Midterm Post- Dominique Marmeno

Sasquatch hospital is seeing an influx of women and men minority groups into our region of care, minority not for the color of their skin but for the religion that they believe in. Ever since our founding, Sasquatch has been predominantly Irish Catholic—with this influx of newcomers our hospital is starting to see a change in reproductive requests. In conjunction with the state and our donor basis we aim to provide all of our patients with affordable and efficient healthcare, but as a community of historically Irish Catholics we cannot forget our faith and our morals when treating our new neighbors. Our donor base has been kind enough to aid us in the subsidizing of healthcare for underinsured patients but they have made it clear that they will not support our healthcare system if we begin to provide abortions to all those seeking them. They have also made it clear that if our efforts to provide our patients with successful reproduction technologies goes beyond the scope of the sanctity of marriage they will withdraw funding.

To accommodate our new neighbors I propose that as a community we work together to be more supportive of young women and their reproductive decisions, a key component to this will be to provide abortions on a case-by-case basis wherein the family will have to meet with a reproductive health counselor in order to get permission to abort. As a healthcare system we must respect the human body “as a person—from the very first instant of his existence” (Donum Vitae). Staying true to our faith, and the faith of our donors, we will accrue respect for the unborn child from the moment of conception and will do our best to make the right decision for the life of the child and for the life of the family. On the opposing side of this, we must also acknowledge that not all women in our growing community are Irish Catholics and that most women perceive a “tension…between human and divine agency” and that not all “women’s reproductive experiences can be clearly derived from particular religious doctrines” (Seeman). Due to these realities, as a healthcare system we must strive to meet every woman’s expectation of exceptional care when they arrive in our waiting room.

In Vitro Fertilization (IVF), as a means of reproducing within a sanctified marriage, will be a procedure that we will allow done. With respect to our Jewish community and their halakha, we will make IVF “available to individuals who need assisted reproduction” (Broyde). Couples wanting to undergo IVF must first meet with a reproductive health counselor to get permission and must also use both the husband’s and wife’s gametes. This is the only way to keep the sanctity of marriage when using IVF, and the only way to respect our own historical faith and the faith or our donor base. Any couple wishing to use donor gametes will be given a referral to a hospital that allows for these procedures, as this completely denies the sanctity of marriage and will not be allowed under the roof of our hospital. Any unused embryos will be left to the discretion of the mother with three options: they can pay to have their embryos frozen and stored in which case they can use them when they are ready to get pregnant again, they can donate their unused embryos to stem cell research, or they can have their unused embryos inserted during a period where the vagina is not conducive to a fertilized egg. In all of these decisions the life of the unborn child is respected. In line with these beliefs amniocentesis’ and other prenatal testing will also be allowed. As a healthcare facility our first priority is both the health of the mother and the health of the unborn child, as such any tests that will make more apparent the health needs of the child will be encouraged. Our donors will be pleased to know that in this regard our stance highly aligns with the Catholic teachings presented in Donum Vitae, which states “prenatal diagnosis makes it possible to know the condition of the embryo and of the fetus when still in the mother’s womb. It permits, or makes it possible to anticipate earlier and more effectively, certain therapeutic, medical or surgical procedures. Such diagnosis is permissible” (Donum Vitae). If prenatal tests come back with results that reflect complications with the pregnancy or complications with the fetus, the mother and father of the unborn child will meet with a reproductive health counselor to decide the best course of action—whether that be abortion or birth. Although the Second Vatican Council has stated that “abortion and infanticide are abominable crimes,” (Donum Vitae) we must respect the lives of the mothers and situational contexts in which the abortion would or should take place.

In addition to reproductive health counselors we will have social workers working alongside our medical staff, it will be the duty of these staff members to make sure that all of our patients are receiving the best medical care for themselves, their families, and their situations. A new change we will be making is to say goodbye to all of our religiously affiliated counselors. Due to the influx of new denominations and from the complaints of the medical staff, we see no need to hire spiritual counselors. These counselors can be sought after by our patients at their own will. Although our healthcare system is historically Catholic and we try to maintain this faith in all of our procedures, we will not subject our patients to this religious viewpoint during an already stressful time. All of our counselors will work to ensure our patients are exceptionally informed, happy with their decision, and trusting of our medical experts. As previously stated, any woman seeking abortion or an abortion-like procedure, must meet with our counselors anyway—in this way all of our patients should be informed from a well-being and holistic perspective. Those patients wishing to explore a more religious perspective, of any denomination, can do so outside of the healthcare system.

Due to our historically Catholic nursing staff we have received some inquiries about whether or not we will be forcing our staff to partake in the execution of procedures that are against their religion. This will not be the case. In order to appease both our staff and our donor base we will be initiating a system of referrals. Any abortion that is deemed necessary or acceptable, after informed deliberation between our counselors and patients, will be scheduled in our facility or will be granted a referral to another facility in a neighboring town. Using our limited budget for new hires we will hire one doctor or nurse that is certified to execute abortions—if for some reason there is no doctor or nurse eligible for hire, we will pay a doctor from the town of Swesquet (two hours away) to visit our facility twice a month to execute abortions. We have already been in communication with a doctor from Swesquet that would be willing to make the drive twice a month in order to aid our patients in their search for convenient and trustworthy healthcare. Again, if our hiring search for a doctor that would permanently reside in Sasquatch fails, the doctor from Swesquet would be introduced to our facility and put on pay roll. In this event, any patient who is in need of immediate care or cannot wait for the scheduled day will be given a referral to an abortion clinic or abortion friendly hospital in the nearest location. Although this will be an inconvenient trip for our patient they will have to both understand and respect our healthcare provider’s spirituality and agency in their decisions to deny abortion procedures.

