Negotiating Catholic healthcare moral dilemmas


Federal Health Minister Tanya Plibersek, St John of God CEO Dr Michael Stanford and Brookfield Multiplex's Chris Palandri at the Midland Health foundation ceremonyOn 8 August, Tanya Plibersek, the Commonwealth Minister for Health, assisted with turning the first sod for the construction of the Midland Health Campus on the outskirts of Perth.

It will include a 307 bed public hospital and a 60 bed private hospital to be run by St John of God Health which has a proud tradition of running first rate Catholic private hospitals. This, their first public hospital venture, 'will help meet the rapidly growing need for additional health and hospital services in eastern Perth', said Plibersek.

'For the first time, people from Midland and the surrounding area will have access to chemotherapy, high dependency care and coronary care and children will be able to be treated in a dedicated pediatric ward.'

Not everyone was overjoyed. Members from United Voice and the Health Services Union joined protesters opposed to government vesting the management of a public hospital in private hands. Carolyn Smith, acting secretary of United Voice, said, 'We don't oppose the Church running hospitals. We don't oppose St John of God running hospitals; they do a great job. But we don't think they should be running public hospitals.'

The protestors claim the public will suffer because some citizens, not sharing the Catholic view on some moral questions, want access to services such as abortion and sterilisation. They say a public hospital should offer the full suite of services, and not omit particular services simply because of the religious beliefs of the managers.

But no public hospital offers the full suite of all possible medical services. If abortions and sterilisations can be provided at other convenient locations, a Catholic provider should not be forced to provide these services which they believe to be morally questionable.

Two weeks later, Plibersek accompanied Prime Minister Gillard to the opening of the Kinghorn Cancer Centre within the St Vincent's Precinct at Darlinghurst, Sydney, which includes St Vincent's Public Hospital which has offered medical services (but not abortions or sterilisations) to the public for over 150 years.

The Kinghorn is a fabulous, state of the art facility, highlighting the benefits of medical and research facilities being provided not just by government health departments.

Julie Soon, a young survivor of leukaemia who received treatment at St Vincent's, said her 'cancer journey was long, dark and very lonely'. 'Therapies such as meditation and speaking with a social worker helped me cope with the roller coaster ride. With my recovery being a lot smoother than for most, I cannot fathom how much harder it would be to cope for the vast number of cancer patients who are not as fortunate as I was.'

To be able to provide a holistic service to patients aspiring to the healing mission of Christ is part of the vision of Catholic healthcare. The nation would be the poorer if this Catholic vision were confined only to those who could afford private health insurance.

The Church's moral teachings provide Catholic health providers with some acute pastoral challenges. Especially with emerging technologies, not all issues are clear cut. Christian charity, pastoral solicitude and respect for a patient's own ethical concerns are usually enough, but not always.

Last month, the Melbourne Herald Sun carried a front page headline: 'Best Friends' Baby Miracle ... and Why a Top Hospital Said No to the Birth'.

Three years ago, doctors at St Vincent's Private in Melbourne saved the life of Melissa Humann when she gave birth to her first child. Unable to carry a second child, Melissa accepted the offer of her friend Tracey Osborn who said she would carry to birth the child conceived by Melissa and husband Craig. Tracey, a mother of three, got the agreement of her husband Andrew, and the surrogacy arrangement was put in place.

Both Melissa and Tracey had appreciated previous hospitalisation at St Vincent's and would have liked the birth to occur there. The treating obstetrician would usually have arranged the birth at St Vincent's.

But with five months notice before the planned delivery, the hospital authorities consulted a Catholic bioethicist and advised that there were moral issues at stake which precluded the hospital from providing its services for a surrogate birth. A booking was made at the Freemasons Hospital nearby.

Three months after the birth of the baby, Tracey and Melissa went public with the story of their happy surrogacy arrangement, which appears to have brought joy to all parties, without undue complications.

Catholic Health Australia has engaged a panel of ethicists to advise on surrogacy, and expects to reach a position next month. Some of the public may well be upset by this delay. But it is good that time be taken to consider the appropriate course of action. Not every surrogacy arrangement will be as free from emotional and moral complexity as the arrangement between Melissa and Tracey.

