The Roman Catholic Tradition Religious Beliefs and Healthcare Decisions By Ronald P. Hamel Updated by Kevin O’Rourke he Roman Catholic church is one of the largest Treligious bodies worldwide, numbering over 750 million members, and is the largest single church in the United States. It identifies its origins with Jesus of Nazareth. Although Jesus himself did not found a church, his followers in Jerusalem organized around the Twelve Apostles after his death (ca. 30 C.E.) and Contents carried on his mission of preaching and teaching the The Individual and the 7 reign of God and the “good news of salvation.” The Patient-Caregiver Relationship latter was the belief among Jesus’ followers that faith in Jesus, whom they believed to have been raised by Family, Sexuality, and Procreation 12 God from the dead, would lead to salvation. Genetics 17 Initially, the disciples of Jesus sought converts Organ and Tissue Transplantation 18 among fellow Jews throughout Palestine and did not view themselves as distinct from Judaism. The apostle Mental Health 19 Paul (d. ca. 67 C.E.) made the first significant attempt Death and Dying 20 to convert Gentiles to Christianity. After his own con- version from Judaism, Paul made several missionary Special Concerns 24 journeys throughout the Roman Empire. By about 60 C.E., he and others had preached the faith in most of the eastern Mediterranean and as far west as Rome. A century later, Christian communities existed in most if not all of the cities of the Roman Empire. The early Christian communities structured them- selves in diverse ways and comprised a variety of Ronald P. Hamel is Senior Associate in Ethics at the Catholic Health Association. Part of the “Religious Traditions and Healthcare Decisions” handbook series Kevin O’Rourke, O.P., is a professor at the Neiswanger Institute published by the Park Ridge Center of Ethics and Public Policy, Stritch School of Medicine, Loyola for the Study of Health, Faith, and Ethics University Chicago. THE PARK RIDGE CENTER ministries and ministers, including deacons, eld- By the end of the fourth century, Christianity ers, presbyters, and bishops. Despite their diver- had made significant strides. Most of the urban sity, these communities did hold some elements population in Italy, Spain, Gaul, and Africa had in common: “faith in Jesus as Messiah and been converted. Much missionary work Lord; the practice of Baptism and the celebra- remained to be done, however, among the peas- tion of the Eucharist; the apostolic preaching ant populations and throughout the rest of and instruction; the high regard for communal Europe. love; and the expectation of the coming Both the spread of Christianity and papal Kingdom of God” (McBrien 1980, 2: 583). The power increased during the early Middle Ages apostle Peter, one of the original twelve, held a (500-1050), largely because of the 600-year position of prominence among the other apos- “invasion” of the Germanic tribes into western tles and within the local churches. Europe. Pope Gregory the Great (elected in 590) During the second and third centuries, took great interest in converting the “barbar- Christians were heavily persecuted by the ians” to Christianity for both religious and polit- Roman government. But this persecution ceased ical reasons. He saw, on the one hand, an oppor- in the fourth century, and Christianity spread. In tunity to spread the faith to larger regions of 313, the recently converted emperor Constantine Europe, and on the other, an occasion to gain not only legalized Christianity, thus ending the the support of the Germanic peoples in order to persecution, but also showed great favor to strengthen his own position, given the virtual Christians in the laws and policies he instituted. absence of support for him from the emperor of This trend was continued by all but one subse- the East. In fact, the collapse of the Roman quent emperor and culminated in 391 when the Empire and the leadership void it created emperor Theodosius declared Christianity the afforded the papacy even more temporal power. official religion of the Roman Empire. Thus The new converts to Christianity and the nations began an intimate relationship between church to which they belonged looked to Rome for and state that continued in Western Christianity leadership. And they in turn were for the pope a for the next thousand years. This relationship source of temporal power and wealth. These was founded on the belief that the emperor was trends were reinforced in the early ninth century divinely appointed and was charged with pro- when Charlemagne became ruler of the Holy tecting the church as well as ruling the empire. Roman Empire. He was a great supporter of the Constantine contributed in yet another way to papacy, and under his rule any lines that still the shaping of the Christian church. In 330, he separated the church and the Western empire transferred the capital of the empire