What's In It for the Romans

Well, there’s a great deal of conversation (and a certain amount of consternation) about the Apostolic Constitution  Anglicanorum Coetibus.  If it hasn’t come to your attention, you can find some good commentary at Thinking Anglicans. 

This Apostolic Constitution has been prepared after years of requests and discussions with the Traditional Anglican Communion, a community whose founders left churches in the Anglican Communion beginning a generation ago over the ordination of women.  At the same time, it arrives in an interesting context.  First, there are other groups of former Anglicans, who have left churches in the Anglican Communion over issues of sexuality.  Second, the Church of England, long the center of the Vatican’s (arguably myopic) perspective of things Anglican, has committed to the ordination of women to the episcopate and has begun to figure out just how to locally adapt that for their circumstances.  As a result, while the folks of TAC are ready, waiting, and basically committed, there are also others both in and outside churches of the Anglican Communion who might be interested.  Certainly, folks in Forward in Faith have certainly expressed some interest; while others, with a more evangelical perspective, have said, “No thanks.”

I have read both the document itself and the Complementary Norms.  Others have noted what this means for the orders and structures of the Personal Ordinariates for the former Anglicans.  However, what struck me about these documents had to do with relations with priests of the Ordinariates and the Roman dioceses.

The importance of such a relationship is established in the Apostolic Constitution in Article VI, paragraph 4: “Priests incardinated into an Ordinariate, who constitute the presbyterate of the Ordinariate, are also to cultivate bonds of unity with the presbyterate of the Diocese in which they exercise their ministry. They should promote common pastoral and charitable initiatives and activities, which can be the object of agreements between the Ordinary and the local Diocesan Bishop.” This would be important, of course, because the Personal Ordinariates for former Anglicans will not be territorial in the same sense as Roman dioceses, and so will overlap one or more dioceses.

What this might mean (and why this might be more interesting to Roman bishops) is clarified in Article 8, paragraph 1, of the Complementary Norms, “The presbyters, while constituting the presbyterate of the Ordinariate, are eligible for membership in the Presbyteral Council of the Diocese in which they exercise pastoral care of the faithful of the Ordinariate.”  That is, while they are priests of the (non-territorial) Anglican Ordinariate, they can also be members of the (territorial) Roman diocese within which they live and/or work.  This only makes sense, because in Article 9, paragraph 1, “The clerics incardinated in the Ordinariate should be available to assist the Diocese in which they have a domicile or quasi-domicile, where it is deemed suitable for the pastoral care of the faithful. In such cases they are subject to the Diocesan Bishop in respect to that which pertains to the pastoral charge or office they receive.”  This does require a written agreement between the Roman Bishop and the Ordinary of the Ordinariate; but with that agreement (and how is the Ordinary to refuse the Bishop) the Bishop can call on priests of the Ordinariate to assist in Roman parishes.

Now, that arrangement can work the other way.  However, it’s notable that “clerics incardinated in the Ordinariate should be available to assist the Diocese;” while “clergy incardinated in a Diocese… can collaborate in the pastoral care of the Ordinariate,” but only “[w]here and when it is deemed suitable.” (Emphases mine)

That suggests to me that the real value of this to Roman bishops is as a new source of assisting clergy.  There is a clear priority of Ordinariate clergy serving Diocesan needs.  In the face of the clergy shortage any new source of personnel has to be interesting.  Moreover, they’re inexpensive personnel; for Article 7 of the Complementary Norms makes clear that the Bishops have no financial responsibility for these new clergy: “The Ordinary must ensure that adequate remuneration be provided to the clergy incardinated in the Ordinariate, and must provide for their needs in the event of sickness, disability, and old age.”  There is, of course, provision for Ordinariate clergy to have secular employment if necessary; but in neither case is the Roman bishop on the hook for these expenses.

