The Roman Catholic Bishop of Phoenix has stripped St. Joseph's Hospital and Medical Center of its 115-year church affiliation because administrators -- including a nun -- allowed doctors to remove a dying 11-week-old fetus from a mother of four because she would have died without the procedure.
Bishop Thomas J. Olmsted said the procedure was an abortion, which can never be justified under church teaching. He added that because the hospital would not agree to demands to acknowledge the error and operate under his direct supervision it could no longer use the "Catholic" label or have Mass celebrated at the chapel.
"It is my duty to decree that, in the Diocese of Phoenix, at St. Joseph's Hospital, CHW [Catholic Healthcare West] is not committed to following the teaching of the Catholic Church and therefore this hospital cannot be considered Catholic," Olmsted said at a news conference.
Catholic Healthcare West is the San Francisco-based parent company of St. Joseph's.
"The Catholic faithful are free to seek care or to offer care at St. Joseph's Hospital," he added, "but I cannot guarantee that the care provided will be in full accord with the teachings of the Church."
Hospital president Linda Hunt said the medical center was "deeply disappointed" by Olmsted's action and pledged that St. Joseph's "will continue through our words and deeds to carry out the healing ministry of Jesus."
"Consistent with our values of dignity and justice, if we are presented with a situation in which a pregnancy threatens a woman's life, our first priority is to save both patients," Hunt said in a statement. "If that is not possible we will always save the life we can save, and that is what we did in this case."
"We continue to stand by the decision, which was made in collaboration with the patient, her family, her caregivers, and our Ethics Committee. Morally, ethically, and legally we simply cannot stand by and let someone die whose life we might be able to save."
Olmsted disagreed. "There is no way to rationalize this," he said
. "It would have been best to try to save them both."
He did not say what should be done if that were not possible. Olmsted also said the hospital was violating other Catholic directives by affiliating with facilities that provided sterilization, contraceptives and in vitro fertilization. But ending the pregnancy was the tipping point in his problematic relationship with St. Joseph's.
The case in question concerned a 27-year-old woman, a Catholic, who was already a mother of four and had become pregnant again despite efforts not to conceive because she suffered from pulmonary hypertension that could endanger her life and that of her fetus.
A 24-page report on the case prepared for the hospital and Bishop Olmsted by a Catholic moral theologian -- and published late Tuesday by the website of Commonweal magazine
-- reveals that when the woman consulted her pulmonologist on Oct. 12, 2009, when she was seven weeks pregnant, he advised her to have an abortion because of the risks.
Because of her moral objections, she declined. Three weeks later, on Nov. 3, 2009, the woman was admitted to St. Joseph's Hospital with worsening symptoms that included "severe, life-threatening pulmonary hypertension," "right heart failure," and "cardiogenic shock."
She was told by several different doctors that her chance of dying "approaches 100 percent" if she were to continue the pregnancy.
Moreover, according to the report by moral theologian M. Therese Lysaught of Marquette University, by Nov. 5, "mother and fetus were both in the process of dying" and only the mother could be saved.
"Due to the age of the fetus, there was no possibility that it could survive outside the womb," Lysaught wrote. "Nor, due to the mother's heart failure and cardiogenic shock, was there any possibility that the fetus could survive inside the womb."
"In short, in spite of the best efforts of the mother and of her medical staff, the fetus had become terminal, not because of a pathology of its own but because of a pathology in its maternal environment. There was no longer any chance that the life of this child could be saved."
"This is crucial to note insofar as it establishes that at the point of decision, it was not a case of saving the mother or the child. It was not a matter of choosing one life or the other. The child's life, because of natural causes, was in the process of ending."
The hospital's ethics committee, which included Sister Margaret Mary McBride, a hospital administrator, agreed that surgeons could perform a procedure that would remove the placenta, which was the creating the toxic situation for the fetus and mother. Under accepted Catholic medical directives, that would obviously result in the death of the fetus but would ostensibly not be considered a "direct abortion" -- that is, killing the fetus as a primary objective -- because the fetus would die as the result of another procedure.
The ethical thinking here is akin to a pregnant woman who has a cancerous uterus removed. Even if she is pregnant, the death of the fetus would be considered a "secondary effect" from the cancer treatment and therefore acceptable under Catholic medical directives approved by the nation's bishops.
But Olmsted and his ethics advisers disagreed with the arguments both by the hospital and Lysaught.
"In this case, the baby was healthy and there were no problems with the pregnancy; rather, the mother had a disease that needed to be treated," Olmsted said. "But instead of treating the disease, St. Joseph's medical staff and ethics committee decided that the healthy, 11-week-old baby should be directly killed."
So after months of what were described as "complex" talks, the bishop moved to strip the hospital of its Catholic designation.
Late Tuesday, Sister Carol Keehan, head of the Catholic Health Association, which represents more than 600 Catholic hospitals around the country, issued a statement
saying that St. Joseph's had "correctly applied" Catholic medical directives in this case.
Olmsted only found out about the case in May of this year, several months after the pregnancy was terminated, and when he did he said
that Sister McBride was automatically excommunicated for her part in the decision and had her reassigned.
The case generated national coverage and put a spotlight on Olmsted, a strongly conservative bishop who was described in a profile
last spring in the National Catholic Reporter as a punctilious, policy-driven churchman who insists everyone play by the rules.