Things May Be Better Off Than We Had Feared

This past Friday I wrote about the Second Report from the Windsor Continuation Group, and their suggestion that the Communion might benefit from a “Faith and Order Commission.” All the Reports of the WCG are now available on line, including the Third Report, which includes a suggestion for a “Pastoral Forum.”

With my concerns, I was interested to see this comment by Bishop Christopher Epting, retired of Iowa and Ecumenical Officer for the Episcopal Church. He’s in Lambeth, and he has more experience in these discussions than I, so I found his perception of the Faith and Order Commission meaningful and reassuring.

I have no real problem with the Communion-wide “Faith and Order Commission.” It is not intended (as the press had said) to be like the Vatican “Holy Office” (Congregation for the Doctrine of the Faith) with all kinds of powers to censure and discipline. It is simply the rolling together of the current International Anglican Doctrinal Commission and the Inter Anglican Standing Commission on Ecumenical Relations (upon which I serve).

I don’t think merging them is a great idea — there is more than enought theological and ecumenical work for both Commissions — but this has been a done deal for some time, partly because of the cost of both Commissions. We need some kind of clearing house to which to refer matters of doctrine and discipline for discussion. The fact that we have not had such a thing in the past is why The Episcopal Church did not do more “consultation” in matters theological dealing with issues of human sexuality years ago.

He goes on to say, on the other hand

The suggested ”Pastoral Forum” is more problematic. It’s to be chaired by the Archbishop of Canterbury and serve as an advisory group to the various Provinces when there are internal disputes and difficulties which affect the whole Communion. Such schemes have been tried (or at least floated) in recent years and have always failed. I’m not sure why this one will have any greater chance of success.

The WCG report described the Pastoral Forum idea in some detail, but the essential points are that the Pastoral Forum would “engage theologically and practically with situations of controversy as they arise or divisive actions that may be taken around the Communion;” and “would be responsible for addressing those anomalies of pastoral care arising in the Communion against the recommendations of the Windsor Report.”

I might have had more concern myself about the “Pastoral Forum,” if someone hadn’t noted how much it seemed like the Panel of Reference. In fact, does the WCG Report specifically connect it to the Panel of Reference, but it’s composition is much the same. Members would be appointed by and report to the Archbishop of Canterbury (oddly, the Report speaks both of the Archbishop as “President,” of an “episcopal chair” that he would appoint). It would be intended for consultation, and members could travel to meet with those concerned in disagreements.

In any case, and again, I do find the connection and similarity to the Panel of Reference does lower my blood pressure somewhat. Last year, I made the following comments about the work of the Panel of Reference:

• The Panel of Reference has established a history of recognizing the institutional, provincial integrity of the Episcopal Church...

• The Panel has established a pattern, in what few results we have from them, of preferring a return to established institutional boundaries while efforts at reconciliation are pursued. This pattern, expressed explicitly in this report, would strongly encourage maintaining within the Episcopal Church those dioceses and congregations that have sought to leave, at least until the Panel responds.

• The Panel has also established a pattern of withholding consideration while issues are being pursued in civil courts. With their preference for maintenance of the status quo ante, this would maintain real property within institutions of the Episcopal Church, again at least until recommendations were received...

• As the Panel is a creature of the Archbishop of Canterbury, he could hardly ignore the Panel’s recommendations. Neither, I think, could he issue any sort of “peremptory judgment” while the Panel consideration was in process (including excluding American bishops from Lambeth).

We might consider any Pastoral Forum in that light. A forum for consultation, with members that would respect the traditional respect within the Communion for provincial differences and local needs, would be much preferable to the juridical process in the Appendix to the St. Andrew’s Draft of the Anglican Covenant.

Of course, we don’t know how this will shake out. Indeed, we won’t really know until these matters – the final reports of both the Windsor Continuation Group and the Covenant Drafting Committee - are presented next year to the Anglican Consultative Council. But while we wait, as ready as we are to challenge unreasonable ideas, we should also be ready to consider at least ideas that might turn out in their implementation to be reasonable after all.

It's Still Not Safe

I am shocked and saddened today by the violent attack yesterday at the Tennessee Valley Unitarian Universalist Church in Knoxville, Tennessee. Knoxville is my home town; and growing up I knew well peers and families who worshipped in that congregation.

