Last week I attended the fall meeting of the Executive Committee of the Assembly of Episcopal Healthcare Chaplains (AEHC). You may have noticed the link to AEHC in my sidebar. I am the Immediate Past President, a position that in general means I get invited to all the parties, but have very little for which I'm actually responsible.
We met, as we have in recent years, on a seminary campus. This year we met at the Church Divinity School of the Pacific, where folks were very hospitable to our little group. We have chosen to meet at seminaries in hope that we will have some opportunity to talk to students, and to talk especially about a vocation to healthcare ministries.
That intent brings me back to one of my ongoing occasional topics: what we would look for in an Episcopal culture for health care. Specifically, in an Episcopal culture for health care, how would we see, or how would we consider, vocation?
The first question to address at that point would be, I think, whose vocation? That is, are we asking about the vocation of the institution, or are we asking about the individual vocations of the persons who work in the institution? As you might guess, I think both are worthy of consideration. This post will consider the vocation of the institution.
How would we speak of the "vocation" of the institution? We know, of course, that the institution has a purpose: it exists to provide health care. That is not a distinctively Christian purpose, much less distinctively Episcopalian. In the area I serve there are Jewish institutions, and civic or governmental institutions that would claim no faith connection at all. In the rest of the world health care institutions have been founded by faithful Muslims, Hindus, and Buddhists, and probably by others not familiar to us.
How would we look beyond the purpose of health care to find some sense of vocation? In that light, what do we mean when we speak of "vocation?" The word itself, as we know, comes from the Latin vocare, "to call." We use it in the church to speak of a specific call from God to a particular ministry. In the Preface to the Ordination Rites in the Book of Common Prayer, we find reference to "The persons who are chosen and recognized by the Church as being called by God to the ordained ministry...." (BCP p. 510) We tend to think of vocation in relation to these and other specialized ministries within the Church: ordained ministries, or monastic orders and communities. However, we recognize that all are called. The Catechism in the Book of Common Prayer notes that "The Church carries out its mission through the ministry of all its members;" and that "The ministers of the Church are lay persons, bishops, priests, and deacons." (BCP p. 855)
But, if we commonly use the concept of vocation to speak of the ministries of individuals, how would we speak of the vocation of an institution? If health care as a purpose is not specifically Christian, how would we see in it any sense of vocation?
I would think that in part we would look beyond the basic purpose of health care to understand how the institution was established, and how it sees itself now. For-profit institutions are as much intent on health care as are not-for-profit institutions; but the establishment and the culture would surely be different. Both are involved in service, but one serves patients to serve shareholders, and the other serves patients for their own sake. An institution founded by Episcopalians would, one hopes, be different in focus and culture than one by a government agency or founded for profit. An institution founded by Episcopalians that became part of another system would surely experience some cultural change, whether the new system was another faith community, or the local civil community.
I think the first place we would look to see that difference would be in the mission, vision, and values. In general, some evidence of that should be easy to find, for institutions and systems have been for a generation developing and refining explicit statements of mission and vision and values. What words have they chosen? What values have they espoused? Do the works they choose seem in any sense congruent with the faith as the Episcopal Church has received it? Even if not specifically so, are they values that we as Episcopalians would embrace?
On a side note, while we might think about looking first to the name of the institution, it might not be as helpful as one would think. Many of the hospitals started by Episcopalians were names in honor of St. Luke the Physician. Unfortunately, between the small size of the Episcopal Church and the sale over the years of many of those institutions to non-Episcopal organizations, and also the success of our Roman Catholic siblings in establishing and maintaining health care institutions, many people, at least in my experience, assume all those hospitals are or were Roman Catholic. It's named for a saint; therefore, it must be Roman. A few institutions include "Episcopal" in their names. For the rest of us, we live with the confusion. (And there’s no shame there. Roman Catholic hospitals are good hospitals. They're just not Episcopal.)
So, we would look to those mission, vision, and values statements. We would then want to see how they function in the life of the institution. How, for example, are new staff and professionals oriented to those values, and to the history from which they arise? How are they expressed by the Administration and leadership, and how are they reinforced in the day to day practice of the institution?
Speaking of leadership, does the founding tradition affect who serves in leadership? Are there members of the Episcopal Church on the Board, for example? Are they there by design, by custom, by courtesy, or by chance? Does a bishop, or representative member of the clergy serve, and in what capacity? While no guarantee, visible presence of Episcopal clergy and lay leaders would lend credence to congruence of the institution's values with those of the Episcopal Church.
Are there positions in the institution held by Episcopal leaders by design? While this would be rare for most positions, it is not uncommon for an Episcopal institution to reserve a chaplain's position for an Episcopal cleric. And, to whom does the Chaplain report? One measure of how the institution values the position is to consider how high in the administration the reports. There is a distinct difference in the influence of a leader in an institution between reporting to a manager or to the chief executive officer.
Finally, does the institution acknowledge an explicit connection to the Episcopal Church, whether active or historic? Certainly, I would have higher expectations that an institution actively connected to the Episcopal Church would meet many of the criteria I’ve considered above. However, I would not disdain an institution that has had a change of ownership but continues to express Episcopal heritage by meeting many of those criteria.
It may feel a bit awkward to speak of the vocation of an institution, or at least of an institution that is not entirely religious in purpose or function. At the same time, we speak of the culture, the ethos of an organization; and that culture, that ethos gets expressed in specific actions. That culture, that ethos has a certain self-awareness about it. After all, it is to a great extent a matter of choices: “This is how we choose to act;” and, so, “This is who we choose to be.” When we explore the sense of vocation of an individual, that self perception, that sense of call by the Holy Spirit, is critical. We may be a Church in which personal call is examined for acknowledgement by the Church; but we don’t go forward unless and until that personal sense has been heard and examined. I think we can make a similar evaluation of the personal sense of call of an institution, expressed both in words and deeds. If an institution is an Episcopal institution, I think we can expect to see words and deeds that express not only a culture or ethos, but a consciousness of call. I think such a sense of vocation would be essential for an Episcopal culture for health care.
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