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Jacob M. Appel

Jacob M. Appel

Posted: May 16, 2010 09:23 PM

One of the defining and moderating aspects of the contemporary American debate surrounding the legalization of abortion is that the controversy only applies to elective procedures where the life of the mother is not in serious jeopardy. In contrast, the right of a woman to choose her own life over that of a fetus or embryo has not been seriously questioned in the United States and, except in a handful of cases involving women in comas, no American court or legislature has challenged this principle in recent memory. Even the Catholic Church, whose official doctrine demands that women be sacrificed in order to preserve fetal life, has for many years made no attempt to impose such a draconian policy upon its vast network of hospitals in the United States. Until last week. In a radical move that is likely to inflame the abortion debate even further and, more disturbingly, to endanger the lives of millions of expectant mothers, Thomas J. Olmsted, the Catholic bishop of Phoenix, Arizona, has condemned and excommunicated a highly regarded nun who approved an abortion necessary to save a pregnant woman's life.

The Irish nun at the center of the case is Sister Margaret McBride, an administrator at St. Joseph's Hospital and Medical Center in Phoenix. McBride was part of a hospital ethics committee that approved the termination of an eleven-week-old fetus after the mother developed a case of pulmonary hypertension that threatened to kill her if she continued with her pregnancy. Although the specific details of the case have not been revealed for reasons of patient privacy, Catholic Healthcare West, which operates the hospital, has described the woman's death, in the absence of termination, as all but certain. In response, Mr. Olmstead declared that the nun was "automatically excommunicated" and warned that: "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." Although St. Joseph's Hospital defended its decision, it subsequently demoted McBride -- an obvious signal to other well-intentioned clergy at other Catholic healthcare providers. Like many Catholic hospitals, St. Joseph's has long had two conflicting policies regarding maternal-fetal conflict on its books. One directive states that abortion is never permitted, even to save the life of the mother, while the other notes that "operations, treatments and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted...even if they will result in the death of the unborn child." Until this recent incident, pregnant women could safely assume that Catholic hospitals would follow both the law and widespread standards of medical ethics in allowing the second directive to trump the first. Suddenly, that time-honored understanding appears to be in jeopardy.

Mr. Olmsted has a reputation as a particularly stone-hearted and intransigent figure, even by the orthodox standards of Vatican hierarchy. He previously gained notoriety for refusing communion to a ten-year-old autistic child who could not swallow and later spearheaded an effort to incorporate local church parishes individually in order to shield the Phoenix archdiocese from suits by sex-abuse victims. He has also been a fierce and vocal critic of President Obama. But Mr. Omsted's pronouncement--rather than the deranged cries of a renegade cleric--reflect a broader, deeply disturbing trend that is reshaping Catholic healthcare. Earlier this year, I drew attention to the revision of Directive 58, which now prohibits Catholic hospitals from honoring the wishes of patients--both Catholic and non-Catholic--who wish to be removed from unwanted life support equipment such as ventilators. The new policy, like the new abortion rule, is both patently illegal and widely regarded as unethical by mainstream secular and religious thinkers. Inevitably, both policies will be challenged in the courts. However, in the interim, pregnant women must ask themselves whether they can trust their care to any Catholic hospitals in the United States. Without overt assurance from the Vatican, I fear that the answer is a resounding NO.

Exactly how much risk to accept before terminating a pregnancy is certainly a difficult choice for any woman and any family. If I served on a hospital ethics committee, I would permit a pregnant woman with capacity to forgo an abortion, even if that meant her certain death, although I would do so with profound sadness. Competent adults have a right to make their own decisions -- no matter how misguided the rest of us may view them. That is the fundamental underpinning of contemporary medical ethics. Unfortunately, it appears that principle may no longer apply at Catholic hospitals, which provide approximately one-third of medical services in the United States. As a matter of public policy, these hospitals -- as public institutions that survive on public funds -- should be and are compelled to terminate pregnancies in medical emergencies. But if my life were at stake, or that of a woman I loved, I would not want to risk the chance that a woman less enlightened or flexible than Sister McBride was the ethicist ruling on my case in a medical emergency. So let me make this clear: At the present moment, as a physician, I would not feel comfortable with a woman I cared about seeking obstetric services at a Catholic hospital. In fact, I would not want a pregnant woman I cared about obtaining any medical treatment at a Catholic hospital. From this point forward, I will tell my pregnant patients, in all but the most emergent and high-risk circumstances, to instruct any ambulance that picks them up to avoid Catholic hospitals. That is tragic, because these institutions have a long and noble history of providing care to this nation's needy and most desperate. Alas, thanks to men like Mr. Olmsted, obtaining obstetric care at a Catholic hospital has become a dangerous game of Russian roulette.

