What If Bishop Olmsted Had Been the Decider?
I have a post below on technical issues of moral theology on whether St. Joseph’s Hospital in Phoenix actually participated in an “abortion” in the sense condemned by the Catholic Church.
Here, I’d like to raise a distinct and hypothetical set of issues: What would have happened if it had been Bishop Olmsted rather than Sr. McBride making the decisions? It seems that: 1) the patient was admitted on an emergency basis to the hospital, and 2) was too ill to be moved–not only to another hospital, but even to an operating room. The Bishop has stated that were he in a position to make the decision, the operation wouldn’t have been performed. Both mother and baby would have died. I’m not sure he would have agreed to transfer a patient–which might on his view also count as formal cooperation with evil. In an case, it appears that if the transfer had been attempted the mother and baby likely would have died.
If this is the case, what would follow from the perspective of secular law?
1. Would there be civil liability? While normally, there is no duty to rescue or to save another person under American law, such a duty does exist if there is a special relationship between two parties– a parent and child, a husband and wife, and a doctor and patient, and a hospital and patient. By taking the patient in, the hospital normally a relationship that would be the basis of a requirement to provide competent care. In refusing to perform the procedure, would the hospital be guilty of negligence or even gross negligence?
2. Would there be criminal liability? In some states, Christian scientists and scientologists have been charged with criminal neglect with failing to provide care to patients in accordance with customary standards of care. Would that be possible here? Or would there be a possible homicide charge , such as involuntary or even voluntary manslaughter? (Dr. Conrad Murray, Michael Jackson’s doctor, is charged with involuntary manslaughter.)
3. Would the hospital’s good standing under the Medicaid and Medicare programs be affected? It seems that the patient was brought to the emergency room of the hospital, which holds itself out as capable of treating emergencies. EMTLA requires such hospitals to treat patients to the best of their ability to stabilize them before transferring them. So transferring this patient before she was stable wasn’t an option.
4. Would the hospital have jeopardized its accreditation status with private accrediting bodies, such as the Joint Commission on Health Care Organizations?
5. How do questions 1-3 (and to a lesser extent, 4) interact with conscience protections, such as the Church Amendment, which protect the right of religiously affiliated hospitals not to perform abortions–and don’t seem to make exceptions for emergency situations? Here’s a nice (although slightly outdated) summary of federal protections. Do these and or state protections modify the standard of care that is due under civil or criminal law?
These are very tough questions. Any health care or tort or criminal lawyers out there?
Tags: Olmsted
I handle medical malpractice litigation in New York. Unless the courts recognize a religious/conscience exception (which I doubt), the hospital’s refusal to perform an abortion, recognized as necessary to save the mother’s life, followed by the mother’s death, would certainly lead to tort liability and probably even to punitive damages. The hospital or other defendant would have had to pay the punitive damages personally, not the insurance company. The New York State Department of Health would also investigate the hospital and doctors, jeopardizing their licenses.
All these consequences would follow from a decision that, judging from the controversy, is apparently quite debatable under either Roman Catholic moral theology or Roman Catholic canon law.
Bishop Olmstead’s rigidity reminds me of the tailors of Laputa in Gulliver’s Travels, who used mathematical instruments instead of flexible tape measures. His views and actions result in judgment as ill-fitting as Laupta’s clothing.
Full disclosure: I have stopped attending the Roman Catholic Church and am now attending an Episcopal Church. I cannot see returning as long as the RCC is a place where moral theology by the supposed teachers (as the RC bishops never cease to remind the flock) leads to such monstrously immoral results as in Phoenix.
Excellent reformatting of the issue to force us to think, Prof. Kaveny. On your other blog, I posted my experience with a large Catholic hospital system headquartered in Dallas. My friend is the SVP of Mission & Ethics.
You raise a number of issues that would jeopardize a hospital’s licensure, accreditation, etc. Allow me to position this in another way – this Texas system has a number of hospitals that historically were Catholic (founded by sisters) but are also the county hospital (only hospital in the couny or within hundreds of miles). This has required the Catholic system to devise “workarounds” – so that the single hospital can meet Catholic moral requirements while at the same time meet state,county obligations/laws in terms of providing service to any patient. So, applied to Phoenix, these catholic/county hospitals would provide the abortion procedure via non-Catholic doctors (of course, the patient may also be non-Catholic and Olmsted would never have been involved). But, at times, a Catholic patient may opt for a morally unacceptable medical procedure (the ethics board lays this out but ultimately it is the patient’s decision). The bishop or diocese/church is assured that catholic moral policy has been followed by the hospital but the patient made their own decision. Thus, the hospital/VP of Ethics is not in jeopardy.
In the Olmsted/Phoenix situation – well, there were other hospitals; but this was an emergency and patient could not be safely transitioned. Patient was a catholic but also got approval from the ethics board. So, would agree that the hospital met various civil society laws – the family could have sued if the mother had died? the bishop potentially could have been sued (actually, this might be a good thing in order to force bishops to seriously consider the cost of their moral theology and they way they interpret and apply it. Does the bishop want to be aligned in the media with scientologists; does the church want its moral theology to be compared or likened to scientology? Well, Olmsted’s decision to make this public lays the foundation for this). The hospital also will not be questionned by associations, state boards, federal HHS because of their actions.
Difficult questions, Prof. Kaveny. As one who works in the behavioral health field with a wife in the medical health field, do not agree with Olmsted’s interpretation. The duty of the hospital, MDs, staff is to support life – how was sister’s decision with a board any different than an emergency triage MD who has three serious patients at the same time and must make a decision to treat the two or one who most likely will survive knowing that the second or third cases would take too many resources, staff, time and thus impact or cause the deaths of the other one or two patients?
Like Mr. Pagano and others who have interpreted section #47 of a document that I suggest is faulty to begin with, this was about “intent” – not sure I would call this an abortion; it was a life-saving medical procedure.
This case is so painful, and no doubt making a public example of it is utterly idiotic for the pro-life cause – whatever one’s view about the casuistry, the case is as extremely difficult as such cases can get. So this public tarring-and-feathering is really inappropriate.
But in the post above, you suggest various details of the case – can you indicate where those are from? I found the following newspaper report of the case, which seems ambiguous:
The actions involving the administrator, mostly taken within the past couple of weeks, followed a last-minute, life-or-death drama in late 2009. The patient had a rare and often fatal condition in which a pregnancy can cause the death of the mother.
Sister Margaret McBride, who had been vice president of mission integration at the hospital, was on call as a member of the hospital’s ethics committee when the surgery took place, hospital officials said. She was part of a group of people, including the patient and doctors, who decided upon the course of action.
The patient was not identified, and details of her case cannot be revealed under federal privacy laws.
Read more: http://www.azcentral.com/arizonarepublic/news/articles/2010/05/15/20100515phoenix-catholic-nun-abortion.html#ixzz0oazzfEyG
While the case is described as “life-or-death,” and your post above indicates that the patient could not be moved and would have died imminently, I am not quite sure how to square that with the consultations mentioned above. Perhaps we simply cannot know this (and this, to my mind, is all the more reason for a bishop to act discreetly, rather than in this public way), but certainly the analysis looks different depending on the actual circumstances.
According to one article I found, the condition mentioned is serious, but also often results in a successful birth – however, this is not a matter of being rushed to the emergency room. The article – at http://www.ncbi.nlm.nih.gov/pubmed/11974533 – suggests a mortality rate of 30-34%. However, I’m just a moral theologian, not a medical expert. Surely the details of this case would be relevant to the discussion about intention had in the prior post, as well as issues of liability.
I got the facts from here: http://www.npr.org/templates/story/story.php?storyId=126985072
After reading your details of this sad emergency. I say the bishop making his ‘pronoucements’ of the procedure and his condemnation of the religious sister public is stupid. It is similiar to the Brazil case of the abortion of the very young girl impregnated by her father. This resulted in the hierarchs arguing across oceans about what to do.. .Do they love ink so much they must intrude in any way they can? As was said 55 years ago to another ink whore. . “have you no shame’?
If Bishop Olmsted was the decider, the risk of civil and criminal liability would be very high.
However, he’d probably be able to avoid jail as did his imediate predecessor who was convicted of felonies for henious conduct resulting in the death of a human being.
Oddly, this doesn’t seem to bother Bishop Olmsted too much: “Bishop Thomas Olmsted, the diocese’s new leader, said O’Brien has an open invitation to participate in the church and would be welcome to celebrate Mass.
“I am relieved and grateful that Bishop O’Brien will not be going to jail,” said Olmsted, who said he continues to pray for Reed’s family as well.”
No sanction, no excommunication.
Thanks Prof. Cathleen Kaveny for your insights and work on this – truly the work of the Holy Spirit.
I think the 5th commandment obliges us to save those lives we can, provided that is done by licit means.
Assuming that the operation really was necessary to save the mother’s life, it would appear that refusal to perform the operation would be a violation of the fifth commandment.
The nun in question would then be a pro-life hero – she did what she could at huge personal cost to save the life she could.
Thank God we have nuns like her in the Church.
One can certainly see the signs of the Holy Spirit of Pentacost at work here in the Church, correcting Catholic Fundamentalism by forcing us to face difficult real life situations; very often the way the Holy Spirit guides the Church into the fullness of truth.
God Bless
I’m not sure he would have agreed to transfer a patient–which might on his view also count as formal cooperation with evil.
How could he not, if the mother or someone else acting on her behalf demanded it?
It seems as if there’s a kind of knee-jerk paternalism at work here, in which the patient is presumed to lack the competence to make informed decisions of any sort.
There are numerous complexities, but first and foremost, Olmstead isn’t a doctor or a medical professional of any kind, and he also is not — so far as I know — “in charge” of the hospital in a formal organizational way. So I actually think that Sister McBride, doctors, etc., would have had no choice but to ignore him in deciding what to do for a PARTICULAR patient, and take the consequences.
