The Cathoholic

Boston's Caritas Christi Deal--What's for Sale?

This spring, when I reported on the Caritas Christi sale to one of the nation's top private equity firms, my story noted that the new buyer would maintain the Catholic identity of the hospital network. At least, that's what I was told at the time. Now, we learn that the deal includes this option: the buyer could pay an additional $25 million to dismantle all vestiges of the network's Catholic identity, including adherence to Catholic moral teaching.

The recent controversy in Phoenix over the morality of a direct abortion at a Catholic hospital underscores the fact that mainstream health care ethics doesn't necessarily conform to Catholic teaching. Critics of the Caritas deal charge that the $25 million opt out fee suggests that even the church's commitment to the sanctity of life is for sale. An additional concern is how this opt out clause--if executed-- would affect the pro-life physicians and nurses who now serve patients through the network.

Bishop Olmstead's Excommunication

Not too long ago, Bishop Olmstead of Phoenix provoked a firestorm when he issued his public judgment that Sister McBride--the administrator at the Phoenix Catholic hospital that approved a direct abortion in 2009--incurred "automatic excommunication for signing off on the procedure. Disputations' David Gibson provides  blackboard illustration on the brutal mechanics of the excommunication. If you want to catch up with the controversy, you can catch my story in the National Catholic Register.

UPDATE: This week, the USCCB Committee on Doctrine issued a statement backing Bishop Olmstead's controversial judgment. The statement of support reflects, no doubt, the U.S. hierarchy's awareness that many American Catholics and healthcare providers don't understand the difference between direct abortion and medical procedures intended to address a pathology that have the indirect effect of ending the life of the patient's unborn child.

Bro. Dan Sulmasy appointed to Obama Bioethics Commission

My story in the National Catholic Register on the differing missions of the Bush-era Council on Bioethics and Obama's  Commission for the Study of Bioethical Issues provided an opportunity to compare the ethical concerns of two administrations. At the same time, Catholic moral theologians and bioethicists applaud the recent appointment of Bro.Dan Sulmasy, OFM a top physician, clinician and bioethicist -- now at the University of Chicago -- to the new commission. The question now is: How will this new commission fulfill its mandate -- given the president's "pragmatic" stance on issues like embryonic stem cell research. My interview with Sulmasy in the National Catholic Register  provides a timely opportunity to consider whether a presidential commission charged with developing practical policies on controversial matters that divide the body politic will offer full-bodied guidance and not simply utilitarian strategies that ignore moral absolutes.

The Catholic Bishops: Feed PVS Patients

Not long ago, fears of health care rationing following the passage of the pending health care reform bill led some pro-lifers to warn of "death boards," and othe government-imposed instruments designed to set limits for the care of the elderly and chronically ill. Supporters of the Democrats' health reform initiative insist these fears are misplaced, and we must hope they are right. However, the intense national debate provoked by the Terri Schiavo case underscored the need for tightened guidelines on the care of PVS patients.

In November, the U.S. bishops acted to strengthen the standards of care at their meeting in Baltimore, and here is my report for the National Catholic Register on their revised Ethical and Religious Guidelines that will render obligatory the artificial feeding of PVS patients--unless death is imminent or the patient is unable to tolerate this care. My story acknowledges that many "Catholic" bioethicists dispute this obligation; it will be up to the bishops to effectively engage this resistance and secure the adoption of these revised standards in Catholic institutions.

Register Article on NIH Guidelines for Stem Cell Research

 

Federal Clone Battle

NIH Guidelines on Stem-Cell Research Spur Pro-Life Fears

BY JOAN FRAWLEY DESMOND

REGISTER CORRESPONDENT

May 10-16, 2009 Issue | Posted 5/1/09 at 8:05 AM

WASHINGTON — The fight over stem-cell research funding is far from over.

Although it seems the pro-life cause lost a battle when President Obama signed an executive order for federal funding of human embryonic stem-cell research, a new battle looms.

That battle may decide whether to create human embryos solely for the sake of medical experiments, putting them at risk of death.

Responding to the executive order, the National Institutes of Health (NIH) issued draft guidelines in mid-April that have alarmed pro-life activists seeking to maintain a ban on practices that permit the creation and killing of human embryos solely for research or that employ cloned human embryos.

At present, the NIH guidelines only address the use of stem cells derived from human embryos created through in vitro fertilization (IVF) procedures at fertility clinics. NIH officials describe the proposed rules governing the informed consent by donors as an attempt to “ensure that NIH-funded research in this area is ethically responsible, scientifically worthy, and conducted in accordance with applicable law.”

