Ill. judge throws out rule on contraception

[Rence]

Rence, I’m not seeing your point in this discussion about DDE. Are you trying to say that since the secular medical community and the Catholic medical community have different standards of morals,

In some cases, it’s obvious that the secular medical community and the Catholic medical community have different standards of morals. The usage of methotrexate to treat early diagnosed tubal pregnancies is one such example because the medical community in general accept that treatment as a standard of care, while the Catholic Church forbids it. Another example is the use of IVF for couples who can’t conceive, which the medical community generally accepts while the Catholic Church forbids it. The medical community at large dispenses birth control and finds this practice moral, while the Catholic Church forbids it. So yes, obvsiously, there is a difference (at times) between what the secular medical community deems “moral” and what the Catholic Church teaches as “moral”. That’s just a fact. I didn’t make it up.

Catholics practicing in secular medical facilities should use the secular morals?

A Catholic working in healthcare should not put themselves in a situation in which treatments provided to patients are in conflict with Church teachings. For example. they should not work in abortion clinics, secular fertility clinics, places that routinely do procedures and treatments that conflict with Church teachings.

Or that secular morals trumps Catholic morals depending upon the setting?

A patient’s right to receive treatments that include IVF are going to trump Catholic teachings in a secular fertility clinic. So in that setting, a patient’s right to receive that treatment is going to trump Catholic morals. That’s how it is, I didn’t make it up. There is nothing that can be done to change that as long as IVF is legal and sanctioned by the medical community regardless of how individual Catholics feel about it or how the Church teaches about it.

There is only one proper formulation for DDE, and it doesn’t change depending upon the situation or the author. Either St Thomas’ formulation is correct, the secular one is correct, or neither. Both cannot be correct, and both cannot be applied separately.

As Catholics, we see that St. Thomas’ formulation is correct. But because we can’t force the world to be Catholic or adhere to the rules of the Catholic Church, the rest of the world does not see that formulation as correct. And there really is little the Catholic Church can do to change it except call it’s followers to obey their rules, and in turn, Catholics can try to lobby to get laws changed to conform to Catholic teachings.

Look, the OP is about requiring, by force of law, that Catholics (and other similarly minded folk) jettison their own ethics and conform to secular ethics. This whole discussion about what DDE is, who it applies to, etc is meaningless. We are talking about the situation of a Catholic nurse, pharmacist, doctor, or other caregiver being mandated by law to act contrary to their conscience.

And, it seems you concern is that many are not well versed in Catholic theology. So what? Who is more guilty? A Catholic nurse ignorant of DDE or a Catholic nurse knowledgeable about DDE acting contrary it? Let’s take your example of treating ectopic pregnancies with Methotrexate. It is either a direct abortion or it isn’t. When used to treat an ectopic pregnancy, what is the intended end of the treatment? Does the Methotrexate serve any other therapeutic purpose besides the expulsion of the fetus? If not (and I don’t think it does in this case), it is a direct abortion. That’s speaking objectively.

The intended use of Methotrexate to treat early diagnosed tubal pregnancies is to prevent hemorrhage, and save the fallopian tube so that it can be used again. It also saves the woman from going under anesthesia, and being cut, which delays healing, and of course, surgery is more expensive. Objectively speaking, this is a standard treatment. A Catholic doctor may know of the rules of the Catholic Church regarding this treatment and refuse to do it, but doctors of other faiths do this routinely because of the above: it saves the fallopian tube so it can be used later, and it saves the woman from having to undergo a procedure under anesthesia, and it prevents hemorrhage without having to go through surgery.

As to more or less “guilty”, I think that if a Catholic knows the rules put forth by the Church, they should do all they can to eliminate any chances of breaking those rules, including by not working in places where they risk being called by their employer to break the rules. For example, if a nurse knows that it’s against the rules of the Church to have an elective sterlization, they simply should not work in an operating room that performs them routinely. As to a nurse not knowing if something is against the rules of the Church, that really isn’t an issue until they become aware of that teaching. Until they are aware of the teaching, the teaching isn’t going to affect the way they live or the way they work.

