Ariz. hospital loses Catholic status over surgery

[kimmielittle]

"The issue is that the moms die three days after delivery because their right heart doesn’t handle all the fluids and changes hormonally after you deliver.”

In each case, Zwicke, working closely with obstetricians and gynecologists, monitors the pregnancy and adapts treatment of the pulmonary hypertension based on what the mother’s heart is doing. Early delivery is key.

Each baby is delivered by C-section between the 36th and 37th week of a 40-week pregnancy, before the body produces extra fluids that ultimately put a strain on the heart’s function.

What happens after birth is a calculated and choreographed course of treatment."We put them in the ICU and we remove with meds and diuretics 9 liters of fluid over the next 72 hours after delivery,” Zwicke said.

wisn.com/health/17994163/detail.html

 

[seekerz]

Fine, the applications, but not the principles themselves. Those are two very different things. And neither you, me, or any doctor is fit to either do that or drive the process ourselves.

Again, you’re first of all assuming that this is what happened based on very little knowledge and also accusing the Bishop himself of taking something so serious as a hospital’s and religous’ Catholic standing so lightly as to “keep a status quo” and not give an inch on “what could be morally considered an abortion.” He’s insinuating, with full knowledge, that the Church is willing to “let” women die in certain circumstances because to do anything otherwise would be intrinsically evil. Knowing full well the entire secular world is going to jump down his throat and villify him. He could’ve just as easily claimed that it did fall under double effect, and in all actuality he most likely wanted it to. Wouldn’t you, as Bishop? Wouldn’t you hope that a hospital under your diocese and people who are your spiritual responsibility would be in the right? He has said as much in public statements.

You know it’s very possible that CHW and St. Joseph’s hospital could have also misrepresented themselves to a certain extent. To do otherwise, and to comply with the Bishop, would’ve caused serious, serious problems for them, and now they look like saints.

I’m trying to give everyone the benefit of the doubt here. The bishop, just by virtue of his authority, had no reason to not act in good faith.

As regards the staff: I have personally known doctors who openly support and perform abortions who will also, when the situation demands it, will give 110% (and a sleepless night or two) to save a baby’s life (feel free to speculate on the incongruity of that state of affairs).

For these reasons, the knowledge that the hospital had a not-so-stellar history does not really impact my view of what transpired in this case, particularly since a hospital/hospital department, is not a person and the individuals involved in that case may or may not be representative of prevailing practices and views at the institution.

It may simply have been a case of information mismatch (medical vs theological). The prevailing comments I have read on this and other forums seem to come down squarely on one side or the next, sometimes with the barest minimum of reflection. I see every reason here for objective and thoughtful reflection.

And the process of applying our principles to such situations, which you allude to in your first sentence, falls very squarely not just into the domain of bishops but into the hands of all childbearing women and their doctors simply by virtue of the fact that they are the ones facing these health situations characterized by changing knowledge and technology.

 

[1holycatholic]

Catholic Hospitals vs. the Bishops
Administrators shop for theologians to support practices that conflict with church teachings.
The severing of ties last week between the Catholic Church and St. Joseph’s Hospital in Phoenix, Ariz., is the latest example of the fraying relationship between the bishops and Catholic hospital administrators. In recent years, some Catholic hospitals have taken greater liberties, authorizing abortions and sterilization procedures that the church strictly prohibits. Earlier this year, for instance, Rev. Robert Vasa, bishop of the Diocese of Baker, Ore., ended the church’s sponsorship of St. Charles Medical Center in Bend over the hospital’s performance of tubal ligations.

But the Phoenix case breaks new ground. In explaining his decision, Rev. Thomas Olmsted, bishop of the Phoenix Diocese, was the first to explicitly point to the role played by Catholic theologians in providing theological cover for “a litany of practices in direct conflict with Catholic teachings.”
…

 

[bookgirl32]

I’m saying that such a statement (i.e. there was nothing wrong with the pregnancy) represents a direct mismatch between medical circumstances as presented by different people involved in analyzing this case. Who can solve a disagreement over medical facts?

As to the medical mismatch, to my knowledge the Bishop is the only one whose ruling has been backed up publicly by statements from actual doctors. I’ve posted those. I’ve also posted the medical ethics director for the diocese statement that the case wasn’t originally even presented by the hospital as a possible “double effect”, it was only after everything got into the press that the theologians and canon lawyers obtained by them got into it. They also were unable to provide supportive letters from other bishops, as they’d suggested they could do.

