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Posts Tagged ‘Sister Margaret McBride’

My article in today’s LifeNews.com

Bishop Thomas Olmsted, of the Phoenix, Arizona Diocese took the extraordinary step last week of removing Saint Joseph Hospital’s Catholic status.

The measure comes after last May’s confrontation between Sister Margaret McBride, the hospital’s administrator who gave permission for an 11-week pregnant woman with a severe case of pulmonary hypertension to have an abortion, and Bishop Olmsted who notified her in private that her actions were formal cooperation in the child’s death, and therefore incurred a laetae sententiae (automatic) excommunication.

Much confusion swirls around this case, and needs to be cleared in the interest of defending the good name of a good bishop.

First, a recap of the initial controversy last May. Pulmonary hypertension is a gravely serious condition that is exacerbated by pregnancy. Testing done at Saint Joseph’s indicated a fairly advanced stage of the disease, and it was deemed that the 27 year-old mother of four would in all likelihood not make it to term with her pregnancy. Termination of the pregnancy was advocated as the means of saving the life of the mother. Thus, the ethical crossroads.

The moral guide for hospitals and healthcare institutions is spelled out in Ethical and Religious Directives of the United States Conference of Catholic Bishops (ERD’s). Directives #45 and #47 both spell out the rules for dealing with a case such as this, and Bishop Olmsted, a Doctor of Canon Law, has made it clear that this case did not fall within the parameters of these directives and what is known as the Principle of Double Effect.

In essence the principle states that a lifesaving procedure that cannot be delayed, such as the removal of a cancerous uterus before the baby can be taken in a Cesarean section at viability (~25 weeks gestation), is permissible so long as the death of the baby is the indirect and unintended effect. The life-saving treatment and resolution of a disease with immediate lethal consequence if no treatment is rendered is the good effect. The unintended death of the baby is the bad, or second (double) effect.

Such circumstances are extremely rare, given how early a baby can be delivered before full term at 40 weeks. The mother’s life must be in immediate danger and the treatment of her disease, which would also result in the death of the baby, cannot be forestalled. The case at Saint Joseph’s did not rise to the level of Double-Effect, as the baby was the sole target of intervention.

While the assessment on the part of physicians was dire, no treatment of the disease was even attempted. There are several medications that can be employed to attempt a reduction in the severity of the disease, none of which appear to have been dispensed in this case. From that point on, the actions of the hospital and Sister McBride pointed toward more than an isolated and extreme case where the decision to abort could have been simply dismissed as one bad judgment call.

There are several hospitals within a three-mile radius of Saint Joseph’s, some mere blocks away, where this woman’s husband could have taken her for the recommended abortion. They were no more than ten minutes from any number of facilities that would have performed the abortion, if that was what the couple wanted. All reports of the incident indicate that at no point was the couple told that Saint Joseph’s does not target babies for death as a means of treating a disease. Again, no evidence has surfaced that the physicians attempted to treat her medically.

This is a critical distinction that separates Catholic healthcare from its secular counterparts. Many physicians resort to abortion as a defensive strategy to avoid potential litigation. Others have signed on to the eugenics agenda and aggressively promote abortion for Down Syndrome and other babies with trisomic disorders, spinal tube defects such as spina bifida and anencephaly, and a host of other imperfections.

Patients who seek Catholic healthcare do so because of the assurance that the facility and its clinicians adhere to the ERD’s. They do so because they seek the assurance that they will be told the truth and treated in accord with Catholic moral norms, and not railroaded down the disastrous path American medicine has decided to follow. The Phoenix case is an excellent example of what happens when rebels take charge and deceive their patients and the bishop.

