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Excommunicating Intentions

For approving an abortion at an Arizona hospital late last year, Sr. Margaret McBride has incurred excommunication latae sententiae—meaning that her actions have caused her to excommunicate herself. Or so, at least, her bishop, Thomas Olmstead of Phoenix, has announced. And the bishop’s announcement has ignited something of a firestorm among Catholic commentators.

The moral principle of Double Effect plays a role here. Catholic teaching condemns only “direct abortion”: abortion in which the death of the child is either directly willed in itself or directly willed as a means to some specific end. The Church does not condemn “indirect abortion”: abortion that is a foreseen but unintended side effect of a medical procedure designed to preserve the mother’s life, which is not wrong, at least not merely as such. (The most common example is an ectopic pregnancy, in which the Fallopian Tube must be removed to save the mother’s life, but the resulting death of the child is not directly willed.)

And that, apparently, was the defense McBride offered to Bishop Olmstead. He rejected it, apparently believing that the abortion was direct and thus immoral. And under Church law, all who procure or otherwise “formally cooperate” in direct abortion excommunicates themselves.

But the question is whether he is indeed right, and that is not clear even to some orthodox Catholics. The mother-to-be had pulmonary hypertension, a condition putting her at high risk of the life-threatening eclampsia that giving birth can cause in women with chronic high blood pressure. And so, one could argue, the purpose of the abortion was not the death of the child (either as an end or as a means) but merely the removal of the child from the womb to save the mother’s life—an indirect abortion, in other words, and thus justified.

There is a canonical problem to consider here: Can somebody excommunicate herself for making what she believes was the right call according to the Church’s own moral norms? McBride is a well-informed Catholic—so well-informed, in fact, that she was considered an authority on medical ethics by her (mostly) Catholic colleagues at the hospital. Yet she and her bishop differed in this case.

Now if Olmstead had excommunicated McBride ferendae sententiae—by his own juridical act—this question would not arise. It would be a case of disagreement between two professionals, one of whom is in authority over the other; and the excommunication could be removed, in principle at least, by a pastoral resolution of the disagreement.

But, according to Olmstead, this is a case of excommunication latae sententiae: The offender has excommunicated herself by approving, and thus formally cooperating in, a direct abortion. And yet, the offender does not appear to believe she approved a direct abortion—only an indirect one, which is ordinarily permissible. Is it really possible to excommunicate oneself not for intentionally violating Catholic moral teaching but for doing something one believes to be fully in accord with such teaching?

The most pertinent canon does not seem clear enough to resolve the question. Canon §1398 reads: “A person who procures a completed abortion incurs a latae sententiae excommunication.” Yet McBride did not even “procure” the abortion; as an ethical consultant, she merely “approved” it as indirect, for what she believed to be good reasons in accord with Church teaching.

Nevertheless, let us grant that such approval was formal cooperation in the abortion, and that her approval can be considered procurement in the terms of the canon, whether the abortion itself was direct or indirect. So if McBride has indeed excommunicated herself, that would be because her conscience was not merely mistaken in this case, but culpably mistaken on a matter of grave moral significance. In other words, given her status and background, she ought to have known the abortion would be direct and thus immoral, and so had no excuse for judging otherwise.

How, as a pastor, Olmstead could confidently make such a judgment in this case is unclear. Going just on the publicly known facts of the case, one could say he has gone too far in making his announcement. The resulting controversy, even among some conservative Catholics, suggests that many would agree with this.

Perhaps, though, Olmstead considers the question of subjective culpability irrelevant. Church law, after all, stipulates excommunication not for acting in bad conscience, but merely for procuring or formally cooperating in abortion. If subjective culpability is indeed irrelevant here, the philosophically interesting question then becomes whether the object of the act in question makes the act morally evil regardless of whether the agent intended the act.

That question has ramifications beyond a dispute between a nun and her bishop.

One learns what the agent intends by eliciting her good-faith answers to the questions “‘What are you doing?”’ and “‘Why are you doing it?” in the sense of ‘‘What for?” If the answers do not describe anything it is intrinsically immoral to do under such descriptions,, then the agent cannot be said to be doing something intrinsically immoral. In McBride’s case, she cannot be said to be aiming at the death of a child either as an end in itself or as a means to saving the mother’s life. The principle of double effect thus applies and exculpates her.

But that by no means settles the matter.

One of the most intense debates among orthodox Catholic moral theologians these days is over whether the morally significant “object” of a human act is only what the agent intends, or whether it can also be something beyond what the agent intends—something that is subject to moral evaluation all the same.

One school of Catholic theologians argues that the object does not make the act evil regardless of the agent’s intention. In some cases using the philosophy of action developed by the late Elizabeth Anscombe (a Catholic) in her influential 1957 book Intention, they argue that one may not regard as the morally significant object of a human act something that the agent cannot be said to intend by the act.

Elizabeth Anscombe seems to have thought the latter, holding that some voluntary acts, although not strictly intentional in her sense, may nonetheless be praiseworthy or, more typically, blameworthy.

That’s the issue, for instance, in the debate over waterboarding. Granted that torture is intrinsically immoral, does it actually matter whether waterboarders intend to do that which makes torture immoral? Some would say not. Even if they don’t consciously intend torture, and even if they intend to gain life-saving intelligence, or whatever it is that makes torture immoral, they have no excuse for not knowing that torture is what they’re engaged in—and thus torture can be said to be the object of their waterboarding even though not its ultimate purpose. Waterboarding would thus be blameworthy as voluntary torture even when not intended as torture.

Another example is that of married couples using condoms to prevent HIV transmission. The Vatican certainly thinks such a practice imprudent, but has not gone so far as to characterize it as immoral per se. Some Catholic moralists argue all the same that it actually is immoral per se, that it is always and necessarily wrong even when the couple act without contraceptive intent and only intend to prevent the uninfected partner from getting the disease.

These moralists’ argument’s point of departure is basic Catholic teaching: The only morally acceptable sexual acts involving orgasm are “conjugal” acts. Citing a 1948 ruling by the Holy Office, they go on to claim that such acts require deposition of semen in the vagina; so, by intending something other than a conjugal act, however laudable the purpose, the couple using condoms for purely prophylactic purposes are engaged in an act whose object is immoral per se—even if they devoutly wish it could be otherwise, and even if they don’t believe themselves to be doing anything wrong.

Perhaps Bishop Olmstead thinks Sister McBride is making a similar error. She almost certainly believed that the abortion she approved was indirect—justified by the principle of double effect—because it forestalled the real, developing risk of a life-threatening condition in the mother. But her intention, the bishop seems to have decided, does not change the reality of her act.

There is, certainly, no a priori reason to believe that such a reason is always sufficient; one needs to ask how much risk there is, and how imminent. And if one’s answers to those questions are both mistaken and used to justify abortion by invoking the principle of double effect, it is at least arguable that participation in the subsequent abortion is blameworthy inasmuch as it was voluntary. If McBride’s reasons for approving the abortion were objectively insufficient in this case, then her formal cooperation in the abortion was a case of an act that’s immoral per se, even assuming neither she nor anybody else nobody intended the death of the child.

If this is what Olmstead had in mind, and if he is right, then, yes, McBride’s excommunication latae sententiae stands even if she was not culpable for judging as she did.

And yet, the bishop’s ability to make such a confident judgment in this case seems very unclear—to me and to many others. Moreover, the public outrage over the Phoenix case illustrates the dangers of making politically significant announcements on the basis of moral reasoning that not many people can follow and that even theologically well-educated Catholics disagree about.

Michael Liccione has taught philosophy and theology in several Catholic
institutions and is currently working on a book about the development of
doctrine. He blogs at Sacramentum Vitae and What's Wrong with the World
.

Comments:

5.21.2010 | 1:42pm
Anne Rice says:
Thank you for weighing in with a well reasoned reflection on this very painful case. But I do think you are right that many Catholics cannot follow these complex arguments. What we are left with is something deeply troubling. I've been posting about this case on my Facebook page and in another forum, and there are Catholics there asserting without doubt that they feel this woman should have been forced to die with her unborn child. I find this chilling. Also the Bishop seems to imply the very same thing, that the woman should have died with the unborn child. This case raises many questions about Catholic hospitals in America. I'm frankly deeply discouraged by the whole issue. But again, I thank you. I thank you for examining this so carefully.
5.21.2010 | 2:07pm
Roger says:
Anne, I'm not a Catholic, but I am pro-life. The question here as broad implications however. It seems here that the question is direction or indirect, and the case involved abortion itself as treatment; it wasn't the inadvertent side effect of some other treatment, say using a medication for hypertension that resulted in a miscarriage.

In the patient's case, death is a possible risk, not a certain outcome. The ultimate culpability lies with the mother. Did she want an abortion to avoid the risk? Does the Church have the authority to exonerate her if she so chooses?

In serving a great and loving God, we know two things. First, he is a God of mercy, grace, and forgiveness; in such difficult ethical cases, I find great comfort in knowing that. Second, He has the power to preserve alive those who may risk seemingly certain death...or take us into His own presence, even as we pay the price for doing the right thing. As a pastor, I'd be personally reluctant to "recommend" abortion, in this case. A loving mother might decide to risk her own life to give life to her baby...something I would respect deeply. If a mother made the alternate choice, I would focus on God's mercy and love.
5.21.2010 | 2:08pm
Martin Gomez says:
Maybe instead of trying to resolve this once and for all by canon law, we should expect the people involved to pray about it, use the gift of discernment from the Holy Spirit, and act accordingly. Making a rule for everything is what got the pharisees into trouble and what St. Paul railed against. Either we believe that the Holy Spirit is with us and use the gifts given to each of us for the benefit of the Church, or we are "dead" in the Pauline sense. We don't need to leave loopholes that a truck can drive through, but we need some leeway for conscience and discernment.
5.21.2010 | 2:25pm
Bibbit says:
Martin Gomez: You seem to be implying that the bishops themselves have no access to the Holy Spirit. Personally I would trust the leadership of the bishops and their magisterial direction much more than I would trust any individual. Our Lord said that He would send the Holy Spirit to the bishops and guide them into all truth. He didn't say He'd send the Holy Spirit to ME and guid ME into all truth. I realize that's a bit simplistic, but still, it's quite powerful. If you don't think you can trust the Spirit to lead the Magisterium into all truth, then maybe you shouldn't be Catholic (assuming you are).

By the way, I find statements like "making a rule for everything" annoying. They do not have a rule for everything, and couldn't possibly even if they wanted to. But they have one for something many don't like, so that translates to everything.
5.21.2010 | 2:41pm
"Now if Olmstead had excommunicated McBride ferendae sententiae—by his own juridical act—this question would not arise."

Dear Professor Liccione,

Might you hazard a reasoned guess as to why +Olmstead chose to announce that sister McBride had excommunicated herself latae senteniae instead of doing it himself with ferendae sententiae?
5.21.2010 | 3:25pm
DNB says:
Sorry Michael, this is very murky reasoning.
In double effect, you cannot do evil in order to achieve a good end, i.e, to kill the child in order to save the mother. That's the end justifying the means. The object of the act does not depend on the intention or purpose of the agent. By that reasoning you could justify torture because the intention or purpose is not to injure but to extract information. Or drop a nuclear bomb because the intention is to eradicate an army, not to kill innocent civilians.
Pace Ann Rice, the question is not complex and not troubling. And Kaveny is a notorious liberal, hardly a trustworthy authority.
5.21.2010 | 3:35pm
Chuck says:
So many people are making the incorrect assumption that this woman would have certainly died without the abortion. This is not correct, and no one, not even the doctors and ethicists involved in the case, could know such a thing.

