Witness, Identity and Common Ground in Collaborative Arrangements: a Partner’S Perspective

WINTER 2019 FEATURE ARTICLE chausa.org/hceusa Witness, Identity and Common Ground Witness, Identity and Common Ground in Collaborative Arrangements: A Partner’s Perspective Mark F. Carr, M.Div., Ph.D. these healing ministries of Christ continually morph and respond to the present-day INTRODUCTION American health care industry and its regulation by the federal government. Could this industry The publication of a revised Part Six of the ever change so much that we should seriously Ethical and Religious Directives for Catholic Health consider backing away from some or all of its Care Services (ERDs) and the proliferation of expressions in our ministries? collaborative ventures, both within Catholic health care and between Catholic health care PART SIX, ERDs, 2018 and other partners, provide a good opportunity to examine three collaborative arrangements First, let’s take a brief look at the new Part Six, (CAs) between Roman Catholic health care which is based upon a Vatican document issued corporations and Seventh-day Adventist health in 2014.3 Ethicists seem to agree that the 1 care corporations. As an ordained Seventh-day revision is more confirmatory or clarifying, Adventist minister and ethicist who presently rather than something entirely new,4 yet there works for a Catholic health care system are some important, if subtle differences. (Providence St. Joseph Health), as well as serving for a time as an ethics consultant for In his analysis of the revised Part Six, John A. 2 one of the three CAs (Centura Health ), I hope Gallagher, Ph.D., points out a shift toward the to offer a unique perspective. church’s “prophetic witness” or “witness to Christ” in our present-day world. Gallagher These cooperative arrangements between our writes: two faiths are both feasible and necessary in the current American health care industry. The These Directives are not primarily success of Centura Health is an indicator of the about the principle of cooperation nor high likelihood of success for present and are they principally about the future arrangements even in light of the recent discernment of moral evils, although ERD revision. However, I think it is also these remain elements of an appropriate important to revisit our idea of “success” as 1 Copyright © 2019 CHA. Permission granted to CHA-member organizations and Saint Louis University to copy and distribute for educational purposes. WINTER 2019 FEATURE ARTICLE chausa.org/hceusa Witness, Identity and Common Ground discernment of the church/world, faith/culture tension. The revisions to “We stayed totally faithful to Part Six of the ERDs are primarily concerned to ensure that prophetic what needed to be different – witness, the church’s witness to Christ our own theologies – yet there and the new evangelization are vitally engaged in the world and culture was so much good work to be through the health care ministry.5 done together that it did not He also suggests that there is less stress on violate our identities.” scandal and the principles of cooperation or double effect and more on “What the church is and what the church does to frame its engagement with the world and culture.” • Sacred Trust of the Northern California Indeed, Gallagher asserts that in light of this area: This CA is still under review by emphasis, “the principle of cooperation has the Federal Trade Commission and the 6 become secondary.” If it is the case that the California State Attorney General.8 primary concern for CAs revolves around the church’s prophetic witness to Christ, how For Seventh-day Adventist health care would an analysis of a potential CA with a corporations, the analysis of a possible CA Seventh-day Adventist health care corporation revolves around two central questions: Is it appear to us? Would discernment about such a beneficial to the long-term financial health of deal take a broad, sweeping look at the corporation and can it maintain its identity commonalities of commitments to being and mission in the process? These questions, in Christ’s witness to world and culture? Or, addition to how such arrangements serve would it be more concerned for the details of society, are also key to Catholic organizations. specific ERDs dealing with abortion, end-of- life care, or contraception? Perhaps both These themes are reflected in personal analyses are essential. interviews with several involved parties of the Centura and Sacred Trust CAs. On first blush, HOW DO ADVENTISTS AND CATHOLICS GO it seems that the analysis (I won’t use the term ABOUT FORMING COLLABORATIVE “discernment” since it is not the term ARRANGEMENTS? Adventists would use) is somewhat ad hoc, but the reader should realize that Adventism is very For the purposes of this article, I reached out to young (at 155 years) in comparison with over twenty individuals who were party to the Catholicism. It is important to highlight the fact discussions that formed three CAs: that as a denomination, Adventism is in a stage of development quite unlike that