Some commentators argue that the Church does not inquire into how conception has occurred, so why should it be worried about surrogacy. While Catholic facilities do not provide IVF services, they do provide birthing services for women regardless of their marital status or mode of conception.

Surrogacy raises extra issues, including appropriate pastoral care for both mothers and their families, and formal cooperation in the surrogacy procedure, including surrender of the child from birth mother to biological mother.

As Martin Day, CEO of St Vincent's Private, insisted, 'Conception is strictly a private matter between parents, not the hospital. We do not know if assisted conception has been used. Surrogacy is different as strict statutory rules must be followed so the hospital does know.' The hospital not only knows, it is intimately involved.

The nation is the better for policies and funding arrangements that encourage public and private providers of healthcare, including the Churches. The public may need to be patient with Church authorities as they discern appropriate moral responses to new technologies. This is a small price to pay for creative diversity which delivers healthcare of the highest standard with a special character cherished by many citizens, not just Catholics.

Frank BrennanFr Frank Brennan SJ is professor of law, director of strategic research projects (social justice and ethics), Australian Catholic University, adjunct professor at the College of Law and the National Centre for Indigenous Studies, Australian National University, and a board member of St Vincent's Health Australia.

Photo: Federal Health Minister Tanya Plibersek, St John of God CEO Dr Michael Stanford and Brookfield Multiplex's Chris Palandri at the foundation ceremony on 8 August.

Topic tags: Frank Brennan, Catholic healthcare, abortion, surrogacy



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Existing comments

Brennan's argument is clear and worthy. It also depends on Australia being multi-faith (and no faith) to work. It relies on a diversity of providers. It is an urban argument since rural areas are less likely to be able to support a diversity of services. This is a fine example of how being multi-faith enables being faithful in provision of social and health services. Protecting, enhancing, and celebrating our religious diversity is essential to healthy co-existence of people of different beliefs and none. Thus care must be exercised to protect diversity and not permit the take-over of sectors of health or social service by any group that would limit the range of services available to Australians. Catholics are the only religious group with the resources to engage in hospital based health care and they have a great history of doing it well, with well known limits to services provided. No one can enter this field with out government funds. It is essential that these funds be used to make sure that all Australians have ready access to the full range of medical care.

Gary Bouma | 05 October 2012  

Fr Brennan asserts that " a Catholic provider should not be forced to provide these services which they believe to be morally questionable." That's quite OK. The problem with the case he discusses is that the provider is not Catholic, it is the Government.

brian finlayson | 05 October 2012  

"If abortions and sterilisations can be provided at other convenient locations, a Catholic provider should not be forced to provide these services which they believe to be morally questionable." I'm not exactly sure what this passage is meant to imply, but, just to clarify: For a Catholic to deny the Church's doctrine on the grave immorality of direct and voluntary killing of an innocent human being is to fall into heresy. And to successfully procure an abortion incurs latae sententiae excommunication. (CCL 1398)

HH | 05 October 2012  

Wasn't Mary's pregnancy with Jesus a semi-surrogacy arrangement with Joseph forsaking traditional fatherhood for the sake of the kingdom?

AURELIUS | 05 October 2012  

United Voice and the HSU have a very valid point - everyone - including women - should be entitled to expect and to receive the full suite of modern medical procedures legally available in this 21st century, in Australia, a deliberately secular country. Quite frankly (no pun intended) the Australian public are well and truly sick of being "patient" with the scandalous Catholic Church authorities - having to tolerate these same regressive, self-interested authorities hijacking the access of members of our pluralist society to modern, comprehensive healthcare at a "public" hospital is simlpy unacceptable.

Michelle Goldsmith | 05 October 2012  

So let's imagine a public hospital using public money run by Jehovah's Witnesses that refused to offer blood transfusions? Would Frank expect us to be patient with them too?

Ginger Meggs | 05 October 2012  

HH, this article is not about 'abortions and sterilisation', it's about surrogacy! How you can talk about abortions, sterilisation, and surrogacy in the same breath staggers me.

And if you want to excommunicate every Catholic who effectively denies 'the Church's doctrine on the grave immorality of direct and voluntary killing of an innocent human', then you may as well start with every Catholic in the Parliament who actively or passively supported or supports the killing done by Australians in Afghanistan and Iraq. And please don't suggest that it is not 'direct and voluntary'.

