By Eric MacDonald | 27 December 2010
Choice in Dying
It is important to cut through sanctimonious crap, and stop pretending that religious institutions have privileged access to the truth about morality. The case of St. Joseph’s Hospital vs. The Bishop of Phoenix is an especially good example of the kind of madness that occurs when it is imagined that they do.
In order to understand this story, it is important to read documents related to the case. The ones that I have been able to gather together (with the help of Ophelia Benson of Butterflies and Wheels, and the commenter — at B&W — Mark Jones) I have included in a pdf file called Phoenix Madness which is available for download by clicking on the title. The file includes a letter from the American Civil Liberties Association, a letter from the Bishop of Phoenix, Thomas Olmstead, to the president of Catholic Healthcare West (CHW), and a theological analysis of an earlier moral analysis of the situation, by the Catholic ethicist M. Therese Lysaught, by Robert L. Conte, Jr., who bills himself as a Roman Catholic Theologian and Bible Translator. M. Therese Lysaught’s analysis does not appear to be available on the net.
The letter from the ACLU points out that failure to provide emergency abortion care would be in contravention of American law, and that hospitals by religious organisations “cannot be permitted to dictate who lives and who dies.” That strikes me as a particularly sane position.
But Bishop Thomas Olmstead does not see it that way. He stands firmly on his authority as the interpreter of the moral law and teacher of “the Catholic faith as a Successor of the Apostles.” He goes on further to state that
The decisions regarding life and death, morality and immorality as they relate to medical ethics are at the forefront of the Church’s mission today.” (1)
Clearly, we must look at the implications of that statement. He immediately goes on to say that, in view of the centrality of moral issues surrounding life and death to the church’s mission, bishops have “a heightened moral responsibility to remain actively engaged in these discussions and debates.” However, this is precisely what he is denying, namely, that there is any room for discussion here. It is not a matter for debate, or for difference of opinion. No. There is one correct answer, and he knows it. And he states it very clearly in a way that brooks no dissent:
I have attempted to do my part in calling CHW and your hospitals to uphold the dignity of human life, and to embrace the fullness of what the Catholic Church teaches on the immorality of those actions that are an affront to the gift of human life and its inherent goodness from God. (2)
There is no room here, as the reader can see, for discussion. The matter is settled, and the bishop is asking CHW to conform its practice to these Catholic moral principles, whether or not they are in violation of the law. And whether or not to do so would violate statutes governing hospitals in the United States, the bishop expects CHW to conform to the ERDs [Ethical and Religious Directives] of the USCCB [United States Conference of Catholic Bishops].
And that puts an end to the discussion. According to the bishop, the abortion that saved the life of a young mother of four children was, in his words, a “tragic abortion.” But more than that, it is a “scandal … amongst the Catholic community.”
How did morality manage to become so mangled as to produce this result? And what is the result? Well, basically, for Catholic morality the abortion of a fetus in order to save the life of a woman who already has children who need her and depend upon her — and this is strictly irrelevant to the moral issues involved – is tantamount to murder. This is clearly stated by the Roman Catholic Theologian Ronald Conte (whose analysis is included in the pdf Phoenix Madness.)
For Roman Catholic Morality, according to Conte, there are three ‘fonts’ of morality:
(1) intention, (2) moral object, (3) circumstances. In order to be moral, each and every knowingly chosen act must have three good fonts. If any one or more fonts is bad, the act is immoral.
So, take the act of the abortion of the fetus of the endangered woman in St. Joseph’s Hospital. The circumstances were such that, if the pregnancy were not terminated, the woman would die, along with the fetus. The intention of the act was to save the woman’s life. But the immediate moral object of the act, in the Roman Catholic understanding of it, was to terminate life of the fetus, or what Conte calls ‘the prenatal’. The intention to save the woman’s life is irrelevant, we are to understand, in judging the morality of the act.
