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Everything you need to know about the case of Sr. Margaret McBride.

You'll recall the controversy surrounding Bishop Olmsted's announcement that Sr. McBride had excommunicated herself owing to her participation in a decision to approve an abortion to save the life of a mother. (We discussed it here and here last month.) If you've been struggling with the challenges posed by such a hard case, worry no more. The American Life League has produced a video that makes it all crystal clear. The piece is a touch long, and we're all busy people, so I've trimmed it to the essential bits, which I present here for your edification.


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Reducing the Church's treatment of this woman to a crude little chalk drawing, complete with knife and rope, illustrates more than was intended.

Isn't it curious--the stick figure bishop doesn't have any eyes--but he does have a mouth. I wonder why they drew him that way?

Another example of how the pro-life movement can self rightously undermine the message of life.

I know many have tried to discuss whether or not Sr. McBride could technically be excommunicated (or have excommunicated herself) according to Canon Law, and I appreciate those discussions.But what bothers me most about video above is that there's no real question about whether any of it is true, instead, all that's being asserted (from the edited clips) is Church teaching (on this line). I can't stand discussions that begin "Article x,y says and CCC 123 blah blah blah."As a committed pro-lifer, I'm still struggling with whether or not what she did was in fact recommend an abortion in the morally relevant sense. I'm struggling to understand if she did in fact, according to that "journalist," do evil so that good may come of it. It seems a case could be made that the sin of omission (letting two die) would have been just as morally problematic for the agent, if not more so, than the sin of commission. But I don't know. I really don't.So though Mr. Nunz uses this episode to make a snarky attack on the "pro-life movement" ("Another example of how the pro-life movement can self rightously undermine the message of life."), I'm more concerned with the lack of charity afforded to everyone involved. And I'm still trying to make sense of it all.

I suggest the American Life League end the video at 43 seconds.

Benjamin --Everyone admits, I think, that this was a hard case. That is, there were competing moral principles involved. In this case: the principles included "all mothers have a right to life", "all children have a right to life", plus other principles. e.g., "an end does not justify a means", and -- here's the hardest one, "moral principles sometimes have exceptions" Sometimes we do not see how these principles can be resolved. What is needed is needed is what the mathematicians call a "decision procedure", that is a meta-principle or set of meta-principles that is a means to discovering whether a given proposition is true or false. Sadly, it has been proven that there is no such decision procedure for arithmetic -- in other words, not every arithmetic statement can be proven to be either true or false. So the mathematicians can never answer all of their questions..Sometimes ethicians need a decision procedure -- a way of reaching a true conclusion about an ethical problem. Years ago a seminarian friend told me that Aquinas provided one. The seminarian didn't have a citation for it. I've looked for it for years in Thomas and not found it, but it certainly sounds like Aquinas == it makes a lot of sense, I think. It goes like this:When you have an ethical problem that seems to lead to contradictory or inconclusive conclusions, Begin by finding out what the experts say ought to be done and the reasons they give for their judgments. When the experts disagree or their opinions really don't make sense to you, consult people who have actually been in the same kind of circumstances. If those people don't agree about what ought to be done, then simply do what you are inclined to do after all your study.Pehaps Sr. McBride, after having studied both the experts and people in that existential position wasn't sure what to do and followed her inclination -- to save the one who could be saved. (I might note that it was a matter of arithmetic -- better to save one than none.)Granted, an "inclination" is a "wanting", and we are often told that we should base our ethical judgments on facts, not feelings. But I wonder if that is true. But that's another question, an extremely fundamental one that, I think, needs to be re-considered in depth. So many hard cases seem to involve it.Jesus never said to us "You will always be wise if you but try".

As a philosopher friend and neighbor once whispered to me at a pro-life weekend program more than three decades ago, "I think I've seen the enemy, and it is us!" It should be said this event was not sponsored by RTL but, instead, if I recall, by a group of Christian congregations. We attended as part of our efforts to set up a pro-life group at our parish.Ann, thank you for your professional philosophical perspective here. If the Phoenix case suggests anything, I think it's the need for our moral "experts" to decipher the reasoning behind the generally (overwhelming?) Catholic acceptance of the hospital's action as morally acceptable. Perhaps the moralists need to play "catch up" with the rest of us?"...[W]e are often told that we should base our ethical judgments on facts, not feelings." I think this observation is quite accurate. Regrettably (and for historical reasons with which I am not qualified to offer comment), the law and its cold-hearted reliance on pure facts and rational argumentation tends to overshadow the feeling part of our human nature. Or maybe it's hierarchs in certain quarters of the church who are so inclined. If Olmsted had been standing next to the gurney in the ER and had the power to do so, would he have prevented the medical staff from undertaking the lifesaving procedure? During those precious moments, would the good bishop have threatened excommunication on any Catholics participating in the abortion? Would Olmsted have stood there and watched the mother die???

Ann,I understand what you are saying. I do. I wonder, though, if "decision procedures" fit facts into a schemas where they don't necessarily fit, but rather are made to fit based upon whatever narrative one wants to offer. You intimate that this is a problem, albeit differently.I think you should wonder if this statement is true: "we are often told that we should base our ethical judgments on facts, not feelings." Neuroscience continues to suggest that our supposedly rational evaluation of the facts of ethical reasoning is not based on any cold arithmetic or purely rational analysis, but based upon, in large part, our deeply held emotional convictions. I doubt Sr. McBride turned her analysis into a hard utilitarian calculus, by the way (one better than none, regardless of means chosen, regardless of emotional concern); I imagine the inclination was "let's do what we can in an impossible situation." There's a fine difference, wouldn't you think?(From a religious perspective, I sometimes wonder about the intellectualist tradition bequeathed to us from Aristotelian Thomism: I don't necessarily believe our natural gift of affective perception is somehow lower and less Godly than our rational capacities.)Anyhow, regardless of my critique of decision-making narratives, I'd still be curious if there ever were some serious discussion from more of the hierarchy about this matter, apart from Bishop O. All the papists seem to want to repeat is that the Church says abortion is murder/abortion leads to excommunication. Yeah, we all know that already.

Ann, your reference to a hypothetical "decision procedure" reminds me of an HR resource found in all federal (civilian) personnel offices, the Guide to Processing Personnel Actions. A sample entry can be found (I hope) at .Benjamin, I think you have alluded to the question of "values", and arguments over values are the most difficult to resolve --- if they can be resolved at all!Regarding McBride's supposed excommunication, I think we've seen how one person in a position of authority can effectively ostracize another person in the church --- without any of the "heavy lifting" required to directly excommunicated her. In this scenario (unless I'm otherwise mistaken), the target of the "latae" announcement has no opportunity to challenge the bishop in a church court but must, nonetheless, suffer the fallout including the besmirching of her good name. This is not right! I'd suggest the Phoenix case is a good example of the need for Rome to jettison such excommunications from the code of canon law. In this particular situation, the bishop enjoys little credibility in a larger Church of Rome whose hierarchs already have damn little credibility --- moral and otherwise --- remaining.

My link includes "decision logic tables" that the government began using ca. 1980 to make it easier to document various personnel actions and capture data for OPM's Central Personnel Data File. Surely moralists could use a similar approach to help various folks in the Catholic community.Of course, "values" would necessarily enter the picture in developing such a resource :)

If this video is targeting primary school students, its content and animation might not be out of line.

Everyone admits, I think, that this was a hard case. Ann,I don't think there would still be such a fuss going on if everyone admitted this was a hard case. Many people seem to be quite sure that direct abortion is never permissible, that this was beyond a shadow of a doubt a direct abortion, that Sr. Margaret McBride knew very good and well that it was a direct abortion, that she should never have permitted it, that both the mother and the unborn infant should have been allowed to die if that was how the Good Lord wanted it, and that Bishop Olmsted was exactly right to announce publicly that she had excommunicated herself. What is so appalling to me is that so many people never conceded Sr. Margaret McBride had a "hard case" on her hands, and some who did nevertheless claimed that although the circumstances were emotionally difficult, the choice was nevertheless crystal clear. Someone asked me what Jesus would have recommended, and I said, "He was a Jew. He would have recommended that the unborn infant should be sacrificed to save the life of the mother. That is what Jews have always believed and still believe." I know abortion is forbidden in the Didache, but that is a Christian document, not a Jewish one.

Ann, regarding facts and feeling: Research into the psychology and neurobiology of decision making has found that people who can't tap into their emotions find it almost impossible to make important decisions. Rightness is NOT just an exercise of analyzing the facts. If that were the case, it seems to me that the fact of one being dead is better than two being dead. Indeed, the principle upon which Olmsted based his assertion that Sister McBride was wrong was NOT a fact -- it was a doctrine. The presupposition is that doctrine is correct, but that presupposition may depend greatly on how one views the emotional and value laden components that went into the construction of that doctrine ab initio. One can properly think that these were incorrect because, for instance, they reflected bias or insufficiently valued the mother's life or put undue emphasis on the action of the doer at the expense of the person who is the subject of the action. Lots of people (lots of lawyers) can easily trick themselves into thinking they are making rational judgments because the values and emotions that went into making the rules they are asked to apply preceded them by years if not generations. These feelings may now be accepted as facts but that doesn't make them so.

The speaker doesn't blink. Should we be concerned?