Now, let me say again that I know this came about the accommodate TAC, and perhaps a few other former Anglicans and Episcopalians (after all, even if they’re not “former” now, they’ll become “former” once they enter the Vatican’s jurisdiction).  At the same time, it can’t have been missed that this will provide Roman bishops with a new resource for clergy, and with clear primacy of Roman bishops over Personal Ordinaries.  I can’t help but wonder if this is the sort of recognition and acceptance that the former Anglicans have in mind.  And I can’t help but wonder if this isn’t what will make this new arrangement acceptable to the Diocesan bishops who will find these folks on their doorsteps.

Where I've Been Lately

I have been on vacation.  Well, to use the trendy term, I’ve been on a “stay-cation,” since my Best Beloved couldn’t get away from her work.  But I reached an important point in the year.  I received a message from my boss who asked, “Do you know how much vacation time you have built up?  Do you know how much of it you use if you don’t lose it before December?”

So, I’ve been on vacation.  Unfortunately, vacation is something I don’t do all that well.  Oh, I can stay home instead of going to the hospital.  I can turn off the alarm and sleep in; which is to say that I can sleep until 7:00 a.m., instead of rolling out by 5:30.

I can set aside some reading.  I went to the library and picked up a couple of books.  Of course, one of them was Sanjay Gupta’s new work on wonderful new medical discoveries.  I set aside some other light reading – articles from the New England Journal and from Resuscitation.

I’m just not good at taking time off, unless I’m really away.  Let me charter a sailboat, or get away to a monastery, and after a little adjustment – okay, two to three days’ adjustment – I can stop thinking about professional things and attend just to what’s around me.  I can leave the phone off, and do nothing more professional than say Morning Prayer and Compline.

Somehow, taking time off at home just isn’t the same.  I know it’s my own fault.  There’s plenty of distraction.  The garage has to be converted back from garden staging area to auto storage.  Hot peppers and raspberries are still coming, if the tomatoes are past it and the basil has shriveled.  Leaves are accumulating on the lawn.  With winds prevailing from the west, no one on my block rakes his own leaves.  Instead each of us rakes up the leaves that blew from the trees of the neighbors to the west.  So, there’s plenty to do.

There are opportunities for cleaning and cleaning out.  It took me a while to work out recycling the old dehumidifier (it was both harder than simpler than I had imagined).  Some of my Styrofoam packing material was clean enough to recycle, but some wasn’t.  Still, my Best Beloved was pleased with the vacuuming.

And I managed not to check my work email – well, not more than once a day.  After all, I didn’t want to get back into the office and have several hundred emails to clear out (and I’m afraid that’s not much of an exaggeration).

But, really, I’m not a workaholic, and I did enjoy my time at home.  I still have some time to work at it.  I still have more vacation days to burn off.  I’ll take some time around Thanksgiving.

Just be patient with me.  I enjoy taking time away.  I’m just not very good at it.

Carrying our Ministry: the Chaplains at Fort Hood

Pray for all of those who have died and suffered in events at Fort Hood, Texas.  Pray for the repose of the souls of the dead.  Pray for easing of suffering and hope for the wounded.  Pray for strength and comfort for families in shock, mourning, and fear.  Pray for health care providers, both those who were serving in the midst of the attack, and those who afterward served the injured and suffering.  Pray for the alleged shooter, that God may touch his heart and turn it from violence back to the peace which passes understanding, whether in this life or the next.

And pray for the chaplains who serve them all.  Several years ago I expressed my admiration and appreciation for my colleagues who serve in the Armed Forces.  Today at the Cafe there are the reports of those serving now at Fort Hood.  I often speak of how honored I am as a hospital chaplain to carry the ministry of the Episcopal Church to so many bedsides.  Today I am honored to be a colleague to the chaplains at Fort Hood, as well as the clergy of Killeen, who are carrying that ministry into the midst of death and injury, fear and anger, sadness and hope.