Notice how language is being used to redescribe the situation to satisfy Roman Catholic moral requirements, as well as how the ‘fonts’ of intention and moral object are being selectively applied to deliver a conclusion already determined by the Magisterium (or teaching authority) of the church. There is absolutely no reason why the intention of the act needs to be described in the way specified. Additionally, the prenatal is so described because it is held to be on a continuum from conception to birth to childhood to adulthood to death, and no position along this continuum is morally distinguishable, in the Roman Catholic view, from any other position. There is no intrinsic reason to accept this judgement either. But the outcome of these choices is the conclusion that to terminate the life of the ‘prenatal’ is equivalent to murder. As Conte says:
The intentionally-chosen act is the removal of the prenatal from the mother prior to viability, and this act is inherently ordered toward the death of the prentatal. The prenatal dies as a direct result of his or her removal. The inherent moral meaning of this act is the killing of an innocent prenatal.
The fact that the fetus would die anyway does not, he says, change the morality of the act, “the essential moral nature [of which] … is murder.” Of course, as Conte points out in detail, this applies as well to the other end of life:
Euthanasia is intrinsically evil (and a type of murder) because the intentionally chosen act is inherently ordered toward depriving an innocent person of life. The intended end to relieve suffering does not constitute or change the moral object.
It is important to see the lengths to which this form of moral reasoning can be taken. In the Roman Catholic conception the moral object of contraception is no different from the moral object of abortion or euthanasia. As Cardinal Cahal Daly says in his book Morals, Law and Life:
The works of the scientific humanists are there to prove that man’s attitude to contraception determines whether he will think it wrong or right for a mother to kill her defective child, or for a doctor “gently and humanely to extinguish his patient’s life.” (45)
The ordering of an action towards the prevention of conception is thus morally equivalent to abortion and euthanasia, and, presumably, approving the first leads by sheer logic to an approval of abortion and euthanasia, which, in Roman Catholic understanding, puts us on a slippery slope towards indiscriminate murder. Contraception, abortion and euthanasia are, for Roman Catholics, intrinsically evil, so evil, in fact, that it is intrinsically wrong for a dying person even to ask for assistance in dying:
Furthermore, [says Pope John Paul II] no one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly. [Evangelium Vitae, n. 57]
As the same pope said in his Letter to the Elderly:
Regardless of intentions and circumstances, euthanasia is always an intrinsically evil act, a violation of God’s law and an offence against the dignity of the human person.
This is in the nature of an absolute pronouncement. No reasons are given, save the claim regarding the dignity of the human person, but there is no reason to think that human dignity would be offended by acceding to the expressed wishes of persons in the relevant circumstances. Indeed, refusing to provide them with the relief that they seek, or preventing them from making free choices regarding their own lives, is surely a greater affront to human dignity.
The idea of human dignity, however, is being used by the pope in a completely idiosyncratic way. In the tradition what confers dignity on human beings is the human ability to reason and to make choices. It does not pertain simply to the identity of living tissue as biologically human. In applying the concept of dignity to fetuses, for example, which do not have the ability to reason or make choices, the pope is using the term as a reinforcing phrase to emphasise what he thinks is of most importance, namely, that (in the cases under consideration) abortion or euthanasia would be violations of God’s law. The use of the idea of dignity implicitly claims to provide a reason, but the claim is spurious.
But there is another incredibly important point that needs to be made in conclusion. At the end of Bishop Olmstead’s letter to Catholic Healthcare West is the telling note: “cc. Most Reverend Pietro Sambi, Apostolic Nuncio of the United Sates.” I have no idea what the implications of this are in law, but the immediate implication is that a claim is being made here that there is a law, the moral law as established and codified by the Vatican — which, according to the Vatican itself, is a sovereign state — which is superior to and judges American law.
Indeed, Thomas Olmstead is making an appeal to a foreign power whose laws in some sense abrogate American law. This is an implication of enormous importance in the debates about issues like abortion and euthanasia that are being conducted in so many countries today. The Roman Catholic Church can bring to bear a great weight of raw lobbying power. Not only does the church have diplomatic representatives in most countries, but the church in each country has immediate access to those representatives, which in turn have access to government. This effectively breaks down the separation of church and state which is a foundational principle of secular government, and gives the church influence over laws which govern people, who are not only not members of the Roman Catholic Church, but strongly opposed to the principles of morality as understood by that church. This is a matter in need of urgent attention.
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