What’s Wrong with the World

Question: Does your claim, Michael, not to know who is right in this case stem from an assumption that _if_ this abortion was necessary immediately to save the life of the mother (both mother and child would have died in short order without it, etc., as the supporters of the decision are claiming), _then_ this was not a direct abortion?

Because I think that's highly questionable. Indeed, to assume that would be to assume that any _true_ life of the mother case constitutes by definition a case in which the "termination of pregnancy" one is performing--performing just exactly the same as any other 11-week termination of pregnancy--is not "really" an abortion.

The fact is, no one on the _supporting_ side seems to deny that this was a plain or garden variety 11-week termination of pregnancy as far as what was actually done. If additional facts are needed to determine whether it was "really" an abortion, it seems to me that this can only be because you are looking for additional facts as to whether it was really a hard case, a true life-of-the-mother, both-will-die-otherwise, case. But if such cases don't make what is done a non-abortion, then it doesn't really matter, does it, to the question of whether this was an abortion?

In fact, as I said at the beginning of the other thread before the whole question went to moral consequentialism more generally, etc., it seems to me that this case is being used plain and simple to argue that the Catholic Church should have a general life-of-the-mother exception, and to try to defend this by redefining the term "abortion" so that it doesn't apply in the real hard-case life-of-the-mother scenarios.

To put it bluntly, I think that would be the sheerest casuistry and is not to be encouraged. If one is going to say, "Abortion is morally permissible when absolutely necessary to save the life of the mother," one should just say it and be done, not play word games.

What Lydia said.

Apparently my clarification was insufficient. So I'll try yet again.

As a Catholic, I believe that intentionally bringing about the death of the fetus as a means to saving the mother's life is intrinsically evil. I have said so repeatedly and publicly over the years. Anybody who infers from my post that I've changed my mind would be committing a howling non-sequitur. My real point is based on the fact that there's something in this case we don't know: whether the act Sr. McBride approved is in fact an act of the sort we agree is intrinsically evil. She seems to think it was not, and nothing I've been able to learn about the case from the bishop's office cites a verifiable fact which shows that it was. Even if the relevant facts would show that Bishop Olmsted's moral assessment is correct, those facts are not now available to us. And that's why his public announcement that Sr. McBride has excommunicated herself is, in my opinion, a political and personal mistake.

I just find this really difficult to understand, Michael. All of Sr. McBride's _supporters_ describe what was done as an abortion and as one necessary to save the mother's life. The child could not possibly survive at 11 weeks. Surely it cannot make a difference to the question you are raising whether the procedure was performed by a vacuum-aspiration without a curette or with one, can it? The child is now indisputably dead as a direct result of the termination of pregnancy procedure performed, which everyone who reports the case anywhere describes as an abortion because of the physical, medical nature of what was done. What else are you looking for?

Physical facts are obviously highly relevant to a moral assessment here, and _these_ physical facts don't seem to be in question. (The only things that are being debated are things like whether the mother and child would both actually have died if the termination procedure was not performed--that is, whether or not it was really a "hard case.")

It's almost as if you think the statement, "This was an abortion" is so heavily "moral" a judgment that even that descriptive judgment cannot be made without a whole wealth of facts that go beyond those that are undisputed, a wealth of facts that you aren't even specifying.

Maybe it would help if you gave examples of the sorts of questions that have to be answered before the bare description of what was done as an abortion can be made without doubt.

Lydia,

I don't question that what was done counted as an "abortion." Up till now, however, Catholic moral theology has recognized a class of abortions called "indirect." Those are cases in which a medical procedure is performed to save a pregnant woman's life, but in which the death of her child is not a means, and therefore not willed as a means, to saving the pregnant woman's life. Cases like that are discussed here. (I offer that little piece merely because it's convenient; it is by no means the most comprehensive treatment by a Catholic moral theologian.) Many such abortions are said, by impeccably orthodox theologians, to be justified by PDE.

What I don't profess to know is whether the medical facts of the case are such as to make it at least plausible that the abortion Sr. McBride approved fell within that class of "indirect" abortions. Clearly, that's the kind of abortion she thought it was. Now as I said in my SV piece, it looks "from a distance" that she was wrong. But we don't really know, and nobody's airing the facts we need in order to know. That's why I believe Bishop Olmsted's announcement is unjustified. Even if he's right, very few people are in a position to know that he's right. To announce publicly, in such circumstances, that somebody has excommunicated herself for what might have been an honest error of judgment strikes me as imprudent and excessive.