 

Works Cited:

  1. Congregation for the Doctrine of Faith, “Donum Vitae:  Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation: Replies to certain questions of the Day”. February 22, 1987.
  2. Don Seeman, Iman Roushdy-Hammady, Annie Hardison-Moody. “Blessing Unintended Pregnancy: Religion and the Discourse of Women’s Agency in Public Health.” Medicine, Anthropology, Theory 3 (2016): 29-54.
  3. Michael J. Broyde, “Modern Reproductive Technologies and Jewish Law,” In Michael J. Broyde and Michael Ausubel editors, Marriage, Sex, and the Family in Judaism (Rowman and Littlefield, 2005), pp. 295-328.

3 Replies to “Midterm Post- Dominique Marmeno”

  1. Hello Dominique,

    Thank you for the well-articulated proposal for the hospital, I really enjoyed reading about the ideas you had in order to get our hospital hitting the ground running. However, I do have a few questions and concerns pertaining to the changes you plan on making and how you plan on making them.

    To start, I wanted to address your “case-by-case” proposition for abortion. My main concern, as a woman, is how your “counselors” are going to judge each case, and what qualifies a candidate to have the abortion. Is there a set of guidelines that counselors will follow? I also want to know how you plan on hiring these counselors; will their religious background be taken into consideration? I am simply concerned that the people hired to be counselors might vary in how conservative they may be, and therefore affect their decisions made about each case. I also would like to know what qualifies a counselor to make the decision on whether abortion is permissible or not permissible. Perhaps having multiple counselors in a group setting may lead to a less biased decision than just one counselor making the decision. This, however, may take a long time to come to a final decision of yes or no.

    Secondly, I agree with your point about “not all women being religious,” and think this is a very important point to make. My question now is, if you implement abortion, how will that affect your patients that feel so strongly against it? Essentially, I worry about the hospital’s ability to keep both religious women and secular women happy. If we keep abortion out of the picture, highly religious women will continue looking toward our hospital for aid while secular women will be pushed away. However, if we include abortion, secular patients may be gained while the number of religious patients may be diminished. How do you plan on addressing this situation and keep both types of women as patients?

    The next point I have is toward your comment stating, “any tests that will make more apparent the health needs of a child will be encouraged.” I am not sure if I am just reading it incorrectly or out of context, but from what I understand, I cannot say I agree with you on this. I do not think controversial testing like this should be “encouraged,” as it can induce more stress on a pregnant mother as well as offend those patients who are strongly against it. A huge concern I have with encouraging testing is that is leads to more and more women using it. What happens when a large number of women are unhappy with their tests results, and therefore look toward abortion as a solution? While I understand that these tests help detect diseases before birth, I can see this becoming a slippery slope of women tempted by abortion. Therefore, I suggest you make the testing “available to women that express concern about it,” but do not “encourage” patients to use it.

    Next, I support your idea about social workers being a part of the patient’s experience. I think this would be extremely beneficial to patients, especially to those that are more ignorant when it comes to healthcare. That being said, I do not support your idea about completely getting rid of spiritual counselors. Religion can be a saving grace for many patients, regardless of their beliefs and practices. In stressful times, patients often look to faith to instill hope and light into their lives, and I see no better way to do this than to give patients access to spiritual counselors. What will you do if a patient requests to see a religious counselor? Will you turn them away and tell them that it’s their own problem to worry about, and that this hospital cannot provide the service? I strongly believe that hospitals are meant to mollify the stress of a patient in any and every way possible, and I think spiritual counselors can do that for a patient. Perhaps spiritual counselors of many religions could be brought in, so that a patient may have many options and are not forced to accept one religion. Plus, having spiritual counselors on deck will reduce a doctor’s stress during the procedure because they can be focused on the procedure only and not have to worry about being a patient’s source of spiritual light.

    Finally, I really support your idea about bringing in a doctor from out of town to complete any procedures that our own doctors will not do. I think this is a great way to get our hospital to stay true to its religious ties, but still allow patients to get what they need or want. My only fear is losing some staff to the change, regardless of your ability to call in another doctor. How might you appease these unsupportive staff members and compel them to stay during this controversial change?

    I look forward to hearing your responses to these concerns!

    Regards,
    Nikki Batt – A concerned Sasquatch community member

  2. Dear Dominique and Nikki,
    thanks for putting in some work to this. I thought this was a well written piece which mostly needs more citation from the readings and more explicit argumentation about why you have made the choices you have. Can you envision what some arguments against you might be and account for them?

    A few specific things:

    1. “Staying true to our faith, and the faith of our donors, we will accrue respect for the unborn child from the moment of conception.” I am not sure accrue is the right word here. Doesn’t sound right.

    2. On the opposing side of this, we must also acknowledge that not all women in our growing community are Irish Catholics and that most women perceive a “tension…between human and divine agency” and that not all “women’s reproductive experiences can be clearly derived from particular religious doctrines” (Seeman). — Good use of quotes.

    3. You seem to want counselors to always support the views, and attest to the efficacy of, medical treatment. But can you actually say that it always the best thing for patients? Can you separate the bureaucratic desire for smooth operation from the need to sometimes have patient advocates not beholden to the party line, including on religious matters?

    Beyond that, I think you should take much of Nikki’s advice.
    Great start!

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