"Question 87: How far may Catholic hospitals cooperate with providers of immoral services?‏" (Germain Grisez, The Way of the Lord Jesus, Volume III, 1997)

P.S. Your Excellency: Could any of our grandparents have imagined that - by the dawn of 2015 - it would be routine for Catholic hospitals to be overwhelmingly staffed by OBGYNs who are NOT NFP-only?  Could our grandparents have imagined that unsuspecting individuals could check Catholic hospital web sites for private contact info of providers of morally excluded services?  Back in 1997's The Way of the Lord Jesus, Vol III (which is available online in its entirety), Germain Grisez provided a fascinating reflection on "Catholic" hospitals and their prospects for remaining truly Catholic:

"to be an apostolate that carries on Jesus’ ministry of mercy, Catholic hospitals must not only deliver quality health care but provide service to 'the poorest and most abandoned of the sick,' give religious instruction and encouragement along with health care, explicitly evangelize, strive to humanize medical practice, fully conform to the Church’s moral teaching, and supply sound formation in that teaching. Of course, even isolated individuals’ work in the field of health care can qualify as a lay apostolate, in the same way as other morally acceptable occupations Christians might undertake, if carried out in a way that struggles against the evils that afflict such work and restores it in the light of the gospel, manifests Christian mercy, and bears clear witness to faith (see AA 5–7; LCL, 102–13). However, Catholic hospitals will have lost their identity unless they meet all the conditions for carrying on Jesus’ mission of mercy ²⁷⁵....

"doing God’s will and entirely avoiding wrongdoing are at the heart of anything that can be called an apostolate. Do not regard actions such as sterilization and abortion merely as forbidden procedures and do not think of wrongful cooperation with them merely as rule breaking, to be avoided if possible. Recognize such acts as grave injuries to persons or their very destruction, and thus contrary to Christian love and entirely incompatible with your apostolate....

"If a Catholic hospital is to carry on its work as an apostolate, its board members and administrators should deal with formal cooperation in various evils by its personnel. If those responsible instead studiously avoid noticing such formal cooperation or decide to tolerate it, they at least materially cooperate in it in a way that hardly can be justified. As a community committed to an apostolate, the hospital will have betrayed itself even if its board members and administrators manage to stop just short of letting its own complicity in evil become formal cooperation.

"Material cooperation with wrongdoing can be scandalous in the strict sense: It can lead people to sin by encouraging them in rationalization and self-deception (which do not free them of guilt) regarding the wrongdoing. The scandal would not be prevented by a Catholic institution’s prohibition of morally unacceptable procedures within the domain remaining to it, even if that policy is well publicized. For to most non-Catholics and many Catholics the material cooperation would seem to imply that those procedures are not wrong in themselves but merely forbidden to Catholics, as eating meat on Friday used to be. Moreover, other things being equal, a Catholic institution’s material cooperation is much more likely to be scandalous than an individual Catholic’s. The institution’s acts are presumed to be fully deliberate and free, not the product of ignorance or weakness, as an individual’s might be. And since the institution claims to be distinguished from others by being Catholic, whatever it does is taken by many non-Catholics and even unsophisticated Catholics to be the Church’s own act.

"In various ways, a Catholic institution’s significant, obvious, voluntary cooperation in wrongdoing inevitably will impair and probably even negate its capacity to provide credible witness. For example, commingled with the service of secularized providers, its activities will become less identifiable and less distinctively Catholic. Again, the closer association with health care providers whose practice violates moral norms taught by the Church often will make it harder for a Catholic institution’s administrators and staff to speak out for the truth of those norms and work against their violation....For those engaged in health care as an apostolate to impair their witness in these and other ways would be utterly self-defeating, since, to repeat, the essence of apostolate is not only to promote a human good such as health but to practice Christian love and bear witness to the gospel’s truth, including love for the tiniest and the most debilitated of Jesus’ sisters and brothers, and the moral truths regarding how they are to be dealt with."

On this eve of the Feast of the Holy Innocents....

Your Excellency:

It has been reported that a Catholic pediatrician is suing the City of Philadelphia, alleging that she was fired for refusing to write prescriptions for "contraceptives" (cf, Philadelphia Magazine, 10/10/14).  What strikes me as most tragic is that faithful health care professionals in secular settings can expect minimal recognition of the right to conscientious objection, if prohibited practices receive a "wink and a nod" on "Catholic" turf.  As per Professor Leonard J. Nelson, III,

• "compliance with 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). 

