Bart Stupak has described himself as a “devout Catholic” and “pro-life Democrat.” Until his despicable sell-out last Sunday, many Catholics and pro-lifers were prepared to believe him. Christopher Badeaux at The New Ledger lays the blame for Stupak’s betrayal at the feet of the American Catholic bishops. “For essentially my entire lifetime,” Badeaux writes, “the Democratic Party has made as one of its governing planks that women have an inherent right to murder their children. Catholic Democrats have not, with a tiny handful of exceptions, bothered to even murmur a protest; the most prominent among them have taken up that position as their own.” Meanwhile, “the men who are supposed to stand against evil every waking moment of their lives appear more concerned about the environment, about immigrant rights, about the death penalty.” The bishops’ emphasis on these secondary issues, coupled with their failure to discipline pro-abortion Catholic politicians, has made them in Badeaux’s view “enablers” of those who, like Stupak, feel justified in compromising on abortion in the interests of pursuing what they take to be other social and political goods.
This is not entirely fair; the bishops have loudly, repeatedly, and consistently condemned abortion, and the United States Council of Catholic Bishops called on Congress to vote down the new health care bill if it failed to prohibit public funding of abortion. The bishops do not seem to be less concerned with abortion than with other issues. Still, Badeaux’s complaint seems to me to have merit – not with respect to every individual bishop, to be sure, but certainly with respect to the USCCB itself. For that body has also loudly, repeatedly, and consistently taken positions on several other matters of public controversy (such as the issues Badeaux mentions) in a fashion that has likely led many Catholics to think – quite mistakenly – that said positions are binding on Catholics and of equal weight with opposition to abortion. And that in turn has likely helped to generate a false impression that where opposition to abortion and the pursuit of some other political end come into conflict, a Stupak-like “trade off” can be justified.
Consider the health care issue. As I have said, before the health care bill vote, the USCCB urged Congress either to alter the bill to prevent federal funding of abortion or to vote the bill down. (The USCCB also objected to the bill’s failure to extend coverage to illegal immigrants.) But the letter in which this request was made also emphasized that “for decades, the United States Catholic bishops have supported universal health care,” that “the Catholic Church teaches that health care is a basic human right, essential for human life and dignity,” and that it is only “with deep regret” that the bishops must oppose passage of the bill “unless these fundamental flaws are remedied” (emphasis added).
Needless to say, the impression these words leave the reader with – whether the bishops intended this or not – is that, were abortion (and coverage of illegal immigrants) not at issue, the moral teaching of the Catholic Church would require the passage of the health care bill in question, or something like it. In fact the teaching of the Church requires no such thing. Indeed, I would argue (see below) that while the Church’s teaching does not rule out in principle a significant federal role in providing health care, a bill like the one that has just passed would be very hard to justify in light of Catholic doctrine, even aside from the abortion question. Nevertheless, as I say, the bishops’ language would surely leave the average reader with the opposite impression. And as the bishops themselves remind us, they have “supported universal health care” for “decades,” in statements that also would leave the unwary average reader with the impression that Catholic moral teaching strictly requires as a matter of justice the passage some sort of federal health care legislation. On the day Obama signed the bill into law, Cardinal Francis George, a bishop with a reputation for orthodoxy, urged vigilance on the matter of abortion while declaring that “we applaud the effort to expand health care to all.”
Now, suppose you are Bart Stupak, or some other Catholic in government. You are ideologically prone to favor statist solutions to social problems, and under constant pressure from your fellow Democrats to support them in any event. You are not a theologian, and must rely on what prominent churchmen say on matters of current public controversy in order to determine what the Church’s teaching requires of you. They tell you that the Church teaches that abortion is tantamount to murder, and if you are remotely serious about your Catholic faith – as Nancy Pelosi, Arnold Schwarzenegger, the late Ted Kennedy, Rudy Giuliani, et al. manifestly are not, but Stupak and his ilk at least appeared to be – then you will dutifully oppose legalized abortion. But these same churchmen also tell you – or seem to, anyway, if you are a layman not versed in moral theology – that it would be a grave injustice not to vote for an expansive federal health care bill if ever you have an opportunity to do so. Now you are confronted with a situation in which you have to choose between what seem to be two grave moral imperatives: to prevent federal funding of abortion, and to vote for what might be the only significant federal health care bill likely to come your way for the foreseeable future. Your conscience tells you to do both if you can, and there is in any event enormous political pressure on you to vote for the bill. Obama’s promise of an executive order, manifestly flimsy though it is, provides just the way out you need.
