Hemlock, health care and Catholic choices

The "Your Life, Your Choices" booklet didn't cause trouble at the Department of Veterans Affairs until late in President George W. Bush's second term. That's when critics spotted an odd detail in this guide for end-of-life medical decisions. It urged aging veterans to seek expert advice from one group – Compassion & Choices. It helps to know that this organization was created in 2005 through the merger of two groups, Compassion in Dying and End-of-Life Choices and that, until 2003, End-of-Life Choices was known as the Hemlock Society.

The Bush White House pulled that edition of "Your Life, Your Choices," but a revised version – minus the plug for Compassion & Choices – has been restored to the VA.gov website. Conservative critics remain worried.

"Obviously, the Catholic church and our bishops have been strong advocates of health-care reform, especially when it comes to making the system more accessible for the poor and needy. That's a no-brainer," said John Haas, president of the National Catholic Bioethics Center and a member of U.S. Conference of Catholic Bishops task force on health care.

"But this VA issue shows why we just don't trust the government when it comes to helping people make all the moral and religious decisions that come at the end of life. ... The Hemlock Society? Catholics would rather do our own counseling, thank you very much."

It's easy for outsiders to get lost in the details of the sprawling packages of legislation now being debated on Capitol Hill. However, Haas stressed that critical questions remain unanswered about how efforts to reform America's health-care system will affect hot-button issues such as abortion, stem-cell research and health-care rationing for the elderly and chronically ill.

Thus, a letter from the U.S. bishops to Congress and the White House pledged support for accessible, affordable, universal health-care reform that truly "protects and respects the life and dignity of all people from conception until natural death."

In the headlines, it is easy for these concerns to be crunched into shouted questions in health-care forums about taxpayer-funded abortions and fears that government "death panels" will micromanage critical decisions in nursing homes.

But calmer, quieter voices inside the Washington Beltway still want to know more about the proposed Center for Health Outcomes Research and Evaluation, which legislation sponsored by the late Sen. Edward Kennedy claims would "collect, conduct, support and synthesize research comparing health outcomes, effectiveness and appropriateness of health care services and procedures."

While striving to avoid risky specifics, President Barack Obama has said it will be impossible to expand health-care services without tough-minded reforms that cut costs. This is especially true when discussing care for the elderly.

"That's where I think you just get into some very difficult moral issues. But that's also a huge driver of cost, right? I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here," said Obama, in a much-quoted New York Times interview.

"I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. ... That's part of why you have to have some independent group that can give you guidance."

The president recently went further, according to Twitter postings from a conference call with 1,000 rabbis. Obama reached out to these religious leaders, stressing, "We are God's partners in matters of life and death."

No one doubts that millions of Americans want help while making decisions about end-of-life medical issues, stressed Haas. The question is whether most would prefer to face these ultimate issues with help from government experts or from their own pastors, rabbis, priests, hospice workers and other religious counselors.

"The Catholic Church has a highly developed body of teachings and traditions to help guide people through these kinds of decisions," said Haas. "We believe that hospice care is normal and good. We believe that it's right to die a good death, with an emphasis on the relief of pain and suffering. ...

"But let's be clear. We think the government has an agenda on these kinds of issues and it's not the church's agenda. When it comes to dying, controlling costs is not our primary goal."

Eunice Kennedy Shriver, pro-lifer

There is nothing particularly newsworthy about a coalition of pro-lifers releasing a public manifesto that criticizes politicos who support abortion rights. Nevertheless, a full-page advertisement in the New York Times during the 1992 Democratic National Convention raised eyebrows because a few prominent Democrats endorsed "A New American Compact: Caring about Women, Caring for the Unborn."

One name in particular jumped out in this list – Kennedy.

"The advocates of abortion on demand falsely assume two things: that women must suffer if the lives of unborn children are legally protected; and that women can only attain equality by having the legal option of destroying their innocent offspring in the womb," proclaimed ad's lengthy and detailed text.

"We propose a new understanding, one that does not pit mother against child. To establish justice and to promote the general welfare, America does not need the abortion license. What America needs are policies that responsibly protect and advance the interest of mothers AND their children, both before AND after birth."

Near the end, the statement added: "We can choose to reaffirm our respect for human life. We can choose to extend once again the mantle of protection to all members of the human family, including the unborn."

It really wasn't a surprise that Eunice Kennedy Shriver – who died on Aug. 11, after a series of strokes – was among those who signed the document, along with her husband Sargent Shriver, the 1972 Democratic nominee for vice president.

Yes, she was the sister of President John F. Kennedy, Sen. Robert Kennedy, and Sen. Edward Kennedy and part of a family dynasty that changed how Americans view progressive politics and Catholicism.

