’t necessary to raise the question of costs; the public is very sensitive to cost issues at the moment anyway. But Bishop Murphy’s letter does endorse the provision of ”comprehensive and affordable health care for every person living in the United States.” This hides a hornet’s nest of questions, many of which revolve around the question of how much health care we can afford for how many. Alas, Revelation does not touch upon this issue. Questions of efficiency and quality are equally complex. For example, would it be unjust to allow persons of means to seek additional or better health care than the universal system provides? This would, after all, give them a social advantage. And would doctors and hospitals be permitted to provide such health care outside the system? Another huge consideration is the impact on illegal immigration of ever-greater public benefits for every man, woman and child residing on American soil.

Willy Nilly Doesn’t Cut It

Again, my point is not to argue against a better solution to health care in our society. As I have indicated, my personal assessment is that, although the best course is far from clear, our society does possess the combination of characteristics which make it morally necessary to think hard about this question, and to consider what might be done. As societies grow and change, along with their resources and their methods of using resources, different questions come to the fore, and sometimes circumstances do change enough to require the application of principles of justice to new areas of life, areas in which the question of justice was quite rightly inapplicable in another place and another time.

But it goes way beyond what we can know in our current context to assume willy nilly that these questions of justice are clear and easily applicable, or that one particular solution is obviously the best course. By all means, the bishops should lead a penetrating discussion of how and when certain social realities push new questions into the sphere of what we might call relative justice. They should apply this discussion very particularly to health care. And they should also point out clearly any absolute moral imperatives they see as critical to the discussion, such as not being forced to participate in murder. Then, based on an ever-deepening understanding of moral issues provided by cogent episcopal teaching, the bishops need to back away and allow the laity to do their own proper job: The formulation and implementation of specific public policies.