WASHINGTON — Last year, Modern Healthcare magazine named Sister Carol Keehan, president of the Catholic Health Association, the most powerful person in American healthcare.

Sister Carol is a strong believer in the power of collaboration between Catholic healthcare institutions, the Vatican, and the United States Conference of Catholic Bishops, when it comes to dealing with difficult questions of medical ethics.

Sister Carol, a member of the Daughters of Charity, spoke April 3 with Contributing Editor Tom McFeely about this collaboration, and how it is strengthening the Church’s medical ministry in the United States and elsewhere in the world.

In his 2002 book-length interview “God and The World,” then-Cardinal Ratzinger praised the contribution of American healthcare institutions in working with the Congregation for the Doctrine of the Faith to guide the

Church in addressing emerging questions of medical ethics. How does this collaboration take place?

I would say that he, and the Congregation for the Doctrine of the Faith, have been superb at really doing that.

Superb at getting clinical input and understanding not only the ethical principles but the clinical issues as they make decisions. They’ve been wonderful about that.

In your experience of this process of collaboration between the Vatican and American Catholic healthcare institutions, what are some of the issues that have been addressed?

The U.S. Conference of Catholic Bishops works closely with CHA, and we tend to be the convener of ethicists and clinicians from around the country, and sort of the interface with the USCCB to look at issues.

For instance, to look at the issue of nutrition and hydration, because there are a lot of people in the press who decided that they speak for the Vatican, or say, “This is what the Vatican meant by what the Vatican said.”

And so the U.S. Conference of Catholic Bishops and their Committee on Doctrine has worked closely to ask the Vatican, “Okay, is this what you meant by what you said, or could you clarify what you meant?”

And the Vatican did. They did a very nice job of clarifying that about nutrition and hydration in patients in a persistent vegetative state just recently.

Now, not everybody who is saying what the Vatican meant by what they said is speaking authoritatively. But certainly the USCCB and what they’ve put out, and what the Vatican has put out, have been what I would call clear statements.

Another time, we spent a great deal of time with bishops and theologians talking about the issue of “co-operation.” When are you co-operating [with a morally problematic medical action] in a way that is not acceptable ethically? And when is it appropriate, and what types of cooperation?

We’ve also talked, and tried to bring to bear with theologians and clinicians, information on new drugs, new treatments and the impact of certain treatments. We’ve also talked to them at length about what constitutes, in an individual patient, an ethics consult that is worthy of an individual made in the image and likeness of God.

People who do ethics consults in the newspaper, never having seen the patient and never having read the chart, to my mind do a great disservice.

And we’ve talked about how important it is to have good, strong ethics committees, what kind of preparation is necessary for ethics committees, how we can help local parish clergy because they’re the ones that very often get asked these very life-and-death kinds of questions. They’re on the front lines.

So we tend to have a lot of dialogues with the bishops’ conference. And then every year CHA has an education program in Rome, and always Father Augustine Di Noia [Undersecretary of the Congregation for the Doctrine of the Faith] speaks to the group.

And Father Di Noia is always available for questions. He’s always available if I have a question, either when I’m over in Rome on one of the numerous trips I make to Rome, or by email.

If we see something coming down the road, either in terms of a new treatment or a new issue or we now have enough data that we can take a look at something that before we didn’t have enough data to take a look at, we tend to pass that along. And if he hears something and has a question about how prevalent this is or if this is an issue, he certainly knows that we’re available to him.

Are American healthcare institutions taking the lead in helping the Church this way?

I would say the Catholic health presence in the United States is unique to the world. I don’t mean that it’s better, just unique.

In many, many countries that are Catholic countries, a much larger percentage of their hospitals are not Catholic, or they’re not Catholic but they may have religious working in them or they may have a Catholic name.

The United States has a very strong network of hospitals. Not only do we have a lot of large Catholic systems, but we have a tremendous commitment on the part of those systems to be part of the whole. We understand how important it is to work together, as Church.

That’s part of why we stay so close to the U.S. bishops’ conference here and bring people to Rome, because it’s not an individual business or an individual good work. We represent the Church’s healing ministry.

What has the Pope said that has been particularly inspirational for your work?

Even though he has written beautiful encyclicals, and I love his book on Jesus of Nazareth, my favorite quote since he’s been Pope was in Vienna.

He was talking about abortion and he was talking about how we, as the Church, are speaking for the unborn, for those who are profoundly vulnerable. He was talking against the abortion culture in Europe.

And he stopped and he said, “And I realize the credibility of the Church’s teaching depends on what we are doing for these women in trouble.”

And so here in this country — not wanting to do assisted suicide, not wanting to do abortion, speaking about the dignity of very frail elderly, the dignity of the people with very serious chronic diseases that diminish their external humanity — I think that’s only effective if you can see the Church being right there and deeply involved in their care.

Because that’s where the Lord would be.

Tom McFeely is based in

Victoria, British Columbia.