One point we need to note: according to reports today, the shooter left a letter in his vehicle before beginning his assault. In it, he expressed his rage at "the liberal movement." In an interview, the Knoxville Police Chief was asked whether the letter spoke of "the liberal movement" in general, or also specifically of GLBT persons and civil rights. His answer: "Both."

In these United States, the Unitarian Universalist Association is well associated with civil rights for all persons, including GLBT persons. So now is the Episcopal Church, if somewhat later and more slowly. It didn't happen in one of our churches; but it certainly could have.

Perhaps this is something that our Episcopal bishops can relate to other Anglican bishops in Lambeth: that while it is less unsafe to support civil rights for GLBT persons, it is not safe (much less to actually be a GLBT person; but that's something that they teach us, not something they need to learn). While some parts of the United States are more tolerant (often, I fear, in a 1960's sort of "some of my best friends are..." manner), many parts of the United States are not. Our belief that our GLBT siblings are as fully in Christ, and as fully redeemed as the rest of us, is quite countercultural in much of these United States (if not as markedly so as in their cultures).

Perhaps this is something that our Episcopal bishops can relate to other Anglican bishops in Lambeth - if any will listen....

What Ever Rowan Wants.... (Updated)

We’re all waiting today to hear more detail about the second report released today at Lambeth by the Windsor Continuation Group. Ruth Gledhill reports on it here and comments on it here, and Jim Naughton does both here at Episcopal Café.

The gist of the report is to recommend an effort at centralization and another at standardization (a distinction I note because the second supports the first but doesn’t require it; while the first certainly requires the second).

The effort at standardization would be further work of the group examining canon law across the Communion to release what Gledhill describes as “a ‘blueprint’ of canon law,” a step short of a single “code of canon law,” but certainly a tool for consistency. I suppose, like so much else, the result would depend on the extent to which the report might embrace variations in process and variations in content. If it were instead to be simply a tool to build from the “blueprint” a “code” of canon law, it would be something different – something of what Gledhill describes as “a fifth ‘instrument of communion.’”

The effort at centralization is more explicit. According to Gledhill, the report says, "We commend the suggestion for the setting up of an Anglican Communion Faith and Order Commission that could give guidance on the ecclesiological issues raised by our current crisis." Were this to be an arena for further discussion and listening, I suppose it could be useful. If instead it were to become an Anglican equivalent to the Roman Congregation for the Doctrine of the Faith (once known as the Holy Office of the Inquisition), defining by content the limits of the Anglican tradition, once again it would be something quite different from the Anglican tradition as we have known it.

Where would we find support for such an effort? According to Naughton,

"It is a flag raised to see who salutes at this stage," said the Most Rev. Rowan Williams, the Archbishop of Canterbury. "I think there is a kind of head of steam behind [it], said Williams, adding that he was "quite enthusiastic" about the proposal.

He said without additional governing structures "we shall be flying further apart."

"There have to be protocols and conventions by which we recognize one another as churches," Williams added.

The last statement says a lot to me. I have written before of my convinction that Archbishop Williams would like to have a Communion more like what the Roman Catholic Church would officially recognize as “a church” (as opposed to a “defective ecclesiastical structure,” as they see us now). These efforts, sustained by strengthening of the Primates and weakening of the Anglican Consultative Council (something else that the Windsor Continuation Group supports), might well accomplish that, but at the expense of the Anglican Communion, not only as we have known it but as we thought it might shape up post-GAFCON.

Here’s how that shapes up for me. The Episcopal Church and some fellow-travelers will not embrace an Anglo-catholic centralized structure any more than we will embrace an Evangelical centralized structure, a la GAFCON/FOCA. However, neither will the GAFCON/FOCA types embrace the new Anglo-catholic structure just because it’s centralized. A new content-oriented approach will fail because ++Williams et al will still represent and be open to a progressive Western culture far more than the GAFCON/FOCA folks will find acceptable. The new Anglo-catholic centralists will likely be too sacramental and too focused on tradition to be comfortable with the sola scriptura crowd.

As a result, this will really only aggravate the divisiveness within the Communion, and especially within the Episcopal Church, the Anglican Church of Canada, the Anglican Church of Australia, and, critically, within the Church of England. The Evangelicals won’t come back; the Latitudinarians will leave; and structural Anglo-catholics will wonder what happened. In the meantime, in those cultural contexts the churches of the Anglican tradition will only look weaker, meaner, and less consequential.