Let us say that Olmstead was the head of the ethics committee and refused to allow intervention based on Catholic principles. Assuming that the patient wants the intervention (as Antonio points out, she does have a say in the matter), then he would again have no choice but to make transportation, etc. available to her even if at that point it is futile. In this regard, it’s not that different from a community hospital looking at a desperate injury it simply doesn’t have the resources to treat. It has to do the best it can. I think if they refused on grounds of material cooperation to provide transportation, they would face potentially extreme liability. It just isn’t, in the end, their decision about what medical treatment this woman is allowed to accept, and they are not being asked (at that point) to actually provide it.
If there really is no chance of transportation, and everyone standing around realizes that the Olmstead panel has just basically decreed this woman’s death, and he is the person in charge? Well, I would hope for the existence of a doctor who looks around and says “I can get another job but this woman can’t get another life,” and ignores Olmstead.
And if they are really precluded from acting and just stand around doing “what they can” but not what they need to — yes, in some states I think there would be potential liability, if for no other reason than most people simply have no fair warning that won’t have available to them lifesaving care.
If someone willingly goes to a Catholic hospital because they want to make sure they only get health care in conformance with the directives, that should always be their choice. But if you are only trying to reach the closest facility then you shouldn’t be forced to limit your treatment options because, essentially, of the luck of the draw of non-medical factors. It’s hard for Catholic hospitals to finesse this because the average person does not understand what treatment they might need, what the hospital will and will not do, and might not have any other option any way.
What “should” happen is that Catholic hospitals would be very up front with people about what cases they shouldn’t be expected to take — and this might work for the EMT crews, who know to take an ill and pregnant woman somewhere else. But it’s hard to see how it would work with individuals who don’t deal with hospitals day in and day out. I think requiring the work around (non-Catholic personnel willing to carry out a patient’s clear wishes) is the only fair thing for emergency facilities, in life and death situations.
I imagine there would be some means of overruling this decision–I am not familiar with Arizona law but I would be surprised if it allowed the ultimate authority on this type of question to be vested in an individual not licensed to practice medicine.
What “should” happen is that Catholic hospitals would be very up front with people about what cases they shouldn’t be expected to take — and this might work for the EMT crews, who know to take an ill and pregnant woman somewhere else.
Assuming, of course, there is a ‘somewhere else’ and that the EMT crew is capable of diagnosing such conditions to begin with.
“While normally, there is no duty to rescue or to save another person under American law, such a duty does exist if there is a special relationship between two parties– a parent and child, a husband and wife, and a doctor and patient, and a hospital and patient.”
Cathy –
Questions of the rightness of killing mother or child aside, if the hospital=patient relationship is similar to the parent-child relationship, I would think that the hospital has such a relationship with *both* the mother and child, If this is so, then the hospital has an equal duty to both. But the hospital is limited by the facts to two alternatives: save one rather or let both die.
I suppose a fairness theory (treat all equally) would say it would be fair to let both die, but it would also it would be equally *unfair* to let both die. (Or would it?) So how to choose one fairly? So should a coin be tossed? (What a repugnant idea!) But I don’t see how trying to reach a rational conclusion by a the random/irrational means of tossing a coin can be a rational way of determining one’s duty. On the other hand, there are two sides to a coin, so maybe the act would not be totally irrational.
(A case from fairness might be made that if the child were viable, then, not having lived an equally long time as its mother, fairness might require that it be given a chance at a longer life — something like the Eskimo grandmother on the ice floe argument. In other words, the rights to life of mother and child are not equal, so the child ought to be chosen. But in this case there has been no talk of the child’s possibly living.)
In other words, how can a hospital’s duty to each be equal when the consequences resulting from its choices cannot be both equal and rational? Or should we be talking about *equal* duties at all? Or about merely fair actions?
IT seems to me that a health care provider should be allowed to do only what he/she chooses to do *IF* he/she does it well and makes it known to the public that his/her practices are limited. In fact, this is exactly what chiropractors do: perform a limited number of procedures for a limited number of health problems. As I remember, in the olden days there were hospitals that were exclusively for obstetric purposes — no heart, lung, etc. problems accepted.
So Catholic and other religious hospitals should not be discriminated against when they do not choose to do abortions. Therefore, they should not be held liable for not doing them if they make it clear to the public that they won’t. (I am an extreme conservative in this regard.)
MEP –
If non=doctors should not be allowed to make medical decisions, why is it reasonable to expect doctors to make difficult philosophical/ethical ones? Theoretically, of course, bishops are supposed to be experts in moral matters, but unfortunately STDs don’t always make them so.
It’s the whole educational system that needs repair, with the notion of competence being restored to all forms of higher education. (See MacIntyre’s recent book.)
IT seems to me that a health care provider should be allowed to do only what he/she chooses to do *IF* he/she does it well and makes it known to the public that his/her practices are limited.
That assumes the hospital makes it clear exactly what procedures are considered abortive — particularly in the case of ectopic pregnancies, not all of which involve the fallopian tubes, by the way, and may thus require directly killing the fetus.
Incidentally, I think the good Bishop Olmsted should be willing to set an example by attending any woman so afflicted, should she submit to his authority and decide to let nature take its course.
If non=doctors should not be allowed to make medical decisions, why is it reasonable to expect doctors to make difficult philosophical/ethical ones?
Because, unlike non-doctors pronouncing on the ethical or moral considerations of a medical situation (that someone else must deal with), they have the expertise to render a valid medical opinion and are held acountable for the consequences. Regardless of what anyone else says, they can’t avoid confronting the moral issues and the dictates of conscience.
…if the hospital=patient relationship is similar to the parent-child relationship,
But it’s not, of course. The patient does not surrender her autonomy when placing herself in the care of a medical provider.
Antonio –
I”m not denying that doctors have no role in such moral decisions. Indeed, they are the ones who can say what the medical facts are. But they are not usually qualified to say what the relevant moral general principles are. That’s why there are ethics committees.
My point was that if the doctors are the ones who determine the facts of a case, it is because they are the ones competent to determine the facts. A fortiori, the moral experts are the ones who are called on to determine the applicable moral principles because they are the ones who are competent in ethics.. It was a sauce for the goose sort of argument, in other words.
Antonio –
The hospital-patient relationship is similar, though not identical to the parent -child relationship. The hospital has a duty to care for the patient, but the patient, unlike a child, has a right to reject the decision of the hospital, if, of course, the patient’s decision does not entail the patient’s determining that the hospital shall do something it did not agree to do from the beginning.
Thanks, Cathy, for the information.
It seems to me that, quite apart from the complex casuistry that one might have to apply to this case one way or the other in order to determine it in the objective sense, the situation that presented itself was sufficiently complicated that those involved (including Sr. McBride) likely did not intend the act as a abortion, and therefore (even if they “sinned” in an objective sense – that is, they decided the case wrongly) would not incur the penalty of excommunication that the bishop has so publicly announced. According to the EWTN website:
“NOTE WELL To actually incur the excommunication one must know that it is an excommunicable offense at the time of the abortion. Canon 1323 provides that the following do not incur a sanction, those who are not yet 16, are unaware of a law, do not advert to it or are in error about its scope, were forced or had an unforeseeable accident, acted out of grave fear, or who lacked the use of reason (except culpably, as by drunkenness). Thus a woman forced by an abusive husband to have an abortion would not incur an excommunication, for instance, whereas someone culpably under the influence of drugs or alcohol would (canon 1325).” http://www.ewtn.com/expert/answers/abortio2.htm
I think it is safe to say that, even if the Bishop and his ethicist are convinced that Sr. McBride offered mistaken counsel, she was “in error about its scope.” It may be (on his view) the responsibility of a bishop to clarify publicly that such an erroneous application was made. But the penalty of excommunication obviously assumes all the usual criteria for “mortal sin” – criteria that involve an assessment of subjective knowledge and consent. If the act subjectively does not involve full knowledge and full consent, then it is no mortal sin (even if it is wrong), and there is no penalty of excommunication. The woman, already a mother of four children, stuck in an emergency room with doctors telling her she is going to die, and with a nun authorized by the hospital telling her that this procedure is OK under the directives – CLEARLY the woman is not excommunicated. But unless the Bishop believes that Sr. McBride actually assessed the case, realized that it was wrong and not morally acceptable – that it was an abortion, and then went ahead and counselled the woman to have the procedure done, then Sr. McBride is not excommunicated. (I mean, if Grisez and Rhonheimer, with all their technical skill, make a case for this not being wrong, then it’s a pretty heavy burden to place on someone in a general hospital to assume that they knew this case to be an abortion, in the full, intentional sense of the word!)
Am I wrong about this? Because it then appears that the Bishop and his ethicists are not very good “legalists” at all. Maybe they are culture warriors disguising themselves as faithful Catholic legalists?
I think that’s right, David. By it’s very nature, culture war mentality is disinclined to casuistry–; culture warriors prefer the language of prophetic indictment.
And sometimes they take technical terms of moral theology and turn them into prophetic terms–like the term intrinsic evil, or cooperation with evil.
I don’t know who her canon lawyer is, but I hope she has a good one.
Given what I know from this and previous posts, it seems the determination of the “morally right thing to do” is complicated, to say the least. There may not be “one right answer” acceptable to moral ethicists with access to all the facts of the case.
What perhaps has been overlooked (and lurks in the shadows) is the sense of community, in this case, the larger Catholic community of the Phoenix diocese. What do “the people” think about the outcomes, i.e., the surgical procedure to save the woman’s life and the bishop’s pronouncement that the sister has incurred automatic excommunication?
Did Sister McBride offend the moral sensibilities of the People of God in the diocese? Did she bring discredit on their church? Taking cues from the New Testament, what would be the outcome if the bishop, as the initial “confronter”, were to present his case for excommunication to two or three additional members of the community and if they were to ultimately bring the matter before the entire community? Would the local church decide that Sister McBride’s action merits excommunication?