There has to be a resolution. There has to be a ruling. The Church can’t throw it’s hands up and say, “Well, we’re not doctors, we don’t have a say” and they’re not going to leave ruling on Catholic teaching to doctors.

All I’m arguing is that when it comes to Catholic hospitals, if they want to be officially tied to the Church, they have to show obedience to the authority of that Church. Which they didn’t do.

 

[seekerz]

I have heard the opposite, methotrexate may not be used as the result is a direct abortion.

Here is one source supporting this. I have seen other sites on which the same morality is upheld.

catholiceducation.org/articles/medical_ethics/me0140.htm

"Of the three commonly performed procedures for addressing ectopic pregnancies, two raise significant moral concerns while the third is morally acceptable.

The first procedure involves a drug called methotrexate, which targets the most rapidly growing cells of the embryo, especially the placenta-like cells which attach the early embryo to the wall of the tube. Some have suggested that methotrexate might preferentially target these placenta-like cells, distinct from the rest of the embryo, so that it could be seen as “indirectly” ending the life of the embryo. Others, however, have noted that these placenta-like cells are in fact a part of the embryo itself (being produced by the embryo, not by the mother), so that the use of methotrexate actually targets a vital organ of the embryo, resulting in his or her death. A significant number of Catholic moralists hold that the use of methotrexate is not morally permissible, because it constitutes a direct attack on the growing child in the tube, and involves a form of direct abortion."

In other words, choose your moralist wisely.

Are you suggesting that this should be an individual exercise for Catholic women - choosing which moralist to believe? You have read, I have read…and pray there’s time to find a priest if you’re ever in a blood-drenched ER seeking or rendering treatment?

 

[jimmy]

As to the medical mismatch, to my knowledge the Bishop is the only one whose ruling has been backed up publicly by statements from actual doctors. I’ve posted those. I’ve also posted the medical ethics director for the diocese statement that the case wasn’t originally even presented by the hospital as a possible “double effect”, it was only after everything got into the press that the theologians and canon lawyers obtained by them got into it. They also were unable to provide supportive letters from other bishops, as they’d suggested they could do.

There has to be a resolution. There has to be a ruling. The Church can’t throw it’s hands up and say, “Well, we’re not doctors, we don’t have a say” and they’re not going to leave ruling on Catholic teaching to doctors.

All I’m arguing is that when it comes to Catholic hospitals, if they want to be officially tied to the Church, they have to show obedience to the authority of that Church. Which they didn’t do.

So what should the hospital have done? Let both die?

 

[kimmielittle]

As to the medical mismatch, to my knowledge the Bishop is the only one whose ruling has been backed up publicly by statements from actual doctors. I’ve posted those. I’ve also posted the medical ethics director for the diocese statement that the case wasn’t originally even presented by the hospital as a possible “double effect”, it was only after everything got into the press that the theologians and canon lawyers obtained by them got into it. They also were unable to provide supportive letters from other bishops, as they’d suggested they could do.

They have yet to even provide evidence that the baby was causing the pathology or putting the mom in danger. It is not the baby - carrying of the baby - BUT the Fluids / hormone increases **after delivery **.

Treat the disease…the baby isn’t the disease

 

[kimmielittle]

So what should the hospital have done? Let both die?

wisn.com/health/17994163/detail.html

 

[bookgirl32]

I’m trying to give everyone the benefit of the doubt here. The bishop, just by virtue of his authority, had no reason to not act in good faith.

Agreed.

As regards the staff: I have personally known doctors who openly support and perform abortions who will also, when the situation demands it, will give 110% (and a sleepless night or two) to save a baby’s life (feel free to speculate on the incongruity of that state of affairs).

My first (logical) thought is that these doctors really haven’t thought through the theological implications of either. Or don’t subscribe to any particular theology at all, and therefore think that the dignity of life is something that isn’t static, objective and unchanging and its only worth is relative to its surrounding situation.

For these reasons, the knowledge that the hospital had a not-so-stellar history does not really impact my view of what transpired in this case, particularly since a hospital/hospital department, is not a person and the individuals involved in that case may or may not be representative of prevailing practices and views at the institution.

As far as the individuals (Sr. McBride not included) I’ll give you that one. Although I would say the “not-so-stellar” history would impact it in that the willingness of the hospital to subscribe to Catholic teaching is not high and so we can expect these directives or the importance of them weren’t passed onto the individuals. Although Bishop Olmsted did mention several cases of Catholic members of the staff expressing to him in writing that they were fearful of their jobs if they spoke up about it themselves.