I have seen cases where doctors make serious prenatal mistakes in judgment, and then call for "termination of the pregnancy" based upon those faulty judgments. In some of those cases, the mother and father decided against the will of the doctors, and their baby was born perfectly healthy - even though the doctors warned that the baby would be born with serious or life-threatening deformities.

There is another article on this site that references a doctor in Wisconsin that has a 100% success rate treating the issue this woman suffered with. That is enough to show that it was NOT certain that this mother, or her baby, would have died without the abortion.

I agree that it is a difficult issue, but life is full of difficult issues, and when they arise, we must grapple with them. Catholics, and Christians of all stripes, should not be siding with the secularists who are denouncing the decision of the Bishop. We should put out thinking caps on and try to understand the philosophical and moral position of the Church on this matter. If we cannot understand it, we should give those in authority over us the benefit of the doubt until we can come to a better understanding.
5.21.2010 | 3:55pm
Pace Cathleen Kaveny, Elizabeth Ancombe's considered views on intention and double effect are not to be found in her book Intention, but in the essay "Action, Intention and Double Effect", which she gave as the Aquinas Medal Address to the American Catholic Philosophical Association (1982), and is reprinted e.g. in Human Life, Action and Ethics (2005).

The "Why?" question methodology is insufficient to determine whether the nun in Phoenix formally cooperated in killing the innocent unborn child. It is a misunderstanding of the book Intention to think that sincere answers to the "Why?" question are automatically revelatory of the respondent's genuine intentions in acting.

The relevant analogy to the Phoenix case, I think, is the removal of a cancerous uterus in a pregnant woman. This procedure is permissible according to Catholic teaching, and does not count as intentional killing of the unborn child who dies as a result nonetheless, because the child and her presence is incidental to the cancer, which is the object of the surgical procedure.

But the pulmonary hypertension case which arose in Phoenix doesn't appear analogous. In this case, the object of the surgical procedure _is_ the destruction of the unborn child, whereas in the cancer case the object of the surgical procedure is the uterus, in which the unborn child just happens to be present. But for the woman with pulmonary hypertension, the presence of her unborn child just is what creates the risk to her health. All pregnancies are risky. Her's happens to be more risky, and perhaps seriously risky. Thus the object of the surgical procedure to "treat" the risk is the pregnancy itself, and therefore the unborn child herself. The "remedy" is to end the pregnancy by destroying the unborn child. Thus the surgeon performs a direct abortion, and the ethicist who approved the procedure formally cooperated in the intentional killing of an innocent human being.

If the facts of the case are as stated above, then Olmstead was right, even if it may have been prudent for him, in order to avoid confusion, also to excommunicate the nun ferendae sententiae.
5.21.2010 | 3:58pm
DNB:

The object of the act does not depend on the intention or purpose of the agent.

You appear to believe that one side in this debate is obviously correct. I'm not saying it's wrong, but if it's right, that isn't obvious. Here's why.

If a given sort of act is intrinsice malum, then of course PDE cannot be used to justify it. But the moral, as distinct from canonical, question in this case is whether the abortion McBride approved was indeed direct, and thus intrinsice malum. If it was, then of course the good sister's believing and intending otherwise doesn't make it right. My argument is that, unless the abortion's being direct was obvious, Bishop Olmstead's announcement is unjustified. I don't believe that people far removed from the case can say whether it was obvious or not.

Best,
Mike
5.21.2010 | 4:08pm
Ziggle says:
Thank you for a most thoughtful and insightful analysis.

Today and ectopic pregnancy is treated by removing the fallopian tube, which as you mention, also terminates the pregnancy, and the Church accepts this.

However, newer methods of microsurgery allow the fallopian tube to be spared, and methotraxate administration alone is sufficient to terminate these tubal pregnancies if identified early enough with research reporting that more than 75% of the women end with a patent (open) fallopian tube.

So in the case of ectopic pregnancy -- is the Church really saying that surgery that removes the fallopian tube (and pregnancy) is ok, but that non-surgical or micro-surgical methods of removing the pregnancy are not okay? Are Catholic women going to be subjected to surgery unnecessarily? Will insurers pay for medically unneeded surgery when a drug option provides a medically safer and better outcome? Should government -- many of whose taxpayers aren't Catholic -- have to pay for medically unnecessary surgery because the mother's religion disapproves of the drug alternative?
5.21.2010 | 4:19pm
Gail F says:
I agree with Anne Rice that this is a complex issue, especially for people who have never thought about it before (I am not pointing to anyone in particular here, but referring to the many people reading the original story who have never wondered what Catholic teaching says about this or why -- and then have to try to figure out "double effect" and other principles in the matter of a few moments).

I think it would help people in such a situation to know that the Catholic Church does not consider a woman and her unborn child to be one "real, living" person and one "future" person. They are both real, living people. This is not a religious argument but a philosophical one, and a scientific one as well -- according to embryology, an embryo or fetus of an organism are the same creature as the adult organism, just a different age. It is not all right to kill an innocent person because killing him or her MIGHT save the life of another person.

I know a woman who was told to have an abortion to save her life and who didn't do it -- she and the baby lived and are fine. I know another woman who was told to have an abortion because her baby would probably be profoundly retarded. Her baby was perfectly normal. But that doesn't mean that doctors are always, or even usually, wrong in such situations.

Anne Rice is correct that saying a woman may not kill her unborn child, and may then die, is a troubling and even frightening thing to say. That doesn't make it false.
5.21.2010 | 4:56pm
Michael Liccione: "My argument is that, unless the abortion's being direct was obvious, Bishop Olmstead's announcement is unjustified."

It's a reasonable argument. Can you proffer an argument as to why +Olmstead chose to announce that sister McBride had excommunicated herself latae senteniae instead of doing it himself with ferendae sententiae?
5.21.2010 | 5:28pm
freelunch says:
Bishop Olmstead comes across as a man who is without compassion, a man committed to a simplistic, black-and-white world where there is no possibility that he could be in error. I think the Pope was very unwise to make him a bishop. It does appear that he claimed that Sr. Margaret McBride has incurred excommunication latae sententiae, because he didn't have the integrity necessary to face her and let her defend her actions.
5.21.2010 | 5:28pm
Ann says:
I believe that Mr. Liccione is mistaken. I am no expert but it would seem that he is misunderstanding or mistating the principle of double effect. Double effect does not apply here. If it does, please explain.

My understanding of double effect is that, for example, if a woman has cancer and is pregnant it is morally licit to use chemotherapy even though one effect of the drugs is the death of the child. This is considered indirect abortion. The Phoenix case involved the death of a child that was "directly willed as a means to some specific end," that is to save the life of the mother. This is a direct aboriton and does not fall under "double effect". The death of the child in this case was intended, it was a deliberate act. It doesn't matter that the reason seemed like a good one.

I look forward to any clarification.
5.21.2010 | 6:34pm
EMK says:
ziggle, a discussion of that scenario here: http://www.cuf.org/faithfacts/details_view.asp?ffID=57
5.21.2010 | 6:41pm
Frank says:
I think Ann is correct, and Mr. Liccione is mistaken. Abortion is intrinsically evil; you can never "approve" an abortion for any reason. In the case of an ectopic pregnancy you are doing a separate medical procedure which has the secondary, foreseen, but unintended, effect of causing the death of the child (namely, you are removing the Fallopian tube, or part of it). But it would be entirely immoral in that instance to specifically target the child for abortion, leaving the Fallopian tube in tact. See the difference? The former is a legitimate medical procedure with an independent goal; the latter is a direct abortion where the death of the child is indeed willed as the only object/goal of the act. From what Mr. Liccione wrote about the case, it unfortunately sounds like Sr. McBride approved something like this. But direct abortion is NEVER permissible, even in the case of an ectopic pregnancy. Therefore Bishop Olmstead seems to be right here.
5.21.2010 | 7:44pm
Mark says:
If one's moral compass dictates the deliberate destruction of an unborn in defense of the mother (in spite of the counter testimony that the mother could have survived until the child reached viablility) then I suppose too one was "on board" when the CIA waterboarded Khalid Sheikh Mohammad to try to prevent another attack on innocent life like 9/11. Why let a dusty old catechism (or a crotchety old bishop) get in the way of saving lives?!
5.21.2010 | 7:55pm
Professor Liccione,

Thanks for a good article.

I believe you are conflating proximate intent with remote intent.

The proximate intent is certainly part of the specification of the moral object.

Proximate intent is the immediate "why" of what we choose to do. In this case, it would be the removal of the baby from the womb (in itself licit).

Remote intent is the long term "aim" we are trying to achieve. In this case it is to save the mother's life (also licit).

You are correct that the remote intent does not justify an intrinsically evil moral object, but the proximate intent is necessary to determine what the moral object actually is.

Hope this helps.

God Bless
5.21.2010 | 8:25pm
Jesurgislac says:
I hope that this public clarification by the Catholic church that the right thing to do, if a pregnant woman is at risk of death if she can't have an abortion, is to let her die, will have at least one beneficial effect - it has made it impossible not to see that Catholic hospitals are providing substandard health care due to gross failures in medical ethics. No woman who might be pregnant should risk seeking treatment in a Catholic hospital or anywhere a Catholic board of ethics will have the deciding say if she's allowed to live or must be left to die.

I and others have been arguing for some time that the "pro-life" position is ironically self-named, as "pro-life" in fact means promoting the deaths of pregnant woman, and, if you count the fetuses as separate deaths, two deaths in one. This case has simply made public and clear, in the Catholic Church's own voice, what we have said all along: the "pro-life" movement is simply a misogynistic indifference to the health and the life of pregnant women.
5.21.2010 | 8:57pm
mike says:
If the Sister made a mistake in judgment, can't the Bishop just forgive her? Why does she have to be excommunicated?
5.21.2010 | 8:58pm
Joe McFaul says:
"So in the case of ectopic pregnancy -- is the Church really saying that surgery that removes the fallopian tube (and pregnancy) is ok, but that non-surgical or micro-surgical methods of removing the pregnancy are not okay?"

yES.
5.21.2010 | 9:33pm
I don't understand why Michael Liccione reserves judgment about whether the abortion was direct or not; I think we have to give the bishop the benefit of the doubt and believe he is in possession of better information than the rest of us. Let's give it a few more days.

mike: yes, the bishop can forgive her but he also has a responsibility to remove scandal from the Church; Sr. McBride's public error must be repaired by public action and public repentance.
5.21.2010 | 10:08pm
Although it makes little difference theologically, I feel I have to point out that Mr. Liccione has his medical facts wrong! It is regular hypertension which is connected with eclampsia, which usually isn't an issue until much closer to the end of a pregnancy. This is pulmonary hypertension, too high a pressure in the pulmonary artery and sometimes the pulmonary vein as well. Someone can have this even when his blood pressure is normal. Pulmonary hypertension makes the R side of the heart have to work too hard to try to perfuse the lungs. It can cause R sided heart failure. People have this, and die of it, who aren't pregnant. However pregnancy with its increased blood volume and increased demands for oxygen, puts a greater stress on the heart and the lungs. This would increase as pregnancy advanced, so one would think that the woman could get the baby to 25 or 26 weeks at which point it has a fair chance of survival. However one can imagine a person so severely compromised that the least increase in stress on the cardiovascular system would be fatal. It is also true in this condition that once the damage is done, it doesn't reverse itself once the stress is removed, so that if the woman did survive to bring the baby to viability she would be left in a condition which was deteriorated from her pre-pregnancy state.