But pro-life activists and bioethics experts on Capitol Hill assert that the NIH guidelines raise serious questions about the direction of federal policy regarding embryonic stem-cell research. Critics also contend that the guidelines governing the “informed consent” of donors do not fully address the range of ethical issues likely to surface as parents consider donating their embryos to science.

Instead of establishing a transparent, “ethically responsible” approach to cutting-edge research, pro-life leaders believe the proposed guidelines actually signal a worrisome new development — the advancement of a stealth strategy to overturn the Dickey-Wicker Amendment. That amendment prohibits “research in which a human embryo or embryos are destroyed, discarded, or knowingly subjected to risk of injury or death”; this language has been employed to limit creation of new stem-cell lines.

Though researchers using adult stem cells have produced a string of cures and scientists can obtain embryo-like pluripotent stem cells through the reprogramming of adult stem cells, many politicians, patients’ advocates, and scientists still clamor for more expansive federal guidelines and funding for embryonic stem-cell research. In the past, the majority of Americans have endorsed this campaign, in part, because they believe “spare” embryos would otherwise be discarded as “medical waste.” 

‘Stealth Attack’

Now, Cardinal Justin Rigali, chairman of the U.S. bishops’ Committee on Pro-Life Activities, contends that the NIH guidelines have altered the moral calculus that once secured broad support for an illicit practice. “Despite supporters’ constant claim that this agenda involves only embryos that ‘would otherwise be discarded,’ the guidelines provide that the option of donating embryonic children for destructive research will be offered to parents alongside all other options, including those allowing the embryos to live,” he said.

He added that the guidelines allow destruction of newly created embryos that were never frozen, increasing the prospects for a rushed and biased consent process on the part of parents using IVF.

Rep. John Fleming, D-La., a physician and an opponent of embryo-killing stem-cell research, is concerned about the “vague” language employed in the guidelines to address a variety of ethical problems — including conflicts of interest that will inevitably surface when research “occurs under the same roof as fertility treatment.”

The NIH should insist on a clear “separation between the fertility clinics and the researchers who want the embryos,” said Fleming. “What will prohibit the stem-cell researchers from pressuring the fertility doctors to ‘encourage’ the donation of more embryos?”

However, the NIH guidelines also present a much larger problem for pro-life activists. “The draft guidelines repeatedly refer to the limitations imposed by the Dickey-Wicker Amendment,” noted Fleming. “It looks like the amendment has a big target sign on it, inviting congressional action. We need to be prepared for a stealth attack on the Dickey-Wicker Amendment as Congress moves through the annual appropriations process.”

Douglas Johnson of the National Right to Life Committee has already alerted his network of activists to prepare for a political battle that could stay under the radar of most Americans.

Some news reports on the NIH guidelines suggested that the status quo on stem-cell research has remained essentially unchanged. But Johnson notes that Obama’s March 9 statements and directives “made no reference to limiting NIH to the use of stem cells taken from ‘leftover’ embryos, or limiting NIH to the use of embryos created through IVF.” 

Democratic Dominance

Indeed, the Democrats’ dominance on Capitol Hill has encouraged advocates to set more aggressive goals.

“I am pleased to see the NIH has moved quickly to draft the guidelines required by the executive order; however, I believe there is opportunity for more expansive guidelines,” said Rep. Michael Castle, R-Del., a co-sponsor of legislation designed to increase federal funding of embryonic stem-cell research.

Most likely, the cloning of human embryos for research purposes is on the horizon, though the NIH guidelines skirted this contentious subject. Johnson points to a March 20 article in Science that acknowledges that many scientists “would like to work with [stem-cell] lines created through research cloning or somatic cell nuclear transfer,” an alternative cloning process.

As pro-life activists in Washington position themselves for the political battle ahead, they have gained an appreciation for Obama’s adept management of a difficult issue. The decision to give NIH responsibility for developing new guidelines, they contend, allows the president to keep a hot-button topic at arm’s length, while asserting that scientific inquiry — not political calculation — guides federal policy.

“I am beginning to understand the president’s reason for giving NIH the responsibility to design the rules. They are crafted wisely from their point of view,” explained Yuval Levin, director of the Bioethics and American Democracy Program at the Ethics and Public Policy Center.

“The guidelines allow everything that is already being done and do nothing to prevent future developments,” said Levin. “For the moment, there is no need to explicitly address research using cloned embryos, for example, because they are trying not to get ahead of the science. But as science changes, the rules can be changed.”