Until coming to this forum, I didn’t know methotrexate was not allowed by the Church for treatment of early diagnosed tubal pregnancies. I just knew that treatment of tubal pregnancies was allowed by the Church. And I knew the treatments for tubal preganancies (either methotrexate, or surgery to remove the tube, or surgery to remove the fetus and repair the tube, etc). The nursing courses I took listed and described the treatments and the nursing involved…but the courses did not explain what was allowed by the Church and what wasn’t. So if it wasn’t for this forum, I wouldn’t have ever known anyway.

 

[Rence]

Now, does the particular caregiver administering the Methotrexate have knowledge of this? For example, a doctor give the order to administer a dose of Methotrexate, and the nurse, ignorant of the effects or intended end, does so. Who has the knowledge here? Now, what if a nurse is educated enough to know what Methotrexate is used for, why the doctor prescribed it, and knows what the intended end is. Are you saying this nurse should be required by law to administer this drug? Or that a pharmacist should be required by law to fill such a prescription?

I think that if a nurse is Catholic and knows that the Church forbids this procedure, she should not work in an environment where this procedure is done. Why work in a place that does this procedure, and in effect, take a job in which she has no intention of doing the job?

I think that the employer has the right to hire employees who will do the job as described. If someone has a problem with that, just like any other job, they should not lie about not intending to do the work, and just not work there. They should find work in which they can actually do the job expected, in the way it is expected.

I think the employer has the right to not hire someone who is not willing to perform the duties on the job description (unless they have agreed that arrangements could be made in certain situations such as switching assignements or finding replacement nurses to do the job), and fire those who refuse to perform the duties as expected.

As to what is required by law, the nurse is required to perform her functions as expected according to her job description, and should not be allowed to leave her patient as long as that patient is her responsibility. She is required to deliver treatment as ordered by the physician and should be. Many times a nurse who has a problem with the delivery of a procedure ordered can switch assignment with another nurse, however, if she cannot find a replacement then she is responsible for that patient and responsible for the delivery of the care ordered. She should be punishable by the law if she abandons her patient and she could lose her job, and her license if she does not treat the patient as ordered.

Someone has to care for the patient, and especially in an emergency. If it’s her patient, she has to do it or face legal consequences and that’s how it should be. And that’s how it is thankfully. Because I would not want to end up in an emergnency room after a car accident and die or suffer additional harm because my nurse was a JW and refused to administer a blood transfusion that I needed because it was “against her religion”. I, or my family, would sue the pants off that establishment if that happened.

Finally, let’s look at what the OP is talking about. Say for example we have a Catholic pharmacist, well catechized and aware of DDE. Also say he is well trained and competent. That is, he is aware of the typical uses of drugs, drug interactions, and possible side effects and other physiological interactions. If a patient comes to his pharmacy requesting Plan B, should he be required by law to dispense it?

If that pharmacy carries plan b, the pharmacist should be required to either find someone to dispense it or dispense it himself if there is no one else available to dispense it for him. I don’t have an opinion about whether he should be required by law to dispense it. I can say I wouldn’t oppose it if it were a law. However, I strongly feel the pharmacy should not have to employ him, or continue to employ him, if he is not willing to do the job (which includes dispensing plan b, if that pharmacy carries and dispenses it). I think a Catholic should just be unwilling to work for a pharmacy that dispenses birth control or plan B and work in a place that doesn’t do so.

Change this up, and make it a nurse in an ER. Again, assume the nurse is Catholic, well catechized and aware of DDE. The nurse is also well trained and competent, and is also familiar with Plan B and its typical use. If a rape victim is admitted to an ER, and the nurse is unable to determine whether the patient has ovulated, or knows that the patient has ovulated, should that nurse be required by law to administer Plan B?

If plan b was prescibed by a doctor for a rape victim in the ER, and the nurse is unable to find someone to administer it, yes, she should be required to administer it. That patient was prescribed a treatment, and should get the treatment as prescribed by her doctor. If the nurse can’t find someone to do her job for her, she will have to do her job herself. In an ER, finding someone to do her job for her shouldn’t be a problem. But if it is, she better do her job or get fired for not doing her job, and for violating the rights of the patient, who does have the right to treatment as prescribed by her doctor. A Catholic nurse should not risk not being able to find someone to do her job for her by working in a place whose policy it is to give plan B even though an ovulation test has been positive.

 

[catharina]

It’s a bit more than just how the “Catholic Church would like it to be.” The universality of DDE is a statement about the objective nature of it, not its application. It is universally true, regardless if the medical community ignores it and defines its own.