But Eunice Shriver also attended convent schools, considered becoming a nun and remained a daily-Mass Catholic throughout her life, while teaching the Rosary prayers to her five children and 19 grandchildren. She was a public supporter of Democrats for Life, Feminists for Life and the Susan B. Anthony List, which supports pro-life women who seek public office.

"She was pious, I think, a very, very pious woman," said Robert F. Kennedy Jr., stating the obvious during a six-hour public wake and Mass for his aunt at Our Lady of Victory Church on Cape Cod.

An official tribute went further while connecting her faith with the issue that dominated her public life.

"Inspired by her love of God, her devotion to her family, and her relentless belief in the dignity and worth of every human life, she worked without ceasing," said the family's public statement. "She was a living prayer. ... She set out to change the world and to change us, and she did that and more. She founded the movement that became Special Olympics, the largest movement for acceptance and inclusion for people with intellectual disabilities in the history of the world. Her work transformed the lives of hundreds of millions of people across the globe, and they in turn are her living legacy."

The mainstream obituaries and media tributes that followed her death also connected Shriver's work with the poignant life of her older sister Rosemary Kennedy, who was mentally disabled. In a historic 1962 article for the Saturday Evening Post, Eunice yanked one of Camelot's most tragic secrets into the open – under the stark headline, "Hope for Retarded Children." In the decades that followed, she worked tirelessly to pull Rosemary into the family circle.

Nevertheless, elite journalists failed to connect the dots between Shriver's fierce activism on behalf of children facing disabilities and her commitment to defending the lives of the unborn, including babies with Down syndrome and other genetic flaws.

For Eunice Kennedy Shriver, the sanctity of life was a Catholic issue, a political issue and an intensely personal issue.

"She was preeminently pro-life, against abortion and there to protect and underscore the dignity of every person. This, of course, manifested itself in her love for children with disabilities," noted Cardinal Sean P. O'Malley of Boston, in a reflection posted online.

"While Eunice's works were remarkable, I don't want to lose sight of the fact that her Catholic faith and education was a very important part of what motivated her and helped her to interpret reality. ... It was certainly the soil out of which grew her passion and dedication to the less fortunate and those who are challenged by disabilities and mental retardation."

Wafer madness

Editor's note: Tmatt did not write a column for Scripps Howard this week, due to last-minute travel to Atlanta for the funeral of my wife Debra's mother, Jeanne Bridges Kuhn. The following is a post written for GetReligion.org, which will interest many of my regular readers. To read the interactive version of this post, click here. * * * *

There is no question what the Roman Catholic Church calls the holy bread that is consecrated during the Mass. It is called the “host.” Anyone who knows anything about Catholic liturgy knows this.

Now, how do you describe or define the host? Those seeking to be reverent tend to call it “consecrated bread.”

The problem, of course, is that the special bread used in Western Rite services is not simply unleavened bread. As the old saying goes, there are two acts of faith involved in meditating on the host during a Mass. The first is to believe that it is the Body of Christ. The second is to believe that it is, in fact, bread.

Thus, many people refer to the host in a variety of ways. Some people insist on calling the host a “wafer,” a term that angers many Catholics. However, there are Catholics who use this term. Still, most simply call it by its traditional name — a host.

It is true that, if you look up definitions online, there is an ecclesiastical definition for “wafer” that applies. Thus, you end up with these two clashing definitions:

1. A small thin crisp cake, biscuit, or candy.

2. Ecclesiastical – A small thin disk of unleavened bread used in the Eucharist.

So, is this unique bread the consecrated “host” or some kind of supposedly holy cookie? That seems to be the question.

I raise this because of the interesting and very detailed story that ran in the Boston Globe the other day about rites of “perpetual adoration,” a tradition that is explained well right at the top by religion-beat specialist Michael Paulson. However, many will stumble, or even scream, right at the lede:

The adorers sit in silence before the wafer.

Some settle cross-legged on the floor by the altar. Others kneel in a favorite pew. They read, or say the rosary; they pray, or think, or just allow the mind to wander. Hour after hour, day after day, they take part in an unusual Catholic ritual that appears to be making a modest comeback — a quest for silence in a noisy life, a desire to be part of a team, a hunger to feel closer to God.

The ritual, called perpetual adoration, is, at one level, strikingly simple: around-the-clock, people take turns sitting in a chapel in the presence of a consecrated wafer. But at another level, the ritual reflects an embrace of the teaching of Catholicism that many find hardest to understand: the belief that, during Mass, bread and wine are literally transformed into the body and blood of Jesus.