We don't know the details of this woman's medical condition, so we can't really make a medical judgment about what would have or could have happened if the abortion hadn't taken place. Sometimes doctors do say that awful things will happen if something isn't done, and when it isn't done, they are proved wrong. Women have delivered babies while hospitals are in court asking for an order to make them have a C section. Babies who were supposed to be deformed or retarded, aren't. I was told not to have more children after my third, who had some neonatal problems, because subsequent children would have the same problem, but worse. I had six more and none of them did. However, sometimes doctors warn of things and they are completely correct. Pulmonary hypertension is a serious medical condition. The possibility that it might have been fatal can't be excluded, and that is the situation in which the moral question here arises.

Susan Peterson
5.21.2010 | 10:16pm
On the fallopian tube/ectopic pregnancy issue. My understanding of double effect has been such that I believed that while the removal of the tube was licit, the newer procedures such as flushing the tube with methotrexate were not licit, because they brought about the good effect of saving the mother by the evil action of killing the embryo in the tube. However in another forum in which this was being discussed, a doctor pointed out that an ectopic pregnancy may be implanted somewhere else besides in the tube; on the outer wall of the uterus or elsewhere in the abdominal cavity. Its presence is detected by pain caused by bleeding when the trophoblast buries itself in to tissues not meant for this. There is no organ to be removed in most of these cases. The doctor in this case said that "the intention is to stop the bleeding and the secondary effect is the death of the embryo." To my mind, there is little difference between saying that and saying in this case "The primary intention was to stop the deterioration of cardiac function..." Or at least, I am having trouble saying what the difference is. Something which seemed very clear to me now seems less clear. Can anyone who believes he has a handle on the double effect distinction address this?
5.21.2010 | 10:30pm
What about this situation in which the mother or the baby issue used to arise, and in which the church's position was roundly condemned in the press-the situation of an undeliverable baby before C sections were safe. This was the case until the 1940's, and was the situation on which the move "The Cardinal" was based. Back then there were no antibiotics, and IV hydration was not routinely practiced either. A woman might survive a C section if she had it in strict aseptic conditions before the membranes ruptured, before she had had many vaginal exams introducing bacteria, and before she became thoroughly dehydrated from long labor without being allowed to drink. But if she had been laboring for over 24 hours, usually much more by the time it was concluded that the baby was undeliverable, her chances of surviving the surgery were not good. What was done in these cases is that instruments were used to crush the baby's head so it could be delivered. Sometimes the baby would be turned and the body delivered, and then the head would be crushed, similar to the procedure known as partial birth abortion. The alternative to this was to risk a C section which the mother had a poor chance of surviving. The whole world except the Catholic church thought that in these cases it was sad of course, but the baby had to be sacrificed. The Catholic church continued to maintain that doctors must try to save both the mother and the baby.

And now, of course, we can. But I want to ask, was the church wrong then? I would particularly like to ask Ann Rice this. She thought the church's position in the current case, that doctors had to try to save both the mother and the baby even if this put the mother's life at risk, was 'chilling.' I think it is easier to think this when the baby is much tinier and less developed, much harder to think so when it is a full term baby's head being crushed, and yet the moral principles involved are really not much different.
Susan Peterson
5.21.2010 | 10:57pm
Ed Peters says:
This case is becoming a textbook example of why we must abandon latae sententiae penalties in the West, as they already have done in Eastern canon law. Navigating the internal and external fora in such cases is not only extremely difficult, but it distracts public attention from the underlying offense (the deliberate killing of innocent human being) and focuses it on complex areas of ecclesiastical law.
5.21.2010 | 11:19pm
freelunch says:
the bishop can forgive her but he also has a responsibility to remove scandal from the Church

It seems to me, as an outsider, that the Bishop has caused scandal by showing himself to be committed to an inflexible, arbitrary moral standard that is willing to kill the mother of four rather than let an abortion occur. He appears to be heartless.
5.21.2010 | 11:46pm
Ziggle says:
Very interesting that the Church's position seems to be that in the case of a tubal ectopic pregnancy, surgical removal of a small section of the fallopian tube is morally acceptable, though it results in the termination of the embryo in the removed portion, while methotrexate (chemical) termination of the tubal pregnancy is unacceptable, as is tube-sparing microsurgery. But removal of the embro in an extra-uterine pregnancy is acceptable -- that's the only treatment that resolves the problem. Not at all sure that I can see any clinical difference between the two. Both intentionally terminate the mis-implanted embryo that is otherwise likely to kill the mother. One eliminates it along with the (otherwise un-offending) fallopian tube, the other just eliminates the mis-implanted embryo. In both cases it is the growing embryo that poses the direct threat to the mother. The fallopian tube itself is not intrinsically disordered -- it isn't like a cancerous uterus, or cancerous ovaries. My suspicion is that the number of good Catholic women who would clearly die almost completely preventable deaths has led to the Church using the pretense that it is the fallopian tube that is at fault. That's not supported by any science that I've seen.

And in the case of a tubal ectopic pregnancy, I'm not even sure that it would be ethical and legitimate (from a legal perspective, not Catholic perspective) to withhold a much less risky treatment in an ER emergency, and instead force the woman to have maiming surgery as the only alternative.

My suspicion is that the Church will see the error of its ways, much as they finally did with Galileo.
5.22.2010 | 12:04am
Michael Liccione says that > On this definition, an abortion is direct when the *death* is willed.

But that’s not how the Catechism of the Catholic Church defines “direct abortion.” It defines it as “abortion willed either as an end or a means” (CCC 2271, 2322). So according to the CCC, an abortion is direct if it, the abortion, is willed. Not the death, but the abortion.

Following this reasoning, an indirect abortion would be one in which the abortion wasn’t willed either as an end or as a means—the abortion was a side-effect. That might sound odd, but it’s not so odd if we think more about what an “abortion” is. If the American Heritage Dictionary is to be trusted, it’s the premature ending of a pregnancy. (That’s the meaning that allows miscarriages to be called “spontaneous abortions.”) Interestingly, in his second paragraph, Liccione first seems to define “indirect abortion” in this fashion, but then he returns to defining direct/indirect in terms of whether the *death* is intended.

So: an indirect abortion is a medical procedure in which the pregnancy is ended prematurely but the premature ending of the pregnancy is intended neither as an end nor as a means. E.g., the doctors give chemotherapy, and that results in a miscarriage. A direct abortion, by contrast, would be a medical procedure in which the premature ending of the pregnancy is intended either as a means or an end—regardless of whether the death of the child is intended as a means or an end.

Now, if I understand what happened in Arizona correctly, there’s no doubt that the hospital staff intentionally brought about the premature end of a pregnancy, and there’s no doubt that McBride approved this. There may be doubt about whether anyone intended the child’s death, but if the above analysis is correct, that’s irrelevant.

But using Liccione’s definition, it’s very relevant. So I think this is something that needs to get sorted out before the matter is discussed any further. What is the sort of thing that brings about excommunication latae sententiae? Direct abortion in Liccione’s sense, or direct abortion in the CCC’s sense? Or perhaps there's some third sense that's important (I'm not an ethicist by trade). For what it’s worth, the CCC itself discusses the excommunication business in the same context (2272), which suggests that the CCC itself teaches that the excommunication attaches to those involved in abortions that are “direct” in the CCC’s own sense.
5.22.2010 | 12:09am
GeekLady says:
What everyone is ignoring here is that pulmonary hypertension is not caused by pregnancy and does not just "get better" once a woman is no longer pregnant. Pregnancy is an added strain on the circulatory system, but ending the pregnancy is not treatment of the underlying disease.
5.22.2010 | 12:14am
vitae says:
@freelunch:
I find it interesting how you state your conclusion: it is the "inflexible, arbitrary moral standard" that "kills" (active verb) the mother of four, rather than "let an abortion occur" (passive verb). The only abortion that simply "occurs" is a spontaneous abortion (miscarriage); this is not what we are talking about here. Also, does the fact that the mother has four children make her life of greater value than that of the baby? By that reasoning, then, the mother of eight children has a life of even greater value than the mother of four. Rather, the Church teaches that the life of the mother and child are of equal value, and every effort should be made to save BOTH.
I'll give you credit where credit is due, however -- at least you said the Bishop only "appears" to be heartless, rather than calling him ACTUALLY heartless...
5.22.2010 | 12:20am
cathyf says:
Susan, such a scenario is fictitious. The first studies decrying over-use of c-sections were 100 years ago. VBACs were pioneered then, as well. My father was born by c-section in 1935 after my grandmother was in labor for 5 days. It was a relatively routine birth after she got to the hospital.
5.22.2010 | 12:46am
I must have done something wrong in my previous post. The first paragraph should read:

Michael Liccione says that a “direct abortion” is an “abortion in which the death of the child is either directly willed in itself or directly willed as a means to some specific end.” On this definition, an abortion is direct when the *death* is willed.
5.22.2010 | 2:22am
Susan Peterson,

William May has changed his view and now supports the use of methotrexate in ectopic pregnancies.

Germain Grisez has supported Craniotomy in the stuck baby case.

Both take the view that the moral object here is not to kill the baby but to treat the ectopic pregancy or modify the baby's skull geometry (itself morally licit) to allow remova.

God Bless
5.22.2010 | 9:53am
therese says:
#1 As you admit in your article, you do not know all the facts in this case. Much of what you're working on is surmise. Until you know as much about this patient & her particular situation, to second guess Bishop Olmstead re: this situation is reckless, at best, and sinful, at worst, because you could be giving scandal. You may legitimately comment in generalities but not on a specific case to which you are NOT privy to the patient's history, vital signs, previous interventions, treatment alternatives and many many other variables.

#2 Please see Ms Scalia's comments on this case. I.e., the Wiggle Room in the hospital statement which could conceivably give cover to any decision that the Ethics Committee made. In & of itself, pulmonary hypertension with the resultant risks of eclampsia is not a rationale to abort "the pregnancy", as the hospital statement identified this (dead) baby.
5.22.2010 | 10:56am
freelunch says:
Vitae,

We know what the current state of medical art is for treating this problem. It is a disappointly poor state, but no other treatment is known to be reliable. Sr. McBride made the morally and medically correct call. Bishop Olmstead did not.

He has no right to practice medicine. He has no right to intimidate those who do. He has no right to put other women at risk because of his ignorance of the problem and simplistic anti-abortion views. He has tried all three here. That is why I conclude that he looks heartless. I notice that he didn't even have the guts to face Sister McBride and discuss the issue with her. We might conclude from his behavior that is because he doesn't want to consider that he might wrong both medically and morally.