In a very real way, these questions seem to reflect a different, but nonetheless legitimate, application of the principle of collegiality at the local level. Where is the opportunity for community input on such a difficult and emotionally charged issue? With no disrespect intended toward moral ethicists, might we not see them as advisors not only to the bishop but also to the larger community of which he is head?
It seems to me that Bishop Olmsted was “shooting from the hip” in light of what I’ve read here and elsewhere. Should excommunication be decided by one individual or by the whole community?
I”m not denying that doctors have no role in such moral decisions. Indeed, they are the ones who can say what the medical facts are. But they are not usually qualified to say what the relevant moral general principles are. That’s why there are ethics committees.
But is that what’s happening. It seems to me the individual doctor is not making a sweeping philosophical assessment that applies to all persons for all time. Rather than usurping the role of the philosopher, she is applying those principles to a specific case in all its uniqueness. As I see it, like any other moral actor, her conscience then comes into play in the matter. Isn’t that what we do every time we make a moral decision in a specific case?
From all these posts, i think Antonio and the original post from Eugene offer the most reasonable assesments of the complexity of both the various actors in the process and the process itself.
As to the Bishop, I think he quickly overreached and there are some who are knowledgeable about Phoenix who wonder about his judgement.
Interesting question. If Bishop Olmsted had been the decision maker, and if the patient had been physically capable of tolerating a transfer to a non-Catholic facility, would Bishop Olmsted have been guilty of forcible detention if the patient or her designated health care proxy approved the move and the Bishop refused it on the grounds that moving her would be complicit with abortion?
The Church’s current position on ectopic pregnancies appears to be: ok to remove the fallopian tube with the ectopic pregnancy in it, not okay to instead use microsurgery to remove the embryo and leave the fallopian tube intact, not okay to use a cancer drug to dislodge the embryo, ok to remove the embryo growing on the outside of the uterus (without removing the uterus) or growing somewhere else within the abdominal cavity. Medically and scientifically, this doesn’t make a whole lot of sense. In the case of a tubal ectopic pregnancy, it is not the fallopian tube that is the direct threat to the woman’s life — it is the growing embryo. Once you’ve decided that removing the embryo is acceptable, why does it matter whether you take the embryo with or without the fallopian tube? Maybe the good fathers of the church feel better in thinking that the fallopian tube was somehow the problem, and the embryo just “comes along” with the fallopian tube, but science doesn’t support that. And what of the extra-uterine embryos that implant outside the fallopian tubes? There isn’t anything much to remove other than the embryo and the placental attachment, unless the embryo has conveniently grown into some structure like the appendix.
In my mind, there is a huge gulf between a termnination because the woman didn’t want — for whatever reason — to continue the pregnancy, and a mis-implanted embryo that has no potential for life and is virtually certain to cause the death of the mother if not removed. The first is an elective abortion. The second is not. The choice of which surgical or drug method is used to eliminate the embryo in the second case seems inconsequential.
In my opinion, the magisteria draws the line the way it does for political reasons. Once you concede that the notion of intent relies a verbal distinction rather than the fig leaf of a physically-based distinction, the whole doctrine begins to unravel.
Olmstead lays down the law
http://www.catholicsun.org/2010/phxdio-stjoes/Q-AND-A-ST-JOSEPH-HOSPITAL-FINAL.pdf
And then of course there are the health care providers, who, believe it or not, don’t quite see it the same way.
http://www.rhrealitycheck.org/blog/2010/05/17/when-catholic-care-isnt-care
About 250,000 catholic women have abortions in the USA every year. According to Olmstead they and anyone who assisted in any way is excommunicated.
I wonder how many of them have sought to get back “into communion” with the Church.
I wonder how many un-excommunicated catholics there are left?
So much for freedom of expression dot.commonweal
I am unable to change my name on .commonweal. I hope the other Michael who posts here is not unfairly tainted by mine. Michael Gonyea.
Bishop Olmsted comes across as heartless.
His official biography, besides factual information, states that he “has been deeply influenced by the witness and wisdom of Blessed Charles de Foucault”, and that his “interest in nature and rural life continues, while his many years in Rome have fostered a devoted loyalty to the universal church”.
It might be good if those on this blog who know the writings of Charles de Foucault found choice quotes with which to awaken in him a more compassionate attitude.
Cathleen, by all accounts, is less than fair. Your comment, is wise Claire.
Good lord.
Michael, I didn’t delete your comment, if that is what’s going on. I have no idea what you said. I’ve been reading seventeenth century pamphlets of Puritan sermons all day and am just checking back in now.
As a general rule, I tolerate a wide variety of opinions but not insults or ad hominem arguments. Those are the ground rules–fair or not.
Good night all.
Ann, I don’t think it’s useful to liken the physician patient relationship to a parent child relationship. It simply confuses the issues. Just for instance, parents are not required to fully inform their children about the choices they have — indeed, the hallmark of parent child is that the parent has very wide latitude in making decisions and can only be stopped when they cross the line into abuse or neglect.
The physician is required to be competent professionally so that advice he or she gives is up to par, medically speaking, is required to fully inform the patient who has the final say of what is in their best interests, and cannot “abandon” a patient during the course of treatment. Most patients probably do follow the advice of physicians as to what is the “best” way to proceed, the way children follow parents, but that’s because of the wide gap of knowledge between them, not the nature of the legal relationship.
In the case under examination, the bishop would essentially assert his role as if he were a parent and usurp the normal physician patient relationship so that neither is free to act in ways that they might deem to be in the best interest of the patient. I won’t revisit what I said previously, but I do note that the bishop makes the same logical flaw that I believe significantly undermines the soundness of the Catholic doctrine:
“Second, the mother’s life cannot be preferred over the child’s. Both lives are equal, both have an
eternal soul and both are created by God. No one has the right to directly kill an innocent life, no matter
what stage of their existence.”
Desafortunadamente, there is a big difference, one that IMHO is morally relevant, when one of those beings is totally physically dependent on the other for their continued existence. The failure to acknowledge and grapple with that difference is willful and ultimately demeaning to women.
When he came to Phoenix, Olmsted told his priests that he IS accounatble; but not to priests and not to people of God, but solely to Vatican.
Michael Gonyea: I’m not sure where you got the impression that you were free to say whatever you wanted on dotCommonweal. You’re not. And I will continue to remove posts in which you call someone an idiot, or some such epithet.
That goes for everyone. We won’t allow this thread to become a forum for character assassination. Argue the merits of the case.
Since this topic is about, ‘What if Bishop Olmstead was the Decider?’ I have a question. This is directed to all and any who can answer it. If Bishop Olmstead was in charge of the ethics committee at St. Joseph’s Hospital, and he was on site at the time of this woman’s admission to the hospital—would/could he be arrested for not permitting any attempt to save her life?
In my mind, I understand all the arguments given above (as to the lack of viability of the
fetus—it could not exist outside of the mother’s body). But if Olmstead refused to permit the abortion (knowing that the mother would die), would/could this be construed as calculated, cold-blooded murder? Could he be held on a Murder #1 accusation? Just wondering.
Little Bear, that’s a very interesting question.
From the perspective of American law, abortion is a legal procedure. So lets look, for a minute, at another legal procedure. Say it’s a blood transfusion. If a hospital refuses to perform a blood transfusion on an emergency room patient, knowing that they would have wanted it and would certainly die without it, you’d at least have a case for a homicide charge–omission in the case of a clear duty with the knowledge that as a result of the omission, the patient would die. You’d have a good case at least for voluntary manslaughter, and maybe even for murder–where the mens rea very often requires foreseen consequence of death rather than the purposed consequence of death.
That’s why one would have to look at how the conscience clause would affect the analysis.
Here’s the other thing–by transferring Sr. Margaret, the hospital seems to have “repented” of the course of action that it took. Does this suggest that the next woman who comes in in this situation will be allowed to die?
And how does the AZ Department of Health look at this situation? I just cannot believe that this “repentance” won’t have licensure implications.
Little Bear, there are layers upon layers here. The most but imperfectly analogous case I can think of are parents who refuse medical help on behalf of their children. They are prosecuted in many states but usually for something less than outright murder. Here there is a very important difference: the bishop doesn’t stand in the shoes of a parent vis a vis his relationship with the patient. He has no special claim to make ethical decisions on her behalf — what he has is an ownership claim on the facility wherein she finds herself. Here are some premises to consider:
Under federal law, (EMTALA), hospital emergency providers have a duty to provide whatever care is required to stabilize a patient notwithstanding ability to pay.
Under federal law, health care providers have a right to decline to provide treatment that would violate their conscience. The scope of this “right” is hotly debated, but let’s assume that no individual is being asked to violate his or conscience and others with no objection stand ready to act.
All else being equal, the bishop has no right to prevent others from assisting a woman who wants to be helped by ending a pregnancy that is a threat to her life.
Within the confines of a Catholic institution, does the bishop have final legal say over what treatments can be administered notwithstanding the conscience objections of the patient and the hospital’s (presumably) non-Catholic staff, and their willingness, ability, and resources to provide the service?
Does the fact that the hospital hold itself out as providing emergency services circumscribe whatever rights the bishop in this case has — that is, no fair warning has been (and realistically, no fair warning could have been) provided to a patient who finds that she should have chosen Door Number 2 and gone the extra 10 or 20 minutes to a facility that would help?
In other words, to what extent does the conscience of the Bishop (standing in the shoes of the Catholic hospital, generally) override the conscience of the patient and those willing to help her simply because they are standing within four walls that are organizationally considered to be Catholic?
Little Bear, the more I think about this, the more I come down on the side of EMTALA: doing what is necessary to stabilize a patient, particularly if there are individuals for whom the help is ethically unproblematic. The notion that patients should be subject to ethical constraints imposed by providers during an emergency even if the provider could help is too disruptive to our notions of medical care and public access. It would be different if, for some reason, a hospital objects to cardiac surgery and so declines to develop the ability to even provide that service. But here, the hospital can do the service — it just chooses not to. At a minimum, I think licensure bodies have to think about how the interests of patients can be adequately protected through disclosure and so on, but this is exceedingly difficult.
