To the ethics committee:
The church decided to become non-denominational. Although the hospital is no longer affiliated with the Catholic Church, I understand non-denominational to still be Christian but without an association to any specific church under Christ such as Protestantism and Catholicism. At the forefront of a non-denominational church are the messages and values of the Bible. Though the Bible has many different interpretations, the Bible sends a message of valuing human life, since it is granted by God. Still being a non-denominational (not non-religious) affiliated hospital, the hospital should still be firm in its conviction and follow God’s words.
Catholics believe that life begins at conception while others believe that life can begin after a certain amount of months, after the baby is born, or even after the baby can start to reason. Why is there an argument over when life starts? If God granted us with the blessing of life, then why are we trying to deny our blessings? A life is a life is a life. Being specific over when life start then becomes a worldly matter and provides an excuse to rationalize one’s decision to perhaps get an abortion. Thus, since conception makes a zygote, which then turns into a fetus, and eventually an embryo, life starts at conception, for those who want to be specific of when life starts. Thus, services such as prenatal testing, IVF treatment, and abortions should not provided at this hospital. I still would like the patients to be informed. I would like them to know the benefits, risks, and alternatives (all sides of the situation) before they still make a decision. Hopefully, after all the genetic counseling as well as non-religious, moral counseling, the patient will decide not to have an abortion.
Mary, the mother of God herself, was blessed with a human life, with Jesus. When angel Gabriel came to tell her that she was going to give birth to the son of God, she was really scared; she was just a teenager. She could have decided to reject Jesus’s life because as some people would say, he was not human or a person yet. Even if they did not have abortion, I believe that if Mary said no to God’s plan for her then God will not have continued to make her give birth to Jesus. However, despite the fact that Jesus was still a fetus then, Mary decided to continue to nurture him in her stomach and eventually give birth to him. Where would Jesus be if he was not born? Similarly, abortion, despite the circumstances, can neglect the future life of the fetus that you were blessed with because your mom did not reject you.
As a Catholic nun, who was raised in a non-Catholic family and converted as a young adult, I do not believe that we should begin providing and subsidizing abortion services for under-insured patients. Every life, which is started at conception, is a gift from God—no ifs, ands, or buts—and thus should be protected. By providing and helping to pay for these services, it shows that we are in support of humans having the right to place or take away value on an innocent life (Donum Vitae 1988: 147).
Moreover, I agree that everyone should have equal access to healthcare. I understand that there are Jewish people (Kahn 2000), Japanese immigrants (Ivry 2009), and Lebanese immigrants who are Shi’ite Muslims who might want abortion services as well as IVF treatments. These IVF treatments may be more attractive than other reproduction methods because for example IVF is funded in Israel to encourage woman to have babies (Kahn 2000). However, patients are coming into a hospital that is known to be Catholic but now non-denominational. It is logical that we follow values of non-denominational Christianity. If we did not follow values of our religious affiliation, then why are we even affiliated with any religion? I would suggest that we refer patients who would like abortion services or even IVF treatments and prenatal testing to another hospital or clinic However, I would only refer them after they have been informed from medical professions and received generalized non-religious counseling. Though some might see this as hypocritical of me to say this, above all the rules and regulations of Catholicism, we are taught to love our neighbors. Though they are seeking something that I would not approve of, I would still like to keep their safety in mind. They might seek unsafe ways of abortion. If even after counseling and informing patients on alternate options and patients still would like to have an abortion, I would rather that it be a safe procedure to help protect the life of the woman.
In terms of extreme cases such as rape, I still do not think abortion should be allowed. There are alternatives. Babies of rape victims can be put up for adoption. Bad things can happen to good people, but that does not mean we should then inflict those consequences on a future baby. They should still have a right to life.
Furthermore, I do not think we should support IVF treatments and prenatal testing including amniocentesis. These services “expose [man] ‘to the temptation to go beyond the limits of a reasonable dominion over nature’” (Donum Vitae 1988: 141). A life is not ours to say whether or not it should be worth living, even if it may be in a woman’s womb.
