Author: Giang T. Ha

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

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). 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 gives 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 does not tell a patient if his or her baby has a genetic disease. It only tells patients if the baby is at risk. In order to ensure a baby has a certain genetic disease, then amniocentesis should be carried out. 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, 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).

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 revered. 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.

In addition to social workers and genetic counselor, the hospital use to provide spiritual counseling by Catholic clergy. This counseling should be continued and not open to clergy of other religions. These Catholic values are not just Catholic. They are humane values of humans valuing other human’s lives. They are values any human could have if they have respect for human life. Though I understand that the medical staff believes that the Catholic clergy are interfering with their work by opposing assisted reproductive technology and late term genetic testing, the medical staff can sometimes be close-minded to not the argument that the Catholic clergy are making. The medical staff can make decisions that they think are the best for the patients but fails to think about its consequences on the fetus. The decision to end a life of a fetus is not favored by us Catholics who also believe that our beliefs align with natural law.

Catholic clergy are not making a rushed decision but rather carefully thought out. We Catholics make our decides 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. For those nurses who are unwilling to perform these procedures, I’d say I would respect their decision and allow them not to perform these procedures. They 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. I would then tell the nurses, if any, who are willing to perform these services to go ahead with them.

I will also try to remind the nurses that ultimately, although I am also against these services, if the hospital starts to provide these services, that we are all children of God. The first commandment that God gives us is to love one another. We are not all perfect and strong enough to decide to have reject these abortion and reproductive services. Shower patients with love and patience while they are going through a difficult moment in their life. Unless they would like to resign from their position or continue to express their discontent to the administrators of the hospital, I would leave the work  with those are willing to do the services. In the case of having no nurses to provide the nurses, then the hospital should reconsider providing abortion and reproductive services especially if some funds will be lost and nurses refuse perform procedures. The hospital has to decide which is more important: serving the patient population or continue operating and functioning as a hospital.

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.

God bless,

Sister Nguyen

The Scripture lays the foundation for most of the discourse on reproductive ethics. In the second chapter of Genesis, it says that “a man leaves his father and mother and becomes attached to his wife… they [will] become one flesh”. This shows God’s image of marriage between a man and a woman. The first chapter of Genesis retells the story of how God created the Earth. This first chapter of Genesis summarizes and emphasizes that God is Creator and that he urges man and women to “be fruitful and multiply”, to bear children in his image. This understanding is the basis of what the Congregation for the Doctrine of the Faith published on the morals of medical intervention for child-bearing (Shannon et. al 140-173). The document understands the power that medical technology can give to man, and even though God gave man dominion over all animals and land, medical technology “can enable man to ‘take in hand his own destiny,’ but they also expose him ‘to the temptation to go beyond the limits of a reasonable dominion over nature”( Shannon et. al 141). From the anthropological side, Pope John Paul II says that “each human person, in his absolutely unique singularity, is constituted not only by his spirit, but by his body as well” (Shannon et. al 144). Therefore, anything that does harm to the body also does harm to the soul. From the support of Genesis, Crossroad argues that “no one can in any circumstance claim for himself the right to destroy directly an innocent human being” (Shannon et. al 147).  This understanding supports the stance that human life should be respected and cared for since conception (Shannon et. al 148).

That human life also has “the right to be carried in the womb and brought into the world and brought up within marriage: It is through the secure and recognized relationship to his own parents that the child can discover his own identity and achieve his own proper human development (Crossroad 158). Furthermore, the parents will also have a sense of fulfillment of “self-giving: the child is the living image of their love, the permanent sign of their conjugal union, the living and indissoluble concrete expression of their paternity and maternity” (Crossroad 158). This document also realizes the negative effects this has on society” “What threatens the unity and stability of the family is a source of dissension, disorder and injustice in the whole of social life” (Shannon et. al 159). This aligns with Rousseau’s vision and reason for supporting the fact that artificial reproductive technology should only be restricted to a heterosexual couple (Ball 570).

Additionally, there is the question of the married heterosexual couple that are infertile. The Catholic Church states that “marriage does not confer upon the spouses the right to have a child, but only the right to perform those natural acts which are per se order to procreation” (Shannon et. al 168). I find this statement to be highly insightful. There are married couples who I say might feel entitled to have a baby, but I believe that a baby is a miracle. Being gifted with that miracle does not come to everyone. Maybe God has another plan for this couple, as supported by this statement that argues that “physical sterility can be for spouses the occasion for other important services to the life of the human person, for example, adoption, various forms of educational work and assistance to other families and to the poor and handicapped children” (Shannon et. al 169).

– What is your opinion on the Catholic Church’s statement of marriage not equating to having the right to have a child?

 

In France, laws to (ART) artificial reproductive technology also only allows “sterile, heterosexual couples of procreative age to use artificial insemination and in vitro fertilization procedures” (Ball 547). Despite the Enlightenment and many others who tried to add amends to this restriction, not much change has happened. However, a law in 1978 to “encourage the birth of children [pushed France to provide] complete coverage of ART” (Ball 550). A deputy said that ART was “dehumanizing” because it pushes away from the nature of procreation (Ball 557). The Enlightenment saw the family as defined as heterosexual couple to be indicative of social stability of society (Ball 559). Thus, this image of family was supported and pushed through the restrictive laws of ART. Overall, society has been deeply rooted in the values pushed on by Scripture, and though, like Professor Seeman has said, many may not identify as religious, these values are engrained in their moral decision making.