Cathleen and Barbara,
Thank you both, for your excellent input. I believe that the questions raised in this case will require much thinking, meditating, and planning for all Catholic Hospitals. And maybe, this would also be points that the Bishops should consider as well.
Does the bishop’s Communications Office’s use of the word “murdering” have any legal ramifications?
http://www.catholicsun.org/2010/phxdio-stjoes/Q-AND-A-ST-JOSEPH-HOSPITAL-FINAL.pdf
It’s been a long time since I practiced health care law, but as I think about it, I think the biggest threat is the possibility of the Joint Commission pulling or qualifying accreditation–especially since it isn’t entirely clear that the Hospital is standing by its decision, which could threaten the next patient to present in this situation.
The Joint Commission is a private accrediting body which is extremely influential. Because it is private, it doesn’t have to worry about any “conscience clause” issues. And in some states, accreditation by the Joint Commission got a facility “deemed” to meet the standards of quality for licensure. In addition, many third party payor contracts–and even some cooperating provider contracts — are contingent upon both parties maintaining Joint Commission accreditation.
Catholic hospitals have always insisted that the ERDs are not inconsistent with good patient care–and that any conflicts can be solved by transferring patients to a different facility. The biggest long-term impact of this case could be that it reveals a gap between generally applicable standards for good patient care and at least some interpretations of the ERDS.
Long term, that’s not going to be good for Catholic health care.
Barbara, what do you think of the possibility of a Joint Commission investigation?
What’s special about health care that makes it Catholic? Is it just health care that happens to be provided by Catholics, or is it a different kind of health care?
If I go to a Catholic food kitchen, the food will be served by Catholics, but it won’t be different from food served in other places. If I go to a Catholic hospital, will I receive different health care? (Other that what we are learning from Bishop Olmsted, that women might be deprived of a life-saving procedure if it happens to involve abortion).
“If I go to a Catholic hospital, will I receive different health care? (Other that what we are learning from Bishop Olmsted, that women might be deprived of a life-saving procedure if it happens to involve abortion).”
———-
Your end-of-life directives will/may not be followed.
http://www.google.com/search?source=ig&hl=en&rlz=1G1GGLQ_ENUS257&q=bishops+direct+hospitals+to+use+feeding+tubes&aq=0p&aqi=g-p1&aql=&oq=bishops+direct+&gs_rfai=
Cathy, I don’t think JCAHO is completely unfettered here. You are right, it is private, but it serves in a semi-public role by providing “deemed” certification for Medicare purposes and in some cases Medicaid purposes. The Medicare program has its own certification resources, but it accepts JCAHO in lieu thereof. The ability/willingness of Medicare to accept deemed certification might be called into question if JCAHO adopts standards that would compromise conscience clause or comparable protections for institutions. This issue has already come up in the area of GME certification, where the entity that accredits graduate medical training in obstetrics adopted certain criteria that some Catholic hospital GME training programs objected to on moral grounds. There was litigation, but I don’t know what the outcome was. The issue was that the hospital didn’t provide training in the handling miscarriages if the service could be used to provide abortion in another context. In other words, no d&c even if treating a spontaneous miscarriage.
So I am afraid I don’t know the answer, but I do think the JCAHO would think long and hard about how to deal with this kind of problem and it might be subject to certain constraints. I agree with everything else you say.
My head is spinning there are so many issues involved in this case. I think it best to try to start with what seem to be the clearest assumptions of each extreme.
On the one hand the Catholic hospital policy makers assume that no hospital is required to provide all services to all people. They also assume that no evil must be done. (Hmmm. Is this a Hippocratic assumption? What kind of evil must not be done by doctors?). Abortion is an evil (the child dies). Therefore, abortion should not be done.
Catholic hospitals assume that only a limited number of services may be provided. Other medical facilities choose to offer limited services (e.g., eye clinics, chiropractor clinics, small hospitals, cosmetic surgery hospitals). Therefore. Catholic hospitals may choose to limit their services. Therefore, they may choose to not-provide abortions.
On the other hand, some argue that because the Catholic hospitals receive public money, those hospitals have an obligation to provide the particular service of abortion at least to Americans. This, ISTM, involves a whole philosophy of entitlement, which I dare not go anywhere near. But it needs to be asked: what entitles you to make demands on me? And vice versa. (Back to natural law theory?)
Some claim that because many patients in emergency situations present themselves to the CH and ask or demand abortions (given that the government is paying for them), that the CHs have an obligation to provide them.. (But how do you connect the dots between some government money and some women claiming a right to an abortions?)
My question: given government subsidies, how can Person A establish an obligation in Person B by *expecting* that Person B will do something for A? Especially when the second person (in this case the Catholic hospital) has already said it chooses never to do what Person A is expecting? How can an expectation establish a right?
I see the most fundamental problems this way: what are the moral and metaphysical grounds of obligations and entitlements? When must the dots between me and you necessarily be connected? Yikes, what a question.
I might add that if the Catholic hospitals have to go out of existence because they won’t do abortions, this is something like the moral quandary of abortion itself/ If the mother is to live, the baby must die and something is lost (the baby). If the hospitals must go out of existence for moral/legal reasons, then something is lost — all the other good that the Catholic hosopitals provide to the poor, including, possibly the mothers who had abortions before the demise of the hosopitals. Sad, sad, sad.
Possible future problem for the communities with Catholic hospitals: if the Catholic hospitals are destroyed, will what is lost by their communities be less, the same, or greater than what is lost when the mothers with problem pregnancies were turned away? My head is spinning there are so many issues involved in this case. I think it best to try to start with what seem to be the clearest assumptions of each extreme.
On the one hand the Catholic hospital policy makers assume that no hospital is required to provide all services to all people. They also assume that no evil must be done. (Hmmm. Is this a Hippocratic assumption? What kind of evil must not be done by doctors?). Abortion is an evil (the child dies). Therefore, abortion should not be done.
Catholic hospitals assume that only a limited number of services may be provided. Other medical facilities choose to offer limited services (e.g., eye clinics, chiropractor clinics, small hospitals, cosmetic surgery hospitals). Therefore. Catholic hospitals may choose to limit their services. Therefore, they may choose to not-provide abortions.
On the other hand, some argue that because the Catholic hospitals receive public money, those hospitals have an obligation to provide the particular service of abortion at least to Americans. This, ISTM, involves a whole philosophy of entitlement, which I dare not go anywhere near. But it needs to be asked: what entitles you to make demands on me? And vice versa. (Back to natural law theory?)
Some claim that because many patients in emergency situations present themselves to the CH and ask or demand abortions (given that the government is paying for them), that the CHs have an obligation to provide them.. (But how do you connect the dots between some government money and some women claiming a right to an abortions?)
My question: given government subsidies, how can Person A establish an obligation in Person B by *expecting* that Person B will do something for A? Especially when the second person (in this case the Catholic hospital) has already said it chooses never to do what Person A is expecting? How can an expectation establish a right?
I see the most fundamental problems this way: what are the moral and metaphysical grounds of obligations and entitlements? When must the dots between me and you necessarily be connected? Yikes, what a question.
When am I entitled to demand that you do something for me and vice versa? May I ever demand that you actively do somehing against your conscience?
I might add that if the Catholic hospitals have to go out of existence because they won’t do abortions, this is something like the moral quandary of abortion itself/ If the mother is to live, the baby must die and something is lost (the baby). If the hospitals must go out of existence for moral/legal reasons, then something is lost — all the other good that the Catholic hosopitals provide to the poor, including, possibly the mothers who had abortions before the demise of the hosopitals. Sad, sad, sad.
Possible future problem for the communities with Catholic hospitals: if the Catholic hospitals are destroyed, will what is lost by their communities be less, the same, or greater than what is lost when the mothers with problem pregnancies were turned away?
Ann, reasonable expectations establish duties all the time in the law. Your doctor, if he’s treating you for an illness, is expected to provide at least the ordinary standard of care–and to make its component parts available to you if go to see him. That’s the default standard. He’s not going to get far by saying, “Oh I don’t like to perform this test–and you can’t make me!”
Hospitals, doctors, and lawyers, are licensed. You can’t just decide you’re going to provide “AnnCare and treat people–whether or not you’ve been trained in medicine–and say, “Hey, I can do what I want. I gotta be me.”
Furthermore, no one has to do business with you–contractually. Medicare, Medicaid, and third party payors contract with providers–and they require their providers to meet certain quality standards, which means providing treatment for certain conditions according to certain protocols. So no one’s going to contract with a Christian Scientist provider or faith healer, or even a practitioner of acupuncture who abjures Western medicine, for a full range of services.
If I have an eye clinic, no one is going to expect me to deliver babies. But if I hold myself out as offering a fully functioning hospital with a fully functioning emergency room, I’m going to be judged by that standard. And patients in emergency rooms are particularly vulnerable.
I’m not sure where you’re coming from. What you can’t argue, it seems to me, is both that a) the Catholic hospital has a right to do what it wants; and b) everybody has to support them in it by giving them their business. If Catholic hospitals become seen as the equivalent of Christian Science hospitals, big third party payors won’t contract with them.
“Within the confines of a Catholic institution, does the bishop have final legal say over what treatments can be administered notwithstanding the conscience objections of the patient and the hospital’s (presumably) non-Catholic staff, and their willingness, ability, and resources to provide the service?”
Cathy –
Is a bishop the legal owner of a hospital? If so, do owners of charitable institutions have the same obligations as other sorts of owners? Are their obligations something more than promises, and limited promises at that?
The hospitals put them before the public as “Catholic”, and the Catholic Church in its teachings emphasizes competence as being necessary for making moral decisions. It claims ultimate competence in moral principle, so I suppose the moral judgment of any well-trained bishop theoretically should trump the moral judgment of any other moralist. They make othre ethicists on ethics committees unnecessary. (I’m just trying to described how Catholic bishops see themselves and present themselves to the public.)
