Benedict's 'Quiet Revolution', and a check-up on Catholic health care

A funny thing has happened as the story of a recent Vatican crackdown on a legendary monastery in Rome has made its way into the English-language press. I mean that literally -- the story has been turned into a joke, thereby obscuring its real significance.

For those with eyes to see, the suppression of the Cistercian abbey at the Basilica of the Holy Cross in Jerusalem, one of the traditional seven major pilgrimage sites in Rome, rates far more than placement in a "news of the weird" column. Instead, it's the latest chapter in what might be called a "Quiet Revolution" under Pope Benedict XVI, referring to a reform in clerical culture beginning in Rome and radiating beyond.

The essence of it is this: it's the end of the "by their fruits, you shall know them" logic that once translated into a free pass, or at least a strong benefit of the doubt, for superstar clerics and high-profile groups charged with misconduct. Once upon a time, the working assumption in officialdom often was that if someone is doing great good for the church, then allegations of sexual or financial impropriety against them were likely bogus, and taking them too seriously risked encouraging the enemies of the faith.

Without great fanfare, Benedict XVI has made it clear that today a new rule applies. No matter how accomplished a person or institution may be, if they're also involved in what the pontiff once memorably called the "filth" in the church, they're not beyond reach.

That's the deep significance of the Vatican's recent action vis-à-vis the Cistercians at the Basilica of Holy Cross in Jerusalem, though you certainly wouldn't get the point from most English-language coverage. A BBC headline on Thursday was typical: "Pope shuts down lap-dancing monastery," it said, playing off the fact that an ex-nightclub performer turned Catholic nun, Anna Nobili, once performed something called "the holy dance" in front of an audience at the basilica that included Vatican dignitaries.

In reality, however, the basilica was hardly a running joke.

First of all, the Cistercians have been at the basilica for almost five centuries, since 1561, and at one stage the Abbot of Holy Cross was also the Abbot General of the entire order. Given Benedict XVI's keen sense of tradition, as well as his reverence for the monastic life, it would take more than a dancing nun to trigger the suppression of the entire abbey.

Further, until quite recently the basilica was actually seen as a major success story. The consensus was that a renaissance was unfolding under Cistercian Abbot Simone Maria Fioraso, an ecclesiastical mover and shaker if ever there was one. Vocations were growing, and the basilica had become a crossroads for Italian nobility, political VIPs and pop culture icons.

In the autumn of 2008, Fioraso scored his greatest PR coup. He organized a six-day reading of the entire text of the Bible, called "The Bible Day and Night," carried live on Italian state TV. The marathon was kicked off by Benedict XVI, and concluded by the Vatican's Secretary of State, Italian Cardinal Tarcisio Bertone. A slew of other Vatican potentates took part, along with celebrities such as actor Roberto Benigni and the former president of Italy, Carlo Azeglio Ciampi. (American Cardinals William Levada, Prefect of the Congregation for the Doctrine of the Faith, and Daniel DiNardo of Houston also participated. DiNardo was in town for a Synod on the Bible, which was the occasion for the Bible-reading festival.)

It's tough to overestimate what a media sensation the event constituted in Italy. Headlines proclaimed, "Holy Cross in Jerusalem becomes a superstar."

Yet around the same time, rumors began to swirl that something wasn't quite right. Some critics charged that Fioraso seemed more interested in cozying up to social elites than in the traditional disciplines of the monastic life, while others raised questions about money management, especially given that the monks ran a successful boutique and hotel, apparently without clear accounting of the revenue flows. More darkly, there were rumors of "inappropriate relationships" carried on by some of the monks, understood to be code for some sort of sexual misconduct.

All that might once have been dismissed as envy or defamation, especially given Fioraso's reputation as a rising star, but not this time. The Vatican's Congregation for Institutes of Consecrated Life and Societies of Apostolic Life launched an Apostolic Visitation, which ended in the dramatic decision to suppress the abbey entirely and to send its roughly 30 monks packing. The decree was signed by Brazilian Archbishop João Braz de Aviz, Prefect of the Congregation for Institutes of Consecrated Life and Societies of Apostolic Life, and by American Archbishop Joseph Tobin, his secretary. It was approved by Benedict XVI.

As is its practice, the Vatican hasn't provided a public explanation; in typically euphemistic argot, officials say only there were "numerous allegations of conduct incompatible with the vowed life." The gist is that there were real problems at the abbey, in terms of both financial accountability and personal morality.

As one official put it, "It was not a good scene."