As I said, we need to wait for more – preferably, to see the document itself. However, these first reports suggest that in the interests of stability the Windsor Continuation Group will actually stimulate fragmentation. ++Williams would indeed have his “church,” perhaps; but it will be a lot smaller than he would hope.

Update: Matt Kennedy has offered his transcription of the Group's verbal presentation here.  Anglican Mainstream has it here.  It is all that we've already heard, and more....

I'm Sorry- They Said What?

On the web site Covenant, Andrew Goddard has posted an extensive critical analysis of the recent documents posted as responses from GAFCON primates to the Archbishop of Canterbury and the St. Andrew's Draft of the Anglican Covenant. It is well worth reading, and while it makes no judgement of where or how, demonstrates that, in those statements at least, something is seriously wrong.

While it is not where he wanted to end up, when he considers the problems with the documents in question, this is his determination:

These conclusions point fairly inexorably to the sad conclusion that the GAFCON movement, although it may talk about its commitment to the Communion and its reform and may appear to have given support to the established Windsor and covenant processes, seems determined to pursue its own agenda on its own terms and to weaken and undermine the wider Communion if it believes that it will not get from it exactly what it wants.

There is a Sufi teaching story. A man once came to the Mullah Nasruddin. "Mullah," he said, "let me borrow your clothesline."

"I can't," said the Mullah. "I'm using it to dry flour."

The man looked shocked. "You can't dry flour on a clothesline. That's hardly a good reason not to lend it to me."

Said the Mullah, "Since I didn't want to lend it anyway, it's reason enough."

Perhaps, deep in the heart of the GAFCON movement, some want to tell that story again.

Wordplay at Episcopal Cafe

My latest post is up at Episcopal Cafe. I've been thinking about the words we use - and right now, especially at Lambeth, the words we use are very important indeed.

Anglican Catechism in Outline: the Final Report

The Final Report of the Global South Anglican Theological Formation and Education Task Force has now been published, just in time for Lambeth. While I have not had time to read through the final report, there don't appear to have been significant changes. One additional illustration has been added; and as I have said before, these should be helpful to us in understanding the circumstances faced by our sibling Anglicans in other parts of the Communion.

You can read my comments on the Interim Report here, here, here, and here; and a summary here.

(And thanks to Mark Harris at Preludium for catching this.)

What Lambeth Has Said on Health Care (2)

You can read part 1 here.

The next two Lambeth Conferences were notable in that they marked a significant change in some of the positions of Anglican bishops on some health issues. More to the point, there was a significant change between 1920 and 1930.

The 1920 Lambeth Conference itself demonstrated little change in health issues from the 1908 Conference. While the was moved from issues of foreign missions to “Social and Industrial Questions,” the 1920 Lambeth continued to address “the evils of drink:”

Resolution 79
Social and Industrial Questions
The Conference notes with deep interest the prohibition by the will of the people of the sale and manufacture of intoxicating drinks in the Republic of the United States of America, and of their sale in most of the provinces of Canada, and commends this action to the earnest and sympathetic attention of the Christian Church throughout the world. The Conference urges members of the Church in other countries:
1. to support such legislation as will lead to a speedy reduction in the use of intoxicants;
2. to recognise the duty of combating the evil of intemperance by personal example and willing self-sacrifice.

More issues related to health were once again considered around issues of marriage. Indeed, the number of resolutions related to marriage grew from ten in 1908 to twelve in 1920. Moreover, there was no significant change in perspective. For example, the resolution in opposition to birth control, and implicitly to abortion, was expanded.

Resolution 68
Problems of Marriage and Sexual Morality
The Conference, while declining to lay down rules which will meet the needs of every abnormal case, regards with grave concern the spread in modern society of theories and practices hostile to the family. We utter an emphatic warning against the use of unnatural means for the avoidance of conception, together with the grave dangers - physical, moral and religious - thereby incurred, and against the evils with which the extension of such use threatens the race. In opposition to the teaching which, under the name of science and religion, encourages married people in the deliberate cultivation of sexual union as an end in itself, we steadfastly uphold what must always be regarded as the governing considerations of Christian marriage. One is the primary purpose for which marriage exists, namely the continuation of the race through the gift and heritage of children; the other is the paramount importance in married life of deliberate and thoughtful self-control.

We desire solemnly to commend what we have said to Christian people and to all who will hear.

