Abortion Is a Polarizing Issue. The Debate Hypothesis Chapter

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Abortion is a polarizing issue. The debate divides families as well as politicians. However, I am all too well aware of the fact that there are many individual stories that are far more complex than the black-and-white shades in which the issue is presented by the media.

Take the example of the aunt of one of my best friends from high school. My friend's aunt became pregnant: this was joyous news for her and she wanted to keep the baby. This was her third pregnancy: the first two had ended in miscarriages. By the third time she became pregnant the woman was in her early 40s, making her pregnancy extremely high-risk for both mother and fetus. The woman was very cautious and followed her doctor's advice and yet, she still had complications. By the end of the third trimester she was in tremendous physical pain and the fetus was unlikely to survive.

The doctors examined her and realized that the fetus was causing a negative reaction to the body of my friend's aunt; they were able to determine that the source of the problem was her advanced age. Her family was given a choice: she could continue to suffer pain and risk her life giving birth to a child that was unlikely to survive or get an abortion and save her own life. My friend's aunt and her husband made the gut-wrenching decision to have a third trimester abortion of the child they wanted but they realized that it was not worth risking my aunt's life to save a fetus with a very low likelihood of viability.

This woman's story is not unique. Erik Eckholm's article in the New York Times entitled "Lawsuit challenges anti-abortion policies at Catholic hospitals" details a similar, more recent case. The facts presented in the article appear simple: Tamesha Means went to the only hospital in her county. She was 18 weeks pregnant and her water broke, which, in medical terms, meant that her baby had absolutely no chance of surviving, but the woman would have a chance to survive with proper medical treatment. However, because the hospital was benefiting from Catholic funding and had to accept Catholic directives, the doctors had limited options. Ideology rather than standard medical advice had to govern their decisions. The hospital would not help the woman until her third visit. At this point she was already in tremendous pain and in danger of a serious infection. She eventually miscarried and the baby died. Tamesha survived but suffered unnecessary pain and her life was put in needless risk.

In a non-religious medical organization, the woman's life would have come first no matter what religious preferences of the staff. In this particular situation, the best scenario would have been to save both the mother and the baby, but when the baby's life was no longer possible viable, the full attention of the hospital should have been on the mother. Many people are unaware of the extent to which ideology -- an ideology they may not necessarily subscribe to -- will determine the medical care in a hospital. And many people are also unaware of the fact that, despite the demonization of 'late' abortions, these acts are almost always performed in the interests of saving a woman's life.

When patients select a hospital they often simply choose an institution which is close and covered by their insurance. If they hear that it does not support abortion, if they intend to bring the baby to term, they might be unconcerned, even though they are not Catholic. Yet the Catholic Church is allowed to dictate over who lives and who dies. Medicine is dispensed according to the dictates of religion, even though many Catholic doctrines are contrary to accepted, evidence-based modern science. The average citizen thinks he or she no longer lives in a world where they can be controlled by religious preferences by the state; they think we live in a world where we must rely on scientific facts to guide our decisions. In this particular case, the scientific facts indicated the baby would not survive at 18 weeks.

Yet Mercy Health Hospital is Catholic-sponsored. This allows the hospital to cover operational costs and even to provide free healthcare to some of the patients who cannot afford it. This is the good side of Catholic sponsorship of medicine: it offers care to people and communities in need. This is why its involvement has always been appreciated by educational and social institutions who might not profess the Catholic faith.

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But at Mercy Health Hospital, Catholic sponsorship comes at a cost. The cost is the fact that medical care is issued with subservience to the ethical and religious directives of the United States Conference of Catholic Bishops. The money it receives comes with 'strings attached.' The bishops specifically state in a document entitled

"The distinction between direct abortion and legitimate medical procedures" that "abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion."

Catholic hospitals thus must, in essence, serve 'two masters.' On one hand, the Hippocratic Oath and the basic principles of modern medicine must support life, including saving the life of the mother. However Catholic doctrine suggests that abortion in all its forms is wrong and the mother's choice or the medical perspective of the doctor is irrelevant.

The intentions of anti-abortion supporters are not necessarily evil or anti-woman. Anti-abortion supporters believe that "every child is a precious and unique gift from God. We have no right to destroy this" gift ("Prolife arguments AGAINST abortion," rsrevision) They also believe that "doctors and nurses promised to save life not destroy it. Abortion breaks the Hippocratic Oath" ("Prolife arguments AGAINST abortion," rsrevision). Nonetheless, there comes a point in which philosophy becomes so intransigent it ignores common sense and utilitarian considerations.

Had my friend's aunt received pregnancy care at a Catholic hospital like Means did, she might have died because she would not have received full counseling about her options. At Catholic hospitals, even suggesting to a woman that abortion might save her life is prohibited, thus preventing women from making informed medical decisions. Nor would she have received guidance as to where she might obtain an abortion. True, "John M. Haas, president of the National Catholic Bioethics Center in Philadelphia…[claimed] that doctors were required to tell patients of the potential risks and alternatives they face, though they may not provide direct abortion referrals." (Eckholm, "Bishops sued over anti-abortion policies at Catholic hospitals"). But while Haas claimed that the "bishops' directives to hospitals were more nuanced than many critics allege," it is difficult to understand what 'more nuanced' means: either a woman is counseled about the likely outcomes of continuing a pregnancy or is given an incomplete picture of the evidence ("Bishops sued over anti-abortion policies at Catholic hospitals").

Prioritizing ideology limits patient choice and does not give patients a full picture of all his or her risks and options. Ignorance can impede the patient from making the best decision for him or herself. Forcing hospitals to make a choice between receiving funding and obtaining appropriate support for their functions is both unfair and polarizing. But the threat of losing critical support from the Church is very real. In 2009, St. Joseph's Hospital and Medical Center in Phoenix, Arizona was banned from identifying itself as Roman Catholic hospital because it performed an abortion which it said was necessary to save a patient's life. The hospital was so adamant it stood by its decision even after a nun who stood by its decision was excommunicated for her efforts in saving the woman (Goodstein, "Phoenix: Hospital loses Catholic affiliation"). Given the weight of such sanctions, many hospitals are loath to challenge them.

Lest someone think that this issue only affects a minority of patients -- think again. "According to the Catholic Medical Association, 12.6% of U.S. hospitals are Catholic and they had 34 million admissions in 2011," not all of whom are Catholic (Mohney, "Debate over Catholic directives). It might also be comforting to think that a non-Catholic can simply leave a Catholic institution if she needs medical care the hospital will not provide. However, "in practice transferring patients can be complicated especially in emergency situations or in rural areas where a Catholic hospital might be the only place to receive care in the region" (Mohney, "Debate over Catholic directives). In the case of Mercy Health, the hospital was the only hospital in the county available to Tamesha Means.

Thus, for individuals dependent on Catholic hospitals whose beliefs are not 'in line' with that of the Church, there is often a difficult choice. At minimum, patients should be aware of the extent to which an institution's faith can impact their medical choices and they should not be complacent that merely because they want to have a child that they….....

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