Of course, as a pregnant woman, one is never certain that even a secular hospital will honor one's wishes. Anyone who reads this column is familiar with the case of Jana Bures-Forsthoefel, a rogue obstetrician who allegedly held patient Samantha Burton as a legal hostage for several days when the patient sought a second opinion from a different provider. (Of note: Five months have elapsed since the ACLU publicized this tragedy and, to my knowledge, Bures-Forsthoefel remains unwilling to explain her conduct or to refute in public the grave charges against her.) The Burton case arose at Tallahassee Memorial Hospital, a private, non-denominational institution. At the same time, I have no doubt that some Catholic-run hospitals remain safe, loving and respectful places for women to give birth. Some Catholic hospitals will let a woman decide if, and when, she wishes to die to preserve the life of her fetus. Regrettably, at the present moment, there is no way to know which hospitals are which -- to separate the wheat from the chaff.

The St. Joseph's incident, coming only months after Directive 58, should force Americans to reconsider the relationship between the Catholic Church and our healthcare system. Catholic hospitals, although run by the Vatican, survive only because American taxpayers subsidize them through Medicare, Medicaid, tax exemptions, research grants, residency training payments and scores of other benefits. But if the Church cannot agree to honor the basic tenets of medical ethics -- such as respecting end-of-life wishes or letting a mother choose her own life over that of an eleven-week-old fetus -- maybe the Catholic Church has no place providing healthcare at all. Moreover, maybe the public should regard its healthcare institutions with greater scrutiny. You shouldn't get a free pass from criticism just because you wear a cassock.

As a religion, which seeks to instruct its own adherents, the Catholic Church is entitled to do as it pleases. As an institution that has played an integral role in furthering art and culture for two thousand years, it is deserving of respect. On the other hand, as a political ideology that seeks to impose its most fanatical and potentially lethal ideas on non-believers, often clandestinely through hospital bylaws, Catholic extremism should be resisted as fiercely at home as we oppose the Taliban abroad. Mr. Olmstead, of course, is entitled to his opinion. As, indeed, are Mr. Ratzinger and his minions in Rome. So are the mullahs in Afghanistan and the proponents of sharia law in Saudi Arabia. It's a free country, so to speak. The fundamental difference is that we don't allow the Afghan mullahs or the Saudi Wahhabi to run our hospitals.

 
 
 
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05:20 PM on 07/04/2010
Today is July 4th and a Sunday. Planned Parenthood Slaughter Houses around this “great” country must be all closed. 4500 babies in this country have one extra day to live in their mother wombs. Their parents are supposed to protect them. However, they are convinced by people like Jacob and Obama, that it is OK to kill their baby.

Let’s make this day a National Repent Day, so we can maintain basic morality of this country.

God Bless America, and have mercy on us.
02:53 PM on 07/03/2010
However, Dr. Paul A. Byrne, Director of Neonatology and Pediatrics at St. Charles Mercy Hospital in Toledo, Ohio, disputes the claim that an abortion is ever a procedure necessary to save the life of the mother, or carries less risk than birth.

In an interview with LifeSiteNews, Dr. Byrne said, “I don’t know of any [situation where abortion is necessary to save the life of the mother].

“I know that a lot of people talk about these things, but I don’t know of any. The principle always is preserve and protect the life of the mother and the baby.”

Byrne has the distinction of being a pioneer in the field of neonatology, beginning his work in the field in 1963 and becoming a board-certified neonatologist in 1975. He invented one of the first oxygen masks for babies, an incubator monitor, and a blood-pressure tester for premature babies, which he and a colleague adapted from the finger blood pressure checkers used for astronauts.

Byrne emphasized that he was not commentating on what the woman’s particular treatment should have been under the circumstances, given that she is not his patient.