Joan Frawley Desmond writes

from Chevy Chase, Maryland.

Cardinal Pell Defends Pope on Condoms & AIDS

Cardinal Pell of Sydney, Australia has defended Pope Benedict, the target of global attacks for his skepticism regarding condom-based programs to slow the AIDS/HIV infection rate in Africa. Argues Cardinal Pell in the Melbourne Herald Sun:

"To blame Catholic teaching for the spread of HIV/AIDS requires proof that those following the first essential Christian requirement of living chastely within and before marriage are still dying of AIDS. Pigs will fly before that argument does.

"Others suggest another variant of the anti-Catholic line, namely that Christians who refuse to obey Catholic teaching against adultery, fornication and homosexual intercourse will still follow Catholic teaching against the use of condoms.

"Truth can be stranger than fiction, but such an individual would be rare indeed."

Time: Obama & Catholics

Time Magazine has a piece on Obama's increasingly tense relations with moderate Catholics who voted for him. The thrust of the article is that the White House should show a bit more finesse in its dealings with those "values voters."  True, some religious Americans, including liberal and moderate Catholics, voted for Obama because they shared his positions on economic and foreign policy issues. They were prepared to tolerate his policy on abortion and other life matters.  However, the article suggests that Obama's recent characterization of opposition to embryo-destructive stem cell research as "a false choice between sound science and moral values" has backfired.  

Here's what Time says:

"Leaders at the U.S. Catholic Bishops Conference denounced the decision, calling it "morally wrong." And a Vatican bioethics official criticized it as "a victory of politics over ethics." But what White House advisers didn't expect was the pained anger in the reactions of far more moderate Catholics. An editorial in the liberal Catholic magazine Commonweal accused Obama of "obfuscat[ing] the moral dilemma by resorting to imprecise talk about the supposedly self-evident authority of scientific 'facts' and the alleged ideological agenda of those opposed to embryonic-stem-cell research." At the websiteBeliefnet.com, religion writer David Gibson labeled the decision "Obama's Stem-Cell Flop." 

The Time article also noted that while the White House marks a new Renaissance of value-free "science" -- along with the miracle cures advocates of embryonic stem cells have promised Americans for years,  a lot of real cutting-edge science has rolled forward without destroying embryos. Indeed,  "for some scientists, it [increased access to embryonic stem cells]  almost doesn't matter.. " Here is Time's list of the top 10 medical breakthroughs of 2008. 

The larger point for Catholics (as Dr. William May, my moral theology professor at the John Paul II Institute for Studies of Marriage and the Family often pointed out) is that moral absolutes that establish the boundaries beyond which we cannot go--such as the direct killing of innocent life--are actually a force that expands our creativity,  in concert with God's loving plan for  the human person. 

Postscript: A caveat about Time's list of the top 10 medical breakthroughs: one of those breakthroughs is a new, still experimental blood test that will allow mothers-to-be to test their unborn child for Down syndrome. Ultimately, the benefit of the test is that it will allow pregnant women to avoid more invasive pre-natal testing, which carries the risk of causing miscarriage. And once researchers develop in-utero therapies for children with this condition, this new blood test will come in very handy. However, at present, such tests are primarily employed for the purpose of "weeding out" and destroying such children before they are born. Thus this particular breakthrough cannot be celebrated by anyone who seeks to protect these children.  

First Things offers a worthwhile reflection by Amy Julia Becker, the mother of a Down syndrome child who is a divinity student at Princeton:

"For a long time, I was looking for answers to questions that were hardly worth asking, and I was trying to recreate my daughter according to a cultural standard of normalcy rather than according to a biblical understanding of full human life. We are created in the image of God, recipients of divine love and grace, and we bear the responsibility and privilege of extending love into the world here and now, and forever more.

"Two and a half years after Penny was born, I don’t think of her as defective, or retarded, or abnormal. I think back to that first evening of her life, when I cringed at the words about the baby next door: “She’s perfect!” I still wouldn’t call Penny perfect. I wouldn’t call any human being, besides Jesus, perfect. I am well aware that Penny needs healing and redemption through Christ, as do I. And Penny’s nature, I hope and pray, will be redeemed through Christ as she becomes the whole person she was created to be. I suspect Penny’s whole person will include three twenty-first chromosomes, but only because any aspect of that extra chromosome causing separation—physical, emotional, relational—will be overcome."

For those interested in learning about research designed to help, not harm persons with Down syndrome: check out the Down Syndrome Research and Treatment Foundation co-founded by Patty O'Brian White, a dear friend of mine whose fourth child, Amy, has this condition. Patty is joined by other parents and dedicated scientists "committed to finding treatments to improve cognition and prevent early  dementia in persons with Down syndrome."