At the time, I remarked to peers in medicine and to groups I was invited to address that there had to be much more to this story than meets the eye. No Catholic hospital faithful to the ERD’s and the Magisterium, within a stone’s throw of several other hospitals, makes such a decision, especially without consulting the local bishop. I opined, and was pilloried for it, that Sister McBride was presiding over a shadow healthcare system that was active in promoting an agenda that ran counter to the mission of the Church. Nobody commits first-degree murder as a first crime. No Catholic hospital administrator, especially a professed religious, signs off on such an abortion for the first time in the manner in which Sister McBride conducted herself.

There was an arrogance, an independent and defiant air about it that pointed to something deeper and darker, something that would eventually come to light.

This past week, Bishop Olmsted shared with the world the extent to which there has been a shadow system operating for over a quarter of a century, performing abortions, sterilizations, and dispensing all manner of contraception. Sister McBride, as it has now been revealed, is hardly the compassionate administrator who made a good-faith, though horrific decision.

In Part II, how Bishop Olmsted was lied to, lied about, what happens next in his courageous pushback against the rebellion within his healthcare system, and its implications nationally for Catholic healthcare.

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Many will recall the battles earlier this year on this blog when I defended Bishop Olmsted for declaring that Sister Margaret McBride, R.S.M. excommunicated herself by approving an abortion at Saint Joseph’s. I wrote several posts on this issue:

FIRST

SECOND

THIRD

FOURTH

FIFTH

SIXTH (How Catholic Bioethics is guided)

SEVENTH (An article on Double-effect)

EIGHTH

Many came out in defense of this monstrous nun. But nobody ever starts with an abortion like this. Now the explosive truth has been revealed, and it’s eye-popping!!

Now that the truth has come to the Bishop’s attention about what a vipers pit that “Nun” has been running, Bishop Olmsted let fly. Here is the Bishop’s own official statement, released through his Office of Communications.

Merry Christmas from Coming Home to one of the few Eagles among our Bishops! God bless you, Bishop Olmsted.

St. Joseph’s Hospital no longer Catholic
Statement of Bishop Thomas J. Olmsted
December 21, 2010

Jesus says (Cf. Mt 25:40), “Whatever you did for the least of my brothers and sisters, you did for me.”

Caring for the sick is an essential part of the Gospel of Jesus Christ. Throughout our history, the Church has provided great care and love to those in need. With the advent of Catholic hospitals, the faithful could also be confident that they were able to receive quality health care according to the teachings of the Church.

Authentic Catholic care in the institutions of Catholic Healthcare West (CHW) in the Diocese of Phoenix has been a topic of discussion between CHW and me from the time of our initial meeting nearly seven years ago.

At that first meeting, I learned that CHW already did not comply with the ethical teachings of the Church at Chandler Regional Hospital. The moral guide for Hospitals and Healthcare Institutions is spelled out in what are called the Ethical and Religious Directives of the United States Conference of Catholic Bishops. I objected strongly to CHW’s lack of compliance with these directives, and told CHW leaders that this constituted cooperation in evil that must be corrected; because if a healthcare entity wishes to call itself Catholic (as in “Catholic” Healthcare West), it needs to adhere to the teachings of the Church in all of its institutions. In all my seven years as Bishop of Phoenix, I have continued to insist that this scandalous situation needed to change; sadly, over the course of these years, CHW has chosen not to comply.

Then, earlier this year, it was brought to my attention that an abortion had taken place at St. Joseph’s Hospital in Phoenix. When I met with officials of the hospital to learn more of the details of what had occurred, it became clear that, in the decision to abort, the equal dignity of mother and her baby were not both upheld; but that the baby was directly killed, which is a clear violation of ERD #45. It also was clear that the exceptional cases, mentioned in ERD #47, were not met, that is, that there was not a cancerous uterus or other grave malady that might justify an indirect and unintended termination of the life of the baby to treat the grave illness. In this case, the baby was healthy and there were no problems with the pregnancy; rather, the mother had a disease that needed to be treated. But instead of treating the disease, St. Joseph’s medical staff and ethics committee decided that the healthy, 11-week-old baby should be directly killed. This is contrary to the teaching of the Church (Cf. Evangelium Vitae, #62).

