A distressing decision

When I was briefly at business school in Ontario the primary teaching method was the case study, followed by a demanding discussion. The measurement of each episode’s success was the degree to which it brought out conflicting issues leading to a decision. This week I have a case study for you which, sadly, is based on real life – although space obliges me to simplify some of the detail.

The scene is a Catholic hospital in America. The protagonist is a mother, 11 weeks pregnant, with pulmonary hypertension. Her condition has deteriorated as a result of the developing pregnancy, and her chances of survival are virtually nil. After discussion between mother, doctors and the hospital’s ethics committee, it is decided to terminate the pregnancy. And this is done.

The local bishop declares that participants are excommunicated for participating in abortion – including a senior nun, a hospital administrator who was serving on the ethics committee. Later, when the hospital refuses to accept that it has behaved wrongly – and taking into account what he holds to be other irregularities – the bishop declares that the hospital may no longer be called Catholic. Nor may Mass or Eucharistic reservation continue. This decision is of course within the authority of the diocesan bishop. The hospital accepts the ruling but continues to defend its actions.

End of story? Not quite.

The Church’s settled teaching in this matter is clear. It is always wrong to take the life of the baby directly (or the life of the mother, for that matter) to save the life of the other. In certain instances – for example, when the pregnancy takes root in the fallopian tube – it is permitted for proportionate reasons to remove the diseased tube even though this will indirectly bring about the death of the baby. The baby’s death is an unintended, though inevitable, secondary effect of the lawful operation.

The hospital argued that “consistent with our values of dignity and justice, if we are presented with a situation in which a pregnancy threatens a woman’s life, our first priority is to save both patients. If that is not possible we will always save the life we can save, and that is what we did in this case.”

A moral theologian who investigated the principles at issue argued that the baby’s death was indirect, and not desired as such. The diseased organ was in fact the placenta. In performing its normal function the placenta brought about cardiogenic shock in the mother; the placenta also became unable to get enough oxygen. In fact, the theologian argued, both the mother and the baby were in the process of dying. The hospital could not save the baby’s life but it could save the mother by removing the pathological placenta. It might be further argued that, since the death of the baby is inevitable in any event, one cannot in fact choose or intend a death which is already in the process of taking place.

So, what do you think?

One view might well be that the bishop is right. Clearly the removal of the placenta destroys the baby just as cutting off the oxygen from a deep-sea diver kills the diver. I would imagine that, in most cases of “mother and baby”, the placenta will play a part since it is the organ of transmission between the two. Consequently it can nearly always be argued that it is at least a contributor to the problem and so can be lawfully removed. What then is left of the strongly defended moral teaching that the baby may not be killed to save the mother? And since that teaching is based on the inalienable rights of human beings, its neglect has the most serious consequences.

Furthermore, the bishop has ruled with full authority that this is in fact direct abortion. Thus every Catholic in the diocese ignores his authority at his peril and, arguably, can never do wrong in following it.

On the other hand, one might claim that this is a matter of conscience; that this has been formed with care by the hospital in this case appears to be likely. The theologian’s argument is well summed up by the hospital’s statement that this was not a matter of taking life but of saving the only life which potentially could be saved. In any event, the effect on the baby was incidental and an unintended side effect of removing the toxic placenta.

Another might claim self-defence against an aggressor. The baby is an innocent aggressor – as a schizophrenic waving an axe may be – but an aggressor nevertheless, against whom one may act in self-defence.

A more direct view, which its proponent would surely style as simple common sense, is that, once you strip away all these casuistic arguments, you are left with a clear issue: which is more pro-life: to allow both to die or to save one? Anything else is cheese-paring.

I hope you do not expect me to plump for any one of these arguments. First of all I am not a moral theologian so I cannot guide anyone with authority. Second, that is not the purpose of a case study. But exploring the strong and weak points of these arguments (and any others which you think are relevant) helps to focus and practise the mind in moral issues. I hope that such a discussion will take place on Secondsightblog.net. I have in fact arrived at my own conclusion but I will benefit much from the thoughts of others – particularly if they show me to be wrong.

Anyone who would like more details of this case can obtain them from here, where you will find links to several relevant documents.

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About Quentin

Science Editor, Catholic Herald. Portrait © Jacqueline Alma
This entry was posted in Catholic Herald columns, Moral judgment, Quentin queries. Bookmark the permalink.

58 Responses to A distressing decision

  1. John Nolan says:

    This is a difficult one. The hospital, St Joseph’s in Phoenix, Arizona had to make a life or death decision, and quickly; it would not have had time to canvass the opinions of moral theologians and canon lawyers. It would appear that the ethics committee believed it was acting within the Ethical and Religious Directives of the US bishops.

    I am no theologian, moral or otherwise, but was impressed with the arguments advanced by M Therese Lysaught; even if the bishop disagreed with her conclusions, this is clearly not an open-and -shut case. If Sr McBride who chaired the ethics committee was an accomplice in procuring an abortion then she is indeed excommunicated latae sententiae, but what about the patient, who (reluctantly) agreed to the termination, and was presumably a Catholic?

    There is a subtext to this case. The bishop of Phoenix, Thomas J Olmsted, is strongly “pro-life”, opposes gay “marriage”, and is openly loyal to the Holy See. Nothing wrong with that, you might say, but in an American context it makes him controversial, even “divisive”. His chief grievance is with Catholic Healthcare West which for years has flouted the ERDs, particularly with regard to another Phoenix hospital, Chandler Regional. This is not under his control, whereas St Joseph’s is; it is difficult to escape the conclusion he is making an example of it.

    I think there are enough grey areas in this case to justify giving the hospital the benefit of the doubt. Hard cases indeed make bad law.

  2. RMBlaber says:

    The Bishop of Phoenix, Arizona, does appear to have decided to make this case a casus belli. Catholic Healthcare West is his target, rather than St Joseph’s Hospital, largely because of its involvement with the Mercy Care Plan and its ‘contraceptive counselling’, supply of voluntary sterilisations, and abortions to women due to their mental or physical ill-health, or when the pregnancy is the result of rape or incest. The other hospital involved, Chandler Regional, also in Phoenix, although it is owned by Catholic Healthcare West, was and is not subject to the bishop’s power of excommunication.