Catholic hospitals may be controlled by the Church, but all have received donations and huge tax benefits to further their mission of _health care_ not of Catholicism. If Bishop Olmstead cannot follow the rules and allow medical staff to treat people with the best medical care available, he has the duty to turn these hospitals over to a not-for-profit organization that will follow medical ethics. He does not have the right to impose his ignorant views on those who need medical care. He does not have the right to put their lives at risk.
5.22.2010 | 11:32am
Max says:
I know that freelunch has said that the Bishop can forgive the nun, but I am unclear as to whether this is in the context of absolution though the sacrament of reconciliation. I have researched this question in the past based on earlier debates on the subject of PDE and the "auto-excommunication" by way of direct support for a direct abortion but never found a clear answer. I presume that surely if a murderer can confess and be absolved, then this sister could as well (assuming she desired to do so)? I understand that the confession and contrition must be sincere etc. I merely ask because I have talked about this subject with other Catholics who feel that in these circumstances the excommunication is final. I cannot believe that is correct, but I've never been able to locate a definitive reference to the contrary. Can anyone point me in the right direction?
5.22.2010 | 12:20pm
Ann says:
If I understood Mr. Liccione correctly, he is questioning whether Sr. McBride understood the abortion to be direct and how much the bishop knew of her knowledge when he made his statement regarding the excommunication.

How could she not understand the abortion to be direct when the death of the child was an intended consequence of the procedure? How can this abortion be viewed as indirect?

The posts here are all very interesting but most of them are missing the point of Liccione's essay. The question is not whether the Catholic Church's position on abortion is right or wrong but what did Sr. McBride know and how does that effect her excommunication. This is my 2nd post asking for Mr. Liccione to clarify my question on how this could be an indirect abortion. I think by not clarifying this point he is doing his readers a disservice and perhaps misrepresenting the issues at play here.
5.22.2010 | 12:36pm
Harry says:
I think the contemporary bigotry towards the child in the womb is evident in the news accounts and discussion of this matter.

The abortion was done at 11 weeks. At that point the child's heart had been beating for over a month. He/she was already recognizable as a little human being.

I assume that in this case the purpose of the abortion procedure was to create a situation where the baby was no longer a burden to the mother's body, not to kill the baby (abortion procedures are usually considered unsuccessful if the child survives). The baby’s death is not what was intended to contribute to the saving of the mother. It was hoped that the child's separation from the mother's body would do that.

I further assume that the abortion procedure used was suction aspiration or dilation and curettage, as such would be typical at 11 weeks. These methods violently dismember the child.

How different would the discussion be if the topic was the morality of dismembering a six-month-old child if that would somehow alleviate the danger to its mother's health? Say, for example, that mother and child are trapped in some wreckage. It appears that they are situated such that neither can be cut free without fatally injuring the other. Most of us would insist on the experts taking the course of action with the best chance for the survival of both. That is because most of us aren't afflicted with bigotry towards six-month-olds. The bigotry of our age is towards the child in the womb.

I will leave to the theologians what courses of action would be permissible in the wreckage scenario I described. (Catholics, such as myself, ought to submit to the teaching of the Church.) My purpose here is merely to point out the bigotry towards the child in the womb.

What exactly is the intrinsic difference between a fetus and a born infant? The infant no longer receives nutrition and hydration from within its mother's body. That is not an intrinsic difference; the infant is the same human being it was in its fetal stage. Whatever intrinsic value it has now it had then – and in its embryonic and zygotic stages. It is only bigotry that makes it seem to some that the child in the womb somehow “doesn't count.” I suspect that this bigotry plays a huge role in the decisions of medical ethics panels.

It seems to me that to grasp the teaching of the Church in these matters it is first necessary to realize the Church's teaching is not adjusted to accommodate the world's current bigotry. The bigotry towards the child in the womb is an aberration that will eventually end. That it is merely an aberration is indicated by the fact that taking the lives of unborn children was traditionally prohibited by civil law, and by the fact that the “First, do no harm” ethic of Hippocrates, whose oath explicitly prohibits abortion, was the ethical guide of Western medicine for thousands of years. It has been rejected only twice in modern history: during the twelve years of the Third Reich and in contemporary society. The Church just isn't going to adjust its teaching to accommodate the world's current bigotry towards the child in the womb.
5.22.2010 | 3:47pm
therese says:
http://www.wisn.com/health/17994163/detail.html

Michael,
Plz read the above article & then try to make sense of what you've written questioning Bishop Olmstead's statement re: McBride's self-excommunication. As I said in my previous comment, pulm HTN does not necessarily = mandatory abortion, as the above article (posted by Scalia) indicates. As in many many cases in modern medicine, the recommendation to abort has more to do with the hospitals' (physicians', insurance companies' etc) fear of responsibility/litigation than it does with sound medicine.
5.22.2010 | 5:17pm
David Mills says:
On Michael's behalf, thank you for all the thoughtful responses. He would address them, but he's away this weekend on a retreat. He'll be responding when he gets back. So keep writing.
5.22.2010 | 6:05pm
Brendan says:
Bishop Olmstead has served the Church well in the past. First, he was rector of the Pontifical College Josephinum and ensured that it did not become a "lavender-mafia" seminary by removing some faculty and not allowing men who could not be chaste from the seminary. He also instilled in the men there a great love for the Liturgy, a devotion to Mary, and faithfulness to the Church.
He also led the Diocese of Wichita, which continues to be blessed with vocations to the priesthood, before being appointed to the see in Phoenix.

The fact is the excommunication is a fraternal correction that is Biblical and was used in the early Church. In this day and age is may seem old fashioned and punitive. Yet, it is meant to teach others that there is such thing as an evil act and that one can depart from grace by choosing it. In this instance, it is apparent that the directives from the bishops on healthcare are so vague as to make them meaningless to such an extent that any one can justify their decision by appealing to them. This is especially the case when one questions other teachings of the Church and sees things as up for grabs. The moral proportionalism that was condemned by John Paul II is unfortunately alive and well even in "Catholic Hospitals".
5.22.2010 | 7:19pm
Anushree says:
As some of the commentators have noted, it may be true that all cases of pregnancy with pulmonary hypertension (PH) do not necessitate an abortion for the health of the mother, but we don't know the specifics of this case to speak confidently either way. There are varying degrees of severity in PH and whether the disease is primary or secondary to some other illness often impacts on how progressive and critical the illness can become. Specifically, there are cases of Eisenmenger's complex, which includes several congenital heart defects that result in PH, which are particularly serious and can exacerbate quickly during pregnancy. I wonder if the physician who reports a 100% success rate in treating pregnant patients with PH has successfully treated patients with more severe variants. It would be good to hear from Catholic physicians who specialize in Maternal Fetal Medicine, especially those who support the Church's teaching on abortion, to comment on this case.
5.22.2010 | 7:47pm
"If subjective culpability is indeed irrelevant here, the philosophically interesting question then becomes whether the object of the act in question makes the act morally evil regardless of whether the agent intended the act. "

CCC reads:

"I. The Sources of Morality

1750 The morality of human acts depends on:
- the object chosen;
- the end in view or the intention;
- the circumstances of the action.
The object, the intention, and the circumstances make up the "sources," or constitutive elements, of the morality of human acts.

1751 The object chosen is a good toward which the will deliberately directs itself. It is the matter of a human act. the object chosen morally specifies the act of the will, insofar as reason recognizes and judges it to be or not to be in conformity with the true good. Objective norms of morality express the rational order of good and evil, attested to by conscience.

1752 In contrast to the object, the intention resides in the acting subject. Because it lies at the voluntary source of an action and determines it by its end, intention is an element essential to the moral evaluation of an action. the end is the first goal of the intention and indicates the purpose pursued in the action. the intention is a movement of the will toward the end: it is concerned with the goal of the activity. It aims at the good anticipated from the action undertaken. Intention is not limited to directing individual actions, but can guide several actions toward one and the same purpose; it can orient one's whole life toward its ultimate end. For example, a service done with the end of helping one's neighbor can at the same time be inspired by the love of God as the ultimate end of all our actions. One and the same action can also be inspired by several intentions, such as performing a service in order to obtain a favor or to boast about it.

1753 A good intention (for example, that of helping one's neighbor) does not make behavior that is intrinsically disordered, such as lying and calumny, good or just. the end does not justify the means. Thus the condemnation of an innocent person cannot be justified as a legitimate means of saving the nation. On the other hand, an added bad intention (such as vainglory) makes an act evil that, in and of itself, can be good (such as almsgiving).39

1754 The circumstances, including the consequences, are secondary elements of a moral act. They contribute to increasing or diminishing the moral goodness or evil of human acts (for example, the amount of a theft). They can also diminish or increase the agent's responsibility (such as acting out of a fear of death). Circumstances of themselves cannot change the moral quality of acts themselves; they can make neither good nor right an action that is in itself evil."

http://www.vatican.va/archive/ENG0015/__P5R.HTM
5.22.2010 | 8:32pm
freelunch says:
Max,

My comment included an attempt to quote where the quoting failed. It was Bill Daugherty at 6:33 last night that I was quoting about forgiving the nun. My problem with the decisions of Bishop Olmstead is that he ducked the hard responsibility of weighing competing interests, a responsibility that Sister McBride had taken on in her role. Not only was Bishop Olmstead unwilling to talk with Sister McBride about it, but he was unwilling to give any credence to the current standards of medical care.

As far as I can tell, Bishop Olmstead is demanding that the Catholic Hospitals in his diocese engage in medical malpractice.
5.22.2010 | 11:22pm
cathyf says:
Max asks a question about whether the automatic excommunication that results from participating in abortion can be lifted through the Sacrament of Confession, and makes the dismaying assertion that he has come across some large group of Catholics who assume that the excommunication is permanent. This is completely false. A person who participates in an abortion and then repents is reconciled to God and to the Church through the Sacrament of Confession -- just like anyone who commits a sin and repents.

There are some special rules when it comes to a confession of abortion -- the main issue is that canon law reserves absolution in these cases to the bishop. In most dioceses the bishop explicitly delegates the authority to some or all of his priests in a blanket order. Even when he does not use a blanket delegation, this is dealt with in a way that preserves the Seal of Confession. So, for example, a woman confesses that she has had an abortion. The priest then contacts the bishop and requests permission to grant absolution in the bishop's name, without giving the bishop any specific information about the woman other than that it was an abortion. The bishop then grants it and the priest grant absolution, and the woman is now restored to full communion with the church.

