Some commentators recently have advanced a novel perspective that because Roman Catholic healthcare institutions live in the secular world, they are not “churches” worthy of the constitutional protection of religion. They argue that all religious institutions serving in secular space should be treated as different from a house of worship or religious grammar school. (See editorial: "Shaky outlook"
Based on Catholic theology and my understanding of legal precedent gained from work I have done with the Chicago law firm of Unagretti & Harris, I would posit that this proposal runs counter to decades of legal precedent and centuries of Church teaching.
We know that the First Amendment prohibits the “establishment” of a religion. But it goes further. In addition to providing freedom “from” an established religion, the Constitution also provides, under what is commonly known as the “free exercise clause,” “space” (that is, freedom) “for” religion. Our founders created this space for religion because they recognized that it benefited the well-being of the nation.
As in other aspects of constitutional law, the “scope” of this freedom has been the source of debate and development. All freedoms are subject to the competing claims of other rights. As the courts have considered these claims, they have sought to avoid becoming entangled in adjucating about the internal dynamics and beliefs of any particular religion. To do so would violate the premise of free exercise. As a result, courts must accept a religion's self-characterization of the purpose of its activities and beliefs as long as those characterizations are provided in good faith. This perspective finds expression in the 1946 3rd U.S. Circuit Court of Appeals' opinion in O'Leary v. Social Security Board, involving a property-tax dispute over the church's cemetery property. The court wrote, “If the Church regards the burial of its deceased communicants and the maintenance of burial space as part of its religious observance, we think that fact makes the operation of the described burying ground a religious function.”
The Constitution thus protects the Church's self-understanding of the religious purpose of its healthcare institutions—to carry on Jesus' healing ministry in the “secular world” just as it protects its public worship in “churches.” Healthcare institutions are a formal work of the Church, an act of religion and part of the Church. The sponsoring organizations (to use contemporary church language) have ecclesiastical status in the Church's Code of Canon Law, and their presence in a particular geographic area is subject to the oversight of the appropriate diocesan bishop. The reason the Church accords this recognition to institutions serving in the secular world is that the Catholic religion has an explicit and well-developed understanding of what is required for it to faithfully advance its religious purpose. Bringing Jesus' healing of body, mind and spirit to the sick, whomever and wherever they are, enables the Catholic religion to advance as a religion. Carrying out Jesus' healing mission is as essential today as it was in days when Catholic healthcare was present among the lumberjack of the Pacific Northwest, when it served the victims of New York City plague or the first suffers of HIV infection in Chicago. The Catholic religion has cared for the human needs of all Americans and been proud to have as colleagues persons of all religions and no religions. Why? Because this is who we are as a religion.
The Rev. Michael Place has served as president and CEO of the Catholic Health Association of the United States and as chair of the International Federation of Catholic Health Institutions.
Contrary to constitutional precedent, some would argue that the government can ignore a religion's self-understanding and can decide for itself whether their activities are a religious function. They urge the government to find that religious healthcare is no different than secular healthcare. At stake for religions is their public exercise of religion in the secular world and the courts' long-held constitutional perspective that the Constitution protects those activities. And so I ask, what constitutional criteria determine that such a well-documented religious self-understanding should be set aside and Catholic healthcare institutions lose their protections under the free exercise clause? How can such potential determinations not represent undue entanglement of the state in the advancement of religion?
In addition, it is important to remember that for Catholics, a Catholic healthcare institution is not an end but a means used to make present the healing love of God. For a means such as a Catholic hospital to provide services inconsistent with its divine purpose would be a sacrilege. And Catholic healthcare will never be sacrilegious.
That being said, part of the Catholic belief is the conviction that the power of God is what sustains us in good times and bad. An expression of this conviction comes from the tradition of the Daughters of Charity, who are so much a part of Catholic healthcare: creation unto infinity. If, God forbid, this nation chooses to redefine “free exercise,” I can assure you, Catholic healthcare will not disappear. Rather to use secular vocabulary, with the help of God, it will re-engineer itself to meet current limitations and human needs. Just as the form and expression of the ministry have developed since the first Ursuline Sisters landed in New Orleans, the creative and dedicated women and men of Catholic healthcare will be as adaptive in the future as were their predecessors.
So have no fear, Catholic healthcare will not be extinct.