And clearly, one of them is wrong. Either the Church is wrong, the secular medical community is wrong, or both are wrong. They both can’t be correct. And this discussion, is about what should be, not what is. These arguments from facts with no subjective premise are meaningless.

Earlier in this thread you were happy to say what should happen. But now you say you don’t care? Which do you think doctors, nurses, and other caregivers should do? Give methotrexate for ectopic pregnancies, or not?

Slavery was what it was, so why was there argument about it? Jim Crow laws were what they were, so why was there argument about it? Abortion is what it is, so why argue about it?

Indifference is not an excuse to let evils continue unabated.

If it simply comes down to “we know better” that is sufficient.
To cling to a precept that says “oh, so what” is to mandate death of innocents.

 

[kimmielittle]

.Soo …why you are arguing with me about his is beyond me. It is what it is.

Because…with ALL the scenarios / excuses offered up, by you, in defense - You miss the point.

The indefensible - Has no defense. … “It is what is”

 

[catharina]

The fact that the medical community has chosen to toss away its morality
is only a clear sign that it is lacking. For the history of medicine, since the
days of Hippocrates (300 BC?) until now, 2000+ years later, one standard
existed - that is to preserve life, to treat it as valued from conception onward.

I think all Catholics are called to the greater good - of not simply refusing jobs
that would negate their held morality - but even more to struggle toward
the return of morality.

 

[kimmielittle]

I think that if a nurse is Catholic and knows that the Church forbids this procedure, she should not work in an environment where this procedure is done. Why work in a place that does this procedure, and in effect, take a job in which she has no intention of doing the job?

Hmmmm evidently YOU work in such an atmosphere - And you do state, you are Roman Catholic?

 

[Rence]

This is a surprise to me. So, if I understand you correctly, secular schools of nursing (and I guess schools of pharmacy, schools of medicine, too) teach the healthcare professional in training to put their own professional ethical judgment aside, and not to pass judgment on the procedure or on the request of the patient, as long as the requested procedure is “legally approved”.

We’re taught to repect the rights of the patient as autonomous individuals who have the right to either consent to, or refuse treatment. This includes competent patients as well as their durable power of attorney. We are taught that if a doctor orders a treatment, and the patient consents to it, that we are responsible for carrying out the order as prescribed by the physican. We are taught that if we do not find the treatment “moral” by our standards, that we should not be in an environment that would create that conflict. For example, of one is opposed to taking part in abortions, we should simply not work where abortions are performed. However,

If we are in conflict with a procedure that we believe is harmful to our patient specifically, we are to advocate for the patient by going to our supervisors. But ignoring a physician’s order is a punishable offense that could get us fired and if it causes the patient any kind of harm, we are at risk for losing our license.

I attended school of pharmacy in the second half of the 1980s, at a secular school, and at that time, they didn’t teach us to put our own professional ethics aside, and to always defer to the requests of the state, and to the request of the patient, whenever there was some civil law in the books which made their request “legally approved”.

I wonder whether your experience, Rence, might be different because secular schools teach medical ethics differently today than 20-25 years ago?

I don’t know if the classes are any different. But I do know we are taught that we can’t just not treat a patient because we personally don’t find the treatment “moral”. If nurses could do that, then patients would die in trauma situations simply because a nurse decided it was against her grain to administer a blood transfusion as ordered by a physician.

At any rate, when I received my training, it wasn’t like your civil lawmaking authority, or the request of the patient, is the ultimate authority. Quite to the contrary, they taught us to uphold the ethical standards of our profession, even if that caused a clash with what other people or civil authorities requested from us. The ethical standards of the profession were the ultimate standard to obey. If your boss or co-worker asked you to do something that seemed controversial, if the patient asked you, or the civil authority asked you so, you were supposed to turn to the ethical standards of your profession, and only obey those requests as long as they didn’t contradict your professional ethical standards.

