To Whom It May Concern:
As you all know recently Sasquatch Community Hospital has become non-denominational. This change will better reflect the growing religious and ethnic diversity of our community. New and varying patient populations with different beliefs from our largely Catholic health practitioners and donors are on the rise. These changes need to be addressed so that the hospital can run smoothly through this transition.
What is not diverse is our donor population. There was no conflict when the community was predominantly Irish Catholic and the hospital was associated with the Catholic Church. As we know, Sasquatch Community Hospital has kindly subsidized care for patients who are under-insured. This was made possible by generous Catholic donors. It will be difficult to maintain donors if money is used to fund medical procedures against their faith. It is of utmost importance to create a vast donor population as medical treatments only become more expensive and the patient population grows. We must attempt to spread the donor population to reflect newer religious and cultural groups in the area. Though these are only minority groups now, they have differing beliefs to the Catholic Church and will want access to procedures previously not offered. We need to prevent a mismatch between procedures offered and our patient population. We are the only major hospital in a roughly hour drive and it is our duty to provide care.
To reduce the risk of losing Catholic donors, we should strategize where donor money can be funded. We can tell donors that they can donate to the hospital overall. We could also tell donors they can pick where to allocate their money, such as the maternity ward, the cancer ward, emergency services, or the reproductive services ward, to name a few.
The reproductive technologies subset of the hospital will include procedures that do not conflict with non-Catholic faiths. For example, a growing Jewish population might want to utilize IVF treatments. In Israel, IVF is an alternative to motherhood for single women. Some Jewish women believe it to be more honest and cleanly, whereas sexual intercourse can be the opposite (Kahn 22). Some Catholic donors and nurses might to respond to single women, or married women utilizing IVF treatment as a conflict to “the gift of human life…actualized in marriage through the specific and exclusive acts of husband and wife” (Donum Vitae 147). Since a required team member for IVF treatment is nurses, I recommend using the argument presented below:
Gilbert Meilaender, author of religion and ethics, reminds us that while the Bible does not speak of a method like IVF for procreation, there is an imperative value on procreation itself. Infertility is considered a “sorrow” (Meilaender 1638). He further explains stressors placed on infertile couples from their community. In such events, he references the work of Paul Simmons, a Christian ethics author, who believes “biotechnical parenting” does in fact highlight the “symbolic value” of parenting that relate to biblical principles. These principles include having offspring by choice, or parenting as a “calling, not to accident or mere biological capacity.” This has large implications for people seeking IVF treatments, and even pre-natal testing and amniocentesis. “Biotechnical parents” will not “resent” a pregnancy, since they are going through difficult means to commit to becoming parents; thus, a child of IVF is guaranteed “caring love” (Meilaender 1639). We should disclose this morale of “biotechnical parents” on Catholic nurses because there are biblical routes to parenthood in this format.
Similar to Catholic faiths, the growing Lebanese Shiite population will raise concerns about IVF treatments, though there are some instances where they will be welcomed for Shiites. There is more leniency in receiving egg donors than sperm donors for Shiites. Controversy arises for sperm donors due to opinion that “’the child would not be from me – it would be like raising some other man’s child’” (Inhorn 104, 112). Still, infertile couples would seek egg donors and completing pregnancies through IVF treatments if they were offered at the hospital.
In terms of pre-natal testing and amniocentesis, there is not a uniform desire for such tests in our patient population. Pre-natal testing for malformations through amniocentesis is morally illicit if followed by an abortion (Donum Vitae 150). Similarly, the Japanese immigrant group comes from a country that prohibits abortions for “eugenic reasons.” In other words, it is publicly understood in Japan that abortions are for “choosing when to have children rather than what kind of children” (Ivry 82). Therefore, if a woman wants to have an abortion in Japan it is available, but not in the case for terminating a disabled fetus. In a few such instances that these types of abortions occurred, they were through “legal reasons” (Ivry 19). In majority cases, Japanese pre-natal care includes attention to maternal nutrition and fetal environment (Ivry 11). These values will not necessarily be ingrained in all Japanese immigrants that enter our hospital, but show us the common beliefs and values of their home country. Contrasting greatly, the pregnancies of Jewish women in Israel hold large importance on pre-natal tests, some of which, like chromosomal biomarker tests are not common procedures in Japan (Ivry 3). While the origins in the Jewish population in Sasquatch are not necessarily known, this group can look to Israel as a model to base their reproductive technology use. For this reason, this Jewish group might look to use pre-natal testing like amniocentesis.