-Can you envision yourself making an amend to your moral in a tough situation?

-Who do you think ART laws should give access to?

Clifford Geertz attempts to explain how anthropologists come to understand culture and to expose the possible dangers of how they do their research. Geertz ends with a possible way to avoid this danger. Geertz states that anthropologists use ethnographies to try to understand the cultures around them, and to him, ethnographies are extensive descriptions of the people and culture they are observing (6). He continues by mentioning that sometimes our perspective may be “obscured because most of what we need to comprehend a particular event, ritual, custom, idea, or whatever is insinuated as background information before the thing itself is directly examined” (9). He urges anthropologists, in order to combat that, to “sort out structures of signification…and determine their social ground” (9). Geertz believes that culture is semiotic and that there are signs that need to be interpreted (14). However, some of the dangers of interpreting a culture is that although we can make it more real by explaining it we could also be reducing it. Geertz asserts that “understanding a people’s culture exposes their normalness without reducing their particularity” (14). This is something that we should strive to do. We need to make sure that we are not separating that event or ritual away from its place of natural belonging but instead clarifying the event to those who may not be as familiar to it (Geertz 16-17). A way to avoid such dangers is “to plunge into the midst of them” because the ultimate goal of anthropology is “not to answer our deepest questions, but to make available to us answers that others…have fun…to include them in the consultable record of what man has said” (Geertz 30).

An example of evidence that Geertz provides in terms of analysis and interpretation problems is the story of the two boys who both seem to be either twitching or winking. One boy in reality could be twitching due to genetics while the other boy could be trying to send a message through a wink. Geertz added another boy who seemed to be doing the same thing, but in actuality, he might have been mocking the other two boys (7). One interpretation of this event could be that the boys could be playing a winking game and later another boy joins while another interpretation could be that they are all brothers who seem to be twitching together. These interpretations, based on Geertz, needs to be put into context based on their culture, finding the unique reason why this event is happening, while being careful not to reduce the event.

• One statement Geertz make that is simple yet holds an important insight is that “culture is public because meaning is” (12). What do you think Geertz trying to get at here?

• What do you think of Geertz’s solution to avoid reducing culture? Can you think of another way?

• If culture was not characterized to be semiotic and culture was based on another definition, how might the interpretations and dangers of analysis be different?

Sherine Hamdy looks at accounts of where patients use religion to help make their decision on whether to include biotechnological intervention. Hamdy argues that “people’s understandings of religion and biomedical efficacy are often inextricably enmeshed and together factor into their cost-benefit calculations about medical intervention” (144). One piece of evidence she provides for this argument is man named Muhammad who suffered from kidney failure and had to decide between life spent with dialysis or getting a kidney transplant (Hamdy 145-146). In order to make his decision, Muhammad used religion to look at his costs and benefits, in which he concluded that the “costs outweigh the benefits, given that transplant operations are not always successful” (Hamdy 146). He would rather live his life continuously thanking and praising God for still being alive than to risk his life going through a transplant in which he may not come out alive (146). Hamdy states Muhammad’s doctor did not think that Muhammad’s submission to God’s will was correct (147). Hamdy argues that the decision to appeal to God’s will is an active one that is made to help cope with suffering (156). She also does not dismiss the fact that sometimes biotechnology is not always efficient treatment (156). She concludes by asserting that passivity to religion should not be looked down upon but rather should be paid more attention to its interrelation with biotechnology (157).

“An appreciation for what it means to embody a religious tradition in which religious reasoning and sentiment are not understood as external to the self, but as central to it, can help us broad our understanding of medical life-and-death decision and of ethical formations in devout patients’ lives” (Hamdy 157).

• What are the ethical implications of Hamdy’s stories in terms of patient-doctor relationships?
• How can Hamdy’s advise also be applied to ethnographies attempting to explain and describe different cultures?

Carol Delaney discusses the issue of frozen embryos and whether they should be used as research. She mentions the split in opinions by giving the example of the two doctors Ibrahim and Basalama. Ibrahim said that a fertilized egg and an embryo different in terms of what should be considered to have bodily integrity rights and is okay to be used for research while Basalama said that embryos should be returned to the woman Delaney (62). This issue was complicated even further by Ibadi and Yasin. Ibadi forbade making frozen embryos at all while Yasin said that certain conditions need to be present for frozen embryos to undergo research (68). Delany concludes that Islamic bioethics as well as Islam is not steadfast but instead of ongoing process (73).

• Have you ever experienced had your “truth” shattered by presenting new evidence or rendering old evidence null?
• What is your opinion what can and cannot be done on frozen embryos?
• Compare and contrast the evidence Delaney and Hamdy uses for their argument. Do you think it is sufficient?