The BVM appeared to me on a partially-eaten taco shell from KFC (don't ask.)She said this: "Abortion is a sad situation in all cases. Life is precious --- all life. There are times that the hard choice to be made is one that one normally would not make. However, in the case in which Sr. McBride was involved, the lesser of two evils was chosen, sad though that decision was.My Son has approved of this message."

Having been involved in the pro-life movement for many years, this situation does not seem to help the pro-life cause and is undoubtedly being used by pro-choicers to confuse the issue in order to protect our current national policy of abortion on demand. While, I am not a Catholic, I have never heard that it is a Catholic mother's responsibility to die for her unborn child if her death is imminent and is directly linked to the continuation of the pregnancy. If I am to believe what the articles have stated, which is a big if (as the Teri Schiavo case has shown), Sister McBride may have been confronted with a choice of choosing one life over another: a difficult and heart-wrenching decision. So I dont believe that it helps to second guess her decision which appears to have been made in an effort to maximize life. Nor do I feel there is a lack of casuistry within the Catholic Church to allow for moral understanding in this case. This whole idea of automatic excommunications in this case is just not helpful.Nevertheless, I truly feel that these extremely rare cases are simply diversions which take our eyes off a national tragedy and the greatest civil rights issue of our day: 1.2 million children killed by abortion each year in the US.

I just love clear teaching on clear matters.

"I have never heard that it is a Catholic mothers responsibility to die for her unborn child if her death is imminent and is directly linked to the continuation of the pregnancy."--------- Even in the good old days when abortion was rarely mentioned, people knew that a Catholic mother WAS required to die rather than end a pregnancy.See, e.g., the bestselling novel of 1950, THE CARDINAL, by Henry Morton Robinson, in which that was made abundantly clear.

"While, I am not a Catholic, I have never heard that it is a Catholic mothers responsibility to die for her unborn child if her death is imminent and is directly linked to the continuation of the pregnancy.Well, you learn something new everyday. Under Catholic teaching, no abortion can be performd even to save the life of the mother. To do otherwise is to get on the slippery slope and it's more important to be consistent than to resolve tough cases.Under Catholic pro-life circles, you're a backslider, only a pro-lifer when it's convenient for you./sarcasm/

Under Catholic teaching, no abortion can be performd even to save the life of the mother. No direct abortion. It makes a difference.As I have pointed out before, removing a pregnant woman's uterus in order to terminate the pregnancy and sterilize her would be the exact same surgical procedure as removing a pregnant woman's uterus because it was cancerous. The first would be a direct abortion (and sterilization, to boot) and would be prohibited. The second would be an indirect abortion and would be permitted.

Actually I think the word is abortion. There's no medical term that qualifies as as "indirect abortion" a theological term at best. The Church simply defines medically necessary uterine or fallopian tube removal as "not abortion."

Pulmonary hypertension causes distension of the lungs so that breathing is labored and will eventually press on the heart and cause heart and lung failure. Clots and massive strokes can also occur.Many women have early C-sections, as early as 26 weeks, when the fetus is viable, to alleviate the condition. However, at 11 weeks, the fetus was not viable. There are some medications and treatments that can be used to treat pulmonary hypertension, but the video does not indicate whether mother in question had tried those medications or whether her condition was too far along to respond to those meds or treatments.Cathleen Kaveny, cited in the video, seemed to be trying to draw a parallel with this abortion and the removal of a fallopian tube containing a fetus in the case of an ectopic pregnancy, which is allowed by the Church. (Cathleen, please correct me if I'm wrong.) I infer that this did not satisfy the video man because what was removed was not an organ gone awry that happened to contain a baby, but the baby itself.Clearly, the hospital could not remove the mother's lungs or heart. Could the hospital have removed the woman's womb that just happened to contain the baby and satisfy Catholic teaching that way? I doubt it, since the affected organ (lungs) were not the ones containing the baby.I think the only Catholic solution here would be to keep the mother as comfortable as possible and allow her to die with her baby.I don't think there's any question that Sr. McBride has excommunicated herself according to Catholic teaching as it stands. To say that, in what sounds like an impossible situation, she has "fallen from grace" of God Almighty, seems like incredible hubris.One of the many reasons I'm a bad Catholic and don't receive anymore.

Thanks David and Gerelyn,You learn something every day. BTW David, the Jewish faith has a long history of prohibitions against abortion ref. Gorman, Abortion and the early Church Wipf and Stock, 1998 and my book, A Love for Life. Wipf and Stock, 2008.

Oh, I do love the chalk cartoon! (Sarcasm? You bet'cha!) Note that, rather than help the woman who had fallen down after she "cut herself off from grace" (itself a ridiculous notion--I'd go so far as to call it blasphemous,) the cartoon bishop wags his cartoon finger and folds his cartoon hands to pray cartoon prayers to his cartoon God.Hmmm, it reminds me of a parable...But yes, the cartoon speaks volumes--some truer than the text.

I share Unagidon's concern that the speaker in the video does not blink. I wonder if he's animatronic, or bad CGI? If he's real, he should beware of drying out his corneas.If he's CGI, then the ALL should get better producers Pixar does more morally nuanced productions--"Up," e.g., and the surprisingly rich "Toy Story 3."

BTW David, the Jewish faith has a long history of prohibitions against abortion ref. Gorman, Abortion and the early Church Wipf and Stock, 1998 and my book, A Love for Life. Wipf and Stock, 2008.Dennis,I was speaking only of abortion in cases where the mother's life is at serious risk. To the best of my knowledge, as close as Jewish and Catholic thought may be in other cases of abortion, Judaism has never contended that the unborn child's life was of equal value to the mother's, and that if an abortion is the only way to save the life of the mother, then both the mother and the unborn child must be allowed to die.I think I was in error for a number of reasons in bringing up the Didache, but if everybody else is going to overlook it, I am not going to point out where I was wrong!

No, Jean, I was trying to say that both clearing the fallopian tube with methotrexate and this sort of situation, and crainiotomy do not count as an intentional "abortion." With Grisez, I do not hold that the physical structure of the act is determinative of intent: rather intent is tracking the immediate purpose of the human act --which is by its nature a purposive act. (That's why the serial killer making the identical cut as the surgeon don't engage in the same human act.I think the tradition always holds out the possibility of internal critique--thinking more deeply and soundly about particular cases. That's what happened with Ligouri and cooperation with evil. I believe that's possible here too.At the same time, I also believe it's necessary to prevent people with mistaken notions of what's morally necessary from harming others (by act or omission). So I would not allow a Catholic hospital to operate an emergency room if it it was going to let women in these situations die, any more than I'd allow Christian Scientists to operate an emergency room. I think it's essential to clarify what the hospital will do in the next case.

More about "The Cardinal" -- the 1963 movie version of the 1950 novel: "The Vatican bankrolled some of the film, and the Vatican liaison was a young Joseph Ratzinger".

The USCCB's Committee on Doctrine has issued a statement in response to the Phoenix abortion case: am grateful for this statement.

With all respect to the committee on doctrine, I see nothing that convinces me that Aquinas was wrong when he wrote:Accordingly the act of self-defense may have two effects, one is the saving of ones life, the other is the slaying of the aggressor. Therefore this act, since ones intention is to save ones own life, is not unlawful, seeing that it is natural to everything to keep itself in being, as far as possible. Summa theologica Part II.2, Question 64, Article 7: Whether it is lawful to kill a man in self-defense?

Jim McKay--The official position of the Church on this is that the child is not an aggressor. But even if it isn't, it seems to me that it is the moral equivalent of an aggressor, so the argument should apply. The child causes the ill health of the mother, and even though the child doesn't intend to threaten the mother, in fact it does.In war, an enemy soldier might in good conscience threaten you to kill you, and thus being an innocent threat to your life. Yet the official position of the Church is that he can be treated as an aggressor, even though he does not intend to do something wrong. It seems to me the moral status of the child is no different: it is an innocent threat to the mother's life.

Well, about that statement from the USCCB Committee on Doctrine, when they cite JP II writing "It is true that the decision to have an abortion is often tragic and painful for the mother, insofar as the decision [...] is not made for purely selfish reasons [...], but out of a desire to protect certain important values such as her own health or a decent standard of living for the other members of the family." -- he forgot to add "important values such as her life". In the text that is quoted, he does not seem to have considered that possibility.And when the statement says: "The first scenario describes a direct abortion. The surgery directly targets the life of the unborn child. [...] The surgery is likely to improve the functioning of the organ or organs, but only in an indirect way, i.e., by lessening the overall demands placed upon the organ or organs, since the burden posed by the pregnancy will be removed. The abortion is the means by which a reduced strain upon the organ or organs is achieved." -- they forgot to add "thus saving the mother's life."So it appears that the statement forgot to put the mother's life into the equation. It may cover most cases, but it is incomplete with regard to the specifics of the Phoenix case.

I am grateful for this statement.Stephen,I was interested (and relieved) to see that the statement you brought to our attention is not a ruling on the Phoenix case and leaves open the possibility that Sister Margaret McBride and the ethics panel made a correct decision. According to an article in America, the target of the surgery approved by Sister McBride and the ethics panel was the placenta. "The placenta produces the hormones necessary to increase the blood volume in pregnant women; in this case, the additional volume put an intolerable strain on the womans already weak heart." It was the placenta that had to be removed, and the death of the unborn infant was not directly caused or willed. The reasoning seems to me at least as sound as the reasoning that justifies a partial or full salpingectomy in the case of ectopic pregnancy.