As IVF treatments become more accepted among non-Catholic populations the newer patient population will desire these treatments. It is possible that some Catholic patients will also desire IVF treatments. Barbara Katz Rothman, author of texts about reproductive technologies and women, states that Catholic women are “over-represented” in terms of IVF. This is due to pressure placed upon women to have children and their worthiness depending on this practice. Women might undergo treatments that go against their religious faith to be welcomed socially in their community (Rothman 1605). Although this is not a guarantee that Catholic families will engage in IVF treatments if they are suddenly available at the hospital, it does show evidence that Catholics are not necessarily as much of a homogenous group on this topic as they make public. This text demonstrates a clear desire for reproductive treatments that are not unheard of in all contexts of the Catholic faith.
To remind everyone, this means that there is a Jewish population, Lebanese Shiite population, and potential Catholic population that would utilize IVF treatments. Although there are many groups listed above that could potentially utilize IVF, I only suggest unused embryos to be donated with reservations. I do not see why Jewish or Shiite groups would disagree with this decision, as they are more open to IVF treatments. On the other hand, in Donum Vitae, Catholics are urged not to allow procedures on live embryos, unless there is “certainty of not causing harm to the life or integrity of unborn child and the mother.” Therefore, science experiments that hold no therapeutic advantage to the embryo violate human dignity (Donum Vitae 152-153). I believe unused embryos should be donated based on the discretion of the people undergoing IVF treatment. Donating unused embryos should not be the status quo offered by the hospital, with the goal to avoid risks of losing Catholic donors.
Until there is a more widespread donor population, I do not think the hospital should provide and subsidize abortion services for under-insured patients. We want to prevent Catholic donors pulling out from the hospital because their money is being used to perform abortions. We also want to prevent nurses from refusing treatments that cut into their employer’s money, but most importantly also their values. Our Catholic nursing population might be most opposed because the Catholic faith prohibits abortions “of any kind” (Donum Vitae 149). We cannot risk losing our donor population, or the hospital will be forced to close, closing all non-reproductive services with it. Therefore, I suggested earlier to diversify our donors so that we can fund reproductive technologies. If in the future there are donors that are not against abortion that want to help fund these services, I see no problem in allowing this to occur. Until that moment, however, abortions should only be administered to those who can have one without needing hospital funding, due to the current largely Catholic donor base. The reason I am separating the allowance of IVF treatment from abortion is that there are more groups that support IVF than abortion in this new patient population. As I push for diversified donors, I must speak about diversifying spiritual clergy that historically have come to Sasquatch Community Hospital.
Although the hospital is now non-denominational I fully expect Catholic clergymen to continue to come to the hospital, despite medical staff disliking their presence due to interference. I believe this counseling option should now include clergy and community members from other religions and cultural groups that now accompany our patient population. This will include clergymen or community members of Jewish, Shiite Muslim, non-Irish Catholic and Japanese people. I want to emphasize that this is an optional service. It should be known to patients that it must be requested, and will not occur without request. For this reason, I want to propose we allow people to sign up for slots with clergy and community members. If this changes the mindset of patients to decide to forgo reproductive technologies, the medical staff must accept this form of autonomy in patients.