Well, it’s a given that we are supposed to carry out orders that are moral and ethical, by virtue of the fact that they are also legal, and are appropriately prescribed for a patient. It’s a given to expect a treatment to be appropriate in the first place. For example, if abortion were illegal, we would question an order for an abortion. If you work as a SANE nurse in a facility that routinely offers plan B to a rape victim, it just doesn’t process to me that a nurse would just say “I don’t wanna do it” when it’s prescribed I’m a Catholic nurse and I just won’t work in the emergency room as a SANE nurse, or in an abortion clinic, or in an IVF clinic, or in a place that performs sterilizations. To me, putting one’s self in a situation when they KNOW they can’t work there is just intentionally causing trouble for the sake of causing trouble. There are plenty of places to work without intentionally working in places where there are known conflicts.

But at least I see now where you and other posters are coming from. If I understand you correctly, they teach you that you should provide the service as long as civil law permits it.

Right…because it’s a given that a service prescribed, which is legal, is also “morally” acceptable. Otherwise, a doctor theoretically wouldn’t prescribe it. After all, it’s his license too.

 

[Rence]

Hmmmm evidently YOU work in such an atmosphere - And you do state you are Roman Catholic?

I work in what atmosphere? I stay clear of situations that would create a conflict between what the Church imposes and what my job assigns me to do.

 

[Rence]

It may be that some conscience provisiions exist which would allow a healthcare professional, in selected instances (I don’t know the full range of law on this), to call on those provisions to announce to a superior how far he or she is willing to act/participate, or alternatively to request reassignment to a different case/patient.

Well, nurses can get other nurses to switch assignments with them. But if no one were available, the nurse would have to treat the patient. I mean, someone has to treat the patient with the order prescribed. That’s just the way it is. But you can talk to your potential employer about concerns that would conflict with your moral upbringing to determine if the job was a good fit. That’s just prudence and common sense.

You especially can’t do (or not do) something that results in the harm or death of a patient just because you didn’t want to (or wanted to) perform a procedure that was prescribed. I can’t even process in my mind refusing to perform a procedure that caused a patient to incur harm or death, simply because I didn’t “agree?” with the procedure. One should just stay out of those situations. Like I said in many posts…there are pleny of places to work in which there is no expected conflict between what the Church teaches and what your employer would require of you.

 

[kimmielittle]

I work in what atmosphere? I stay clear of situations that would create a conflict between what the Church imposes and what my job assigns me to do.

Thank You! You had me confused.

Now the next question: If you stay away from situations that would create a conflict between what the Church Teaches and what your job assigns you to do… why are you trying to defend against conscious clause?

The usage of Plan B…Methotrexate?

It makes no difference if these are approved by the medical profession - They are not approved by the Catholic Church

 

[Rence]

Earlier in this thread you were happy to say what should happen. But now you say you don’t care? Which do you think doctors, nurses, and other caregivers should do? Give methotrexate for ectopic pregnancies, or not?

What should happen is that patients rights are respected by doctors, nurses and other caregivers. Therefore, I think the doctors, nurses and other caregivers should respect the rights of their patient. If a nurse works for an entity that treats early diagnosed tubal pregnancies with methotrexate instead of surgery, and the patient consents to the methotrextate, then the nurse should either find someone to give it for her, or do her job and give the methotrexate. If she has a problem with this, she needs to make sure before she takes the job that she can get a replacement, or not work there at all.

 

[Rence]

Thank You! You had me confused.

Now the next question: If you stay away from situations that would create a conflict between what the Church Teaches and what your job assigns you to do… why are you trying to defend against conscious clause?

Due to the rights of the patient

The usage of Plan B…Methotrexate?

It makes no difference if these are approved by the medical profession - They are not approved by the Catholic Church

Not everyone is Catholic. Not only that, being Catholic is a choice, not an infliction. Catholics have the right to refuse plan B, and methotrexate. Non-Catholics have the right to consent to such treatments.

 

[kimmielittle]

Due to the rights of the patient

NO one right outweighs the right of another “It is what is”

Forced servitude is unconstitutional under any guise.

Not everyone is Catholic. Not only that, being Catholic is a choice, not an infliction. Catholics have the right to refuse plan B, and methotrexate. Non-Catholics have the right to consent to such treatments.

AND Catholics have a moral / ethical right not to be party to it.

 

[Rence]

NO one right outweighs the right of another

As a nurse, I was taught that my patient’s rights are paramount and I am called to be my patient’s advocate.

AND Catholics have a moral / ethical right not to be party to it.