of • Centura Health of Colorado: Catholicism. One important commonality I https://www.centura.org/ 7 have found, however, regards the tension • AMITA Health of the Chicago area: between the clerical branch and the health care https://www.AMITAhealth.org/ 2 Copyright © 2019 CHA. Permission granted to CHA-member organizations and Saint Louis University to copy and distribute for educational purposes. WINTER 2019 FEATURE ARTICLE chausa.org/hceusa Witness, Identity and Common Ground branch for each tradition. I’ll say more about is more hierarchical than the Adventist this later. system, so cultural differences began to surface. “There was never a struggle In 1995, in the Denver market, a deal was over mission or names,” King says, struck between PorterCare (Adventist) and the “but our ways of doing business were Sisters of Charity Health Services, Colorado to different. The Adventists have a less form Centura Health. Stephen King (Adventist) centralized system. The Catholic side is and Sister Nancy Hoffman (RCC) were present more hierarchical.”14 at the outset. Sister Nancy noted in a 1999 article, “It seemed a most unlikely Pointing to the overall mission and identity partnership.”9 But market forces compelled concerns of both sides (what Gallagher these unlikely partners into considering the identified as aiming toward the prophetic unusual: witness to Christ in our world and culture), Sister Nancy and Stephen King wrote about They were, indeed, extraordinary times. their experience together at Centura: “Those of By the early 1990s, the for-profit us whose mission and values support the health hospital giant Columbia/HCA had and well-being of all members of the rolled into Denver, purchased several community have struggled to find innovative hospitals, forced closures and buyouts, ways to continue to provide quality service and and captured 35 percent of the market patient care to our fellow human beings” they share…10 said. Even though they “lived out…[their] faithfulness to sponsors in different ways,” they Stephen King highlights the second of the two attest to a “reverence” for each other and their concerns, namely maintaining Adventist traditions as well as a “confidence” in the identity and culture (an issue similarly future.15 important to the Catholic side of the Centura deal): “We stayed totally faithful to what needed After a restructuring in 2014, there was a to be different—our own theologies—yet there reduction in mission leadership, which gave rise was so much good work to be done together to concerns about whether mission identity and that it did not violate our identities.”11 What leadership formation would suffer.16 appeared at first to Sister Nancy as an “unlikely partnership,” years later had become a For Charles Sandefur, at the time president of “wonderful journey” for which she comments, the Rocky Mountain Conference of Seventh- “When you come down to the true Christian day Adventists, the Centura Health deal was a message, you see how similar we are.”12 “pivotal moment” for Adventist health care in the United States. As the General Conference Yet, there were and remain significant of Seventh-day Adventists backed away from differences. In a Spectrum13 article, Linda legal ownership of Adventist health care Andrews writes: corporations in the late 1980s, those corporations began to coalesce into five entities …. there have been some tensions. along roughly regional lines. PorterCare in the King explains that the Catholic system Denver area didn’t naturally fit into any of the 3 Copyright © 2019 CHA. Permission granted to CHA-member organizations and Saint Louis University to copy and distribute for educational purposes. WINTER 2019 FEATURE ARTICLE chausa.org/hceusa Witness, Identity and Common Ground five areas. Realizing they needed help to stay in our understanding of ourselves and this is the health care ministry, they came to the good. difficult conclusion that they would be better off partnering with the Sisters of Charity. In the process of negotiating with interested parties, Sandefur went to Chicago to visit with a Many of the Adventist constituents, however, select group of bishops from the United States felt it was better to be purchased and get out of Conference of Catholic Bishops. He felt they the business than to partner with Catholics. But were impressed by the Adventist ability to insist Sandefur and enough others felt that in order to upon and find qualified persons of the maintain the mission of Adventist health care Adventist faith to place in executive leadership ministry, it needed to be dragged into the 21st in the health care corporations. For his part, century regardless of the existential angst Sandefur walked away from these meetings associated with forming such a collaborative with a new appreciation for Catholic concern association. Those who opposed the for social justice and for providing health care collaborative association represented an intense to the poor and vulnerable of our Adventist, anti-Catholic sub-culture.

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