Best,
Mike

It may be worth pointing out that impeccably orthodox theologians can be wrong; so their impeccable orthodoxy has little if any bearing on the validity of their arguments, which ought (the arguments) to be evaluated on their own merits. The linked article makes a number of debatable claims, e.g. that the presence of the baby in no way changes the nature of the act of removing a diseased uterus. So while the conclusions may not be daft or heretical they are certainly debatable and quite possibly wrong.

Zippy:

I made no argument premising that impeccably orthodox theologians are always and as such right. My argument is that the category of licit, indirect abortion has been traditionally recognized by theologians whose orthodoxy has never been questioned on that account. If you want to argue that such a tradition is mistaken, your complaint is with the Vatican, not with me. That wouldn't be the first time you've tried to argue for a position more stringent than the Church requires.

Best,
Mike

Mike:

My argument is that the category of licit, indirect abortion has been traditionally recognized by theologians whose orthodoxy has never been questioned on that account.

Every time I've done due diligence on more specific claims like the ones expressed in the article you linked, especially when it comes to modern medical ethics but also in other areas, I've found there to be less to the "tradition" in the particulars than meets the eye. Most often I find what resembles a batch of mutually reinforcing opinions from Catholics who attend the same cocktail parties, dressed up as an authority with important words like "tradition". Rarely if ever do I find Magisterial support for the confident proclamations on particular matters which are presented as if they were authoritative.

If you want to argue that such a tradition is mistaken, your complaint is with the Vatican, not with me.

That wouldn't be the first time you've tried to argue for a position more stringent than the Church requires.

So I don't understand what the objection is to my methods of inquiry. The truth on these particular questions is by absolute necessity more narrow than "what the Church requires". And what concerns me, as always, is what is true.

The territory we are in right now is not that vast open plain of what the Church explicitly requires, as if the Church magisterially settles every highly specific question for us. That is the least of what a Catholic should care about. What a Catholic should care about is what is true; and what often bothers me about assertions like "the presence of the living fetus in the diseased womb does not alter the nature of the act which the surgeon performs" is that such statements are (1) far from obvious, (2) have no specific Magisterial warrant, as far as I am aware, and (3) are treated as if they did.

I don't doubt that the writer believes it to be true, of course. But when I express doubts about it, and you claim that my doubts imply a conflict between myself and "the Vatican", you have, shall I say, overreached just a wee bit.

Mike, it sounds as if your argument is that because you don't know the facts of the case Bishop Olmsted is therefore wrong. This is, if I may say without offense, an odd argument.
Bishop Olmsted knows the facts, his Medical Ethics advisor knows the facts, and even Sister McBride and her supporters are not arguing that this was a case of indirect abortion. The Diocesan statement even addresses the issue of indirect abortion resulting from the treatment of an underlying condition. From the facts that have been presented (as limited as they must be to preserve privacy), it appears that this was a D&E or C&E abortion. You may wish to view the Diocese explanation here: http://www.catholicsun.org/2010/phxdio-stjoes/ Do note that Bishop Olmsted's statement declares that a "direct abortion" is acknowledged by the hospital.
Given what facts we do know, Bishop Olmsted was not only justified, but was in fact obligated, to act as he did.

Zippy:

Two things make me uneasy about this discussion. One is that nobody seems interested in addressing the question whether Bishop Olmsted's announcement is justified even if he happens to be right about the morality of the abortion itself. From both a pastoral and a political point of view, that is a very important question, and many intelligent Catholics across the theological spectrum understand why. Ed Peters, a canonist I'm sure you've heard of, and who's just been appointed as a "referendary" of the Apostolic Signatura, thinks the bishop probably is right about the morality of the abortion itself; but he also thinks that this case is a classic example of why the whole category of latae sententiae excommunication needs to be jettisoned. He has said so at his own blog, as well as in a comment on my original post at "On the Square."

