So many things are galling about Phoenix Bishop Thomas J. Olmsted's excommunication of Sister Margaret McBride, a member of St. Joseph's Hospital Ethics Committee, for approving the termination of the life-threatening, 11-week-old pregnancy of a 27-year-old mother of four that it's hard to know where to begin. But surely one of the most urgent issues this case raises is the danger faced by any woman who sets foot in a Catholic hospital in the midst of a reproductive crisis.
Just to recap, late last year a critically-ill pregnant woman was brought into St. Joseph's suffering from pulmonary hypertension. Her pregnancy posed such a burden to her heart and lungs that carrying it to term almost certainly would have killed her. Sister Margaret approved the decision of the physicians, the patient, and her family to terminate the pregnancy.
When Olmsted learned that this procedure had taken place, all hell broke loose. Without a scintilla of empathy or sympathy for the dying woman and her family, Olmsted said: "The direct killing of an unborn child is always immoral, no matter the circumstances." Since the abortion was not "indirect" (i.e., the byproduct of another procedure necessary to save the mother's life, such as removing a cancerous uterus), the correct moral action, according to Olmsted and the Phoenix diocese, was this: Let the mother and the fetus die.
We do not know how often such decisions come up in Catholic hospitals. Nor do we know if any go the other way -- that is, the beliefs of the Olmsteds of the Church prevail and discharge is followed by a funeral. What we do know is that Catholic hospitals, charged with abiding by the Ethical and Religious Directives for Catholic Health Care Services, pose a real danger to women's health and lives.
"One of the most troubling areas is in the treatment of reproductive emergencies," says Lois Uttley, director of the MergerWatch Project, which works with communities facing Catholic-non-Catholic hospital mergers to preserve reproductive health services. A miscarriage in progress is an example of the emergencies Uttley is referencing. When it happens so early in pregnancy that the fetus cannot survive, the pregnancy has to be terminated quickly. Unfortunately, explains Uttley, in some Catholic hospitals, this isn't what happens; the fetal heartbeat has to stop before doctors can do the procedure.
The disturbing findings of a report published in late 2008 in the American Journal of Public Health bear this out. The researchers set out to explore the impact of residency abortion training on the medical practices of a sample of ob-gyns. In the course of conducting their interviews, they got an unexpected glimpse into the conflicts posed by the Directives for physicians attempting to manage miscarriages.
One doctor working at a Catholic hospital reported receiving a woman whose pregnancy "was very early, 14 weeks," with "a hand sticking out of the cervix," indicating that "clearly the membranes had ruptured and she was trying to deliver." Because there was still a fetal heart rate, the ethics committee refused to approve the abortion; they sent the woman to another institution 90 miles away.
Another doctor, at an academic medical center, reported that a Catholic-owned hospital called to ask her to accept a pregnant miscarrying patient who was already septic and hemorrhaging. She urged them to do the uterine aspiration themselves, but they refused. That doctor accepted the patient and did the procedure, but saw this case as a form of "patient dumping." She reported the hospital for an Emergency Medical Treatment and Active Labor Act violation.
Obviously and fundamentally, the question is this: Why does a woman lying at death's door have to worry about whether a procedure that will save her life violates the so-called "ethical" Directives of a religion she doesn't belong to or long ago abandoned, Directives that treat women as disposable delivery systems for new humans, while flying in the face of standard, approved medical practice?
One answer is that the original conscience clauses, approved by Congress after the passage of Roe v. Wade, have been bastardized. They now apply not only to people -- physicians and nurses who oppose abortion -- but to institutions whose "consciences" trump not only the patient's own conscience, but also violate her right to informed consent and to medically indicated care.
We need more research into how often and in what ways physicians compromise patient care as a result of the Catholic Directives. But for now, the experience of the nameless, faceless, pregnant woman who Bishop Olmstead would have sentenced to death (rather than having her live "the rest of her existence having had her child killed," which is how the diocesan statement put it) is a cautionary tale.
Unless you are a deeply devoted Catholic and want your local bishop to make your most intimate medical decisions, when the ambulance pulls up, be ready. Have your own ethical and moral directive saying: Do Not Take Me to a Catholic Hospital. If for no other reason than this: there may not be a Sister Margaret in the house.
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If that sister had not happened by at that moment, my friend could well have bled out.
Decades after the fact, I am still enraged on behalf of my friend and her family. I avoid Catholic hospitals like the plague. I do not want any money I spend going to support their policies.
But revenge is like a boomerang. What goes around comes around.
