Thursday, July 30, 2009
Still, General Convention is a multifaceted experience, and my impressions and memories are multifaceted as well. So, let me do some further reflection.
General Convention is a marathon. My days began before 6:00 a.m., and usually ended somewhere around midnight. Perhaps I had more to do than some folks. We would wander in and out of the diocesan Conference Room for breakfast. The diocese paid for the room, and one of the alternate deputies kept it stocked with breakfast and lunch fixings. That saved the diocese money, and made it easy to eat within our tight schedules. Legislative committee meetings began at 7:30, and even those of us who were not members of committees had issues and resolutions we were tracking, and so all of us were off.
Committee meetings offered the opportunity to testify about specific resolutions, and there were several I had an interest in, and so spoke to. In addition, I had committed on behalf of the diocesan deputation to follow the resolutions about the denominational health insurance plan, and other health related issues. And, since the various resolutions were distributed among a couple of different committees, I was at different meetings different mornings. Once or twice I found myself trying be in two places at once, or at least in close succession.
Committee meetings ended at 9:00 and the first legislative session each day began at 9:30. That made just enough time most days to indulge in another cup of coffee, and sometimes a fancy one, and then get to our place on the floor of the House of Deputies. I found myself chatting much of the time with a deputy from Milwaukee, with whom we shared tables. He was experienced at Roberts Rules, but new to General Convention. Between my experience and his appreciation of legislative structures, we had some interesting perspectives on the process.
Eucharist would begin at 11:30. The schedule usually indicated the legislative session would end at 11:00 to allow for transition; but usually we didn’t allow ourselves that kind of time. At each General Convention the host diocese imparts a certain character to the worship. At the same time, there were certain characteristics expected and provided: lots of music and lots of diversity of language and culture. I will admit being somewhat disappointed at times this year with the music. I won’t go into excruciating detail (those who know me best, who know my capacity, will breathe a sigh of relief). I will note, however, that I would never hire an organist, however fine a performer or choir director, who didn’t understand that the job is to lead the congregation. Also, not every hymn of the church benefits by being reinterpreted with a gospel sensibility.
After Eucharist we would scatter for lunch. We would gather again in the diocesan conference room for sandwich makings. The deputation, both deputies and those alternates who had come, would be there, as would the bishop. We would also have the diocesan delegates to the ECW Triennial, and at times others from the diocese. One of the members of the official Youth Deputation was from our diocese, and she was sometimes there. We had a group of diocesan youth come out for several days, and they would join us, and for a couple of days we had several clergy who had come out simply as visitors to the Convention. And there were other visitors, usually folks who had some connection in the past with the diocese. We even had the team from one of the national news outlets because one of their runners had done CPE in my health system. We would discuss events in both Houses, and would catch up on specific resolutions. The gathering would leave us perhaps half an hour to put our feet up.
Then it was back to the House at 2:00 p.m. That session would continue until 6:00, making for a long afternoon. Of course, there were something over 420 resolutions, most of which we would actually have to do something with. And there were interruptions: an intermittent parade of guests, each of whom had something to say, sometimes even something interesting.
There were daily prayers and meditations in the House, including an intercession list. The Chaplain to the House did a wonderful job, both in his daily duties and when called upon to pray for a special concern. And that was often enough; for in almost any difficult moment some deputy would ask as a point of personal privilege for prayer from the Chaplain.
The House would end its work each day more or less on time around 6:00. That would allow time for dinner – that is, unless one was involved in evening events. Some of those were special events, such as the Integrity Eucharist, or the U2charist (with a remarkably accurate Bono impersonator; I wasn’t surprised that he wasn’t “the real thing,” but he looked so good his American accent gave me pause, even face to face). For some of the more committed legislative committees there were evening sessions in addition to the morning sessions.
And dinner wasn’t that easy. With bishops, deputies, alternates, exhibitors, and visitors all coming out at roughly the same time, restaurants filled up fast. By the time one had gotten back to the room to drop the paperwork and gotten back out to eat, it was 7:30 or so. Too, almost all of us had some sense of budget constraint. I tended to move from fast food one night, with a preference for something small and local, to something more upscale. Of course, the fact is there wasn’t much “in the middle.” But, then, this was resort California.
Some deputations, including ours, had a view from one room or another overlooking Disneyland. During the day, who cared? We weren’t there; and at half a mile even Disneyland lost some of its image. However, each might at 9:20 p.m. there were fireworks, and those rooms gave a wonderful view.
That made for a nice break before I began to write. Granted, there were some things written during the day from the floor of the House. But most of what I wrote, I wrote after the fireworks. (I just hope it wasn’t too evident in what I wrote.)
And so the days went on. As legislative committees completed their work, it got easier. I found time, too, to network with various folks about chaplaincy issues in the Church and AEHC. By the middle of the second week I was dragging, as were many of us. Perhaps that’s indicated by a daily report titled, “A Hard Slog.” However, we did finish. In fact, for the first time anybody present remembered, we not only addressed everything that made it onto the legislative calendar, but we finished more than an hour early. The marathon was done.