The other thing causing me unease is that you seem to think the Vatican ought not to allow as much room for indirect abortion as it has in the past. I'm willing to entertain an argument for that position, but I think the argument is gradually being settled by the development of medical technology. It's becoming possible to save both mother and child in more and more situations that used to permit saving one life only at the expense of the other. Why clang the iron door shut even faster than it's already closing? I find it hard to believe the reason is just zeal for truth.

Best,
Mike

But Mike, look: I looked at the article. I disagree with it. But let's waive that. The author of that article himself (Healy) _expressly rejects_ opening the fallopian tube to remove the unborn child as, he says, that would be an attack on the child. It's utterly clear that in every single case he lists he only gets the "indirect" thing from the fact that some whole organ (or the fallopian tube) is removed and therefore he can say that the removal of the pathogenic organ is the direct object of the act.

Again, I don't agree with his moral judgement that this is all right, but the point in this case is just this: _Nobody_ alleges that the woman in the case Sr. McBride agreed to had a pathogenic organ internally of any kind. Nobody alleges an ectopic pregnancy or uterine cancer or anything in that family where an entire organ had to be removed and the baby just "comes along with it." Her problem was her _blood pressure_. The danger supposedly arose from the effect of the pregnancy on her blood pressure.

An abortion at that stage would normally be done by either suction or curette or a combination of the two--going into the womb and removing the child. That would _easily_ satisfy Healey's very own criteria for an "attack" on the unborn child just as in the case of opening the fallopian tube, which he condemns.

There isn't even the remotest allegation about the medical facts in this case that would put it in the type of class Healey is talking about. One can't just throw around a term like "indirect abortion," even if one agrees with the licitness of that category. He obviously has a reason for applying that term, and it has to do with this "diseased organ" issue.

Tyler:

The diocesan statement in question, which I read before I posted my original piece at First Things, indicates Bishop Olmstead's belief that the abortion was direct. On grounds we both understand, that document does not cite his reasons for that belief. On the same grounds, Sr. McBride is not giving her reasons for disagreeing with Bishop Olmstead. So I don't think it's safe to assume that either side is right about the morality of the abortion itself. We just don't know all the relevant facts. That's why my treatment of this matter does not take sides on the question of the moral status of the abortion. I'm concerned mainly with the question of the justice of announcing her excommunication when very few people are in a position to know who is right.

Best,
Mike

Mike:

One is that nobody seems interested in addressing the question whether Bishop Olmsted's announcement is justified even if he happens to be right about the morality of the abortion itself.

I find it hard to believe the reason [I pursue the lines of thought I pursue] is just zeal for truth.

Lydia:

The position that you and my other conservative critics are taking amounts to saying that we know enough to conclude with moral certainty that Sr. McBride was wrong. That suggests in turn that she, who unlike you and me was directly involved with the case, had no excuse for making the call she did. I'm sorry, but that just strikes me as way overboard. The few times in my life when I've been inclined to judge people that harshly, I've turned out to be wrong. And that's when I personally knew the people and situations in question. Needless to say, I've been judged that harshly myself on more than one occasion, and I was morally certain that my accusers were wrong.

If one is morally certain that Sr. McBride made the wrong call, it would be more reasonable to say that she made an honest error of judgment. If we were willing to give her even that much, then we could actually discuss the matter that first interested me in this case, and which outsiders can discuss while knowing all the relevant facts: whether announcing a latae sententiae excommunication for an honest error of judgment is a move that makes pastoral and political sense.

Best,
Mike

Mike, if you knew for a fact that this abortion was performed on a previously living fetus by dilation and curettage (for example), and if you knew that Sr. McBride knew that ahead of time as well, and that no other organ of any sort or kind would be removed in the process, would you then agree that this was undeniably not an indirect abortion (by the definition Healy discusses) and that Sr. McBride should have known that, too?

If...if...if...

then yes.

IF.

Well, Mike, given that one wouldn't treat pulmonary hypertension by removing the ovary, the fallopian tube, or the uterus, or any other organ that would contain the child, and given that everyone within striking distance of the case on both sides agrees that an 11-week abortion was performed, and given that we know how 11-week abortions are typically performed, and given that no doctor would declare a normal uterus to be "diseased" merely because a woman has pulmonary hypertension...

I really don't think there's much doubt here. It seems to me that you're just throwing out doubts out of some highly generalized spirit of charity, when even the people most firmly on Sr. McBride's side are not supporting those doubts.

