Wednesday, May 18, 2005

Sorry, Bill, you're wrong on this one

On May 11, Bill Donohue of the Catholic League for Religious and Civil Rights issued this press release:


For the past two years, a non-Catholic pro-life group, Alaska Right to Life, has become increasingly critical of Providence Alaska Medical Center, a Catholic hospital that is under the tutelage of Anchorage Archbishop Roger Schwietz; it has also become quite critical of the archbishop. Alaska Right to Life contends that Providence permits abortions, something the hospital and the archbishop deny.

In 2003, when Archbishop Schwietz was told by Alaska Right to Life that a procedure called early induction of labor was being performed at Providence, and that it was a form of abortion, he immediately declared a halt to it. After he concluded that Catholic ethical principles were not being compromised, he lifted the moratorium. He then asked officials at Providence to work with the National Catholic Bioethics Center to make sure that its guidelines were air tight. The Catholic community was satisfied, but it did nothing to satisfy Alaska Right to Life.

Catholic League president William Donohue commented as follows:

"It is patently untrue, and grossly unfair, to say that Providence Alaska Medical Center performs abortions and that Archbishop Roger Schwietz approves of them. To his credit, Archbishop Schwietz sought the counsel of Dr. John Haas, one of the nation’s leading Catholic bioethicists; he is a person I know and trust. Dr. Haas helped the hospital revise its guidelines, which are constantly being updated, so that there would never be any loopholes.

"Alaska Right to Life stands for a noble cause, but its intrusive manner—lecturing the Catholic community on what the Catholic Catechism says—has turned off the Knights of Columbus and the Catholic Daughters of America. Add the Catholic League to this list. The final straw for us was the April edition of its newsletter wherein it asked its members to appeal to the Vatican to intervene in this issue. This crosses the line—a secular group like Alaska Right to Life ought to learn to mind its own business. Its reputation as a meddler does not help its cause."

(You may recall that I covered the story about Early Induction for Fetuses with Anomalies Incompatible with Life (EIFWAIL) at Catholic hospitals for Our Sunday Visitor and National Catholic Register.)

Now I respect the Catholic League a lot and what Bill Donohue does for them and the Catholic Church in the United States. But, unfortunately, Bill got this one wrong on a number of fronts. I called the League on May 11 to talk with him about this. I got a call back from Communications Director Kiera McCaffrey and talked with her about it. And I did run this e-mail by them hoping that Bill would talk to me about it. The only response I got was that I could post it. So here goes:

1) Providence's CEO, Al Parrish, has told AKRTL vice-president, Ed Wassell, a solidly orthodox Catholic, that they are still doing the procedure. You see, Parrish has frequently let Wassell know when they have done the Early Induction for Fetuses With Anomolies Incompatible with Life (EIFWAIL), either by calling him or by answering the question directly when Wassell asks (strange arrangement, I know, but that is what happens). And virtually every time it has been done, Wassell has asked if it was for the life of the mother, and the answer always is "No." So even though Providence have policies in place prohibiting the practice, by Parrish's own admission, they are not following those procedures.

2) Early induction is a fairly common procedure for many different obstetrical situations, usually to intervene in some sort of life-threatening situation (life-threatening to either the mother or child). But as it is stated in the press release it would appear that AKRTL believe that any hospital doing early inductions is doing an immoral procedure, and that is wrong.

AKRTL are objecting to a very specific procedure called EIFWAIL. It is meant to terminate a pregnancy with a child that has severe post-natal, life-threatening abnormalities, such as anencephaly (a baby with only a brain stem), renal agenesis (failure of the kidneys and lungs to form) and other rare conditions. Providence and other Catholic hospitals practice this induction at 23 to 24 weeks gestation in order to get around the Ethical and Religious Directives of the US Conference of Catholic Bishops prohibition on abortion by saying these children have reached the age of viability.

As I stated in my OSV article after interviewing Drs. Thomas Hilgers and Byron Calhoun, both of whom are maternal-fetal specialists: "Both physicians emphasized that early induction can be done in these situations for the same conditions in which it would be done with normal children, such as when the mother’s physical health is imminently endangered."

But Dr. Hilgers, founder and director of the Pope Paul VI Institute at Creighton University in Omaha, Neb., made clear that "these babies should be allowed to go to term as any other babies are. The bottom line issue is, would you do this to a baby who is normal? No, you would never subject that baby to prematurity."

