In response to the recent changes enforced upon the Sasquatch community Hospital, the Catholic Church wishes to engage our own perspectives and insights in the on-going ethical debates relating to public subsidizing of abortion services, fertility treatments, and amniocentesis; the spiritual counselor’s role in the medical healing process; and the professional rights and duties of the tenured nurses’ opposition to performing abortion and reproductive services. As a long-tending Catholic Monsignor serving the Christian Sasquatch community for over forty-years, I believe it is my professional and religious responsibility to clarify and provide resolution to moral problems raised as a result of both the altercation to the hospital’s religious affiliation and cultural diversification of surrounding community. Through this declaration, I do not aim to settle on compromise for these complex issues, but rather, strive to uphold the status of the church as “the expert in humanity”, and further celebrate the values and means by which the church has sought to bring order in moments of moral chaos during its 2000 years of existence (Cahill et al. 142).
Throughout the centuries, when moral questions relating to advanced technology and cultural shifts have arisen, the church has provided the framework for understanding how these changes would be implemented for the human life. Questions of kinship, fertility, and the right to life are not new ethical landscapes. However, the present age has proven to pave a new pathway down this familiar terrain. Modern medicine and advancements in biotechnology now challenge the previously established framework for understanding what role humans play in the reproductive process through the introduction of new methods and technologies that allow for the human to completely dominate reproduction. Procedures such as abortion, in-vitro fertilization treatments (IVF), amniocentesis, and many more, are unnatural and yet, readily available tools that hold the power for a human to subjectively select for the life outcome of another individual. Thus, critical evaluation and formal explication from the church relating to these topics is urgently required in order to ensure that we remain grounded in our own humanity.
I should note that in no way am I claiming that I am an expert on the development of reproductive technologies or their mechanical use. However, I do not view this status as a limitation factor to the insights I may provide regarding the implications of such technologies within our immediate cultural setting, specifically the western, American small-town, predominately Christian culture. Anthropologist Rayna Rapp author of Testing Women, Testing the Fetus, describes reproductive technologies as “complex cultural objects”, and argues that the knowledge and interventions of these technologies are “culturally constituted” (Rapp 13). She further goes on to acknowledge that, “science as culture is constructed inside clinical laboratories, consulting rooms, and technical services; it is also the site of cultural intersection” (Rapp 13). Rapp’s argument is both compelling and relevant for the current events within our community. I want to emphasize that this proposal is not a call for termination of scientific and clinical research as they relate to advancements in knowledge and practice during the reproductive process. It is impossible to argue against the fact that modern medicine has improved the overall lifestyle and longevity of our western populations. However, the church and its leaders are strong cultural powers that must provide direction as we attempt to implement reproductive technologies while approaching this highly complex and congested intersection of science and culture. Therefore, I hope my suggestions and considerations will be taken seriously with respect to my expertise in the moral and ethical framework of our local culture, and further exemplify how the church’s moral perspective is remarkably reflective and aligned with American human right’s law.
Furthermore, as a Catholic Monsignor, I see it as my spiritual and professional duty to comment on the current crisis within our community. My professional duties include, but are not limited to, providing homily at every Catholic service, managing the parish education program, facilitating outreach ministries to both local and outside communities, conducting the seven sacraments, and providing guidance and counseling to members of the church who seek help. With much respect to medical professionals, who are responsible for providing relief to the physical ailments of one’s disease or condition, I see my responsibility as providing relief to the spiritual afflictions and moral concerns introduced by the condition. My professional ethics serve as the basis for my arguments, and I seek to have my opinions and concerns evaluated as both sincere and legitimate even as they apply within the medical context.
I. Prenatal testing procedures such as amniocentesis may be subsidized for under-insured patients. However, the hospital should not subsidize abortion services or in-vitro fertilization treatments for under-insured patients, nor should the hospital permit the practice of these services to any patient. Furthermore, it is morally illicit for the hospital to collect unused embryos and use them for research and/or experimentation.