This being so, I see no reason why they should not be held responsible for the moral decisions they make for the hospital or moral principle they mandate for their ethics committees. But the question then becomes: can most health professionals work for Catholic hospitals without violating their own consciences?
About “conscience restrictions”. I find the term confusing. Do these restrictions *prevent* someone from doing something? Or simply allow someone not-to=do something someone else wants/requires them to do? Or what? Could you tell us a bit more about this?
No, the bishop doesn’t have final say, at least in secular law. The hospital (and I haven’t checked the bylaws) is likely a not-for-profit corporation ultimately controlled by (not “owned”) a board of trustees. The bishop might be the chair, but hat doesn’t make him control it. The by-laws doubtless say that it will follow the ERDs. But in this case, as I understand it, the question is who gets to interpret the ERDs. Furthermore, each doctor and those responsible for the day-to-day operations of the hospital are accountable for what they do according to the standards of secular law.
So what worries me isn’t that the bishop is upset, but that the Hospital demoted her.
The question Barbara and I are grappling with is the degree to which the duty of care owed by the hospital is modified by any legally protected right of conscientious refusal to do certain procedures. Some conscience clauses say that the federal govt. can’t penalize institutions or docs that won’t do abortions.
But it is not clear how that interacts, say, with the EMTLA–which requires hospitals with emergency rooms to treat and stabilize patients.
I guess I think the Joint Commission could decide not to accredit a Catholic hospital with an emergency room that refused to do this procedure. I think Medicaid and Medicare would simply have to do their own, separate analysis, which took into account federal law.
If I may introduce some other thoughts:
- Prof. Kaveny – admire your patience in trying to parse and understand the levels of defining “abortion” in this and other threads (obviously, you are a lawyer). But, the three of you seem to have finally arrived at the “stumbling block” – the current manner in which the hierarchy interpret “natural law” dating back to the unfortunate HV pronouncements. Would suggest that you can parse all you want but that HV and 40 years later, B16 needs to accept his own Portugal words and realize that natural law’s truth is still there but how we express it in moral theology & in the manner the hierarchy interprets in the cultural wars currently is outmoded, outdated, and does not reflect any attempt to integrate today’s technology, advances in the sciences (medical for example), or in our own intellectual understandings. Abortion as an “intrinsic evil” is a manualist approach – VII tried to establish groundwork to move away trom that but subsequent popes and canon law have forced us to live with an “effectively” deficient moral theology. The only ones who suffer from this are the catholics who try to force a “round peg” into a “square hole.”
- the best post is Prof. Kaveny and David – May 26th – 8:36AM…..causistry is what you three are trying to do; but Olmsted is in the world of “Prophetic Indictment”. It would be interesting if Prof. Kaveny compared/contrasted the causistry of moral theology with the types of prophetic indictments that we have seen over the last 18 months from folks such as Morlino, Burke, Finn, Sodano, Bertone, Chaput, George, Hoyos, various Irish bishops (some now resigned); etc. around major issues – US elections; US SCOTUS appointments; sexual abuse; homosexual unions; SOLs; parish closures; immigration; nuclear weapons; children of gay parents admitted to catholic schools.
- may I add some other curious questions in terms of “The Rest of The Story”; although Olmsted can say that the “sentence” is automatic – this event happened over 6 months ago. So, why make it public now? For what purpose? Who was/is compelling him to take a public stand? (questionnable move pastorally)
Did Olmsted ever meet with Sister? Did he meet with the hospital ethics board? Or did he merely read an account of this and then make a judgment? Did he meet with the family; the wife and husband? There is a lot of information that I do not know that significantly impacts your blog title – If Olmsted is the decider?
- along these same lines: the sentence is automatic if you interpret this medical procedure as abortion. What if moral theologians disagree on that? what recourse does sister have? why is sister the only one receiving this automatic sentence? Where is the due process in latae sentintae pronouncements? Does anyone have more of the story?
(Prof. Kaveny – you make a comment at one point about – “hope she has a good canon lawyer”….my experience in the Vatican courts vs. a bishop is that the best you can hope for is a “no decision” on a Vatican ruling…they will come back and state that the decision is suspended or some type of wording along those lines but will never find in your favor or against the bishop….they will basically plead for the bishop – nola contendere and let it quietly die.)
Appreciate John Churchman’s comments from Australia – here is his latest reply to these types of church issues: http://www.catholica.com.au/gc3/jc/005_jc_230510.php John – not that Olmsted on this Feast of Pentecost showed any type of Open Awareness. Rather, in the upper room the faithful had gathered in fear but the spirit allowed them to find their courage to go forth. The fear is there but it is trumped by the power of the spirit. So, comparing Olmsted and Sister – these situations are filled with fear…but who moved forward trusting the spirit; and who moved backwards via a prophetic indictment? Is excommunication basically a “fear” threat or step? Does it have anything to do with the spirit?
Bill, the book I’m trying to finish is on the morality of prophetic indictment. My Santa Clara lecture looked at Chaput in these terms.
http://www.scu.edu/ignatiancenter/events/lectures/archives/upload/w-09_Kaveny_Lecture-2.pdf
So I should probably stay off the blog and finish it!
Thanks, Prof. Kaveny – I have saved your link. Remember when you provided this months ago. In re-reading your points, it does not appear that Olmsted’s announcement meets your criteria for a prophetic indictment…it clearly is an indictment. I especially focused on your criteria that, if a prophet is speaking to his/her own people, s/he must stand with the people in their suffering, pain, etc.
That is why I have asked the series of questions I asked above – the rest of the story may give us an inclining about whether Olmsted made any effort to stand with the family, the ethics board, the hospital, the MDs? Or, has he just made a public announcement of a “de facto” penalty?
Again, thanks for your challenging post.
Cathy -
Thanks for facing the complexity of the issues involved in this case and for seeing that its implications could be extremely far-reaching. It has my head spinning, involving as it does so many rights and obligations, so many claims and competencies.
There are many moral principles which can guide us in concrete cases. But are there are meta-moral principles which can tell us *which* of our relatively concrete moral principles must be applied in concrete cases involving *conflicting* rights and obligations? What are these meta=principles, if they exist?
Thanks, Ann–I myself think that if the decision had gone the other way, and the woman had died, it would have resulted in a great blow to Catholic health care. There would have been a reactive movement to abolish conscience clauses–and not just in a life–of -the mother situation.
I myself don’t think it’s principles and rules all the way down–I’m a virtue theorist, and prudence comes in–and the subparts of prudence.
Of course, Cathy. Not only can your team call names, but they cannot even be called on it…nice!
Eggloff, this thread is not your opportunity to air your general grievances with dotCommonweal.
The Bishop has walked into the most interesting, and wrenching, problem in the abortion debate: diirect abortion to save the life of the mother.
Overwhelmingly the polls show a popular preference for this option, even among prolifers. But it has no basis in the Catholic moral Tradition.
The potential legal liabilities are huge and scary, but I don’t think Catholic moral theology should be based on fear. I think this aspect of financial and criminal liability, though daunting, should be disregarded in a serious debate about the justice of the actions.
Thank you, so much, for clearing that up, Kathy.
Of course, if you read the prior thread, you’d realize the debate is about what counts as a “direct” abortion, which in turn depends on how to define the “object” of the act!
But why cloud the issue with actual, technical moral theology!
One possibility is that the hospitals could separate themselves entirely from the official Church. They’ll be hospitals in the Catholic tradition–but not bound by a bishop’s interpretation of the ERDS. That’s already happened–in Oregon, I think. It was not acrimonious.
Land O’Lakes for hospitals, in a nutshell.
Cathy, I follow Basil Cole in thinking Grisez missteps on intention. The problem is the reduction of intention, which is a complex of the physical activity towards an end AND the interior motivation, to simply the interior motivation.
(Cole was answering Grisez on the craniotomy question. I don’t have the reference handy.)
Kathy says: “But it has no basis in the Catholic moral Tradition.” Guess all that moral theology history I studied needs to go out the window. Catholic moral tradition around abortion has been all over the place – read Thomas; read some of the popes in the Middle Ages; etc.
Guess you can make a recent statement such as yours but even that is questionnable in the understanding of experts in moral theology. http://www.religiousconsultation.org/News_Tracker/moderate_RC_position_on_contraception_abortion.htm
For me, these post about Olmsted raise multiple issues – “direct abortion” being only one among many. No one seems to have the answers or willingness to explore other issues raised by Olmsted’s public display?
As Bill D. states, moral theology has a long and varied tradition that will continue to move – currently away from the manualistic trends of the past.
i wanted to add that approaches by rule only are highly limted as rules are constantly in need of revision due to our imperfection and to updating due to deeper insights acquired as we go along.
My own view is that we overvalue ( the very human) canon law and note that Bishop Olmstead is another of the JCD bishops with a number of years in beauracracy in Rome but little pastoral experience.
Given the governance sytem buttressed by the same canon law, there is little one can do about the Bishop”s actions -he can do what he wants as does the Bishop of Lincoln towards
the Review Board.
All of which raise the question of justice and equity and how it is handled here and that “technical moral theology” in itself is incapable of solving that.
Bill deH. –
Thanks for the article. High time the Vatican looked at the facts of Church history/tradition.
The article says that after Humanae Vitae in 14 countires the bishops said thatt HV did not bind the consciences of the faithful. I’ve never heard of those bishops. Do you have any information on hte matter?
Bob Nunz –
It’s the manualist tradition of the past that seems to have gotten it right. The trouble with Bishop Olmstead is that he doesn’t *know* the moral tradition, i.e., the philosophical traditions.
Ann – will have to do some historical work to identify those bishops and the fourteen countries.
Manualist approach – not sure that it got it right so much as take away all need or ability to use “prudential” and moral thought in pastoral situations. Would say that there is no adequate evolution from the manualist position – VII set a direction but then it appears to have floundered.