While there is an absolute need to properly understand and interpret the USCCB's Ethical and Religious Directives for Catholic Health Care Services, isn’t it possible that some would simply prefer to be ignorant of a proper understanding and interpretation?  With reimbursement for top people at Catholic hospitals in the hundreds of thousands of dollars, [i] such ignorance could be seductively comfortable!  Why rock the boat?  As per the character Che in Evita, “When the money keeps rolling in, you don't ask how.”

In 2014, I believe that Catholic hospitals in the Archdiocese of Philadelphia continued to foster scandal, through cavalier and continued cooperation with providers of morally excluded services[ii].  What possible sense does it make for hospitals to be associated with physicians who prescribe substances (e.g., hormonal contraceptives), which are potentially fatal to babies and women?  And why would any parish allow advertising for a pharmacy that sells hormonal contraceptives[iii]?  

In February, the Congregation for the Doctrine of the Faith provided "Some Principles for Collaboration with Non-Catholic Entities in the Provision of Health Care Services", reminding everyone of the need to prevent "a diminution of the prophetic witness to the Faith" and scandal and offering 17 specific principles.  Those specific principles would lessen the chance for improper understandings and interpretations of the ERDs. [iv]  From their recently concluded meeting, we have been told that

“The bishops also voted 213-2-1 in favor of pursuing a revision of Part Six of the ‘Ethical and Religious Directives for Catholic Health care Services’ to incorporate guidance the USCCB received from the Vatican’s Congregation for the Doctrine of the Faith last February. This action item was presented by the USCCB Committee on Doctrine.” 

Particularly as the Archdiocese is home to Catholic Health East which has “regional healthcare systems in 11 eastern states from Maine to Florida,” the Archdiocese can hardly seem to wait for the entire USCCB to act.  Please immediately remind Catholic Health East and all hospitals in the Archdiocese of the need to adhere to the Vatican’s Principles.

Thank you.

Sincerely,

---

[i]  If ignorance helps maintain astronomical levels of financial compensation, it pays handsomely to be ignorant of Catholic medical ethics!

Holy Redeemer: The president/ceo recently had $767, 949 in total compensation (http://pdfs.citizenaudit.org/2013_05_EO/23-1534300_990_201206.pdf).

Catholic Health East: For 2012, the president/ceo had $3,890,553 in "reportable compensation from the organization," as well as $17,510 in "estimated...other compensation from the organization and related organizations" (http://www.che.org/about/pdf/2012CHE99signed_filed.pdf).

St Mary Medical Center: For 2012, the CEO had $705,458 in "reportable compensation from related organizations," as well as $39,905 in "estimated...other compensation from the organization and related organizations" (http://www.che.org/about/pdf/2012CHE99signed_filed.pdf).

Mercy Health Systems of SE Pennsylvania: For 2012, the CEO had $401,992 in "reportable compensation from related organizations," as well as $29,859 in "estimated...other compensation from the organization and related organizations" (http://www.che.org/about/pdf/2012CHE99signed_filed.pdf).

[ii] 1) Holy Redeemer

An archdiocesan priest is the face of "ethics" at Holy Redeemer.  While Holy Redeemer's physician directory includes only one OB/GYN who can be found on an NFP-only list, 20 others cannot be found! 

At Reproductive Medicine Associates of Philadelphia (RMA)  and Abington Reproductive Medicine (ARM), people can choose from a smorgasbord of morally excluded services, such as egg/embryo/sperm "donation," IVF, and "surrogacy."  Yet, Holy Redeemer's physician directory includes seven physicans (i.e., 1, 2, 3, 4, 5, 6, 7) from RMA and ARM!  When people obtain contact information for the seven physicians from a Catholic hospital with a priest ethicist, how are they to understand the immorality of such services?

•  As acknowledged by the U.S. Department of Health and Human Services, "Assisted Reproductive Technologies (ART)....primarily includes the technique of in vitro fertilization (IVF)....ART alone now accounts for 1.5 percent of all births in the United States."
• For 2013, the Pa Dept of Health reports a total of 47,546 births in Bucks (4,916), Chester (5,395), Delaware (6,527), Montgomery (8,690), and Philadelphia (22,018) Counties.  While an inadequate demographic tool, 713 (1.5%) would be a good guess of how many of those 47,546 births in the Archdiocese were associated with ART/IVF. 
• According to the U.S. Centers for Disease Control and Prevention, Applying the 1.7% rate (Yes, I realize that demographers would have a field day with that being an inadequate technique) would lead to a guess of 854 IVF births in the 5 counties of the archdiocese in 2013. With about 30 embryos created for those 713 successful births, it can be estimated that 21,390 embryos were created in the Archdiocese “with many lost, discarded or destroyed by research. Some…lives are still on ice waiting for a chance to finish their lives. Many will die waiting” (cf, LifeNews.com, 7/25/12).

