Transcript Ignatius` Presupputio SpirEx #22

Presented by
James T. Bretzke, S.J., S.T.D.
Professor of Moral Theology
Boston College School of Theology & Ministry
[email protected]
In order that both s/he who is giving the Spiritual
Exercises, and he who is receiving them, may more
help and benefit themselves, let it be presupposed
that
• Every good Christian is to be more ready to save
his or her neighbor’s proposition than to condemn
it.
• If s/he cannot save it, inquire how s/he means it;
• and if s/he means it badly, correct him/her with
charity.
• If that is not enough, seek all the suitable means
to bring him/her to mean it well, and save
him/herself.
Issues Angle
Truth Claims
Judgment Angle
Goals
Application Angle
Issues Angle from Medical Staff View
A1) Fetus cannot be saved regardless of what
is done
F1) Mother’s life in imminent danger due to
continued pregnancy
A2) No time for extensive, broad-based ethical
consultation
F2) Decision must be made very soon
A3) Patient’s will should generally be
respected & followed
F3) Mother gives informed consent
A4) Mother’s ongoing role in the family is quite
important
F4) Mother a husband & 4 other minor
children
A5) The medical procedure is not being
chosen to end an otherwise viable
pregnancy
F5) Pregnancy is unplanned, but initially
mother decides to continue it. Her decision
changes only when it is clear she will die
before the fetus could come to term.
A6) Belief that all that is required by the
Church has been done in this case
F6) Staff follows established Catholic
guidelines
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“I am gravely concerned by the fact that an abortion was performed several months ago in a
Catholic hospital in this Diocese. I am further concerned by the hospital’s statement that the
termination of a human life was necessary to treat the mother’s underlying medical condition.
“An unborn child is not a disease. While medical professionals should certainly try to save a
pregnant mother's life, the means by which they do it can never be by directly killing her
unborn child. The end does not justify the means.
“Every Catholic institution is obliged to defend human life at all its stages; from conception
to natural death. This obligation is also placed upon every Catholic individual. If a Catholic
formally cooperates in the procurement of an abortion, they are automatically
excommunicated by that action. The Catholic Church will continue to defend life and proclaim
the evil of abortion without compromise, and must act to correct even her own members if
they fail in this duty.
“We always must remember that when a difficult medical situation involves a pregnant
woman, there are two patients in need of treatment and care; not merely one. The unborn
child’s life is just as sacred as the mother’s life, and neither life can be preferred over the
other. A woman is rightly called ‘mother’ upon the moment of conception and throughout her
entire pregnancy is considered to be ‘with child.’
“The direct killing of an unborn child is always immoral, no matter the circumstances, and it
cannot be permitted in any institution that claims to be authentically Catholic.

“As our late Holy Father, Pope John Paul II, solemnly taught in his encyclical “The Gospel of
Life,” a ‘direct abortion, that is, abortion willed as an end or as a means, always constitutes a
grave moral disorder, since it is the deliberate killing of an innocent human being’ (The Gospel
of Life #62).
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“The Ethical and Religious Directives for Catholic Healthcare Institutions (ERDs) are very
clear on this issue: ‘Catholic health care ministry witnesses to the sanctity of life from the
moment of conception until death. The Church’s defense of life encompasses the unborn and
the care of women and their children during and after pregnancy.” (ERD, Part Four,
Introduction) The ERDs further state 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 health care institutions are not to provide abortion
services, even based upon the principle of material cooperation. In this context, Catholic health
care institutions need to be concerned about the danger of scandal in any association with
abortion providers.’” (ERD 45)
Bishop Olmsted, by virtue of his office, is the authoritative voice on faith and morals in the
Diocese of Phoenix. This includes every official Catholic institution of the Diocese.