    I note that Sr. Margaret McBride, the St Joseph Hospital Administrator excommunicated for her role in approving the operation, is a Sister of Mercy. Do the local Sisters of Mercy run the ‘Mercy Care Plan’, I wonder, and is that another reason why she has been singled out?

    We are talking here about a patient who would have died if an operation had not been carried out; she would have died, and so would her child – there was no way the child’s life could be saved independently, not when it was only 11 weeks old, given the current state of medical science. Nor was there any way of saving both mother and child – it was a case of either/or. Given the mother’s condition, action could not be delayed, but was a matter of urgency, even of extreme urgency.

    No-one involved in the operation intended anyone to die, still less an innocent child. What they were concerned with was saving the life of a desperately ill mother. The death of her baby was an unintended consequence of that effort, not the result of a direct abortion.

    If the Bishop of Phoenix wants to take a pro-life stance – and I’m sure he does – then he has chosen the wrong casus belli, and acted both with unseemly haste and a total lack of judgement. I fear he will live to regret what he has done, as will the majority of his flock and the wider Church.

  3. James H says:

    Very distressing. It seems the Bishop is the villain in the piece, especially if he’s ‘making an example’.

    I agree wholeheartedly with RMBlaber’s last paragraph; but the trouble doesn’t end there. A story like this will be used by the culture of death to attack the church’s position on just about any life issue, no matter what logical leaps are required to do so.

  4. This is a tricky issue. Seen simply as a moral conundrum – it is of course far more – it is a variant of the question on the use of condoms by HIV-positive sexual partners. In a particular example there, the Pope settled on the “least harm” principle in what seems a clear if limited and arguably belated application of common sense.

    In the present more serious case, if the inevitable death of the baby was a correct prognosis (which a bishop has no standing to challenge) then its fate was already as firmly decided as can be humanly determined. Removing it from the womb may then be considered a practical acknowledgement of the fact and, again assuming its genuine necessity for the mother’s survival, virtually obligatory. It is hard to see what the child could lose in being taken from a situation that was itself lethal.

    There is of course an obvious danger that the argument could, or rather almost certainly would, be extended to cover euthanasia of the terminally ill. An important difference is that such patients, however decrepit, must be presumed still capable of some moral decisions that may need more time to be made.

    The argument that anyone following the bishop’s ruling could never do wrong may be valid in law, but I doubt whether by itself it would hold for anyone able to see beyond the letter of the law. A permanent feature of our parish bulletin urges us always to think “What would Jesus do?” Given his dismissal of treating healing on the Sabbath as an infraction of Mosaic law, the answer seems fairly clear.

    However, the bishop is also in a difficult position. Had he ruled otherwise, he would be accused of selling the pass on this important aspect of Catholic teaching. Moreover, such a decision would assuredly be taken as a precedent to be applied in cases progressively less clear-cut, as always happens in matters of this kind. His response to the situation may perhaps have been unduly heavy-handed, but without knowing all the details of considerations that went into it, I think we should be cautious about criticising.

  5. claret says:

    Some well reasoned points being raised in the replies and what seems a fairly clear case ( to me anyway,) of a Bishop going farther than he ever need do is tempered by the risk of making a precedent that can go beyond the case in point.
    However as this is based on a real set of circumstances it does raise the question as to why there was any need for the Bishop to be involved. I assume the birth Mother would not have chosen an abortion in any circumstances and that this is more of a medical procedure to save a life and not to lose one.
    Excommunication would appear to be a gross violation . I am reminded of that case that also attracted world wide controvesy where a girl of tender years was raped by a relative ( her father I think, ) and an abortion than performed because of her young age ( around 10 years if memory serves me correctly.) Again an excommunication was carried out on the medical persons involved.
    One could speculate that a members of the clergy committing serious offences against the person are not excommunicated. Indeed recent history shows us that the worst they got was to be ‘counselled!’

  6. John Nolan says:

    The question “What would Jesus do?” is purely rhetorical – we can’t second -guess God. You could ask “What might Jesus have done?” but the answers would inevitably be speculative and subjective. Catholics don’t go in for situation ethics.

    RMBlaber is a tad unfair in accusing Bishop Olmsted of “unseemly haste” and “total lack of judgement”. The abortion (direct or indirect, depending on your point of view) took place in November 2009; the bishop did not remove the hospital’s Catholic status until last month. And although Olmsted’s opponents in the NCR and elsewhere make condescending comments about his upbringing on a Kansas farm, he does have a doctorate in Canon Law from the Gregorian University in Rome.

    Interestingly, both the National Catholic Bioethics Center, which consulted at length with both sides, and the Catholic Medical Association agree with the bishop. See:
    http://www.ncbcenter.org/NetCommunity/Document.Doc?id=171
    http://www.cathmed.org/issues_resources/blog/phoenix

    • Quentin says:

      Thanks for these links, John. I read them with great interest.

    • From John Nolan’s first reference (thanks for that) it appears that the legitimacy of this operation depends crucially on whether in removing the unborn child from one inevitably fatal situation to another, the clinicians deliberately killed it or simply allowed it to die. Is this known of the particular occasion? And since the practical outcome is the same anyway, might someone not versed in the subtleties of ethical debate be forgiven for seeing in it, however wrongly, a distinction without significant difference?

      More generally, I suggest that in such disputable cases, where an action subsequently judged unlawful has been performed for apparently compelling reasons and with thoroughly praiseworthy intentions, the Church might be well advised to apply a sanction less drastic than excommunication, or where this is automatic to rescind it after due consideration.

  7. Mr Rubio says:

    I am not qualified in medicine or competent to address confidently the matters of catholic morals and canon law raised in this difficult situation. I am concerned, on an initial impression of it, by the apparently troubled relationship between the persons concerned in the hospital and the Bishop long before the incident became public. I also note that the ethicist who examined the issue was selected, instructed (and paid?) by the organisation behind the hospital. I would like to know her terms of reference and whether she sought the Bishop’s comments before reaching her conclusions. Call me old-fashioned (!) but I think catholics should begin to approach this from the position that the Bishop took his decisions in good faith after much prayer and reflection and to be tentative about offering criticism.

