Chen examines the causes behind the hardship. Beginning in the 1980s, St. Mary's, in keeping with the Catholic faith's traditional self-reliance, began gradually weaning themselves off of foreign donations-domestic contributions have always been sporadic. Moreover, the restructuring of the medical system based on enterprise and market principles had shaken the more public-service-minded St. Mary's, even threatening their once reliable obstetrics department.
陳世賢解釋：首先，依隨天主教的「自立自養」政策，聖母醫院自 1980 年代後逐漸斷絕海外募款，本土捐款卻始終極少；其次，在國內醫療體制掀起「企業化」與「市場化」潮流下，公益性格的聖母醫院連原先的產科強項都漸漸動搖。