Phoenix Bishop Defends Life, Catholic Health Care
May 18, 2010
FAQs About Phoenix Case
CMA issues these comments about the Phoenix case based on facts disclosed in news accounts.
1. What happened: Several months ago, an abortion was performed on a woman at St. Joseph Hospital in Phoenix, Arizona. The hospital is owned and operated by Catholic Health West. The woman was suffering from pulmonary hypertension. This is a serious disease, and pregnancy can exacerbate it. Without careful medical management (and sometimes in spite of it), pulmonary hypertension can cause significant complications for both the expectant mother and unborn child during pregancy and, in some cases, may be fatal. Sr. Margaret McBride (not a "nun" but a Sister of Mercy) approved the abortion as part of an ethics consult. Hospital leaders have since argued that the abortion was necessary to protect the woman's health, and perhaps her life.
2. The moral teaching of the Church:
- 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. . . . 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.” (Ethical and Religious Directives #45).
- "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).
3. Some thoughts on the clinical and ethical details:
- There are some very complicated diseases and health care conditions that affect women during pregnancy. The Church has long recognized that there are situations in which an expectant mother is suffering from a serious disease (for example, uterine cancer) where only effective treatment (for example, hysterectomy) results in the death of the unborn child. To deal with these hard cases, a 4-step process of moral analysis, called the principle of double effect, has been developed. Working through this process helps us to ensure that neither the intent nor the direct effect of the action proposed is morally evil. In the case of uterine cancer, the intent is to treat a dangerous disease. The direct effect of the action is to remove the mother's diseased organ. While the life of the unborn child is lost, the child is not directly targeted and killed; nor is the death of the unborn child the means by which the mother's life is saved. While this is true for certain diseases (for example, server preeclampsia and premature rupture of the membranes with infection) and treatments, it is not true for all. In the case of pulmonary hypertension at hand, it seems it was the intent of the health care providers to end the life of the child rather than to treat an organ or condition of the mother. And, the means chosen to promote the health of the woman was to abort a viable pregnancy.
- While moral theologians, physicians, nurses, and hospital administrators may struggle with the complicated clinical and ethical details of a case, it is the role of the bishop of a diocese to teach with authority on faith and morals. The bishop has the authority to accurately apply the principles of Catholic moral teaching in his diocese. Hopefully this can be done prospectively, to avoid any violation of moral law. But it can and must be done retrospectively to protect the faithful, the integrity of the Catholic health care ministry, and the dignity of human life.