Sometimes It's Hard to Claim Middle Ground

 Published in Spirit, a new quarterly publication of the Diocese of West Missouri:

Some years ago at Clergy Conference I found myself in intense discussion with a colleague from the Southern Deanery.  He was more conservative and I more liberal, but the discussion was really good.  We were discussing how best to provide for the poor.  What made the discussion good had little to do with how.  We didn’t agree on how much at all.  However, we could agree that, however much we disagreed about how, we were called as Christians to be concerned for the poor.  We could disagree respectfully about the means because we could certainly agree about the end.

I was honored when Hugh Welsh invited me to write the first column in “The Middle Ground” in the new Spirit.  His goal for the column, as he shared it with me, was “to find a middle passage (if you will) between a hot topic with a stated pro and con.”  Certainly, there are a number of pros and cons related to universal access to health care.  Whether we speak about “health care reform” or “health insurance reform,” there are certainly different points we might consider. 

We can certainly have respectful arguments about the means.  We can ask just how much Government action is required, and how much we need to focus on personal accountability.  We can think about how to balance employer mandates and individual mandates and subsidies to help the working poor buy insurance.  We can discuss balancing cost control for physicians with tort reform.  We can discuss various means to provide access to health care for all Americans.

However, what we can all agree about as Episcopalians is that providing that access to health care is an appropriate end.  In General Convention we have called on our government to pursue health care reform since at least 1985.  We have reaffirmed it as recently as this summer, when General Convention passed three resolutions on to universal access to health care.

We take that position because it’s consistent with our faith.  It is consistent with the Summary of the Law, that in addition to loving the Lord our God we are called to love neighbor as self.  It is consistent with the Baptismal Covenant; for the Apostle’s teaching calls us to proclaim by word and example, serving Christ in all persons.  So, for us this is the end on which we can agree, even if we see pros and cons about how.

Unfortunately, there are those who do disagree that this is an appropriate end.  They may argue that we lose freedom if the government is involved.  They may argue that an informed individual can make better decisions for his or her own good than any bureaucrat.  However, if we listen carefully we will discover that their arguments come back to a single theme: that I have a right to make the decision that is best for me and mine without regard for anyone else.

That may be legal, but we wouldn’t call it “true,” because it isn’t true to the faith as the Episcopal Church has received it.  We continue to believe we are called to love neighbor as self in ways that proclaim by word and example the good news of God in Christ.  And so we agree that this goal, this service, and specific strategies to achieve it, like universal access to health care, is an end to which God calls us, even if we might disagree about the means.

When States Collide

While I haven’t read the book, I’ve been interested and sometimes amused at the title, What’s the Matter With Kansas.  You see, while I live in western Missouri (or as we commonly say, “On the Missouri side”), and my health system is headquartered in Missouri, the hospital I serve is in Kansas.  As a result, I pay attention to health news from Kansas with as much attention as from Missouri.

So, I didn’t miss this news item in my local paper: “Kansas state lawmakers push for health care insurance opt-out.”  It seems that three Kansas legislators have decided that any public option offered as a part of national health care reform would be an unacceptable trampling on states’ rights.  Moreover, they fear it will become a trampling on the rights of citizens (although whether they are more concerned about individual citizens or corporate citizens - i.e., insurance companies - remains to be seen).  To that end, they want to amend the state constitution to say that any health insurance mandate, whether requiring individuals to purchase health insurance or requiring employers to provide it, cannot be enforced in Kansas.

My initial reaction to this was that these state legislators were raising this issue only in Kansas.  In fact I was uninformed.  There have been efforts in other states for months now.  They are coming from conservatives who state they’re placing a high value on freedom to choose, including the freedom to choose not to purchase health insurance.  Thus, Federal individual and employer mandates are unacceptable.  In fact, for some apparently a Federal effort to make health insurance more affordable by offering a public option in a health insurance exchange, thus creating competition for private insurance companies, is somehow coercive.  So in many places efforts are being made to change state constitutions to prevent this perceived Federal encroachment.