Is this how Stupak reasoned? I cannot claim to know, of course; and both this video clip from last year and his statements since the vote make it hard to believe his prolonged public hand-wringing was entirely in good faith. But perhaps such a rationalization passed through his mind. It has surely passed through the minds of many other Catholic politicians, particularly those who like to claim that their advocacy of socialized medicine and other left-wing causes shows them to be no less loyal to the teaching of the Church than Catholic pro-lifers are.
It is in any event important to remind ourselves of what the Church actually teaches, and what she teaches is not at all what such liberal Catholics think it is. To be sure, in line with statements made by popes John XXIII and John Paul II, the Catechism of the Catholic Church does indeed speak of a “right to medical care” as among those the “political community” has a duty to uphold (2211). But does this entail that universal health care must be funded by and/or administered by the federal government, or indeed by any government? No, it doesn’t. Consider first that the same documents that affirm a “right” to medical care also affirm “rights” to “food, clothing, [and] shelter” (John XXIII, Pacem in Terris 8) and “to private property, to free enterprise, [and] to obtain work and housing” (the Catechism again). But no one claims that the Church teaches that governments have a duty to provide everyone with a government job, or free food, clothing, shelter, or other kinds of property at taxpayer expense, or a guarantee of entrepreneurial opportunities.
Why not? Because the term “right” is simply not used in Catholic moral theology in the crude manner in which modern American liberal politicians like to use it, viz. as expressing a legally enforceable demand on the part of an individual that he be provided with some benefit by government (either in the form of a service funded by the taxpayer or in the form of coercion of those who might otherwise “discriminate” against him). Rather, the theory of rights enshrined in traditional natural law thinking and the traditional Catholic moral theology informed by it is very complex and nuanced, and includes a number of crucial distinctions that must be borne in mind in any analysis of what the magisterial documents of the Church entail. There is, for example, the distinction between objective right – some thing or act one might in some sense have a claim to – and subjective right – the moral power he might have to claim that thing or act he has an objective right to. There is the distinction between natural rights – rights we have simply by virtue of being human – and positive rights – those that exist only given a certain man-made legal framework. There is the distinction between a connatural right – a right one has independently of any conditions – and an acquired right – a right one has given the fulfillment of certain conditions. There is the distinction between an affirmative right – a right to have some good provided to one – and a negative right – a right merely not to be impeded in the pursuit of some good. There is the distinction between a perfect right – a right which is a precondition of the possibility of everyday moral life – and an imperfect right – a right which is not strictly necessary to make everyday moral life possible but which nevertheless considerably facilitates it. Among perfect rights, there are those which must be enforced via the power of the state (e.g. the right not to be killed unjustly) and those which are not appropriately enforced in this way (e.g. the right to be treated with respect by one’s children). Among imperfect rights, there are rights to things strictly due to us (e.g. gratitude from those we have benefited) and rights to things that are not strictly due to us (e.g. to be treated pleasantly by those we come into contact with in day to day life). There are further distinctions to be made, and elaborations and qualifications to be made to the distinctions already made; and a good book on ethics or moral theology of the sort I recommended in an earlier post will spell them out for the interested reader. (Volume I of Cronin’s Science of Ethics is particularly good on this subject, as on so much else.)
The point for present purposes is to emphasize that noting that a magisterial document speaks of a “right” to something by itself does nothing to show that government must provide it. All it shows is that people have a claim of some sort against others – how strong a claim, how that claim is to be respected, whether and to what extent government has a role in ensuring that it is respected, etc. are all further issues requiring careful analysis. This is especially so of something like a “right to medical care,” which, unlike such negative rights as the right of an innocent person not to be killed, involves a positive claim against others that a certain service be provided. Does the right to medical care entail that government itself must provide medical services? Or only that it provide citizens with the means to purchase such services? Must it provide them to all citizens, or only to those otherwise unable to afford them? What level of government is supposed to do this – municipal, state, or federal? Does it require government to force some individuals to become medical doctors, nurses, and the like so that the services can be provided? (They don’t grow on trees, after all.) Or is government involvement really necessary here at all? Is the right in question instead only a right that others provide those who need medical assistance with the means to do so in some way or other – through government if necessary, but through private means if possible? And if so, which persons in particular are supposed to provide this aid – family members and friends, churches and charities, or total strangers too? Merely noting that the Church teaches that people have a “right” to medical care (or to food, shelter, a job, etc.) answers none of these questions.