Here is what the National Catholic Bioethics Center has posted on its website about the procedure:
Early induction of labor for chorioamnionitis, preeclampsia, and H.E.L.L.P. syndrome, for example, can be morally licit under the conditions just described because it directly cures a pathology by evacuating the infected membranes in the case of chorioamnionitis, or the diseased placenta in the other cases, and cannot be safely postponed. However, early induction of an anencephalic child when there is no serious pathology of the mother which is being directly treated is not morally licit, emotional distress notwithstanding. Early induction of labor before term (37 weeks) to relieve emotional distress hastens the death of the child as a means of achieving this presumed good effect and unjustifiably deprives the child of the good of gestation. Moreover, this distress is amenable to psychological support such as is offered in perinatal hospice. Lastly, induction of labor before term performed simply for the reason that the child has a lethal anomaly is direct abortion. (emphasis mine)
3) Archbishop Schwietz did indeed call on the NCBC to help draft new guidelines, which was a good call. But their efforts to do so were hampered by Providence. Even after the policies were written and sent to Providence, it was not entirely clear to the NCBC staff that the hospital would even adopt them as they were free to use them or not.

Providence finally did take them. However, they will not let anyone outside the organization have them. I have requested to see them to no avail. When Ed Wassell asked to see them, he could only do so sitting in the office of a Providence administrator and no copies were allowed to be made or taken.

4) Many of the principals of AKRTL are Catholic. So even though AKRTL is officially a secular organization, its leadership and membership are made up of faithful Christian people, including Catholics. They are, therefore, rightly interested in what goes on at Providence, particularly if they are doing something as serious as EIFWAIL.

Quoting the Catechism of the Catholic Church seems to me to be a very appropriate thing to do when one is confronting a Catholic institution that is not living up to its responsibility -- even, or especially if the group doing the quoting is not Catholic.

5) Bill claimed that the April newsletter of AKRTL called on the group's members to appeal to the Vatican to intervene. That is not correct. Here's what the newsletter did say:

Since the Pope and Vatican in Rome have ultimate jurisdiction over Providence Hospital, Alaska Right to Life petitioned the Holy See in January 2004 to intervene and bring a halt to the practice of early induction abortion. The letter was signed by Karen Vosburgh, Executive Director of Alaska Right to Life. Response from such communications typically takes a lengthy period of time, because such matters are very carefully investigated.

Alaska Right to Life will continue to pursue all means at our disposal to halt early induction abortions.
However, they were not the only ones. Others also reported this to the Congregation for the Doctrine of the Faith in early 2004, so it is quite likely that Pope Benedict XVI himself is aware of it. And if you look at John Paul the Great's ad limina speech to the bishops of Oregon, Washington and Alaska last year, there are hints that he even knew about it:
5. The many initiatives of American Catholics on behalf of the elderly, the sick and the needy – through nursing homes, hospitals, clinics and various relief and assistance centers – have always been, and continue to be, an eloquent witness to the "faith, hope and love" (1 Cor 13:31) which must mark the life of every disciple of the Lord. In the United States, generations of religious and committed lay people, by building up a network of Catholic health care institutions, have borne outstanding testimony to Christ, the healer of bodies and souls, and to the dignity of the human person. The significant challenges facing these institutions in changing social and economic circumstances must not be allowed to weaken this corporate witness. Established policies in complete conformity with the Church’s moral teaching need to be firmly in place in Catholic health care facilities, and every aspect of their life ought to reflect their religious inspiration and their intimate link to the Church’s mission of bringing supernatural light, healing and hope to men and women at every stage of their earthly pilgrimage. (emphasis in original)
6) Bill's claim that the Catholic community was satisfied with what Providence did is up for debate. Maybe the NCBC were satisfied when the hospital finally adopted the policies. Archbishop Schwietz appears to have been.

Three things, though:
a) as demonstrated in number 1 above, Providence haven't implemented the policies the NCBC wrote for them;
b) the NCBC do not constitute the whole of the Catholic community; and
c) even if the archbishop is satisfied, weren't certain other prelates satisfied that clerical abusers wouldn't abuse again after getting treatment for their predilictions and their psychologists said everything was OK?

7) Besides EIFWAIL, there are serious issues with Providence that show a deep disregard for the teachings of the Church as evidenced by two key facts of which I am presently aware:

a) They have in their employ one Dr. Nelson Isada who is a known and published abortionist. He authored or co-authored numerous articles on abortion techniques while he was at Wayne State University in Detroit. Two years after he got to Alaska and was in Providence's employ, he was party to a lawsuit against the State of Alaska after the state passed its Partial-Birth Abortion Ban Act. He is now a maternal-fetal physician on staff there and the head of Providence's genetic counseling center (scary thought).