There were new concerns raised. A series of resolutions addressed concerns both personal and social: venereal disease, appropriate preventive education for young persons, and what we might call today the “sexualization of the culture:”

Resolution 69
Problems of Marriage and Sexual Morality
The Conference, moved by responsible statements from many nations as to the prevalence of venereal diseases, bringing suffering, paralysis, insanity, or death to many thousands of the innocent as well as the guilty, supports all efforts which are consistent with high moral standards to check the causes of the diseases and to treat and, if possible, cure the victims. We impress upon the clergy and members of the Church the duty of joining with physicians and public authorities in meeting this scourge, and urge the clergy to guide those who turn to them for advice with knowledge, sympathy, and directness. The Conference must condemn the distribution or use, before exposure to infection, of so-called prophylactics, since these cannot but be regarded as an invitation to vice.

Resolution 70
Problems of Marriage and Sexual Morality
The Conference urges the importance of enlisting the help of all high-principled men and women, whatever be their religious beliefs, in co-operation with or, if necessary, in bringing pressure to bear upon, authorities both national and local, for removing such incentives to vice as indecent literature, suggestive plays and films, the open or secret sale of contraceptives, and the continued existence of brothels.

Resolution 71
Problems of Marriage and Sexual Morality
With regard to the education of the young in matters of sex, the Conference presses upon parents that the duty of giving right teaching on these subjects rests primarily with them, and that it is the duty of all persons giving such instruction to prepare themselves for this responsible task. Boys and girls should be guarded against the danger of acquiring knowledge of sexual subjects from wrong persons and in wrong ways.

Resolution 72
Problems of Marriage and Sexual Morality
Bearing in remembrance the example of our Lord, and the prominent place that he gave in his ministry to protecting the weak and raising the fallen, the Conference deplores the common apathy of Church people in regard to preventive and rescue work*, and urges on bishops, clergy, and all Christian people the duty of taking a more active share in this essential part of the Church's life.
*That is, in relation to sexual delinquency.

However, between 1920 and 1930 something happened. Once again, there are twelve resolutions on marriage and family life. However, that there has been a change of perspective is clear from the first such resolution:

Resolution 9
The Life and Witness of the Christian Community - Marriage and Sex
The Conference believes that the conditions of modern life call for a fresh statement from the Christian Church on the subject of sex. It declares that the functions of sex as a God-given factor in human life are essentially noble and creative. Responsibility in regard to their right use needs the greater emphasis in view of widespread laxity of thought and conduct in all these matters.

And the reason for the change is clear in the second:

Resolution 10
The Life and Witness of the Christian Community - Marriage and Sex
The Conference believes that in the exalted view of marriage taught by our Lord is to be found the solution of the problems with which we are faced. His teaching is reinforced by certain elements which have found a new emphasis in modern life, particularly the sacredness of personality, the more equal partnership of men and women, and the biological importance of monogamy.

A turn is visible in the understanding of marriage expressed at Lambeth.

Resolution 13
The Life and Witness of the Christian Community - Marriage and Sex
The Conference emphasises the truth that sexual instinct is a holy thing implanted by God in human nature. It acknowledges that intercourse between husband and wife as the consummation of marriage has a value of its own within that sacrament, and that thereby married love is enhanced and its character strengthened. Further, seeing that the primary purpose for which marriage exists is the procreation of children, it believes that this purpose as well as the paramount importance in married life of deliberate and thoughtful self-control should be the governing considerations in that intercourse.

Now the “sexual instinct is a holy thing implanted by God in human nature;” and while procreation continues to be “the primary purpose for which marriage exists,” it is also true that “intercourse between husband and wife… has a value of its own within that sacrament.”

This difference is also seen in the discussion of birth control.

Resolution 15
The Life and Witness of the Christian Community - Marriage and Sex
Where there is clearly felt moral obligation to limit or avoid parenthood, the method must be decided on Christian principles. The primary and obvious method is complete abstinence from intercourse (as far as may be necessary) in a life of discipline and self-control lived in the power of the Holy Spirit. Nevertheless in those cases where there is such a clearly felt moral obligation to limit or avoid parenthood, and where there is a morally sound reason for avoiding complete abstinence, the Conference agrees that other methods may be used, provided that this is done in the light of the same Christian principles. The Conference records its strong condemnation of the use of any methods of conception control from motives of selfishness, luxury, or mere convenience.