Now, I will say first and foremost that, even if these constitutional changes pass in some states, I don’t see how they can stand for the long term.  I have already argued that all health is public.  Indeed, we’ve seen just how public it is in our current H1N1 flu pandemic.  With this, and with any contagious disease, we have reaffirmed that we are our siblings’ keepers, at least in this.  What I do to protect myself from getting the flu also protects anyone I might infect if I get it.  For me hospital patients are the special group for concern; but it also protects the grocery clerk and the waiter and the librarian whom I encounter, and even the grocery customer and the diner and the library patron who cross paths with me.  For much of our health care, we depend on a certain “herd protection.” 

It’s also the case that economically we are our siblings’ keeper.  We all pay for one another’s health care, whether it’s through taxes or insurance premiums or through the price increases brought about by losses for unreimbursed care.  That is already the case, and it won’t be changed by the reforms currently considered in Congress – or for that matter any reforms that weren’t considered.  Nor will it be changed by an attempt to prevent some government management of the competition among insurance companies.

A consequence of both these facts is that health care, and so reimbursement (or lack of reimbursement), is a matter of interstate commerce.  I am acutely aware of this in my position.  As I said, I live in Missouri but work in Kansas.  In fact many people in the eastern counties of Kansas find their health care in institutions in Missouri.  That’s a common enough occurrence in the Kansas City area, of course; but it’s also true farther south, where the larger towns and larger institutions are east of the state line.  While I don’t know the numbers, I can only imagine that in the far western counties folks who need intensive care find it in Denver or Colorado Springs.  I would bet, too, that some in the northeastern counties find it in Omaha or Lincoln.  So, in my part of the world health care is explicitly interstate commerce.

That is a regional expression, but there are other ways.  Think, for example, of the large networks of health care providers.  Such for-profit companies as HCA and Tenet are certainly interstate companies.  So are such religious networks as Adventist and Ascension.  Now, they deal already with differences between states.  However, they might find if difficult to do business in a state if it essentially establishes a population risking unreimbursed care.

One way or another, states that allow individuals to go without insurance, through lack of an individual mandate or of an employer mandate or through some other mechanism, will necessarily place burdens on institutions in other states, and so on citizens in other states.  That seems to me ripe for a decision from the Supreme Court; but that would take years.  It might take years, too, to change state constitutions; but one can only hope that those efforts fail.  Health care issues respect our political divisions no more than the illnesses that raise issues.  Let’s hope that most of our citizens, and the legislators that represent them, will see this clearly and take responsibility, not only for their own individual health needs, but also for the needs of their fellow citizens.

During the Festivities

While I don’t make reference to it here, folks know that the system and the hospital within which I work are named for the Evangelist who was also a physician.  This week in our system is Saint Luke’s Week, when we highlight the work of chaplains in the system.

One of the special events I schedule during Saint Luke’s Week is the Blessing of the Hospital.  Using a service modeled on house blessings, I walk through the hospital praying and asperging with holy water.

Today as I made my way through the hospital, folks noticed smoke coming from the hospital’s roof.  It was a simple mechanical issue with no risk to person or property.  However, we did get an immediate response from the fire department, which simply added to the concerns of observers.

At a later point, one of our administrators stopped me and, smiling, asked whether I thought my blessing was responsible for the smoke.  I said, “Well, I don’t know, but I suppose I might have hit something evil.” 

His eyes widened for a moment; and then he smiled.

Curious Connection Up at Episcopal Cafe

So, my newest piece is up today at Episcopal Cafe. Just to peak your interest, this is the first sentence: "So, there I was, watching Project Runway, when I found myself thinking about Clinical Pastoral Education." Now, if that doesn't make you curious, I don't know what will.

So, go over and take a look at the Cafe. And while you're there, read what my colleagues have also written - read, and take the time to leave a comment. We're there to show just what good stuff folks in the Episcopal Church have to offer..