  8. RMBlaber says:

    I think this is a cautionary tale (in Belloc’s sense) of what happens when political considerations – meaning ‘ecclesio-political’, rather than party political – interfere with or cloud moral judgements. For it is very clear that the Bishop of Phoenix has not acted on the basis of a purely moral judgement.

    In saying this, I am not for one moment impugning his character, still less asserting he has acted out of deliberate malice.

    It was Aristotle who famously defined Man as a ‘zoon politikon’, a political animal. The Church is as much a ‘polis’ as civic society. St Augustine (of Hippo) did, after all, contrast the ‘City of God’ with the ‘City of Man’ in his ‘De Civitate Dei’.

    The Church is a political entity in two senses – a narrower one and a broader one. In the narrower sense, which does not concern us here, it is ‘political’ in the sense that any organisation, where at least some individuals within the organisation pursue their own goals within the organisational structure, either subordinate to the overall objectives of the corporate body or in conflict with it, can be so described. Thus one can discuss the micro-politics of firms, schools, hospitals, charities, and so on. Political parties as well, of course!

    The broader sense of ‘political’ is reflected in this ‘blog: it is the conflict between different concepts of the Church, and different ideas about what is right and what isn’t. It is the conflict between left and right, ‘liberals’ or ‘progressives’, on the one hand, ‘conservatives’ on the other, with ‘moderates’ somewhere in between.

    The Most Rev Thomas J Olmsted, 64, was ordained priest in 1973 and consecrated bishop in 1999, meaning that he spent 26 years in the priestly ministry before his elevation to the episcopate, and suggesting, superficially at least, that he is not unduly ambitious. He became Bishop of Phoenix in December, 2003, having spent the preceding 4 years first as Co-Adjutor Bishop, then as Bishop, of the Diocese of Wichita, Kansas.

    According to his biography, found here: http://www.diocesephoenix.org/bishop/olmstedLifeHighlights.htm,
    he is a bishop who has had only 4 years’ experience as a parish priest. Even if you add on the 3 years he spent as ‘associate pastor’ of the Cathedral of the Risen Christ in Lincoln, Nebraska in 1973-6 (a long time ago!), that is still not much in the way of previous pastoral experience at the priestly level.

    Is this relevant? I think it is. This is a man who, according to his Wikipedia entry, denied communion to a 10-year old autistic boy on 12th February, 2006. See article from ‘The Arizona Republic’ here:
    http://www.azcentral.com/arizonarepublic/news/articles/0304communion0304.html?&wired.
    The case might seem complex for anyone not on the autism spectrum, but for those of us who are, it is clear cut. Matthew, the boy concerned, cannot eat or drink some substances because of their texture or taste. I say ‘cannot’: it is not merely a case of disliking particular textures and tastes, and rejecting foods or drinks on that account, but an extreme aversion resulting from hyper-sensitivity to specific stimuli and obsessive-compulsive rigidity of behaviour. The problem is not psychological, but neurological, in that autism is a neurological developmental condition.

    The point is that Matthew could no more help his behaviour than he could the colour of his skin. Yet the Bishop of Phoenix could not be flexible, and allow the possibility that Matthew might intend to receive Communion, and might be able to receive Communion spiritually, even if not doing so in a physical sense, his father acting as his proxy in actually receiving Communion in both kinds for him physically. (See the Wikipedia entry for Thomas Olmsted and the ‘Arizona Republic’ article for details.)

    We see here a man who represents a vision of the Church that can only be described as medieval, obscurantist, self-marginalised and completely out of touch with contemporary society. This is a vision that wishes the Reformation, the Enlightenment and the Industrial Revolution had never happened; that modern science and progress would just go away. It yearns for an unattainable status quo ante, and comforts itself with Tridentine Masses (in Latin, obviously).

    Furthermore, this vision is totally unjust: it is unjust to women; it is unjust to gays; it is unjust to the disabled; it is unjust to the laity, who are expected to put up, pay up and shut up. Well, I will have nothing whatsoever to do with it, albeit that – thanks to Pope Benedict XVI and his predecessor – it is the dominant vision within the Roman Catholic Church.

    I pity the poor folk of the Diocese of Phoenix for having been landed with such a canon lawyer (not a compliment!) of a bishop. I agree entirely with Peter D Wilson on this point, in opposition to Quentin, that we cannot rely on either Canon Law or the authority of the Church as a guide to our actions, but must rely on our consciences. It is one thing to be correct within the letter of Canon Law; another entirely to be true to the Spirit of Love, and the Law of Love.

    • Quentin says:

      I don’t think that I expressed an opinion concerning the wisdom of the Church’s actions. I just wished to make it clear that it was required automatically by Canon Law. Once the Bishop had ruled it (correctly or incorrectly) as direct abortion, excommunication followed as night the day.

    • John Nolan says:

      In the case of the autistic boy Matthew, the boy’s father took it upon himself to invent a rite for the reception of Holy Communion which is clearly illicit, and no priest or bishop has the authority to sanction it. No doubt Bp Olmsted’s episcopal confreres were mightily relieved it landed on his desk and not theirs, because they would have had to rule exactly as he did and face the inevitable bad publicity (although in the case of a “liberal” bishop it would have been less strident).

  9. claret says:

    Quentin,
    Thank you for pointing out Canon 1398 however while I accept my knowledge of the intricacies of Canon Law is not in any sense born of experience in these matters the law referred to does not seem to me to be as wide as you state it. Viz. it reads that ‘any person who procures an abortion’ which might give rise to questions of culpability. It is also not so clear cut when one cross refers to other aspects of Canon law viz. Irregularity.
    As ‘a rule of thumb’ my understanding has alway ben that abortion is permitted if its sole purpose is to save the life of the Mother.
    This position has been enunciated publicly by members of the Catholic hierarchy including Belgian Bishops ( speaking as one,) “He who performs an abortion, except to save the life of the Mother , sins gravely.”
    So it is far from clear cut and so excommunication, a grave step to take, is quite possibly a step too far and therefore unjustified in practice and in law.

