Assisted suicide of Catholic hospitals.

Because of mounting debts, all levels of government have introduced cutbacks in education and health care since 1993. The redesigning of health services includes the closing and merging of government-funded hospitals.

In New Brunswick, Frank McKenna's government expropriated six Catholic hospitals while closing another one with only feeble opposition. In Saskatchewan, Alberta and Ontario also, hospitals have been or are being downgraded, closed or merged. For Catholics the saddest aspect is the disappearance of the Catholic health care ethic, an ethic which had been undermined for years and which is now shown to be practically meaningless.

Does this title "Assisted suicide of Catholic hospitals" exaggerate? Consider the following:

St. Michael's Hospital and St. Joseph's Hospital in Toronto both perform contraceptive female sterilization, insert intrauterine devices (which are always abortifacient) and provide information on contraception via Ontario government and other pamphlets, which are available for everyone to pick up in their family health clinics. They have done this over several decades. St. Michael's Hospital, in response to the anti-Catholic outcry from Toronto AIDS patients whose hospital was ordered to merge with St. Michael's, issued a special message this summer to celebrate "gay pride" week (July 7, 1997). A poster showed an image of St. Michael against a backdrop of a rainbow. The message made a point of explaining that the rainbow was a symbol of "renewal and affirmation.of the lifestyle of the gay/lesbian community."

I submit a sampling of the recent history of Catholic hospitals in three Ontario cities. Their history provides graphic examples of material co-operation (material in the sense of Thomistic theology) in the performance of acts forbidden by Catholic Church teaching. It also shows evidence of assimilation of Catholic hospital boards into public boards. This frequently implies institutional cooperation in evil.

Assimilation by stealth

The Health Services Restructuring Commission (ref. 1) set up in 1996 by the government of Ontario has directed the Board of Directors of St. Michael's Hospital to

"Amend the by-laws of St. Michael's Hospital to provide for a period of three years starting on Sept. 30, 1997, that one third of the members of the Board of Directors of St. Michael's Hospital will be appointed from nominees provided by the Wellesley Central Hospital."

(Editor:.Wellesley is the general hospital whose AIDS patients or their spokesmen have already loudly opposed the Catholic teaching on homosexuality).

"In conjunction with Wellesley Central Hospital . . . develop a plan to incorporate a new corporation by November 30, 1997, `Sherbourne Hospital Corporation' to establish and assume the ownership and governance of an ambulatory care centre at the site of the Central Hospital. The governance structure will provide for individuals from St. Michael's Hospital, equal in number to one-third of the corporation's Board of Directors. The remaining Board members will include one-third appointed on a one-time basis from the Board of the Wellesley Central Hospital and one-third from the community. Subsequent Board appointments will be one-third from the Board of St. Michael's Hospital, and two-thirds from the community."

St. Michael's Hospital has acceded to both of these directions. In other words, it has opened its Board of Directors to representatives whose opposition to Catholic ethical standards is part of their hospital background. Experience from other institutions tells us that in such a climate the defence of the Catholic health care ethic is well-nigh impossible.

Sudbury

The Sisters of St. Joseph in Sudbury, following the closing of their hospital (Sudbury General) have been referred to by the Hospital Restructuring Commission as an "entity' within the new Sudbury Regional Hospital Corporation. The Sisters call themselves "their own corporation." (ref. 2) Asked if their Order was happy with the compromise, spokeswoman Deborah Dunn said: "We don't want to comment on that. The Sisters accept the deal negotiated and are pleased with the continuance of the over-all structure." In other words, the Sisters were happy because they were still in business.

Despite approval of "a Catholic mission" in health care by the commission, the commission makes clear that abortions will be performed at Laurentian Hospital in Sudbury. This is the new public hospital in which the Sisters will be participants! Deborah Dunn, speaking for the Sisters of St. Joseph, said that these abortions will be done in a "discreet.area to be defined later"! (My emphasis).

Pembroke

In Pembroke, Ontario, the public hospital, Pembroke Civic, was closed down. The Catholic hospital, Pembroke General, still functions. A public outcry developed because some complained that they would not be able to receive the medical care that they wanted. In their view, this included abortion, morning-after abortifacient pills, contraceptive sterilization, referral by doctors for abortion, AIDS literature advocating the use of condoms and prenatal screening. How did the Sisters respond?

According to the Ottawa Citizen, Sister Marguerite Hennessey (ref. 3) was reassuring to the complainers. The morning-after pill comes in all sexual-assault kits, she said, and emergency doctors can write a prescription for anyone who asks. "The General (RC) has long performed vasectomies and hysterectomies," she stated, and "no emergency procedure is delayed by the Ethics board."

The executive director of this hospital, Sheila Schultz, has said in an interview that intrauterine devices, birth control pills, and even sterilization "could be" available at the General, at the quiet discretion of the doctors. She repeatedly stressed that, "there are no services now available in either hospital that will not be available at the General" (ref. 4).

Loyalty of Catholic hospital boards to Church teaching

How do we know that a hospital board, which is partly constituted by any party other than the Sisters, or their representatives, will act in consistence with the moral teaching of the Catholic Church? This question was not adverted to by the Sisters of St. Joseph. The Pembroke General's board is constituted only by persons who agree, in writing, to "respect the Catholic values of the hospital."