It was thus my duty to declare to the person responsible for this tragic decision that allowed an abortion at St. Joseph’s, Sister Margaret McBride, R.S.M., that she had incurred an excommunication by her formal consent to the direct taking of the life of this baby. I did this in a confidential manner, hoping to spare her public embarrassment.

Unfortunately, subsequent communications with leadership at St. Joseph’s Hospital and CHW have only eroded my confidence about their commitment to the Church’s Ethical and Religious Directives for Healthcare. They have not addressed in an adequate manner the scandal caused by the abortion. Moreover, I have recently learned that many other violations of the ERDs have been taking place at CHW facilities in Arizona throughout my seven years as Bishop of Phoenix and far longer.

Let me explain.

CHW and St. Joseph’s Hospital, as part of what is called “Mercy Care Plan”, have been formally cooperating with a number of medical procedures that are contrary to the ERDs, for many years. I was never made aware of this fact until the last few weeks. Here are some of the things which CHW has been formally responsible for throughout these years:

• Contraceptive counseling, medications, supplies and associated medical and laboratory examinations, including, but not limited to, oral and injectable contraceptives, intrauterine devices, diaphragms, condoms, foams and suppositories;

• Voluntary sterilization (male and female); and

• Abortions due to the mental or physical health of the mother or when the pregnancy is the result of rape or incest.

This information was given to me in a meeting which included an administrator of St. Joseph’s Hospital who admitted that St. Joseph’s and CHW are aware that this plan consists in formal cooperation in evil actions which are contrary to Church teaching. The Mercy Care Plan has been in existence for 26 years, includes some 368,000 members, and its 2010 revenues will reach nearly $2 billion. CHW and St. Joseph’s Hospital have made more than a hundred million dollars every year from this partnership with the government.

In light of all these failures to comply with the Ethical and Religious Directives of the Church, it is my duty to decree that, in the Diocese of Phoenix, at St. Joseph’s Hospital, CHW is not committed to following the teaching of the Catholic Church and therefore this hospital cannot be considered Catholic. The Catholic faithful are free to seek care or to offer care at St. Joseph’s Hospital but I cannot guarantee that the care provided will be in full accord with the teachings of the Church. In addition, other measures will be taken to avoid the impression that the hospital is authentically Catholic, such as the prohibition of celebrating Mass at the hospital and the prohibition of reserving the Blessed Sacrament in the Chapel.

For seven years now, I have tried to work with CHW and St. Joseph’s, and I have hoped and prayed that this day would not come, that this decree would not be needed; however, the faithful of the Diocese have a right to know whether institutions of this importance are indeed Catholic in identity and practice.

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Well, this was only a matter of time. An NPR article questions the justice and integrity of Phoenix Bishop Olmsted in declaring that Sister Margaret McBride incurred automatic excommunication when she gave her approval for an abortion in an 11-week pregnant 27 year-old woman with pulmonary hypertension judged to be near death. The article questions the excommunication of a nun trying to save a life, while pedophile priests incur no such penalty.

Good question for a canon law seminar or a social justice seminar, worthy of great consideration. However, in this case, and in all others dealing with excommunication, it is a dangerous and illogical conflation.

A child was killed in a Catholic hospital. The moral dimensions surrounding that decision stand on their own merits and do not rely on the merits of unrelated human rights violations. The line of argumentation in the NPR article that suggests as much illustrates a dangerous conflation of issues and ignorance of morality and justice.

There is no doubt that the sexual abuse of children is truly horrifying, whether by a Priest, a parent, a school teacher, scout leader, or any other person betraying a position of authority and trust. Whether or not that abuse merits excommunication is an argument that I would love to see vetted by moral theologians and canon lawyers.