    • Quentin says:

      Claret, little would surprise me about the Belgian Bishops. I have:

      “Second, there is the relevance of the notion of “direct.” When the Belgian bishops were discussing this matter, they adverted to the direct/indirect distinction but finally concluded: “The moral principle which ought to govern the intervention can be formulated as follows: since two lives are at stake, one will, while doing everything possible to save both, attempt to save one rather than allow two to perish.”

      If that is the relevant principle—and I believe it is—then it is clear that the direct/indirect distinction is not functioning here—indeed, is redundant. What is functioning, in both Grisez’s move and that of the Belgian hierarchy, is the common-sense assessment that we need not stand by and lose two lives (the fetus is doomed anyway) when by intervention one (the mother) can be saved. That constitutes the intervention as the only proportionate response in these tragic circumstances, whether it is direct or not.”
      http://www.ts.mu.edu/content/46/46.1/46.1.4.pdf

      If you have an official quote, can you provide a link? This is certainly not the Church official position, as it stands at present. I suspect that we shall hear more about all this before long.

  10. Ion Zone says:

    This is one I am sure about: Save the mother. If inaction means both will die, and action means one will live….the course is clear and straightforward.

  11. Ion Zone says:

    Even if it seems unpalatable.

  12. An intriguing question that arises from this discussion is whether it is possible to sin by following Church law. It seems to me that in the case at issue, inaction by the clinicians would have been a grave sin of omission for which strict adherence to canon law could be cited only as a plea in mitigation.

    Does anyone know whether this question has been considered by moral theologians?

  13. John Candido says:

    I believe that the doctors involved in the operation to save the mother have done the right thing. The ethics committee arrived at a correct conclusion in clearing the way for the clinicians to urgently save the mother’s life. The moral theologian has made a written analysis of 24 pages in length, and concluded that “the only morally good thing that can be chosen here is to save the life of the mother.’

    Bishop Thomas Olmstead has overreacted badly to the specific circumstances at hand, and has made quite significant theological errors. There is no question that he is a product of the old church. Look at his decisions to excommunicate Mercy Sr. Margaret Mary McBride, and the removal of the name ‘Catholic’ to the hospital in question, which means that the Eucharist and the mass cannot reside/celebrated in the hospital’s chapel for the benefit of all staff, patients, and visitors.

    Thomas Olmstead needs to broaden his theological library, his set of advisors, and revisit his thinking in order to correct this error. This is probably an impossible request given his past track record in ruling on situations as a canon lawyer rather than as a pastor. We all have our bias; for example, we all read the newspaper or listen to or watch current affairs by selecting those articles and programs that we are in agreement with.

    In my view, Thomas Olmstead is clearly in error. If you were to read the NCR article in full at http://ncronline.org/news/no-direct-abortion-phoenix-hospital-theologian-says , the theologian known as M. Therese Lysaught quotes Pope Pius XII’s four principles as theologically supportive of the doctors and the ethics committee in their decision. Ask yourself; is it more pro-life to allow only one person to live or to allow two people to die?

    This case is quite clear to me as being a case of canon law getting in the way of commonsense, good theology, and compassion. There is a need for canon law for a structure like the church, but it needs to be tempered for the Gospel. It is the Gospel that matters above all else. Thomas Olmstead has a Bachelor of Theology, but I think that either he has obtained it within a conservative faculty of learning or he has simply fallen in with his own conservative brethren after graduation.

    This case also confirms what Fr. Eric Hodgens has said in his piece called, ‘Reflections on an Ordination Golden Anniversary’. Hodgens said, ‘Paul VI began appointing bishops opposed to the council’s ethos’. Further to this issue he said, ‘a more grievous abuse of power by John Paul II was his appointment of bishops. Appointees were to be clerical, compliant and in total agreement with his personal opinions. This has emasculated the leadership of the Church. The episcopal ranks are now low on creativity, leadership, education and even intelligence. Many are from the ranks of Opus Dei – reactionary, authoritarian and decidedly not creative’. This explains a lot of my suspicions in this case.

    Hodgens goes on to say, ‘many, often at the top of the hierarchical tree, are embarrassingly ignorant of any recent learning in scripture, theology and scientific disciplines. Many are classic company boys. Some of the more intelligent and better educated seem to have sold their souls for advancement. Can they really believe the line they channel? Ecclesiastical politics have trumped integrity. And when these men are appointed as the leaders of priests without any consultation they become a standing act of contempt.’

    Apart from these considerations, there is the very well established teaching within moral theology concerning objective morality and subjective morality. This teaching specifies that there is the objective moral rule or law as it is known and recorded in the teachings of the church. For example, all of the moral norms contained within the Catechism of the Catholic Church, assert moral precepts that all Catholics are obliged to follow. For example, the Decalogue has ten precepts that all Catholics are called on to follow as adherents of Christianity.

    Subjective morality concerns the level of culpability of individuals, due to the circumstances that the person has found him/herself in, the level of freedom that the individual had when ostensibly committing errors of faith or serious breaches of Christian precepts. For example, a person kills another person out of jealousy, or to steal some property of the victim is fully culpable of murder. Extenuating circumstances can lessen the level of culpability of the aggressor, depending on the seriousness of these pre-existing circumstances.

    While subjective and objective morality is not the specific issue here, it is however a useful pastoral and theological guide to the personal culpabilities of offenders of the church’s moral codes. It should have alerted Thomas Olmsted that the written objective rule is only the beginning of moral theological analysis. The other half is the detail within this scenario, which can help determine whether error has occurred. The decision of the doctors and the ethics board of the hospital is one that ultimately falls within the primacy of the human conscience, and not one of transgression against a moral principle or a rubric of canon law, important as they no doubt are, in informing attitude and behavior.