Where in 1920 “unnatural means for the avoidance of conception” reflected “theories and practices hostile to the family.,” and fraught with “grave dangers,” now it could be permissible “where there is clearly felt moral obligation to limit or avoid parenthood… provided that this is done in the light of… Christian principles.” The suggestion that there might be “Christian principles” for “limiting or avoiding parenthood” is in itself new (although said principles are not explicitly stated in the resolution).

Clearly, however, there continue to be Christian principles for not using contraceptices:

Resolution 17
The Life and Witness of the Christian Community - Marriage and Sex
While the Conference admits that economic conditions are a serious factor in the situation, it condemns the propaganda which treats conception control as a way of meeting those unsatisfactory social and economic conditions which ought to be changed by the influence of Christian public opinion.

Resolution 18
The Life and Witness of the Christian Community - Marriage and Sex
Sexual intercourse between persons who are not legally married is a grievous sin. The use of contraceptives does not remove the sin. In view of the widespread and increasing use of contraceptives among the unmarried and the extention of irregular unions owing to the diminution of any fear of consequences, the Conference presses for legislation forbidding the exposure for sale and the unrestricted advertisement of contraceptives, and placing definite restrictions upon their purchase.

So, contraceptives are not appropriate either for the social good of reducing poverty nor for private use outside of marriage.

Proper education of youth about sex and relationships is important, but in light of the new perspective so is education of clergy:

Resolution 12
The Life and Witness of the Christian Community - Marriage and Sex
In all questions of marriage and sex the Conference emphasises the need of education. It is important that before the child's emotional reaction to sex is awakened, definite information should be given in an atmosphere of simplicity and beauty. The persons directly responsible for this are the parents, who in the exercise of this responsibility will themselves need the best guidance that the Church can supply.

During childhood and youth the boy or the girl should thus be prepared for the responsibilities of adult life; but the Conference urges the need of some further preparation for those members of the Church who are about to marry.
To this end the Conference is convinced that steps ought to be taken:
1. to secure a better education for the clergy in moral theology;
2. to establish, where they do not exist, in the various branches of the Anglican Communion central councils which would study the problems of sex from the Christian standpoint and give advice to the responsible authorities in diocese or parish of theological college as to methods of approach and lines of instruction;
3. to review the available literature and to take steps for its improvement and its circulation.

Some things, of course, did not change. Abortion was explicitly rejected, while social workers and others who address social consequences of these issues are praised.

However, a change was clear, one that begins to sound more familiar to us today. The attitude toward sexual expression was changing, from something inherently fallen, tolerated in marriage for procreation, to something still intended for marriage but a good and healthy gift of God. While procreation was still the “primary” purpose for marriage, we began to see appreciation of the partnership in marriage, and the sexual component of marriage as formative for that partnership. These changes will continue to evolve in future Lambeth Conferences.

What Lambeth Has Said on Health Care (1)

One of the original purposes of this blog was to consider actions of General Convention related to health care. With that in mind, and seeing an opportunity that won’t come around for another ten years. I thought I would look into what had come out of Lambeth Conferences related to health care. Blessedly, actions from past Lambeth Conferences are available on line. You can start here, and see for yourself what Anglican Bishops have said in Lambeths past.

The first resolution of Lambeth that appears to have addressed an issue in health care was passed at the third Lambeth in 1888. It the first resolution passed that year. It was short, and to the point: “That this Conference, without pledging itself to all the statements and opinions embodied in the Report of the Committee on Intemperance, commends the Report to the consideration of the Church.” Unfortunately, the Archives on line do not have the Report of the Committee on Intemperance. However, knowing the tenor of the times (this was the heyday of the Temperance Movement in the United States, and the early days of the Salvation Army in both Great Britain and the United States), we can safely infer that it addressed “the evils of drink.” It is of interest that the bishops commended the Report for consideration “without pledging… to all the statements and opinions embodied in the Report….”

The next such resolution appeared in 1897, and was similar: “That this Conference desires to give expression to its deep sense of the evils resulting from the drink traffic on the west coast of Africa and elsewhere, and of the hindrance which it presents not only to the development of native Churches, but also to the acceptance of Christianity by heathen tribes.” Granted, the health effects among “the drink traffic on the west coast of Africa and elsewhere” were not the only, and perhaps not the primary concern. However, they were certainly included.

A second resolution in 1897 was also of interest to a chaplain.