Ms. Mary Eberts, lawyer for Pembroke Civic Hospital objected that this requirement excluded people who "won't agree, in writing, to respect those Catholic values, thereby denying them access guaranteed under the Charter of Rights."

John Laskin, lawyer for the Restructuring Commission replied, "Respect is something different from adherence or belief." (ref. 5) Surely respect that does not require adherence is no respect at all.

Material cooperation in health care

Catholic Church teaching in regard to cooperation by Catholic hospitals in unethical demands of the modern permissive society, is definitively stated in an authoritative response to a question of the American bishops to the Congregation of the Doctrine of the Faith (CDF). The document is entitled Sterilization in Catholic Hospitals (1975) (ref. 6) Msgr. William Smith, a leading moral theologian, has discussed this matter also (ref. 7 and ref. 8).

The U.S. Catholic Conference on Health Affairs, with the approval of the Board of the National Conference of Catholic Bishops, published a Commentary (Sept. 15, 1977) on the CDF response. Msgr. Smith points out that the Commentary mentions "duress" as crucial in understanding the principles of cooperation, but that the term "duress" does not appear at all in the CDF reply and is not even defined in the Commentary.

The Commentary distinguishes between the reason for the sterilization and the reason for the cooperation. This reduces the question largely to a matter of intentionality only, the justification being: will cooperation do more harm than good? Msgr. Smith asks, "Are financial and functioning goods (of the hospital) to be measured and calculated against moral goods and moral evils? The Commentary does not say, but surely opens the way for a `proportionalist' reading and calculation in those pre-Veritatis splendor (1993) days."

(Editor:.Veritatis splendor or the Splendour of Truth is the encyclical in which the Holy Father, John Paul II, condemned the theory of moral theology known as proportionalism. It was this theory that allowed Catholic moral theologians in the USA and Canada to assure Catholic hospital administrators that sterilizations were O.K.)

In 1994 the U.S. bishops issued Ethical and Religious Directives for Catholic Health Care Services. This contains a one-page Appendix called "The Principles governing cooperation" (p. 29). The appendix relies more heavily on the USCC Commentary (1977), than on the Vatican statement of 1975. Msgr. Smith states that the 1994 directives were aimed at the current situation of institutional mergers, joint ventures, co-sponsors, etc., but that the principles as they read are examples of individual rather than institutional cooperation (ref.9).

To sum up: Any official approbation of an action which is intrinsically evil (e.g. contraceptive sterilization, abortion, etc) and, even more so, its management and execution in accord with hospital regulations, is a matter which, in the objective order, is by its very nature (i.e., intrinsically) evil. Such approval also does great harm to the Church and country and is therefore forbidden (ref. 10).

The secular political strategy

"If you can't lick 'em, join 'em." This appears to be the tactic of Canadian provincial governments with regard to Catholic hospitals. Closing down too many Catholic hospitals would have produced a public uproar with unpredictable and dangerous consequences for politicians. But co-option seems to be doing just fine, thank you. The fact that Catholic hospitals have been "going along to get along" for thirty years has made this tactic both easy and inevitable.

Catholic tradition in hospital care

Christians had established hospitals for lepers, cripples, the blind, and the sick poor by the fourth century A.D.

These hospitals still fulfil their ancient role of caring for the sick and the poor. With regard to psychological counselling, obstetrics and gynecology, natural family planning, palliative care and the promotion of chastity as the only true prevention of diseases spread by promiscuity, our Catholic hospitals should be playing a leadership role.

The medical profession has been hiding many facts from the public, including the fact that abortion leads to breast cancer and that the human papilloma virus is a major cause of carcinoma of the uterus. Catholic hospitals have a serious moral responsibility to inform the public about these and similar matters.

We can save our hospitals if we have the will.to do so. Perhaps you, who still have Catholic hospitals, should write your bishops. We owe it to God and to our fellow Catholics and to society at large. Defending the Catholicity of our hospitals will take courage and daring. Our faith is, after all, a sign of contradiction. We should recall that Pope John Paul II, at the very outset of his papacy, raised his cross on high for all to see and quoting Our Lord, he cried, "Be not afraid."

References:

1. Health Services Restructuring Commission. In the matter of the Public Hosptials Act R.S.O. 1990, c.p. 40, as amended; Ontario Regulation 87/96 made under the Public Hospitals Act; the Ministry of Health Act R.S.O. 1990, c.m. 26, as amended; Ontario Regulation 88/96 made under the Ministry of Health Act.

2. Catholic Register, David Stapleton, June 9, 1997.

3. The Ottawa Citizen, June 7, 1997.

4. The Toronto Star, Michele Landsberg, June 9, 1997.

5. The Canadian Press, Hollie Shaw, July 23, 1997.

6. Origins, 6 (6/10/76), pp. 33 and 35.

7. Linacre Quarterly, 44 (May 1977), 107-108.

8. Homiletic and Pastoral Review, Jan. 1997, pp. 67-69

9. Ibid. p. 69.

10. Aertyns-Damen-Visser, 1, n. 365, 11, p. 400, Zalba, 11, n. 253, no. 1, p. 129. Healy, E., Medical Ethics, Chicago, Loyola, 1956, p. 104.