Friday, December 24, 2010

In Praise of St. Joseph's Hospital and the Sisters of Mercy

Although I believe that Bishop Olmsted was wrong from the perspectives of both secular and Catholic medical ethics when he decreed that St. Joseph's Hospital "no longer qualifies as a 'Catholic' entity...[and] may not use the name Catholic or be identified as Catholic in the Diocese of Phoenix," the moral seriousness and dignity of the conflict has much to teach. (See here and here for previous posts on the topic.)

Here's how St. Joseph's Hospital explained its views about the clinical circumstances:
A woman in her 20’s with a history of moderate but well-controlled pulmonary hypertension found out she was pregnant. There was concern for her health, because pregnancy with pulmonary hypertension carries a serious risk of mortality. Because of the severity of her disease, the woman’s risk of mortality was close to 50 percent. In November 2009, the woman was admitted to St. Joseph’s Hospital and Medical Center with worsening symptoms. Tests revealed that she now had life threatening pulmonary hypertension. The chart notes that she had been informed that her risk of mortality was close to 100% if she continued the pregnancy. The medical team contacted the Ethics Consult team for review. The consultation team talked to several physicians and nurses as well as reviewed the patient’s record. The patient and her family, her doctors, and the Ethics Consult team, agreed that the pregnancy could be terminated, and that it was appropriate since the goal was not to end the pregnancy but save the mother’s life.
The Bishop's condemnation and St. Joseph's defense both draw on a component of Catholic tradition that I, a non-Catholic, especially admire - the preferential option for the poor and vulnerable. This commitment to social justice comes from Jesus, as in this passage about the last judgment from Matthew (King James version):
34 Then shall the King say unto them on his right hand, Come, ye blessed of my Father, inherit the kingdom prepared for you from the foundation of the world:

35 for I was ahungered, and ye gave me meat: I was thirsty, and ye gave me drink: I was a stranger, and ye took me in:

36 naked, and ye clothed me: I was sick, and ye visited me: I was in prison, and ye came unto me.

37 Then shall the righteous answer him, saying, Lord, when saw we thee ahungered, and fed thee? or thirsty, and gave thee drink?

38 When saw we thee a stranger, and took thee in? or naked, and clothed thee?

39 Or when saw we thee sick, or in prison, and came unto thee?

40 And the King shall answer and say unto them, Verily I say unto you, Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me.
I encourage readers to watch the press conference in which Bishop Olmsted explained his decision. Although I was not impressed by his reasoning, I was moved by his moral passion. Here's the Bishop's response to a question he was asked about being vilified in the media:
I really don’t read the blogosphere. I try to pray each day to find my identity in Jesus Christ… My identity comes from Christ. Christ is present in his living body, the church… That’s my identity, it comes from there. If I am unfaithful to that, then whether I’m looked at one way or another, if I’m given praise or given ridicule doesn’t matter. What I’m called to be is faithful to Jesus Christ and his church.
The Bishop sees himself as defending the vulnerable fetus, since the life-saving intervention used the same medical technique that is applied in most abortions. What he fails to recognize, however, is that the fetus was not simply vulnerable - it was in the process of dying. The choice the family and the caretakers faced was whether to stand by and let the mother die as well, or terminate the pregnancy, which gave the mother a chance to live. There was no scenario by which the fetus would become a living child.

I'm in no way expert on Catholic medical ethics, but to my reading paragraph 47 in the Ethical and Religious Directives for Catholic Health Care Services exactly describes the situation the patient, family, and caretakers faced:
Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.
Had the caretakers postponed the intervention they made, both mother and fetus would have died. In concluding that it was ethically and theologically correct to terminate the pregnancy the patient, family, and caretakers were acting in accord with Jesus's teaching "I was sick, and ye visited me." I am sad to see Bishop Olmsted attach his moral passion to a conclusion that appears to be erroneous within his own theological and ethical tradition.

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