The U.S. bishops and the Catholic Health Association attempted to put difficult disagreements over the past year behind them in a recent series of phone conversations and an exchange of letters in January. According to the U.S. Conference of Catholic Bishops, “In response to questions raised about the authority of the local bishop in the interpretation and implementation of the Ethical and Religious Directives for Catholic Health Care Services [E.R.D.s],” conversations took place that included C.H.A. President Sister Carol Keehan, D.C., U.S.C.C.B. President Archbishop Timothy Dolan of New York and Bishop Robert Lynch of St. Petersburg, Florida, a member of the CHA Board of Directors.
In a Jan. 18 letter, the U.S.C.C.B. reports that “Sister Keehan affirmed to Archbishop Dolan C.H.A.’s acknowledgement of the role of the local bishop as the authoritative interpreter of the E.R.D.s in such Catholic facilities.” And in a January 26 response, Archbishop Dolan thanked Sister Keehan for “making clear that C.H.A. and the bishops share this understanding of the church’s teaching.
“As you, Bishop Lynch and I discussed, any medical case, and especially one with unique complications, certainly requires appropriate consultation with medical professionals and ethical experts with specialization in the teaching of the church. Still … it is the diocesan bishop’s authentic interpretation of the E.R.D.’s that must then govern their implementation. Where conflicts arise, it is again the bishop who provides the authoritative resolution based on his teaching office. Once such a resolution of a doubt has been given, it is no longer a question of competing moral theories or the offering of various ethical interpretations or opinions of the medical data that can still be legitimately espoused and followed. The matter has now reached the level of an authoritative resolution.”
Sister Keehan told America that she was not aware that the U.S.C.C.B. intended to release the exchange of letters to the public and “write a story about it,” that her understanding was the exchange was intended for distribution within the conference. She reiterated the main theme of her letter to Dolan, that the C.H.A. has never challenged a local bishop’s right to interpret or address ethical and religious directives within his diocese. “The C.H.A. has said and has always said that a bishop in his local diocese has the right to promulgate [the directives] and to interpret the E.R.D.s.,” Sister Keehan said. “He can even write his own E.R.D.s if he wants.
“We have never questioned that,” she said. “But can we have a difference of opinion? Absolutely.” Sister Keehan said part of the mission of the C.H.A. has always been to assist hospitals and U.S. bishops make practical sense of the church’s ethical and religious directives. She said, “The C.H.A. will continue to contribute its reflections and its input both on the pastoral and clinical needs of patients to the bishops and to the individual bishops within their dioceses.”
The U.S.C.C.B. and C.H.A. had a rough run in 2010. The C.H.A.’s qualified support for the health care reform legislative package in March proved pivotal to its eventual passage. This very public divergence with the position of the U.S. bishops was described by then U.S.C.C.B. President Chicago Archbishop Francis George as a “wound to church unity.” That wound opened a little further later in the year when the C.H.A. issued a statement of support for Arizona’s St. Joseph’s Hospital after Phoenix Bishop Thomas J. Olmsted decreed Dec. 21 that it could no longer describe itself as a Catholic hospital, charging that he could not verify that St. Joseph’s provided health care consistent with “authentic Catholic moral teaching.”
The hospital and its parent system, Catholic Healthcare West, had reached an impasse with Bishop Olmsted over whether a November 2009 procedure was a violation of Catholic moral teaching and church law. The hospital had intervened, its administrators said, to save the life of a mother of four who was near death because of extreme pulmonary hypertension. In doing so they terminated an 11-week pregnancy. Bishop Olmsted determined that the procedure represented a direct abortion, and said Sister Margaret McBride, a senior administrator at St. Joseph’s and part of the ethics committee which approved the procedure, was excommunicated by that decision.
Sister Keehan said she acknowledged the right of Bishop Olmsted to “kick them out of the diocese,” but said she, like many Catholic theologians, still believed St. Joseph administrators were properly following Catholic directives in the difficult decision. The hospital remains a C.H.A. member institution.
In the U.S.C.C.B. response to Sister Keehan’s correspondence, Archbishop Dolan acknowledges that “there are many moments on the horizon that could present a challenge to both Catholic health care and to the U.S.C.C.B. But these are also opportunities for us, as a church, to reaffirm our commitment, especially to the poor and needy, as well as to our Catholic respect for the right to life and for religious liberty. It will be very important for the church to speak with one voice on those occasions, and I would welcome the continued support of the CHA for these issues.”
Specifically Archbishop Dolan expressed his gratitude for C.H.A. collaboration on the Pitts-Lipinski Bill, which would “definitively resolve the outstanding questions about [the Patient Protection and Affordable Care Act's] inclusion of funding for abortion services and for plans that include abortion” and other pending legislation related to clarifying and improving health care reform in the future.