from Rome quickly dissolved. to Byzantium in the East, renaming it By the time Gregory VII was elected pope in Constantinople. This action had profound conse- 1073, the Holy Roman Empire had shrunk in quences, among them, a gradual increase in size and had become fragmented into feudal papal power. The transfer of power to the East municipalities. Christianity was no longer coex- left a political vacuum in the ancient capital of tensive with the Western empire and, in fact, Rome, a vacuum increasingly filled by the pope. transcended its boundaries. Given all of this, it The papacy began to view itself as having seemed only fitting to Gregory that the pope absolute spiritual and temporal power within the should enjoy political as well as spiritual church and established Rome as the spiritual supremacy, and he acted accordingly. Popes dur- capital of Christianity. Some popes even saw ing the remainder of the High Middle Ages con- themselves as the Western counterpart to the tinued the tradition of a strong papal monarchy. emperor in the East and as having ultimate This changed during the late Middle Ages power within western Europe. (1300-1545) with the rise of nation-states of 2 THE ROMAN CATHOLIC TRADITION: RELIGIOUS BELIEFS AND HEALTHCARE DECISIONS nationalistic populations headed by powerful With the founding of the colonies, Roman rulers. These forces ultimately led to the collapse Catholicism in the United States grew slowly. of papal supremacy and the power of Western Most of the colonists were Protestant, and in Christianity. The Great Schism (1378-1417), dur- 1652 legal restrictions were placed on Catholics ing which there were two, and at one point three, in Maryland, the colony they had founded in popes reigning simultaneously, further eroded 1634, as well as throughout the other colonies. the status and authority of the papacy. The Revolution, however, brought Catholics reli- The final blow to the unity, influence, and gious and political freedom. With the adoption power of Christianity and to the authority of the of the Constitution in 1787, religious equality pope came with the reform efforts of Luther, was legally guaranteed. Zwingli, and Calvin, the leaders of the Protestant Shortly after the Revolution, just over 18,000 Reformation. Initiatives by several popes and a Catholics lived in the U.S., concentrated mostly number of monastic orders to reform abuses had in Maryland, Pennsylvania, Virginia, and New limited success. The Protestant reformers took York. They had no clergy and were essentially more radical steps, challenging not only moral unorganized. After considerable conflict, John laxity and particular abuses within the church Carroll was named the “prefect apostolic” of the but also some of its theology. By the middle of 13 original states; the vicar apostolic of London the sixteenth century, the British Isles, refused to continue to exercise jurisdiction over Scandinavia, and much of France, Germany, and the “rebels.” By the early 1800s around 150,000 Austria had broken with Rome. The Catholics had organized about 80 churches. By Reformation “brought to an end the medieval 1890, the number had grown to 6,231,417, Catholic Church, a structure that had exercised largely because of the flood of immigrants from nearly exclusive authority in religion in western Catholic countries on the Continent. Today the Europe for a millennium” (Amundsen 1986: over 51 million Roman Catholics in the United 68). States belong to about 18,250 churches and The Counter Reformation was launched make up roughly 22 percent of the population. with the election of Pope Paul III in 1534 and the Council of Trent, which met from 1545 until 1563. The council corrected some abuses INSTITUTIONAL AUTHORITY AND and was extraordinarily influential in clarifying INDIVIDUAL CONSCIENCE matters of faith and in issuing disciplinary decrees, but it was not able to reunify Western The Roman Catholic church is probably the Christianity. most centralized of religious bodies. Authority Catholicism first came to North America with ultimately resides in the first among the bishops the early Spanish explorers, beginning with and the spiritual leader of the church, the bish- Columbus in 1492. By 1565, the first permanent op of Rome or the pope. His authority is parish in America was founded in St. Augustine, believed to derive from Jesus himself, who Florida. Subsequently, other missions were entrusted to St. Peter, chief among the Twelve founded in Florida, Alabama, California, and the Apostles, the authority to govern the church: “I Southwest by Spanish clergy, many of whom for my part declare to you, you are ‘Rock,’ and were Franciscans. The French explorers also on this rock I will build my church, and the jaws brought missionary clergy with them, and some of death shall not prevail against it. I will entrust of the explorers—Cartier, Joliet, Marquette, and to you the keys of the kingdom of heaven.