I'm quite frankly horrified by the notion that Max has met so many Catholics who think that excommunication would be permanent and not remediable through the Sacrament of Confession. How the heck where they catechized?!? That NOTHING is outside of God's grace and forgiveness was the single most important message that all of my religious education came back to over and over. I remember as a 1st-2nd-3rd grader we ask what about confessing this, what about that, what about this other thing, with all of the most lurid imaginings of evil that we were capable of. The answer was always yes! Mass murder, apostasy, what have you. Catholics who go to Church come in contact with all of the Church's efforts to reconcile those who commit the sin of abortion. During October (pro-life month) we will hear about Project Rachel, which is specifically aimed at women who have had abortions and reconciling them to God and to the Church. We publicize writings and speeches from women who have had abortions and repented of them, as well as doctors and others who used to be involved in the abortion industry before having had conversion experiences. That Catholics could walk by the posters and hear the homilies and read the stories in their Catholic papers and think that these folks are permanently and hopelessly excommunicated -- how clueless can they be?!?
5.23.2010 | 12:40am
GNW_Paul says:
Was this a direct abortion or not? Michael Liccione proposes the argument "one could argue, the purpose of the abortion was not the death of the child (either as an end or as a means) but merely the removal of the child from the womb to save the mother’s life—an indirect abortion, in other words, and thus justified. "

I think this argument doesn't hold water at all at 11 weeks. 1st, unless the baby was removed from the womb alive and intact, then the baby was killed before it was removed from the womb. So to my mind that throws the argument out the window. Abortion is not merely removing the baby from the womb, it is first killing the baby and dismembering it, then removing the body parts from the womb.

Maybe the could perform a C-Section at 11 weeks and call that removing the child from the womb and we could get closer. Still I don't believe so because we have to ask "how long could the child survive outside the womb?" At 11 weeks the baby has absolutely no chance of being able to breath so without any intervention it would die in minutes. So unless there was some plan of actually treating the baby like a person and trying some extraordinary measures to give it a chance at life, removing it from the womb is directly killing because that removal takes away everything that is keeping the baby alive.

Its a tragic situation all around. But agree with the comment above that we'd look on this much differently if the child was 1 year old or even 1 month old.
5.23.2010 | 12:58am
GNW_Paul says:
In Defense of Bishop Olmstead

Bishop Olmstead did not hold a press conference or issue a press release to announce that Sr. McBride had incurred a latae sententiae excommunication. The Bishop was announcing the results of his investigation which included the removal of Sr. McBride from her positions. The excommunication issue was brought up in that context. This wasn't a first reaction from the Bishop. He had already reviewed the case and concluded that in his judgment it was a direct abortion. While mentioning the latae sententiae excommunication may not have be totally necessary it wasn't exactly superfluous either.

If the case had been resolved more positively, the Sr. McBride could have admitted she made a mistake either in her judgment or her understanding of how to apply Catholic ethics in this situation and the excommunication could have been lifted.

However, it is clear that she has not been persuaded that she was mistaken. So it not a matter of Bishop Olmstead not being willing to forgive her. It is a matter of an administrator and ethicist at a Catholic Hospital holding her own private judgment of the situation over that of her Bishop and making it clear that in similar circumstances she would make the same decision.

I can see where this is a very difficult area of ethics and of canon law. There may be some chance that Bishop Olmstead is mistaken on the ethics. However, he actually conducted an investigation, he got the facts, it is likely he consulted with other ethicists and Bishops and canon lawyers. This is the conclusion he reached. I'll give him the benefit of the doubt at least until it goes to the Rotta.
5.23.2010 | 12:59am
Christi says:
As several commentators said, the principle of double effect doesn't apply to this case. Bishop Olmstead isn't rash. Rather, it appears he investigated the matter and no doubt consulted doctors, then made his statement months after the deadly offense. I, for one, do not trust the hospital's ethics committee over Bishop Olmstead. Trusting the committee strikes me as severely naive.
5.23.2010 | 2:11am
Gordon says:
Hello!
The bottom line of all of this discussion is should that child been aborted or not. The amazing amount of discourse about canon law, whether or not certain canonical requirements were met, I believe are distractions from the bottom line of whether or not a life would be saved. It was not. What did Jesus Christ say was the epitome of self-giving? One who gave their life for another. Are the people who are demeaning the Bishop Catholics? Are they Protestant Christians? I see that those who participated in the decision to kill the unborn child as confused followers of Jesus Christ.
Peace and God Bless, and may Jesus Christ be the center of your life.
5.23.2010 | 9:25am
freelunch says:
GNW_Paul-

What medical training does Bishop Olmstead have that allows him to decide that Sr. McBride was unquestionably wrong in allowing an abortion to save the life of the mother? What rules say he should not have discussed this with her and the rest of the medical ethics panel?

I see no evidence that he is remotely competent to judge Sr. McBride's decision. Could you tell me where he took the classes necessary to understand this medical problem?

Christi, would you trust Bishop Olmstead to make a medical decision for you? Why?
5.23.2010 | 9:39am
Jesurgislac says:
I believe are distractions from the bottom line of whether or not a life would be saved. It was not.

Well, that works if you simply do not regard the pregnant woman as a life.

If the bottom line is: was a life saved?

Then yes: an 11-weeks pregnant woman was dying. Had she died, the fetus she was carrying would have died too - no way to save a pregnancy that far along after the woman's death.

What did Jesus Christ say was the epitome of self-giving? One who gave their life for another.

So in effect: the unborn child gave her/his life so that their mother would live. The epitome of self-giving.

Are the people who are demeaning the Bishop Catholics? Are they Protestant Christians? I see that those who participated in the decision to kill the unborn child as confused followers of Jesus Christ.

Why confused? The mother in this instance couldn't give her life to save the pregnancy: the pregnancy was killing her, and when she died, that would be it - inaction leading to two deaths. Bishop Olmsted says that would be the right thing to do - two deaths by inaction better than one life saved.

But if you feel that it's the epitome of self-giving for one to give their life to save another, so you can honor the unborn child for giving their life to save the mother - and you would not support the Bishop who felt that both should die.
5.23.2010 | 2:55pm
Here's an interesting article, "Catholic teaching under attack by Catholics ... again!".
5.23.2010 | 3:50pm
Bill says:
It's clear from the specific facts of this case that it wasn't merely a health risk on delivery, but that the mother was indeed in immediate danger of dying, too ill to even survive transfer to another hospital.

The question then condenses down to:

Is it morally obligatory for a mother to die to avoid a _direct_ abortion, even when there is no chance her baby will survive?
(first-trimester fetuses don't survive outside the womb)

Given that those are the specifics of the case under discussion, I look forward to the author's thoughts on the above question.
5.23.2010 | 9:02pm
Micha Elyi says:
"...torture can be said to be the object of their waterboarding..."-Michael Liccone

Really? Look again at how the Church has historically defined torture and then check to see if waterboarding fits that definition.
5.23.2010 | 11:14pm
Christi says:
freelunch: Your questions are non sequiturs. Bishop Olmsted sought the medical facts before he declared Sr. McBride excommunicated. the only scandal here is that members of a Catholic hospital staff, including Sr. McBride, recommended, decided or somehow performed this abortion and thus they became accessories to murder. Had Bishop Olmsted ignored this, he would've been guilty of scandal. GeekLady gets it. Even if the government permits direct abortion, it isn't a legitimate treatment for pulmonary hypertension or any disease. So Bishop Olmsted and the Church objectively expect the same of everyone: individuals should make their own medical decisions according to the truth.
5.24.2010 | 1:20am
Max says:
cathyf: Thank you much for the clarification and confirmation of what I felt had to be the right answer. I would not say that "many" Catholics I have talked to have taken that position, but some have. I would not call them "well catechized" though. But what concerned me was that I could not find a definitive answer on the matter. I was not aware of the requirement that absolution occur from the bishop (or only by delegation from the bishop). In any event, I greatly appreciate your responding. Peace of Christ.
5.24.2010 | 10:36am
John Hinshaw says:
As only God can, this tragic case has brought forth some necessary good. It's about time that serious Catholics turned their thoughts to such difficult, real problems. For some, it is the first time they have bothered about the humanity of the unborn child, proprieties of excommunication and the ethical education of our nuns. Some of us have been wriestling with this for years.
5.24.2010 | 1:30pm
Thanks to everyone for making this such a lively thread.

For my information about Bishop Olmsted's decision, I'm going by this release from his office. It does not rebut Sr. McBride's contention that the abortion was indirect and thus justifiable under PDE. It simply assumes she was wrong, that the abortion was direct and thus unjustifiable by PDE or anything else. That's why I raised the questions I did. I find it curious that the grounds for such an assessment are not stated, and that the statement was issued without any discussion with Sr. McBride. If the moral status of her act were that obvious, why not state openly the medical facts that make it so? Perhaps the mother's confidentiality is being protected. But if that's the case, then the Bishop's announcement is inappropriate. He has announced an excommunication whose grounds cannot be made public. As a Catholic, I'm embarrassed by the political ineptitude of such a move.

I have to say that I agree with canonist Ed Peters, who's just been appointed to the Apostolic Signatura, about latae sententiae excommunication. He commented above: "This case is becoming a textbook example of why we must abandon latae sententiae penalties in the West, as they already have done in Eastern canon law."
5.24.2010 | 3:53pm
Austin Ruse says:
The error that the author and also Cathy Kaveny at dotcommonweal have made is the almost blithe mention of "removing" the child from the mother. Kaveny referrs to the "separation" of the child from the mother. This makes it sound like the doctor was simply inducing an early birth. Not true. While we don't know the method used. It is likely he either cut the child limb from limb or he burned the child with poison and induced labor. This is the deliberate killing of an unborn child, not the treatment of a medical condition. We all agree it is allowable to treat a medical condition that may also result in the loss of the unborn life, but this does not and can never include deliberate abortion.
5.24.2010 | 5:42pm
Cathy f, I'll do further research about the early 1900's mother vs baby issues. I have read old obstetrics books which discuss this, along with prictures of the destructive instruments used, but they were late 1800's to very early 1900's. I know that there was florid language about this issue (Are women safe in Catholic hospitals?) in Blanshard's American Freedom and Catholic Power, which I think was written in the 40's, but he is hardly a reliable source and may have been using already medically outdated information. Likewise the movie "The Cardinal." So I will find out more.

Chris Sullivan: William May....Germain Grisez... your comment only drops their names. How about summarizing their articles, or giving links? I must say that I shrink from the idea that anyone would say crushing a baby's skull is acceptable in any circumstance! The methotrexate issue...well show me an argument. I am no more anxious than anyone else to chop out women's tubes! But I think the principle that we may never make a direct attack on innocent human life is so important to maintain that I was ready to stick with the distinction.

free lunch, How do you know the bishop was unwilling to talk to Sister McBride about it? And ask for the rest of your comments, you keep talking about this as a "medical decision," and about all the medical facts which had to be weighed. It is the ethical decision which is in question! Whatever medical facts you weigh, even if you could be sure the mother were going to die in the next 15 minutes, there is no possible justification for starting to cut up the child in the womb, even if you could be sure that that act would save the mother's life. Of course in this scenario the baby would die also, but no human being would have killed it. The facts in this case are unlikely to be that clearcut, but I stated them that way to make the point that what you say about "weighing the medical facts" makes no difference at all. Medicine can tell us the facts of the case, but it can't tell us what it is right or wrong to do. And yes, I believe that in cases like these, what a Catholic hospital should do might well be judged to be medical malpractice.

Doctors are using ethical assumptions as well as their medical training to determine what is the "standard of care" and if their ethical foundations are different from ours, it isn't surprising that there should be some points of conflict. When there is a conflict, a Catholic hospital must put Catholic moral teachings above the standard of care, above what is or isn't considered malpractice.

Michael, I still don't get why you think there is any question about this being a direct abortion. I can't see any possible way that double effect could apply.
The good effect of saving the mother's life can never come about through the evil act of taking the life of the unborn child. Right? I can't see any reason to criticize the bishop. For courtesy's sake he might have discussed this with Sister McBride if he really didn't, but I can't see how the results could have been any different.