That’s right KimmieLittle, they should steer clear of those jobs that conflict with the Church’s teachings. This isn’t just prudent. It’s common sense.

 

[catharina]

Due to the rights of the patient

Not everyone is Catholic. Not only that, being Catholic is a choice, not an infliction. Catholics have the right to refuse plan B, and methotrexate. Non-Catholics have the right to consent to such treatments.

Again, you are ignoring the fact that such rights are in total oppostion to
the morality that guided all medical practice until about forty+ yrs ago.

You do accept that fact, don’t you?
Morality in meidcine hit the skids 40+ yrs ago and has never been seen since.
All the more reason for Catholics to work for morality in all of medicine.

 

[Rence]

NO one right outweighs the right of another “It is what is”

Forced servitude is unconstitutional under any guise.

There are plenty of places for nurses to work that wouldn’t conflict with Catholic teachings. No one is forced to work in an environment that is known to deliver treatments that would conflict with their morals. So there is no such thing as forced servitude for a nurse working in a place to which she applied and accepted an offer of employment. You have to do the job you were hired to do. It’s immoral, and unethical to accept a job under the guise that you can do the job, when in reality, you have no intention to do so. It is what it is. And that’s just lying.

 

[kimmielittle]

There are plenty of places for nurses to work that wouldn’t conflict with Catholic teachings. No one is forced to work in an environment that is known to deliver treatments that would conflict with their morals. So there is no such thing as forced servitude for a nurse working in a place to which she applied and accepted an offer of employment. You have to do the job you were hired to do. It’s immoral, and unethical to accept a job under the guise that you can do the job, when in reality, you have no intention to do so. It is what it is. And that’s just lying.

I can see, as evidenced by your answer, what I said - went way over your head.

No one right outweighs another’s right - this would be a forced servitude.

 

[Suudy]

So yes, obvsiously, there is a difference (at times) between what the secular medical community deems “moral” and what the Catholic Church teaches as “moral”. That’s just a fact. I didn’t make it up.

I didn’t suggest you did. I only stated it is was meaningless to suggest that since they are different, to leave it be. Objectively speaking, only one is true. And it is meaningless to argue over whether there are different perceived standards, since nobody suggests otherwise. Further, the very fact that there are different perceived standards doesn’t render the issue moot. We shouldn’t do as you seem to suggest and throw our hands up and say “It is what it is.”

A patient’s right to receive treatments that include IVF are going to trump Catholic teachings in a secular fertility clinic. So in that setting, a patient’s right to receive that treatment is going to trump Catholic morals. That’s how it is, I didn’t make it up. There is nothing that can be done to change that as long as IVF is legal and sanctioned by the medical community regardless of how individual Catholics feel about it or how the Church teaches about it.

They don’t have an moral right to IVF, only a legal right. And you seem to be confusing the two. Here, on a Catholic message board, we discuss what should be, not what is.

The intended use of Methotrexate to treat early diagnosed tubal pregnancies is to prevent hemorrhage, and save the fallopian tube so that it can be used again. It also saves the woman from going under anesthesia, and being cut, which delays healing, and of course, surgery is more expensive. Objectively speaking, this is a standard treatment. A Catholic doctor may know of the rules of the Catholic Church regarding this treatment and refuse to do it, but doctors of other faiths do this routinely because of the above: it saves the fallopian tube so it can be used later, and it saves the woman from having to undergo a procedure under anesthesia, and it prevents hemorrhage without having to go through surgery.

The ends do not justify the means. The discussion is about what should be done, not what is done.

 

[kimmielittle]

That’s right KimmieLittle, they should steer clear of those jobs that conflict with the Church’s teachings. This isn’t just prudent. It’s common sense.

The LAW says different

 

[kimmielittle]

I didn’t suggest you did. I only stated it is was meaningless to suggest that since they are different, to leave it be. Objectively speaking, only one is true. And it is meaningless to argue over whether there are different perceived standards, since nobody suggests otherwise. Further, the very fact that there are different perceived standards doesn’t render the issue moot. We shouldn’t do as you seem to suggest and throw our hands up and say “It is what it is.”

They don’t have an moral right to IVF, only a legal right. And you seem to be confusing the two. Here, on a Catholic message board, we discuss what should be, not what is.

The ends do not justify the means. The discussion is about what should be done, not what is done.