47. Operations, treatments, and
medications that have as their direct
purpose the cure of a proportionately
serious pathological condition of a
pregnant woman are permitted when
they cannot be safely postponed until the
unborn child is viable, even if they will
result in the death of the unborn child.
Issues Angle From Bishop Olmsted’s View
A 1) Pregnancy termination was a direct
abortion
F 1) Medical procedure removed the fetus
directly
A 2) Hospital Staff knowingly engaged
in “formal cooperation”
F 2) Staff knew the procedure would remove
the fetus directly & allowed this to happen
A 3) Hospital sought to hide the
termination case
F 3) Staff did not bring this case to the
bishop either before or after the case
A 4) Hospital is engaged in other
violations of the ERDs
F 4) Hospital maintains its decision was
correct and would do it again
A 5) Bishop has chief role to determine
the application of the ERDS
F 5) Hospital refuses Bishop’s ultimatum
A 6) Bishop must safeguard Catholic
identity of institutions in diocese
F 6) Refusal is causing serious scandal
Issues Angle from USCCB View
A 1) Local Bishop must maintain
authority in diocese
A 2) CHW & CHA probably stretching or
ignoring the ERDs
A 3) USCCB must support any bishop
under attack
A 4) “Culture of life” is under attack,
especially by secular culture
A 5) Theologians misapply double-effect
principle ala proportionalism
A 6) Episcopal authority is being eroded
overall in the USA
F 1) Olmsted has taken a clear position in
this case
F 2) CHC-West statements support the
hospital against the bishop
F 3) Olmsted needs support qua bishop (the
legitimate “decider” in his diocese)
F 4) Case shows lack of respect for fetal life
F 5) Except for Haas, theologians & Sr.
Keehan, etc. are publicly supporting the
hospitals
F 6) Bishops as a whole are being unfairly
criticized in this case
In order that both may more help and benefit
themselves, let it be presupposed that
• If s/he cannot save it,
inquire how s/he means
it;
• and if s/he means it
badly, correct him/her
with charity.
P 1) Health care professionals primary
moral code must be followed
P 2) Hospital protocols should be
followed
P 3) Save all lives you can
P 4) Indirect abortions are morally
allowed
P 5) Act according to best medical
knowledge currently available
P 6) Act in a timely, but not precipitous
manner
Truth Claims
Medical Staff’s Judgment Angle
T 1) Hippocratic Oath gives ethics standards for
health-care professionals
T 2) Hospital has established ethical protocols for
difficult cases
T 3) It is morally unreasonable to let more people die
when some (or one) can be saved
T 4) Not every “direct removal” of a fetus constitutes a
“direct” abortion
T 5) Mother’s prognosis without termination of
pregnancy was morally certain death with no
possibility of saving the fetus
T 6) Emergency situations require immediate action
P 1) Never abort a fetus.
P 2) Never allow pregnancy to constitute
grounds for the Double Effect Principle
P 3) Never directly (physically) terminate a
pregnancy regardless
P 4) Accept moral martyrdom if the situation
warrants
P 5) Never allow a termination of a pregnancy
through direct means
P 6) Bishop must take action when Catholic
teaching is under attack
Bishop Olmsted’s Judgment Angle
Truth Claims
T 1) Life of a fetus is absolutely sacred
T 2) Pregnancy is not a medical disease
T 3) Any surgical intervention that physically “attacks” the fetus
is a “direct” abortion
T 4) Life of the mother is not to be preferred over life of the
fetus
T 5) Knowingly Allowing “X” to happen = “formal cooperation”
with evil
T 6) Bishop has moral responsibility to safeguard Catholic
identity & doctrine & corresponding authority to “authentically”
interpret the natural law
P 1) Act to support the bishop &
avoid improper role of
episcopal correction
P 2) Formulate doctrinal
statements of principles
P 3) Defend against any proper
encroachments against
legitimate episcopal authority
P 4) Act responsibly in living out
the 3 munera (teach, govern,
sanctify)
USCCB Judgment Angle
Truth Claims
T 1) The USCCB serves as collegial support for
residential bishops.
T 2) The USCCB has a formal role to articulate & defend
Catholic doctrine, especially when under attack.
T 3) The USCCB has the primary authority for deciding
disputed questions & maintaining policy directives such
as the ERDs
T 4) Bishops has the charism of authority & therefore the
special assistance of the Holy Spirit in their 3 munera
(teach, govern, sanctify)
In order that both may more help and benefit
themselves, let it be presupposed that
• Every good Christian is
to be more ready to save
his or her neighbor’s
proposition than to
condemn it.
G 1) Have mother make
informed medical choice
G 2) Save both mother &
child if medically possible
G 3) Save whatever life is
possible if cannot save both
G 4) Follow ERDs & Hospital
protocols
G 5) Keep case low profile to
protect woman & hospital
S 1) Give mother best
medical information, time,
and respect her decision
S 2) Continue treatment of
mother and her pregnancy
S 3) Determine when
situation becomes critical
& advise accordingly
S 4) Convene ethics board
S 5) Do not advertise the
case with the bishop or
press
Goals
Medical Staff’s Application Angle
G 1) Consolidate Catholic
identity & orthodoxy in all
institutions in the diocese
G 2) Uphold clear Catholic
teaching on abortion & intrinsic
evil
G 3) Tighten up after the looser
governance of his predecessor
Bishop O’Brien
G 4) Confirm legitimate authority
of the local bishop
G 5) Indicate the Cost of
Discipleship for Catholics
S 1) Ultimatum to St. Joseph’s
Hospital
S 2) Insist on the black/white nature
of the issue
S 3) Declare the latae sententiae
excommunication & remove
Catholic designation of St. Joseph’s
S 4) Insistence on bishop’s role as
“decider” on natural law
interpretation
S 5) Moral martyrdom may be
required at times such as this case
Goals
Bishop Olmsted’s Application Angle
G 1) Support Bishop
Olmstead
G 2) Forestall “other voices”
from pronouncing on the
merits of the case
G 3) Exercise munus
docendi on relevant ethical
prinicples
G 4) Focus on Culture of Life
dynamic
S 1) Maintain collegial
support (at least by
silence?)
S 2) Engage Sr. Keehan &
CHA
S 3) USCCB Committee
on Doctrine note on Direct
& Indirect Abortion
S 4) Reiterate Culture of
Life theme and AntiAbortion rhetoric in other
media possibilities
Goals
USCCB’s Application Angle
In order that both may more help and benefit
themselves, let it be presupposed that
• Every good Christian is to be more ready
to save his or her neighbor’s proposition
than to condemn it.
• If s/he cannot save it, inquire how s/he
means it;
• and if s/he means it badly, correct him/her
with charity.
• If that is not enough, seek all the suitable
means to bring him/her to mean it well, and
save him/herself.
CLARIFICATIONS ?