And why was it worth it to put ourselves through all of that? That, beloved readers, will be the topic of another post.
Monday, July 27, 2009
I enjoy a great deal discussing theology in the hospital. The sad part is that it is only rarely that I get to discuss any theological issue other than the problem of suffering.
I wrote some posts during Convention, and will have more to write. If you want to see it all, look to your left for the label "General Convention." That will pull it all up, and as always the most recent will be on top.
Thursday, July 23, 2009
Well, here I am at home again, recovering from General Convention. I say “recovering” advisedly: while there were breaks for meals, my days frequently began at 6:00 a.m. and before and ended sometime after midnight. Yes, it was worth it, but it was a marathon. I managed to serve as a deputy, including reporting for my diocesan web site; to network on chaplaincy issues on behalf of AEHC; and to write for my own blog and Episcopal Café.
What will I remember about General Convention? Many things. There were wonderful daily Eucharists, with words and music and images from the many cultures within the Episcopal Church. There was the pleasure of meeting colleagues from Episcopal Life and others whose words I have read. There were the Disneyland fireworks, visible every night from the suite where my diocesan deputation gathered for breakfast and lunch. There was that one exorbitant supper that was worth the $60 it cost. And, of course, it wouldn’t be General Convention if there weren’t a protester outside telling us that we’re all destined to Hell.
Others have already written about the two resolutions, D025 on ministry and the Anglican Communion, and C056 on blessings for glbt couples, that got attention from the press. While I certainly have opinions about what we were doing in passing those resolutions, I’ll probably let others take point on those. I will also be writing about the healthcare related resolutions, two of which I had a hand in.
However, as I have done before, I want to focus on something important that I think others will overlook. During General Convention there were a number of events – literally, distinct periods of time – that were emotionally intense. I have already written about three of them: the first hour of listening about D025; the actual debate about D025; and the debate about C056. There was another: the introduction of the Triennial Budget. When it was presented we were confronted with a crisis. Before General Convention the Program, Budget, and Finance Committee had reviewed their expectations of income for the next three years. Between the general crisis in the economy and the specific issues facing dioceses and congregations, they decided to reduce their expectations and to make the consequent changes.
One of the issues they faced was the number of dioceses that do not pay their full assessment each year. One deputy suggested that whenever one of us spoke in the full House we should each begin by announcing the percentage paid by each diocese, up to the full 21%; and that our opinions should be taken seriously in proportion to our diocesan contribution to the national Budget. While we didn’t all do that, some did – including a few who admitted some appallingly low percentages – and it brought home one problem we have as a Church in supporting our ministries. In response the Committee actually lowered the assessment percentages for the next Triennium, in hope that with lower expectations more dioceses might rise to them.
There were some difficult, even tragic decisions. Some thirty-plus positions have been cut – thirty-plus people who will be joining the unemployed. That thought left me somewhat ambivalent: some of the positions represented ministries we would consider important. At the same time, while I’m not happy when anyone loses a job, I’m also aware of how many positions my hospital has cut. We have difficult decisions to make in difficult times, and it would not make moral sense to exclude the Episcopal Church Center.
The statement from Program, Budget, and Finance was that these important ministries would no longer be coordinated from the top. Instead, they could be approached through the peer sharing and the development of networks. There’s a lot to be said for this approach. While good leadership from the top can offer a clearinghouse function and stimulate creativity, poor leadership at the top and laziness in the field can stifle creativity and lose valuable ideas. Decentralized leadership can offer opportunities for experimentation and adaptation to local needs. Sharing those ideas can be valuable for colleagues with similar circumstances.
I believe this is a unique opportunity for the chaplains and others in health care in the Episcopal Church. There are two structures already available to contribute to any networking on health care issues. The first and best established is the Assembly of Episcopal Healthcare Chaplains (AEHC; link to your left). While the organizational title speaks specifically of chaplains, we are actually a broader organization with opportunities for bishops and healthcare administrators to be members. Indeed, our original name as the Assembly of Episcopal Hospitals and Chaplains, and there might be reason to return to that.
The second is the developing network of Episcopal healthcare institutions as a part of the Anglican Health Network. I wrote about the first meeting of this group in the United States in January. Since then connections have been made across the Communion, and the Anglican Health Network has been officially recognized by the Anglican Consultative Council. This new network, with support from a number of Episcopal dioceses and institutions, and with some significant energy behind it, could also contribute to networking within the Episcopal Church.
So, resources are there. We need to begin the communication, the reaching out, that can bring networks together. We can look for some models. There are networks of Christian educators and of ecumenical officers already in place. But we need to begin soon. The business of the Church is mission; and health and healing have a well established place as ministries in that mission. We can do a lot together, with perhaps a little help at the national level in finding each other. We can do a lot together, once we can get together.