Prenatal testing and amniocentesis give patients the knowledge and the chance to “play God”, to be able to choose whether the life of a fetus is worth living or if the patient is able to care for the fetus when born. Prenatal testing gives the mother knowledge of either presence or risk of a genetic disease. This knowledge can induce fear of not being prepared or capable to care for someone who has a genetic disease. Although some people believe that they have a right to know if their fetus is going to have a genetic disease, some people believe that they have the right to not know(“The Burden of Knowledge: Moral Dilemmas in Prenatal Testing” 1994). The latter allows them to practice the virtue of patience but encourages them to love the child as he or she is. Furthermore, amniocentesis is an invasive process, and when getting this procedure, the patient has a 1:200 chance of getting a miscarriage, which is the same ratio of chance of a patient’s baby having Down’s syndrome if the patient is older. Additionally, according to one of the parents in The Burden of Knowledge: Moral Dilemmas in Prenatal Testing, being a parent includes the commitment to unconditionally love one’s baby, and choosing to get an abortion because of a genetic disease interferes with that commitment. Also, if given the option, “an infant wouldn’t choose to die like an adult would choose to die at the end of his [or her] life” (“The Burden of Knowledge: Moral Dilemmas in Prenatal Testing” 1994).
Some would argue for abortion in that any right that she may give up still pertains to her (Thompson 1971: 51), but however, there are differences between rights innate to us as humans and rights that are given to us by God. Right to not carry a baby in her stomach and denying the right to a life that is already there. Another point made in rebuttal is that a fetus is still a part of the mother before a certain stage (Thompson 1971: 60). Because the fetus is a part of the mother, then aborting the baby will be killing a part of the mother. Thus, protecting the life of a baby is protecting the life of the mother.
Giving these services and allowing patients to choose whether or not to keep the fetus further puts a stigma on people with disability. Why is it okay to have a normal baby whose personality might drive one crazy rather than a baby with Down’s syndrome? Why is it not normal to have a baby with Down’s syndrome? This is answer is due to societal pressures and a pressure to look like everyone. Lastly, these services only test for certain genetic diseases. There are a million other things that could go wrong during a pregnancy that we do not have technology to test for. If money and fear of not being able to provide the necessary care for children with genetic diseases arise, then there are still options such as putting the baby up for adoption. For example, according to the documentary “The Burden of Knowledge: Moral Dilemmas in Prenatal Testing”, there is waiting list of people wanting to adopt kids with Down’s syndrome (1994).
Though the local area is home to those who are in favor of IVF treatments, abortion, prenatal testing and amniocentesis, the hospital was based on Catholic roots. I think the Catholic roots should be respected. The hospital was able to make it where it is today while respecting Catholic roots. Additionally, the donor base is still prominently Irish Catholics. The hospital operates mostly from funds from our donors. Since we are choosing to subsidize medical care for under-insured patients, this hospital cannot function without our donor base, and thus the hospital should look to uphold Catholic values.
Our society, which seems to be more secular than before, are still strongly tied to and influenced by religious values. Similarly, the influence of the way the hospital is run is still influenced by religious values. Catholicism, which aligns with non-denominational Christianity, speaks to something more than just a rule or a positive deed. Its values are based on natural law, rights that we believe to be innate to our own human being. The chances of a sperm and egg becoming a zygote is very slim; hence, this is the reason why during IVF treatment women have to give more than one egg to ensure that an embryo forms. It truly is a blessing if an embryo is formed.
In addition to social workers and genetic counselors, the hospital should continue to provide spiritual counseling by Catholic clergy. Because the hospital is non-denominational, I believe that we should open up counseling by clergy, in additional to Catholic clergy, to those of Protestantism and non-denominational Christianity. If people would like counseling from another religion, I would refer them to a clergy of their own practice outside of the hospital, keeping in line of the convictions of non-denominational hospital.
Though medical staff are expertise on their technical knowledge of medical treatment and procedures, I do not think they should be superior to the clergy. Medical staff have knowledge on a specific expertise in their specific field. They have knowledge on technical procedures. However, a lot of the moral decision-making come from a conceptual standpoint that society tends to fall back on religion to help answer. (Braun 2005:45) There are conceptual, moral questions that I do not think technical experts should be the only person to help decide.
On non-religious and moral standpoint, there is no rational statement that a fetus is nothing other than human (Arkes 1986: 388).
Catholic clergy are not making a rushed decision but rather carefully thinking through the decision. We Catholics make our decisions based on natural law. Natural law refers to rights that are embedded in nature and that can be reasoned out. Therefore, natural law cannot be opposite of what Scripture says. Both reason and Scripture influence each other. Natural law is also evident in the Declaration of Independence, a document that is dear to the hearts of all Americans. It states that we Americans have self-evident rights, which are then listed as life, liberty, and the pursuit of happiness. Life here is extended to the life of unborn people as well since life starts at the point of conception. Thus, the reason that the Catholic Church makes universal claims that we think others should also consider is because they are grounded in natural law.