The suppression is part of a pattern under Benedict XVI, which began with crackdowns against high-profile clerics such as Gino Burresi, founder of the Servants of the Immaculate Heart of Mary, and Marcial Maciel Degollado, founder of the Legionaries of Christ. More recently, in September 2008 Benedict laicized a well-known priest in Florence, Lelio Cantini, whose Queen of Peace parish was regarded as among the more dynamic in the country. Earlier this year, Benedict permanently removed Fernando Karadima from ministry, a legendary priest in Chile known as a spiritual guide to a large swath of the clergy and episcopacy.

All those cases, and others like them one could mention, pivoted on charges of sexual misconduct and abuse.

Also part of the picture are Benedict's policy moves to expedite procedures for weeding abusers out of the priesthood, including a recent set of revisions to canon law, as well as his decision earlier this year to create a new financial watchdog authority with the power to ride herd over once-untouchable entities such as the Vatican Bank or Propaganda Fide. The overall impression is that this is a pope weary of scandal, doing what he can to clean house.

Critics, of course, will object that this quiet revolution remains incomplete until it reaches into the episcopacy -- that is, until the bishops who presided over the sexual abuse crisis, or various financial scandals, or other forms of "filth" in the church, are themselves brought to account.

Whatever one makes of that objection, the fact remains that even an incomplete revolution is still a revolution. And that's no joke.

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On Monday, I was in Fort Lauderdale to speak at a governance and management conference of Catholic Health East, a sprawling health care system employing some 54,000 people in facilities up and down the East Coast, ranging from Maine to Florida. Ranked by the number of visits, Catholic Health East is also the largest provider of home health care services in the nation.

While there, I had the chance to listen to presentations by four representatives of the sponsors of CHE facilities and systems. Together, they offered some valuable insights about the challenges facing Catholic health care, and how leaders in the field are thinking about them.

Sisters and sponsorship

First up was Mercy Sr. Barbara Wheeley, who coordinates the sponsors' council for Catholic Health East.

Wheeley observed that the idea of "sponsorship" of Catholic health care systems is, historically speaking, a novelty, having arisen only in the past 40 years. America's Catholic hospitals were largely built by religious women, but these days there simply aren't enough sisters to staff and administer them -- hence the notion of "sponsoring," rather than directly running, a hospital or system.

As Wheeley explained, many religious orders have erected institutions under church law, called "public juridical persons," to act as sponsors of their health care operations. Generally these "PJPs" are composed of a few sisters, along with laity who have both professional expertise as well as knowledge of the order's tradition.

Since these institutions are erected under church law and approved by Rome, Wheeley said, "We have a canonical responsibility to preserve the Catholic identity and integrity of our ministries."

Wheeley noted that quite often, the laity who serve on these sponsoring bodies are drawn from the ranks of "lay associates" of religious orders, which she called "a kind of new movement in the church." (A recent study by the Center for Applied Research in the Apostolate at Georgetown confirms that lay associates are indeed a growth industry. The total number of associates in America grew from around 15,000 in 1995 to more than 25,000 in 2007.)

Most women's orders expect to be able to continue sponsoring their health care systems "for at least a few more years," Wheeley said. Yet given the rising average age and declining membership of many communities, she said, they have to prepare for a time when they may not even be in a position to supply a handful of sisters to serve on a sponsoring body.

To prepare for that future, Wheeley said, Catholic Health East has developed a new institution called "Hope Ministries," a joint venture among the orders which make up the CHE system, which is itself a public juridical person under canon law. The idea is that Hope Ministries can take over sponsorship "when and if a religious community moves on, or just can't do it anymore," thereby preserving both the Catholic identity of the facility and at least something of the original order's tradition.

New sponsors: Hope Ministries

Wheeley's remarks provided a segue to Stanley Urban, a veteran Catholic health care executive who currently serves as the chairperson of Hope Ministries.

Urban explained that as a public juridical person, Hope Ministries has direct accountability to the Vatican. (Generally, approval to erect a public juridical person on behalf of a religious order is granted by the Vatican's Congregation for Institutes of Consecrated Life and Societies of Apostolic Life, popularly known as the "Congregation for Religious.")

Each year, Urban said, Hope Ministries files a "comprehensive written report" with the Vatican, outlining "how Catholic identity is being nurtured in these organizations and how Gospel values permeate them."

The governing board for Hope Ministries, Urban said, includes five lay persons and three women religious, representing the elected leadership of their communities. Urban said their internal conversations demonstrate "the true integration of laity into the ministry of sponsorship," because "you couldn't tell who's laity and who's religious based on the nature of the discussions or the contributions that people make."

On the whole, Urban said, the emergence of vehicles such as Hope Ministries suggest a viable future for Catholic health care, even beyond the possible eclipse of some of the founding women's orders.

"The Holy Spirit is indeed alive and well within our ministries," he said.