Friday, July 17, 2009
The voices are largely the same. Oh, there was the deputy who asked whether passing this resolution, which allows “an open process for the consideration of theological and liturgical resources for the blessing of same gender relationships,” and functionally allows bishops who wish to “provide generous pastoral response,” which we all understand to mean blessings in some form for same gender relationships. Would this violate the Canons and the rubrics of the Prayer Book? It was noted that the resolution sought to change neither; but for those who want no such blessings at all that is beside the point. But the ruling of the Chancellor and the Legislative Committee is that no.
There is also recognition that we are asked to concur – that is, we are receiving this from the House of Bishops for agreement, for acceptance of changes and adjustments that they reached with their own hard negotiation. We have been reminded of that, and it is no small point. If it fails here it is done. If it is amended here, it will be sent back to the bishops, but for lack of time it will be largely done.
So, we are hearing about how many GLBT parishioners will find this compassionate and inclusive. We are hearing how many Episcopalians have already left, with implication that many more might leave, over this issue. We are hearing of the call of the Spirit for compassion and justice. We are hearing that this violates the tradition of the Church, and the efforts at unity in the Communion written in the Windsor Report and its requested moratoria. We are hearing that we are following the world and not the Scriptures; and that the world is, at least in this, reflecting the movement of the Spirit better than the Church. And everyone, everyone, is arguing that his or her position is a commitment to the mission of the Church.
Once again, the voices are fervent, pleading, with perhaps an edge of anger. No one is casual; and once again no one is dismissive of those with whom they disagree (although, once again I doubt that those who listen don’t feel dismissed).
We are asked to consider what we might mean now, at the end of Convention and with this resolution and D025, by “ubuntu,” or “I am because we are; and because I am we are.” What does that mean? How are we accountable to one another, both within our own body and within the larger Communion? How are they accountable to us? We do not have that answer; but those who disagree with the resolution are clear that they feel the majority have not been and will not be sufficiently accountable to them, or to the wider Communion. And, of course, those who agree with the resolution, with the majority, feel the majority of the Communion have not been sufficiently accountable to us, sufficiently sensitive to our specific circumstances. So we are told we are prideful, ignoring the voices of Windsor and of Primates, violating the calls for moratoria. We are conversely told that the Communion is prideful, having violated the moratorium on provincial boundary crossings, while we held off on the possibilities of confirming the election of a partnered gay bishop or of blessing a faithful gay couple.
We will deal with this resolution, and will most likely pass it. It will certainly not heal the breach, either within the Episcopal Church or the Anglican Communion. Conversely, I don’t think it will make matters much worse. Those who have gone will not return if this fails, nor will those in the wider Anglican Communion who have broken communion move to re-establish it. Those bishops who believe pastoral generosity cannot extend to any blessing for gay or lesbian coupled will not have to, and probably will not, participate in the collecting of resources. In their dioceses, and in those congregations that oppose them, blessings will not happen. In those dioceses that do support this collecting, this experimentation, blessings will happen, perhaps more openly than they might have otherwise, than they might have already.
And yet I can’t say that nothing will change. There will be incremental changes. Some bishops will feel they have institutional support they did not have before to allow experimentation. Some couples will be prayed for, blessed in a tangible way, that would not have been otherwise. Within “civil jurisdictions where same-gender marriage, civil unions, or domestic partnerships are legal,” something more open may be done. No one is really confused: with this act we are as the Episcopal Church inching toward recognizing these couples as capable of faithful, loving, and specifically holy relationships. May God bless us and keep us, every one.
C056 has passed. It has passed, in a vote by orders, by wide margins in both laity and clergy. It is done.
(To be sung to the tune of “Downeaster Alexa;” with apologies to Billy Joel)
1. Now we’re here in the Church called ECUSA
And we’re cruising through hot Anaheim.
We have charted a course toward inclusion,
But we can’t seem to get off the dime.
Some resolutions leave us thrilled and some appalled.
We pray no one amends before the question’s called.
We act and each House asks the other to Concur;
And then we grumble when the other House won’t stir,
So if you see wand’ring Episcopalians
With their names framed in purple or red,
Tell them get their butts back to the voting
So we can put this Convention to bed.
2. So we’re here in this Church called ECUSA,
Although most now would say “T-E-C.”
We are all called to make sacrifices,
And then ask, “That won’t really mean me?”
A resolution will seem moderate or mild,
And be defended like someone’s endangered child.
And then a measure set with consequences stark
Will pass with but a single deputative bark;
So when you see gathered Episcopalians
In the sunshine, communing with God,
Tell them Katherine and Bonnie are sending
Out a page with a hot cattle prod.
3. Now we drive this grand Church called ECUSA
More and more every time that we meet
Farther out from our Anglican siblings,
Building fire under Arch. Rowan’s seat.
We have folks at home who say they want our love.
Those abroad say that we grieve the saints above.