When asked about this rather incongruous situation of having a known abortionist working at a Catholic hospital, the Archdiocese told me it was a hospital issue. (But the implementation of the Ethical and Religious Directives, one of which states, "Catholic health care institutions need to be concerned about the danger of scandal in any association with abortion providers," is to be overseen by the local bishop.) Providence's response to me was, "Dr. Isada knows and follows our policies."

Prof. Kevin Miller of my alma mater, Franciscan University of Steubenville, posted the following about Dr. Isada on the Heart, Mind & Strength blog (originals are here, here, here and here) after my OSV articles were published:

3. What has Dr. Isada published on abortion?

Here are some relevant citations/abstracts:

  • N.B. Isada et al., "Fetal intracardiac potassium chloride injection to avoid the hopeless resuscitation of an abnormal abortus: I. Clinical issues," Obstetrics and Gynecology 80 (1992): 296-99.

Abstract. OBJECTIVE: With the intention of preventing the attendant medical, ethical, and legal problems arising from the birth of live-born, anomalous fetuses, we initiated a program offering fetal intracardiac potassium chloride injection as an adjunctive measure in the setting of genetically indicated second-trimester abortion. METHODS: A lethal fetal injection was offered to patients carrying chromosomally or structurally abnormal fetuses at 19-24 weeks' gestation who desired abortion. When the patient elected this procedure, real-time ultrasound guidance was used to inject 3-5 mL of potassium chloride (2 mEq/mL) directly into the fetal cardiac chambers, followed by observation of fetal heart activity to ascertain cessation. Labor was subsequently induced with uterotonic prostaglandins. RESULTS: The procedure caused immediate cessation of fetal heart motion in 20 of 21 cases. There were no maternal complications. No fetuses were live-born. CONCLUSIONS: Direct fetal intracardiac potassium chloride injection effectively causes immediate fetal cardiac arrest. This approach may be adopted in cases of abortion by labor-induction methods at advanced gestations to ensure that the abortus is stillborn.

  • Fletcher, N.B. Isada, et al., "Fetal intracardiac potassium chloride injection to avoid the hopeless resuscitation of an abnormal abortus: II. Ethical issues," Obstetrics and Gynecology 80 (1992): 310-13.

Abstract. Following the diagnosis of a genetic anomaly, some couples choose to have a legal abortion. However, following later abortions at greater than 20 weeks, the rare but catastrophic occurrence of live births can lead to fractious controversy over neonatal management. To avoid this situation, we have added fetal intracardiac potassium chloride injection to cause fetal cardiac arrest before induction of labor. The ethical issues surrounding such a practice are complex. We support this practice for three reasons: 1) The women's decision for abortion is protected because this practice assures her right for non-interference; 2) potential psychological harm to the patient and other family members is avoided; and 3) the potential for coercive intervention by other health care personnel is eliminated. At least three objections can be raised: 1) All abortions are unjust; 2) newborns and second-trimester fetuses at similar weights with identical defects should be managed in like fashion; and 3) the patient is not entitled to death of the fetus, only to evacuation of the uterine contents. On balance, we believe that our approach is justifiable ethically as it reduces the burden of conflict between the wishes of the patient and those of the neonatal care givers. It should be introduced only in situations in which the likelihood of civil or criminal liability or unwarranted medical intervention is high.

4. How else has Dr. Isada been involved in pro-abortion advocacy?

In 1997, he was one of eleven plaintiffs on whose behalf the Alaska Civil Liberties Union filed a suit against the state's partial-birth abortion ban.

b) A counselor at Providence helped a 15-year-old Laotion girl and her 17-year-old boyfriend to fly to Seattle at state expense in order for her to have an abortion. Her parents are now suing the counselor and the hospital.

8) While the Knights of Columbus and the Catholic Daughters of America have, for now, severed their ties with AKRTL, this appears to simply be a case of bad communication and misinformation. Ed Wassell has admitted to me that he did mess up in communication before and at the annual service the Knights have to honor the unborn who have died through abortion, but it was not an intentional slight. I think he would admit that AKRTL's tactics have not always been the best. But bad tactics do not amount to being wrong on this issue.

9) Finally, Bill never called the people at AKRTL to get their input on this press release. AKRTL found out about it only after I sent it to them. If I were to write a story about some controversial subject without calling all the parties involved, particularly if those parties were considered friends or allies, I would rightly be excoriated for doing such and I could possibly even be sued for libel or some other malfeasance.

Yet there's still one more thing to look at. On May 12, the day after he sent out the release on AKRTL, Bill sent out another press release, this one rightly castigating Rainbow Sash for planning on protesting at cathedrals and parishes on Pentecost. It seems to me that to attack AKRTL one day and then go after Rainbow Sash the next practically equates the two.

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