Mike,
It might be fruitful to read the original Arizona Republic article, also linked with the other documents at the Catholic Sun web-site. I suspect you have already, in which case I would commend a few points to your attention, if I may. The board chairwoman of Catholic Healthcare West, St. Joseph's parent organization, does not argue that this was indirect abortion, but rather that direct abortion was the only way to avoid the death of the mother. And the hospital vice-president of communications, Suzanne Pfister, issued a statement that, "In this tragic case, the treatment necessary to save the mother's life required the termination of an 11-week pregnancy."

So, given that all sides are in agreement that this was a direct abortion performed to save the life of the mother, there is no basis for dispute of that fact. That leads us then to the question: is direct abortion ever permissible, even to save the life of the mother? The Church says no, without exception.

And so to your statement of being "concerned mainly with the question of the justice of announcing her excommunication when very few people are in a position to know who is right." Given that there is no dispute that this was direct abortion, and given that we know the Church's unequivocal position on direct abortion, we may put aside your qualifier; we know who is right, insofar as the teachings of the Church are concerned. And we know it with moral certainty.

Thus we are left only "with the question of the justice of announcing her excommunication." That he was within his right to so do, is a given, of course; he is the Ordinary. We may, perhaps arguably, dismiss the political element; Bishop Olmsted in not a Bishop to be influenced in his pastoral duties by political considerations, nor, if we believe in the sovereignty of truth, should he be.

Was it the right thing then pastorally? Bishop Olmsted is known to be a bishop of great pastoral sensitivity, and nothing in his record suggests he would take such a public action without good reason. All we know of him would suggest that pastoral considerations were the basis for his action. And given the section on the meaning of excommunication in the Diocese Q&A, and the reference to problems with another CHW hospital in the Diocese, that conclusion seems well-supported.

Sometimes, as much as it may gall us, we have to trust our bishops. This seems a clear case where we may be comfortable doing so.
Tyler

Am I mistaken in thinking that only by publicizing the excommunication could the bishop let a wide swathe of priests know not to administer communion to Sr. McBride?

Tyler's right. No one in any of the articles expresses the least doubt about what kind of abortion was procured. The pained sensitivity to the possibility that the Sister made an "honest error in judgement" contains approximately 0 credibility. I think what interests Michael is getting rid of this particular form of excommunication. Why I have no idea. "I find it hard to believe the reason is just zeal for truth." If procuring an abortion is not worthy of automatic excommunication, then nothing is.

If I'm being excessively charitable by refusing to infer, from the available evidence, that Sr. McBride was acting in bad faith, then I gladly plead guilty. I'm just obeying what I take Christ to mean by "Judge not, lest ye be judged." If, on the other hand, she just made an honest error in judgment, then for the reasons that Ed Peters and I have already stated, I question both the prudence and the value of announcing her latae sententiae excommunication.

Of course, there's always the possibility that something relevant and mitigating happened in that hospital which she has good reason not to talk about publicly. But there I go again, lousy liberal that I am...

Lydia, the bishop could have issued a directive to all the pastors in the diocese telling them about the excommunication. Putatively, that would have ended up public anyway, but it wouldn't have been the bishop doing it. It wouldn't have been an alert to the rest of the country. Which purpose is, finally, pretty shaky all around: there probably will be some priests who will go out of their way to invite Sr. to speak now that she has been excommunicated over this.

Mike, let us grant that we don't know for certain exactly what procedure Sr. McBride thought was in train when she gave an "approval". But the vast weight of the public evidence leans in one direction, with essentially nothing counterbalancing that evidence towards even enough to create real, honest, serious doubt. The medical problem of the mother was not a problem of a sort that an indirect abortion would be any kind of obvious solution.

In order for us to step back and say, whoa, maybe there is more to this than a simple direct abortion, somewhere there has to be a suggestion of a rational line of thought that Sr. or anyone might have had that could have ended at "this is an indirect abortion." You have stipulated that maybe she thought that, but there isn't anything about the evidence that actually suggests that. Can you suggest a realistic, possible line of evidence (that has not yet been made public but could be released), that (a) is consistent with the evidence that has been given, and (b) is also consistent with an intelligent, highly educated person concluding "this looks like an indirect abortion?" I cannot think of anything that would do the trick, and most of my friends are well aware of my imaginative capacity for creating off the wall scenarios that deal with odd exceptions. The problem is that the underlying health problem has NOTHING to do with the reproductive organs.