Read a recent analysis that touches on this discussion and touches on the legal issues around the Vatican saying that the episcopacy is independent from Rome (per how you interpret, read, understand apostolic succession). This leaves each bishop as free-standing, not accountable or responsible except in a vague, moral, or global directive. At one time canon law was the structure that guided bishops but now Rome seems to “ditch” canon law and replaces it with bishops or conferences setting up their own “law by bishop” versus rule of canon law”…..examples – Dallas Charter overrides due process on priests; Rome speaks out of both sides of their mouth in terms of reporting abuse to civil authorities rather than using both a civil and church process.
If I am a bishop, the mixed messages are overwhelming.
One thing that often gets forgotten in discussing moral theology is that the history of casuistry and the manuals is geared toward a specific purpose: that is, seminary training of priests for service in assessing people’s sins in the confessional. I actually believe that the tools are often very useful for this purpose – however, when they are lifted out of this purpose and made to apply in some other way (prophetic indictment, exhaustively specifying which actions are acceptable and which not, etc.), they sometimes show themselves to quite inadequate to the task.
Put another way, I can imagine (and I understand people might disagree about this) that the discussion about what exactly this act was, whether it would require some sort of regret and penance, might actually be a fruitful conversation between a person and their confessor.
One of the great problems of V2 and moral theology was that, on the one hand, there have been a lot of very fruitful theoretical developments in the past fifty years, but on the other hand, all this theory still lacks an adequate counterpart in the ordinary practice of Catholic life, analogous to the practice of confession. Without such a practical “home,” the discourse of moral theology is apt to be put to all sorts of problematic and ill-fitting uses.
Thanks so much for this thoughtful article. A few weeks ago I was lamenting the closing of St. Vincent’s Hospital in Manhattan. As a primary care physician, reading all of the comments expressed in Commonweal and FIRST THINGS on the issue of this excommunication I have changed my position. I now think that the hierarchy of the Catholic Church must be removed from any health care decision making in the United States.
Bill deH. –
Please don’t take any trouble researching those bishops. I really just wanted to know whether in fact there *was* such opposition to Rome. So thanks.
As to the position of the bishops, it seems to me that if there were no supreme pontiff there would be 2460 little popes, or however many bishops there are. Every large organization needs somewhere for the buck to stop. But how to limit the powers of the pope or toss him out — there’s the problem, as I see it. I also think that perhaps the main problem right now is that the bishops are not competent teachers. That means, at least in most cases, that they be competent theologians and Scripture scholars. There ought to be a law, but as you say, canon law seems to be “inoperative” to use a much abused term.
As to the theological direction of VII, it strikes me as mainly anti-the immediate past, that is, anti-the “manualists”, the ones who tried to boil down the whole of the middle ages. Can’t be done. But it’s also a tremendous mistake to throw out the medieval insights. Unfortunately, not only do the bishps not know the medievals they know even less of the modern thinkers (most of their works having been on the Index of Forbidden books) except, perhaps for a few who knew/know a some Kant, the phenomenologists and existentialists. Vatican II urged dialogue with contemporary secular culture, but the bishops, being ignorant of the main roots of the contemporary secular culture which often opposes the Church ( i.e., the Enlightenment, scientism, process philosophy and pragmatism) are not likely to be taken seriously, And why should they be?
Yes, the above is a big over-simplification, but I think the outline is correct. There’s an intellectual game going on, and the bishops aren’t players.
Dr. Murray – you’ve made that decision on the basis of one decision by one bishop in a case that everyone agrees is excruciatingly difficult?
It just seems to me that, in order to conclude that Sr. McBride’s judgment was unquestionably correct, we need to know things that, apparently, nobody is revealing to the public (or at least, that I haven’t seen yet): whether there was any other means of treating the underlying malady that wouldn’t be a direct abortion. (Or, if we’re not certain that what happened should be considered an abortion, then a direct attack on the life or well-being of the baby in the womb).
I mention this because, based on the public statements of Bishop Olmstead and his medical ethics adviser, Fr. Ehrich, that seems to be the heart of their confirmation of Sr. McBride’s excommunication – that the treatment constituted a direct abortion. The reader is left to wonder whether alternative means of treatment were available.
Cathleen, in regard to your original post: probably I’ve watched too many episodes of House, but in thinking a little bit about your questions about civil and criminal liability and other pitfalls for the caregivers and the hospital, it occurred to me that these considerations would bear upon Sr. McBride as well. My understanding is that, in addition to being the ethicist on call, she was also an officer of the hospital, and presumably would be expected to take its interests, including its financial interests, into consideration. And as an officer, she may be liable in ways that a non-officer wouldn’t be.
None of us wants financial and legal-liability considerations to enter into the decision-making process in a life-or-death situation – and yet that seems to be what this thread is about, and so I’m raising the question (not entirely comfortably, I should add).
I apologize to Sr. McBride if raising the question impugns her integrity. I have no reason to think that she handled this incredibly difficult situation with anything except the utmost personal and professional integrity. But this case seems to illustrate that there is a conflict of interest inherent in being both an ethics adviser and a corporate officer in a Catholic hospital. Perhaps one of the lessons learned is that ethics advisers shouldn’t be officers.
Jim – refer to Prof. Kaveny’s post on May 21st – 3PM: taken from the National Public Radio story on this event –
“Last November, a 27-year-old woman was admitted to St. Joseph’s Hospital and Medical Center in Phoenix. She was 11 weeks pregnant with her fifth child, and she was gravely ill. According to a hospital document, she had “right heart failure,” and her doctors told her that if she continued with the pregnancy, her risk of mortality was “close to 100 percent.”
The patient, who was too ill to be moved to the operating room much less another hospital, agreed to an abortion. But there was a complication: She was at a Catholic hospital.
“They were in quite a dilemma,” says Lisa Sowle Cahill, who teaches Catholic theology at Boston College. “There was no good way out of it. The official church position would mandate that the correct solution would be to let both the mother and the child die. I think in the practical situation that would be a very hard choice to make.”
Jim – this seems to outline the “facts” of the case per the hospital documents quoted. Guess that a reporter could obtain some of these facts without patient identification information that would violate HIPAA.
What do you question about this? My questions go beyond these outlined events and medical situation – what did the bishop do between November 27,2009 and now – did he meet with the mother/father; did he meet with the ethics board, the hospital administration, did he ask to meet with Sister McBride?
I ask these questions because the original blog title was – what if Olmsted was the decider? I would hope that he had consulted with all of the above mentioned in making any type of pastoral decision; much less waiting six months and announcing an excommunication. To what purpose and end?
Jim – the position of VP Mission or Ethics is usually separated from the hospital board and administration on purpose for the very reasons you are speculating about.
The position of ethics director is to educate, consider, consult, weigh and advise MDs, the hospital, the patient and their family in terms of supporting the “Ethical and Religious Directives for Catholic Health Care Services”. Ultimately, it is the patient and/or family that makes the decision. I know of many situations where the Ethics VP has had to overrule or recommend against an MD course of action because it did not meet the Ethical and Religious Directives for Catholic Health Care Services. We can assume that Sr. McBride carefully applied these directives and arrived at the decision and recommendation that happened. But, in reality, we do not have the actual documentation – we do not know who said what; what the actual medical prognosis was; etc. And I wonder if Olmsted had this information?
If the facts relayed by NPR are accurate, there was not much time for this specific process to happen – lives were at stake.
Would love to see a comment from Sr. Carol Keenan, DC on this?
“What do you question about this? ”
I had already read the NPR piece. It’s the only story I’ve seen that contains that unattributed detail about the mom being too sick to even move to an operating room.
Yet it doesn’t answer the question that I believe Bishop Olmsted’s statements raise – were there any alternative treatments, of whatever risk, that wouldn’t have resulted in a direct abortion?
“We can assume that Sr. McBride carefully applied these directives and arrived at the decision and recommendation that happened. But, in reality, we do not have the actual documentation – we do not know who said what; what the actual medical prognosis was; etc. And I wonder if Olmsted had this information?”
I agree, and you raise very good questions about the thoroughness of Bishop Olmsted’s investigation. I wish he would be more forthcoming on what went into his decision. (Or perhaps he has been forthcoming – perhaps there wasn’t much more to it than what has been described in the diocese’s public statements).
David C., you’re right–although I think casuistry (in both the legal and the moral theological realm) can be a vehicle for exploring complexity, not just applying law.
In any case–this is a legal case now. A woman who gave her life–her whole self–to the Catholic people–has been declared to be removed from the body of Christ. It’s the closest the Church gets to capital punishment. So it’s important to get this right.
Jim, I think there several questions here:
1) Was this, in fact, a direct abortion (previous thread)? If it was, then the procedure was illicit according non-revisionist moral theology.
2) Are we ever going to get a full account of the facts–likely no, because the patient’s privacy trumps. Is there, in the public realm, an account of the circumstances which present the choice as very dire? Yes. Is that account plausible? Again, yes. I think, given the very predictable firestorm, they would have loved to transfer her if they could have done so safely.
4) Should the Bishop have publicly stated that the nun was excommunicated by saying, essentially, “Trust me” on the facts? I myself think whatever pedagogical function that the law has is deeply diminished in thee circumstances. If you can’t publicly explain the whole situation (and he can’t because of patient privacy), you probably shouldn’t make a public statement in the first place, imho. Actually, I’m not sure how the diocese got access to sufficient info to make a judgment consistent with the very stringent laws on patient privacy.
On the legal issues–I’m not sure what you’re implying–that Sr. McBride really didn’t think the procedure was morally correct, but just went along to avoid legal liability? First, I’m not sure she would have been on the line in this way–m guess is that she wouldn’t have had the authority actually to say, no go. That would have probably had to come from the hospital president and the physician medical director. But I’d have to read the by laws and policies to know for sure.
I think she did what she believed was right, and paid the price.