Ginger Meggs | 05 October 2012  

Thanks, Frank Brennan.
HH, since you are unsure, the theological principle behind CCL 18 would preclude your comment. Second, CCL 1398 has nothing to do with heresy. Third, a charitable rather than negative approach to Frank's helpfully subtle sentence renders your statement irrelevant as well as off-topic.

Paul Fyfe | 05 October 2012  

Thanks Paul. 1.) My citation of Canon 1398 obviously references the preceding statement, not my whole post. 2) Canon 18, literally and/or in principle, does not forbid one pointing out penalties canonical (l.s. excommunication) or spiritual (heresy) which apply to certain acts or situations, actual or possible. Rather, it forbids an authority from applying penalties on the basis of loose interpretations. I was not seeking to apply any penalties. So, Canon 18 and any principle it is based on are irrelevant. 3) Since you're adept at reading the subtlety of Fr Brennan's statement, can you reword it for poor stupid me in a way that captures whatever Fr Brennan legitimately meant to say, yet avoids the alarming implication of the proposition as it currently stands that, when abortion and sterilization facilities are not available at other convenient locations, Catholic hospitals should be forced to provide them?

HH | 06 October 2012  

When a doctor is confronted by human life in a mother's womb his obligation is to the well-being of that life no matter how it got there. The ethicist consulted regarding treatment and care for a human life was morally wrong when he/she advised against treatment because of how the child was conceived or in which mothering environment that unborn was living. Such human life, like it or not, has resulted from the creator's mechanism of creation of human life. Once that life exists there are no exclusions to the Catholic obligation to care for it.

JOHN FRAWLEY | 06 October 2012  

So what's the difference between the church providing an army chaplaincy service and providing a hospital that performs abortions? The termination of human life is carried out in both scenarios - but the actual killing tasks are left for the lay people to carry out. The chaplain is merely there for moral/spiritual guidance - or perhaps to absolve sins.

AURELIUS | 08 October 2012  

Also, Michelle Goldsmith, 21st century international law also allows the slaughter of whales for scientific research purposes, and the Australian Government is a loss to do anything about the Japanese Government doing this. Thankfully, Greenpeace looks beyond the letter of the law and sees the protection of whales as a justice issue (for the whales' sake) In the same way, I don't see human rights as just a religious issue (including the human rights of the unborn), but a simple defence of the defenceless. If my mother or your mother had an abortion, we would not be here today to comment about it.

AURELIUS | 08 October 2012  

It is a truism to say that all babies brought to birth are precious beyond measure. My question is this:Despite the surrogate mother having freely signed over the baby,to the "adoptive" parents, can this ever extinguish her right to claim the child as her own?

Claude Rigney | 08 October 2012  

Hi Aurelius - must say, I usually enjoy your comments, but your strange adage that I'd not be here had my mother had an abortion really lets you down. My mother was educationally, financially, emotionally and socially secure. She had planned her pregnancy. Her physical and/or mental health were not threatened by her pregnancy. She was not the victim of sexual crime or assault, nor the victim of coercion. As a married woman aged in her early twenties, she had the approval and support of family and society. She had access to healthy food, clean water, secure housing, modern healthcare and the knowledge that her child would have all the security, safety and myriad other advantages of the peaceful first world. Unlike my mother, many women and girls do not live under these conditions - they are rendered, therefore, somewhat "defenceless" if the fundamental human right - the right to have sovereignty over their own bodies, therfore, their own lives, is denied them. The potential future for their less-than happily anticipated babies is even more dire. What "scientific" whaling has to do with that, I don't know.

Michelle Goldsmith | 09 October 2012  

I'm sorry if I let you down - and that my comments don't fit the normal Leftist paradigm of other civil freedoms that I support, but abortion is one issue where I draw the line - on a very fundamental human rights basis - that an unborn baby still has the right to be born, even when all the ideal conditions you listed are not present. I have many friends living in poverty in third-world countries and I wouldn't like to think they had less right to exist than someone living in Australia.

AURELIUS | 09 October 2012  

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