We’re trying hard to be both Cath’lic and Reformed,
Despite our critics, in the faith where we were formed.
Wednesday, July 15, 2009
Once again there will be a vote by orders – no surprise there. What more needs to be done?
It is an opportunity for some to speak again in favor or against. It’s an opportunity for some to try to kill by amendment, as the saying is, “to be nibbled to death by ducks.”
There is the occasional new image, like suggesting that the “season of B033 has passed like a bout of the flu.” There is, for the first time, a reference to how American money is perceived outside the Episcopal Church. Young people speak of their generation, and some speak of the change among their peers, and how the Church is seen as unfriendly to glbt persons. And yet some speak as young conservatives, themselves not wanting to align with so many of their peers.
We have not operated under a special order, and so the time for debate was no longer than for most resolutions. The predictable motion to extend the time of debate was made, but too late, after the time for debate had already expired. I would have expected such a resolution to fail anyway: clearly, many in the House want to see this done, to see what we had already done completed.
Is the resolution better for the addition of these few words? It is at least no worse. The words are accurate, in that we do consider ourselves “a constituent member of the Anglican Communion,” as we state in the Preamble of our Constitution. And certainly vocation is “a mystery which the Church attempts to discern.” For many the argument for this resolution has been that it is simply accurate, reflecting where and how we are in the Episcopal Church. For some the argument against this resolution has been its failure to address explicitly 2006-B033; but they would find these words no less accurate.
The vote is being taken. We will be waiting, even while we try to get on with business, to see the result.
It passes and it is done. The margin was not close – certainly well more than two thirds. Here is the final form.
So, now it is done. Or is it? There are a few related issues that will come up yet. However, this one is complete. We have as a General Convention said that we will follow the Canons, and that no single characteristic of will bar a person from consideration of call. That doesn’t create a “right” to ordination; only a right to full and reasonable consideration. We have as a General Convention said that we are committed to the Anglican Communion, even to the point of financing. That doesn’t create a right for other Anglicans to dictate to us, any more than we claim a right to dictate to them.
No, I think this is done, at least for a while. We’ll be arguing about exactly how to apply each clause. Some say it rescinds B033; but it doesn’t say that. Some say it changes nothing; but that doesn’t seem quite right either.
No, in a way we’re still where we were before we had a report of the vote. Folks across the spectrum will be deciding what they can and can’t do based on this; and until they do, until they actually take steps based on D025, we won’t know what that means. So, we were earlier today, we will be waiting, even while we try to get on with business, to see the result..
While you're there, check out The Lead, the news blog at Episcopal Cafe. It's a good place to get a sense of what's happening here in Anaheim.
Tuesday, July 14, 2009
Most important to me was Resolution D011, “End of Life: Principles for Decisions at the End of Life.” This was the same resolution I wrote for the 2006 General Convention, that was lost uncompleted at the end of business. (You can find the final version here; and my 2006 blog post here.) It was passed in the House of Bishops first, and was so strongly supported that it was presented in the Consent Calendar, as a resolution that should pass and isn’t subject to debate. While I would have loved to speak to this in the House (and did in the Legislative Committee), I was pleased that the Committee thought this so worthwhile. Among other things, it commends chaplains in AEHC and health ministers in NEHM, as well as chaplains and counselors certified by APC, ACPE, AAPC, and CPSP, as resources for the Church in areas of health care and ethical issues.
Another was Resolution A077, “Episcopal Health Ministries.” This was proposed by the Standing Commission on Health, and “urges the congregations of The Episcopal Church, which have not already done so, to explore and implement health ministry as an organizing concept or vital component of outreach and pastoral care of the congregations by 2012….” It was also passed as part of the Consent Calendar. (You can find the final form of the Resolution here. You can find my blog post here.)
In addition, three of the resolutions from the Executive COUncil Committee on HIV/AIDS have been adopted. Resolutions 159, 160, and 161 have all been approved in both houses. (I wrote about them here.)
This is just a brief update, but I’m trying to follow these issues. Last Convention was a tough one for health issues, because many were squeezed out by the time spent on responding to the Windsor Report and the wider Anglican Communion. This Convention is looking a whole lot better. Keep watching this space.
Monday, July 13, 2009
We have come on Sunday of all days to discuss the ordination of bishops in the Episcopal Church – or, really, the ordination of partnered gay and lesbian bishops, for there is no other issue in general regarding the ordination of bishops. Indeed, we aren’t really discussing that, either. We’re actually discussing D025, titled, “Anglican Communion: Commitment and Witness to Anglican Communion.” The real issue is a resolution from 2006, B033. That was the resolution that called for bishops and Standing Committees of dioceses to “exercise restraint” in consenting to the election of a bishop whose “manner of life” would displease Anglicans elsewhere.
The legislative committee on World Mission considered three sorts of resolutions. Some would simply repeal or rescind B033. Some would make a positive statement about not allowing discrimination in admission to discernment for any office, ordained or lay. Some would make a broader statement. They chose D025 as the broadest response.