Susan Peterson
5.24.2010 | 10:22pm
Philothea says:
According to Mr Liccione's reasoning, it would then be all right for me to break into his house and take out all his valuables to help the poor, no?
5.25.2010 | 9:41am
Ann says:
"embarrassed by the political ineptitude"

I'm not, thank God a bishop is not thinking like a politician is thinking like the shepherd he is supposed to be. Political astuteness got us the bishops covering up sexual abuse. Political bishops is the last thing we need. The truth is pretty much always unpopular and politically deadly so lets have more of it.

"Perhaps the mother's confidentiality is being protected." Gee, do you think so? Her medical information of protected under federal law and you would be howling if it was released.

I know you saw Jimmy Akins article in which he states that his research shows that Bishop Olsted was responding to questions from the press, and he responded after the hospital admitted the abortion took place. Your essay and comments leave me with the impression that the bishop fired the first salvo and brought this all to the public's attentions. From what I can gather, the bishop did no such thing and was trying to handle it privately and discreetly. I am disappointed in your essay and follow up. And I still do not know why you think this was not a direct abortion. The absence of information in the bishops statement doesn't seem to be reason enough to suspect him of being unfair or dishonest.
5.25.2010 | 9:54pm
Matt Bowman says:
Ann's right: think of the position the hospital apparently put the Bishop in when it publicly announced it had performed an abortion for hypertension, in a circumstance apparently the Bishop had reason to know wasn't justified. What was he supposed to do--let the Catholic hospital in his diocese pass on such a policy? There are lots of facts that the public hasn't been told in this case, which prevent any of us from judging the Bishop's actions here, because those facts may well fully vindicate him. And Austin is also right: the idea that there was a mere removal of a baby is a fact that is not known, and instead seems to have been repeatedly disputed by the diocese, whose public statements refer repeatedly to D&C and D&E, neither of which can be accurately described as having as their "object" mere removal, since the "what are you doing" of those methods is shredding and dismemberment not removal.
5.26.2010 | 9:56am
Jesurgislac says:
Matt: "Ann's right: think of the position the hospital apparently put the Bishop in when it publicly announced it had performed an abortion for hypertension"

Did it? What was the order of events?

A hospital saving a woman's life by performing an emergency abortion for pulmonary hypertension is not news, unless someone involved in it is a celebrity - and it happened last November.

What was the order of events? The first I heard of this - quite literally - was when the news broke that Bishop Olmsted had declared a nun excommunicate by her own actions in approving an abortion.

THAT is news - "Bishop Excommunicates Nun" isn't something that happens every day, especially when the nun is being excommunicated for saving a life.

Was there any public announcement whatsoever by the hospital that they had performed an abortion in November, *before* Bishop Olmsted made the announcement that Sister McBride was excommunicated for it?
5.26.2010 | 10:32am
Matt Bowman says:
J: Strictly speaking that may be another fact we don't know with precision. But I'm going off Jimmy Akin's estimated timeline. It was the same day at best. http://www.ncregister.com/blog/what_are_the_true_facts_regarding_the_abortion_approving_nun/
Either way, the hospital's statement is what it is. It seems to me that the Bishop would be hard pressed to let it stand in public that the Catholic hospital in his diocese admits that it did an abortion and justified it, especially if the Bishop knew more and troubling facts as he seems to have known.
5.26.2010 | 5:48pm
Ann says:
Jesurgislac-you are being dishonest when you say "the nun is being excommunicated for saving a life."

That is not the issue and you know it. She excommunicated herself by procuring a direct abortion.

The bishop did not excommunicate her, she excommunicated herself by her actions with a direct abortion. Everyone else involved also excommunicated themselves automatically. The bishop does not have to confirm it in order for the excommunication to be a fact. It happens as soon as the action takes place. The remedy is repentance.
5.26.2010 | 10:42pm
Joseph says:
What is clear from this discussion is that this is a morally complicated situation. When so many intelligent people of good will can come to different conclusions and make different assessments we certainly have a morally difficult situation. It does everyone a disservice to claim that the morally correct position in this situation is obvious, clear or self-evident. The only thing that is clear is that is morally complicated.

I give the benefit of the doubt to Bishop Olmstead and to Sr. McBride. I believe both are probably sincere, good Catholics who were attempting to make the decision that each thought was morally correct. Sr. McBride was in a position where she had to discern the seriousness of the risk of a having two people die or, in an attempt to save at least one of the lives the life of the other would be lost. We have no reason to doubt her sincerity of belief that this was an indirect abortion. Bishop Olmstead was in the position of having to uphold the value of life and the moral teaching of the Catholic Church unambiguously so as to avoid confusion or scandal. I believe he sincerely believes it was a direct abortion.

However, I think it would go a long way if Bishop Olmstead, and other bishops in similar circumstances, would explicitly recognize and state something like, "I realize the morally difficult circumstances of this case. And, while I believe those involved operated with the best of intentions, I believe they were morally incorrect for the following reasons..."

The ONLY thing clear in this situation is that this is morally complicated. And we should all recognize that as the beginning point of discussion.
5.27.2010 | 2:29am
Christi says:
Yeah, "embarrassed by the political ineptitude" is chilling. This commentary continues to bother me on many levels, but I will only mention two: I'm shocked that Michael Liccione wrote it and his follow up; I'm appalled that First Things published it. Good to hear from Austin Ruse, Ann and Matt Bowman.
5.27.2010 | 9:09am
Matt Bowman says:
Joseph I think there's something to what you are saying. However, there's also a growing gap in our society between different sincere judgments on particular issues. It is possible for two people to be sincere and still be extremely far apart in their conclusions. Increasingly, sincere disagreements are not close calls. This is especially true for massive evils that our society has embraced like abortion. John 16:2 is not hyperbole. Catholics are not immune to these divergent lines of thought, even Catholics serving the Church's mission. So it is possible that both were sincere in this case, and yet that the Bishop didn't need to depict his judgment as a close call over which reasonable Catholics can disagree.
5.27.2010 | 10:29am
Joseph says:
Matt, I agree with you. I am not suggesting that Bishop Olmstead need suggest that he is just offering one opinion among many or one "over which reasonable Catholics can disagree" as if there is no morally "correct" answer. I am just trying to highlight the actual situation which is that reasonable pro-life Catholics ARE disagreeing. I am suggesting that the principle of being unequivocally pro-life from the moment of conception until natural death must sometimes be applied in confusing, difficult circumstances where the correct moral choice is not so clear (people posting here have offered several difficult scenarios). The Bishop still has the obligation to clarify the morally correct position for the faithful. It is his duty to teach, guide and instruct precisely because there are morally confusing and difficult situations (that is also why a hospital has an ethics committee). However, as I wrote earlier, explicitly and accurately articulating the context of this situation in that teaching, I believe, is an important thing to do - and it makes the teaching more helpful and effective. This would involve recognizing that this is a tough one and that some sincere Catholics made the wrong choice; and, THEN explaining why.

I have a question. My understanding is that in order for one to be excommunicated latae sententiae one must know exactly what one is doing. In the same sense that one cannot be guilty of committing a mortal sin by accident (you have to know what you are doing and have to freely choose that act). I have always had a similar understanding of excommunication latae sententiae: you can't do it accidentally. I believe this is what Prof. Liccone may be addressing. If Sr. McBride sincerely believed that, because of PDE, this decision was a morally acceptable one, has she still excommunicated herself? This is not to say that the act itself is not ontologically evil, it is to ask about the personal culpability of Sr. McBride (or the other hospital staff involved) and hence her excommunication. If the medical staff was informed by the ethics committee that their actions were morally acceptable are they also excommunicated? Even though they believed this was PDE and acceptable? Can one excommunicate oneself without knowing that is what one is doing? It seems that Bishop Olmstead is saying "yes" while Prof. Liccione is suggesting "perhaps not."
5.27.2010 | 12:19pm
Matt Bowman says:
Joseph, I would only add that reasonable pro-life Catholics are to some extent disagreeing, but only without knowing all the facts or even most of the facts. It is possible, as far as any of us know publicly, that we would not disagree if we knew all the facts. I leave your canon law question to others.
5.27.2010 | 2:49pm
Joshua says:
The Church has been unequivocal that abortions like this one are direct


The teachings of the Catholic Church admit of no doubt on the subject. Such moral questions, when they are submitted, are decided by the Tribunal of the Holy Office. Now this authority decreed, 28 May, 1884, and again, 18 August, 1889, that "it cannot be safely taught in Catholic schools that it is lawful to perform . . . any surgical operation which is directly destructive of the life of the fetus or the mother." Abortion was condemned by name, 24 July, 1895, in answer to the question whether when the mother is in immediate danger of death and there is no other means of saving her life, a physician can with a safe conscience cause abortion not by destroying the child in the womb (which was explicitly condemned in the former decree), but by giving it a chance to be born alive, though not being yet viable, it would soon expire. The answer was that he cannot. After these and other similar decisions had been given, some moralists thought they saw reasons to doubt whether an exception might not be allowed in the case of ectopic gestations. Therefore the question was submitted: "Is it ever allowed to extract from the body of the mother ectopic embryos still immature, before the sixth month after conception is completed?" The answer given, 20 March, 1902, was: "No; according to the decree of 4 May, 1898; according to which, as far as possible, earnest and opportune provision is to be made to safeguard the life of the child and of the mother. As to the time, let the questioner remember that no acceleration of birth is licit unless it be done at a time, and in ways in which, according to the usual course of things, the life of the mother and the child be provided for". Ethics, then, and the Church agree in teaching that no action is lawful which directly destroys fetal life. It is also clear that extracting the living fetus before it is viable, is destroying its life as directly as it would be killing a grown man directly to plunge him into a medium in which he cannot live, and hold him there till he expires.

Coppens, Charles. "Abortion." The Catholic Encyclopedia. Vol. 1. New York: Robert Appleton Company, 1907. 27 May 2010 .


I light of that, I see no room for debate
5.28.2010 | 12:15am
RAnn says:
What is the morally acceptable thing to do in the following situation:
1. A woman is pregnant
2. The baby isn't viable outside the womb and won't be for a very long time
3. The pregnancy is an immediate and serious threat to the life of the mother--and that threat won't go away until she is no longer pregnant--or dies, whichever comes first--and one will happen SOON

Try to save both sounds right, moral and good, but what if you just plain can't? A cancerous pregnant womb can be removed, even though we know that doing so will result in the death of the baby; but what if the problem is the baby? It is permissible to remove an ectopic pregnancy that is in the abdominal cavity (no tube to remove, the only thing to remove is the baby). This, as others have said, isn't a matter of a mother giving her life for the child; if the mother dies, so will the child.
5.28.2010 | 3:45am
Ben Dunlap says:
RAnn, it's extraordinarily difficult -- even heroic -- to DO what's right in the situation you've described. It's not at all difficult to KNOW what's right, at least in light of Catholic teaching: You can't procure a direct abortion, period.

The Church is more clear and consistent on that point than on just about anything. That doesn't make it an easy teaching to follow.