In addition, Holy Redeemer's Advance Directive form fails to clearly specify:

·         Catholic teaching with regard to nutrition and hydration, and

·         that health care services cannot honor non-specific directives to forego nutrition and hydration.

2) St. Mary Medical Center (Catholic Health East)

While St Mary's directory includes one OB/GYN who can be found on an NFP-only list, 27 others cannot be found on that list.  While Drs. Richard Latta, Marc Rosenn, and Stephen Smith are on the list, each is from Abington Perinatal Associates - a practice reported to be involved with fetal "reduction" – a euphemism for abortion (See # 1, # 2, and # 3.).  In addition, Saint Mary's Advanced Directives and Living Wills fails to clearly specify:

·         Catholic teaching with regard to nutrition and hydration, and

·         that health care services cannot honor non-specific directives to forego nutrition and hydration.

3) Mercy Fitzgerald, 4) Mercy Philadelphia, 5) Mercy Suburban, 6) Nazareth (Catholic Health East/Mercy Health Systems of SE Pennsylvania)

·          There is No OBGYN in the Mercy Health System of Southeast Pennsylvania, who can be identified on One More Soul's list of NFP only OBGYNs.

[iii] For example, the parish bulletin for St. Charles in Bensalem.  

[iv] “CDF Principles for Collaboration with Non-Catholic Health Care Entities: Ministry Perspectives” (CHAUSA, 2014) highlights the USCCB’s needs to step up to the plate, to prevent "a diminution of the prophetic witness" and scandal:

·          Peter Cataldo, Ph.d. of the Archdiocese of Boston says  “The CDF’s Principles…confirms recent interpretation and application of the Principle of Cooperation to Catholic/otherthan-Catholic health care collaborations.”  Business as usual?

·          Carl Middleton, Jr., D. Min. of Catholic Health Initiatives also seems to see a confirmation of the status quo: “the CDF’s Principles seem to be principles that have generally guided transactions between Catholic and other-than-Catholic health care entities.”

·          John. A. Gallagher, Ph.D., thinks the whole topic is  none of the Vatican’s business!  He says that the 17 principles “are new, they are innovations, and, like any innovation in Church teaching, they need to be treated with a high degree of skepticism until their link to the authentic magisterium can be verified. But the mystery remains, from where did these principles come? Is it possible that ‘the voice is that of Jacob, but the arms are those of Esau?’….[What is being addressed is]a uniquely American issue. It is an important and more than valid question. But it needs to be discussed, debated and resolved by American theologians, representatives of the Catholic health care systems and members of the American hierarchy. Such a conversation needs to begin with the question the bishops posed to the Congregation, not with the 17 principles.”  Wow!  Who pays his salary?

·          It is refreshing that Father Michael D. Place, S.T.D. at least recognizes that the 17 principles are relevant to so-called “‘carve outs’….entities that provide illicit services outside of the Catholic institution”

·          Steven J. Squires, MA, MEd, Ph.D. of Catholic Health Partners, sees this as  “an opportunity to reflect upon, dialogue, and discuss the Principles and the PoC, not only with our bishops and their advisors, but also within our organizations, especially with our leadership and boards.”  Is it an opportunity to disseminate guidance and adhere to that guidance?

On Sunday, November 23rd, Catholics and others who share the same cycle of readings, heard especially pointed words:

"'Depart from me, you accursed, into the eternal fire prepared for the devil and his angels.  For I was hungry and you gave me no food, I was thirsty and you gave me no drink, a stranger and you gave me no welcome, naked and you gave me no clothing, ill and in prison, and you did not care for me.’  Then they [i.e., That would be a lot of us.] will answer and say, 'Lord, when did we see you hungry or thirsty or a stranger or naked or ill or in prison, and not minister to your needs?’ He will answer them, 'Amen, I say to you, what you did not do for one of these least ones, you did not do for me.’  And these will go off to eternal punishment, but the righteous to eternal life." 

Difficult words for so many of us baby boomers, who grew up on a diet of “Jesus is my cuddly pal” theology!