Interestingly enough, D025 doesn’t speak to 2006-B033. It doesn’t repeal or rescind it. Rather, it speaks of openness in discernment. It also speaks of maintaining as best we can our relationships with other Anglicans around the world, including financial support. It also speaks of the ministries we already see of gay, lesbian, bisexual, and transgendered persons in the Church, and the way that folks in those ministries have demonstrated the gifts of the Spirit.
As when we heard so many voices two days ago, there aren’t really any new points being made. Once again the points made are made with passion, and with clarity. One could speak of “the usual suspects;” that is, voices from dioceses that have been pushing the Church toward inclusion support the resolution. Voices from dioceses that have been anxious, both about Scriptural issues about inclusion of glbt persons and about relations with those parts of the Anglican Communion that are unhappy with us, do not support it.
Interestingly enough, folks from both ends speak of sacrifice, and about who within our own ranks will be lost – some literally, driven to leave the Episcopal Church because it is too slow in embracing all the baptized or because it is too fast in incorporating all the baptized. Several times reference has been made to the image of a plane, requiring two wings to fly. The image is clear, of course, as is the concern: just who can we “afford” to lose – and I put that in quotes because any loss isn’t good or even acceptable, even if comprehensible.
And yet now and again there is something more positive. There has been a person who read the story of Jesus healing at the pool at Bethesda, and ended by calling for the House to “sin no more so that nothing more bad may happen to us;” but although she self-identified as being against the measure, I have to admit I wasn’t clear on how she meant that. There has been a person supporting the measure whose tone was not simply earnest but hopeful. There was the person who stated, “In the first place readiness for many has nothing to do with our baptismal vow,” which seems a rather odd thing to say; or, better, an odd way to say that baptism in and of itself doesn’t qualify one for ordination, which I think is what the person meant.
We’re operating under a special order, and not simply the Rules of the House of Deputies. So we’ve had thirty minutes of testimony before anyone might offer an amendment.
There has been a call for a vote by orders. When we vote, then, the clergy deputies of our diocese and the lay deputies will confer separately, and will each offer a single, separate vote. In an interesting constitutional maneuver, there has been a request to divide the resolution into two parts. That is, each part would be voted on separately, and could stand or fall independently. Essentially, the point chosen would separate our affirmation of our life in the Anglican Communion from our affirmation of the glbt persons in our midst and are accession to our Constitution and Canons in opening discernment for ministry. So, the first part could pass (and it almost certainly would), while the second part could fail (which I doubt it would, but it would be much closer). Moreover, there has been call for a vote by orders on the motion to divide.
And of course all this takes time. We’ve already clarified that the time for these voting machinations aren’t taking time from time for debate or amendment. We haven’t discussed how much energy it’s taking from the members of the House.
I will spare you the machinations. I expect they will in fact carry on for a while. Suffice to say that something will happen, and many of you will see it in the news before you see my comments here. But I want to tell you two things. First, everyone is quite serious. No one is casual, and no one is flippant. The house is intent, if not yet intense.
Second, it is hard to hear in the midst of so much talk of sacrifice those voices that speak of mission. No one considers mission irrelevant. Every person thinks this will in one way or another affect our ability to do God’s work. But few are actually speaking of that.
But then few are actually speaking. Most of us are paying attention, voting when called upon, and hoping: hoping that we can indeed focus again on mission. Most of us indeed seem to want “to get past this.” We’re just not agreed on what we’ll find past this when we get there.
And now we’ve voted – and while we wait for the results of the vote by orders, we’re trying to get on with the business of the house. There is certainly other business to do, and even important business. Still, our attention is divided while we wait….
The motion has passed, and passed with a margin of roughly 70% to 30 %. The rules of the House of Deputies do not allow for applause, and there is none. That may be due as much to exhaustion as to the rules. Rather, there is prayer and departure, for the legislative day has ended.
I was a visitor in the House of Deputies in 1976 when the change to Canons allowed for the ordination of women to the priesthood. I was an exhibitor in 1979 when the Prayer Book was approved. I was a visitor in 1982 to see the debate and approval of the Hymnal. I was sitting in the Alternate gallery in 2006 when B033 was approved. And now I was a Deputy, voting on this. I have a feeling that this is another event in the life of the Church that I will be talking about in years to come..
Saturday, July 11, 2009
Even as I write, I sit in the House of Deputies. We are meeting as a Committee of the Whole, hearing how many among us have seen the results of passage of B033 at the end of General Convention in 2006. I say “hearing” rather than “discussing,” because while many are speaking, it is not technically “debate.” I am not among those planning to speak. I simply feel others will say what I would say, and perhaps say it better. I am happy to listen; and listening, let me share some reflections.