I think that some of the comments above are mixing two different senses of "morally difficult".
5.29.2010 | 4:09pm
Mr. Liccione asks: "Is it really possible to excommunicate oneself not for intentionally violating Catholic moral teaching but for doing something one believes to be fully in accord with such teaching?" The answer is "Yes, but the sin would then be strictly a material sin rather than a formal one." Thus, the soul would incur no guilt. Sister McBride, unknowingly, ruptured communion with her Catholic fellows. Now that she knows better, all she need do is repent, confess, and recant to be restored to full communion. That she has not already done so, makes her sincerity suspect. Was it not Fr. Neuhaus who wrote that bioethicists are to medicine what prostitution is to marriage?
6.1.2010 | 2:28am
Jesurgislac says:
Ben Dunlap: "RAnn, it's extraordinarily difficult -- even heroic -- to DO what's right in the situation you've described. It's not at all difficult to KNOW what's right, at least in light of Catholic teaching: You can't procure a direct abortion, period."

Heroic? What exactly is "heroic" about letting a pregnant woman die when you are a ER doctor and know what you could do to save her?

I can see that when such an action - two deaths considered better than one, as Bishop Olmsted explicitly said - is mandated by the Catholic Church, under threat of excommunication if the doctor decides that it is better to have one live than both die, then it is certainly moral according to the Catholic Church's ideas of morality, and it is certainly very, very obedient.

But the idea that it is "heroic" to ignore a woman's right to life because she is pregnant and the fetus is killing her, just is... absurd.
6.1.2010 | 3:27pm
Thales says:
RAnn, Jesurgislac, and others,

Consider 2 people trapped in a cave-in, a mother and a daughter. Rescuers will be able to free them in 2 days. Unfortunately, there is only enough air for 1 person for 2 days (and thus enough air for 2 people for only 1 day.) The daughter's existence spells certain death for the mother, and vice versa, before the rescuers reach them. What is the solution to the dilemma? Can the mother directly kill her daughter, because the mother has a right to life which is threatened by her daughter's life?
6.2.2010 | 7:21pm
Jesurgislac says:
Thales, what you are missing is:

When the mother dies, the daughter dies too. So the rescuers have a choice: they can rescue the mother alone, or they can leave both mother and daughter to die. In this illustrative scenario, they cannot rescue both mother and daughter: it's not physically possible. They can leave both mother and daughter to die in the cave-in, or they can rescue the mother alone.

The Catholic response to this is apparently that the rescuers should wait till both mother and daughter are dead. Rescuing just the mother is cause for excommunication.

The normal humane response - and the legal & ethical obligation of a rescue service - is that if they can only rescue one, they must rescue that one. They must not let both die just because the daughter can't be rescued.

The mother has the option of deciding to commit suicide by rejecting rescue, and apparently to the Catholic Church her suicide is more of a moral act than her survival.
6.2.2010 | 7:34pm
Jesurgislac says:
Thales, in the situation you describe, how is it "heroic" for the rescue team, discovering that the daughter is going to die no matter what they or the mother do, to hang back and refrain from rescuing the mother until she too is dead?

I can accept that as a matter of religious Law or doctrine, the Catholic Church requires devout Catholics to believe that it's better two people die than one live. And that Catholics who cannot repent of saving one life rather than letting both die are permanently excommunicated.

But trying to claim this is heroic or humane or even just - no. It's not. It's a heartless dismissal of the woman's right to life, to argue that she must die because she cannot live with her pregnancy. It's inhumane, and it's tantamount to murder, to deliberately abandon the pregnant woman to die because the Law of the Catholic Church mandates that saving her life will incur excommunication.
6.3.2010 | 5:15pm
Ann says:
Jesurgislac-You misunderstood the scenario that Thales gave you.
The scenario was:
"The daughter's existence spells certain death for the mother, and vice versa,"
not as you stated:
"discovering that the daughter is going to die no matter what they or the mother do"

The question in this scenario is that only one can live since there is only enough air for one for 2 days. If I understood Thales, they both have an equal chance but only if there is only one of them. You can save one not both but it doesn't matter which one in terms of one surviving. So which do you choose? Mother or daughter? Why?

"Can the mother directly kill her daughter, because the mother has a right to life which is threatened by her daughter's life? " If yes, please explain. Doesn't the daughter have a right to life which is threatened by the mother?

"that Catholics who cannot repent of saving one life rather than letting both die are permanently excommunicated. "

Again, you mistate things. The excommunication is not necessarily permanent, that is up to Sr. McBride. And the excommunication is not for "saving a life" but for taking the life of the baby. You keep referring to "one life" "two lives" but haven't explained why one life, any life has more value than the other. Why is the mother's life more valuable than the baby?

And NO I am not saying that the mother's life is of less value than the baby. They are both of equal value. The good of saving the mother's life is not justified by the murder of the baby.

-" two deaths considered better than one, as Bishop Olmsted explicitly said "

Can you tell me when and where he said this? I have read this statement, the q and a and the article in the Arizona Republic but must have missed this. Or did you misunderstand the point about you cannot justify saving a life by taking another life?
6.6.2010 | 1:18pm
Jesurgislac says:
//The scenario was: "The daughter's existence spells certain death for the mother, and vice versa," not as you stated: "discovering that the daughter is going to die no matter what they or the mother do"//

I did not misunderstand Thales' scenario: Thales misunderstood the scenario we were discussing on this thread. Which is, and always has been: The daughter is going to die no matter what. No intervention, and no non-intervention, will end with the daughter alive. The rescue team, in this scenario, has the choice only of deciding whether to let the mother die with her daughter, or busting in to save the mother, presuming that busting in to save the mother is one of the ways which will kill the daughter.

And, in this scenario, the rescue team, appraised of the facts that they could not save both, did choose to save the one they COULD save.

Now the rescue team is apparently being told that it would have been "more heroic" for them to hang back and wait for BOTH mother and daughter to die. I disagree. What's heroic about failing to act, knowing that means two deaths instead of one?

//they both have an equal chance but only if there is only one of them. You can save one not both but it doesn't matter which one in terms of one surviving. So which do you choose? Mother or daughter? Why?//

I hope never to be in that situation, and it's important to note that Sister McBride wasn't either. There wasn't any choice about WHICH ONE would survive: the only one who COULD survive was the mother. The daughter was dead, whatever choice was made.

//Doesn't the daughter have a right to life which is threatened by the mother? //

Doesn't the mother have a right to life? It seems not, in the Catholic mindset: if the daughter can't be saved, leave the mother to die.

//The excommunication is not necessarily permanent, that is up to Sr. McBride. //

Apparently Sister McBride has repented saving the woman's life, which is sad, but I hope it was on terms of "Sorry if I upset you, Bishop" (as Bishop Olmsted explicitly said he felt the woman should have been left to die).


//And the excommunication is not for "saving a life" but for taking the life of the baby.//

But that life was going to be taken, whatever happened.

Either Sister McBride approved the hospital "taking the life of the baby" by deciding that "the baby" ought to be abandoned to die within the uterus of her dead mother. Since hte mother was about to die if the pregnancy was not terminated, and no fetus at any stage of development will live if the mother dies. But apparently, if Sister McBride had approved two deaths - let the mother die, let "the baby" die with her - that would have been Okay.

Or Sister McBride approved the hospital "taking the life of the baby" by removing "the baby " from the uterus (whole and entire, in a first-trimester abortion - an 11-week fetus is very small) todie outside (since an 11-week-fetus can't live outside the uterus). And the woman lives, since the presence of "the baby" in her uterus is what was killing her.

// You keep referring to "one life" "two lives" but haven't explained why one life, any life has more value than the other. Why is the mother's life more valuable than the baby? //

I haven't said, anywhere, that I think one life is MORE valuable than the other. Whereas Catholics on this thread and elsewhere have repeatedly argued that it would have been better to take the life of both "the baby" and the mother, since it was impossible to save "the baby", and they have not explained why they think the mother's life is so worthless that, if "the baby" can't be saved, the mother ought to be left to die.

//And NO I am not saying that the mother's life is of less value than the baby. They are both of equal value. ///

Is that how you justify killing the mother? If you regard them of EQUAL value, and you can't save "the baby", do you think that means the mother's life has NO value, since no matter what happens, the baby has no life?

//
Can you tell me when and where he said this? //

In his initial statement. He said it wasn't better for the mother to live.
6.17.2010 | 11:07am
Geremia says:
"And so, one could argue, the purpose of the abortion was not the death of the child (either as an end or as a means) but merely the removal of the child from the womb to save the mother’s life—an indirect abortion, in other words, and thus justified."

How is that an abortion at all? That sounds like an induced labor, but since the mother was 11 weeks pregnant, there was neither any reasonable chance of induced labor nor viability outside the womb. So, regardless whether the abortion was surgical (i.e., dismemberment with a suction device) or chemical (i.e., RU-486 / Mifepristone or Methotrexate, which basically starve the pre-born to death), IT WAS STILL A DIRECT ABORTION.
6.21.2010 | 12:21pm
Jesurgislac says:
//So, regardless whether the abortion was surgical (i.e., dismemberment with a suction device) or chemical (i.e., RU-486 / Mifepristone or Methotrexate, which basically starve the pre-born to death), IT WAS STILL A DIRECT ABORTION.//

And what is wrong with a direct abortion performed when the continued pregnancy will kill the woman?

This is what no one has been able to explain: why is it better, in the eyes of the Catholic Church, to kill the woman directly and the fetus indirectly, by refraining from providing life-saving treatment to the pregnant woman? Apparently it IS better to kill the woman and thus ensure her unborn fetus dies when she does, than it is to save the woman's life by performing an abortion that will kill the fetus when removed from the uterus.

Why is it better to kill a pregnant woman and her unborn child by withholding treatment from her. when the alternative is to perform a direct abortion so that the woman lives?

Why is it that killing the woman doesn't matter, while killing the fetus does?
7.21.2010 | 2:47pm
Joseph says:
Jesurgislac has the most clear, cogent and convincing position in my opinion. This nuanced and complicated discussion cannot hide the upside down argument that allowing two people to die when one life could have been saved is the "pro-life" position convinces no thoughtful person. Most people find this position to be immoral.

The bumper-sticker slogan argument that "evil means cannot justify a moral outcome" is nonsensical. Almost by definition a moral dilemma is a situation where evil means do justify a moral outcome. For example, self-defense (killing someone to protect yourself or another - evil means, moral outcome). Less dramatically we could use the example of surgery (cutting someone open in order to correct some disorder - evil means, moral outcome). Someone violating the trust and confidence of a friend or family member in order to protect them from harming themself or someone else (evil means, moral outcome). Good means achieving a good outcome is an easy decision (a "no-brainer"). Repeating an inaccurate slogan as if it were eternal truth does not advance the discussion.

In order to demonstrate the courage of their convictions (right or wrong), Bishop Olmstead and those who unequivocally endorse his conclusions and his actions should request a meeting with this young woman, wife and mother of four and explain to her, her children and her husband why they wish she was dead, why they believe a correctly calibrated moral compass would have called for her death, why the world be a better place morally if she were dead. Unless you are able to do that it might be better to pray for her and her family and withhold judgment on Sr. McBrien.
8.8.2010 | 11:29am
VatCanonist says:
Mr. Liccione,

After reading your article, I could not refrain from submitting the following comments.

