The care of pregnant women in Catholic hospitals

Fr. Tadeusz Pacholczyk

At the beginning of December, the American Civil Liberties Union filed a sweeping federal lawsuit against the U.S. Conference of Catholic Bishops over its Ethical and Religious Directives for Catholic hospitals, alleging that the directives, with their prohibition against direct abortion, resulted in negligent care of a pregnant woman named Tamesha Means. Ms. Means’ water broke at 18 weeks, leading to infection of the amniotic membranes, followed by spontaneous labor and delivery of her child. The child lived only a few hours.

During the course of these events, Ms. Means went to a Catholic hospital in Michigan several times, and, according to the lawsuit, was sent home even as contractions were starting. The lawsuit not only suggests that she should have been given a drug to induce labor early on but claims this wasn’t possible precisely because the hospital was Catholic and bound by the directives. It further asserts that Catholic hospitals are not able to terminate a woman’s pregnancy by inducing premature labor “even if necessary for her health,” because to do so would be “prohibited” by the directives.

In point of fact, however, the directives would not prevent the early induction of labor for these cases. Not infrequently, labor is induced in Catholic hospitals in complete conformity with the directives. Directive No. 47 (never mentioned in the lawsuit) is very clear: “Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.”

Deciding about whether to induce labor involves the recognition that there are two patients involved, the mother and her in utero child, and that the interests of the two can sometimes be in conflict. In certain situation—for example, when the child is very close to the point of viability and the pregnancy is at risk—it may be recommended to delay early induction of labor in the hope that the child can grow further and the pregnancy can be safely shuttled to a point beyond viability, allowing both mother and child to be saved. Sometimes expectant management of this kind is not possible. Each case will require its own assessment of the risks, benefits, and likely outcomes before deciding whether it would be appropriate to induce labor.

When a woman’s water breaks many weeks prior to viability and infection arises, long term expectant management of a pregnancy is often not possible. In such cases, induction of labor becomes medically indicated in order to expel the infected membranes, and prevent the infection from spreading and causing maternal death. Early induction in these cases is carried out with the foreseen but unintended consequence that the child will die following delivery, due to his or her extreme prematurity.
Such early induction of labor would be allowable because the act itself, that is, the action of inducing labor, is a good act (expelling the infected amniotic membranes), and is not directed towards harming the body-person of the child, as it would be in the case of a direct abortion, when the child is targeted for saline injection or dismemberment. The medical intervention, in other words, is directed toward the body-person of the mother, using a drug to induce contractions in her uterus. One reluctantly tolerates the unintended loss of life that occurs secondary to the primary action of treating her life-threatening infection.

On the other hand, direct killing of a human being through abortion, even if it were to provide benefit for the mother, cannot be construed as valid health care, but rather as a betrayal of the healing purposes of medicine at its most fundamental level. Such an action invariably fails to respect both the human dignity of the unborn patient and his or her human rights. It also gravely violates a mother’s innate desire and duty to protect her unborn baby. If she finds herself in the unfortunate situation of having a severe uterine infection during pregnancy, she, too, would appreciate the physician’s efforts to treat her without desiring to kill her child, even if the child may end up dying as an unintended consequence of treating the pathology.

The application of Catholic moral teaching to this issue is therefore directed toward two important and specific ends: first, the complete avoidance of directly killing the child, and, second, the preservation of the lives of both mother and child to the extent possible under the circumstances.

Based upon these ends, the Ethical and Religious Directives of the U.S. Conference of Catholic Bishops provide important ethical parameters for framing the appropriate treatment of both mother and unborn child in high-risk pregnancies, while simultaneously safeguarding the fundamental integrity of medical practice in these complex obstetrical situations.

COMING UP: Celebrate and support the sacred gift of life

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Editor’s Note: This column is adapted from Archbishop Aquila’s remarks to the 2018 Celebrate Life March, which took place on January 13th in front of the Colorado State Capitol building.

As we gather today to celebrate life, we must remember three things: 1) life is a gift, 2) life is sacred, and 3) rebuilding a culture of life requires joy.

We are here today to celebrate our joy over the gift of life. Every minute and every day we live presents us with an abundance of gifts that seem mundane and are often overlooked: our health, the gift of creation, or something as simple as having food on our plates. Above all, we should give thanks for the gift of life!