It may simply have been a case of information mismatch (medical vs theological). The prevailing comments I have read on this and other forums seem to come down squarely on one side or the next, sometimes with the barest minimum of reflection. I see every reason here for objective and thoughtful reflection.

I have no problem there. But I don’t think you can rightfully assume without any evidence that anyone posting here hasn’t done so, just based upon the fact that they support the bishop. And morally speaking, they do have grounds to simply say, “The Church says I should believe the Bishop, I believe the Bishop.” I realize I may sound like I’m relieving anyone of the responsibility of thinking for themselves. But again, to a Catholic, the Bishop holds the moral high ground and it is not wrong for people to believe his statements without doing serious medical research of their own.

And the process of applying our principles to such situations, which you allude to in your first sentence, falls very squarely not just into the domain of bishops but into the hands of all childbearing women and their doctors simply by virtue of the fact that they are the ones facing these health situations characterized by changing knowledge and technology.

I completely agree with you here. This is why I don’t really buy the “what if there are non-Catholics” at the hospital argument. If they don’t take responsibility for knowing where they are and who is taking care of them, who will?

 

[seekerz]

I hope you don’t think the morality of issues such as this depends on individual Catholic hospital personnel. Such employees are not theologians. It seems that the idea of situational morality has such a strong hold on moral thinking that objective truth is disregarded by many organizations claiming to be catholic.

No, but I think the morality of the treatment has to be decided by such personnel and their patients. In other words, they do not get to make the rules but they ARE called upon almost daily, to apply them. It’s pretty evident from the article I quoted that there is significant variation in the application. One would imagine that if such persons simply didn’t care for Catholic ethics they would choose to work elsewhere, so the reason for this variation should be probed.

 

[bookgirl32]

No, but I think the morality of the treatment has to be decided by such personnel and their patients. In other words, they do not get to make the rules but they ARE called upon almost daily, to apply them. It’s pretty evident from the article I quoted that there is significant variation in the application. One would imagine that if such persons simply didn’t care for Catholic ethics they would choose to work elsewhere, so the reason for this variation should be probed.

Sorry, I know you weren’t addressing me. But the reason for the variation lies with the administrations of the hospitals and institutions. Which is why I say that the history of CHW’s actions are so telling. A hospital with solid record of following Catholic teaching probably only has that record because they made the rules known to their emloyees and enforced them.

You can say that St. Joseph’s could’ve been acting to avoid a lawsuit (and the doctors in this situation as well) but the fact that the other non-emergency treatments and procedures were offered is evidence to the fact that the doctors may not have ever been warned they would be in a situation like this. I’m sure it would be possible for many Catholic hospitals to scare prospective employees away.

 

[bookgirl32]

So what should the hospital have done? Let both die?

There are situations where, yes, that would be the only moral thing to do. Do the best you can according to the dignity of both lives and entrust the rest to God. We are Catholic, afterall.

 

[seekerz]

As to the medical mismatch, to my knowledge the Bishop is the only one whose ruling has been backed up publicly by statements from actual doctors. I’ve posted those. I’ve also posted the medical ethics director for the diocese statement that the case wasn’t originally even presented by the hospital as a possible “double effect”, it was only after everything got into the press that the theologians and canon lawyers obtained by them got into it. They also were unable to provide supportive letters from other bishops, as they’d suggested they could do.

There has to be a resolution. There has to be a ruling. The Church can’t throw it’s hands up and say, “Well, we’re not doctors, we don’t have a say” and they’re not going to leave ruling on Catholic teaching to doctors.

All I’m arguing is that when it comes to Catholic hospitals, if they want to be officially tied to the Church, they have to show obedience to the authority of that Church. Which they didn’t do.

I think that to prevent repeats of similar controversies, there has to be moral guidance offered on general principles of managing placental pathology (similar to the theological arguments given for treatment of ectopic pregnancies - which themselves seem to be changing) because more and more is being learned of how placental function or malfunction affects disease processes. That, for me, is the greatest sticking point in this case because the evidence and reality of the placenta sometimes being involved or being the cause of disease in pregnancy is pretty clear.

It didn’t first become an issue with this case and it will not go away as a consideration in future cases. Unless laypeople and professionals are assisted (in a proactive rather than reactive manner) in sorting out these dilemmas, the result might be widespread supplanting of applicable Church doctrine in these matters, with secular ethics (as is here illustrated by a pro-life poster with the “baby’s going to die anyway” argument). Put bluntly - we need to keep up with changing times: not by changing beliefs but by continually revisiting their application.