Now the Church definitely rejects the radical libertarian position that government can never, even in principle, justly intervene to help even the neediest citizens to acquire services of this sort. Catholic social teaching affirms the principle of solidarity, according to which we have, by nature, positive obligations to one another that we did not consent to and that the state as a natural institution can in principle step in to assist us in fulfilling when necessary. But the Church also firmly rejects the leftist tendency to regard governmental action as the preferred or even the only appropriate means of fulfilling our obligations to others. And she firmly rejects too the egalitarian tendency to regard our obligations as extending to all other human beings in an equal way. Contrary to what the libertarian supposes, the individual is not the basic unit of society; contrary to what socialists, communitarians, and many liberals suppose, “society” or “the community” as a whole is not the basic unit either. The family is the basic unit, and it is to our family members that our obligations are the strongest and most direct, with positive obligations to other human beings, though deriving from natural law rather than consent, becoming less strong and less direct the further they are from the family. Hence my obligations to the local community are stronger and more direct than they are to the nation as a whole; and my obligations to the nation as a whole are stronger and more direct than they are to the community of nations.
This approach is enshrined in another central principle of Catholic social teaching, the principle of subsidiarity, according to which the needs of individuals, families, and local communities ought as a matter of justice to be met as far as possible by those individuals, families, and communities themselves. Here are some key magisterial texts on subsidiarity:
As history abundantly proves, it is true that on account of changed conditions many things which were done by small associations in former times cannot be done now save by large associations. Still, that most weighty principle, which cannot be set aside or changed, remains fixed and unshaken in social philosophy: Just as it is gravely wrong to take from individuals what they can accomplish by their own initiative and industry and give it to the community, so also it is an injustice and at the same time a grave evil and disturbance of right order to assign to a greater and higher association what lesser and subordinate organizations can do. For every social activity ought of its very nature to furnish help to the members of the body social, and never destroy and absorb them. (Pius XI, Quadragesimo Anno 79)
Neither the State nor any society must ever substitute itself for the initiative and responsibility of individuals and of intermediate communities at the level on which they can function, nor must they take away the room necessary for their freedom. Hence the Church's social doctrine is opposed to all forms of collectivism. (Congregation for the Doctrine of the Faith, Libertatis Conscientia 73)
By intervening directly and depriving society of its responsibility, the Social Assistance State leads to a loss of human energies and an inordinate increase of public agencies, which are dominated more by bureaucratic ways of thinking than by concern for serving their clients, and which are accompanied by an enormous increase in spending. In fact, it would appear that needs are best understood and satisfied by people who are closest to them and who act as neighbours to those in need. (John Paul II, Centesimus Annus 48)
Experience shows that the denial of subsidiarity, or its limitation in the name of an alleged democratization or equality of all members of society, limits and sometimes even destroys the spirit of freedom and initiative… An absent or insufficient recognition of private initiative — in economic matters also — and the failure to recognize its public function, contribute to the undermining of the principle of subsidiarity, as monopolies do as well. (Compendium of the Social Doctrine of the Church 187)
Various circumstances may make it advisable that the State step in to supply certain functions… In light of the principle of subsidiarity, however, this institutional substitution must not continue any longer than is absolutely necessary, since justification for such intervention is found only in the exceptional nature of the situation. (Compendium of the Social Doctrine of the Church 188)
And here are some magisterial texts concerning the priority of the family to society as a whole and to the state:
Inasmuch as the domestic household is antecedent, as well in idea as in fact, to the gathering of men into a community, the family must necessarily have rights and duties which are prior to those of the community, and founded more immediately in nature. If the citizens, if the families on entering into association and fellowship, were to experience hindrance in a commonwealth instead of help, and were to find their rights attacked instead of being upheld, society would rightly be an object of detestation rather than of desire. (Leo XIII, Rerum Novarum 13)
The Church considers the family as the first natural society, with underived rights that are proper to it, and places it at the centre of social life. (Compendium of the Social Doctrine of the Church 211)
A society built on a family scale is the best guarantee against drifting off course into individualism or collectivism, because within the family the person is always at the centre of attention as an end and never as a means. (Compendium of the Social Doctrine of the Church 213)
The priority of the family over society and over the State must be affirmed… The family, then, does not exist for society or the State, but society and the State exist for the family. Every social model that intends to serve the good of man must not overlook the centrality and social responsibility of the family. In their relationship to the family, society and the State are seriously obligated to observe the principle of subsidiarity. In virtue of this principle, public authorities may not take away from the family tasks which it can accomplish well by itself or in free association with other families. (Compendium of the Social Doctrine of the Church 214)
There can be no question, then, that while the Church allows that government can legitimately intervene in economic life and in other ways come to the assistance of those in need, she also teaches that there is a presumption in justice against such intervention, a presumption which can be overridden only when such intervention is strictly necessary, only to the extent necessary, and only on the part of those governmental institutions which are as close as possible to those receiving the aid in question. This surely follows from the principles of subsidiarity and the priority of the family. And it surely rules out not only libertarianism but also the sorts of policy preferences typical of socialists, social democrats, and egalitarian liberals.