First, I am not particularly struck by the opinions. Oh, they’re articulate and well thought through. It’s just that there’s nothing new in them. We’ve heard them before. I don’t say this to be dismissive but descriptive. While some are speaking from microphones who have not spoken so publically as those of us in the blogosphere, they’re saying things that have been said here. Oh, there are the occasional surprises. There was the deputy who spoke of just how resilient our Communion is, with bonds of affection based on the personal relationships shaped by the Millennium Development Goals. There was the deputy who chose an interesting image of B033 as “the crucible of adaptive change.” But most of the statements made familiar points.
So, what strikes me is the continuing passion, the audible pain and anxiety that were quite clear. Many speak of sacrifice – of the sacrifice of people, the sacrifice of relationships, the sacrifice of the Communion. Many speak of cost – of cost in lives, of cost in relationships, of cost in ministries and vocations lost. No one speaking – no one - is casual, and no one is dismissive. Of course, the pain being what it is, I don’t know that those most engaged don’t still feel dismissed. I rather expect they do.
At some point, we will address this with a resolution. It will be a clear instance in which we will do that because it is our process, and not because it’s ideal. It would perhaps be ideal to seek consensus. It would also be a clear sign of the presence of the Spirit. It would be a sign of the coming of the Kingdom, and I for one would be waiting for the roof to roll back and the heavens to open and the dead in Christ to rise. We are not sufficiently in one place to come to consensus, common thought and feeling. The voices are making that clear. There are perhaps more speaking of, in some sense, moving beyond B033 than there are speaking of staying where we are. But, the number calling, sometimes pleading to stay where we are, is enough to indicate a significant, and not a tiny minority. Where shall we go from here? Yet, the one thing we cannot do is stay here.
The day has passed, and I’m back in my hotel room. However, this morning’s discussion took me back a few days. My first day of Convention started early, and not in Anaheim. I began with a morning flight. I roused early, and made my plane. My only mistake cost me my pocket knife – again. However, I had chosen the particular pocket knife specifically because I wouldn’t be devastated if I lost it.
As the ground below me went from green to tan to red, I did some studying – studying that I hadn’t been able to do up to this point. Oh, I’ve had the materials. I just haven’t had the time. While folks in the hospital wouldn’t disapprove of me taking time to study for Convention ahead of time, the patients simply wouldn’t stop coming. What can one say? And so my time was committed to matters more immediate.
The theme of this Convention is “ubuntu.” Of course, in all my convention material the word is capitalized. However, I haven’t done so here because the word is first a concept, and not a title. It’s most common meaning – common in the sense of most often quoted – is “I am because we are; and because we are, I am.” The real meaning is broader than that. It really encompasses a statement that personhood is only known in community. I can’t be me apart from participation of and with others. It might be called a “communitarian” position, somewhere between our sense of Western individualism and cultures in which the community is all in all.
We first heard it in context of the Lambeth Conference. It was intended to give us some sense as Anglicans of interdependence. It was tied to the Gospel of John, who spoke of us being in Jesus as he is in the Father and the Father in him; and to Paul’s image of the Body: “The eye cannot say to the hand, ‘I have no need of you.’”
All of which made it rather hard for everyone to really embrace. Oh, great statements were made, but few changes. There were those who weren’t there, functionally saying, “I have no need of them.” There were those who were there but saying, “I have need of you, as soon as you fall in line.” There were those who were there but saying, “I really want to be with you, but if need be I’ll do without.”
And now it is the theme of the 76th General Convention of the Episcopal Church. Some things are the same. There are those who were with us three years ago who have departed, saying, “I have no need of you.” There are those present prepared to say, “I really want to be with you, but if need be I’ll do without.” And while no one said, “I have need of you, as soon as you fall in line,” some said, “I fear they will have no need of us if we don’t fall in line.”
We do not do community well in America. Some talk about our militant individualism, as if we’ve lost touch with what it means to be defined in relation to a community. I can see that, but I sometimes think it’s just the opposite: that many of us have experienced what it has meant to be defined by a community – call it our small town, or our family, or our class – and defined as outcast, and we’ve wanted to flee away. We are not so much individualists because we have no sense of community, as much as we believe we are recovering from community by being individuals.
And so this morning voices were heard, all of whom felt they were speaking of being included in an important relationship. The many who spoke moving beyond B033 did so to feel included, or to include another, in the Body of Christ in the Episcopal Church. The smaller number who spoke of staying with B033, believing we could do so without abandoning GLBT Episcopalians, almost to a person spoke of being included in the Body of Christ in the Anglican Communion. And everyone – virtually everyone – spoke of sacrifice.
“Ubuntu” – the idea that we are who we are most fully in the context of community, and the community is most fully complete with we are all in it – is more than the theme of Convention. It is a Gospel value. It is the Biblical norm, both for Israel and for the early Christian community. We are indeed called to it, however confusing and confounding it may seem to us. The difficulty, a difficulty that is clearly painful, is to figure out how we can embrace it. For many have come to a point of knowing that this must involve sacrifice and risk, while feeling that they have already risked more than they can afford to lose.