Our historically Catholic nursing staff has been alarmed by the possibility that the hospital will now provide abortion and reproduction services. I do not think that abortion services should be provided. The nurses and medical staff should make sure that the patients do know all the current options available. Being misinformed can result in a decision that the patients are going to regret, especially while carrying fetus and while the woman’s body is going through hormonal changes. For example, if some patients knew that there was a waiting list of people wanting to adopt children with Down’s syndrome, they would not have continued with abortion. Making sure to reiterate their options to the patients will help them to make a more informed decision. I would ask the nurses to listen to the patients to see their reason for doing such procedures and see if there is anything the nurses can inform them about to help them make their decision.
There have been some interests in opening a clinic close by that provides prenatal, IVF, and abortion services that is not affiliated in any way to the hospital. I am opposed to the idea of opening a clinic close by that is not affiliated with the hospital because of my universal Catholic values. However, I still want to protect life. That being said, I cannot stop what the ethics committee ultimately decides. I will say that although technology has helped to advance medicine and treatment in our society, not every technological advancement is necessarily morally right.
Though we no longer in Biblical cosmology, Biblical cosmology can still continue to shape our society (Delaney 1995: 188). Our subconscious knows that life is precious. Killing a person can bring much guilt to a person. Conception brings about life that cannot be denied. If you had been someone with Down’s syndrome, and your parents decided to terminate you, how would you feel? Though at that point, one probably would not be able to feel, one also does not have the right to decide to terminate another person’s right. Every human, fetus, and embryo has the self-evident right to life.
I believe that my perspective and viewpoint broadens this discussion amongst the people within the ethics committee. I give my own angle to this difficult, moral problem. Without presenting many, different perspectives, the people who have a say at this ethics table will have a more narrow, less multi-faceted overview of how to proceed.
God bless,
Sister Nguyen
Dear Sister Nguyen,
I really appreciate your policy proposal on how our hospital should go forward on these important issues. From a physician standpoint there is a lot we may disagree on, but I also think there is a way for us to find some common grounds. I think it was interesting that you referred to prenatal testing as ‘playing God’. I would understand if someone called a procedure such as an abortion ‘playing God’ but prenatal testing is simply a test to learn more about someones unborn child. If this would be called playing God, should treatment of cancer also be called playing God? After all, I think many people could argue that a person getting cancer and dying as a result from it may have been God’s will. Us prolonging someones life and curing the cancer, may also be then considered playing God because we are changing what God’s will may have been. What if we said that humanity creating procedures such as prenatal testing was also God’s will and because of this we were able to have such technologies, and we should thus use them. I think the whole argument of someone playing God is a very slippery slope and can be used in many different forms and ways for different kinds of arguments. I also do not agree with you on the points of abortions and IVF. I think it is anyone’s right to refuse to perform an abortion or IVF treatment, but I do not think we have to ban it entirely. Both procedures are legal in the United States and if there are physicians able and willing to perform them, they should be allowed to. I think both sides should be able to freely choose whether or not they would like to perform such a procedure instead of banning it completely. I must say I am surprised to learn that you would oppose abortions even if the women are victims of rape and I do not think this would be a reasonable policy. Furthermore I was even more surprised to learn that you referred to women being raped as just a ‘bad thing‘ that can happen. At this point I am really curious to learn about your point of view for abortions where the mother’s life is in jeopardy? Should we also not perform those because it would be playing God, or should we offer to perform them because we would be saving a human life? I understand that coming from a catholic background you would prefer having mostly catholic clergy at the hospital. I understand and agree that our hospital’s clergy should be mostly catholic because of the hospitals history, but I do not see how it could harm anyone to have clergy from other religions there, too? After all, Christians are not suddenly going to decide to convert to Islam or Judaism, when they hear that clergy of those religions is available for counseling, too. I think especially with the recent influx of Lebanese Muslim immigrants as well as our rising Jewish community it would not hurt to offer Muslim and Jewish clergy for counseling. I do not think this would in any way bother any of our patients or affect the care at our hospital. I look forward to working with you on a final proposal for the hospital and to discuss our differences of opinion.
Best,
Wall, M.D.
Dear Sister Nguyen,
Thank you for providing a very thought provoking proposal to our ethics committee. Although we hold differing opinions on most of the instances we are attempting to address, I found your insight to add an interesting point of view on some topics.