Prenatal tests, such as amniocentesis and the triple screen test, are common procedures used to identify a possible chromosomal abnormality in the developing fetus (Ivry 3). It is my personal view that prenatal tests should not be required for mothers-to-be. However, should the test be recommended by a physician for a mother in a high-risk group (over 35), the procedure should be subsidized by the hospital. Furthermore, and more importantly, the subsidization of such procedures may in no case justify abortion of the child. As written in the “Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation”, “a diagnosis which shows the existence of a malformation or a hereditary illness must not be the equivalent of a death sentence” (Cahill et al. 150). Moreover, a diagnosis of a malformation and a resulting abortion may lend a cultural perception that those born with abnormalities are unworthy members of society, and further place our small community on the “slippery slope of a eugenic boutique”, where we subjectively select for the lives we deem suitable for life on earth (Rapp 37). In line with church doctrine, it is my belief that such cases should by guided by God the Creator’s good will and spirit without intervention from persons on earth.
With respect to prenatal testing, some individuals may suggest that permitting such practices conflict with church doctrine, for the miscarriage rate for using prenatal technologies is about 1/200 (Ivry 39). These individuals acknowledge the loss of life that may occur, and comply with church doctrine which suggests that “no one can in any circumstance claim for himself the right to destroy directly an innocent human being” (Cahill et al. 147). However, my own research into prenatal tests leads me to believe that significant death rates for children due to testing remains largely inconclusive (Rapp 31). I am also aware that many Catholic parishioners already use prenatal tests such as amniocentesis during their pregnancies (Rapp 157). Therefore, I uphold the woman’s right to such knowledge that can inform her of the chromosomal status of her child. In such cases where the child tests positive for chromosomal abnormality, the mother may have adequate time to prepare herself mentally, emotionally, physically, and spiritually for the child’s arrival; and furthermore, gracefully gain confidence for her prospective maternal role.
In-vitro fertilization treatment is a reproductive medical procedure where an egg is fertilized by sperm in a test tube or elsewhere outside of the body. According to scientists, embryonic loss is a major problem after IVF (Mesrogli & Dieterle 1). IVF procedures often implant multiple embryos in order to increase the probability of pregnancy, and clinicians vary greatly in the number of embryos they suggest to transfer (Klitzman 12). Additionally, embryos left unused often become experimental materials for scientific research, or become stored in large stock freezers where they run the risk of being destroyed if never used (Beil 1). In contrast to the rate of child deaths in prenatal testing, the death rate for children through the use of IVF is significant. Although no one knows for sure how many embryos are lost or destroyed each year (Almendrara 1), reports speculate that around 93% of the 3.5 millions embryos created between 1991 and 2012 had been thrown away (Doughty, 1). Given the the highly ineffective precision techniques of IVF treatments and the significant loss of life, I demand the hospital reevaluate their position on use of such technologies for they unlawfully result in murdering the lives of millions of human beings.
The position of the Catholic Church on IVF technologies is clearly outlined in the “Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation”, which states, “Heterologous artificial fertilization is contrary to the unity of marriage, to the dignity of the spouses, to the vocation of the proper parents, and to the child’s right to be conceived and brought into the world in marriage and from marriage” (Cahill et al. 158). In addition to the unlawful practice of throwing away potential life, the church further emphasizes the view that IVF treatments violate the right of the child to be born through natural means. Every child must be granted the right to be brought into the world through marriage, and be raised within a marriage between a man and a woman. Children, thus, may only be naturally conceived through the proper conjugal act. Any means of reproducing otherwise not only deprives the child of his rights, but also exceeds the limits of reasonable domination of nature that overrides God’s significant power over man. Furthermore, abstaining from the practice of IVF promotes the well- being of the family unit, and its subsequent impact on how we shape our cultural society…
In response to retaliation from other my other religious counterparts, specifically Orthodox Jewish Rabbis, who defend the use of IVF by acknowledging the passage of the Old Testament that states, “be fruitful and multiple”, I defend my interpretation as I believe that it is more aligned with United States law. Although I recognize that these procedures may gift an infertile couple with a child, I do not believe the ends justify the means. In other words, the birth of one child does not justify the loss of millions unused embryos. Under our constitution, it is unlawful to kill the life of another human being, and IVF is responsible for killing millions of human beings.
