The practical conclusion to the re-configuration is that a ''stand alone'' position is not always a viable option. In most cases it is foreseen that isolation would entail eventual closure. Market pressure is considered the ''sufficient reason'' which is one of the ''ingredients'' necessary to justify material cooperation. Scandal must also be overcome. Scandal is not the same as a public relations problem.
Scandal is the serious suggestion that evil is attractive or permissible.
Any partnering between Catholic and non-Catholic health services must avoid the impression that Catholic moral doctrine is not being observed. There are five basic principles the Pope John Center is using to evaluate partnerships. We can only do together what all partners agree to be appropriate. This means that while the partnership need not be Catholic, it must nevertheless observe the Ethical and Religious Directives as respecting the ''corporate conscience'' of the Catholic partner. The observance of these principles should issue in a morally sound and scandal-free partnership that will contribute to the Catholic health care tradition.