1. Was your mother's life also in jeopardy during your birth?
2. If so, was it your mother's decision, or the decision of the ethics board, to risk her life so that you were born?
3. Do you feel it is ever justified to let one person die (when it is not their decision) to allow for the possibility that another may live?
I am not trying to be unfeeling or uncaring. My mother's health was at risk while she carried me as well, and she chose to go on regardless of the risk. That was her choice. Honestly, I would understand if she didn't want to continue the pregnancy. I would not like us to have to go back to the days when mothers were routinely killed during the labor of child birth.
Is it not a parent's place to do anything possible to save their child's life?
Whatever happened to that oath? Letting a woman die so as not to abort an un-savable fetus goes against the Hippocratic oath.
"I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion."
So there are actually a good many physicians who support women over this oath. I am truly not sure if they actually administer the oath at graduation anymore, that would be an interesting bit of info to find out.
Since I first started reading this post, I have talked to my cousin who is a nurse in a Catholic Hospital. She tells all her friends and acquaintances not to let their daughters deliver at any Catholic Hospital. I don't know what she has witnessed (she wouldn't say--HIPPA laws), but she was very clear about it. She said even many employees of the hospital go to the hospital two towns over to have their babies.
I am liking this less every day!
There are exceptions to the law, such as releasing information for business purposes (insurance payments, etc.), for QI purposes (quality of care studies, etc.), and for patient care purposes (calling another doctor for information, etc), but I am not aware of an exception for 'religious purposes.' It's possible that the hospital has something in its consent form, but I can't imagine that would hold up in court, especially in circumstances like this, where the patient was critically ill, and probably had her husband sign. If its not compliant with the law, it shouldn't be allowed.
This would be like a hospital calling a southern baptist minister to let them know that a church member was being treated for HIV that he caught from homosexual activity, and the pastor telling them they should have let the patient die because homosexuality is against his religion.
Where are all our lawyer friends that would just love to help this family out?
A young woman with a legitimate RU 486 prescription should not be turned away from the only pharmacy for miles around open late on a Saturday night. Thus sayeth my husband, the pharmacist.
I, too, would not patronize any pharmacy that would hire a pharmacist who would not fill birth control prescriptions--out of solidarity for other women. Just as I will not patronize any Catholic hospital anymore.
So, make it the law that health care providers must post this information for the public, then let the pharmacies and hospitals decide whether to hire people who will not do their jobs.
Once again, we have assault against women. It must not be tolerated.
I really agree with your statements about pharmacists. My 13 year old daughter had severe menstrual cramps that kept her out of school for 2-3 days every month, and her doctor prescribed Seasonale, a type of oral contraceptive. When we went to fill it at the (catholic) hospital pharmacy adjoining the clinic, the head pharmacist literally threw the prescription back at me and said "We don't carry that kind of stuff here." Then just walked away. It was so humiliating, and it hadn't even occurred to me that they would/could do something like that. I would truly rather DIE than be taken to that hospital, so perhaps they've indirectly accomplished their goal of killing off women one gal at a time.
Yeah, I thought about a couple of things a man might be turned away for after I posted. But none are life-threatening and none would cause him to have a fertilized egg implanted by Monday if his birth control wasn't filled before the weekend was over.
I do think the public deserves to know if they are getting a full-service pharmacy, hospital, doctor--or something much less---before they choose to patronize that person or place.
http://ncronline.org/news/ethicists-fault-bishop%E2%80%99s-action-phoenix-abortion-case
Since then, I have heard other horror stories similar to this one.
When my husband's former employer was changing insurance plans, the one he proposed dealt with only Catholic Hospitals. Though I am past child-bearing years, several other women and I petitioned the employer to stick with BC/BS, where the patient could choose the hospital. Though the premiums were a bit more, most of the women employees and wives were of child-bearing age, and I was willing to pay the difference to keep them safe.
Sister Margaret made the only logical (and right) decision in saving this young mother's life so she can continue to raise her other children. What purpose would it serve to have allowed her to die? God's purpose? Had the board decided to allow her to die, they should all have faced murder charges, as should any administrators who make these ridiculous, life-threatening decisions.
Catholic Hospitals need to practice good medicine, or they need to close their doors.
I think that in any area where a secular hospital is not within a few minutes range, that Catholic hospitals must have a secular annex where non-religious medicine is practiced.
That said, I've been to my local hospital (which is Catholic) a couple times, and have no problem with it. But only for kitchen cuts and twisted ankles, which have not been addressed by the Vatican. As far as I know....