Whatever the source of the phrase “Better to ask forgiveness than to seek permission,” its Jesuitical effectiveness is clear in St. Louis, where Jesuit Fr. Lawrence Biondi won out over powerful opponents of his plan to sell St. Louis University Hospital for $300 million to Tenet Healthcare Corp., a for-profit hospital chain.

Some of the nation’s most powerful prelates, including St. Louis Archbishop Justin Rigali, strongly opposed selling the Catholic hospital to investor-owned Tenet. In the end, they were able to produce some Vatican finger-wagging at the Jesuits, helping to ease the pain of the prelates’ loss.

At the culmination of this five-month dispute, all parties got something to feel good about. As for the larger question lurking at its foundation, the question of Catholic identity for hospitals and schools, Sr. Kathleen Ross, president of Heritage College, may see the future most clearly.

As Ross sees it, Catholic outreach is less about the institutional church and more about the gospel. In the future, institutions that reflect the Catholic spirit are less likely to derive from resources of religious orders and more likely to come from the ingenuity and resources of people, whatever their faith, who share a worthy goal.

Amid the face-saving verbal fencing of churchmen in the St. Louis case -- a theater of the irrelevant if there ever was one -- the critical questions lurking around the controversy could easily be lost. The questions, as serious as the future of health care for our nation’s poor, are riddled with ironies that beg examination.

Rigali seems certain that hospitals serve the community better when they are in Catholic hands. Yet for-profit Tenet is since 1995 principal owner of Creighton University’s teaching hospital in Omaha, Neb., where both university and church officials say that Catholic values and practices continue to be upheld.

Elsewhere in the hotly competitive health care marketplace, some nonprofit Catholic hospital groups accumulate reserves that, while not legally defined as profit, make them look for all the world like for-profit companies. A leader of the St. Louis-based Daughters of Charity, an order that has accumulated reserves of $2 billion for its 49 hospitals in 12 states, has pragmatically summed up the problem. “No margin, no mission,” says Sr. Irene Kraus, former president of the Daughters’ system (NCR, Jan. 23).

Perhaps most telling of all, during the five months of the St. Louis controversy the Catholic Health Association, which views profiting from human illness as inherently immoral, has been unable to show that Catholic hospitals do better than others at serving the poor.

In the Northwest, however, an innovative and daring educational enterprise suggests a different twist to Kraus’ epigram. Ross and two Indian women saw a need and established their mission not with a margin, but on the margin. It is to that other margin -- at the edges of the culture where the disenfranchised often live without hope, longing for a bit of what the rest of us take for granted -- that the gospel, if we are listening, must inevitably lead us.

Increasingly, it takes a sophist to distinguish Catholic hospitals, and sometimes universities, too, from the non-Catholic institution down the street. In some ways, that’s good news. It’s a sign Catholics have “made it” in America. But the matter of “Catholic identity” for our institutions, of what makes them truly unique, often eludes astute observers. Could it be time to, as Biondi has done, let some of these institutions go and, as Ross has done, put more resources at the margins?

It will take decades, of course, to know who is the real winner in the St. Louis sale. Will an investor-owned hospital be able to resist treating people as commodities? Will Catholic principles, rooted in the dignity of the human person, be observed in both patient care and employee relations? Will pastoral care remain a high priority? Perhaps most important in terms of the gospel, will the poor be served? Will Catholic institutions be clearly so in ways other than name?

From Ross’ vantage point, Catholic mission requires neither Catholic resources nor a Catholic label. She and others like her know that Catholic identity is more than name, more than the faith claims of donors, more than adherence to canon law. The likes of Sr. Kathleen Ross -- and there are many others out there -- bring hope and empowerment to formerly powerless people. Here Catholic identity needs no sophistry to define.

National Catholic Reporter, March 6, 1998

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