David, interesting take. Though I never find legalistic thinking particularly helpful in situations where both a mother and baby will die without some action helpful, think you can look at the placenta in two ways:Is it part of the mother that happens to contain a fetus, so it can be removed like a fallopian tube with an ectopic pregnancy as in an indirect abortion?Or is it part of the baby (which is how I would construe it; it is expelled after birth), in which case removing it and the baby would constitute a direct abortion?Pope John II's statement and that of the bishops who quote him in the link leave the hard words unsaid: If treatments do not work, and the only option left is a direct abortion, then the mother must die. Sad, tragic, worthy of our prayers. But die she must.I presume that if the mother were to die, but could be placed on artificial life support to bring the fetus to a viable stage as has happened sometimes when mothers have strokes or accident that render them brain dead, that would be permissible.Church teaching seems to be aimed at protecting the most defenseless forms of human life, whether they constitute full human being-ness or not. Since the fetus is not in a position to make its wishes known, whereas the mother, in no less danger of losing her life than the fetus, can speak and make decisions, she would be less defenseless and less in need of protection. Which boils down to being more expendable.What am I missing here?

Jean--I agree your characterization of the placenta. Though a remarkable physiological and morphological tissue that provides the vital two-way conduit between developing fetus and mother, there is a placenta-womb barrier that does not allow a complete connection between the fetus and the mother. Nutrients dissolved in the mother's plasma, and oxygen carried by her red blood cells, can traverse the barrier (and, conversely, carbon dioxide and waste products (e.g., urea) can pass from the fetus to the mother), but the barrier when functioning normally prevents the mixing of the mother's and the fetus's blood. The reason is obvious--not all blood types can be mixed without very serious, often fatal, consequences. The only place where I'd disagree with you is your characterization of the fetus as not yet "constitut[ing] full human being-ness." From the time of conception, the embryo and fetus possess full human being-ness. An embryo-fetus-child-adult has the same unique configuration of DNA throughout its entire existence, and the DNA is genotypically "human."I don't think the issue is human being-ness, it's whether all of the developmental stages of a human being should be recognized as a "person" under the law. As the law now stands, the unborn are not persons entitled to the law's protection, but laws change for all kinds of reasons (slavery, child labor laws, moratoria on deep sea oil drilling, etc.), and I think that the unborn will one day--when a tipping point is reached as to people's perceptions--be regarded as persons under the law.

David, I understand the efforts you are making to soften the effect of the Church's otherwise incredibly harsh doctrine, but I think you (or America) are engaged in a case of wishful thinking. Second, if the "placenta" theory is deemed to be "acceptable" sort of like removing the fallopian tube, all I can say is, it's another victory for deception and denial that excuses the Church from fully grappling with the unique biological nature of pregnancy and the moral complexities that flow from it. Since a determination to impose this rule would be a disaster for Catholic hospitals, like St. Joseph's, that run high risk pregnancy units (their website doesn't have an asterisk that says your options might be limited due to Catholic theology), I have to believe that a lot of doctors are going to funnel their truly high risk moms to non-Catholic hospitals if they can. No one should have to worry about whether the Church will consider "removing the placenta" to be an acceptable workaround, however dishonest it seems to people like me.

Leaving aside this particular case, there are other questions that are not settled under American law. I myself do not think personhood settles this issue. Why does the mother have a duty to provide bodily life support to the fetus at great harm to herself when there is absolutely no other instance of a parent being required to do so. If a pint of blood is required to save a child, there is no requirement that a parent give it to the child under American law.The church's answer seems to be that women have a duty to do this because they're women. That's not an answer that flies under American law.

Jean says: Or is it part of the baby (which is how I would construe it; it is expelled after birth), in which case removing it and the baby would constitute a direct abortion?William says: I agree your characterization of the placenta.There are at least two cases in which there is a placenta without a baby: (1) molar pregnancy, in which a genetic error takes place in fertilization, resulting in a "pregnancy" without a developing embryo, and (2) missed miscarriage, in which the unborn infant dies in the womb but is not expelled, and the "pregnancy" continues. That would indicate to me that a placenta is not part of the baby. It is more akin to the uterus, and if there is something like cancer of the uterus, the uterus can be removed whether or not a baby is present. It seems to me the same argument can be made regarding the placenta.Also, what does it mean to be "part of the baby"? Fetal surgery can be performed to remove a tumor, and the tumor is part of the baby. Certainly an arm or a leg is part of a baby, but if for some sound medical reason it had to be removed before birth, that would not be prohibited. If by "part of the baby" you mean "essential to keeping the baby alive," then the uterus is part of the baby. It seems to me that targeting the placenta in the Phoenix case is more defensible that targeting the fallopian tube in the case of ectopic pregnancy. If the embryo in the case of an ectopic pregnancy were not going to continue to grow, there would be no reason to remove the fallopian tube. The danger to the mother is really the embryo's development, which must be stopped. I think the removal of a placenta to prevent its hormonal effects in a woman with pulmonary hypertension is a more plausible application of the law of double effect than the removal of a fallopian tube in the case of ectopic pregnancy.Personally, when a mother's life is in danger from a pregnancy, I don't believe it is necessary to invoke the law of double effect or other rather esoteric principles of moral theology to justify saving the mother's life. However, the Phoenix case is a Catholic controversy, and I think the actions of Sister Margaret McBride and the rest of the hospital ethics panel are defensible based on well established principles of Catholic moral thought.

Thank you for the link to the USCCB Committee on Doctrine. This would seem to be a very important development, in that it raises the defense of the decision from that of an individual bishop (who might be engaging in idiosyncratic reasoning) to that of (at least by implication) the entire college of bishops.

it raises the defense of the decision from that of an individual bishop (who might be engaging in idiosyncratic reasoning) to that of (at least by implication) the entire college of bishops.Jim,I disagree. The document does not take the side of Bishop Olmsted in the Phoenix case. The particulars of the case are not discussed, nor is the rationale for the decision of the hospital ethics panel. The document restates what well informed Catholics already knew about abortion. Direct abortion is impermissible, indirect abortion is permissible under certain circumstances. Nowhere in the document does it say the Phoenix abortion was a direct abortion.

William, I understand that the Church does not see a distinction between the fetus and the mother's human-ness. I also understand that the Church would see the direct abortion as a murder, whereas the mother's death--and almost surely the fetus's--would simply be the sad result of a medical condition. So the upshot is that it's better for the mother and baby to die of the medical condition than to actually murder one of them.What I object to about the video is that it focuses solely on the destruction of the fetus and ignores the spiritual, mental, and physical suffering of the mother. It also purports to know where Sr. McBride stands with God; as far as I know the Church can only say where someone stands with any particular teaching of the Church.Yes, I realize that my distinction between human life and human being does not tally with Church teaching, and it is something I struggle with. However, I do object to the implication--if that's what you're implying--that this puts me in the same camp as those who promote slavery, child labor, eugenics, whale slaughter, and drill, baby, drill.

Thanks to all for insights and takes, gets me pondering, as medically ignorant and Canon Law, dogma, doctrine, etc... distinterested as I am. I'm one of the millions of simple minds and hearts in the pew with the forest through the trees vision, of saving the life that could have actually been saved.Btw, was surprised by this sad assessment from Fr. Joe Girzone, always loved his Joshua books...

David Nickol has a good point. The conclusion of the USCCB statement may be sweeping, but it is clear from the discussion preceding it its reach is actually incomplete: the document forgot the (rare) cases when the pregnancy is causing the death of the mother. Catholics believe in the sanctity of human life, so such an important fact can not be left aside as ancillary. So the rules in the statement cannot be applied to the Phoenix case.

Sensus Fidei,Father Joseph Girzone writes as if he has not read any of the excellent articles on the Phoenix case in America, The National Catholic Reporter, and First Things (to name a few).And very strangely, he says, "Performing the abortion is done by crushing the skull of the fetus, thereby directly killing the unborn baby. No matter how one looks at that, if we are honest it is barbaric." We don't know how the abortion was performed in Phoenix, but we do know it was an 11-week-old fetus, which would be about about 1.75 to 2.4 inches long and weigh about three-tenths of an ounce. The only reason to deliberately crush the skull of a fetus during an abortion would be if it were too large to be easily extracted. This would not be the case until much later in pregnancy (say, after 21 weeks).

Jean: I, too, make a distinction between fertilized egg, embryo, fetus, baby, and I know that the distinction between human life and human being does not tally with current church teaching. I cannot embrace the personhood of the fertilized egg and it leaves me as perplexed as, say, the incredible story of the resurrection of Lazarus. I understand that I am supposed to believe both but find myself incapable to assent and am reduced to silence. Maybe we need grace to be able to see that a fertilized egg is a person just as much as any person on the street.