It is important to emphasize that this is not a mere pragmatic consideration. For a central government, or any level of government, to intervene when it is unnecessary for it to do so is not merely not required. It is not merely unwise. It is, in the words of Pius XI, nothing less than an “injustice,”“gravely wrong,” a “grave evil and disturbance of right order.” It is disturbing, then, that the USCCB does not balance its emphasis on the Church’s teaching about the “right to medical care” with equal emphasis on the principle of subsidiarity – a principle which has a longer history in Catholic social teaching than the (very recent) affirmation of a “right to medical care,” and which has a much more sophisticated and worked out theoretical basis in Catholic moral theology and natural law theory than the latter right has ever been given. (Astonishingly, the USCCB’s online summary of the basic principles of Catholic social teaching includes no reference to subsidiarity at all; and its more extended online overview of Catholic social teaching mentions subsidiarity only once, in passing, without explaining what it means.)
In particular, it is disturbing that no consideration of subsidiarity or the rights of the family seems to have informed the USCCB position on the health care bill, which, as I have noted already, seems to allow that the bill is acceptable or even required by Catholic teaching apart from the elements concerning abortion and coverage of illegal immigrants. How does respect for a “right to medical care” justify the federal government forcing every citizen to buy insurance, of a kind the government (rather than parents or individuals generally) decides the citizen needs? How does it justify increasing government power to determine for citizens what sorts of treatments are worth paying for? How does it justify moving towards a de facto monopoly as health insurance companies are transformed into heavily regulated government contractors? How does it justify the bill’s “marriage penalties”? Even apart from considerations of subsidiarity and the independence of the family, it is hard to see how such policies could be justified; in light of those considerations the policies seem positively immoral. Add to that the bill’s staggering increase to the already crushing debt we are facing, the dubious constitutionality of some of its components, the rushed and irresponsible way a transformation of one-sixth of the economy was cobbled together for political reasons without sufficient attention to unforeseen consequences, and the bill’s Rube Goldberg system of bribes and special breaks – as well as the USCCB letter’s admission that the bishops are “not politicians, policy experts or legislative tacticians” and thus without any special competence vis-à-vis the practical side of health care policy – and it becomes mystifying why the USCCB should think that, apart from the matter of abortion, the bill is something to “applaud” (as Cardinal George put it). The bill is not even an improvement on the existing system; it’s not even equally bad. As Steve Burton points out, it takes what is already wrong with the existing system and doubles down on it.
There is a reason why, as then Cardinal Ratzinger once put it, “no episcopal conference, as such, has a teaching mission.” (The Ratzinger Report, p. 60) It is rather the individual bishop who properly has the role of teacher of the faithful, and “it happens… that with some bishops there is a certain lack of a sense of individual responsibility, and the delegation of his inalienable powers as shepherd and teacher to the structures of the local conference leads to letting what should remain very personal lapse into anonymity.” (Ibid.) The result is that “the search for agreement between the different tendencies and the effort at mediation often yield flattened documents in which decisive positions (where they might be necessary) are weakened.” (p. 61) Ratzinger gives as an example the German bishops’ conference in the 1930s: “The really powerful documents against National Socialism were those that came from individual courageous bishops. The documents of the conference, on the contrary, were often rather wan and too weak with respect to what the tragedy called for.” (Ibid.) Needless to say, the tragedy that occurred last week was by no means comparable to the tragedy that followed upon the rise of Hitler and the Nazis. But it was a tragedy all the same. Where abortion is concerned, the USCCB response seems indeed to have been “rather wan and too weak.” Where the bill’s threat to the principle of subsidiarity is concerned, the USCCB has offered no response at all. And the failure to interpret the “right to medical care” in light of subsidiarity has arguably led Catholics of the Stupak stripe falsely to believe that voting for a health care bill like the one in question was a moral imperative as grave as that of opposition to abortion – and, in particular, that such a vote could be justified in light of Obama’s “executive order” stratagem.