“But given just pulmonary hypertension, the answer is no” to abortion, said Byrne.
02:32 AM on 06/27/2010
Jacob, you have been misled, Bishop Olmsted did NOT excommunicate Sr. McBride. His letter makes NO reference to anyone, rather a general "If a Catholic formally cooperates ... they are automatically excommunicated by that action."
http://www.azcentral.com/community/phoenix/articles/2010/05/14/20100514stjoseph0515bishop.html
Just one sentence in an entire letter explaining Church teaching. Many sites did link excommunication to Sr. McBride, notably Life Site News http://www.lifesitenews.com/ldn/2010/may/10051712.html but this attributes a connection Bishop Olmsted himself did not make. Life Site News twisted statements in an article by Arizona Republic that itself published a misstatement:
"A Catholic nun and longtime administrator of St. Joseph's Hospital and Medical Center in Phoenix was reassigned in the wake of a decision to allow a pregnancy to be ended in order to save the life of a critically ill patient.
The decision also drew a sharp rebuke from Bishop Thomas J. Olmsted, head of the Phoenix Diocese, who indicated the woman was "automatically excommunicated" because of the action."
http://www.azcentral.com/news/articles/2010/05/15/20100515phoenix-catholic-nun-abortion.html#ixzz0s21jglZM
Life Site News merged the two paragraphs to maintain that the excommunication applied to the nun, when it in fact applies to the woman having the abortion. And, Sr. McBride resigned her post voluntarily, not forcibly reassigned as Arizona Republic suggests. Any debate is being invented by Life Site News and their anti-nun agenda.
04:22 AM on 06/13/2010
If I am a fetus, I want my mom to be taken care of by a real Catholic Hospital, because they strive to take of me and my mom.
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DarcieRN
can't get an acceptable microbio
11:54 PM on 06/13/2010
I think you have the reasoning ability of a fetus.
At a 'real' Catholic Hospital, they "strive" only to promote their belief system, which means that the fetus inside of, and dependent on, a woman's body, is important, whereas a living, breathing, walking woman with relationships, beliefs, hopes...she doesn't count when it comes down to it. That's it, on the surface.
Underneath it all is fear of women, and power.
The catholic church has long feared women and the hierarchy has long had a need to keep women in subservient positions, any way that it can.
So yeah, I could see where you'd want women to go to a catholic hospital, if it's all about power and forcing your religious beliefs on others in a very personal and life-threatening way.
02:17 AM on 06/28/2010
Were you a fetus too?

Of course they not only take good care of the patients, but also promote the best belief system, human dignity and eternal life.
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Anya Khan
06:09 AM on 06/08/2010
If you can't accept the doctrine which runs the hospital, don't go there. This is not rocket science. Catholic hospitals don't perform abortions, don't provide birth control, don't sterilize.
As a Catholic, I don't however, believe we should take federal or state funds-at all. We follow Chr*st, and can't expect the government to pay for our beliefs.
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DarcieRN
can't get an acceptable microbio
12:01 AM on 06/14/2010
Good thing to read older postings, where it is explained that in many regions of the country, there is no choice. Unfortunately, in these areas there IS no hospital where medical science trumps supernatural beliefs that are twisted around to make it ok to murder women in order to save nonviable fetuses.
And no, a fetus is not a baby. And neither is a zygote. And sorry, but if it's in a woman's body, gee, guess who gets to make the decisions? And that REALLY riles you, doesn't it?
09:19 PM on 05/23/2010
I cannot believe this is happening in this country. To be fair, I live in the Northwest and have had excellent care in the Catholic hospitals in Oregon and Washington. However, I am not Catholic, and am beyond child bearing years, so have not faced the consequences of this article. I do not have a problem with the Catholic religion per se, but I do have a deep seated problem with the male hierarchy and their need to subdue and extinguish women and their rights. How is it that the pedophile priests are absolved, but the life of a mother (of five children needing a mother) can easily be disposed of in one of their morality edicts? It is long overdue to shake up the good old boy bunch of hypocrites and get a religion ready to exist in the 21st century, not the 15th! Male domination needs to be addressed, broken up, and get out of mid-evil mentality!
04:55 AM on 06/13/2010
Dear Rita,

Pedophiles sneake into the Church is a misfortune.

