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Many readers will be surprised that I use so many medical metaphors in this book. This is because, in terms of health and disease, similarities between the body corporate of the Catholic Church and the human organism immediately spring to mind. Moreover, using medical language in analysing the Church’s condition allows me to formulate certain truths more clearly than if I were to use legal language. I do not see myself as a judge, but rather – in the broadest sense of the term – as a kind of physician.

My fundamental criticism of the Roman System is grave, and I will give my reasons for it, point by point. I will attempt, to the best of my knowledge and in all conscience, to make an honest diagnosis throughout this book and to offer effective suggestions for treatment. Doubtlessly, the medicine will often be bitter, but the Church requires such medicine if it hopes to recover. The story I tell here is a gripping one, and – as is usually the case with descriptions of progressive disease – it is hardly pleasant. But I have not described my diagnosis so explicitly simply because I testily insist on being right or because I enjoy being contentious, but only to fulfil my duty in conscience to offer this service (possibly my last?) to my Church, a Church which I have endeavoured to serve all my life.

Based on my previous experience, I expect that Rome will do everything it can, if not to condemn such an uncomfortable and inconvenient book, then at least to keep it as far as possible under wraps. I hope, however, that this book will receive support from within the church community and from the public at large, in particular from theologians and, if possible, also from those bishops who genuinely wish for change. I also hope that this book will shake up those who are ideologically hidebound, and awaken the legally and financially entrenched Roman hierarchy from its complacent slumber, so that they will at least begin to take note of the pathogenesis presented here and to give thought to my explanation of how the disease from which the Catholic Church is suffering has developed, and of the consequences of this disease, so that they will not obstruct the unpleasant but urgently necessary therapy.

What a wonderful way this would be to mark the fiftieth anniversary of the prophetic Second Vatican Council! While not everything can be healed overnight, the agenda set forth here will, I am convinced, remain on the table as an important order of business for the Catholic Church in the coming years. And if that is the case, all of my effort has been worthwhile.