Jean--I wasn't implying anything, but if I created the impression that I was, I apologize. I limited my comment to the status of an embryo/fetus as possessing, to use your term, "human being-ness" and how that issue and personhood, while they have some overlap, are distinct. That's all I intended to address with my post, and I certainly was not characterizing your position in any way as being in any "camp." My references to slavery, child labor. etc. were merely illustrations of instances where the law has done an aboutface as society's perception of the issues changed. I think that aboutface will one day take place as to the unborn, but I am also fully cognizant of, and struggle with, the primary other interest you raised, i.e., the mother's interest. In addition, I try never to make ad hominem criticisms--though I may slip at times--preferring instead to argue the issue. And besides, I would never imply anything with you, Jean, because I'm still trying to convince you of the literary worth of a certain British author's 20th century trilogy. ;)David-- Re the placenta...You make a number of good points, but on a purely anatomical basis, the placenta develops from embryonic tissues (though the uterus undergoes changes where the placenta connects), and its DNA structure would be the same as that of the embryo's somatic cells. More scientific evidence that the placenta itself is part of the embryo/fetus is that significant numbers of parents are having umbilical cord blood preserved for possible use later in the child/adult's life because the cord blood contains stem cells that have proven useful in treatments for leukemia, for example.

Thanks, David, for your opinion on Fr. Girzone's take. You relayed my concerns too. I even wondered if it was really he, seems so different from what I inferred from his TLC, creative novels. Couldn't inquire as comments aren't enabled there.It was pretty much a very odd mix of factors he tried to force together, while ignoring the critical points in question. I wonder if he has been ministering lately as he sounds disconnected from laypeople and their realities.

"The document does not take the side of Bishop Olmsted in the Phoenix case. The particulars of the case are not discussed, nor is the rationale for the decision of the hospital ethics panel. The document restates what well informed Catholics already knew about abortion. Direct abortion is impermissible, indirect abortion is permissible under certain circumstances. Nowhere in the document does it say the Phoenix abortion was a direct abortion."Hi, David, While I agree with you that the Committee on Doctirne statement doesn't deal in great depth with the circumstances of the particular case, I'm not sure how else to intepret the statement except as a confirmation that Bishop Olmsted approached the case from the correct doctrinal principles. Compare the bishop's explanation of his decision to the Committee on Doctrine's statement. It seems they're very much in accord.If there were doctrinal principles that would lead to Sister McBride's decision, this statement would have been the opportunity to point them out.

I have just read, first, the USCCB's Committee on doctrine's June 23, 2010 document to which Stephen M. O'Brien provided the link, and second Richard Alleva's review of the film "Please Give" in the June 18 issue of Commonweal. I haven't seen this film, but I am struck by what Alleva says about it. The film certainly presents a very different view about how one ought to try to address hard ethical issues from the way the Committee on doctrine addressed the Phoenix case.Would that there was some evidence that the USCCB Committee had tried to meld there two very different ways of addressing these hard cases. Of course, if you believe that all moral issues have one uniquely right answer and that you possess the analytic resources with which to derive those right answers, then obviously you would have no reason to look anywhere else. Why would you complicate things! For some of us, though, there are many, many issues in life that strike us as tragic. Tragic issues are those for which all available responses are bad and there is no clear way of assessing which of them is unequivocally "least bad." Phoenix, I believe, is one of them.Reflecting on tragic cases, Alber Camus concluded that when we confront them the most we can aspire to is what he called "reasonable culpability." I think he's right about this.

More scientific evidence that the placenta itself is part of the embryo/fetus . . . William,If the placenta is part of the embryo, how can it develop in the case of a molar pregnancy when no embryo develops? Or how can it continue to live when the embryo dies? Also, if the embryo is taken to be a person rather than just an organism, what is part of a person? Is a leg a part of a person? Is an amputee any less of a person for having lost one or more limbs? It seems to me, in order to discredit the decision by the ethicists in Phoenix, you must demonstrate not merely that the placenta is part of the embryo, but that it is such an essential part that it is the embryo. You must establish that to target the placenta for destruction is not indirectly killing the fetus, it is directly killing the fetus. You must demonstrate that one really can't say they wish to destroy the placenta without truly wishing to kill the embryo. If it is credible that one can remove the part of a fallopian tube with an implanted embryo in it, without wishing to kill the embryo, because the tube is damaged, then I don't see why it is not credible to wish to destroy the placenta to stop it from secreting life-threatening hormones without directly willing the death of the embryo. In the classic cases of indirect abortion, the death of the embryo is foreseen and inevitable. It is just not willed. I don't see why that cannot be the case when the placenta is what threatens the life of the mother. I think a good (although probably imperfect) test for indirect abortion is asking whether the medical intervention contemplated would be taken were there no embryo present. This is certainly the case with hysterectomy in the case of uterine cancer discovered during pregnancy. It would certainly be the case in the case of a molar pregnancy or in the case where the fetus had died but the "pregnancy" continued. From the tiny bit of research I have been able to do, is seems to me that a molar pregnancy (with no fetus present) could result in the same situation as in the Phoenix case -- that is a woman's life being threatened by the presence of a placenta. No one would suggest that under those circumstances that it would be illicit to remove the placenta. So it seems to me a solid case can be made for removing a placenta without willing the death of the embryo. Yes, you know it is going to die, but you do not will that it dies.

Im not sure how else to intepret the statement except as a confirmation that Bishop Olmsted approached the case from the correct doctrinal principles. Jim,The doctrinal principles explained in the bishops' document are well established, and the document contains nothing in the least new. It is not over doctrinal principles that the principles in this case disagree. I am sure Sister McBride and the remaining members of the ethics committee would endorse the document without reservations. The statement opens, "On November 5, 2009, medical personnel at the St. Joseph's Hospital and Medical Center in Phoenix, Arizona, performed a procedure [it does not say an abortion] that caused the death of an unborn child. Most Reverend Thomas Olmsted, the Bishop of Phoenix, has judged [it does not say he judged correctly] that this procedure was in fact a direct abortion and so morally wrong." If the bishops had wanted to declare Olmsted correct, it was open to them to do so. Why didn't they? Maybe I am seeing only what I want to see, but it seems clear to me that there is enough ambiguity in the document that for either side to use it to support their case, something unstated has to be inferred. On the one hand, I am glad that the Church often does not make unequivocal, definitive statements on hard issues like this. On the other hand, it can be truly annoying when it makes what appears to be a clear statement that actually has ample "wiggle room."

It looks to me like paragraph two is the key to explaining the "why" of the USCCB statement:

The position that Church teaching supports the direct taking of unborn life has been widely reported at the national level by media outlets, which has caused some confusion among the faithful as to what the Church teaches regarding illegitimate and legitimate medical procedures used in cases where the mothers health or even life is at risk during a pregnancy. In order to clarify doubt regarding the Churchs teaching on this important matter, the Committee on Doctrine, following its mandate to provide expertise and guidance concerning the theological issues that confront the Church in the United States, offers the following observations on the distinction between medical procedures that cause direct abortions and those that may indirectly result in the death of an unborn child.

So their objective is to clarify that the Church does not "support[] the direct taking of human life," contrary to what has been "widely reported." Has it been widely reported, though, or is that a straw man? I'm not sure what to think, given that, on the topic of health-care reform, the bishops keep making statements to "clarify" things that are not actually in dispute.

William, forgive my testiness. The point you were making was not the one I inferred in my irritation over the fact that the video and the USCCB's statement do not make it perfectly plain that there are some instances in which the Church would rather see a mother die (which will also often lead to the baby's death) than to end an unborn life or to face the fact that these instances do occur. What I object to most about the video and, to a lesser extent, the USCCB's statement is the way the Church pitches the abortion issue exclusively as a "saving babies because we're open to life" message.I have never heard any apologists or Church hierarchs face head on what this means, practically speaking, for a married woman. Being "open to life" means that she may not use artificial contraception, even if she is in a high risk pregnancy group. She may use NFP--and put up with a lot of wearing complaints about it if she has one of those "spontaneous" husbands. And she must be ready to die for the fetus if she gets pregnant without intending to and something goes wrong during the pregnancy.I'm not sure how you put a positive spin that, unless it's to hold out sainthood in the next life for being willing to give your life for your child.

I have never heard any apologists or Church hierarchs face head on what this means, practically speaking, for a married woman. Jean,They don't care. Women are at best second-class citizens. They can't possibly hope to compete with the unborn for the concern of the bishops and the pro-lifers. Even nuns are under investigation now. When a high-profile case like this (or the 9-year-old in Brazil, pregnant by her step-father), if any empathy or compassion is expressed at all, it is an afterthought. They don't care.

I've just read the Bishops' Committee on Doctrine's statement and I have to agree with Bernard Dauenhauer. The agonizing questions so many people have raised here point up the complexity and tragic implications of almost any course of action or inaction in the circumstances involved in the Phoenix case. The Bishops' statement reduces the matter to very simple terms and seems to be directed toward providing a guideline to satisfy their own felt need to be able assert that there is a guilt-free, correct, and easily attainable answer as to what to do in such circumstances, and they have it. After all, according to JP II what is licit or illicit here should be obvious enough, since " the Law of God is written in every human heart, knowable by reason itself, and proclaimed by the Church." If only it were that simple.

