Last summer, Bishop Olmsted of Phoenix askedCatholic Healthcare West to provide a moral analysis of the case that started this controversy. So CHW secured the services of the moral theologian M. Therese Lysaught. Her analysis, sent to the bishop in October, was rejected by Olmsted last month. We have obtained Lysaught's cover letter to CHW along with her analysis.In her cover letter, Lysaught summarizes her conclusion: "The procedure performed at St. Joseph's Hospital and Medical Center on November 5, 2009, cannot properly be described as an abortion. The act, per its moral object, must accurately be described as saving the life of the mother. The death of the fetus was, at maximum, nondirect and praeter intentionem. More likely, the fetus was already dying due to the pathological situation prior to the intervention; as such, it is inaccurate to understand the death of the fetus as an accessory consequence to the intervention."Lysaught's analysis includes a detailed summary of the medical condition of the mother. In October 2009, the mother's doctor counseled her to terminate the pregnancy because the symptoms of her pulmonary hypertension were worsening. He estimated that, given the advanced state of her disease, she would have a 50-50 chance of surviving the pregnancy. The mother, a Catholic with four children, decided against ending the pregnancy. Less than a month later, she was admitted to St. Joseph's with more severe symptoms.

A cardiac catheterization revealed that the woman now had very severe pulmonary arterial hypertension with profoundly reduced cardiac output; in another part of the record, a different physician confirmed severe, life-threatening pulmonary hypertension, right heart failure, and cardiogenic shock. The chart noted that she had been informed that her risk of mortality approaches 100%, is near 100%, and is close to 100% if she were to continue the pregnancy. The chart also noted that surgery is absolutely contraindicated.

As Lysaught makes clear, the pregnancy itself exacerbated her symptoms. Owing to physiological changes accompanying pregnancy, the mother's heart could no longer supply enough oxygenated blood to sustain her organs--or the fetus. "In short," Lysaught writes,

in spite of the best efforts of the mother and of her medical staff, the fetus had become terminal, not because of a pathology of its own but because of a pathology in its maternal environment. There was no longer any chance that the life of this child could be saved.This is crucial to noteinsofar as it establishes that at the point of decision, it was not a case of saving the mother or the child. It was not a matter of choosing one life or the other. The childs life, because of natural causes, was in the process of ending.

There's much, much more in the rest of the document--including Lysaught's analysis of the intervention based on the work of Fr. Martin Rhonheimer and Germain Grisez, along with her response to the National Catholic Bioethics Center's analysis and an application of the USCCB statement [PDF] responding to the controversy. The whole document is worth your time.You can read Lysaught's cover letter to Lloyd Dean, president of CHW,here [PDF]. And Lysaught's twenty-four-page analysis is availablehere [PDF].NCR's story on Olmsted's decision to revoke CHW's Catholic status is here (be sure to follow their helpful links).

Grant Gallicho joined Commonweal as an intern and was an associate editor for the magazine until 2015. 

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