If anyone has ever studied the Sociology of Health and Illness you will have certainly come across Talcott Parsons’ ideas on the ‘Sick Role’. This ‘paternalistic’ model of the Doctor-Patient relationship and other models like it (i.e. the co-operative and the consumerist) can be applied to the process of seeking help from a Bishop in the process of repentance. This analogy is based on an assumed similarity between the roles of Bishop/Doctor & ‘Sinner’/Patient. I think this is a useful, though not flawless, comparison but it is one that might help us think through how a Bishop could respond to someone who is seeking to confess and repent. Further I think it could also facilitate discussion upon the issue of how ‘Sinners’ can navigating this difficult relationship.
Parsons’ model speaks from a position where the physician possesses a high degree of control and therefore outlines for the patient what is in their best interest. In this view, the Bishop then is one who diagnoses and then prescribes the necessary course of action for the sinner. The patient is expected to comply with these directions otherwise the sick role is not ascribed to the patient, if this role is not available or accepted other exclusionary measures are enforced. In this way, the sick role can be a good place to be, for it can mean that the individual can be justifiably relieved from normal day-to-day expectations. Applying this to the Bishop-Sinner relationship it is possible to see the Bishop as the person who allows the sinner to enter a particular, transitory relationship with the Lord and the Church that can reduce the need for excommunication. In my experience this is the model most Bishops use and most ‘sinners’ expect.
There are of course some problems with this approach. The sinner becomes quite powerless after they confess. Their role is not wholly passive but there is clear sense that power lies with the Bishop. In situations where a person feels extreme guilt it might be counter-productive for a Bishop to assume a role that implicitly removes an individual’s spiritual autonomy and which further separates them from the Lord by being the one who becomes the receiver of His will.
In addition to this view, there are at least two other types of model that have been discussed regarding Doctor-Patient interactions. The Consumerist model is another possibility. In this model, the Patient (Sinner) has high control and uses the Doctor (Bishop) more as an advisor rather than as a source of reliable healing knowledge. Clearly in this view there is no ‘need’ to confess sins to a Bishop in order to achieve full repentance and this might contrast with the views of some who would see this as essential. Moreover, in the organisational context of the Church this model might be considered problematic if standards of worthiness are to be formally delineated. For in this model some people would be within their rights to avoid the Bishop, but more than that they might be able to argue that going to the Temple or taking the Sacrament would be most helpful in their repentance process.
The third model is often described as one of mutuality. In this relationship both parties are active and where ideas and beliefs are shared. In this view both the Bishop and the Sinner discuss the issues and try to understand the constraints and possibilities of the other side. Though I suspect that most people reading this would find ‘mutuality’ an appealing way of approaching these issues I think there are some real problems with it. For example, there is a strong possibility that both parties might have irreconcilable views upon these particular issues and if this is the case how then are they to proceed. This is especially likely if revelation is claimed on both sides. Further in this model this incompatible revelation must be respected and valued. Moreover, you have to consider whether such a form of interaction is possible in an environment where Priesthood, revelation and judgement are centralised in the leader regardless of the forms of discourses used around such issues.
I do not believe that any of these approaches is inherently destructive. I see the benefits of a paternalistic relationship in a situation where someone is blind to the damage they are causing to people around them. However, I can also see the benefit of the Bishop seeing his role as helping someone to judge themselves in a more co-operative sense. I can see the wisdom, for example, of a Bishop asking the ‘Sinner’ to pray about whether they should take the sacrament or not. Yet, considering that forgiveness is a gift offered by grace, I can also see that a consumerist model is also useful in not allowing the Bishop to become the person who distributes forgiveness. Moreover, I suspect that the consumerist model would reduce those (rare) instances of ecclesiastical abuse.
My questions then are these: which approach do you think Bishops should adopt in their interactions with ward members in the process of repentance? Which model should the sinner adopt? Can these approaches be different and have a satisfactory conclusion? Further, I am curious as to how you think these models would play-out in real situations?