Those "hungry and you gave me no food…thirsty and you gave me no drink…stranger and you gave me no welcome " parts have me painfully recalling last night's ice cream drowned in Hershey's syrup, contrasted with images of impoverished people fleeing to our borders - many being minors and victims of human trafficking.  I have a long way to go, when it comes to generosity and sharing.  As noted so well on November 21^st by one world leader: “in areas of the world in difficulty, where the lack of work prevents individuals and their families from achieving a dignified life, there is a strong drive to see a better future wherever that may be, even at the risk of disappointment and failure.” 

In its emphasis on family preservation, President Obama’s Immigration Accountability Executive Action appears to be a step in the right direction.  Kids need the protection of their moms and dads.  Who among us would want our minor children to be alone in a strange land?  Yet, the  IAEA is only a tiny, temporary band aid.  I agree with the U.S. Catholic Bishops, in that we need comprehensive reform that provides a path to citizenship, preserves family unity, provides for those with less marketable skills, promotes due process in enforcement, and addresses root cause of why people are leaving their homelands.

The “naked and you gave me no clothing…ill and in prison, and you did not care for me” parts also give me pause.  I do try to be thrifty about clothing expenditures, so as to have more to share.  Yet to my shame, I have never visited anyone in prison.  

I believe that authentic health care is a basic human right, but I am deeply troubled by certain hideous abuses in “health care.”  For example, many are familiar with the estimate of nearly 60 million abortions in the U.S., since 1973.  Were you to add fetal deaths, owing to the abortifacient qualities of certain “contraceptives,” the number would actually be 308 million (cf, Pharmacists for Life International).  Abortion is not health care!  At an absolute minimum, there should be comprehensive conscience protections in place for health care workers to refuse involvement in such practices.  Kudos to Mike Fitzpatrick and Pat Toomey for co-sponsoring the Health Care Conscience Rights Act (HR 940 / S1204).

It’s a pretty simple message -  If we feed the hungry, give drink to the thirsty, welcome the stranger, clothe the naked, visit the sick, and visit the imprisoned, we will be doing well.

ads in OLA, OLS/St.Anthony's, St.Ann's, and St.Charles Borommeo

Rev. Cesar Rubiano

Our Lady of the Angels
Trenton, New Jersey
olatrenton05@aol.com

Rev. Msgr. Thomas Gervasio
Our Lady of Sorrows / St. Anthony
Mercerville/Trenton, New Jersey
info@ols-sa.org

Rev. Gerard F. Lynch, O.SS.T
Saint Ann
Lawrenceville, New Jersey
csainfo@churchofsaintann.net

Rev. Msgr. Edward Deliman
St. Charles Borommeo 
Bensalem, Pennsylvania
olf.parish@verizon.net



Greetings:

Catholic parishes - and others of good will - should not be cooperating with pharmacies which provide contraceptives and potential abortifacients, by allowing their advertisements in parish bulletins.  To the best of my knowledge, the St. Clare Pharmacy is the only pharmacy in the Central Jersey/Bucks County area NOT selling contraceptives and potential abortifacients.

Poisons which we often call "contraceptives" can often act as "abortifacients."  Since 1973's infamous Roe v. Wade Supreme Court decision, it has been noted that there have been more than 57 million abortion in the United States.  Yet as hideous and horrible as that number is, it is an underestimate.  When you properly count abortions from chemical and mechanical methods (e.g., hormonal contraceptives, IUDs), Pharmacists for Life International puts the number of abortions in the U.S. since 1973 at 308,000,000.  

While the Pro Life community has grown more aware of Planned Parenthood's role in the genocide of pre born children, the role of the pharmaceutical industry most often goes overlooked.  To our shame, New Jersey and the Philadelphia suburbs are home to some of the world's "leading" manufacturers of hormonal contraceptives:

• Gynétics of Lawrenceville (NJ),  
• Jannsen-Cilag: "Janssen" is part of Johnson and Johnson and is in Titusville (NJ)
• Merck of Whitehouse Station (NJ), 
• Pfizer of Morris Plains (NJ),  
• Ortho-McNeil of Raritan (NJ), 
• Pharmacia of North Peapack (NJ), 
• Warner-Chilcott of Rockaway (NJ),  
• Women's Capital Corp is part of Teva of North Wales (Pa)
• Wyeth of St. David's (Pa))

Teva of North Wales manufactures the infamous Plan B and tells this to us, to our children, and to our grandchildren:

"You can start by looking for Plan B One-Step^® in the aisle. Otherwise ask anyone in the store where it's located. Then just take it off the shelf, and pay for it at the cashier. No prescription or ID required....Enter your zip code below to see which stores in your area may carry Plan B One-Step^®. Before you head out, call to make sure Plan B One-Step^® is in stock."