Suppose it were an offense that merited excommunication? Further suppose that pedophile Priests incurred the penalty. Excommunication is a penalty intended as a medicinal remedy. Readmittance to the Church is made through confession to a Bishop (unless he delegates that authority to his Priests). Even if all of that were already operative, it would have no bearing on the intrinsic merits or demerits of the case in Phoenix.

Further, the Pope is the one with the authority to promulgate canon law. The NPR piece deceptively leads one to the erroneous conclusion that Bishop Olmsted, or any other Bishop, has discretion in excommunicating pedophiles, when in fact he doesn’t. Bishops can only adjudicate as much as Church law allows them to adjudicate, and I have not heard of Bishop Olmsted being implicated in cover-ups of pedophiles.

Yet this will be the new narrative when going after other abuses, “But what about the pedophiles…?” The pedophiles are now being dealt with decisively.

So let’s return to matters at hand.

Regarding Sr. McBride, the issue here is not medical, but administrative.

The Catholic Church has clear guidelines in moral theology and bioethics about what is, and is not permissible. A Catholic hospital’s administration is responsible for communicating those boundaries to the attending physicians, who are then responsible for respecting those limits, and communicating them to their patients.

This woman didn’t go from totally healthy to needing an abortion overnight. In going for her prenatal care, the physician no doubt was treating her for the hypertension, and should have communicated that the pregnancy could exacerbate the condition, presenting the dilemma of abortion v. danger of maternal mortality prior to viability at 25 weeks. Further, the physician should have communicated to the parents that if the condition did deteriorate, presenting at St. Joseph’s would preclude abortion as a therapeutic option.

In the time it took to go to St. Joseph’s and wait for a round of medical/ethical consults, the couple could have gone to another hospital in a city of 1.5 million, with a metro area of 4.5 million.

It isn’t hard to see that there was a breakdown in the communication of clear limits regarding abortion. Someone needed to be held to account for that breakdown. Sister McBride’s decision could not be left standing as a precedent for the future in a Roman Catholic Hospital.

There are plenty of other hospitals where this is an acceptable procedure. The clear communication of these limits by the administration and OB/GYN’s on staff would direct patient management in cases like this toward facilities offering the abortion option, if that is an option that the couple wishes to hold in reserve.

That said, this was a case tailor made for more Bishop bashing by abortion’s apologists who would love nothing more than to see Catholic hospitals forced through law, or bad administrative precedent, into performing abortions. Bishop Olmsted is to be commended for his moral clarity.

{HT: Jill Stanek}

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In the case of the latae sententiae excommunication (automatic excommunication by one’s formal participation) of Sister Margaret McBride, administrator at Saint Joseph’s Hospital, Phoenix Arizona, who approved the abortion of an 11-week baby because the mother was suffering from the often fatal condition in pregnancy of Pulmonary Hypertension (PHT), we simply do not know all of the facts to hold a rational discussion.

So I propose that we do just that as the antidote to the vitriol that has swept the web these past few days: Hold a rational discussion.

What we do know is this: An 11-week pregnant woman suffering from pulmonary hypertension was deemed in need of an abortion to keep the developing pregnancy from killing her. It’s a serious matter. The abnormally high pressure in the narrowed arteries of the lung make the heart work harder at pumping blood. The prognosis is usually poor, but there are several medications available to treat the condition.

We know nothing beyond that. How critical was this woman was remains open to speculation. Whether or not the doctors tried to treat her medically is also unknown.

An attorney once told me that bad cases make bad law. This is such a case in the realm of Catholic bioethics.

All of that said, we do have enough information to sketch out a plausible series of steps that a Catholic hospital administrator might consider for future related cases.

First, the abortion is not akin to pressing a reset button for the pulmonary hypertension. There is no immediate (in minutes) rebound to pre-pregnancy physiologic status.

Next, assuming that this was not a patient presenting for the first time in the pregnancy, and doing so with hours to live, then the case is not so emergent as to warrant the abortion being performed in a Catholic hospital, especially in a large city such as Phoenix, AZ, with a metro population of 4.5 million. St. Joseph’s is far from being the only act in town, or even within a ten minute drive.