Where difficulties arise in regard to the administration of Holy Communion to the sick, we recommend that these difficulties should be left to be dealt with by the bishop of each diocese in accordance with the direction contained in the preface to the Prayer Book of the Church of England "Concerning the Service of the Church"; And forasmuch as nothing can be so plainly set forth, but doubts may arise in the use and practice of the same; to appease all such diversity (if any arise) and for the resolution of all doubts, concerning the manner how to understand, do, and execute the things contained in this Book; the parties that so doubt, or diversely take any thing, shall always resort to the Bishop of the Diocese, who by his discretion shall take order for the quieting and appeasing of the same; so that the same order be not contrary to any thing contained in this Book. And if the Bishop of the Diocese be in doubt, then he may send for the resolution thereof to the Archbishop.

Now, it is clear that the primary concern was some liturgical conformity in what we now know as “Communion Under Special Circumstances.” However, it is evidence that communion was offered under those circumstances.

A related issue of communion with those who might be sick was addressed in Lambeth in 1908. However, in this case the issue was not those at home but those at the altar rail:

Resolution 31
For reasons given in the Report on the Administration of Holy Communion, as well as for other reasons, the Conference is convinced that it is not desirable to make, on the ground of alarm as to the possible risk of infection, any change in the manner of administering the Holy Communion. Special cases involving exceptional risk should be referred to the bishop and dealt with according to his direction.

Once again, we do not have the Report in question. However, use of the common cup has been an issue for this reason, as long ago as the Spanish Influenza, and as recently as AIDS.

We can note, too, that the issue of addiction was raised in 1908, but this time with a different substance.

Resolution 51
The Conference, regarding the non-medicinal use of opium as a grave physical and moral evil, welcomes all well-considered efforts to abate such use, particularly those of the government and people of China, and also the proposal of the government of the United States to arrange an International Commission on Opium. It thankfully recognises the progessive reduction by the Indian government of the area of poppy cultivation, but still appeals for all possible insistence on the affirmation of the House of Commons that the Indian opium traffic with China is morally indefensible. It urges a stringent dealing with the opium vice in British settlements, along with due precautions against the introduction of narcotic substitutes for opium.

Finally, it calls upon all Christian people to pray for the effectual repression of the opium evil.

Lambeth in 1908 addressed a series of resolutions to issues of sacramental care of the sick.

Resolution 33
With regard to ministries of healing, this Conference, confident that God has infinite blessings and powers in store for those who seek them by prayer, communion, and strong endeavour, and conscious that the clergy and laity of the Church have too often failed to turn to God with such complete trust as will draw those powers into full service, desires solemnly to affirm that the strongest and most immediate call to the Church is to the deepening and renewal of her spiritual life; and to urge upon the clergy of the Church so to set forth to the people Christ, the incarnate Son of God, and the truth of his abiding presence in the Church and in Christian souls by the Holy Spirit, that all may realise and lay hold of the power of the indwelling Spirit to sanctify both soul and body, and thus, through a harmony of man's will with God's will, to gain a fuller control over temptation, pain, and disease, whether for themselves or others, with a firmer serenity and a more confident hope.

Resolution 34
With a view to resisting dangerous tendencies in contemporary thought, the Conference urges the clergy in their dealings with the sick to teach as clearly as possible the privilege of those who are called, through sickness and pain, to enter especially into the fellowship of Christ's sufferings and to follow the example of his patience.

Resolution 35
The Conference recommends the provision for use in pastoral visitation of some additional prayers for the restoration of health more hopeful and direct than those contained in the present Office for the Visitation of the Sick, and refers this recommendation to the committee to be appointed by the President under the Resolution on the subject of Prayer Book enrichment.

Resolution 36
The Conference, having regard to the uncertainty which exists as to the permanence of the practice commended by St. James (5.14), and having regard to the history of the practice which professes to be based upon that commendation, does not recommend the sanctioning of the anointing of the sick as a rite of the Church.

It does not, however, advise the prohibition of all anointing, if anointing be earnestly desired by the sick person. In all such cases the parish priest should seek the counsel of the bishop of the diocese. Care must be taken that no return be made to the later custom of anointing as a preparation for death.

They provide somewhat ambivalent guidance, affirming trust in the Holy Spirit for healing, while also accepting that the sufferer might through individual pain and suffering “enter especially into the fellowship of Christ’s sufferings;” and concern for appropriate prayers for visitation, while discouraging sacramental anointing – unless, of course, the sick person is insistent, and the bishop permits, and the sacrament is properly understood (it’s not “Last Rites,” thank you very much!).