For one, I thought your repeated assertion of making sure patients were as informed as they could be in order to make a decision was and important point to make, and I agree. Patients should be well informed, both from genetic and non-religious counseling services, for I think it allows them to better understand their situation in full. I appreciated that you were able to acknowledge that even though a patient’s beliefs might differ from your own, making sure the patient was well informed and safe remained one of the most important things to you.
Also, while I agree that arguing over when a life truly starts makes the concept a life a worldlier matter, I think it is hard to neglect these debates. The debate on when life begins is a tricky subject because, for the most part, people are uncompromising in their beliefs, whether they be rooted in religious or non-religious reasoning. I don’t for see a settlement on this debate any time in the near future, but I disagree with your statement that we shouldn’t be arguing over this. I think it is too prominent of a matter in the realm of bioethics and medical technology to simply be neglected based on one religion’s assertion that life begins at conception.
While I understand and respect your suggestion to not provide abortions, I disagree with your statement that choosing to get an abortion because of genetic disease interferes with the commitment one has to love one’s baby unconditionally. I think there are many more considerations that go into the decision on whether or not to get an abortion due to genetic diseases ranging from inability to take care of a child or fear that you will not be able to provide the child with the life it deserves. However, I do agree with you and think educating people on the alternatives to abortion, like the list of people looking to adopt Down Syndrome children, could lead more individuals to not follow through with abortion. Also, I think in the case of rape, not being able to have an abortion could lead to psychological traumas for the women. Having to carry your rapist’s child can serve as a constant reminder of the terribly traumatic event that occurred, and personally, I don’t think many women would want to go through with a pregnancy after rape, but I know that that is just my personal opinion.
When you state that providing services such as IVF and prenatal testing puts stigma on people with disabilities, I completely disagree. I don’t believe people are choosing to get abortions because their baby might have disabilities for the purpose of them not being ‘normal’ or due to pressure from society to look like everyone else. I find this to be an invalid argument because people are factoring many other things after realizing they could potentially have a baby with a disability. While you say there are a million other things that could go wrong with a pregnancy that we don’t have the technology to test for, I agree, but wouldn’t this change soon? With the rapid development of technology, especially in the world of medicine, people are seeming to become quicker to jumping onto new medical technologies when they are presented to them. I think that as soon as medical technology provides more insight into other technical problems of pregnancy, people are going to want to have access to these technologies, especially if they could potentially prevent life altering diseases for their children.
Overall, I appreciate the insight you provided in your proposal because it allowed me to think of the topics we are approaching from a different viewpoint. I also respect the dedication you have to your faith, while also recognizing that others might view things differently than you.
Best regards,
Dr. Nestor
Hi Sister Nguyen,
I wanted to thank you for proposing a policy for the hospital ethics committee in the continued attempt to understand the assisted reproductive technologies we are discussing. As a Hindu, Indian-American physician and researcher, I found myself disagreeing with your proposed policy in many instances. However, I understand that our backgrounds and professions are different and that affects our viewpoints when discussing these topics.
While I disagreed with your stance on abortion and IVF, I was taken aback by your statement regarding abortion in the case of rape. As a woman, I find it shocking that you would discuss it as “bad things can happen to good people.” I believe that the emotional pain would be unimaginable to force a woman, who has been raped, to bring a child of their attacker into the world. I think that should be a decision left to the woman, as she would have to be constantly reminded of the instance throughout the pregnancy. If the woman chooses to put herself through that, it is up to her, but I don’t think there is a right for any hospital or healthcare provider to persuade a woman in any direction.
The hospital has become non-denominational, which is defined as “a person or organization that is not restricted to any particular or specific religious denomination.” My interpretation of that definition differs with yours, in that I do not think there is an affiliation with the Church in more of a capacity than there is an affiliation between the hospital and the teachings of Judaism, Islam, Hinduism and the other major world religions. While you discuss your policy from a non-denominational Christian standpoint, I want to point out that there is the ability to discuss the same policy from a non-denominational Jewish and non-denominational Muslim perspective as well. Since your hospital is the only one within a 45-minute drive, I believe the hospital should incorporate the religions of the community it serves, as the hospital will not only be providing services for a Christian community. This does not mean the hospital is “non-religious” but rather inclusive of other religions practiced by the patient population the hospital serves. I think this nuance is the source of the disagreements I have with the policy you have proposed.
I hope I was able to relay my feedback regarding your policy proposal and I hope that it can change your understanding of the necessity for some of these reproductive technologies.
Best,
Greeshma Magam, M.D.