How can a medical
procedure that seems to
directly operate against
the fetus still be
considered an
“indirect” abortion?
CORRECTIONS?

If one accepts the views
of Martin Rhonheimer,
OD et al., then
correction is not
necessary, but if one
accepts the views of
Haas, Cavanaugh, etc.
then we seem to have a
real problem. How to
decide? Who’s to
decide?
CLARIFICATIONS?
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Understanding of
“Formal Cooperation”
with evil??
The “Missing” ERD
#47?: Operations, treatments, and
medications that have as their direct
purpose the cure of a
proportionately serious pathological
condition of a pregnant woman are
permitted when they cannot be
safely postponed until the unborn
child is viable, even if they will
result in the death of the unborn
child.
CORRECTIONS?
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It seems he is mistakenly
conflating “material”
cooperation with formal
cooperation, and that
would be a significant
departure from the
Catholic moral tradition
that even as a resident
ordinary he would not be
empowered to make in his
own diocese
Interpretation of ERD #47
in this case?
CLARIFICATIONS?

How do we understand
the legitimate roles of
the moral theologians
and Sr. Keehan, etc. to
be essentially sidetracked as non-decisive
in this case?
CORRECTIONS?

Are we confusing or
equating episcopal
juridic authority with
the munus docendi such
that if Bishop X says
that Proposition “Y” is
the natural law in his
diocese then we must
conclude that Bishop X
is necessarily correct?