If you're looking for other sources, the ones I recommend are the Episcopal News Service and the Episcopal Cafe. I would encourage also to look at other diocesan web sites. Many dioceses have someone writing regularly, whether bishops, deputies, or both; and that variety of writers will give a better perspective on feelings and perceptions, and not just the news items.
General Convention is a significant event every three years, and a lot of people are involved. Take some time to hear those voices.
Friday, July 10, 2009
One item that caught my attention was the report that representatives of the American Hospital Association had told the White House and Congress that hospitals would accept significant cuts in Medicare and Medicaid over the next ten years in support of a plan for universal access to health care.
For years now hospitals especially have struggled with the Medicare and Medicaid payments they’ve been receiving. That’s because the payments were set at a percentage of what the folks at the Centers for Medicare/Medicaid Services (CMS) thought costs ought to be (as opposed to paying fully what the costs actually were). While there are worse payers than Medicare and Medicaid, they’re big players; and their restrictions have helped make economics tight for everybody.
So, why would they accept these cuts? Because they’re hoping for a big jump in economies of scale. With roughly 40 million folks un- or underinsured, hospitals are losing 100% of the costs for many of those patients. If they can get something for those patients, even if it’s only, say, 60%, that will make up – perhaps more than make up – the lost increases from Medicare and Medicaid.
Remember that one of the ongoing issues in paying for health care is cost shifting. It’s basically the same consideration retail folks have for loss and petty theft: you know you’re going to have some marginal losses, so you raise the price of everything so that what you do sell will cover your costs. In health care the principle is the same, even if the dollar values are much greater. If hospitals are losing out entirely for some patients - and for some institutions this can run to millions of dollars – they have to raise their rates to cover the gaps. Since this raises all their rates, and since all institutions in a given economic area have the same pressures, that effectively raises costs, and so the value of the percentage they do receive from Medicare and Medicaid.
So, if there is coverage for those 40 million or so un- or underinsured, or even for a large percentage of them, that will provide revenue for hospitals that they aren’t getting now. With this new revenue where previously there was total loss, there will be less need to cost shift. So, the lower increases from Medicare and Medicaid will be acceptable.
That said, this all hangs on passing something like universal access to health care. If that doesn’t happen, the hospitals can’t accept the change. On the other hand, I think the hospitals will get enough to really help. After all, as we’re more and more aware, none of us will be able to accept the consequences of not changing.
Wednesday, July 08, 2009
The music is just as diverse. We will hear rhythms that few of us hear regularly. We will be exposed to texts and tongues that few of us would hear at all otherwise. I collect the worship booklets to take home and share with parish clergy, hoping it will inspire them to some experimentation – some modest, well considered experimentation – in worship.
One difference between the Eucharists this year and those in 2006 has been the absence of movement after the sermon. In 2006 each day once the sermon was over a noticeable group of folks would rise and work their way out of the worship space. They were, by and large, on their way to an alternative daily Eucharist offered by some who were dissatisfied with the direction they saw General Convention taking.
My reaction to their absence this year is mixed. On the one hand, I’m saddened. They aren’t leaving this year because they aren’t here in the first place. Many have found their ways to other ecclesial bodies outside the Episcopal Church and arguably unrecognized by the Anglican Communion. They have despaired of feeling a place within the Episcopal Church. They have despaired, in many cases, of us entirely.
At the same time, I have to admit that it’s a joy to be worshipping together as one without such public demonstrations of separateness. I could not help then but see it as a distraction. I am happy not to have the distraction now.
That said, I will have to reflect a little sadness. These actions were perhaps a distraction, but the people were not. They were members of the Episcopal Church, however dissatisfied; and they continue to be members of the Body of Christ. I don’t expect I will see it; but perhaps in a generation those after me will see some reconciliation. I still think things will be more complete when once again they feel they can worship with us.
Saturday, July 04, 2009
I have commented before about the narrowness of the arguments about universal access to health care. What I mean is that most of the time the examples are limited to three. There are arguments about the Canadian model and the British model – usually discussions of their limitations – and about the American model – usually its strengths, although it isn’t really a model of universal access. I have commented before that other nations have other models, and manage to provide universal access to care, almost always at less expense as a percentage of GDP, and almost always with better outcome statistics.
An article in today’s Kansas City Star, my hometown paper, tries to address this. The author, Scott Canon, has looked at a variety of models. He’s also sought comments from a variety of experts on them.
This is a comment article in a paper, and not a scholarly review. On the other hand, it’s the first effort I’ve seen at least trying to show that other nations are using a variety of tools to offer provide universal access. Each model has its strengths and limitations. Each involves some hard political decision-making, and some rationing. On the other hand, our model also involves some hard political decision-making, and involves rationing, however hard we try to deny it.Take a look at the article. It won’t resolve arguments one way or another. However, it will offer images of more than just three ways of addressing health care needs. That by itself is worth the time and trouble.