    • st.joseph says:

      John Candido Before you give your opinion on Opus Dei Prelature, I suggest reading The Moral Dignity of Man. Catholic Moral Teaching on Family and Medical Issues. by Father Peter Bristow. He obtained a doctorate in theology at the University of Navarre,Spain. He served as chaplain to the Southwark branch of the Guild of Catholic Doctors.
      What ‘rank’ do you come from?

      • John Candido says:

        I didn’t give my opinion of Opus Dei. I was quoting Fr. Eric Hodgens. However, never let an opportunity slip. I think that Opus Dei is a secretive, elitest, right-wing cult, favoured by Popes John Paul II and Benedict XVI precicely because they are a throwback to a dark and distant past era.

  14. John Nolan says:

    John, there is a distinction between informed conscience and private judgement which seems to have eluded you. When you say that Bp Olmsted represents “old church” what precisely do you mean? I accept the teachings of Vatican II as embodied in its documents – you would presumably claim that they are not authoritative unless you happen to agree with them.
    As for the “ethos” of the Council, this seems to have a polarization between conservatives and liberals which is said to have greatly distressed the dying John XXIII. Fr Hodgens and his ilk are embittered because the “new church” which they fondly imagined was being ushered in existed only in their imaginations.

    • John Candido says:

      John, there is an old church and it is one that is conservative and tends to live in the past, while the new and presently unrealised church, will be more liberal and free and will tend to live in its present moment. The old church is a product of older prescriptions within ecclesiology, theology, philosophy, and liturgy, while the new church will take every opportunity to make its theology, philosophy, ecclesiology, liturgy, and its mode of governance contemporary. The new church will take every opportunity to look to the magisterium of science and the humanities, as they are a product of university research, to update its understanding of the gospel through a new and ever unfolding comprehension of human beings and the universe that we inhabit.

      The new church will come; it will take a very long time getting here and is largely a matter for liberals like myself to be very patient. Given the centralisation of ecclesiastical power and the moribund nature of Vatican governance, it is most likely that we all will not live to see the new church. This is really quite sad when I think about it.

      If the Catholic Church were to stay as the old church, it will wither and die. If the Catholic Church were to embody the contemporaneous magisterium of modern theological, philosophical, and ecclesiological research, it will rejuvenate itself and thrive. If the church were to reform itself in every way, which will include a new respect for our human consciences, the laity will come back, we will have new members because of our modern voice, we will strike a chord with our youth, we will have a greater respect within the secular world, and we will have inevitable increases to vocations to the priesthood and religious life. If the church continues with the same fare, we will die. This is what I mean by the old and the new church.

      John you say, and I quote, ‘there is a distinction between informed conscience and private judgement which seems to have eluded you’. I agree with some of what you are saying. There is a distinction between these two if you mean that a private judgement is arrived at without rigorous and conscientious attention to the church’s teaching magisterium, in the first instance, and is followed by sincere prayer and careful thought, together with the guidance and input of relevant religious and secular experts.

      After such a rigorous process has been undertaken with complete integrity, we should all stand back and allow the person or persons involved, to make up their minds in total freedom. Once this decision has been arrived at by this thorough process, it is really nobody’s business as to what has been decided because it is a decision that is arrived at privately, and is between God and them alone. The conscience has been described in the past as a private moral space, and this is exactly what it is.

      If all that any Christian would need to do in any moral quandary is to simply follow what the teaching magisterium enunciates initially, there would be little need for a free conscience. All that you would need to have is a copy of the Catechism of the Catholic Church, and to read the latest papal encyclicals. The trouble with this is that these important sources of Christian teaching, sometimes fail to adequately address the specific circumstances that individuals find themselves in. And this is where an informed and free conscience comes to the fore.

      • st.joseph says:

        John, when that time comes we wont need God!
        Or else the One True God- because we will all be gods by then !The question I asked you which you avoided was ‘Which rank do you come from?

      • John Nolan says:

        John, let’s get this straight. According to your analysis, for nearly 2000 years the Holy Ghost has not guided the Church which we as Catholics believe to have been founded by Our Lord Jesus Christ. Suddenly, “between the end of the Chatterley ban and the Beatles’ first LP” (to quote Philip Larkin) a new church emerged only to be stifled by that arch-reactionary Paul VI in 1968. You accused me of refusing to debate with you. Against my better judgement I posted some observations on Golden Anniversary Reflections which I hoped might temper your wilder generalizations. I now know from the above that I was wasting my time. Unless you wake up to the fact that your so-called new church is a chimera based on 20th-century hubristic wishful thinking you will end your days as disappointed and embittered as poor Fr Hodgens. As you know, I like to sign out with a quotation from a man far greater than myself, in this case Alexander Pope:

        A little learning is a dangerous thing;
        Drink deep, or taste not the Pierian spring:
        These shallow draughts intoxicate the brain,
        And drinking largely sobers us again.

        Cheers!

  15. A further thought, if you will permit it. It is generally accepted that when a line of argument leads to an absurd conclusion, there must be an error in either the premises or the deductions from them. Here we have a situation where saving a woman’s life in the only way humanly possible, with no detriment that was not already inevitable, is condemned as gravely sinful. I find it hard to think of anything short of proving two and zero to be equal that would be more patently absurd.

    John Nolan says “Catholics don’t go in for situation ethics.” Well, perhaps on occasion we should, or at least take the situation more fully into account. Everyone agrees that the baby’s death was humanly undesirable, but since it was due to causes entirely outside human control, can it really be considered an evil in moral terms? It is more like a natural disaster, and for once the fatalistic Moslem attribution to “the will of Allah” seems more truly appropriate. We can hardly suppose the will of God to be evil. The only resolution to the difficulty that I can see is to remove this label from the action; the ethical dilemma in the particular case – I emphasise particular – then disappears.

    Of course there may be a fallacy in my reasoning, and if so I should be grateful to have it pointed out. Otherwise we shall still have to deal with the remaining difficulties, notably where to draw the line when it is applied to other cases, but such a line would then be easier to defend in logic.

  16. st.joseph says:

    John ,do you always answer a question like that ?They say the best form of defence is attack.