(Yes, there is a remote possibility that in addition to hypertension, the mother ALSO had uterine cancer or something else in that line. But it is totally unrealistic that ALL of the parties would have failed to mention it.)

Just for the record, I have often wondered at the prudence of latae sententiae excommunications. Especially since many, if not most, of the people who will incur them won't even know of the excommunication because they have never heard of it. The bishop says of the excommunication that "The purpose is to repair scandal, to restore justice and to reform the offender." How can it reform the offender if he doesn't know he has been excommunicated?

Most of the people around who might be scandalized by the sinful action typically don't know of the sinful action (who goes around publicizing having an abortion?), so they cannot be scandalized, or never knew that the sinful action was gravely sinful, and never knew that there was a penalty attached, and so they could not have been kept from scandal by the automatic penalty. So how worthwhile is such an automatic penalty in these degenerate times?

If a case is noteworthy enough for the bishop to take a direct hand and state publicly that a gravely sinful act was committed, then that case is noteworthy enough for the bishop to levy the penalty with his own authority.

Good grief Mike! Now you're just cracking jokes. The only person accusing you of being a liberal - or implying that is a bad thing - is you! I don't think you get to be a martyr by throwing yourself to the lions.

As to a Catholic hospital administrator religious sister making an "honest error" in thinking direct abortion is permissible, that is indeed an uncharitable suggestion on your part. We have no available evidence from which to infer that Sister McBride is stupid.
Tyler

Heya All,

While I more and more agree that Sister McBride made a grave mistake here, I can see some of Mike's point. He's more than once talked about the pastoral and political aspects of this case, and I think most people here could agree (of course, correct me if I'm wrong) that just because someone is correct doesn't mean that their method of communicating their answer isn't flawed. (To give an example miles apart from this case - imagine if every time you did something wrong, someone rolled their eyes, sighed, and pointed out your error with a tone of voice that sounded like they were addressing a child. Are they right? Yes. Could they handle this better? Yes.)

That does seem to be the problem here: The image of a bishop dispassionately (and with what sounds to most people like esoteric legalese) yet sternly condemning someone who made a difficult and heartbreaking decision, showing no sympathy. Frankly, that's a movie villain stereotype. And yes, I think that depiction of the bishop's actions here is skewed and warped, but he also made it easy for this sort of caricature to be made.

Also, I think the very topic of automatic excommunication is a difficult one to talk with most people about, since the idea of it being automatically incurred goes over many people's heads. (You won't have to look far to find people who think the bishop himself excommunicated Sr. McBride.) So I'd agree with Mike that politically and pastorally this could have been handled far better. On the other hand, I would never want political concerns to trump moral ones - and that may mean being willing to say, "No, direct abortion - even in case where you could imagine having much sympathy or understanding for one - is not licit."

I'm trying to put myself in McBride's shoes--what would I do as a Catholic hospital administrator? Now, while I don't have a degree in it, I have studied the principle of double effect alot. Enough that I can follow an argument about, and enough that I can confidently make points with it; and frankly, enough to tell when someone is full of crap when invoking it. Even then I still wouldn't trust myself completely with a decision with elements of pde in it. So if I found myself declared LS excommunicated by the bishop, my first thought is that I am probably wrong and how do I get myself unexcommunicated as quickly as possible. Which means I'm rushing over to the bishop's office with hat in hand, explaining as many facts as I can, and if he still isn't convinced, I'll concede the point and repent. I need to do more reading here, but the sense I'm getting from the Sr. McBride camp is one of belligerent how-dare-the-bishop-throw-his-weight-around-like-this? So putting myself in a situation where people are defending me like this, I would be writing an open letter to the effect of, "I appreciate the support, but until I get this resolved with the bishop, kindly stuff a sock in it."