Remeber – Olmsted merely announced publicly what a “direct abortion” causes per Rome law – automatic excommunication. But, why make this public? Is that a pastoral move? Why only Sr. McBride? Alternatives – based on the NPR story, there were no alternatives; no time for alternatives.
As I said above in one of my posts, the bishop can basically wiggle around this by stating that her actions led to this sentence – it is beyond his doing; it is automatic.
But, much of this post and two others by Prof. Kaveny attempts to drill down and explore the various levels & impact of this type of public announcement – was this a “direct abortion”? Can reasonable catholics disagree on this? What about the whole concept and current usage of the term – “intrinsic evil” – which has very little moral theology history?
If I may compare these actions to Chaput vs. O’Malley on another cultural war topic – admitting or keeping children of gay parents in a catholic school. Notice – Chaput follows his interpretation of the law and denies continued placement in the catholic school based on his read of the situation; O’Malley came to a radically different conclusion that the child is the center of the question and should not be denied a catholic education because on the decision or lifestyle of their parents. Catholic education is there for more than passing judgment on parents. Can you see the same dynamic going on here? Can you see a different bishop arriving at a different conclusion?
If you push this “indictment” far enough, you will eventually arrive at Dr. Michael’s or Prof. Kaveny’s belief that Catholic Hospitals would have no alternative but their own version of the catholic universities’ Land O’Lakes statement.
“I think she did what she believed was right, and paid the price.”
Yes, I agree.
“On the legal issues–I’m not sure what you’re implying–that Sr. McBride really didn’t think the procedure was morally correct, but just went along to avoid legal liability?”
I really don’t think she did that, but if she was an officer (and Bill D., who works in the industry, thinks she wasn’t for exactly this reason), then the conflict of interest seems inherent to the setup. (But people can do the right thing despite conflicts of interest, and I have no reason to think that Sr. McBride did otherwise).
Appreciate that St. Joseph’s has been in business for many, many years. I have it on very good authority that situations similar to this have come up on many occasions. There have not been past episcopal objections to medical decisions made in good faith by the hospital, its health plan affiliate, or the good sisters. We have a new sheriff in town, Thomas Olmsted, and Catholic theology has changed.
Jim, it is simply untenable that someone who might not even be Catholic would encounter such a dramatically different outcome at Catholic and non-Catholic facilities based on non-medically based distinctions, as a result of seeking emergency services. This isn’t just an issue of moral philosophy, it is an issue of whether a third party can impose their ethical will on you in your own life and death situation when you had no reasonable expectation that this would be the outcome of a normal request for help. The only reason this doesn’t cause massive problems for Catholic hospitals is because it is rare enough and, I speculate, hospital staff simply don’t let it happen, no matter who the sheriff is.
Vital thread with many ramifications, but I can just imagine all the debate and issues in play while the suffering patient gets lost somewhere.
This only confirms my resolve not to be taken to a Catholic hospital where some bishop/sheriff might decide to intervene in my conscientious life decisions should he so choose. No thanks for the second-guessing.
I had to make a decision about a feeding tube for my seriously ill mother within 24 hours of her death, (obviously, not realizing it was such at the time), and said, no. It was unthinkable to put her through such a procedure at that time.
As Gerelyn notes above (May 23rd, 2010 at 1:53 pm), you never know what a Catholic hospital may do or not do about your or your relative’s expressed directives.
http://compassionandchoices.org/blog/?p=866
Hi, Carolyn!
A woman died in 1992, aged 90. She was a resident of a Little Sisters of the Poor home. She had suffered a number of small strokes. She had expressed end-of-life directions quite clearly, including NO feeding tube.
She had another small stroke and was taken to a Catholic hospital. They stabilized her, etc., and said she could be returned to the Little Sisters home. But they said she would have to have a feeding tube inserted. They told her daughter this.
The daughter said NO feeding tube. They — hospital staff — told the daughter that without the feeding tube, the Little Sisters of the Poor would not take her mother back. They convinced the daughter of that.
The daughter went back into her mother’s room and explained that she had to have a feeding tube. She then went back out into the hall to call her family members and tell them the latest development. When she got off the phone and went back into the room, her mother was dead.
Her daughter believes she died of fear/frustration/horror at being helpless in the hands of strangers determined to force feed her.
As it turned out, of course, the Little Sisters had said nothing like that. It was simply the hospital staff who were determined to do what they wanted to do, regardless of the patient’s wishes.
It didn’t occur to the daughter to call the Little Sisters of the Poor and ask them if that was really their rule for their residents. She trusted the Catholic hospital staff.
“On the legal issues–I’m not sure what you’re implying–that Sr. McBride really didn’t think the procedure was morally correct, but just went along to avoid legal liability? ”
Cathleen, one more comment on this particular strand of the conversation: I guess I’m confused by the original post’s juxtaposition of the various legal question that you’ve itemized, and the hypothetical situation in which it had been Bishop Olmsted in the room rather than Sr. McBride. Surely all of the same legal hazards would apply to whoever the adviser was in the situation? I guess I’m not sure why we need to hypothesize person A’s participation, when person B requires no hypothesizing – her participation and potential liability were real.
I’m assuming your point in imagining that Bishop Olmsted were part of the actual discussion is that he might not have been so quick (rash?) in speaking out about her being excommunicated had he had a real stake in deciding who lived and who died that day. And of course, the threat of lawsuits is yet another reason to recommend what Sr. MccBride apparently did recommend. From the bishop’s point of view, it adds yet another layer to the heroic sacrifice that he expected Sr. McBride to make in that situation.
Jim: “it adds yet another layer to the heroic sacrifice that he expected Sr. McBride to make in that situation.”
Don’t want to belabor this but – “heroic” in whose estimation…..what standards or principles are heroically at stake here? the bishop’s? You again assume that this event meets the bishop’s announcement, his interpretation, and his (to use Prof. Kaveny’s PC term) pedagogical role.
For some of us, what the bishop belatedly assumes and demands by his announcement would have been compliciteness with a wrong-headed action – lack of appropriate medical treatment and decision? To comply would have been to abdicate your role as a professional catholic and ethicist using your own expertise and conscience rather than just blindly following what some “old” pope said; did or did not do. It would have been giving in to fear and letting a law decide rather than taking a risk of faith and deciding for life. A famous English writer defined COURAGE as “grace under pressure” – that is what is heroic and I believe that grace is the spirit moving in a faith filled person. I see little courage in what Olmsted did; much less grace under pressure.
What Prof. Kaveny is trying to do is imagine the same situation but Olmsted in Sr. McBride’s position – would he have had the courage to act?
Thank you, Gerelyn, for the reminder to verify first always, then trust…maybe.
What a horror. My reaction is to research fraud statutes, and whatever remedy the law allows for emotional distress, and violation of the mother’s express directive. What a travesty to have died so suddenly, in fear of force feeding like that, whatever rationalizations to the contrary might pertain. I would have been the daughter from hell in that circumstance.
Bill, thank you as well for your observation. We know what Olmsted would have done by his response to Sr. McBride. Heroic sacrifice?? God help those in the hands of the Olmsted’s of this world. “It would have been giving in to fear and letting a law decide rather than taking a risk of faith and deciding for life.” Exactly. And then to deprive Sr. McBride of the Eucharist for the rest of her life? For shame.
The more I read of Catholic health matters, as in this post, the more frightening the possibilities. I appreciate where Michael E Murray MD (May 24th, 2010 at 2:04 pm) is coming from.
The tragicomedy is that there appears to be no way of resolving such matters through casuistry that doesn’t come down to something like the witch trial scene in “Monty Python and the Holy Grail.”
Jim, I suppose what I’m saying is this: 1) I assume that if Bishop Olmsted had been in charge, he would have let the mother die rather than perform the procedure. 2) I’m asking what would have followed from that decision, from a legal point of view.
“Don’t want to belabor this but – “heroic” in whose estimation…..what standards or principles are heroically at stake here? the bishop’s? ”
Yes, Bill – the bishop’s, and (in his view) that of the guiding ethical directives. Clearly, he expected Sr. McBride to make a decision that would have resulted in the death of two human beings, and arguably would have opened her up to the various sorts of legal liability that Cathleen listed in the original post.
And yes, I’m permitting myself to view this situation from his point of view – a good practice for anybody who comments here.
I suppose this should go without saying, but – it’s entirely possible that he judged rightly.
I often try to permit myself to see the other situation. First, not sure that Sister would have had any legal liability – the hospital and its insurance company would have the exposure. I say that because she made the recommendation she made – what if she had insisted and the hospital/MD had done nothing and mother/fetus had died. Then, Sister might face legal liability but again, the family would have gone after the hospital, etc.
For numerous reasons that I have tried to express in above threads, I do not believe that the bishop judged rightly nor do I believe that he acted pastorally. I place his actions along with other bishops who delight in “prophetic indictments” as fearful; orthodox and loyalty have little to do with moral reasoning or applying moral theology.
Here is what bothers me about this case: the bishop actually made no decision beyond waiting 6 months and making public what was an automatic penalty. Why? We do not have the information to answer that question, His only right judgment was to make this public – for what purpose? It was not his judgment – he took a rule and announced it. We have no information about how he arrived at this (to use your phrase – right judgment); but it does not appear that he met with sister, the hospital, the family – he passed judgment from afar. Not sure that I agree given his lack of due process; any attmept to listen and understand beyond what (reading about this case or reviewing hospital notes?)
The guiding ethical directives, imho, would lead you to the decision that sister recommended; not what the bishop says. Prof. Kaveny submits that the bishop may have felt that his “pedagogical” role as pastoral leader required this public announcement – is there a track record for this? In fact, this bishop seems to lack clear moral reasoning in other public situations e.g. former bishop and his crimes…..at least, that bishop clearly committed crimes yet Olmsted is grateful he faced no jail time (how does that compare to what he has done to sister and her rights as a catholic? His hypicrosy is grating at best….sister is guilty only of applying the moral directives and arriving at the best conscience recommendation she could in the time and experience God gave her.