In 1908 there were also a series of resolutions regarding marriage and married life, and three of those were related to health care.

Resolution 41
The Conference regards with alarm the growing practice of the artificial restriction of the family, and earnestly calls upon all Christian people to discountenance the use of all artificial means of restriction as demoralising to character and hostile to national welfare.

Resolution 42
The Conference affirms that deliberate tampering with nascent life is repugnant to Christian morality.

Resolution 43
The Conference expresses most cordial appreciation of the services rendered by those medical men who have borne courageous testimony against the injurious practices spoken of, and appeals with confidence to them and to their medical colleagues to co-operate in creating and maintaining a wholesome public opinion on behalf of the reverent use of the married state.

So, the resolutions condemn abortion and artificial birth control, and affirm physicians “who have borne courageous testimony against” them. We might also note that Resolution 42 could also be interpreted as discouraging procedures that we now think of as common in prenatal care or infertility treatment. I would also wonder what issue they sought to address by "creating and maintaining a wholesome public opinion on behalf of the reverent use of the married state."

The Lambeth Conference was itself born in a situation of perceived crisis of Communion-wide import. However, the bishops involved found the meetings meaningful enough to continue. As time passed, the issues considered by the bishops grew; and while issues we might call health-related were few in the first generation, by the fortieth year and the fifth Lambeth health issues in the life of the Church were seen as sufficiently significant to be worthy of attention at Lambeth.

Shades of Lambeth Past

I’m doing some looking tonight at resolutions of past Lambeth Conferences related to health care. In the process, I am discovering some interesting things.

Particularly, I’m interested in two resolutions from the Lambeth Conference in 1897:

Resolution 45
That this Conference recognises the exclusive right of each bishop to put forth or sanction additional services for use within his jurisdiction, subject to such limitations as may be imposed by the provincial or other lawful authority.

Resolution 46
That this Conference also recognises in each bishop within his jurisdiction the exclusive right of adapting the services in the Book of Common Prayer to local circumstances, and also of directing or sanctioning the use of additional prayers, subject to such limitations as may be imposed by provincial or other lawful authority, provided also that any such adaptation shall not affect the doctrinal teaching or value of the service or passage thus adapted.

One wonders how these would be received by those who have wished to elevate resolutions of Lambeth to quasi-jurisdictional authority. After all, what some bishops see these days as “affecting the doctrinal teaching or value of the service or passage,” others see as “adapting to local circumstances.”

No, the argument isn’t new; but isn’t it interesting that Lambeth was looking at issues of local adaptability (albeit it, I know, not the specific issues with which we wrestle today) more than a century ago?

Reflection for 7.8.08

From today's Daily Office Lectionary: Romans 8:31-39

31 What then are we to say about these things? If God is for us, who is against us? 32He who did not withhold his own Son, but gave him up for all of us, will he not with him also give us everything else? 33Who will bring any charge against God’s elect? It is God who justifies. 34Who is to condemn? It is Christ Jesus, who died, yes, who was raised, who is at the right hand of God, who indeed intercedes for us. 35Who will separate us from the love of Christ? Will hardship, or distress, or persecution, or famine, or nakedness, or peril, or sword? 36As it is written,‘For your sake we are being killed all day long; we are accounted as sheep to be slaughtered.’ 37No, in all these things we are more than conquerors through him who loved us. 38For I am convinced that neither death, nor life, nor angels, nor rulers, nor things present, nor things to come, nor powers, 39nor height, nor depth*, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord.

*Nor bishops who are women, nor bishops who are "wrongly" partnered, nor biblical literalists, nor biblical scholars, nor Lambeth, nor GAFCON, nor reasserters, nor reappraisers....

Another Ethics Resource

I have written before of the Center for Practical Bioethics as a resource for ethical issues in healthcare. Center staff have now started a blog to comment on such issues. I've added a new link to your left; and you can access the blog "Practical Bioethics" here. I commend it to your attention.

Thoughts on Vegetables

The estimable Tobias Haller, has offered this as his “Thought for 7.02.08:”

Isn’t it strange that we take more care over a funeral than over a dying person? We treat the comatose dying person as ‘a vegetable’ (what an assault on human dignity!) but treat the dead body with incredible ritual respect. Haven’t we got it backwards or at least unbalanced?

He offered this “With special thanks and prayers for all who serve in hospice work and hospital chaplaincy, and those beginning their CPE this summer.” At the same time, I discovered I had very mixed feelings about the statement.