Although some Orthodox Jewish Rabbis support the use of IVF, many still oppose the use of such technology due to the procedure’s questionable ethical and moral legitimacy (Kahn 144). This controversial technology not only stirs conflict within our immediate community and the rest of the United States, but also continues to ignite internal conflict within discrete religious communities. As stated before, some Jewish communities who support IVF due so on account of God’s commandment to “be fruitful and multiply”, and human technological interventions are often favorable and necessary in order fulfill God’s commandments. In these situations, the Jewish debate then switches to complex debates of kinship regarding who the actual mother of the child is (Kahn 144). Furthermore, additional debate arises as to whether the mother and the child himself will be subject to the negative and unwanted social status for having brought or having been brought into the world through acts that can be conceived to be acts of adultery (Kahn 145). It is through problems that arise such as these that I suggest use of IVF technologies should be limited all together, for they clearly burden the social status of both the mother and child within both their religious communities. I uphold the teachings of the church and United States Law when I suggest that all children should be granted the right to be brought into this world through natural means, and no child should be unlawfully murdered as a result of imprecise IVF practices.
Given the I have just provided on IVF treatment, it should be obvious that the church does not support embryos collected from IVF treatments and left unused to be employed as scientific material for experimentation. Living embryos hold the potential for human life and thus are deserving of the same rights as all individuals. As discussed in the “Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation”, “If the embryos are living, whether viable or not, they must be respected just like any other human person; experimentation on embryos which is not directly therapeutic is illicit” (Cahill et al. 152). Therefore, under no circumstances may an embryo and potential human life have its human rights stripped to be used for the sake of scientific curiosity.
Furthermore, the hospital should not, in any circumstance, subsidize or perform an abortion, for these practices also exceed the limits of reasonable domination of nature. The abortion issue will be further addressed in detail in section III below.
II. The hospital should continue to provide spiritual counseling by the Catholic clergy. Additionally, in response to the growing influx of immigrant community members of diverse spiritual and religious backgrounds, the hospital should seek employment of other religious leaders in order to satisfy the spiritual needs of all patients.
Medical professionals primary concerns include identifying and diagnosing disease, guiding patients through treatment plans that mitigate the physical symptoms of the disease, and healing the body within the physical sphere. Religious leaders’ responsibilities focus on targeting spiritual concerns or gaps within the patient’s experience of the disease, providing guidance and counseling to the patient throughout and beyond the treatment process, and healing the human soul within the spiritual realm of existence. Just as I, a religious leader, respect the boundaries of the medical professional and do not impose my training and talents in treatment of the physiological disease, I would expect medical professionals to demonstrate the same line of respect and not interfere with my methods and pathways of spiritual healing. Therefore, given that both the medical professionals’ and religious leaders’ interests lie in healing the human composed of both body and soul, I defend the right of all religious leaders to contribute their spiritual healing specialities to the patient during the healing process. Furthermore, I preserve the right for religious leaders to provide guidance to patients challenged by moral dilemmas without intrusion from medical professionals (i.e. doctors, nurses, etc.).
Rayna Rapp’s work in Testing Women, Testing the Fetus provides further support for the spiritual intervention into healthcare institutions when she suggests that “religion and science continue to have an intertwined discursive relation… religion provides not only spiritual direction, but social and material resources to many people” (Rapp 154). Patients who actively seek out help for spiritual guidance may also mutually be seeking out assistance for medical resources and support groups. If religious organizations have access to the hospital space, then it is more likely that patients will have readily accessible resources to meet their needs. Furthermore, with religious contribution of such materials, the hospital can allocate its budget to provide more financial assistance to subsidize treatments that some patients may not be able to afford otherwise.
