Abortion, Health Care & Moral Minimalism

In writing about abortion and health care reform, I have advocated that whatever legislation is finally approved should be "abortion neutral." Some of the more vociferous members of the pro-life community object to this phrase – and to what it represents – on the grounds that as Catholics we can never be neutral regarding abortion. True enough, but only in one sense. I remain convinced that when abortion becomes the lens through which we see all public policy debates, when it becomes the only issue, then we cut ourselves off from the messy, necessary, complicated, compromising, yet noble task of self-governance to which we are called as citizens. Conversely, if we try and skip past the issue of abortion to reach the Promised Land of Catholic social teaching on the other side, then we cut off that teaching from its roots in our anthropological beliefs about the dignity of the human person. Our commitment to the defense of human life is foundational, but it is not exclusionary.

There appear to me to be twin dangers in this debate. The first is that our concern to reduce abortion will blind us from seeing the good that can be achieved by adopting universal health insurance, indeed that the current health care reform effort may actually help reduce the abortion rate by making pregnancy more affordable for poor women. The reason to be precise in calculating the way the legislation is written is because there are two great goods involved: We cannot cooperate with evil and we must enact universal health insurance. In this free, pluralistic country of ours, there is no way that health care reform can become a vehicle to reduce the abortion rate: too many liberals who support health care also support abortion rights. I think they are wrong. I do not understand how abortion can be seen as health care except in the most extreme cases of a physical threat to the life of the mother. But, I have to concede that abortion is legal, it is covered by some current insurance policies, and that any effort to restrict such coverage as currently exists will kill the chance at health care reform. And, to repeat, universal health insurance is a great good to be achieved, a basic human right currently unmet in our land, an instance of social solidarity of the type advocated by Pope Benedict in his encyclical Caritas in Veritate.


The other danger is that of minimalism. There is a reason that casuistry got a bad name. To use a banal example, wolfing down a burger at one minute past midnight on Good Friday seems to miss the point of the law not to fulfill it. In seeking to define what constitutes formal cooperation with the evil of abortion, and insisting that we can get close to that line but not cross it, are we not inviting a kind of minimalism about the moral life? After all, we are called as Catholic Christians to do more on behalf of justice and love and solidarity than merely to avoid formal cooperation with evil. We are called to holiness, to perfection even. Isn’t there something corrupting about all these careful, precise calculations as to what does, and does not, constitute a federal subsidy and whether or not such a subsidy, if it is indirect, constitutes formal cooperation with evil?

This concern for minimalism is broader than the current debate. I have argued elsewhere that the Church’s natural law theorizing tends to issue in an act-centered morality that invites minimalism. And, I regret that the drafters of the Catechism organized the Church’s moral teachings around the Decalogue rather than the Seven Deadly Sins. The Decalogue has the great advantage of being scriptural, but it fails to capture the psychological aspect of sin the way the Seven Deadly do. You did, or you did not, steal or bear false witness and while there is value in knowing whether you did not did not do these bad things, we humans are crafty at covering our bad deeds with good intentions. The Seven Deadly Sins suggest a more nuanced – and accurate – model, e.g., there is a bit of pride in all of us (perhaps a big bit of pride in those of us who live off of our opinions!), there is a bit of greed and envy and malice in all of us, etc.

In health care, however, both in legislating about it and in administering it, we need casuistry because the questions are complicated and difficult. When my mother was dying, we had to face some of these questions and it was a great comfort to have a Catholic ethics board help us understand the issues. We, as a nation, face some of the complexity of those issues as we consider health care legislation. It is not enough to say, "Oh, we are never neutral on abortion" and then try and defeat any health care bill that does not prohibit the procedure. I think it is reasonably certain that providing health care options to women facing crisis pregnancies is a good thing that will help reduce the abortion rate. The lack of care for forty million of our fellow citizens certainly results in many thousands of unnecessary deaths, and that should concern pro-lifers as well. In this free society of ours where abortion is legal, we cannot force our views on others, we must persuade them. And employing our views to defeat health care reform is not the way to persuade them. We are right to draw lines, and we are right to worry about what happens when we draw lines and scoot up close to them. It is the price we pay for being moral persons.