David--I have some background in physiology, but I'm not a doctor, and I don't pretend to know the obstetrical details of molar pregnancies. From what I gather, however, placentas, whether in a normal or a molar pregnancy, are formed from the trophoblast cells that make up the outer layer of the blastocyst that results from a fertilized egg. Whatever placenta that develops therefore arises from the embryonic process that follows fertilization. Molar pregnancies are the result, however, of a genetic defect that was present at the time of fertilization, and they rarely involve development of an embryo. The genetic defect produces grape-like, fluid-filled vesicles that usually result in natural termination of the pregnancy. While true that molar pregnancies occur in about 1 in 1,000 pregnacies, any placental tissue that forms is derived from cells that are part of genetically-flawed fertilized egg and blastocyst. I think I'm going to leave my inexpert foray into obstetrics right there. ;)

William,My advanced degrees in medicine and moral theology were acquired from The University of Google.

"They dont care. Women are at best second-class citizens. "I don't believe this is true of Catholicism or most Catholics; having Baptist in-laws gives me a different perspective on gender roles in various Christian denominations.I think the Church does, however, struggle with--and sometimes sidesteps--the fact that its teaching sometimes requires the death of a mother to avoid the death of a fetus.

"Im not sure how you put a positive spin that, unless its to hold out sainthood in the next life for being willing to give your life for your child."That it may sound strange to say this may itself be food for thought: sainthood isn't a neglible prize. It's the point of the exercise we call human life. Preaching sainthood isn't spinning.

"The Bishops statement reduces the matter to very simple terms"It could have been more pastoral.

David Nickol: "They dont care. Women are at best second-class citizens."There are no second-class citizens or first-class citizens in the Church; only saints. The situation would be the same for you yourself if somebody put a gun to your head and said, "Deny Christ or die!" You may not commit apostasy, not even to save your life. It's not because "they" don't care. It's just because Christ said "Be ye perfect, even as your father which is in Heaven is perfect."And if anybody can't manage perfection, there's the Sacrament of Reconciliation.

Jean: Im not sure how you put a positive spin that, unless its to hold out sainthood in the next life for being willing to give your life for your child.Jim: That it may sound strange to say this may itself be food for thought: sainthood isnt a neglible prize. Its the point of the exercise we call human life. Preaching sainthood isnt spinning.Jean: But, Jim, they DON'T preach this. Nowhere does the bishop's statement nor Mr. Video Head's spiel talk about the virtue of a mother who turns away from a life-saving abortion and allows herself (and likely her child in this case) to die so as not to actively end the life of her fetus. There is not one word about that kind of caritas or nobility of spirit. Not one.In fact, they talk very little about the mother at all. Or the father. What should they do in this situation? Perhaps this should be part of prenuptial counseling. Wives, you must be prepared to lay down your lives in pregnancy if saving your life would mean aborting your fetus at any stage. Husbands, you must be prepared to remonstrate with your wife if she is so fears and dreads death that she cannot set aside her life for her fetus.OK, sorry for hogging this thread and making this issue so raw. But I weary of airy theorizing and chalk-board drawings of issues that, in reality, mean sitting by the bed of someone who's dying and dealing with the real live realm of flesh, bood and bone. Am off.

The situation would be the same for you yourself if somebody put a gun to your head and said, Deny Christ or die! You may not commit apostasy, not even to save your life.Felapton,Denying Christ with a gun to your head is not apostasy. It is acting under extreme pressure. From the Catechism:

1857 For a sin to be mortal, three conditions must together be met: "Mortal sin is sin whose object is grave matter and which is also committed with full knowledge and deliberate consent."

You can't act with deliberate consent with a gun to your head. Now, a heroic person may choose to face death rather than make an insincere and forced denial of Christ. He or she would, I suppose, be a martyr. But heroic martyrdom is not achieved by imagining God holding a gun to the other side of your head and saying, "Deny Christ and I will shoot." I recall a discussion on Vox Nova in which one side argued that Saint Maria Goretti -- the young girl who died resisting rape -- would have committed a mortal sin had she "allowed" her boyfriend to rape her at knifepoint rather than kill her. I have rarely heard anything more preposterous in my life.

That it may sound strange to say this may itself be food for thought: sainthood isnt a neglible prize.Jim,Is a woman who dies rather than have a life-saving abortion assured salvation? Is she a martyr? On the other hand, is a woman who consents to an abortion because she is afraid that without it she will die committing a mortal sin? Is it likely she is giving the kind of full consent required in my quote from the Catechism in the previous message? When you have four children at home to take care of, is choosing to save your own life necessarily selfish?

Thank you, David, for the scenarios. It affirms some thoughts I had when we first learned about Sr. Margaret. Re St. Maria, I believe she is a Saint because of the incredible forgiveness, mercy and love she expressed for her murderer. That's the only paradigm that adds up for me. A dear priest and I often spoke of our confusion on how one becomes a Saint while insisting to be murdered rather than raped. Seems most people and the social mores say murder is worse than rape, so she encouraged him to commit a greater sin. (That would be my choice as a potential rape victim but not b/c I want to be pure and holy or have concern for that but rather for my sanity and psychological pain.) Any rate, if St. Maria's canonization is viewed solely through the prism of virginity, many questions arise about the Church's unhealthy obsession with sex. Re the selfish aspect of leaving 4 children and hubby... I believe I lost a friend over this issue. I asked her opinion of Sr. Margaret and the tragedy and she seemed stunned there was even any question. She immediately stated I must not be pro-life and at that point I was. Then she explained in great detail how in this situation she would have insisted on being killed (aka allowed to die) and that if the physicians did not enable that she would likely kill herself. I was appalled at her extremism, first, but her selfishness, immaturity and insanity also. She obviously has an issue with this issue which defies reasoning. How she considers it holy to insist upon dying and imho escaping the pain, sacrifice and responsibility of living is something which eludes me and my faith. But if it comes down to a faithful using his/her informed conscience and that's what Sr. Margaret decided and if my prayerful friend chose otherwise at that moment of crisis, how is auto exco in effect? You pray to God to do the right thing and make a decision and then at that moment you simultaneously auto exco? All of this surpasses any of my understanding, and I thank God for that.

"My advanced degrees in medicine and moral theology were acquired from The University of Google."That's somewhere near Sydney, isn't it? ;)

The blood transfusion analogy doesn't work too well for me. Would a mom really refuse to donate a pint of blood to save her child's life? Wouldn't that be abnormal?How, then, is abortion normal?

Kathy, she wouldn't be REQUIRED to donate. Just as "most moms" would donate blood, "most moms" don't have abortions. It's an issue of interdiction and normative rulemaking not existing mores. And certainly, many moms might in fact refuse more invasive procedures: donating a kidney or part of their liver or even bone marrow. They don't "have to" and they aren't expected to if the donation would in any way compromise their own health.

"Is a woman who dies rather than have a life-saving abortion assured salvation? Is she a martyr? "No, I don't pronounce on assured salvation - I let the church do that. But ... such a choice would be a heroic witness to faith, would it not? If, as an act of faith, she makes this choice, then ... it seems to me quite possible - conceivable - that the church here on earth might discern, in due time and after the appropriate consideration and investigation, that she is one of the saints. "On the other hand, is a woman who to an abortion because she is afraid that without it she will die committing a mortal sin? Is it likely she is giving the kind of full consent required in my quote from the Catechism in the previous message? When you have four children at home to take care of, is choosing to save your own life necessarily selfish?"No, I don't think the two alternatives are symmetric ('choice A wins heaven; choice B condemns to hell'). I can't imagine that the woman would be fully morally culpable for any choice she made in this situation. It really is a "gun to the head" scenario in that sense.Sr. McBride's risk, so to speak, would be of a different order - no gun to her head. But based on information we have, I wouldn't make the pronouncement that Bishop Olmsted made.

Barbara,The other aspect of the analogy that fails is this. If a child requres a kidney transplant and the mother doesn't want to give it, she does not ask someone to directly kill the child. For Catholic moral theology that is an all-important distinction. For consequentialism, it's, well, an inconsequential distinction.

Jean, I agree with you that there are a number of important things to say that, thus far, have not been said (or at least said with adequate words). We've had ample pronouncement on the doctrine - thank you, legal analysts and textbook writers. Now, it's time for someone to gather up the strands of this tragic situation and try to find a way to preach some Good News - that's what our hearts really hunger for.

Catholic teaching as it now stands says that that a fetus, as the most helpless form of human life, must be protected from destruction by any intentional act to destroy it.Moreover, I think Kathy finds the analogies that might provide some "wiggle room," as my friend David N. calls it, unsatisfying because, at least in the first 26 weeks, the fetus cannot live outside the womb. There really ARE no analagous medical situations to pregnancy.I find it unsatisfying that the Church, in taking this line, does not therefore seem to be adequately preparing women to accept that their deaths are expected in these situations as part of their faith formation. Nor does it seem to be providing training to religious like Sr. McBride about how to do the hard work of helping these women make the decision to give up their lives.Moreover, the bishop's statement refers to "widely reported" caveats that allow for abortions in certain circumstances, and I think they must bear some large measure of responsibility for not making Catholic teaching and the consequences for women clearer. Most of my cradle Catholic friends were stunned to learn I had stopped receiving after having a tubal ligation; they had no idea that this was against Church teaching. I know two cradle Catholic women who had abortions in their 50s because of they had diabetes, and their doctors advised them against trying to bring the pregnancy to term. Their priests told them that having an abortion in such circumstances was morally neutral.(Sorry, can't leave this alone.)