An 11-week old baby is a human being in the 15th century. Another 11-week old baby in the 21th century is also a human being. Not changed, and the way to deal with it shouldn't be changed.

To learn Catholicism, please visit: http://wordonfire.org/Home.aspx

To know St. Rita, read: http://en.wikipedia.org/wiki/Rita_of_Cascia
or other Catholic side.

John
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Erica Anderson
07:05 PM on 05/20/2010
I just had a great idea. Why not privatize all Catholic hospitals and then have all the people are against health care reform go there for their health care needs while we get the public hospitals who won't deny women services because of a bunch of superstitions and fairy tales?
12:17 PM on 06/12/2010
You alway have choice. But is is wrong to choose to kill innocent human life.
01:25 PM on 05/20/2010
I learned a valuable lesson from my mother, never go to a catholic OB GYN and never go to a catholic hospital. My mom had a troubled pregnancy, almost from the beginning, after 3 healthy normal pregnancies. She was seeing a catholic Dr. who gave her DES to artificially preserve an otherwise unhealthy pregnancy. It almost killed her. considering that 1/4 of pregnancies end in miscarriage and she had already had 3 normal pregnancies, the wise course would have been to let nature take its course. Not sure what the circumstances were in this situation, but she shouldn't have gone to a catholic hospital or transfered once the prognosis was known. Why couldn't St Joseph's just transferred to her to a hospital where she could have the procedure done??
12:20 PM on 06/12/2010
You have thank the Dr. who saved your younger sister/brother, and kept your mother alive.
06:45 PM on 05/19/2010
What century are you living in? Medical science has been able to save untold numbers of pre-term babies who would have died in utero or after birth. Isn't that remarkable? And women who could never conceive are able to do with today's knowledge. But doctors don't have the answers for everything obstetrical; women die in labor - particularly if they are very young, older, or living with illness. So you believe if they get pregnant, no matter how that happens, they should gamble on their life and on that of the fetus? How screwed up is that?
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lisalulu
I stand for Planned Parenthood.
01:53 PM on 05/18/2010
Mr. Olmsted has a reputation as a particularly stone-hearted and intransigent figure, even by the orthodox standards of Vatican hierarchy. He previously gained notoriety for refusing communion to a ten-year-old autistic child who could not swallow and later spearheaded an effort to incorporate local church parishes individually in order to shield the Phoenix archdiocese from suits by sex-abuse victims"

Gee I wonder what J.C. would think or say to this faux priest. The only good thing about the Catholic religion (not church) is the reverence of Mary; Mother Mary spoke through this nun's compassion.
02:00 AM on 06/13/2010
You don't call a person trying to save human life "Stone-Hearted".

The parents who kill their one babies are stone hearted.
01:33 PM on 05/18/2010
I don't understand why they take go in such extremes by excommunicating someone who made a decision to save a life while being so feeble in protecting their church members from deviant, repugnant priests.

Scenario 1: Mother lives, baby dies. (1 life saved)
Scenario 2: Mother dies, baby dies. (0 life saved)

The Catholic Church doesn't seem to have a knack at accounting, that is probably why many of them are facing financial problems.

It cements my belief that the majority of the nuns are the one who is doing God's work instead of the males.
11:51 PM on 05/18/2010
Scenario 1: Mother may live with knowledge she killed her baby; baby is killed and is killed before it otherwise would have died naturally; doctor participates (forced to participate?) in the intentional killing of a human being
Scenario 2: Mother may die; baby may die

Food for thought if accounting is everything:
Scenario 1: Terrorist is tortured: city is saved
Scenario 2: Terrorist is treated humanely; city may blow up killing thousands

Also, what is the value of each second of a persons life? Who are you to set that value? Utilitarianism opens up a pandoras box.
12:47 AM on 05/19/2010
Did it occur to you in your second scenario that letting them both die may be akin to forcing a doctor to allow in the unnecessary death of a human being and that this may be just as or even more abhorrent, from his or her perspective, as performing the abortion? In the latter case, there would be two deaths on the doctors hands rather than everyone dealing with one.

