Saturday, April 08, 2006

Toward an Episcopal Culture for Health Care: General Convention

I have been writing recently about actions of General Convention about health care. There's a lot more to be addressed in that vein: the Church's response to AIDS, abortion, care at the end of life, etc. General Convention has spoken on all those topics, and more.

And as I do this, it raises a question for me on my other ongoing subject: if there is an Episcopal Culture for health care, how is it affected by, responsive to, actions of General Convention? General Convention is the single authoritative voice of the Episcopal Church as a whole. Bishops can speak with authority, both as individuals and as a House. But as the current arguments in the Communion make clear, and as the bishops themselves have made clear, final authority to speak for the whole Episcopal Church rests with General Convention. So, how should an Episcopal culture of health care be affected by the actions of General Convention?

This is not an idle reflection for me. As the chaplain in an Episcopal hospital, in an Episcopal health system, I do get asked what the Episcopal Church has to say on certain issues. Abortion and end-of-life issues have been foremost among those, but there is also some general interest in other ethical positions of the Episcopal Church. Most folks here see that as in keeping with being a church-related hospital, in parallel with Catholic, Jewish, and Adventist hospitals. And taking seriously both the questions, and my own status as a priest of the Church, I do review General Convention actions that may be relevant.

First, we have to distinguish among the actions of General Convention regarding their authority for the Episcopal Church generally. We see differently actions affecting Constitution and Canons or Prayer Book and Liturgy from those expressing the opinion of the Church on social issues. While all have some room for personal interpretation and expression, the former are formative for us as a Church to a degree that the latter are not.

I think we can say also that the Episcopal Church has long valued individual conscience and individual thought. This is based on a number of themes in the tradition. The classic model in the Anglican tradition for sources of theological authority is the “three-legged stool” of Scripture, Tradition, and Reason. In theological reflection “Reason” is more clearly described as “reasoned reflection on the action of God with God’s people as reflected in Scripture, and in the history and tradition of the faith, and in the contemporary lives of the believers.” But even with those qualifications, it is clear that the capacity to reason is valued as one part of how we recognize God’s presence and action in the world. By the same token, we take local experience seriously. For example, in the Chicago-Lambeth Quadrilateral the clause describing the Historic Episcopate qualifies it as “locally adapted… to the varying needs of the nations and peoples….” Again, rational reflection on current experience helps make this sensible.

What, then, should be the relationship between actions of General Convention and an Episcopal culture for health care? To be considered an “Episcopal” institution, and particularly for those health care institutions maintain an official relationship with an institution or agency of the Episcopal Church, we should expect some responsiveness to the most authoritative body of the Episcopal Church. This would surely mean some awareness and reflection of actions of General Convention. I would suggest that special responsibility for providing education about those actions falls to Episcopalians within the institution and/or the Episcopal agency with which the health care institution is affiliated. There should, certainly, also be an expectation of recognizing local experience in how these actions are reflected in the policies and actions of the health care institution. To take an example from my own experience, the General Convention has expressed the opinion that “legislation concerning abortions will not address the root of the problem.” (Resolution 1988-C047, reaffirmed in Resolution 1994-A054) At the same time, health care institutions can be expected follow federal and state laws respecting abortion. And certainly, health care institutions would be expected to base clinical care on the best clinical information, and not simply on actions of General Convention.

As with most of these reflections, this is only a beginning. There can be a deeper examination, beginning with our own understanding of how we view actions of General Convention within the Episcopal Church itself. I have noted a more or less official distinction between “constitutional” actions of Convention, and those more expressive of opinion or education. We also make distinctions as individuals based on our own personal reflections and experiences, in light of Scripture, Tradition, and Reason. Still, it makes sense to me that to claim connection with the Episcopal Church, an institution must be responsive to the most authoritative voice of the Episcopal Church, the General Convention. That calls me as an Episcopal chaplain in an Episcopal institution to the responsibility to relate those actions within the structures of my institution; and for all of us who want the Church to be involved in health care to be aware once again of what the General Convention has said.

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