Rapp also acknowledges that “different religions hold diverse stances toward reproductive technologies, [and] practitioners within religions may vary widely in their interpretations of official doctrine and personal adherence” (Rapp 157). Although I also acknowledge that in future cases I may disagree with guidance provided by other religious leaders on issues such as IVF and abortion, I will vow to remain open for discussion on the moral disagreement. For example, just as in the case where I would disagree with a Jewish rabbi on IVF technologies and its use, it is likely that I may also disagree with a Muslim ayatollah in regards to IVF as a means to uphold the religious mandate of nasab. However, as religious leaders, both perspectives should see it as our duty not only to provide guidance for our patients, but to confront and make sense of our moral stances in open discussions about how such religious guidance affects our local context. Keeping in mind our local community as the ground that unites us all, it is my belief that we religious leaders can work together and peacefully administer guidance that puts the interests of larger community first. Marcia Inhorn’s work on Middle Eastern Muslim men’s discourses of adoption and gamete donation seems to agree with this line of thinking when she says, “For individuals confronting the moral stances and ambiguities of their local religious traditions, they must attempt to make sense of such religious responses while at the same invoking their own moral subjectivities to find acceptable solutions to their often dire health needs and concerns (Inhorn 96). Therefore, it is my belief that we can work together to make sense and find solutions to moral ambiguities in a way that satisfies both our religious and local social context.
Thus, in response to the recent changes that have transformed the hospital from a Catholic institution into a non-denominational institution of medical practice, I propose additional spiritual leaders from other sects of religion be hired in order to ensure the hospital continues to serve the spiritual needs of all patients. As Swasti Bhattacharyya emphasizes throughout her work on Hindu bioethics, “Globalization, pluralism, and multiculturalism all increase, not negate, the need for all to pay closer action to the cultural and religious perspectives and experiences of patients, families and healthcare providers” (Bhattacharyya 19). It is therefore, in the best interest of our community at large to welcome diverse religious perspective and guidance. Although I acknowledge that in future cases I may disagree with guidance provided by other religious leaders, I vow to remain open for discussion on the moral disagreement, and will strive to participate in peaceful debate as to how we can devise a solution that reflects the best interests of the community at large.
III. The hospital should not offer any abortion services, and thus not force any nurse or doctor to perform such services who desire to not perform such procedures on the basis of her own professional ethics. Abortion is equivalent to first-degree murder, and thus, subject to both mortal spiritual and licit consequences.
The United State’s constitution outlines a human’s basic rights as freedom to pursue “life, liberty, and the pursuit of happiness”. It is within Catholic Church teaching that an individual has gained their human rights from the very moment of conception. From the very first moment of human life, individuals have the right to pursue their own life with their own sense autonomy. These principles extend to our own community, where we are held responsible to uphold freedom for our citizens, and serve justice to those individuals that violate another citizen’s human rights.
The “Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation states, “The child is not an object to which one has a right nor can he be considered as an object of ownership: Rather, a child is a gift, “the supreme gift” (Cahill et al. 168). Under this reasoning, the child in the womb cannot be seen as an object, but rather, another subject. Our moral compass has evolved in recent centuries to disavow acts of human beings owning other human beings. Likewise, the mother of a child cannot claim to own the human growing inside of her as her own property. The child is another human endowed with rights, and therefore, acts such as abortion that intentionally inflict harm upon the human by another human are morally illicit and subject to the most severe legal consequences. Abortion, in the eyes of the law, is equivalent to first-degree murder, and should not be permitted under any circumstance.
Faye Ginsburg, author of Contested Lives: The Abortion Debate in the American Community, sheds light onto the pro-life movement’s arguments against abortion as the murder of another human being, and more interestingly, how abortion comes to affect on the larger society. Ginsburg states that most pro-life activists, “see abortion as symptomatic of other social problems. In particular, they are concerned that materialism and narcissism are displacing nurturant ties of kin and community” (Ginsburg 9). Although many defendants of abortion only see the pro-life movement as protecting the individual fetus, it should be acknowledged that our concerns are far more complex than they make them seem to be. As we become a more advanced society and culture, we become more susceptible to loosening the grips on our own moral standards humanity. If we progress in the mindset that abortion should be a set norm, where everyone can receive an abortion who wants one, we blindly will follow a path that no longer truly values the extraordinary and blessed process that is human reproduction. Children in the womb are beautifully innocent, and we must always welcome them into our community that continually strives to be humane and compassionate.
