In parts 4/4.5 of this occasional series, I discussed the case at an American hospital, St Josephs in Arizona – a case which we know must have been repeated out of sight of the world media over and over again, with more tragic conclusions: of a woman who arrived at the emergency department of a Catholic hospital deathly ill from her pregnancy. (Pulmonary hypertension, in this specific instance, but there are many things that can kill a woman when her pregnancy goes wrong.)
There was a simple, obvious, and awful way to save the woman’s life: perform an abortion on a wanted pregnancy. (She was 11 weeks pregnant and there is a health center that provides abortions in Phoenix Arizona: it seems reasonable to conclude that she wanted the baby, who would have been her fifth.) The woman was told that to save her life the pregnancy would need to be terminated. She agreed to the operation. (In the first trimester, aspiration is the normal method – it’s non-surgical, can be performed with only a local anaesthetic, and would have put minimal stress on her over-taxed heart.) The operation was performed: she lived. Had the doctors refrained from performing the abortion – or had they even moved her to an operating theater – she would have died. Of course, when she died, the fetus would have died too.
My guess is that people who’ve read me on Why pro-choice is the ony moral option are surprised that I say it was an awful way to save the woman’s life. But it was: losing a wanted baby is a tragedy. To have to decide to terminate a wanted pregnancy in order to live is a very dreadful choice to have to make, and a pregnant woman has the right to choose not to have an abortion, even though the doctors tell her she would die otherwise. It’s everyone’s right to decide to die rather than receive treatment that goes against their conscience. But no one has a right to make that decision for other people. And a doctor’s overriding ethical obligation, unless they know their patient has other wishes, is to preserve good health and life.
I’ve read a good many pro-life arguments, over years and in the past few days, that talk of how horrible it is to “dismember” an unborn baby, to “rip it apart”. In the first trimester, in fact, a fetus is likely removed whole from the uterus whatever method is used: the fetus dies not because it has been “ripped apart” but because, before the doubtful window of 20-24 weeks, no fetus can live when removed from the gestating woman. Her whole body – her heart, her lungs, her guts, her muscles and bones – is keeping the fetus alive. Once removed, the fetus dies. Prior to 15 weeks, it is a biological impossibility for the fetus to feel pain – at 11 weeks, the fetal brain is so undeveloped that it’s impossible to diagnose even very serious abnormalities on a scan. But the pro-lifers who argue it is torture nonetheless, and promote their imaginative ideas of suffering onto an 11-week fetus as if it were an 11-week baby, never seem to exercise their imagination in a different direction: suppose the fetus were an 11-week baby, enclosed in a tiny chamber, with all nourishment and oxygen and comfort provided by the lifelink into the chamber. The pro-lifers never think of the miraculously-endowed fetus of their imagination struggling and gasping in the chamber of liquid which has become its tomb, desperate for oxygen that will never come because the mother’s lungs no longer work, blood no longer flowing because the mother’s heart has stopped, the incalculable comfort provided by the living warmth of the mother’s body ebbing away into cold and silence. And in that tiny chamber of death, the fetus also dies.
That’s the death pro-lifers preferred to condemn this woman’s unborn child to: the baby they imagined, they preferred to have die inside the uterus. If the fetus had any awareness at all, if the fetus could survive more than seconds after the mother died, both of which the pro-lifers claimed as truth – that struggling death like a fish in a tank of rotting water is what they wanted for this “unborn child” they claimed to care for.
(That is a fantasy, of course. At 11 weeks gestation, there’s no brain to be aware of anything – not the swift death of an abortion, not the slow death inside a dead mother.)
My point in this series of posts has always been that “pro-life” is ironic as a name for the movement, both political and religious, that opposes women having safe, legal, and accessible elective abortions. It is ironic because the denial of safe legal abortion worldwide causes the deaths of about 70,000 women a year in illegal abortions – since a woman faced with a pregnancy she does not want, will get an abortion any way she can. Illegal abortions are still statistically safer than childbirth, though: worldwide about 130,000 women a year die in childbirth or from pregnancy-related causes. This woman at St Joseph’s hospital very nearly became part of that statistic: she was saved, because the doctors performed an abortion.
If she had died, the fetus she was gestating would also have died. Two deaths instead of one.
Because it was a Catholic hospital, the ethics committee were consulted: the nun who sat on the ethics committee approved the abortion because it was to save the woman’s life. Bishop Olmsted of the Diocese of Phoenix has since decided that it is not justifiable to perform an abortion merely to save a pregnant woman’s life. There is a directive allowing lifesaving treatment to be performed on a pregnant woman even though doing so will kill the fetus (for example, if the uterus is cancerous, it’s allowed to remove the uterus) but if the pregnancy itself is killing the woman – if she’ll live if the fetus is removed and will die if the fetus is left inside of her – the Church says the woman must be left to die.
One of the Catholic bloggers I have been reading who has been explaining and justifying this position, Gerard M. Nadal PhD has found it necessary for his own comfort to delete all of my comments on his blog.
He complained that my plain English statements of the Church’s position were “calumnies” and that I was “defecating” on his blog. I pointed out to him that his own posts were a large part of what convinced me that this isn’t just a Bishop claiming a nun was automatically excommunicated for political reasons. (Bishops have used their power to excommunicate wrongly before: as another Catholic blogger noted, Olmsted avoided any pastoral resolution – which might have found Sister McBride justified – by declaring the nun automatically excommunicated.)
But after I pointed out to Gerard that it was his own posts and quotes and arguments which were convincing me that the Catholic Church really does require pregnant women to die if their life can be saved only by an abortion: that is, the Church requires devout Catholics to believe on pain of excommunication that it is better for two to die than for one to live – he deleted all my comments. Apparently, while sincerely holding this belief and desiring to promote it to others, he regards it as “defecation” to say so in plain English.
(His posts on this topic which I read, aside from the first couple of NIMBYish ones, were mostly in response to a Doctor Judith Becker who tried, patiently and at length, to get Gerard to acknowledge the medical facts, apparently on the assumption that if only Gerard understood that the pregnancy was killing the woman he would have to accept that the woman had a right to live: The Phoenix Abortion: A Pediatric Cardiologist Weighs In, More Debate on the Phoenix Abortion, More Debate With Dr. Becker on the Phoenix Abortion, How Catholic Bioethics is Guided, and The Principle of Double Effect. I’ve devoted a lot of space here to Gerard Nadal’s views, but several people in this thread were shocked, shocked, to find that their view that the hospital ought to have left the woman to die was being directly interpreted as callousness and unconcern for the woman’s life.)
But regardless of Gerard’s discomfort with having it stated plainly; when Bishop Olmsted declared Sister McBride excommunicated because she chose life for the one who could be saved, he set out in the open for all to see the policy of the Catholic Church that women’s lives do not matter. And Gerard’s and others defense of this policy have made it clear that Olmsted was no rogue bishop: it is Catholic doctrine that a pregnant woman and her fetus have an equal right to death, but not an equal right to live: if the fetus will die anyway, the Catholic Church discards the woman’s life unwanted.
That is Gerard’s belief. He’s said so on his blog. He’s said it at length, with long words and long sentences, but summarised in plain English he finds it unbearable, and deletes me.
So I say: plain English ain’t shit.
(A possible title I considered and rejected for this blog post. But I prefer not to use language that could cause a blog to trip Unsafe For Work alarms for people reading it at the office, and decided that posting it in the title of the blog was probably going to do just that.)