It strikes me that the USCCB statement doesn't really resolve the issue of whether any abortion is ever permissible and this discussion will go on.It also strikes me that the USCCB statement cited here was an attempt to get past the reporting of Cardinal George's private remarks to his fellow bishops in Florida and the putative leak thereof.I think that raises an important presuppositional discussion question.The new NCR has an article on the US Bishops sending a group to the Catholic Media convention in early June. Bishop Zavala, chair of the communications comittee, gave a major address. He's quoted as saying"First, Catholic Media should work from a Catholic perspective, not the so-called"objective" perspective of the secular media(and of course we know that secular media are not objective anyway...)Second, Catholic Media has a responsibility to the larger Catholic community. Two useful words here are loyalty and service."I'd be interested in how our reporting folks here at Commonwel feel about that and do they think abut those issues as say they report USCCB statements.Since the Cardinal is also concerned about Catholic universities and their relations with Bishops, I wonder how many of the instructors at Catholic colleges look at that kind of presentation.These are clearly hard tiumes for our Church. We talk about truth (and justice).Issues of life, sexuality and justice dominate lots of the discussion.I think it's important to be clear what we bring to the table on those issues.

Jean, I guess here's my worry with your approach: I think it doesn't account for the capacity of the tradition to use its fundamental premises to reflect upon, nuance, and develop its approach to particular cases. I think John Courtney Murray saw the potential for development in the Church's teaching on religious liberty--advocated for it, and the teaching developed--in an authentic manner.And I think he--and the Catholics who agreed with him--who advocated for religious liberty as consistent with the deepest commitments in the Church in the late 1950s were doing the right thing --even if the institutional church itself rejected it. I think one of the jobs of a moral theologian is to reflect on hard cases and show how they can be resolved in a way that is consistent with church teaching and with the best insights of human experience. That's what natural law is about, at bottom.I think that's what it means to apply a hermeneutic of charity in interpreting church teaching. But if I get to the point that I can't do that anymore --that I think it's foolish-- I too will leave the church.And I think that is what it means to integrate faith and reason.I can't stand the image of faith and reason as two wings seamlessly integrating their flight path. It's never been like that--the movements forward are jerky and ungainly. The seamlessness doesn't come until the beatific vision.

I cant imagine that the woman would be fully morally culpable for any choice she made in this situation. It really is a gun to the head scenario in that sense.Jim,What about a hospital ethics committee?

"What about a hospital ethics committee?"Indeed. What is their role in this situation, and what should we (including the bishops in that "we") expect of them?It occurs to me that there are at least three things the ethics committee is not:* The patient, the patient's family, or anyone else burdened with making the actual decision. The ethics committee can not and should not make the decision, even if the patient is distraught.* A provider of health care. Medical advice should come from the doctors, nurses and other health care professionals.* A hospital chaplain / one whose primary function is to provide pastoral care. Empathy is the chaplain's job.I believe Bishop Olmsted said she excommunicated herself for formal cooperation. Apparently his expectation was that she would take part in the decision in a way that did not entail formal cooperation in an abortion.

By the way, has any information come to light about the precise needs of the patient--whether death would have been imminent, or would have necessarily followed from the pregnancy? Not that it would make a difference to a moral theologian.

Kathy,According to several accounts, the pregnant woman was not merely too ill to be moved to another hospital, she was too ill to be moved to the operating room. One can only conclude that she was in imminent danger of death.

The ethics committee can not and should not make the decision, even if the patient is distraught.Jim,I don't understand the role of the ethics committee if they are not to decide what the hospital is going to do. The woman was too ill to be moved to another hospital. If the ethics committee had merely advised the patient of her options and she had decided to have an abortion, what would have happened then?

Let's step back and consider for a bit what would happen if our moral theology always began with a presumption for compassion. Love must come first, and not just abstract love, but actual cherishing of the real human beings involved--in this case, the mother, her husband, their 4 other children, and, sure, the doomed fetus. Even if we wish to embrace the Church's strong stance that any embryo/fetus should be regarded as a person (and thus the subject of rights,) would we really stand by and multiply this tragedy by forcing the mother to die as well as the doomed embryo? Really? Who will explain to grieving young children that their mother had to die in order to uphold a moral theological distinction between direct and indirect abortion? Who will tell the husband that the notion of the embryo as a materially unjust aggressor was tossed aside with a mere rhetorical question by the magisterium, so his wife and partner in raising their kids had to die? As a moralist , I appreciate (and teach!) our tradition's moral distinctions, its short-hand decision trees like double effect, cooperation and just war. They are useful in helping us navigate difficult moral territory, and help us think clearly about tough cases. But when our moral tradition is no longer in synch with the basic Christian requirement of compassion,then our moral theology is no longer compatible with the example of Jesus, who was willing to ignore the requisites of moral and religious law in the name of compassion. Compassion is not the only requisite of good moral reasoning. But all good moral reasoning must be compatible with basic human compassion. Same as just war thinking must begin with an abhorrence of killing.

Fr. Girzone's unfortunate statement has two problems, IM (not so) HO:First, he raises an alarm that (some) people aren't reproducing enough. Sorry, celibates and others childless by choice really don't get to criticize others, even abstract others like "Europe," or "England and Ireland," for not having enough kids. It's a put up or shut up thing, especially since he asserts that it's God's will that Europeans and Brits and others have big families. He could lament, he could encourage, but he cannot criticize the discernments of others, especially since his own discernment led him to believe that God wanted him to remain childless. Second, while I don't believe Girzone's intent was to make a racist statement, he really treads that line very closely. He complains that it is Europeans and Americans not having enough kids that requires, i.a., "35,000,000 Mexicans" to come work here, which is a threat to "civilization." Huh? I thought 35,000,000 Mexicans could also be described as brothers and sisters in Christ, forced to migrate here because of hard economic times at home. Our receiving them as neighbors in need would be a tribute to our civilization, not a threat to it. Alas, we haven't done so well.

Cathleen, I believe that the Church has a special mission as the repository of the Truth of God. But I also believe that in some cases that Truth is only partially uncovered. I do not presume to say where, but I have my hopes, fears and opinions.Truthiness aside, my beef (that no one seems to want to chew on here) is that IF the Church insists that no fetus die by intentional human intervention for any reason whatever, and IF it insists that abortion is the single sin that brings down instant excommunication on anybody who has one, encourages anyone to have one, or assists anyone to have one, THEN it needs to make it much clearer in its faith formation that women of child-bearing age are expected to die for their fetuses if the fetuses can't be delivered with any hope of living outside the womb.If the Church is NOT willing to beat that drum a lot louder than it does, then it needs to re-examine its teaching, either on abortion to save a mother's life or on sterilization for women with conditions for whom age or illness would make childbirth a grave risk.I like your image of the herky-jerky flight of the Angel of Faith and Reason. I feel like that every day as a bad limping lapsed Catholic.

Lisa, excuse my bluntness, but "compassion" is a weasel word. A compassionate act is predicatedon where you draw the line about abortion. Those who believe there must be no intentional abortion would have to consider morphine and valium compassionate care to help the mother die.Those who believe that it's unreasonable to expect a mother who can be saved to die for a fetus that will die when she does might consider abortion compassionate.

Very true, Jean! I agree and believe we must make it our mission to insist this is specifically covered in Pre-Cana, Pre-Jordan and all religious education classes at the appropriate age level.Anyone want to bet that when a similar or age-appropriate simple scenario is presented to a child, without hesitation they scream, "Save the mother!"

May we revisit Sophie's choice here? The Nazi tells mother Sophie that she has to kill one of her two children, within minutes, or he will kill them both. She kills her daughter, saves her son, and lives with the guilt the rest of her life. The pertinent question here is: Does anyone not pity Sophie? Or even her son? Does anyone (other than the authorities) not understand that Sophie's choice was tragic, as was her predicament? The evil here rests solely on the shoulders of the Nazi authorities, who had no feeling, who made decisions based on facts not feelings. That cold-blooded, lifeless regime had no pity for any of the humans involved, assured solely by the soundness and superiority of their facts.

"Who will explain to grieving young children that their mother had to die in order to uphold a moral theological distinction between direct and indirect abortion?Who will explain to grieving young children that their mother had to die in order to uphold a moral theological distinction between direct and indirect abortion?"Lisa --I do not agree with Bishop Olmstead. However, let's stick to the realities. The issue was not whether or not to uphold at theological distinction. It was whether to kill the baby or let both mother and child die. For the sake of argument, let's say the mother had agreed with the bishop and accepted death. Then what to tell the other children? If it were I, I would insist that my other children be told that I would not kill the baby in my womb anymore than I would kill one of them. I think that puts a different light on Bp. Olmstead's position. I still don't agree with him, but I think it makes his position more understandable.

Funny stuff. Expecting someone to die for an unborn child just because the Church says they should doesn't pass the giggle test.