In part, I had these feelings after spending a couple of the wee hours of this morning at the bedside of a patient who ultimately died. I watched the careful, passionate, at times desperate attention of family members to the patient. I watched the thoughtful, sensitive, even tender care of patient and family members by professionals. Although the patient was past the point of offering any intentional response, I would not have connected the image of “vegetable” with the patient as seen in either the concern of the family or the care of professionals. And I hope you will trust me when I say this is consistent with my experience in more than 25 years in health care ministry.

In part, though, and in contrast, I have some feelings after walking with my wife in our back yard. In our modest back yard there are tomatoes and onions, peppers and eggplant, potatoes and melons and beans. There are tarragon and basil, oregano and sage, and berries black, blue, and rasp. We stopped to look at the peach tree, realizing that we need to spray more copper solution to control those spots on fruit and leaf.

That garden, and every crop in it, have benefited from careful, passionate, and sometimes desperate commitment. They have required thoughtful, sensitive, and even tender care. While they will not produce enough to sustain us through the winter, they will make a difference we will be able to appreciate. For a long time after their time in the garden, they will support us, as we supported them when they needed it.

I regularly hear patients and family members say, “I don’t want to be left a vegetable;” but they aren’t talking about the quantity or quality of care they expect to receive. (And yes, I do hear the same sentiment from professionals, if not in the same words.) Folks speaking of being “a vegetable” as a projection of their fears of being suspended, too ill or injured to live but too well-maintained to die. Indeed, if they worry about their care, most worry not about too little attention but too much. They worry about being maintained, sustained, as bodies with the mechanisms of personality gone. I certainly believe there is more to person or personality than brain; but with a brain unable to process sensory input and expressive output, there is no experience of dignity or indignity, or respect or disrespect. To worry about “being a vegetable” is to worry about whatever dignity the individual perceives, not about the dignity those around the individual express.

This is not to say there aren’t thoughtless families or careless professionals. As much as it appalls us – both those cared for and those providing care – they certainly exist. But, really, they’re not treating patients like vegetables, but rather like wildflowers: valued enough when they are pretty and flourishing, and entirely disposable when they are not. They are appreciated, and perhaps even cherished, when they bloom; and neglected, if not actively removed, when they do not.

We wrestle with this issue of dignity. We project our own fears onto the situations of others. Sometimes in our fear and our projection, we try to avoid realities as much as possible. But so much of the time it’s because we perceive the dignity of another as inherent and even God-given, even as we perceive our own as contingent on our capacities, whether to reason or to function or to relate. And even when family members make hard decisions, it’s almost never about the values of the person making the decision but about the values of the person in the bed: not “This is what I think best,” but “This person said he or she wouldn’t want to live like this.” We are willing to honor dignity in others, even to the point of acting on their expressed fears of dignity lost. What a paradox that is: to so honor another’s dignity as to accept that which we do not believe, that the person we care for has lost dignity.

That, of course, does have a parallel in funeral plans; but not in a way I find comforting. Many – too many - who believe their dignity is dependent on capacity will leave instructions not to “take care over the funeral.” To say, “I don’t want anyone to make a fuss,” is to say, “I’m not worth the effort.” Once again, it is about the individual’s perception of contingent dignity, and not about the wishes of those around the individual. And once again, many are sufficiently committed to respecting the dignity of the deceased that they deny themselves the opportunity to show the dignity they perceive in the deceased, or to dignify themselves in their own grief.

So, if we “treat the comatose dying person as ‘a vegetable’,” I think it is an expression, and not a denial, of human dignity. In fact the care in many ways does parallel the careful, intent work of the gardener, attentive and concerned, rather than neglect. Families and professionals may perhaps care too much, in the sense of exceeding the wishes of the patient; but they do care, and in doing so demonstrate that they indeed attribute dignity and value to the patient. They do care, often at the expense of body and mind and pocketbook, and even their own dignity.; and I am honored to have the vocation of caring for them.

Accepted Again for Grand Rounds

I've had another post accepted for the long-running blog circus "Grand Rounds." You can see the latest edition here, with mine and many other interesting posts.

The host this week is Dr. Rich of Covert Rationing Blog. After you've looked at other posts in "Grand Rounds," look at some of his posts. I don't agree with all of his idea about the best solutions; but I certainly agree that covert rationing is already happening, and we need a solution.