The lede seems to settle the issue. It’s a wafer. The Catholic church may say that it is the Body of Christ, or even consecrated bread, but it’s a wafer. For many readers, this rite is an act of faith. Others will consider it a mild form of madness.

I think it’s likely that they Globe newsroom stylebook even settles this language question (I’d love to know the actual answer, in fact). The story uses the term “wafer” eight times — including in a direct quote — and the term “host” only once. I found it interesting that the term “host” is left undefined. If the term is so common that it does not need to be defined, then why not use “host,” oh, eight times and the term “wafer” once? Just asking.

I also wondered if this statement is true:

Later this week, in a Back Bay shrine, the Archdiocese of Boston will celebrate the return of perpetual adoration to Boston for the first time in decades. Volunteers at St. Clement Eucharistic Shrine are signing up 336 people — two for every hour of the week except during Mass — who will agree that, starting Saturday and continuing indefinitely, they will spend an hour a week in the presence of the consecrated wafer, a practice they understand as spending an hour a week with God.

That’s interesting. I had no idea that perpetual adoration was this rare, since I have heard about the practice in a number of contexts through the years. Are there no monasteries in Boston? Did this particular archdiocese ban or discourage the practice for some reason? I’m curious.

Please understand that I am not attacking the Globe report (and certainly not Paulson) on the “wafer” vs. “host” issue.

Still, I have no doubt that many Catholics were not offended by the drumbeat references to their adoration of a “wafer.” However, I am sure that some were offended and there is a good chance that some traditional Catholics still read the Globe.

My question is more basic: What was gained by using the blunt “wafer” reference in the lede? Is the word “host” so strange in a heavily Catholic region? Why not open by saying that they are kneeling before the “consecrated bread” that they believe is the Body of Christ? A reference to the belief of the worshippers would be accurate, even for skeptics. Correct?

Behind this question is another: Should journalists cover the beliefs of others with some sense of respect for the language that they would use? What is accomplished by using language that is sure to offend many of the “stakeholders” — that’s a journalistic term used by Poynter.org and in some other academic settings — who will care the most about the accuracy and sensitivity of this fine story?

There is no question that the Catholic church calls this a “host.” And there is no question that the Boston Globe calls this bread a “wafer.” I am asking this question: Why does the “wafer” language need to win in this debate? Is there a way to be both neutral and to show respect?

Real, live, postmodern preacher

The Rev. Gordon Atkinson had few specific goals when he started planning his 13-week sabbatical from his duties at Covenant Baptist Church near San Antonio. "I knew that I didn't want to be in charge of anything," said Atkinson, long known as the "Real, Live, Preacher" to those who read his intensely personal online journal (reallivepreacher.com).

"Preachers talk and talk and I wanted to get away from that. I didn't want to be a worship tourist, but I thought it would be refreshing to worship in some places where I was the person in the room who knew the least about what was going on."

It helps to know that Atkinson leads an unusual Baptist flock, a "contemplative Christian community" that holds spiritual retreats based on the writings of St. Francis of Assisi and men's fellowship meetings over beer and pizza. Covenant's belief statement stresses that the "fullness of the gospel cannot be contained in any one church."

While proud of his Baptist heritage, Atkinson said the "glory days" when "moderate" and "conservative" Baptists fought to control the old corporate machinery are long gone. Now, many congregations are experimenting with "emerging," "post-denominational" and "postmodern" identities and forms of worship.

Thus, Atkinson began his sabbatical by visiting the radical stillness of a Quaker gathering, a tradition that asks believers to remain silent until God inspires someone to speak. For 30 minutes, every cough, sneeze or stomach growl was audible.

"You have to lose a lot of your shame when you sit in silence with people," he wrote. "These sounds are not disturbing to the time of worship. Not at all. They are the delightful sounds of humans trying to be quiet. And we cannot. ... So even the sounds of people trying to be quiet are a part of the lesson."

A few Sundays later, Atkinson found himself swimming in words and symbols when his family visited an Eastern Orthodox sanctuary.

"It was like they were ripping raw chunks of theology out of ancient creeds and throwing them by the handfuls into the congregation," he wrote. "I heard words and phrases I had not heard since seminary. Theotokos, begotten not made, Cherubim and Seraphim borne on their pinions, supplications and oblations."

The experience, he concluded, was an "ADD kid's nightmare," with the "robes, scary art, smoking incense, secret doors in the Iconostas popping open and little robed boys coming out with golden candlesticks, chants and singing from a small choir that rolled across the curved ceiling. ... There was so much going on I couldn't keep up with all the things I couldn't pay attention to."

His family struggled, but Atkinson had tears in his eyes by the end of the nearly two-hour liturgy. After years of focusing on user-friendly ways to attract people to church, he was stunned to attend a service that – much like the Quaker meeting – placed intense demands on all the participants.