Jean and Carol --You upset a hornet's nest when you raise the issue of the role of feelings in moral choices. I"d say that these days the most common philosophical ethical position is that we ought to be lead by our feelings, and that most people put compassion at the top of the list.However, as Jean points out, different people see compassion as calling for diametrically opposed actions? It follows that that feeling alone is not enough to tell us what is right or wrong in that given situation with those particular moral factors.Further, as the Sophie story shows the *feeling* of guilt is not the same thing as actual guilt. Something else besides feeling must be involved. However, there are those who disagree. I knew a psychoanalyst who said "If you feel guilty, then you *are* guilty". Oh, yeah??? In other words we cannot rationally say that in every case feelings tell us what is right and what is wrong. On the other hand, they do sometimes help us get to the truth of an issue. I'm even convinced that there are some feelings that are not simply subjective reactions to evil doing or virtue, but rather, some feelings have something to do with an affective grasp of evil and good. The problem is I know of no way to distinguish what I would call merely subjective feelings from what might be called objective feelings, that is, feelings which reveal a fact. (And doesn't the latter sound like an oxymoron!) For instance, I can't prove to my own satisfaction that torture is evil, abut I'm convinced purely on the basis of my feelings about it that it that it has got to be wrong.Eichmann felt it was good to kill Jews. Surely that didn't make it right.

"The issue was ... whether to kill the baby or let both mother and child die. "Ann, thank you - that is the best, most succinct statement yet I'cve seen of this predicament.

I've already commented on this situation, and haven't changed my views. If anyone cares what those are, they can re-read prior threads at dotCom. Having said that ...I agree that love needs to underlie our moral choices. And that love isn't always compassionate. It can be stern and terrible.Bishop Olmsted could mount an argument that, in trying to prevent the woman from committing a mortal sin (and in what was, by all accounts, a near-death situation), his desired guidance was the loving guidance.

I found the story of the excommunication of Sister Margaret McBride, announced by Bishop Thomas J. Olmsted of Phoenix reprehensible, and it represents the worst of institutional religion. Jesus castigated religious leaders who imposed heavy burdens of law on others and did nothing to lift their burdens.Where is the compassion that Jesus showed to every sinner andsuffering person? How does the suffering and death of an unborn and mother give glory to God? The decision was to save the life of a mother of four, not lose two lives. There was no mention about the anguish in the hearts of the mother and sister McBride, who ministered to her, having to make such a decision?The bishop said an evil means cannot be chosen to accomplish good. What about the illegal and immoral war in Iraq? Where there any statements by his office condemning those who kill for the alleged purpose of national security?If I were to be judged by Jesus in this matter, I would rather stand in the skin of this nun and mother, than in the skin of those who have condemned her. I pray that her religious community will stand firmly behind Sister McBride.Fr. Rich BroderickCambridge, Ny 12816

Bishop Olmsted could mount an argument that, in trying to prevent the woman from committing a mortal sin (and in what was, by all accounts, a near-death situation), his desired guidance was the loving guidance.Jim,The only solution I see for those who agree with Bishop Omsted is simply not to tell the dying mother she has an option. If you tell her an abortion can save her life, she chooses abortion, and you refuse to perform one, you have put her in the position of wanting to commit a mortal sin on her deathbed (which intention, presumably, could be considered a mortal sin) and then letting her die. Better not to say anything to her and the family at all. Unless you believe you should let others make life-and-death moral decisions for you, this seems to me a very good argument for avoiding Catholic hospitals. Perhaps every Catholic medical facility should have a sign saying, "We will not perform direct abortions, even to save your life. If our ethicists have any doubts at all regarding a medical procedure, your case will be referred to the local bishop, who will make a decision on your behalf and on behalf of the ethics committee."

I think Thomas Aquinas's view of abortion is the morally correct one. St. Thomas Aquinas says abortion was not homicide unless the fetus was "ensouled," and ensoulment, he was sure, occurred well after conception.

Forgot to add that the following was issued by Pope Benedict XVI in 2007 on the feast day of St. Thomas Aquinas (28 January): "with his charism as a philosopher and theologian, he (Thomas Aquinas) offered an effective model of harmony between reason and faith".

Joseph, Thomas would have thought that ensoulment occurred well before 11 weeks. He was basing this idea on faulty Aristotelean biology which modern science proved wrong some time ago.

Kathy,While it seems to me safe to assume Aquinas would not have based his views regardin ensoulment on Aristotelian biology if he had known modern biology, I don't think it is safe to say when he would have thought ensoulment takes place. And in any case -- correct me if I am wrong here -- the Catholic Church does not claim to know when ensoulment takes place, and consequently the Catholic position on abortion is not based on the idea that it is acceptable to abort before ensoulment and unacceptable after.

Oh, PLEASE, let's not drag Thomas Aquinas into this discussion yet again.Neither St. Thomas nor the Church knows for sure when a fetus is ensouled, so to cover all contingencies, the Church teaches that we must consider a fetus a human being at the moment of conception. Based on the assumption that a fetus is ensouled at the moment of conception, the Church considers it a human being in full. Church teaching further extrapolates that as a human being in full, and wholly defenseless, the fetus deserves the same protections as any other human being and that no one may intentionally destroy it, even to save the life of another, born or unborn.I do not think it is a sin for a mother to have faith that the Church is correct and to die with her unborn baby rather than let it come to harm. However, neither do I believe that, based on assumptions and unknowns undergirding this teaching, a mother or those who carry out an abortion to save her life when no other help is at hand, has necessarily lost God's grace.

I think it is possible that "abortion on demand" -- which accounts for 99 percent of abortions in the United States -- is such an overwhelming issue for those who are pro-life, that it becomes difficult for them to consider lifesaving, therapeutic abortion dispassionately. In 1902, the Holy Office forbade intervention in an ectopic pregnancy until the sixth month. It was not until the 1930s that moral theologians came up with what we now consider the classic example of "indirect abortion" -- the removal of the fallopian tube (or some part of it) with the implanted embryo. As with the rationale of the Phoenix ethics committee about the removing the placenta, the idea of removing part of the fallopian tube with a living fetus in it was probably not greeted with universal cries of, "Yes, that's it!"

Oh, let's do drag Aquinas into it, and all of his interpreters! Why not? A 1940s Jesuit Aquinas scholar whose name I forget but whose four volume interpretation I studied for years, interpreted Aquinas on original sin, saying it is directly linked to the sexual intercourse which leads to conception. His explanation involved the statement that were it possible for a child to be conceived in a test tube, THAT PERSON would be without original sin. At the time he wrote, test tube babies were science fiction. I don't recall the Vatican verifying that theory--and citing Aquinas scholarship--once the test tube babies became reality. The moral of that story is that purely academic explication of moral theology doesn't satisfy any goal, especially one leading to a life-or-death action. And of course moral decisions can't be made purely on the basis of feelings, any more than they should be made solely on the basis of rational/factual/emotionless void. The food pantry I volunteer for has as good a solution as any. People sign up to qualify for food & emergency assistance. One never knows, of course, if a con man is filling out our forms...just as the con men used to go rectory-to-pastorate telling the same fictional sob story, collecting from each minister. But our motto is: "Err on the side of compassion." I think it's the most sensible choice: Christlike, yet allowing for our own fallibility.

"He was basing this idea on faulty Aristotelean biology which modern science proved wrong some time ago."Not so simple, Kathy. Yes, the biology was faulty, but he also included philosophical premises and at least one scientific one which hold to this day in chemistry (you can tell what a thing is by what it can do). Granted the biology is irrelevant, but Rome ignores the philosophical part and scientific part of his argumentation, as do many on this blog who then say he's irrelevant without even knowing what he says.

Why was this young woman not afforded safe birth control? All could have been avoided. What avoided? Her own terrifying painful threat of death, the threat of her motherless four children, her spouse without her love, support for their life together, her loss to her parents, siblings, close friends and neighbors, her loss to her parish community, our nation. Her loss of the fetus. The pain of the hideous yet essential decision of the Ethics Team and certainly of Sister Margaret McBride. All could have been avoided, simply avoided. Period.Why was it not? Why in the name of God was the simple, lawful, practical use of a prescribed effective birth control measure not made available to this young woman? Ask yourself why? Ask no man, he is incapable of knowing. Period.

Ann, I 'm well rebuked. I'm more familiar with Thomas on the subject of the Immaculste Conception (also wrong) than on ensoulment simply. Let me look it up and I'll get back to you.Moral theology is not an academic subject solely, which accounts for its near-disappearance of late. It's my conviction that moral theology is by nature "from above." Its principles are given in the revelation and through the truths about the human-divine relationship. It's not a series of case studies, like ethics, that can be argued to satisfy everyone, believers or not, using arguments that may or may not have any depth of religious motivation. Moral theology is what St. Paul does sometimes, sometimes not: once he makes a case for universal Christian celibacy but says that this is from himself, not from the Lord. But he makes the case for ecclesial unity based on what he himself received and handed on as of first importance.

I'm back late to the discusion (glorious tennis morn), but i must defend Lisa who is right on to my mind.I just reread Fr. McCabe in the thread below and the importance of the hierachy listening to the world around and the lived experiences of the faithful.I the reject the notion that most people are making moral decisions by "emotion" instead of the philosphising and intellectualizations some prefer.What is critical to the Christianm life is relationalism of which compassion, empathy, etc. are part of the love the Lord demads.I agree with Fr. John Meier that we really learn about Jesus through the Word by His relations with others then to understand Him now.I like Fr. Jim Martin who tells tells us that the Lord meets us as we are and leads us on in relationship if we get on board. and see Him in others too.The two great commandments ground our morality and must deal with the messy experiences and struggles we go through.So today, i think we'd all be better off listening to Fr. McCabe about how we need to get to balance by better realating.

