Conscience Protection & the Catholic Health Association

His Eminence Cardinal Daniel N. DiNardo, Chairman
USCCB Committee on Pro-life Activities
Most Reverend Timothy M. Dolan, President
United States Conference of Catholic Bishops

Your Emminence & your Excellency:

When Cardinal DiNardo reminded us that H.R. 361, Abortion Non-Discrimination Act "is urgently needed to protect the civil rights of health professionals and other health care entities" (1/20/11), his words could not have been more timely. Conscience protection is absolutely under assault:

• As per a 2/4/11 report on LifeNews.com, "On March 10, 2009, the Department of Health and Human Services ('HHS') under President Obama issued a 'notice of proposed rule making' to rescind the conscience protection regulations promulgated by President Bush."
• As per a 2/8/11 report on EWTN, "Catholic health care workers are facing a worldwide erosion of spiritual and moral standards in their profession....'In the United States, the biggest problem that Catholic nurses are facing is the ability to use their conscience,' said Marylee Meehan, president of the International Catholic Committee of Nurses and Medical-Social Assistants....In addition to abortion and euthanasia, the committee is seeing concerns related to 'children's condoms,' in-vitro fertilization, AIDS transmission and the concept of bearing children as a 'right.' There are also questions about adequate medical attention for the elderly. Amid the many issues that assail the nurse's conscience today, 'it takes extreme courage to be a Catholic living the Catholic life in their professional environment,' said Meehan."
• As per a 2/18/11 report on the ChristianNewsWire, "The 16,000-member Christian Medical Association (CMA) today protested the decision of the Obama administration to weaken the only federal regulation protecting the exercise of conscience in health care."

Sadly, conscience protection legislation will do us little good, if authentic Catholic teaching on medical and life issues is not better disseminated, and Catholics are not open to the Holy Spirit's emboldening them to do what is right. Some who should be our allies in promoting authentic Catholic health care seem to instead be giving aid and comfort to the enemies of life. For example,

• Catholic Healthcare West recently "issued $1.2 million in grants or organizations in central California....The grants include donations to Planned Parenthood and Women’s Health Specialists, both of which do abortions" (LifeNews.com, 1/28/11).
• The current issue of U.S. Catholic evidences utter confusion about the responsibility for forming consciences according to Church teaching. It even cites the recent defiance of Catholic teaching at St. Joseph Hospital in Phoenix, as though it were a legitimate implementation of Catholic teaching.
• As per the documentary, “28 Days on the Pill,” it is routine for potentially abortifacient, hormonal contraceptives to be prescribed in Catholic hospitals in the United States: “what the official teaching is and what is done in practice can be two different things.” If accurate, this would appear to be a direct and grievous violation of Directive #52 of the USCCB's Ethical and Religious Directives for Catholic Health Care Services (ERDs).
• As per Professor Leonard J. Nelson, III, adeherance to the ERDs "has been uneven when it comes to contraception and sterilization. Typically, obstetrician-gynecologists practicing in Catholic hospitals and physician office buildings owned by Catholic hospitals provide prescriptions for contraceptives to their patients" (p. 53). Professor Nelson maintains that "any argument in favor of exemption from laws requiring a hospital to provide these services may be substantially undermined by the fact that the Catholic hospital is already, in some fashion, involved in either providing those services - as in the case of sterilizations - or involved in partnerships with entities providing such services" (pp. 132, 137).

Directive 36 of the ERDs outlines situations in which so-called "emergency contraception" (aka, the morning after pill) could be morally used for women who report themselves to be victims of sexual assault - IF such medication was not abortifacient. Yet the Catholic Medical Association 2003's "Resolution in favor of prohibiting all 'emergency contraception' in Catholic Hospitals" indicates the assumptions for acceptable use to be unrealistic:

• "Whereas women who are victims of a sexual assault should be treated with compassion and provided with all the legitimate means to prevent health consequences from the assault, And
• "Whereas pregnancy is a rare outcome of rape, occurring in less that 5% of cases, And
• "Whereas ample evidence exists that 'emergency contraception' which can be given up to 120 hours after the act, adversely affects the function of the corpus luteum and affects endometrial development, making implantation of the blastocyst less likely, And
• "Whereas 'emergency contraception' given prior to ovulation does not consistently prevent ovulation or pregnancy, and still has an effect on the corpus luteum and the endometrium, preventing implantation,
• "Therefore be it resolved that 'emergency contraception' is a misnomer as it does not consistently prevent fertilization, And
• "Therefore, be it further resolved that as 'emergency contraception' has the potential to prevent implantation whether given in the pre-ovulatory, ovulatory, or post-ovulatory phase, that it cannot be ethically employed by a Catholic physician or administered in a Catholic Hospital in cases of rape."

When specifically asked in 2008 whether there could be exceptions for so-called "emergency contraception" (aka, the morning after pill) in cases of rape, the response from the head of the Pontifical Academy for Life certainly appeared to confirm the position of the Catholic Medical Association: "It is not able to prevent the rape. But it is able to eliminate the embryo. It is thus the second negative intervention on the woman (the first being the rape itself)." Later that year, Section 23 of Dignitas Personae appeared to confirm that answer. After distinguishing interceptives from contragestatives, Dignitas Personae stated that "the use of means of interception and contragestation fall within the sin of abortion and are gravely immoral." While there was absolutely no discussion of exceptions, the Catholic Health Association's "Talking Points" was dismissive of this Vatican document, as well as of the positions of the Catholic Medical Association and the head of the Pontifical Academy for Life:

• "implementation of Directive 36 of the Ethical and Religious Directives remains unchanged. Plan B, the medication of choice for emergency contraception, does not appear to have a post-fertilization effect, given the results of repeated scientific studies....The document is unlikely to have much of an impact on Catholic hospitals because these hospitals do not employ the procedures addressed in the document."

We are fast approaching the 6th anniversary of the death by forced starvation of Terri Schindler-Schiavo. Since Section 120 of the Vatican's 1995 Charter for Health Care Workers had clearly stated that "The administration of food and liquids, even artificially, is part of the normal treatment always due to the patient when this is not burdensome for him: their undue suspension could be real and properly so-called euthanasia," I struggle to understand why so much confusion reigned at that time with regard to Catholic teaching and why it took till 2009 for this to be incorporated into Directive #58 of the ERDs.

As per the Holy Father's Message for this month's World Day of the Sick,

• "'....A society unable to accept its suffering members and incapable of helping to share their suffering and to bear it inwardly through 'compassion' is a cruel and inhuman society’ (Encyclical letter Spe salvi, n. 38)....during the course of the pastoral visit to Turin, I was able to pause in reflection and prayer before the Holy Shroud, before that suffering face, which invites us to reflect on He who took upon himself the passion of man, of every time and place, even our sufferings, our difficulties, our sins....I send an affectionate greeting to...all those who dedicate themselves with love to treating and relieving the wounds of every sick brother and sister in hospitals or nursing homes and in families: in the faces of the sick you should know how to see always the Face of faces: that of Christ."

Amidst its vast bureaucracy, the Catholic Health Association seems to have lost this vision of Catholic health care. I fully support the American Life League's request that that the United States Conference of Catholic Bishops disassociate itself from the Catholic Health Association.

Sincerely in Christ,