It was, he concluded, as if visitors were being told: "You don't know what Theotokos means? Get a book and read about it. You have a hard time standing for two hours? Do some sit ups and get yourself into worship shape. It is the Lord our God we worship here, mortal. ... THIS IS BIGGER THAN YOU ARE."

Atkinson was intrigued and eventually attended Russian, Greek and Antiochian Orthodox churches.

Nevertheless, by the end of his sabbatical this liberal Baptist preacher knew he had a problem. While Atkinson appreciated the symbols, rituals and sacraments he encountered, he also knew that he couldn't accept the doctrines that defined the worship, especially the Orthodox rites.

Simply stated, his views on sin, sexuality, salvation, heaven and hell were too modern. There was "no wiggle room" in the ancient doctrines and, Atkinson concluded, "I just couldn't buy all of it."

Now he is returning to his Baptist pulpit, while hearing choirs of voices arguing in his head representing many different eras of church history.

"What I don't know how to do is rank all of these voices and decide who has authority," he said. "Who is right and who is wrong? ... And I want to know, where does Gordon Atkinson fit into this whole picture? I know that I can't go back to the old Protestant, evangelical way that I was, but I don't know where I'm supposed to go now. This is a problem."

Catholic pain in health-care fight

In Catholic debates, it always helps to be able to quote the official Catechism of the Catholic Church. Consider, for example, this reference to health care in its chapter on the biblical instruction, "You shall love your neighbor as yourself."

"Life and physical health are precious gifts entrusted to us by God," notes the catechism. "Concern for the health of its citizens requires that society help in the attainment of living-conditions that allow them to grow and reach maturity: food and clothing, housing, health care, basic education, employment and social assistance."

The implication is that governments – as a matter of social justice – should help citizens obtain basic health care, according to a letter sent to Congress and the White House by the Domestic Justice and Human Development Committee of the U.S. Conference of Catholic Bishops.

Health care is a human right, not a privilege, argued Bishop William F. Murphy.

"All people need and should have access to comprehensive, quality health care that they can afford, and it should not depend on their stage of life, where or whether they or their parents work, how much they earn, where they live, or where they were born," wrote Murphy.

But there's a problem. The letter stresses that the church will support accessible, affordable, universal health-care reform if it "protects and respects the life and dignity of all people from conception until natural death."

Try telling that to Health and Human Services Secretary Kathleen Sibelius, Speaker of the House Nancy Pelosi, surgeon general nominee Regina Benjamin, Vice President Joe Biden and other Catholics who play strategic roles in Washington, D.C., right now – while rejecting Catholic teachings on many critical health-care issues.

That's the political reality that the bishops are facing, said Leonard J. Nelson III, a health-care law specialist at the Cumberland School of Law at Samford University.

For the bishops, Catholic teachings on the sanctity of human life are crystal clear, from birth to death, from abortion to euthanasia. Yet the bishops also support health-care for all – rich and poor. It's getting harder and harder to keep these issues woven together.

"The bishops have been talking about social justice and health care for years and years and now the political climate has changed around them," said Nelson, author of the new book, "Diagnosis Critical: The Urgent Threats Confronting Catholic Health Care."

"The politicians who are in command are ready to pass some kind of health-care reform and they have all kinds of reasons to include abortion in that package. ... That's the fix that the bishops are in."

Meanwhile, he said, leaders of Catholic hospitals and health-care systems will almost certainly face challenges in the near future.

For starters, they could be pressured to join networks and cooperatives that have no reason to follow the bioethical guidelines detailed in the "Ethical and Religious Directives for Catholic Health Care Services" adopted by the U.S. Catholic bishops. It will be hard for Catholic leaders to cooperate with government approved health-care programs and receive government funds while declining to offer services such as contraception, sterilizations and referrals for abortions.

Catholic leaders also know that another life-and-death issue looms in the background. As President Barack Obama noted in a recent New York Times interview, it's impossible to cut or control costs without government efforts to shape health care in the final years of life.

"That's where I think you just get into some very difficult moral issues," said Obama. "But that's also a huge driver of cost, right? I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here."

The Catholic bishops, noted Nelson, have not addressed these end-of-life scenarios – yet. Will government agencies or advisory boards be given the power to decide whether patients facing Alzheimer's or Parkinson's disease receive expensive medications? Who will decide whether elderly patients have a high enough "quality of life" to continue receiving medical care?

"Productive people in the middle years of life are always going to get the health care they need," said Nelson. "The big threats to the sanctity of life come at the very beginning and at the end. If you're going to defend the church's teachings on health care, you have to focus on those threats. The bishops have to find a way to do that."