Appendix 2 of Difficult Moral Questions is especially relevant to this question; its last two sections comment on the appendix on formal and material cooperation in the 1994 revision of the ERDs and the moral significance of various sorts of pressure – “duress” in a wide sense.
2.
John PaulI.I., Vita Consecrata, 83 (notes omitted), AAS 88 (1996) 460–61, OR, 3 Apr. 1996, xvi.
3.
Richard McCormickS.J., “The Catholic Hospital Today: Mission Impossible?”Origins24 (1995): 648–53, proposes several characteristics of the context in which health care is now being delivered as grounds for suggesting (though he does not firmly assert) that “the heart of the Catholic health care culture is gone. The mission has become impossible” (649). An illustration of the tension between mission and financial viability for one (unnamed) Catholic hospital: Marie Wolff,” ‘No Margin, No Mission’: Challenge to Institutional Ethics,” Business and Professional Ethics Journal, 12: 2 (Summer, 1993): 39–50.
4.
In my judgment, they are morally similar to the “simple case” of in vitro fertilization.
5.
CahillPatricia A., “Response to ‘The Principles of Cooperation and Their Application to the Present States of Health Care Evolution’,” in The Splendor of Truth and Health Care, Proceedings of the Fourteenth Workshop for Bishops, ed. Russell, SmithE. (Braintree, MA: The Pope John Center, 1995), 238–42, makes the point (239): “The majority of joint ventures, networks, mergers and affiliations which have occurred and which are on the drawing board are, from my observation, driven from a business or economic perspective. The leaders responsible for consummating these arrangements understand the business world well. They also understand and support fully the fact that no proscribed services may be offered by their own Catholic institution. However, when the transaction under consideration is between the Catholic provider and a non-Catholic provider and its consummation promises improved fiscal well-being for the Catholic partner, attention sometimes shifts from strict adherence to the Ethical and Religious Directives to a tone of compromise which recognizes the ethical perspective of the non-Catholic provider and softens the principle to achieve the desired outcome. These are not people who intend to do wrong but they are people who have not necessarily had the theological and philosophical preparation to address appropriately the material cooperation questions before them. They hear the term ‘material cooperation’ but do not understand its philosophical underpinnings and rationale and thus, in my opinion, are ill equipped to apply the principle to the matter at hand.”
6.
SmithWilliam B., “Cooperation in Health Care”, Homiletic and Pastoral Review, 96: 9 (July 1996): 70–72, agrees in questioning the possibility of avoiding formal cooperation with other parties’ wrongdoing when setting up the joint arrangement.
7.
The quotations in the argument are from SmithRussell E., “The Principles of Cooperation and Their Application to the Present State of Health Care Evolution”, in The Splendor of Truth and Health Care, 228–29.
8.
SmithRussell E., “Ethical Quandary: Forming Hospital Partnerships”, The Linacre Quarterly, 63: 2 (May 1996): 90.
9.
CassidySheila, Sharing the Darkness: The Spirituality of Caring (Maryknoll, NY: Orbis Books,1991), shows both how providing hospice care can be a true apostolate and how great the need is for such care; as the culture of death intensifies, the need and apostolic potential of such work will increase. For a fuller understanding of hospices and how they differ from hospitals, see Sandol Stoddard, The Hospice Movement: A Better Way of Caring for the Dying, rev. ed. (New York: Vintage Books, 1992)
