There have been a lot of encroachments on a woman’s right to choose, all on the state level, in the past few months. But – and I never thought I’d have to say this – we are relatively fortunate that when a mother’s life is at risk, abortion is seen by secular institutions as an unquestioned right. This is apparently complicated by the intersections between religion and reproductive freedom, which play out in very real ways in Catholic hospitals. Last week, a Catholic nun who worked in such a hospital was excommunicated and demoted by Thomas J. Olmsted, the Catholic bishop of Phoenix, Arizona, for approving the termination of a pregnancy that would otherwise have resulted in the death of the mother.
Sister Margaret McBride, an administrator at St. Joseph’s Hospital and Medical Center in Phoenix, was part of the hospital ethics committee that approved the termination of an eleven-week-old fetus when the mother developed a serious case of pulmonary hypertension. Without the abortion, the woman would have died. This certainly seems like an ethically correct decision on the part of the hospital, but the bishop apparently disagrees. Olmsted explained that McBride was “automatically excommunicated,” and continued, saying, “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.”
Jacob M. Appel, a physician and bioethicist, wrote a great piece for the HuffPo about the situation, explaining that the hospital has conflicting directives about such cases. One states that abortion is never permitted, even to save the life of the mother, illustrating the extent to which the mother can lose in the maternal-fetal conflict; the other, and the one that is usually followed because it corresponds with secular medical ethics, allows for small concessions when the mother’s life is in jeopardy. But now, a dangerous precendent seems to have been established by Olmsted’s actions. Olmsted himself is extremely conservative, even by Vatican standards, and has been a strong critic of Obama. But Appel claims that this is not really about Olmsted – instead, the decision is reflective of a general trend in Catholic heathcare. Competent adult women, Appel suggests, are no longer allowed to make their own decisions in Catholic hospitals, which comprise approximately 1/3 of medical services in the country.
I took a Christian ethics class last year, and read some of the fierce Catholic ethical arguments both for and against abortion. Many of the ethicists came to the conclusion that although abortion itself was morally repugnant, that the Christian doctrine of love left space for moral support for abortion when it would save the mother’s life. Others cite the principle of double effect, which allows doctor who are morally opposed to perform certain medical procedures that would save a woman’s life, knowing that the action will kill the fetus; because the direct intent is to save a life and to not terminate a pregnancy, the action is morally permissible.
I don’t know enough about the medical details of the case to know whether this could be applied, but it certainly shows that Catholic ethicists are aware of the moral imperative to show as much care in saving the mother’s life, if not more. But this seems to have been lost in the maternal-fetal conflict in modern healthcare, and it’s certainly a nuanced argument that Olmsted does not seem able to grasp. But I do agree with Appel, who points out that the Catholic Church can do what it wants – but that the imposition of its moral directives on citizens who may not want these ethics imposed on them should be resisted. Because of cases like these, I have to agree with Appel – maybe the Catholic Church shouldn’t be providing healthcare at all. Certainly, it seems to get caught up in political struggles (like the Catholic Church’s charities in DC, which were threatened by the passage of gay marriage) that jeopardize the well-being of the people whom the hospitals ostensibly serve.
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