Catholic teachings and health care

Q&A

August 10, 1993|By Frank P. L. Somerville | Frank P. L. Somerville,Staff Writer

The academic dean at St. Mary's Seminary and University in Roland Park believes that Roman Catholic teachings about justice, life and death have "significant insights" to contribute to the national debate over health care, and he has written a book to try to prove it.

"Speaking as a moral theologian, I would find it most regrettable if health care reform were based solely on economics and pragmatic political considerations," the Rev. Philip S. Keane, S.S., says in the book's introduction. "Health Care Reform: A Catholic View" has just been published by the Paulist Press.

His starting point is the concept of "distributive justice," the belief that society owes every citizen a guaranteed minimum of the goods necessary for a decent existence. Health care, he says, must now be added to such shared needs as education, defense and transportation.

Father Keane was born in 1941 in Syracuse, N.Y. A professor of moral theology with a doctorate from Catholic University, he has been dean at St. Mary's since 1986.

For nearly 17 years, he has advised three Catholic hospitals on medical ethics: Mercy and Bon Secours in Baltimore and Holy Cross in Silver Spring. His other books, also published by the Paulist Press, are "Sexual Morality: A Catholic Perspective" (1977) and "Christian Ethics and Imagination" (1984).

QUESTION: What Catholic teachings are relevant to health care reform?

ANSWER: Our theological tradition on social justice, especially since the end of the 19th century, and our whole theology -- it's really existed since the 16th century -- about the caring of the dying, about what's required and what's not required.

Q: What is required?

A: Ordinary kinds of health care should be provided but extraordinary means are not required.

I don't see how we can come to a truly just system of delivering health care in our culture unless we face up to the fact of death -- that death is a part of life -- and unless we are willing to let go of treatments that really do not benefit dying patients but simply prolong the suffering of the dying.

Q: Is the American public ready to accept your view of death?

A: Our culture is strongly individualistic on the one hand, but there is such a wide refusal to deal with death. I mean, just look at television and the way products are advertised. They're all going to make us young or glamorous or beautiful or whatever. I think we need a new attitude about somehow accepting our mortality, that death is a part of life, and that we can't do everything theoretically possible to prevent it. That issue is of great concern to me.

Q: How does it relate to health care reform?

A: I wonder if we can have a really coherent health care delivery system unless we face the fact that there is a limit to how much of our economic product we can spend on health care. My sense is that we have gotten too enamored of modern technology.

I don't deny that absolutely wonderful things have happened in health care in the 20th century, and we want them to continue. But I have this fantasy that we'll spend so much money developing health care technologies and so little on education that in another generation we'll have an enormously sophisticated set of health care technologies and no one that has the intelligence to use them. That's overstating it -- but you see what I'm getting at.

Q: So we need to set limits, to ration health care?

A: I don't want to say that every system of rationing that's been proposed would meet the criteria of justice. I know that the Catholic bishops have raised concerns about some of the

models. Obviously, rationing has to be a last resort. All sorts of other steps need to be dealt with first, like being sure that we are not spending money on nonbeneficial treatments.

But especially when you get to the area of research for the future, we may just have to make some decisions that we cannot afford to spend every conceivable dollar or cure every conceivable disease.

Q: You suggest in your book that a United Nations-administered international fund for medical research might be necessary. Is that practical?

A: I don't know. I feel that some of the other productive economies in the world need to take a larger role in funding health-care research.

Q: Has Catholic teaching changed relative to health care?

A: More and more, we see access to health care as a human rights issue. When human rights thinking became prominent in the 18th and 19th centuries, health and the care for health were in such a primitive condition that we didn't tend to focus on it like we did on public education and some other things.

My view, from a human rights position, is that every person in this country, as is the case in many other countries in the world, ought to have access to a reasonably decent package of health care services regardless of economic status, age or any other factor.

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