Reform and Rationing: Reflections on Health Care in Light of Catholic Social Teaching

Abstract

In this essay, I analyze two issues at the forefront of recent policy discussion — health care reform and health care rationing — in light of Roman Catholic social teaching. It is important, as I begin, to identify and critique a position often deemed to be the conventional wisdom on the place of religion in policy debates. Many would assert that the claims of particular religious communities are irrelevant or unnecessary to the formulation and justification of public policy in a secular and pluralistic society. However, their easy dismissal of religious voices can be questioned on two grounds. First, they assume, with little or no argument, that the claims of religious communities cannot be justified in more general terms. If such common ground were indeed absent, it would seemingly follow that religious communities could not fully participate in policy formation because of constitutional concerns regarding the separation of church and state. However, this first assumption is demonstrably false. The facts of overlapping consensus, despite the varied theological, philosophical, and political viewpoints of those who achieve practical agreement, play a pivotal role in legislative pronouncements and judicial reasoning. Shared moral and legal conclusions on particular issues and common policy conclusions on appropriate societal remedies are possible despite the lack of agreement about the first principles at work in particular perspectives, whether religiously informed or not.

Singificant sections of this essay closely parallel my analysis of recent Catholic documents on health care in ‘The Common Good in a Secular Society’, The Journal of Medicine and Philosophy 18 (1993), 569–587.