I have read where Ed Peters isn't thrilled about LS excommunications because of the PR messes they create in the hard cases, but I'd bet he'd be quick to say it's not his job to like the law, it's his job to apply it. Frankly, I can see it being an important tool. Catholic Hospitals are already under enormous pressure from an increasingly hostile culture to break with teaching and provide immoral procedures (i.e. the Church isn't going to win any PR poinst anyway). So they are already going to push the envelope of acceptable acts to the absolute limit. If bishops don't dig their heels in, provide clarity, and get over the fear of confrontation and bad PR, then Catholic hospitals are going to latch on to the prinicple of double effect like a get out of jail free card, and that will amount to the camel's nose in the tent.

My impression from what I've read is that the bishop only published the excommunication _after_ meeting with Sr. McBride and finding her unwilling to change her mind that the abortion was a "good thing" in the circumstances. It seems like he went to the publication of the excommunication only because she was intransigent.

My own impression is that we are moving towards a situation where it isn't implausible that a person in that woman's position would be forced to have the abortion. The message that Catholic hospitals are going to hold the line on abortion is actually a good one, in the present social context.

Three points:

1. The known facts seem to point to this having been a D&C or some other direct killing of the fetus, and if so then there simply is no question that it was the sort of thing Catholic teaching regards as murder. And thus, if this is what happened, then whatever reasons Sr. McBride thinks justified it -- maybe she believed that the case was morally analogous to the "indirect abortion" tubal pregnancy scenario even if it involves directly killing the fetus -- are reasons no Catholic who adheres to the explicit teaching of the Church can regard as plausible. (Any more than "But I just honestly don't agree with the ban on contraception" would excuse a Catholic in contracepting.) We don't know for sure that this is what happened, but again, that seems to be what the evidence is pointing to.

2. As Jimmy Akin points out, if this is really what happened, then Sr. McBride would by canon 1329 indeed have incurred a latae sententiae excommunication if the direct abortion would not have occurred without her approval, as seems to be the case:

http://www.ncregister.com/blog/what_are_the_true_facts_regarding_the_abortion_approving_nun/

3. As Akin also points out in the same article, Bishop Olmstead seems in fact to have been reluctant to make a public issue of this, and did so only when forced by events.

In short, the available evidence seems to show that Bishop Olmstead acted in accordance with Catholic teaching, canon law, and Christian charity. Certainly the burden of proof is on the person who claims otherwise, and as far as I know no one has shown that any of points 1-3 is incorrect. In which case, it seems to me unjust, given what we know, to second-guess the bishop's actions here.

Wow. So this whole thing about the bishop's "publicizing" her excommunication seems to be totally wrong. It looks like it was the hospital and the press that "publicized" it, and the Bishop gave a statement (which did not name her explicitly) in response to a request from the press for comment.

Lydia:

So this whole thing about the bishop's "publicizing" her excommunication seems to be totally wrong.

This pattern repeats itself over and over again. The political Left is composed of pathological liars and tyrants, led by the Father of all lies.

If it was the hospital or others who started the PR rigamorol, then I would agree with Lydia that the Bp did the right thing. He has a pastoral responsiblity to the flock to make sure there is no misunderstanding of teaching on this subject.

If both sides were keeping this private, then perhaps he could have refrained from public comment for pastoral reasons, although it would have been within his judgment to make a public comment (and I would likely have disagreed with his judgment if he did).

Related questions: If the hospital stuck to its Catholic guns, would it have been civilly liable for malpractice if the mother died? I wonder if that factored into the decision at all? (I can understand if no one but me is interested in these questions).

Yes, the hospital and attending physician probably would have been civilly liable, and I can't help thinking that probably factored into the decision. It is even possible that people think implicitly that if one is civilly liable for not doing x as a medical treatment then it must be objectively wrong or at least "unprofessional" to refrain from doing x as a medical treatment.

To put a softer point on it, I suspect that for many people the threat of being held civilly/legally liable if they refrain from doing X counts as compulsion to do X, so that their reasoning is "Hey, I didn't want to do this, but legally I was compelled to." They could even remark that it was objectively wrong, but, the law's the law.

Laws, especially laws that can be and are enforced, are pretty good motivators for many people.

Civil liability in this case would probably not be a matter of any law expressly addressing this type of situation. But if medical personnel do not follow "standard of care" and something bad happens to the patient, they can be successfully sued.

Here is a recent article, referenced in MOJ, by a canon lawyer.

http://www.americamagazine.org/content/article.cfm?article_id=12348