The Americans for Civil Liberties Union is suing the U.S. Bishops. The principal allegation is that their misguided policies forced a Catholic hospital to put a woman’s life at risk by remaining silent about her need for an abortion.
The policies in question are promulgated by the U.S. Bishops, and known as the 5th edition of the Ethical and Religious Directives for Catholic Health Care Services – ERDs for short.
According to the account at the ACLU’s website a woman, 18 weeks pregnant, had vaginal leakage of her amniotic fluid, associated with severe pain, and went to a Catholic hospital for care. She was sent home but soon returned and was again sent home. On her third trip back she spontaneously delivered. Her baby died shortly thereafter. It is reasonable to assume that on each visit she was given an examination. Other than pain described as “excruciating” and fever on her third visit, she appears to have had no other complication.
According to Dr. Allahyar Jazayeri and others writing in online Medscape,
leakage at 18 weeks pregnancy is uncommon, potentially serious, and management can be difficult. There is up to a 35 percent chance of fetal membranes becoming infected. Between one and two women out of 1,000 of such infections will die.
Well understood medically, is that if woman shows signs of infection developing, delivery must be induced immediately. Induction of an 18-week-old baby – which cannot survive outside the uterus – is equivalent to an abortion according to ERD # 45—but it is permitted in this case since the intent is to remove infected membranes. The baby’s unavoidable delivery is an unwanted effect.
In this case
At whatever point this young woman complained of severe pain, she likely was going into irreversible labor. But her baby was still alive, there were no signs of infection, and induction would therefore be immoral. Allowing her to simply miscarry from her own labor is reasonable practice. And given that 12 percent of such premature leakages can go on and survive, according to Dr. Jazayeri, expectant management – close observation and careful follow up – are not unreasonable in such cases.
There might be those who would counsel that since she’s in labor, the baby is almost certainly going to die anyway, so let’s lessen the chance of infection by performing an induction and finish this ordeal. Perhaps they also consider that if the child survives five more weeks to early viability and then delivers, there is a high probability of developmental abnormalities. Ignored is that there are two patients here, and this the direct killing of one of them. Whether or not the baby is close to death is morally inconsequential.
The patient claims she was not given adequate information. Part Three of the ERDs require mutual respect, trust, honesty, and that patient and care giver act together in the healing process. Directive 27 requires that the patient receive all reasonable information about the proposed treatment, and any moral alternatives to treatment including no treatment at all.
The ERDs do not require informing patients of immoral choices. However, if there was a medical case for her having an abortion, it would not violate the ERDs to tell her so, and it would probably be prudent in our pluralistic society. She would then be free to choose another facility.
But should Catholic hospitals or their bishops be obliged to inform patients whenever there are immoral alternatives to their medical treatment? Giving such information outright, especially when there are morally good options, could be a source of scandal. Perhaps if they are not doing so, Catholic physicians and health care institutions would do well to inform patients ahead of time, that they will not recommend immoral alternatives to good care, including abortion, but will answer any and all questions.
Does the ACLU have a good case against the bishops? I doubt it, but a lawsuit like this will surely inflame anti-Catholic hostility and perhaps this will be enough for them. However, even a cursory read of the Ethical and Religious Directives will easily demonstrate that the highest standards of patient care are supported – but only in the preservation of all life. Simply because an immoral procedure such as abortion is legal and expedient, doesn’t automatically make it good medical practice. Benedicamus Domino.