Is it entirely possible that Olmsted judged rightly – hard for me to see that. His jedgment is easily two or three steps removed from the live and death moral issues faced by sister; he shows no mercy but acts as a judge publicly announcing a rule – does not take much courage to follow the leader. What we are dearly missing in the church are bishops who are pastorla leaders; who listen; and who judge only as a last resort and then in private.
Not sure, Jim, that you have really explored “his point of view” – again, not sure you or I have enough information to even know what or where he came from on making this judgment.
If you want to learn more about Bishop Olmsted, see
http://whispersintheloggia.blogspot.com/search?q=olmsted
It’s rather unedifying. You should probably read those stories before trying to explore his point of view. See the bit about the autistic boy and communion, for example. Hmph!
Thanks, Claire.
I’m glad to see that the issue is not whether the bishop was well intentioned, but whether he used good judgement. And I strongly agree with Bill that one wopuld have a hard time defending he may have judged rightly.
There is enormous chatter about this on the internet and great unhappiness toward the bishop. I’m much in agreement with a recent NCR editorial that says the crisis in the church is really a crisis of the hierachy (to which I’d add their regular defenders.)
Relevant comments from Sr. Joan Chittester today: http://ncronline.org/blogs/where-i-stand/whatever-happened-middle
Highlights: “……consider the question of the nun ethicist in a Catholic hospital who read the law in favor of an early abortion for a dying mother of four other children in order to save one life instead of losing both. We’re told that for that act of ethical judgment the nun is excommunicated and may be forced to leave her order. Why? After all, bishops who protected pedophile priests are still in their chanceries, despite the harm those decisions made to thousands of other children?
How is it that the eternal principle that “we may never do evil to achieve good” works for sick and pregnant women but not for predator drones or the nuclear bombs of Hiroshima and Nagasaki that destroyed entire populations?
Instead, as a Christian society we kill for national political reasons, we kill in self-defense, we kill to punish criminals, we kill under stress and for reasons of emotion. And one at a time, we judge the seriousness, the morality, of every one of those actions — separately — in the light of the situation and circumstances. How is it, then, that every other life issue admits of degrees of guilt but not this one?”
“Is it entirely possible that Olmsted judged rightly – hard for me to see that. ”
Probably, it would go something like this:
The starting point has to be that abortion is intrinsically and objectively evil – it is evil of its own accord and regardless of any extenuating circumstances. What makes this case so difficult is that it is extenuating circumstances on steroids – the fiendlishly perfect alignment of circs such that. seemingly, there is no out. (I say “seemingly” because, as others have argued, here and elsewhere, perhaps there was a probability -even if a very low probability – that the mother might have survived without the abortion. That strikes me as a critical point – one that would significantly change the calculus used in reaching a decision. But for purposes of moral analysis, it simplifies things to assume the mother would not survive – and perhaps the actual facts even bear that assumption out, although I don’t think we know for certain).
Very few people on dotCommonweal think abortion is okay. But this discussion has illustrated, I think, that most of us have at least some small mental reservation somewhere in a corner of our minds, along these lines – ‘abortion is wrong, and I wouldn’t support it – except in circumstances like this nearly-impossible one that Sr. McBride came upon.’ But – to say that abortion is instrinsically and objectively evil is to admit not even the smallest, slightest mental reservation of this sort. If it is intrinsically and objectively evil, then there are no circumstances – not even these ones – that can admit of an exception.
Then there is the consideration of the baby in the womb. I have seem several expressions of solidarity with the mom in these threads, but very little has been said so far about the baby. Yet there was a death that day – the death of a human being who, the church says, has a right without exception to not be directly assaulted as this one was. It’s even possible that the baby’s death was horribly painful – agony beyond bearing.
Finally, there is the consideration that an excommunicaiton should not be thought of as the equivalent of a ‘death penalty’. The remedy is straightforward; a single sacramental conversation between Sr. McBride and Bishop Olmsted could resolve it.
Let me close my participation in this thread by observing that I doubt, were I Sr. McBride, that I would have come to any conclusion other than what she did – and, if I hadn’t had the benefit of Cathleen’s mini-course here, for much worse reasons than, perhaps, Sr. McBride did. May God lead us not into temptation.
Tom Doyle has an important analysis of this case at NCR:
http://ncronline.org/news/justice/shades-grey-world-apparent-absolutes
Shades of grey in a world of apparent absolutes
snips:
On the surface it all seems clear, cut and dried, but it is not. The Catholic church has long realized that excommunication can be the ecclesiastical equivalent of a deadly weapon. Consequently canon law contains a number of requisite conditions that must be taken into consideration before an excommunication is declared (as in this case) or imposed as in most other cases of ecclesiastical crimes….
Let us presume that the religious sister knew that an abortion is not only intrinsically wrong but punishable by excommunication. Yet she was faced with a situation of having to participate in a decision which would preserve, at least temporarily, the eleven week old life in the womb but would almost certainly end in the eventual termination of that life and the life of the mother. On the other hand the procedure would terminate the life of the fetus but greatly enhance the chances of survival of the 27-year-old mother of four other children.
‘Moral powerlessness’
This certainly appears to be a case of necessity as envisioned by the Code. One of the respected commentators on canon 2205, 2, Gommar Michiels, writing in 1929 said:
“In penal law necessity may be defined as that objective condition of things, brought about in any manner whatsoever, in which an act that according to penal law is to be placed or omitted cannot so be placed or omitted because of an absolute or moral powerlessness, whether this latter be physical or spiritual.” (De Delictis et Poenis, I, 199).
In less dense language, this means that the condition of things, that is, the combination of the pregnancy and the critical heart condition leading to a nearly 100 percent chance of the mother’s death, and the absence of any other medical procedure that would enhance the mother’s chances, presented a situation where the sister and possibly the others in the decision making process, were in a situation described by the canonical commentators as “moral powerlessness.”
Thank God, some common sense somewhere!
Continuing Tom Doyle’s analysis:
“Norm 47 interjects a shade of grey that pits the absolute up against the often painful, uncontrollable and unpredictable circumstances of life. The canonical criminality of the choice made by the sister and the others is by no means as cut and dried as it may have seemed to the bishop and his advisors. The canon law on abortion is quite clear. What is also clear is that the same canon law recognizes that real-life situations can be agonizingly complex. In this case the full recitation of the facts (to use the stark canonical terminology) seem to argue for the protection of the sister, the mother and all others involved from the harshness of excommunication rather than for their condemnation.
My canon law professor from seminary days regularly insisted that we always remember that the purpose of canon law is to “save souls.” The soul of the unborn child was not the only one to be protected. There were six others directly impacted by whatever decision was made: the mother, her husband and their four children. My professor was right. What is also obvious is that it is far easier to presume guilt than it is to use the law to save rather than condemn.”
Olmsted’s decision is bad judgment personified.
Carolyn – just saw and read Tom’s NCR piece – thanks and excellent.
Jim – thank you for the powerful faith statement: “Let me close my participation in this thread by observing that I doubt, were I Sr. McBride, that I would have come to any conclusion other than what she did – and, if I hadn’t had the benefit of Cathleen’s mini-course here, for much worse reasons than, perhaps, Sr. McBride did. May God lead us not into temptation.”
Your parish is blessed to have you as a deacon – fully human, faithfully alive, not afraid to question and explore; patient and merciful; able to walk in other’s shoes. When I need the ordained church again, I pray that there will be a person of faith like you. Peace and Amen.
Kristof this morning:
http://www.nytimes.com/2010/05/27/opinion/27kristof.html?hp=&adxnnl=1&adxnnlx=1274965232-fyy+wdSITHdwWxzCHA+3dg
“The excommunication of Sister Margaret McBride in Phoenix underscores all that to me feels morally obtuse about the church hierarchy. I hope that a public outcry can rectify this travesty.”
The comments below Tom Doyle’s analysis are excellent.
http://ncronline.org/news/justice/shades-grey-world-apparent-absolutes
Bill, your words moved me – thank you for your kindness.
Carolyn, not that I’m an expert, but to me, Tom Doyle’s words ring true to the way that canons are to be applied.
Thank you, Jim. And I too was moved at Bill’s words to you.
I do not have the vocabulary for theology and canon law, but something in me recoils at a visceral level when a case like this occurs. It is scary to think that the Tom Doyle’s of this world are so rare that in his absence the alternative course is the norm. I fear the Pharisees are alive, well, and in charge. Talk about laying burdens on others…
When the suffering mother and her family get lost in the abstract hyper-distinctions of black and white interpretations, I only have instinct as guide. And the reflections of Ann and Barry Ulanov: “It is always the concrete person before the abstract principle” — something along the lines of equity trumps law that Prof. Kaveny has written about.
I see Olmsted’s response as of the same cloth as bishops’ reactions to sexual abuse: removed, disengaged from the damage their own actions caused, and too focused on legalisms that deny the humanity of the injured. I find it instructive that the judges who first unsealed documents are female, as of course is Sr. McBride. Not every man or woman fits a pattern, but clericalist celibate males seem a different kind altogether.
How precious is Tom’s witness in the current desert of rectitude and self-righteousness.
People cannot be excommunicated,I believe, for merely following their conscience or showing poor ethical judgement even if it goes against the teachings of the Church.We all go against the teachings of the Church [Christ] every time we sin.People can be excommunicated for taking a stand publicly that is diametrically opposed to the moral and/or theological teachings of the Church.[if you believe abortion is just or that Jesus Christ is not God, for example].We can’t help what we truly believe either ethically or theologically but when we take a public stand which opposes the teachings of the Church than we are willfully disobeying the Church. It is this willful disobedience that warrents excommunication.We are all fallible and our private views cannot be helped but choosing to publicaly take a stand against the Church’s teachings can be helped.Of course this applies to teachings that are deemed infallible-not everything a pope or bishop says.The people who deserve to be excommunicated, I believe, are public figures who publically support legalized abortion and I would add preemptive war.