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9 years 3 months ago
There is much to be lauded in this essay Michael. However it still seems to set up a false either/or which isn't quite so.... that is, either we pass "health care reform" now, or we'll 'never' get universal coverage. Seems to me, everyone can afford cell phones, tvs, and tennis shoes. So it would seem lowering cost for care is the best way to proceed - and that doesn't necessarily demand Catholics line up behind THIS CURRENT set of "plans".
All the current plans aren't scheduled to be deployed until 2013, so why not hold out for a better, more Catholic and more universally palatable set of "plans" that more than 47% of the population can agree to? Why THIS plan and why NOW? No one denies that we need to improve access to all Americans (and residents in the US)... so there IS a bi-partisan consensus on the need. Why NOT seek a truly bi-partisan plan that's simpler, clearer, and less full of special interest gerrymandering and king-making?
Finally, while it's nice to SAY that Obama wants to "reduce the number of women having abortions" it's hard to PROVE IT when he hikes funding for Planned Parenthood and many other abortion promoters, providers, and political dynasties, uses abortion as a litmus test for all his political appointees, and actually employs long time abortion providers into key positions with nary a peep from "Catholic" democrats.... if the end game we all agree on is to reduce abortion, what are we to make of many Catholics' apparent acceptence of the status quo as a given rather than something intolerable to be actively undermined and overthrown via the political process?
If Catholic Democrats truly wanted to remove the plank from their party, they already have the numbers and leverage to do so by threatening to walk out on this set of Health care "plans" - which would force the hard-left to compromise and come 'right' towards a more Catholic (and moderate) position. That's how political persuasion works. By declaring the status quo to be simply "the way it is" and then squabble over minor details of these hugely complex bills full of loop holes and pro-abort 'ethics' panels, is to fall for the premise of the side we all need to evangelize - to wit, that human dignity is not a Catholic concept and Human rights simply don't come from the Supreme Court, Congress or POTUS but either come from the fact that a human being IS, or they don't exist at all. America was founded on the concept that rights inhere in human beings qua human beings....
If you "Catholic democrats" would join us on this issue we'd be able to pull BOTH parties towards the center.
You'd be genuinely shocked to know how many pro-life Republicans would shed the GOP in an instant if the Democratic Party became truly pro-life.
9 years 3 months ago
I don't know how much clearer the Alan Guttmacher Institute has to make it - births go down 25% and abortions go up 25% when funded, even though pre-natal care is also funded (your point on minimalism tells me that you understand we are massively increasing the funding of killings).
We need to put aside our feelings and our hopes that this healthcare bill will lead to abortion reduction - and instead rely on the 3 decades of research that say funding substantially increases abortion. That means that this healthcare bill will ensure the killing of millions upon millions of people who would have been born.
Patience is a virtue. I am fully committed to universal health care and aware of the current political advantage, but I am not willing to jeapardize the lives of millions of babies in my lifetime and in the future. This is difficult for everyone (especially the uninsured) but Catholics need to tell President Obama, ''thanks, but no thanks''.
9 years 3 months ago
Overall, you seem to be backing away from your earlier ''line in the sand'' post about abortion (in which you threatened to not vote for a Democrat again if abortion were expanded).  In my opinion, you're too tied to the Liberal Democrat plan and are trying to force it into Catholic Social Teaching.  I think its a round peg in a square hole problem.
I also agree that you seem to have a moral equivocation problem in this post between the Church's abortion teaching on the one hand and social teaching on the other.  The only fair analysis is that the two are harmonious AND that abortion and threat to innocent human life is a fundamental or primordial moral concern because it threatens to undo all the rest of Catholic social teaching.  So you can't really just balance the two out; abortion must be primary (without, of course, being the single issue).
9 years 3 months ago
Correction: According to Guttmacher, when abortion is funded for low-income women, births go down 25% because those pregnancies are aborted. Abortions don't go up 25%, however they do rise significantly. 
9 years 3 months ago
According to Guttmacher, no abortion is chosen for only one reason, but the most common reason is poverty.  Poor pregnant women not only risk losing their income due to pregnancy complications and restrictions, but they also risk losing any savings they might have accumulated should they or their children have medical issues.  The prospect of being sure that any needed medical care would be available for a simple, low, regular percentage of one's income that is paid whether one uses the medical care or not could do a lot to sway the person considering an abortion. 
9 years 3 months ago
If you use Guttmacher statistics, then you must also recognize that their research shows that 73% of women say they abort for economic reasons.  Bettering their economic by, lets say passing health care reform, will reduce abortions - although assuring that they are paid a living wage is also key to this.  Expanding the refundable child tax credit to do this nicely.  This could be done in a revenue neutral manner by shifting the child exemption to the credit and ending the deductibility on home mortgages and property taxes(which mostly go to the rich).


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