Thursday, July 02, 2009
My dad has been in a discussion on another blog about whether a doctor should ask a patient if he could pray for the patient. My mom and dad are very much opposed to a doctor asking a patient if he can pray for the patient. Others think it is fine for the doctor to ask that. Are there any rules at hospitals on this subject?
I have two experiences that I think about with this question. One is the story of a colleague, who spoke of a pre-op visit with a patient. The patient commented that she hoped her surgeon was a good Christian. He answered, “At the moment, ma’am, you’d better hope he’s a good technician.”
The second is the portion of my orientation of new staff that addresses our System’s policy, “Protection of Religious and Cultural Rights and Beliefs.” I comment that my goal is that the hospital be a “spiritually safe place;” which is to say a place where each person can be the same person spiritually in the hospital that the person would be elsewhere. I then note that I’m not the only person who pays attention to spiritual care. I note that many professionals pray for patients; while a few besides me also pray with patients.
Part of that discussion is the need to really think “protection” when we think of a spiritually safe place for patients and/or families. It might seem trivially true, but it has also been studied. Patients are anxious, and don’t want to upset the people taking care of them. That raises the risk that they will say what they think we want to hear. For the hospital to be a “spiritually safe place,” we really do need to think about protecting that space.
That said, I find in my own work that many folks can accept as an expression of good will the thought that someone might pray for them, even if they would not pray themselves or want the other person to pray with them. Sometimes, too, they will ask for prayer or indicate that they value prayer. My own thought is that if they ask, and the person asked is both free to accept or decline, and also feels appropriate participating, praying with the patient, or being present while the patient prays, is okay. Now, if you think that through, that in most circumstances suggests that the patient from his or her position of vulnerability can ask the staff; but the staff person from his or her position of power cannot ask the patient.
Now, there is another dynamic in play here. In the last decade or so health care professionals other than chaplains have been thinking about how the spiritual lives of both patients and professionals affect both relationships and outcomes in health care. Nurses have actually been including this in their professional discussions for some time. However, physicians, psychiatrists, social workers, and counselors have also been thinking about the effects of spirituality in their work. In most instances this isn’t a discussion of faith or miraculous healing. Rather, it’s recognition that for many individuals spiritual beliefs influence how they live their lives and make decisions.
One consequence has been that physicians of faith have felt less pressure to hide. They have been prepared to acknowledge that prayer is an important part of their lives, and that they pray for their patients, and for help carrying out procedures. Again, for many patients this is simply a statement of good intention, and they’re not offended. Some do indeed find it comforting. So, consider this conversation:
Patient: I know things are in God’s hands, and that things will be all right.
Physician: Well, I will be praying for that as we go to the OR.
Patient: I’m glad to hear that. Could we pray together?
Contrast it with this conversation:
Physician: I just wanted you to know that I pray before all my surgeries.
Patient: That’s good.
Physician: May I pray with you?
I think the latter conversation verges on manipulation. Again, if we consider that the patient might well say what we want to hear (and what patient wants to offend his surgeon, however slightly, just before the procedure?), the second conversation is questionable. But is the first? The doctor has responded to a comment from the patient with a statement about his own practice, with no expectation of the patient. If the patient then makes the request and the doctor feels comfortable participating, is this a bad thing? It arguably strengthens the doctor-patient relationship. It supports the patient’s hope and lowers stress, both of which have been shown to support health and wholeness.
There are some hospitals that have a culture that discourages professionals other than chaplains or clergy from praying with patients. Those institutions feel that’s necessary to respect and protect the spiritual beliefs of the patient. They may or may not have an explicit policy; but corporate culture can be very clear and very powerful. In some environments chaplains feel they have to be the clearest enforcers of such policies. They distrust the judgments of the other professionals around them, fearing that they will jump too quickly to suggest their own spiritual perspectives instead of respecting the patients’, mostly because they simply imagine that everyone will agree with them, or at least understand them.
In my own setting, I don’t have that fear. New staff members do get orientation from me on the subject, including explicit directions against evangelizing or proselytizing. They also get diversity training as part of their orientation; and I connect to this by noting that our religious and cultural beliefs are simply another category of diversity that the System expects us as employees to respect.
Now, doctors don’t have that orientation. At the same time, they are offered opportunities for diversity training, and hear regularly that respect for diversity is a central tenet of the System. My sense is, both in my own institution and in others, physicians praying with patients are uncommon (although I can well imagine that many are praying for patients). For those who do, if they do that in a context that’s not manipulative and that satisfies the patient, I’m comfortable. If I were to learn that is was manipulative, that would be another thing altogether – one that I’d probably find myself in the middle of, at least in my institution.
Like so many things that happen in health care, prayer with a patient is one that can be done appropriately or inappropriately. More doctors feel free to be authentic about their own faiths, and I think that’s a good thing. If they can be authentic about their own faiths, and also respect the faiths of their patients, that’s even better.