Thursday, December 16, 2010

Theological Showdown over Abortion in Arizona

Bishop Thomas J. Olmsted, the Catholic Bishop of Phoenix, has thrown down a theological gauntlet to St. Joseph's hospital. If the hospital does not acknowledge that he was right in his condemnation of a medical procedure that involved abortion he will revoke it's status as a Catholic hospital.

The story goes back to November 2009. All that is publicly known is that a patient at the hospital (1) had pulmonary hypertension, (2) was pregnant, a combination associated with a high rate of fatality, and that (3) Sister Margaret McBride, vice president of mission, was a member of the hospital ethics committee that was consulted about the case.

On May 14, 2010, Bishop Olmsted made the following statement:
I am gravely concerned by the fact that an abortion was performed several months ago in a Catholic hospital in this Diocese. I am further concerned by the hospital's statement that the termination of a human life was necessary to treat the mother's underlying medical condition.

An unborn child is not a disease. While medical professionals should certainly try to save a pregnant mother's life, the means by which they do it can never be by directly killing her unborn child. The end does not justify the means.

Every Catholic institution is obliged to defend human life at all its stages; from conception to natural death. This obligation is also placed upon every Catholic individual. If a Catholic formally cooperates in the procurement of an abortion, they are automatically excommunicated by that action. The Catholic Church will continue to defend life and proclaim the evil of abortion without compromise, and must act to correct even her own members if they fail in this duty.

We always must remember that when a difficult medical situation involves a pregnant woman, there are two patients in need of treatment and care; not merely one. The unborn child's life is just as sacred as the mother's life, and neither life can be preferred over the other. A woman is rightly called 'mother' upon the moment of conception and throughout her entire pregnancy is considered to be 'with child.'

The direct killing of an unborn child is always immoral, no matter the circumstances, and it cannot be permitted in any institution that claims to be authentically Catholic.

As our late Holy Father, Pope John Paul II, solemnly taught in his encyclical 'The Gospel of Life,' a 'direct abortion, that is, abortion willed as an end or as a means, always constitutes a grave moral disorder, since it is the deliberate killing of an innocent human being' (The Gospel of Life #62).

The Ethical and Religious Directives for Catholic Healthcare Institutions (ERDs) are very clear on this issue: 'Catholic health care ministry witnesses to the sanctity of life from the moment of conception until death. The Church's defense of life encompasses the unborn and the care of women and their children during and after pregnancy.' (ERD, Part Four, Introduction) The ERDs further state that 'Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion.(ERD 45)"
Here's the statement St. Joseph's hospital had made:
At St. Joseph's Hospital and Medical Center, our highly-skilled clinical professionals face life and death decisions every day. Those decisions are guided by our values of dignity, justice and respect, and the belief that all life is sacred.

We have always adhered to the Ethical and Religious Directives for Catholic Health Care Services as we carry out our healing ministry and we continue to abide by them. As the preamble to the Directives notes, 'While providing standards and guidance, the Directives do not cover in detail all the complex issues that confront Catholic health care today.'

In those instances where the Directives do not explicitly address a clinical situation - such as when a pregnancy threatens a woman's life - an Ethics Committee is convened to help our caregivers and their patients make the most life-affirming decision.

In this tragic case, the treatment necessary to save the mother's life required the termination of an 11-week pregnancy. This decision was made after consultation with the patient, her family, her physicians, and in consultation with the Ethics Committee, of which Sr. Margaret McBride is a member.
In a subsequent interview Suzanne Pfister, vice president of communications for the hospital, added: "We believe that all life is sacred. In this case, we saved the only life we could save, which was the mother's."

On November 22 Bishop Olmsted sent a remarkable four page letter to Lloyd Dean, president of Catholic Healthcare West, the large not-for-profit system with 40 hospitals - including St. Joseph's - in Arizona, California and Nevada. (The letter was made available to, i.e., leaked to, and published by, the Arizona Republic.)

The Bishop quotes from a letter from Catholic Healthcare West as saying "many knowledgeable theologians have reviewed the case, and reached a range of conclusions. If we assume that these individuals are motivated by their faith and desire for justice, one must at least acknowledge that this is a very complex matter, on which the best minds disagree."

The Bishop will have none of it. Here's his response - "There cannot be a tie in this debate. Until this point in time, you have not acknowledged my authority to settle this question. Your actions communicate to me that you do not respect my authority to authentically teach and interpret moral law in this diocese. Failure to fulfill these requirements will lead me to decree the suspension of my endorsement of St. Joseph's Hospital, forcing me to notify the Catholic faithful that St. Joseph's Hospital no longer qualifies as a Catholic hospital..." He gives Catholic Healthcare West until Friday December 17 to capitulate by acknowledging in writing that they have made a grave error and that he is correct.

I do not know the particulars of the clinical situation, but from the Bishop's letter I infer that the patient's physicians concluded that there was no way to save the lives of both mother and baby-to-be. The choice was two deaths, or one.

The Bishop is correct that Canon Law decrees him to be the "decider." But if I am correct in my inference about the clinical facts, he will not be regarded - including by many Catholics - as having moral, as opposed to legal, authority. He will not be seen as a true arbiter of what is right in the situation.

(See here and here for two excellent articles by Michael Clancy in the Arizona Republic. The second article has a brief quotation from me - I'm grateful to Mike for contacting me about the situation.)


Anonymous said...

In a strange way, I'm glad to see this debate.

The religious right has been so successful in making people think that the abortion issue is all about some borderline-mythical demographic having third-trimester abortions for convenience's sake.

This provides a reminder that the pro-lifers would let you die to avoid directly killing an unviable fetus the size of a lime.

Jim Sabin said...

Dear Anonymous -

As I said in a post I wrote earlier today, I agree with you that this is a worthy debate.

That post gives links to the Bishop's 12/21 decree and the hospital's response. I believe you will find the hospital's position respectful, dignified and persuasive.

Thank you for your comment!