Partnerships, mergers and new models

Mercy Sr. Lorraine LaVigne tackled the changing business climate for hospitals and health care systems, noting that "various models of partnership" are emerging, often involving both Catholic and non-Catholic providers, which is inevitably a prescription for "complex relationships."

LaVigne ticked off five different forms these cooperative arrangements are taking:

• Joint operating agreements


• Joint ventures


• Mergers


• Affiliations


• Contracts for specific areas of collaboration

LaVigne pointed to a recent merger in New York, centering on St. Peter's Hospital in Albany, as an example of the "very creative partnering experiences" being pioneered these days.

(In late April, the Federal Trade Commission approved a three-way merger among St. Peter's Health Care Services in Albany, Northeast Health and Seton Health, with full integration expected to take roughly three years. Seton Health is a Catholic system, while Northeast Health is secular. The company resulting from the merger will be a member of Catholic Health East and has pledged to abide by the "Ethical and Religious Directives" of the U.S. bishops, but will not itself be a Catholic entity. Northeast Health will remain secular, while St. Peter's and Seton will retain their Catholic identities.)

LaVigne said that sponsoring orders are well aware that given the changing nature of the market, hospitals and health systems "will be exploring a variety of opportunities" along these lines. The key, she said, is to make sure that the sponsors are involved in the conversation from the beginning.

She suggested that in evaluating possibilities, the following key questions be asked:

• Will the proposed new structure or agreement advance the mission and values of Catholic health care?


• Will it meet an unmet need in the community, or increase the range of services?


• Does the agreement have financial value for the hospital or system?


• Are the possible partners aligned with the vision and strategy of Catholic Health East?

Finally, Sr. Kathleen Popko, President of the Sisters of Providence, offered a perspective on the relationship between women's religious communities and the official structures of the church, with a special eye to lessons learned from the current Vatican-sponsored "Apostolic Visitation" of women religious in America.

Popko defined women's orders as "a prophetic life form in the church," insisting that they are not to be seen as a "workforce for ecclesial projects." Religious orders "do not receive their mission from the church," Popko said, but rather each order "articulates its own."

Women religious "strive to work collaboratively with the ordained leadership of the church," Popko said. That said, she insisted they "are not agents of the church enforcing its teachings and policies," and they "must not be co-opted for institutional purposes."

Popko conceded that putting the accent on the "prophetic" role is in some ways a prescription for conflict, but insisted that's nothing new. Even casual perusal of the lives of founders in centuries past, she said, reveals that some were forced to leave their dioceses or removed from leadership, while their fledging communities had their assets taken away or faced other sanctions for "insubordination to the clergy."

Such tension, she said, continues to this day. In that context, she offered five lessons from the experience of the Apostolic Visitation which, she said, are also relevant to the challenges facing Catholic health care.

First, she said, the visitation has taught women religious to "look inward." In responding to the Vatican investigation, she said, women's orders found a deeper "sense of dignity" and of their own "competence," rooted in their history and accomplishments. That experience, she said, has fueled "a sense of cohesiveness and solidarity" that will outlast the visitation itself.

Second, Popko said, it's important "to network and collaborate," adapting a "flexible but common approach" when confronted with new challenges. Today, she said, the spirit among women's orders is "the most unified it's ever been in U.S. history," a unity which she said "happened at the grassroots."

Third, Popko urged, "Do not stand alone." Instead, she said, women's orders have drawn upon canon lawyers, theologians, and other experts, who have helped them develop a better-informed response to the visitation -- including, for instance, how to reply to requests for financial data and other internal information.

Fourth, Popko said, "Maintain engagement," including with the clergy, the bishops, and various currents within the laity. In responding to the visitation, she said, women's orders "did not rupture relationships. We've kept the conversation going."

Fifth, Popko said, the bottom line is "to remain faithful to the Gospel call." That has involved much soul-searching, she said, as women religious have struggled to maintain unity with church leaders, while remaining determined that "we must be true to ourselves, to our consciences, wherever that may lead us."

"In the history of the religious orders, we see that much positive change was initially rejected by the church but eventually accepted," Popko said, implying that the same trajectory may well play itself out again today.

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As this column was going to press, we got the news that NCR Publisher Joe Feuerherd had lost a battle with cancer he'd been fighting since October 2009. He was just 48 years old.

The newspaper has already published an obituary of Joe, who was my friend, colleague, and boss over the years, winning my admiration and respect in each of those roles. I ask prayers for Joe, his family, and for the extended network of all who knew and cherished Joe's passion, his loyalty to his friends, his keen reporter's nose, and his unfailing sense of humor.

For myself, my sadness is mixed with faith that Joe is now part of the Communion of Saints. As a cardinal recently told me in Rome, apropos of the beatification of Pope John Paul II, "It's good to have friends in Heaven!"