  

Unless it can be ascertained that a pharmacy is NOT selling Plan B - or any other abortifacient or contraceptive - their inclusion in parish bulletins seems grievously inappropriate.  To the best of my knowledge, the St. Clare Pharmacy is the only pharmacy in the Central Jersey/Bucks County area NOT selling contraceptives and potential abortifacients:

• The bulletin for Our Lady of the Angels carries inappropriate ads for Vizzoni's and Episcopo's.  Efforts to bring this to the attention of the former pastor were ignored.
  
  In June 2009, I met with James Vizzoni and was advised that Vizzoni's did NOT deal in the Plan B poison. However, Vizzoni's was dispensing contraceptives, including oral contraceptives which can act as abortifacients. 
  
  When I phoned on 6/24/13 and asked owner Episcopo's owner John Berkenkopt whether he sold contraceptives and other abortifacients including Plan B, he would not answer.  Responding that I would assume the answer to be "yes," he told me that I could assume anything that I like.  As per the  Episcopo ad: "Also available FRANCISCAN MISSION ASSOCIATION Mass Cards."  Is that not a sacrilege?  

• The bulletin for Our Lady of Sorrows / St. Anthony also carries the ad for Episcopo's, which notes: "Also available FRANCISCAN MISSION ASSOCIATION Mass Cards." (The bulletin actually includes two Episcopo ads), as well as an ad Risoldi's Market and Cafe (which includes a pharmacy). 
  
  When I phoned Risoldi's on 10/20/14, they expected to have Plan B in on 10/22 and indicated that it costs $50.

• The bulletin for St. Ann's in Lawrenceville carries an ad for McGrath's (with the note: "Member of the Diocese") and Penlar. 
  
  Back in July 2009, I phoned McGrath's and was advised that they DO provide Plan B.  On 6/24/13, I left an extended message for owner Steve Zagoreos, in an effort to get my information updated, but my message went unreturned.  Efforts to bring this to the attention of the former pastor were ignored.  On 10/20/14, I phoned Penlar and was advised that Plan B is available for $48.99.

• The bulletin for St. Charles Borommeo in Bensalem carries an ad for the Riccio Family Pharmacy. Like Vizzoni's, Riccio is NOT believed to be dispensing Plan B but to be dispensing "contraceptives," including hormonal contraceptives which can act as abortifacients.  Efforts to bring this to the attention of the former pastor were ignored.

Sincerely, 


"we need to recall briefly the principles assumed in classical moral doctrine with regard to the problem of cooperation in evil, a problem which arises every time that a moral agent perceives the existence of a link between his own acts and a morally evil action carried out by others....

"The first fundamental distinction to be made is that between formal and material cooperation. Formal cooperation is carried out when the moral agent cooperates with the immoral action of another person, sharing in the latter's evil intention. On the other hand, when a moral agent cooperates with the immoral action of another person, without sharing in the intention, it is a case of material cooperation.

"Material cooperation can be further divided into categories of immediate -- direct -- and mediate -- indirect -- depending on whether the cooperation is in the execution of the sinful action per se, or whether the agent acts by fulfilling the conditions -- either by providing instruments or products -- which make it possible to commit the immoral act.

"Furthermore, forms of proximate cooperation and remote cooperation can be distinguished, in relation to the 'distance' -- be it in terms of temporal space or material connection -- between the act of cooperation and the sinful act committed by someone else. Immediate material cooperation is always proximate, while mediate material cooperation can be either proximate or remote.

"Formal cooperation is always morally illicit because it represents a form of direct and intentional participation in the sinful action of another person. Material cooperation can sometimes be illicit -- depending on the conditions of the 'double effect' or 'indirect voluntary' action -- but when immediate material cooperation concerns grave attacks on human life, it is always to be considered illicit, given the precious nature of the value in question.

"A further distinction made in classical morality is that between active -- or positive -- cooperation in evil and passive -- or negative -- cooperation in evil, the former referring to the performance of an act of cooperation in a sinful action that is carried out by another person, while the latter refers to the omission of an act of denunciation or impediment of a sinful action carried out by another person, insomuch as there was a moral duty to do that which was omitted.

"Passive cooperation can also be formal or material, immediate or mediate, proximate or remote. Obviously, every type of formal passive cooperation is to be considered illicit, but even passive material cooperation should generally be avoided, although it is admitted, by many authors, that there is not a rigorous obligation to avoid it in a case in which it would be greatly difficult to do so" (Bishop Elio Sgreccia, President of the Pontifical Academy for Life, 6/9/05)