I look forward to your responses on behalf of my proposal to allow IVF, and abortion services with proper funding. A large part of my proposal includes efforts to diversify our donor population. I am in favor of the use of assisted reproductive technologies because I believe there is substantial evidence that many members of our patient population could benefit from these treatments. I believe abortions and pre-natal testing must be handled separately and be funded through donors who support these services due to the risk of losing Catholic donors that fund all areas of the hospital. By allocating new donors to reproductive technologies these services will be made possible, while keeping the hospitals many other essential services intact.
Works Cited
Donum Vitae In Shanon, Thomas A. and Lisa Sowle Cahill. “Religion and Artificial Reproduction: An Inquiry into the Vatican “’Instruction on Respect for Human Life in its Origin and on the Dignity of Reproduction.’” Crossroad, 1988.
Inhorn, Marcia. “He Won’t Be My Son: Middle Eastern Men’s Discourses of Gamete Donation.” Medical Anthropology Quarterly, vol. 20, no. 1, 2006, pp. 94-120.
Ivry, Tsipy. Embodying Culture: Pregnancy in Israel and Japan. Rutgers University Press, 2009.
Kahn, Susan Martha. Reproducing Jews: A Cultural Account of Assisted Conception in Israel. Duke University Press, 2000.
Meilaender, Gilbert. “New Reproductive Technologies: Protestant Modes of Thought.” Creighton Law Review, 1991, pp. 1637-46.
Rothman, Barbara Katz, “Reproductive Technologies and Surrogacy: A Feminist Perspective.” Creighton Law Review, 1991, pp. 1599-1607.
Hi Lindsay,
I enjoyed reading your proposal and I found many of your solutions to problems unique and inciteful. I will try to address what I liked about your proposal for you to expand on, as well what I feel needs improvement.
First, as an overall review of your paper, I felt as though the arguments you made were strong and the flow of your paper was nice, but that at times, which I will highlight below, it was unclear what exactly your thoughts were on it. I think you relied to heavily on the interpretation of the sources to make your argument for you rather than using them to strengthen your argument. Luckily though, that can be easily fixed.
Your introduction was slightly confusing. I was unclear of why the church and hospital were parting, it seemed as though you were saying it was because the population of Sasquatch was diversifying, is that correct? If so, I would make that a little more clear, and maybe explain what internal processes lead to that decision. Either there were new hires to the administration or something along those lines, just to clarify exactly what happened. In my paper I did not give a reason, I just stated that it happened. I think that would be an acceptable alternative as well.
As for your solution to the donors, I think that it was interesting your emphasized getting a more diverse donor base so as to ease the pressure the hospital might feel if some of their new changes cause old donors to leave. I think that was a good idea, and I would elaborate how you might achieve something like that. Be it reaching out to local non-catholic businesses or having fundraisers for things your know certain communities leaders would be interested in such as a fundraiser for an IVF fund. However, I would say that is of a more long-term solution, but you sometimes use it as the sole solution to the problem in a few different places. I would keep that in but also put in something about what can be done in the short term.
The policy surrounding the addition of IVF and the reasons why were also clear so I think the bones of that argument are good but I would try and make it a little more clear as to what your feelings are about it and why you feel that way. I think your point of adding in why Catholics would be okay with the addition of IVF services is a little misguided. The main issue they have with it being used for an infertile woman is that the doctors are usurping God’s choice in the reproductive process, meaning sometimes God just does not want women to have children and it is not our place to change that. And their main issue with it being used with a single woman is that it is unfair to the child to force it to grow up outside the context of a married couple. So while I think that part you put in about educating the Catholic nurses and donors about the fact that there can be love of equal value in other contexts should stay, I am not so sure that is a strong enough argument to convince devote Catholics. One possibility though would be to mend your argument about how Catholics are not so homogeneous as many presume with your argument that marital love is not an essential part of parental love. Also a small correction, you put that IVF is an alternative to motherhood, but I think you meant an alternative means of reaching motherhood.