    • John Candido says:

      st.joseph, sometimes the best form of defence is explaination rather than an attack.

    • John Candido says:

      st.joseph, my poor choice of words has failed me again. In my previous post I wrote, ‘I think that Opus Dei is a secretive, elitest, right-wing cult, favoured by Popes John Paul II and Benedict XVI precicely because they are a throwback to a dark and distant past era’. What I meant to say is, I think that Opus Dei is a secretive, elitest, right-wing cult, favoured by Popes John Paul II and Benedict XVI precicely because it is (not ‘they are’) a throwback to a dark and distant past era’. John.

  17. Mr Rubio says:

    I commend use of the following link. It will take you to a radio interview, in which the Bishop and an authorised moral theologian and canon lawyer comment on the case.
    http://thebishopshour.org/2010/12/23/the-bishop-the-hospital-and-the-diocese-of-phoenix/

  18. claret says:

    Perhaps an additional dilemma arising from this case is how , as a Church, we project ourselves to the wider world and should we even be concerned ? Regretably the Catholic Church has earned for itself a despicable record of abuse of all kinds dating back to the Emperor Constantine. Despite this it has generally manged to keep its head above water as a teacher of morality until the child abuse of many years has become a public scandal that will haunt the Church forever, and reduces its moral authority to somewhere around Zero in the eyes of those not of the Church and a struggle for those within it.
    Cases of this kind only add fuel to the fire and seem so uneccesary. The adverse publcity surrounding it is bound to bring further discredit to an already discredited organisation.
    Now is not the time for sticking our heads above the parapet especially when the situation is one of grave doubt as to the morality of what has been done.

    • John Candido says:

      Well done Claret! Your questions are very important and they need to be carefully considered by all who have a sincere interest in the current position and future life of the Catholic Church. Thank you very much for your post because it certainly can focus everybody’s mind on these difficult and contemporaneous issues.

  19. Iona says:

    Having (belatedly) read Quentin’s original link to the case, and listened to most of the radio interview which Mr. Rubio’s post gave us, I now feel that the case is not as cut-and-dried, black-and-white as I had originally thought. At first it seemed clear and commonsensical, – continuing the pregnancy is going to result in the certain death of both mother and child, and the child cannot be saved by any means, so obviously the mother’s life should be saved by prompt removal of both placenta and baby.

    But apparently it’s not quite so clear. During the interview, it was reported that in a number of cases of pulmonary hypertension it has been possible to care for the mother and keep the pregnancy going until it reaches a point when the baby is viable, at which time a caesarian section can be carried out. It seems this option wasn’t considered in this case.
    Also, the bishop’s action in declaring the hospital no longer Catholic was based on abuses which had been going on for years, which he had repeatedly asked for explanations of, and which he had been assured would be given but which never were.
    One thing we know nothing about is the mother’s outlook and attitude; during the interview, this was mentioned but it appears nothing at all can be disclosed about the mother, as it would violate the patient’s right to privacy. But her views could have been crucial.

    • st.joseph says:

      Yes Iona my thoughts too.
      I seem to think we already discussed this matter in another topic on the blog.
      So I didn’t feel the need to add further comments.
      I agree with Claret in his last comment.
      I made it on here to answer John Candidos rewrite for the third time on
      Fr Hodgens reflections-which I did not find applicable-only as an opportunity to make remarks on his dislike of the church-which he doesn’t even practice.
      Opus Dei would not give a second thought to his level of intelligent thinking when placed next to theirs.

  20. John Candido says:

    Hi Quentin,

    Can you replace this post with my last one on the 24th January 2011 as I have forgotten to add some points about the community and the resolution of conflict and its relationship to debate? Thank you. (done, Q)

    John, I never said or implied that the church had never had the Holy Spirit to help guide it in past centuries. Although I did not expressly say this; my point is that the church continually evolves over time, and at any point in time the spirit is always at hand to help and guide the church.

    As for the issue of debating one another. It is never a waste of time to engage in respectful debate on any issue. Why is this so? Because public debates conducted in a civil manner, are in the public interest for many good personal & communal reasons. Firstly, if you are going to be an effective and persuasive debater, you have to use, as much as time permits, your intellect by thinking, writing, discussing, and wide reading. Secondly, debating others means that you have to defend your point of view with relevant points and counter points. You have to listen and respond to your antagonists in a rational and civil manner. This alone is an exercise for the mind, and it helps to civilize all people engaged in debate so as to make it habitual to resply to others without recourse to personal attacks. Thirdly, engaging in respectful debates helps those who are engaged in them to intellectually clarify what it is that they sincerely believe in.

    Fourthly, civilly debating others brings us closer to our inner soul. This is our conscience or our private moral space. If we are doing this we are engaging our integrity or our real selves. This process will add to our maturity as persons over time. Other important points that I want to make are that debate is a way of resolving conflict between individuals in any context, without resorting to violence or intimidation. It is how communities and democratic nation-states make progress towards a better way of life for everybody. Apart from interviews and the investigative power of journalistic research, civilized community debates are the basis of how a quality mass media is founded on and operates. I also think that respectful debates are essential if we are to conduct ourselves as civic minded Christians. Thank you for your reply. John Candido.

  21. st.joseph says:

    John, what you dont realise is that Satan is in the church, his disciples are doing his work outside,so he spends all his time trying to win the victory over Our Lords Victory on the Cross, we all know he wont succeed.It has been like that since the Ressurection,and will continue until He comes again.
    You wont find the perfect church here on earth-however much you think you understand it as your mission.
    You speak very fluently about the way we ought to conduct our debating on the blog but perhaps we should show the same respect to everyone in the Church, even if we disagree with them.

  22. Ian Cairns says:

    If the events in your article include all the relevant evidence, then the bishop is wrong and he is making the Church appear hard and dogmatic to the point that all Christian Charity has been disgarded. It is a case of the lesser of two evils. One life is saved and the other is lost, although the loss is not intended; or both lives are lost. It seems the hospital made the obvious and correct choice.