First, no one is excommunicated latae or ferendae sententiae according to the universal law of the Church if committing a canonical delict "culpably," that is, without "dolus." Any suggestion that Bishop Olmstead would have declared the accused excommunicated for having posited the actus reus out of mere culpability is one error no trained canonist simply makes.

In verity, Sister Margaret McBride was ostensibly declared excommunicated for having violated can. 1329-2, connected with the violation of can. 1398 perpetrated by the mother and doctors under Sister's authority or direction having directly procured an abortion of her child.

The interesting article you write regrettably misses the real legal issue in this canonical case, which is not the philosophical issue of whether an agent intending or believing to do good, but committing evil, is to be exculpated or punished: it is one of evidence, or proof -- not philosophy.

The true issue in Sr. McBride's case is whether or not, as the accused in this case, she was able to rebut, or not, the canonical presumption of can. 1321-3 that she was fully responsible for the actus reus of giving her consent qua administrator of a hospital, consent apparently needed sine qua non the abortion could not have been procured by the mother or the doctors in the case:

Framed differently: "Whether Sr. McBride has sufficiently rebutted the canonical presumption of her guilt by malice aforethought (operative from the moment that it was proven that she committed the actus reus)."

This is because absent full proof capable of rebutting the canonical presumption (cf. can. 1321-3 CIC 1983) that one, when giving true consent to an abortion having been performed directly, did not intend to consent directly (as opposed to indirectly), and absent full proof rebutting the canonical presumption that one did not know that the object of one's consent (an act to be held as objectively being one of direct abortion) was forbidden or subject to the penalty of excommunication according to the universal law and the Magisterium of the Church (cf. can. 15-2 CIC 1983), deliberation is presumed (cf. can. 1321-2 CIC 1983), and consequently a Catholic subject to the penal provisions of the Code of Canon Law is to be presumed excommunicated.

vc
8.10.2010 | 1:16am
VatCanonist says:
Typo: the last paragraph above should read:

"did intend to consent directly [...]" and "one did know that the object of one's consent [...]"

vc
8.11.2010 | 2:55am
nattyice says:
Just to clarify... the correct spelling is Bishop Olmsted and Sr. McBride.
To Joseph 8/8 Catholics do not wish the mother dead. Please read the posts by Chuck 5/21 and by Susan Peterson 5/21. The Catholic position is to try and save both baby and mother. There are two patients in the hospital when it comes to pregnancy, not one. Killing the child to avoid complications early on is intrinsically evil. By choosing to be a part of the decision to abort the child or advising it in some manner, Sister MrBride excommunicated herself as vatcannonist has explained so very well. A professional religious should know better than involve oneself in something like that. Neonatal care now can sometimes treat a 21 week old baby. Could the mother have held on another 10 weeks? Maybe, maybe not. But St. Joseph's hospital didn't advise her to hold out any longer, they advised an abortion? I would assume that there are a number of non catholics on that ethics board, maybe sister didn't want to "rock the boat?" Who could say? It's dangerous for me to even begin to suggest motive. The mother was not in imminent danger at the time of the abortion. That is the truth!
8.11.2010 | 12:41pm
VatCanonist says:
As a follow-up to my previous animadversion regarding the key issue of Sr. McBride's "imputability" under can. 1321-3 of the Code of Canon Law of 1983, which issue is inevitably raised by Mr. Liccione's thought-provoking article, the Code of Canon Law of 1983 no longer provides a single operating presumption of "malice aforethought" on the part of one who has been proven to have posited an external violation of Canon Law, in comparison with what the prior Code of 1917 provided: it now provides a generic presumption of imputability with respect to the volitional element of the crime (cf. can. 1321-3 CIC 1983), viz. that the accused truly willed to posit the act which he or she has been proven to have committed in an external manner.

Nonetheless -- and this is where all too many canonists and faithful are continuously led into error by badly formed practitioners of Canon Law -- the previous canon 2200-2 CIC 1917, encapsulating both a) a presumption of generic imputability regarding volition and b) a specific presumption of malice aforethought or "dolus" on the part of the accused whose external commission of the violation of the law has been demonstrated, has not disappeared altogether from the Code of 1983 in substance and juridical effect: it simply has become bifurcated into two separate canons, they now being: 1) can. 15-2 CIC 1983 regarding a presumption knowledge of the law and penalty, knowledge of a fact concerning one's own actions, and knowledge of a notorious fact concerning another; and 2) can. 1321-3 CIC 1983 concerning the presumption of imputability regarding the mere volitional element of the crime externally proven to have been committed -- instead of one all encompassing canon like can. 2200-2 CIC 1917.

Instead of devolving from one single canon like can. 2200-2 CIC 1917, the presumption of malice aforethought now devolves from two canons - can. 15-2 and can. 1321-3 CIC 1983.

What this means is that if an accused, like Sr. McBride in this case, is unable to rebut both presumptions of cann. 15-2 and 1321-3 as described above, then "deliberation" is presumed according to can. 1321-2 CIC 1983.

As such, if an accused "deliberately violated a law or precept," he or she "is bound by the penalty prescribed in that law or precept."

Succinctly applied to the present case, if Sr. McBride did not rebut the presumption of malice aforethought per se raised by the absence of effective rebuttal on her part, beyond a reasonable doubt, of the two presumptions of knowledge of the law and penalty, and volition in the placing of the actus reus of the criminal act, then she is presumed "a iure" or by the operation of universal law itself to have committed the prohibited act of being a necessary accomplice to a direct abortion with malice aforethought, such that she would not be able to escape the incurrence of excommunication latae sententiae established by cann. 1329-2 and 1398 CIC 1983.

vc
8.14.2010 | 3:06pm
Vatcanonist:

You wrote:

In verity, Sister Margaret McBride was ostensibly declared excommunicated for having violated can. 1329-2, connected with the violation of can. 1398 perpetrated by the mother and doctors under Sister's authority or direction having directly procured an abortion of her child.

That only holds on the premise that the abortion was direct to begin with. That premise has not been independently established. And even if it were, it has not been established that Sr. McBride was in a position to know it was.
8.21.2010 | 10:10am
VatCanonist says:
Mr. Liccione,

Regarding your first point, the Diocese of Phoenix has stated the following publicly:

"Question: Why was Sr. McBride excommunicated? Answer: Sr. McBride held a position of authority at the hospital and was frequently consulted on ethical
matters. She gave her consent that the abortion was a morally good and allowable act according to Church teaching. Furthermore, she admitted this directly to Bishop Olmsted. Since she gave her consent and encouraged an abortion she automatically excommunicated herself from the Church. “Formal cooperation in an abortion constitutes a grave offense. The Church attaches the canonical penalty of excommunication to this crime against human life.” (Catechism of the Catholic Church #2272) This canonical penalty is imposed by virtue of Canon 1398: “A person who procures a completed abortion incurs a latae sententiae excommunication."

This statement relates the judgment that Sr. McBride "admitted this directly to Bishop Olmstead," namely, that she authorized an abortion which was, in its nature, directly to be procured.

In reply to your second question, can. 15-2 of the Code of Canon Law shifts the burden of proof, in application to the fact pattern at hand, to Sr. McBride, to demonstrate that she was not knowledgeable of the doctrine of the Church - Divine Law - concerning what is and is not a directly procured abortion. It is not for the Diocese to "establish" that Sr. McBride was in a "position to know it was." It is for Sr. McBride to prove, beyond a reasonable doubt, once she had confessed that she authorized the abortion, that she did not know that it was a direct abortion.

Apparently, she was unable to prove her innocence to Bishop Olmstead.

vc
10.12.2010 | 3:22pm
Maria V. says:
What is unclear is , how could those who authorised the abortion , so unequivocally predict a dire outcome for the mother - that she would develop preeclampsia and so on ...what efforts were made froma faith level , to deal with the situation ...why was the Bishop not contacted early on ...

We , who are called to be of faith can take things in the other direction - that this was a child destined to show the intercessory power of the next to be saint or blessed , giving one more witness of God's power in a world that needs same ...

that , this child in some miraculous way could have shown how pulmonary hypertension in pregnancy can be helped ...

How needed would the sorrow of Sr.McBride be , to set things as straight as can be under the circumstances ...and that that alone would be the intent of the Bishop .
12.20.2010 | 10:28pm
John says:
Just stunned by Olmstead. I wonder if he finds it so difficult to locate sufficient theological justification to grant annulments? Isn't it ultimately all about using reason and common sense to do the right thing within the bounds of Catholic theology? Instead, he chose moral posturing over pastoral care. Olmstead comes across as just...unintelligent and unlettered, having neither a keen mind nor an equable temperament, nothing at all like a Jesuit; in fact, I doubt he'd get past the front door at a Jesuit institution. It doesn't say much for the Church that this fellow who would be lucky to get a job working in the Georgetown U. laundry room is a diocesan bishop.
12.22.2010 | 1:56am
I fear that the bishop may have fallen into a trap in his statement to the Arizona Republic newspaper in mid May of 2010. The case that McBride was involved with is hardly typical of the thousands of abortions performed in the U.S. -- legally, as a result of federal court decisions. And yet his statement reads, at least in part, as though it were. I feel safe in saying that in your typical abortion mill, there is no ethics committee and no Margaret McBride. No medical excuse is needed. The bishop said, "An unborn child is not a disease." But nobody in this case claimed anything of the sort, and this was obvious in news reports.

He quotes the Ethical and Religious Directives for Catholic Healthcare Institutions: "In this context, Catholic health care institutions need to be concerned about the danger of scandal in any association with abortion providers." But I seriously doubt that anybody was associating St. Joseph's Hospital with abortion providers. There was no such scandal. Instead, there was what any dummy would recognize as a thorny, tragic lose-lose choice. And this was obvious, too.
12.24.2010 | 12:53pm
Jesurgislac says:
I don't see how Bishop Thomas Olmsted can be said to have fallen into a "trap" when, after months of consideration, his response to the St Thomas hospital saving that woman's life, was that they either had to acknowledge themselves in the wrong for not allowing both the mother and her fetus to die naturally, or cease to be a Catholic hospital.

I suppose the only positive point out of this is that the St Thomas hospital will now be free to save lives without concern for who the Catholic Church wants dead.

It is ironic that so many Catholic prolifers seem to have read the will of their Church and registered that "better two die than one live" is an appalling ethic to live by, while still not turning away from it. Planned Parenthood's ethics have far more compassion and respect for life than the Catholic Church, as Bishop Olmsted has just demonstrated. No doctor working for Planned Parenthood would ever be asked to let a pregnant woman die when she could be saved, but apparently doctors who work for the Catholic Church must, or risk excommunication.
12.25.2010 | 10:11pm
sigh says:
So, the dogma boils down to: "if a woman's life is endangered by her pregnancy, she should just die and get it over with".

If/When an ill pregnant woman dies in a Catholic Hospital because that hospital is scared of winding up like St. Joseph's, all hell will break loose.

Bibbit, spare me the nonsense about the Bishops judgment. I've read enough cover-up memos.

(Speaking of which, can anyone tell me if using the priesthood to rape children is "intrinsically evil"? I'm gonna guess NO.)

I'm gonna guess.....no.
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