As suggested by a very good friend who is Evangelical Protestant and socially Catholic, who is also an OB Nurse, the medical staff following the mother in a Catholic hospital need to stress that their goal is to try and save both the mother’s and the baby’s lives. Therapy will be targeted to keeping the PHT manageable with a view of delivering the baby via C-section at the earliest opportunity (~25 weeks), if at all possible. If the parents are that risk averse, then they need to be informed that they cannot be aided at the Catholic hospital in aborting the child.

The outcomes are always least complicated when the limits are set down with clarity from the outset.

The limit here is that Catholic moral teaching is perfectly clear: the ends never justify the means, no matter how good or noble the ends. We must employ just means toward just ends. The direct, intentional killing of a baby is always immoral and impermissible. This differs from procedures such as hysterectomy in a newly pregnant woman discovered to have advanced uterine cancer, or a tubal pregnancy where the diseased or damaged organ is immediately life-threatening and must be removed. In such cases, the mother would die before the baby became viable AND the death of the child was an UNINTENDED consequence of the intended good, which is the removal of the diseased organ. That is the Principle of Double-Effect. In attempting a morally good action, the objective evil done is unintended.

Intent matters.

Bishop Olmsted is being pilloried for being uncharitable toward Sister Margaret in his upholding Catholic moral teaching. Perhaps the bishop knows more than most. Sister Margaret’s history on these issues is an unknown at this point.

Bishop Olmsted’s actions represent a departure from the very patient and measured responses by the Bishops to Catholics publicly breaking with the Church on this issue, especially Catholic politicians. Something is behind that departure.

In the end, this is just a very bad and probably unnecessary case that could in all likelihood have been avoided. There is no shortage of hospitals in the city of Phoenix. With St. Joseph’s firm “NO” to abortion as an option, this woman’s husband/family could have arranged immediate transport to a neighboring hospital to procure the abortion.

Beating on the Bishop for holding the line is convenient. In fairness, it has been the Catholic Bishops who stood in the breech for years, rallying the growing pro-life movement around them. For that reason alone, I’m inclined to err on the side of defending Bishop Olmsted in this matter. It’s not clear how firm or early on, or whether the limits were articulated at all regarding abortion.

With current confidentiality practices, we’ll never know.

UPDATE 5/18/10: Erin Manning is perhaps one of the most gifted Catholic observers of contemporary culture and writers whom I have ever encountered. Erin took me to the woodshed, in her very loving way, over a part of this post. Her points were well made and well received. They are a portion of her post on this topic, made on her Blog, “And Sometimes Tea”. Erin’s comments are reprinted here:

“I do have one minor quibble with Gerard; I think we need to stay away from the framework which suggests that because this happened in a place with plenty of secular hospitals willing to perform an abortion there was no need for the Catholic hospital to to so–because the flip side of this will come back to haunt Catholics, if under government health care Catholic hospitals in poor rural areas are coerced into performing “emergency” abortions. We can’t ignore the peril of suggesting that simply because other willing executioners of this child existed the Catholic hospital was off the hook, so to speak; the Catholic hospital had an opportunity to lead the way by providing care for both the mother and the baby, and it failed utterly to do any such thing.

“That said, I am sadly not surprised that a Catholic religious sister would apparently see no contradiction between her faith and vows on the one hand, and the slaughter of an innocent human being in utero on the other. There is, alas, no shortage of feminist nuns who completely lack any understanding or acceptance of the Gospel of Life, and are all too willing to adopt the “pregnancy-as-oppression” framework their secular counterparts push at every opportunity. I wonder whether the bishop, or any other responsible party, has inquired into whether the hospital in question routinely dispenses contraception, including the abortifacient variety; so many so-called “Catholic” hospitals do this, oblivious to the sin and scandal of it.”

Read the two follow-up articles HERE and HERE.

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