    • Horace says:

      I think you are perhaps being a bit hard on the bishop. He knows very well that if he even appears to sanction an abortion this will open the floodgates!

      I seem to remember an example of an analogous moral problem that we discussed at school as follows:-
      After the ship went down a man finds himself on a raft which can just bear his weight but which will sink if another person tries to climb aboard.
      Another man swims toward it.
      a) Would the first man be justified in killing the second one (say with a pistol that he carries) to stop him attempting to climb aboard?
      The drama is witnessed by a third man some way away.
      b) Is this (third) man justified in killing the second man (say with a rifle that he carries) to save the life of the individual on the raft? (Both will die if nothing is done).

  23. st.joseph says:

    The Solemn Mass for Life,on the 25th January 12.30pm.
    Celebrated at theBasilica of the National Shrine of the Immaculate Conception in Washington.DC.
    Archbishop Timothy Broglio,Celebrant and Homilist made quite a few comments about Catholic Hospitals and abortion.
    It may be found on EWTN ‘s website.
    Some may find it interesting.

  24. st.joseph says:

    John Candido.I have managed to get in touch with a personal friend of my family a secular priest who is a member of Opus Dei..(of whom I know many)
    He has confirmed to me what I already knew.
    Opus Dei is not a secret society, one can read their web site.
    When Jose Escriva was a Venerable and waiting to be Beatified, a taxi driver in Madrid had a prayer card in his window, and a customer made the same comments as
    Fr Hodgens, the taxi man replied ‘ I thought he was for taxi drivers’.
    Opus Dei means ‘Work for God’Their lay members are made up from labourers, farm workers-in fact from the man in the street as the saying goes.
    We are sanctified by our ordinary daily work.

    The President of the High Court Judges in Ireland Rory O’Halleran (RIP) was defending the abortifacient effect of the morning after pill. my friend the priest who is a member of the Association of Lawyers for the unborn defended this case, and won, but the reaction was ‘he is a member of that secret organisation Opus Dei.’
    The liberal thinkers in the church will always find ways to discredit anyone who is orthodox and is faithful to the teachings of the catholic church.
    Opus Dei has written a book on the Da Vinci Code.
    My grandon is definitely not an elitest, from the rank of a right wing cult.

  25. st.joseph says:

    Thank you Quentin I have now read everything on the site you gave in the case of the aborted baby.I did not do so at first,having a ruptured placenta pregnancy myself- then three more miscarriages after that. Thank God my baby survived ,although I was told he was dead. I don’t like discussing subjects like that.
    What I found interesting reading through, Theresa Lysaught cover letter to Mr Dean on the analysis of the intervention at Marquette University, Dept of Theology, was his comment as follows. ‘I provide a moral analysis of the intervention drawing on Magisterial teaching and the works of two of the most reputable Catholic philosophers and theologians, Fr Martin Rhonheimer and Germain Grisez. Both are expert scholars of the Thomistic Tradition in Catholic Moral Theology,follow Veritatis Splendor to analyze questions of obstetric conflicts. Based on this analysis part three provides a response to the NCBC and on application of the USCCB statement.

    Fr Martin Rhonheimer is from the order of Opus Dei.

    • John Candido says:

      st.joseph, I have a link that you can go to from an organisation called ODAN, which stands for ‘Opus Dei Awareness Network’. It has personal stories from disaffected past members of Opus Dei as well as providing lots of information to the public about this organisation. http://www.odan.org/ .

      P.S. As the subject of Opus Dei is not part of ‘A Distressing Decision’, I will not be entering into a debate with anybody on this subject because it is inappropriate to the topic under discussion. In addition, I will refrain from making any more comments on Opus Dei out of respect for other contributers, in case they want to continue posting any writing that is germane to ‘A Distressing Decision’. Thank you.

      • st.joseph says:

        John, I could mention a lot more Web Sites like ‘ODAN.’ about any subject The only comment I will make and that is ‘Its written in a true ‘Liberal style’.and to remind you that it was you who brought the subject up.

      • st.joseph says:

        P.S to my post below John.
        I am not a member of OP myself, I am quite happy the way I am,but if my grandson decides to do so, I would prefer him to ,sooner than to be roaming the streets in gangs,taking drugs, and into porn He is at Uni studying Criminology and Forensic Science, and if he gets his degree, he ‘will’ be going to Sandhurst as an Officer-has passed all his very strict tests-and then maybe fight for his country and our freedom. He is not demonstrating for his rights as some students.He works when he is not studying to pay his way.
        So please remember him in your prayers

  26. Superview says:

    Power corrupts. The untrammelled power of religious leaders, whether they be parish priests, bishops, or popes, risks their corruption. A cleric with an agenda is in greater danger of corruption. The bishop in this case appears to have seized upon a situation crying out for the compassion of God to achieve another personal objective. It is not good that the structures of the Church allow this to happen.
    Second Sight has been here before in July 2009 discussing the consequences of ectopic pregnancy. I wrote then, and still hold, that the issue is straightforward to those using their humanity to guide their judgement and not some ‘law’:
    (1) Can both mother and child live? No.
    (2) Can one of them live? Yes.
    (3) Everyone wants the child to live.
    (4) Everyone wants the mother to live.
    (5) The worst outcome is that both die. We have a moral obligation to prevent this. It would be ‘inhuman’ to allow this to happen.
    (6) The best possible outcome is that one lives.
    (7) Which of the two can be saved? If the mother, save the mother. If the child, save the child. This is both logical and moral.
    To discuss it in terms of is it an abortion or is it not seems to me to introduce controversy where there should be none. It seems to me that it is a fallacy to claim it as a religious issue.

    • John Nolan says:

      Superview, in the case of ectopic pregnancy the removal of the fallopian tube will of course occasion the destruction of the foetus, but this is an indirect effect and does not constitute a deliberate abortion. On reading Quentin’s original article and the links he provided I was inclined to side with the hospital (see my original post) in the belief that they acted in good faith. Subsequent research suggests I might have reached my conclusion a little prematurely. It is a pity that the waters have been muddied by the usual crop of liberal-relativists who are using the case to renew their attack on the Church.