An argument often proposed by pro-choice defenders in response to the abortion debate centers around the idea that “the government cannot tell a person what decisions to make about their body”. However, many governmental laws already intact do manage the way citizens conduct their bodies if it is in the interest of protecting another life. For example, the government tells all of its citizens that they are prohibited to swing their arms continuously with a knife in their hand and murder another person. Laws presently imposed on our bodies inhibit the behaviors that inflict pain or death upon another individual. Thus, laws against abortion serve to protect the life of the baby from harm intentionally imposed upon them.
Furthermore, the hospital may not force any medical professional to perform abortion, as the action itself violates the ethical guidelines and mission in the medical field. The values driving the professional medical field including diagnosing and treating disease, while preserving the right to life and death with dignity. Performing an abortion and killing the life of a child is in direct conflict with the medical professional’s ethical mission (Ginsburg 66). Thus, nursing professionals who have voiced concern over the procedure and stated an unwillingness to perform such services must be heeded to by hospital administration. The nurses have the right to act within their own autonomy when it comes to what they believe to be their profession’s ethical boundaries.
In conclusion, the path ahead regarding the implementation of public policy standards and ethical guidelines within Sasquatch Community Hospital is far from complete. However, as new technologies advance and culture changes, the moral questions posed in response to these changes will forever persist. It is inevitable that we will face challenges and disagreements in our work geared toward preserving the humane, moral, and ethical branches of our community. As a united community, it is our responsibility to ensure that such challenges are met with the all encompassing and cultivated perspectives that ground and mold our society to be reflective of the interests of both the individual and community at large. With these goals in mind, I hope my input on the matters relating to the changes to the Sasquatch community hospital are taken sincerely and legitimately when deliberating the ethical questions ahead.
References:
Almendrala, Anna. “No One Knows How Many Frozen Embryos Are Lost Or Destroyed Each Year”. HuffingtonPost, 19 Mar. 2018. https://www.huffingtonpost.com/entry/the-destruction-of-thousands-of-embryos-reveals-just-how-under-regulated-fertility-clinics-are_us_5aab04bfe4b0c33361af1b45
Beil, Laura. “What happens to extra embryos after IVF?”. CNN, 1 Sept. 2009. http://www.cnn.com/2009/HEALTH/09/01/extra.ivf.embryos/index.html
Bhattacharyya, Swasti. Magical Progeny, Modern Technology: A Hindu Bioethics of Assisted Reproductive Technology. Albany, State University of New York Press, 2006.
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).
Doughty, Steve. “1.7 million embryos created for IVF have been thrown away, and just 7 percent lead to pregnancy”. DailyMail, 30 Dec. 2012. http://www.dailymail.co.uk/news/article-2255107/1-7-million-embryos-created-IVF-thrown-away-just-7-cent-lead-pregnancy.html
Ginsburg, Faye. Contested Lives: The Abortion Debate in an American Community. Berkeley and Los Angles, University California Press, 1989.
Inhorn, Marcia. “‘He Won’t Be My Son’: Middle Eastern Muslim Men’s Discourses of Adoption and Gamete Donation”. Medical Anthropology Quarterly, vol. 20, no. 1, pp. 94-120.
Ivry, Tsipy. Embodying Culture: Pregnancy in Japan and Israel. New Brunswick, Rutgers, 2010.
Kahn, Susan. Reproducing Jews: A Cultural Account of Assisted Conception in Israel. Durham and London, Duke University Press, 2000.
Klitzman, Robert. “Deciding how many embryos to transfer: ongoing challenges and dilemmas.” Reproductive Biomedicine & Society Online, vol. 3, no. 1, pp. 1-15.
Mesrogli, Mahmoud. Dieterle, Stefan. “Embryonic losses after in vitro fertilization and embryo transfer.” Acta Obstet Gynecol Scand, vol. 71, no. 1, 1993, pp. 36-38.
Rapp, Rayna. Testing Women, Testing the Fetus: The Social Impact of Amniocentesis in America. New York and London, Routledge, 2000.