Protect Conscience Rights in Health Care

The U.S. Bishops have called on Catholics to protest  President Obama's plan to rescind provisions that beefed up protections for physicians, pharmacists and other federal health care workers under pressure to participate in abortions or provide emergency contraceptives, among other issues. The Department of Health and Human Services (DHHS) is inviting public comment on Obama's plan. This is time to make your views known to the Office of Public Halth and Science at  the DHHS.

* Online through  www.usccb.org/conscienceprotection

* By emailing directly to proposedrescission@hhs.gov

Don't wait, TAKE ACTION NOW !!!  The deadline for comments is April 9 -- just four days to go!

Postscript:

The Senate voted against the conscience provision.

Donor Offispring & Human Identity

Just read an interesting piece in the excellent pro-life journal, the Human Life Review about "Donor Offspring"--the children born from women or men who use anonymous sperm or egg donors to fulfill their dreams of having a family. Author John Burger, the news editor of the National Catholic Register,writes a touching and thought-provoking portrait of the sometimes crushing emotional toll of this practice on the donors' biological sons and daughters. These young people seek to heal their fragmented sense of identity by locating the missing person or genetic component that might help explain their own habits and values. But when they fulfill their mission, the encounters can be deeply disturbing.  Imagine suddenly discovering in an Internet chat room that you have multiple half-sisters and brothers: Is it comforting, or do you get the feeling that you're simply one more human "product" churned out by the local fertility clinic?  

The Catholic Church has long held that each human person possesses a "right" to be born through the loving act of their mother and and father. Though it may seem abstract and unfeeling, that teaching is partly designed to protect early human life from Brave New World experiments. It also acknowledges that the order of love, designed by a Creator who is Love, offers the "one flesh" union as the way to bring human life into the world, affirming the unitive and procreative dimensions of married love. Christian anthropology, rooted in the Incarnate Word, arises from an integrated vision of the human person in which the body reflects an individual's deepest values. Thus, the human body -- our body or anyone else's -- cannot operate, nor be treated, like a machine.  

Decades ago, the tragedy of infertility first led scientists to provide cutting edge reproductive technology to assist married couples, then single people and gay couples gradually joined in. Meanwhile, the nation's fertility clinics preside over hundreds of thousands of frozen embryos, some of which will be used, and then destroyed in stem cell research, and -- not too long in the future -- some of which will be appropriated for human cloning. 

Back in 1995, the University of Chicago's Leon and Amy Kass offered their take on such matters in a prescient First Things article, "What's in a Name?" that is well worth reading.

Postscript: For those ready to inhabit the existential world of human clones, try reading Never Let Me Go, by novelist Kazuo Ishiguro, the author of The Remains of the Day. Beautiful and tragic.

The Pope and AIDS in Africa

As I mentioned in a previous post on Pope Benedict XVI and condoms, many well-intentioned people have long believed that Catholic opposition to condom use has worsened the AIDS epidemic.  Thus when the pope questioned the strategy of making condom distribution the centerpiece of AIDS/HIV prevention, many critics piled on,  and suggested his views fueled the infection rate for HIV on the continent.  At the Atlantic, blogger Ross Douthat is fed up with the drumbeat of recriminations against the pope and asks for hard evidence that Catholic teaching on condoms has  exacerbated the epidemic in Africa. Writes Douthat:

"Do religious Africans have higher infection rates than the irreligious? Do heavily-Catholic populations contract HIV in higher numbers than Muslim, Protestant, or animist populations? Are frequent mass-attenders more likely to contract the disease than infrequent churchgoers? Do graduates of Catholic schools have higher infections than their peers? Are Africans who seek treatment at Catholic hospitals more likely to pass the disease along than people who get their medicine from secular institutions?"

Until such hard evidence is available, Douthat suggests that papal critics ponder another set of facts that might actually be more relevant on the ground in Africa:

".... consider that Benedict XVI is the head of an international institution that does as much to fight disease and poverty as any NGO in the world. The Church runs hospitals, clinics, and schools; it channels hundred of millions of dollars in donations from the developed world to the wretched of the earth; it supports thousands upon thousands of priests, nuns and laypeople who work in some of the most difficult and dangerous conditions in the world. And it does so based on the same premises - an attempt to be faithful to the commandments of Jesus Christ - that undergird the Pope's insistence on preaching chastity, rather than promoting prophylactics."