      • John Candido says:

        John, can you enlighten us all with your subsequent research that has led to your change of mind or at least a review of your original decision? Thanks.

  27. st.joseph says:

    Superview, I agree with you That is what the theologians said .But do we know the whole truth in this case. Will we ever know?
    Speculation only causes more damage.
    To try and save the two is right if that is the case,but if the child dies that is not to my mind a direct abortion.
    I dont believe if that was the case an excomunication was right, but I thought one excomunicated oneself, the church doesn’t ,only in the case of direct abortion.
    In my case it was to save both,thank God we both lived.If it had been me, my husband would have to take care of two children.And I believe it was prayer that saved us both,and of course Gods Will.
    There seems to be a problem with the hospital,and if I am right in the same way as the Catholic Hospital in Westminster,whereby the Cardinal took ,or was going to take its catholic name awayPerhaps someone will say what happened there,I can’t really remember!

  28. JohnBunting says:

    It seems to me that the Bishop is saying, in effect, “You must not act in a way that would normally cause the death of an unborn child, even though, in this case, the child will die anyway”. So does the action taken here come into the category of ‘doing evil in order that good may result’?
    Nature of course is not a totally mechanistic system, faultless in operation: hence these hard cases will occur from time to time. There is almost a temptation to rail against God about it: “If You present Your people with these agonising problems, You can hardly blame them if they get it wrong sometimes”; especially when a decision has to be made quickly.
    As Paul put it, “The whole creation groans in pain from the beginning until now”: (Romans 8. 22). I find it difficult to imagine that those who acted for the best in this case, as they saw it, will be harshly judged.

  29. John Nolan says:

    John, in reply to your question:
    Firstly, the links I provided in my 21 Jan. post, particularly the report of the National Catholic Bioethics Center, and secondly, Bp Olmsted’s own account of his actions which no-one has seriously challenged.
    Many of those who rushed to attack the bishop betray an ignorance of what is meant by the word “pastoral”. In the case of a priest it implies an ardent concern for the souls of those under his care. St John Vianney was a great exemplar of this, as were the Victorian priests, Newman included, who ventured into the slums; not to “fight poverty” in the reductionist modern sense, but to combat the ignorance and vice which poverty, both material and spiritual, engendered. These men did not see it as their mission to make people feel good about themselves. They wanted them to repent and save their souls.

    A bishop’s pastoral concern is wider. He is successor to the apostles and has a duty to confirm the brethren in faith and uphold the doctrine of the Church. He cannot make up the rules as he goes along. We are rightly critical of the worldly prelates of past centuries such as Wolsey and Richelieu (both great statesmen). We should also question those present-day bishops who are so anxious to be “all things to all men” that they forget their primary pastoral duty. St Paul warns us: Et nolite conformari huic saeculo, sed reformamini in novitate sensus vestri: ut probetis quae sit voluntas Dei bona, et beneplacens, et perfecta. (Romans 12:2)

    • Mr Rubio says:

      I wonder whether the hospital, which clearly has consulted ethicists & other catholic experts on the matter generally, has considered appealing the Bishop’s decree. One would hope that if those at the hospital had indeed formed their consciences with care they would have the conviction to follow the matter through. I also wonder whether money played a part in the hospital’s decision; we know that there was an exercise of clinical judgment in the decision over the pregnancy, and an ethical one too through an ethics committee, but we know not whether the staff involved were required to perform any cost-benefit analysis. Presumably extending the life of the unborn baby in the hope of making it viable while trying to address the mother’s pulmonary hypertension, a course of action which some of the medically qualified commentators have said was possible and should have been chosen, would have used up a lot of resources.

  30. st.joseph says:

    A Distressing Decision yes.. Reading the Statement that Bishop Thomas J Holden made on 21st December 2010. I found also distressing ,in what he said regarding the way the hospital was carrying on and( will list them in case no one read them)
    He says’Here are some of the things which CHW has been formally responsible for many years. Contraceptive councilling,medications and supplies and associated medical and laboratory examinations including,but not limited to oral and injectable contraceptives,Intrauterine devices,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.
    He continues his statement…..
    It is there to look at on video,which Mr Rubio kindly gave the web site,or else to read.

    I don’t think that the Bishop needed a reason to remove its catholic name from the hospital, when we read its history, in fact it is a real disgrace that it went on for so long,and we ought to thank him for having the courage to do what he did, we need more like him to stand up for the unborn from conception.
    I wonder if NFP was taught there!
    We dont know how many babies will have been aborted over the last 7 years.
    It is worrying.

  31. st.joseph says:

    I ought to have made it clear as to what NFP is.
    It is Natural Family Planning- Fertility Awareness.

  32. Superview says:

    May I suggest that in future John Nolan writes all his contributions in Latin?
    Some of us, if not many, can then move on quickly, happy in the knowledge that, though deprived of his erudition, ignorance is bliss.

    • John Nolan says:

      By all means, but don’t let your knuckles drag on the ground as you go.

    • tim says:

      Personally I welcome Latin quotations on the blog, as I think they add distinction (like RLBlaber’s contributions, if in a different way). You can always translate them using Google, viz:
      “And be not conformed to this world, but be transformed by the renewing of your mind, that ye may prove what is the will of God is good, and the acceptable, and the perfect”. I haven’t checked this against a more orthodox translation of the Epistles, nor is it strictly grammatical, but you get the idea.

  33. John Nolan says:

    Thanks, Tim. That’s actually not a bad translation for Google. Douai-Rheims (ed. Challoner) has “that you may prove what is the good, and the acceptable, and the perfect will of God”. The reasons I quoted in Latin were these:
    1. Educated Catholics should have some contact with the Vulgate;
    2. I liked the rhythm of the Latin, the adjectives qualifying ‘voluntas’ coming at the end of the sentence;
    3. The Devil hates Latin – ask any exorcist;
    4. NuChurch liberals hate Latin, which is perhaps not entirely coincidental;
    5. It is easy enough to look up, given chapter and verse.

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