Your argument for prenatal testing was a little unclear and after reading your paper I was a little unsure of what the official stance of the hospital was on that, especially in contexts beyond just using amniocentesis for things other than deciding whether a mother wishes to move forward with her pregnancy or not. So if a mother wishes to get an amniocentesis because she wants to be better prepared for whatever outcome may occur, could that be administered at the hospital or will it simply not stock anything relating to amniocentesis for fear of someone using the information gathered to seek an abortion. I think your argument can go both ways, but I would clarify that point.
Lastly, I think you should include something about how you will deal with alienating the local Catholic population. You put a big focus on the hospital being more inclusive, especially since it is so rural, but I would also put something in about the hospital not being exclusive. Some members of the community may not feel comfortable going to the hospital due to these changes and will instead just not go to any hospital for non-essential problems, so I would definitely put something in about how you may deal with such a fear.
Overall I think you did a really good job and integrated the sources very well, which is something I personally struggled with. If you have any questions please comment below, I believe you critiqued my paper as well so I liked that I was able to see what your stance on a lot of different things was. I think it will help me integrate some of your comments and I hope you gain the same insight from my comments and paper as well.
Hi Lindsay,
Overall, I really enjoyed reading through your proposal. I thought you provided strong arguments, and appreciate that you took a more economic and policy based approach to answering the prompt.
I thought bringing up the importance of the donors’ roles in hospital policy was a very good point, and one that I did not even consider when addressing this prompt. I think addressing and diversifying the donor base is a key issue to focus on. However, I would also consider how you may want to address a proposed budget designed by the hospitals economic advisors, board members, and other key figures as to how these personnel would want the donations to be allocated. To me, it seems that if you just leave an open-ended statement saying that donors can choose to donate to whatever section of the hospital they want, you are giving a significant amount of power to Catholic donors during this very premature time of the hospital transition, and this could actually slow down the overall adjustments being made. Therefore, I think a proposed budget would better catalyze the change the hospital is currently undergoing because it would provide a strong and structured framework for managing short-term goals that you could further address as steps to the long-term goals. Overall, I still think it was very wise to address this issue so deeply, and aim to make slow and steady changes to hospital in order to parallel the donor base and hospital’s policies.
Although you strongly lay out the framework for the many different cultural perspectives in the community, I think your argument could be further improved if you specify exactly how the hospital should handle each case. Personally, I could easily understand how you were relating each group and their perspectives on the reproductive technology, but it wasn’t exactly clear to me what you thought the hospital should do or what the hospital’s approach would be regarding these issues.
Additionally, I think you can also better clarify your position on scientific research on unused embryos. Specifically, talking more about what other reservations you have about donating the embryos besides losing Catholic donors, and addressing what your long-term reservations about having such research done in the hospital would be. Do you think that when you get a more diverse donor base that the hospital would be more open about embryonic research?
Hi Lindsay, Jaqueline and Brantley,
Thanks for this. You all put a lot of effort into this and did very good jobs. Lindsay, I thought your essay was pretty well written and clear. Like your commentators, I agree that your focus on expanding the hospital’s donor base was creative and interesting. I also agree with most of their other comments about what could be made clearer, so pay close attention to what they have written. I have only a few additional comments to add:
1. “We should disclose this morale of “biotechnical parents” on Catholic nurses because there are biblical routes to parenthood in this format.” This sentence does not make any sense to me. You need to clean it up. Also, you cannot “disclose on people” only “to people.”
2. ” In other words, it is publicly understood in Japan that abortions are for “choosing when to have children rather than what kind of children” (Ivry 82). This was a very good quote.
3. I do not know what “cutting into their employer’s money” means.
4. Although the hospital is now non-denominational I fully expect Catholic clergymen to continue to come to the hospital, despite medical staff disliking their presence due to interference. can you think of any way to minimize problems or bad feelings on both sides?
Good luck!
DS
Hi Lindsay, I forgot one more thing. You refer to a good mix of our readings, but you could do more with them. With the exception of Meilander, you did not go into the arguments much or make explicit claims about how they have informed you view. That would be one other way to improve this paper.