 

[jimmy]

There are situations where, yes, that would be the only moral thing to do. Do the best you can according to the dignity of both lives and entrust the rest to God. We are Catholic, afterall.

And that is one of the reasons why moral theology is bankrupt in the west. It has a distorted sense of good and evil. It is kind of like the scenario in which a man is hiding Jews in Nazi occupied territory; must he tell the truth when they ask whether he is hiding Jews? Moral theologians would say yes, he must tell the truth and to lie would be a sin. In that scenario a fact takes precedence over human life. It is morally bankrupt. The situation with the hospital is similar. For the sake of some convoluted idea of dignity - that really serves no ones dignity in this case - you are willing to allow both to die.

 

[kimmielittle]

you are willing to allow both to die.

Actually, we / nor the hospital /can say the Mother would die.

What can be said: Is they did kill the baby.

 

[jimmy]

wisn.com/health/17994163/detail.html

That sounds like a good alternative. Maybe they should have followed that doctors methods.

 

[kimmielittle]

That sounds like a good alternative. Maybe they should have followed that doctors methods.

There is hope!!!

 

[jimmy]

Actually, we / nor the hospital /can say the Mother would die.

What can be said: Is they did kill the baby.

Death is death, and life is precious. No matter how you put it, they will die, whether you kill them or not. You can say ‘we decide to let them die naturally and hope that maybe there is a slight chance that one will live.’ Or you can decide to take action to try to save one or both of them.

 

[bookgirl32]

I think that to prevent repeats of similar controversies, there has to be moral guidance offered on general principles of managing placental pathology (similar to the theological arguments given for treatment of ectopic pregnancies - which themselves seem to be changing) because more and more is being learned of how placental function or malfunction affects disease processes. That, for me, is the greatest sticking point in this case because the evidence and reality of the placenta sometimes being involved or being the cause of disease in pregnancy is pretty clear.

I have no problem with that. But that’s only one side of the problem. Theological decision-making can’t be put on hold until things become more clear, because our understanding as humans is always going to change. That’s why the Church was given to us in the first place. And it’s precisely these kinds of changes that make it necesarry for the Church to act and be the final arbitrator. One, becuase it is the only institution that has the authority, and two, because there will always be differing opinions and the dignity of human life can’t be subject to relativism.

It didn’t first become an issue with this case and it will not go away as a consideration in future cases. Unless laypeople and professionals are assisted (in a proactive rather than reactive manner) in sorting out these dilemmas, the result might be widespread supplanting of applicable Church doctrine in these matters, with secular ethics (as is here illustrated by a pro-life poster with the “baby’s going to die anyway” argument). Put bluntly - we need to keep up with changing times: not by changing beliefs but by continually revisiting their application.

I don’t have a problem with that either. But again, I also don’t see how that needs to inhibit a Bishop’s responsibility and duty at the time of his decision. Or his right as seen by the Catholic faithful (including hospitals) to do so.

 

[bookgirl32]

And that is one of the reasons why moral theology is bankrupt in the west. It has a distorted sense of good and evil. It is kind of like the scenario in which a man is hiding Jews in Nazi occupied territory; must he tell the truth when they ask whether he is hiding Jews? Moral theologians would say yes, he must tell the truth and to lie would be a sin. In that scenario a fact takes precedence over human life. It is morally bankrupt. The situation with the hospital is similar. For the sake of some convoluted idea of dignity - that really serves no ones dignity in this case - you are willing to allow both to die.

Of course it serves someone’s dignity if it directly and purposefully killed the baby. Even if the baby was certain to die in minutes. It has a right under natural and divine law to it’s life until it’s natural death. That’s why the concept of “double effect” is such a hot button for so many. Becuase if the situation falls under it, than the death of the baby is unintended and considered a natural death as a result of morally neutral actions. If it doesn’t, then it’s murder.

As far as your case with the Nazi hiding the Jews, you’d have to show that lying is intrinsically evil, that is in no case, ever, can it be morally neutral and licit due to a worthy outcome. Lying does not always directly and purposefully deprive someone of their God given human dignity by killing them. Abortion does. Just as when a man stealing bread for his famiy if that is his only recourse possible to keeping his family from starving is not committing a sin but asserting his natural and divine right to feed his family.