Thursday, May 20, 2010

Nun "Excommunicated" Over 'Ethical and Religious Directives for Catholic Health Care'

Well, immigration policy isn't the only thing Arizona is infamous for.

Conservatives there have run amok on yet another issue, the National Catholic Reporter says.

This time it's religious conservatives: Phoenix Bishop Thomas J. Olmstead has declared that Margaret McBride, the highest ranking Sister of Mercy at St. Joseph's Hospital and Medical Center, excommunicated herself when she interpreted a gray area in the U.S. Bishops 2001 'Ethical and Religious Directives for Catholic Health Care Services' (ERD) as allowing a therapeutic abortion of an 11-week old non-viable fetus to save the life of a mother of four.

NCR reports that the hospital disagrees that it did not follow the bishops' guidelines:

"In a statement, Suzanne Pfister, a hospital vice president, said that the facility adheres to the Ethical and Directives for Catholic Health Care Services. But, she argued, the directives leave some gray areas.

"'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,' she said. 'In this tragic case, the treatment necessary to save the mother's life required the termination of an 11-week pregnancy.'


"Pfister issued the statement on behalf of the hospital, its parent company Catholic Healthcare West, and the Sisters of Mercy, McBride's religious order.

"A letter sent May 10 from Catholic Healthcare West, signed by Sr. Judith Carle, board chairwoman, and President and CEO Lloyd Dean, asks Olmsted to provide further clarification about the directives. Agreeing that in a healthy mother, pregnancy is 'not a pathology,' it says this case was different. The pregnancy, the letter says, carried a nearly certain risk of death for the mother.

"'If there had been a way to save the pregnancy and still prevent the death of the mother, we would have done it,' the letter says. 'We are convinced there was not.'"


The article quotes a Catholic News Service report "that in a letter to the editor of The Arizona Republic May 18, Dr. John Garvie, chief of gastroenterology at St. Joseph's, called McBride 'the moral conscience of the hospital' and said 'there is no finer defender of life at our hospital.'"

So far the NCR article has generated five pages of reader comments. Most of the them are strongly critical of the bishop's interpretation of the health care guidelines and his cavalier assertion that Sister McBride procured a direct abortion and therefore incurred automatic excommunication under canon law.

A number of commentators point out that there is in fact a gray area between two different provisions in the ERD.

Directive 45 reads: "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, which, in its moral context, includes the interval between conception and implantation of the embryo. Catholic health care institutions are not to provide abortion services, even based upon the principle of material cooperation. In this context, Catholic health care institutions need to be concerned about the danger of scandal in any association with abortion providers."

However, Directive 47 adds: "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."

The ethics committee and the hospital argue that in this case the mother's pulmonary hypertension was a pathological condition requiring treatment and that allowing the pregnancy to continue would have killed both the mother and the fetus. They saw this specific situation as not being clearly addressed in the directives and believed that saving the only life which could be saved was their clear priority.

Obviously there is room for an alternate interpretation by the bishop and his ethics advisers. However, because there is room for more than one interpretation, the hospital and its ethics committee members should not be penalized for conscientiously doing their best with the guidelines they had.

For the bishop to construe the situation as Sister McBride directly procuring an abortion in violation of Directive 45 is arbitrary, unwarrantedly excessive and unjustifiably punitive. And for him to show no commitment toward saving the life of the mother of four existing children seriously undercuts his credibility as a moral theologian. If the church is pro-life, surely it favors life continuing for the living.

The bishop should retract his intemperate, ill-considered remarks and join the rest of us in affirming Sister Margaret McBride as a Catholic in good standing with the church.

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