Sensus Fidei said: " --- many questions arise about the Churchs unhealthy obsession with sex. "A paraphrase of what is stated in "A Streetcar Named Desire": "But it IS, Blanche - it IS!!!"

I don't remember that from Streetcar, but I remember, "But ya are, Blanch! Ya are in that chair!" from What Ever Happened to Baby Jane.

Ann, I m well rebuked.Kathy,You, of all people, should know the word is 'buked.

Thanks for the good word, Bob. I'll stand by compassion. It surely can be misused, and is open to plural interpretations in some cases, but I think that without a firm ground in basic, heartfelt love, then Christian morals becomes merely a matter of principles and conclusions set apart from the actual lives of the faithful. It becomes heartless, as when we think that allowing a mother to die because she is pregnant is somehow for the good. Kathy, I must say I disagree with your characterization of moral theology. Moral theology, to my mind, anyway, is the living out of discipleship in a messy world of shades of gray, and not at all a pure science of clear deductions from given principles. For example, what to do with a woman caught in the act of adultery--the very act!--when the law is very clear on that point? What do you do when some guy's been beaten up by thugs and left in a ditch, a guy who might, for all we know, already be dead, and therefore touching him would make one "unclean"? From the other side of the street, you just don't know.Catholic moral tradition makes its arguments on the basis of natural law thinking, that is, plain old human reasoning about human nature, amenable to believer and pagan alike. This is based on two startling, perhaps hubristic principles (from Thomas Aquinas,) first that our reason is "like" God's reason--we're not as quick, as infallible, or as all-seeing, but we think like our creator. Therefore any human of good will and open to dialogue and critique and engaged in the ongoing search for what's right can glean some portion of ultimate Truth. The second presumption is that God wants what's good for us. Human flourishing, social and individual, IS God's will. God is reasonable, and wants us to flourish--hence, natural law thinking.Where Christians differ from others, at least ideally, is that, because of the example of Jesus, (who commanded compassion as the sum of the law,) we should not just be interested in the welfare of all, but on fire for it. But saying that women in life-threatening pregnancies with no hope for the embryo should just be quiet and die--nope. Doesn't pass the compassion test.And the notion "I'd tell the kids that the mother couldn't kill the embryo any more than she could kill one of you," I'd wager that any kid older than 7 or so would come right back with "the baby in her womb could not live. Why did she leave us for a baby who could not live?" Or, as Cathleen's 7 year-old companion from another thread said, such reasoning, well, "it's just pretend."

Lisa, my point isn't to argue against "compassion" or to argue for looking at solutions to life-and-death problems from a purely dispassionate and legalistic POV, but to push people to think about how that translates into action in real life. Last month, amid the horror show of my dad's death, I listened to my sleep-deprived mother tearfully plead with the nurses to euthanize him (they did not, though I would have tried to prevent them). She said--direct quote--"We're more compassionate to sick animals!"Even within a relatively Catholic group here, you're going to find people differing on what the "compassionate" thing to do is. Throw it out there to society at large, and you'll get an even bigger debate.

Two conceptions of morality are contending here: the view that morality is a matter of producing the best possible outcomes and the view that morality is a matter of following rules. Both of these conceptions rest on profound moral intuitions, but they are incompatible. This is obvious both in the Phoenix case and in Sophie's choice. There are two possible outcomes: two people will die (if nature takes its course in Phoenix or by the hands of the Nazi commander in Sophie's case) or one will be saved provided the other is deliberately killed by the person(s) faced with the moral choice. The "outcomes" conception of morality says that one death is a better outcome than two and so it is moral to kill one person in order to save the other, while the rule-following conception of morality says a person may not be deliberately killed, whatever the outcome. The "outcomes" conception says we are responsible for the state of the world, and holds that it is just as serious a fault to let bad outcomes happen as it is to deliberately cause them to happen. The rule-following approach says we are responsible only for our actions (and not the state of the world), and therefore considers there is an important moral difference between actively doing something and passively letting things happen. If Sophie refuses to kill one of her children and both of them are then killed by the Nazi commander, then he is the only one who has done anything wrong; Sophie herself is blameless because she did not actively do anything but simply let things happen. (She has clean hands.) There are elements of both approaches in traditional Catholic moral theology. The rule-following conception is quite obvious in the notion of intrinsic evil and the claim that one may never do evil in order to produce good. But Catholic morality has also always been concerned about outcomes. That explains why there are exceptions built into certain rules. If the rule against homicide allows for the justifiable killing of aggressors and criminals convicted of certain crimes, it is because of the belief that these exceptions lead to better outcomes than a blanket rule against all homicides. (Indeed, the increasing condemnation of capital punishment by Church leaders results from the realization that it does not produce better outcomes.) The "outcomes" approach is also evident in the well-known claim that general rules cannot adequately solve all particular cases, and that equity or epikeia is needed to complement the rules. Also, when a decision is justified as being "the lesser of two evils", an "outcomes" approach is being invoked.So, traditional Catholic moral theology is an amalgam of both approaches. One could claim that both approaches are needed in order to do justice to the fullness of moral experience. The problem is that the two approaches lead to incompatible results in certain cases. In the Phoenix case, the "outcomes" conception of morality requires us to take one life to save the other (the lesser of two evils), while the rule-following approach prohibits us from taking a life and requires us to let both die.

To reduce the non-consequentialist strain of Catholic moral teaching to "rule following" is a serious misunderstanding. Moral theology is not nominalism or some low rung of Maslow's hierarchy of needs. A life focused on the One Who alone is good leads limited beings to share the limitless life of the triune God--that is moral theology. In its compass you'll find honesty and generosity and everythiing else we value in our neighbors (and possibly in ourselves). The goodness Catholics aspire to, through baptism, doesn't fit on any scale of moral growth. It's super-human goodness. Ethics does not begin to understand moral theology.

The "outcomes" and the "rule following" solutions to moral dilemmas reminds me of old-school Catholics back when Catholics took the Church's prohibition against birth control seriously. Since "artificial birth control" was a mortal sin, on a level with abortion, after the couple had reached their limit on children, the husband used the birth control, (vasectomy or whatever). In other words, the husband did the manly thing and committed the sin. The wife was blameless; she only had intercourse with her husband. In the confessional, wives had nothing to confess. Husbands often quit going to confession, and perhaps communion, and sometimes church. This homespun blend of "outcomes" and "rule-bending," (if not enforcing/observing), worked for generations. Then the pill gave women a chance to take charge of our own decisions, without input from the men, ordained and not. Super-human goodness it was not, but desperate times called for desperate measures and this was the best folks could come up with, with no help from theology. The bizarre outcome of this is that homilies on the Church's ban on artificial birth control have bit the dust, along with those manly men who assumed the burden of our sins. Artificial birth control is still a sin, right? I'm just sayin'.

Carol DeChant, as a musician, I find your name beguiling :-)

Kudos to everybody, this has been a very insightful, unique discussion! I appreciate such interesting perspectives and of course the lack of rancor. Wonderfully refreshing and it instills hope!

Ditto, Sensus Fidel. I've never followed a discussion of a Commonweal piece before. Who knew?Jim Pauwels, I have encountered you somewhere in the Chicago diocese. Doing homilies for burials of children via Rest in His Arms? Not in the music scene, as only my name is musical...which translates to Sing Sing, or Song of Songs, btw, depending upon one's frame of reference, I have found.

"Jim Pauwels, I have encountered you somewhere in the Chicago diocese.Doing homilies for burials of children via Rest in His Arms? "Yes ... amazing what a small world it is. If you would, please write to me off-line and let me know how you've come to know Rest In His Arms.

While I think the circumstances of this case are sufficiently rare that I disagree with Jean that we need to stress to Catholic girls that the need to be prepared to surrender their lives for the sake of their unborn children, I do think she is on to something that we have been less than frank about how great the price of the pearl can be.It seems to me this is a mirror image of the torture debate, though the reality of this case is closer to a constructed hypothetical than the reality of the war on terror is to ticking-time-bomb scenarios.But the reality, which we don't want to believe, is that, yes, we should be prepared to die rather than torture someone. Even a terrorist.And yes, we should be prepared to accept death rather than kill another. Even an unborn child who is doomed anyway.The symbol of our salvation is an implement of torture and death. We don't want it. That doesn't make us bad -- Christ Himself didn't want the Cross, and pled with His Father to take it away!--I have been struggling to figure out what good can come from this horrible case. But maybe this -- a reminder of the heroic virtue we are called to.

I also feel compelled to add that this Catholic still takes the Church's teaching on artificial contraception seriously, and knows may others who do as well.

@AreopagiteIf I people would indulge me in one more post.I acknowledge that "rule-based" and "outcome-based" morality are often in tension, and in the Phoenix case can be in direct contradiction.But I submit they can also be in harmony, and this is where the Church is coming from. A world where people don't deliberately kill each other is a better world than one in which they are allowed to.It also seems to me that many of these situations (though it doesn't appear the Phoenix case is one of them) are a result of sin in the world that has led to a state of the world that is less than ideal. Isn't this the pro-life case for health care reform? That if people are more secure in knowing their needs will be taken care of, abortion is not as severe a temptation?The works of mercy are more about the state of the worlds than in following rules.Cases like the Phoenix case are important, and it is good for us to talk through the implications of the different options.But I think we should also thing about what we can do upstream from where these terrible dilemmas face us.

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