As people involved in protecting life at every stage, the challenge we face is not just one of providing resources to mothers and fathers in need or ensuring people battling a terminal illness have good palliative care. Our challenge is to also communicate to them that they are loved, that their unborn child or their own lives are gifts, no matter the circumstances.

Many of us fought in 2016 to prevent doctor-assisted suicide from becoming legal in Colorado, and one person who helped in that effort was a courageous man named J.J. Hanson. J.J. was a Marine veteran and father of two young children who was working for a real estate investment firm in Florida when he found out he had glioblastoma multiforme brain cancer. His doctors told him that it was a very aggressive cancer that meant he only had four months to live.

Despite his odds, J.J. resolved to fight. His motto was: “Every single day is a gift, and we can’t let that go.” What’s even more remarkable is the fact that J.J. dedicated his time and energy to fighting the legalization of assisted suicide around the country, all while undergoing chemotherapy and other treatments. There was hardly a speaking engagement or trip to testify before a legislature that J.J. turned down. His conviction that life was a gift propelled him to defend that gift however he could. As pro-life people, we need to have that same conviction.

Just about two weeks ago, on December 30th, J.J. was called home to the Father – three years beyond what doctors told him to expect. St. Anthony of Padua church in upstate New York, where his funeral was held, was filled with people who paid tribute to how J.J. inspired them to embrace every moment of life, no matter its difficulties as a gift, not something to be thrown away.

All of us are called to embrace life as J.J. did, and in doing so we will help recover the culture of life that is being neglected or forgotten as people cast God and truth aside.

I have said that life is a gift, and while that is true, it’s more than that. Life is also sacred. Life is sacred because it comes from God, the God who is love and who has loved us first. Our lives are also sacred because our beings are made in God’s image and likeness.

We are called to participate in the love of God and to see that every human being, from the moment of conception until natural death, is invited into relationship with God. We are called to ensure that life is set aside for God, that it is honored and recognized as sacred.

The struggle for so many today is that they do not even believe in a god; their only god is themselves. They truly do not believe in the God who is love. And because of this limited worldview, a person’s life can lose its value if their “quality of life” declines.

In the words of Pope Francis to participants in the 2013 Day for Life, “All life has inestimable value even the weakest and most vulnerable, the sick, the old, the unborn and the poor, are masterpieces of God’s creation, made in his own image, destined to live forever, and deserving of the utmost reverence and respect.”

When Jesus speaks about the Judgement of the Nations in Matthew 25, he tells us that life is always sacred by saying that when we love the weak and vulnerable, we are loving him.

The more that we can love the sacred gift of life and celebrate it with joy, the more we will contribute to building a true culture of life in the U.S.

A wonderful example of concretely loving the sacred gift of life is a story I recently heard about a 15-year-old Colorado teenager named Missy, who showed up with her parents at an abortion clinic in Albuquerque, New Mexico.

Missy was a sophomore in high school and was in her second trimester of pregnancy. As they approached the clinic, some pro-life volunteers who were parked nearby in a mobile crisis pregnancy van saw them and invited them inside. The volunteers learned that Missy wanted to complete high school and that this desire was pushing her to consider an abortion. One of the volunteers told Missy about how she was faced with the same choice as a teen and chose to keep her child. “It wasn’t easy, but it was amazing,” she reassured Missy.

Missy also worried about the father of the child not being around, to which her dad responded by taking her hand and saying, “I’ll be that man in your child’s life.”

This kind of accompaniment and willingness to heroically support the gift of life is vitally important to forming a culture that welcomes the unborn, the elderly, the disabled and the dying as a gift.

Building a culture of life begins by first receiving the love of the Father, who loves each of us as his sons and daughters. He never abandons us, even though we might abandon him or reject his love.

A culture of life grows when we share his love with others, helping them to embrace life as a gift and a joy, rather than a burden.

Life is a gift, it is sacred and our celebration of the joy of life helps build a culture of life.

I encourage you to be those who are unafraid to give witness to life. Be not afraid to give witness to life. Even though people might ridicule you, yell at you, or reject you, know that Jesus experienced it all so that you might have life, and life abundantly.

May God bless you and help you celebrate life in 2018!