Given the fact that everyone consulted agreed that the abortion should be performed, apparently the thought of losing both the mother and child was far worse than performing the abortion.
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DarcieRN
can't get an acceptable microbio
11:02 AM on 05/19/2010
Best scenario: mother is human adult who happens to be female but is allowed to make own personal private medical decisions with informed consent. Based on her own personal private beliefs. Based on her own private personal beliefs - that's the key here.

Whatever happens, the key is: based on her own private personal beliefs.
If the fetus dies, the woman deals with that knowing she made the best decision she could based on informed consent and in line with her private personal beliefs.
If the woman dies, her family deals with that knowing that she made the best decision she could based on informed consent and in line with her private personal beliefs.
If both die, again, family deals with that knowing that at least their loved one knew everything about her medical condition and made the best decision she could based on informed consent and in line with her private personal beliefs.

That's the only scenario that should be happening at all, in any hospital, for any condition.
12:30 PM on 05/18/2010
It's a rather perverted religion that believes in a deity who would "damn" a woman for saving her own life or damn a physician for saving her life. Perhaps certain religious people should reflect on whether they have faith in their god, or if instead they've been misled to abandoned faith in their god and replace it with faith in self-righteous old fools who have enabled atrocities while prancing around in red pumps and claiming their own sort of divinity.
12:07 PM on 05/18/2010
The Church, as much as I hate it for being corrupt and for protecting a bunch of criminal pedophiles, is entitled to its opinion, and if they operate a hospital in Vatican City they can apply whatever rules they want to their patients.

However, in America we operate under the rule of law. The law in this country states that you are not allowed to force a woman to continue a pregnancy that will kill her if she makes the decision to terminate it. The Church may not like it, but if they want to play in our country, they have to play by our rules. If they don't want to do that they can pack up and leave, and I say good riddance. Close down all your church hospitals, shut down all your churches, and go back to Rome where you can live your lifestyle of pedophilia and intolerance. We don't need you.
11:56 PM on 05/18/2010
Rules allow physicians to not perform abortions. Who are you to force a person to intentionally kill an innocent child.
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DarcieRN
can't get an acceptable microbio
11:09 AM on 05/19/2010
I imagine you meant to say, "to kill what I believe to be an innocent child despite the fact that the woman may not believe that it is a child and despite the fact that the woman really should be allowed to make her own personal private medical decisions"?? Because you believe that what a woman should be allowed to do, and what personal private medical decisions she should be allowed to make ---should be YOUR decision, based on YOUR private personal beliefs?
Get over it.
Women now have the right to vote. Can't take that away now.
Women get to go to college. Can't stop that either.
So,,,,,,,,,,,,,,,going after something where you have some doddering superstitious authoritarians on your side? bully for you.
01:42 AM on 06/13/2010
How do you know that which paticular pregnancy will kill the mother?
What kind of nun, parent and doctor who work together to kill an innocent human life?
Are you once a fetus baby before?

If the Church you hare does not protect fetus you might not come to exist.
11:22 AM on 05/18/2010
Okay, help me do the math here. If a pregnant woman dies and her non-viable 11-week old fetus also dies, how many lives have been saved by refusing to perform an abortion?
11:59 PM on 05/18/2010
First, your premise makes the assumption that we can predict these things with a moral certainty. Last I checked we cannot. Some healthy pregnancies result in death. Some troubled pregnancies result in both surviving. The only moral certainty here is that by performing the abortion you have killed one life. Also, a morality of the ends justifying the means can result in massive atrocities.
12:49 AM on 05/19/2010
Moral certainty is far less precise than scientific and medical certainty. She had a disease that is fatal on its own, and the pregnancy would have killed her. That's why they went through with the procedure. It doesn't take a rocket scientist to figure this out.
07:33 PM on 05/19/2010
Just say it doesn't matter. Women's lives are cheap. Because otherwise you cannot convince me that this is not abuse of women.
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DevonTexas
Eternal Optimism
10:57 AM on 05/18/2010
'Mr. Olmstead declared that the nun was "automatically excommunicated" '
How Middle Ages!!

The Catholic Church: Putting politics before healthcare!
11:59 PM on 05/18/2010
That assumes the intentional killing of a life is healthcare.
08:38 AM on 05/19/2010
Antibiotics are used to kill bacteria.