WASHINGTON—This year, the annual meeting of the National Conference of Catholic Bishops made headlines for what it didn't do.

When the U.S. bishops met in November, they did not make some expected changes to the Ethical and Religious Directives, the code that guides the conduct of Catholic hospitals.

This non-action led to charges that they were “stalling” and “watering down” the guidelines, or even trying to change the Church's teaching on controversial medical issues like contraception and sterilization.

The proposed changes would have added tough language—sterilization was called “evil,” and contraception was “absolutely forbidden.” Those changes were tabled, though the bishops’ conference says it will revisit them in June.

But spokesmen for the U.S. bishops stressed to the Register, there will be no softening of church teachings on sexuality when the final version is eventually approved.

Frances Kissling, director of the pro-abortion lobby Catholics for a Free Choice, did not return repeated calls for this article. However, she told the Miami Herald, “This is a sign that both the Catholic bishops and the Catholic health systems want to negotiate with the Vatican behind the scenes. They are hopeful they can soften the language and get that accepted.”

Kissling's group, which has been denounced by the U.S. bishops for misrepresenting itself as an authentically Catholic organization, lobbies for the Church to abandon its opposition to contraception, abortion, and sterilization. The organization is currently spearheading a campaign by pro-abortion groups to strip the Holy See delegation of its Permanent Observer status at the United Nations.

“Unless this Pope dies before this issue is settled, there is very little chance that the Vatican is going to back down,” Kissling told the Herald. “I think we will see as much stalling as the bishops can muster.”

Kissling presented the same “Vatican undermines Catholic health care” scenario on CBS's “60 Minutes,” but without the claims that the U.S. bishops wanted a compromise (see sidebar).

Spokesmen for the U.S. bishops strongly disagreed with Kissling's diagnosis. James LeGrys, theological adviser at the bishops’ secretariat for doctrine and pastoral practice, said, “That sounds like wishful thinking on the part of Frances Kissling.”

Father Michael Place, head of the Catholic Health Association, said, “That is a complete misrepresentation of the truth. The bishops have not backed down on anything.”

He explained that the revisions to the health care directives deal with how the Church's teaching on contraception, sterilization and human sexuality should be applied in a complex world where Catholic and non-Catholic institutions are often closely intertwined.

“The revisions to these directives do not apply to the teachings about human sexuality,” he said. “The issue at hand is how, in partnership with people who do not share our values, do we maintain our integrity.”

Stressed Father Place, “There is no softening of the teaching” on sexual matters. “Bishops can't change the Church's position on abortion, sterilization, or anything else,” pointed out Bill Ryan, a spokesman for the bishops’ conference.

In November, he explained, “[the bishops] decided they wanted more time to study” another version of the health care directives, which will be presented in June.

Humanae Vitae (Human Life), Paul VI's 1968 encyclical, expressly prohibits any kind of contraception or sterilization. “The Church ... teaches that each and every marital act must of necessity retain its intrinsic relationship to the procreation of human life,” Paul VI instructed. “ ... Equally to be condemned, as the magisterium of the Church has affirmed on many occasions, is direct sterilization, whether of the man or of the woman, whether permanent or temporary. (Humanae Vitae, No. 12 and No. 15)

Still, no one disputes that Catholic medical ethics are getting more complicated as economic pressures force non-religious hospitals into mergers or alliances with Catholic health care providers. In such cases, the Catholic partner must tread carefully to make sure that it does not cooperate with immoral actions.

Catholic Ethics, Grateful Patients

When the bishops convene in June, North Dakota may be one place they will consider as a model for how ethical directives should play out in the lives of patients and doctors.

Carrington Health Care Center in Carrington, N.D., had never undertaken elective sterilizations, but it did perform them in situations that Bishop James S. Sullivan of Fargo found inappropriate. He notified the hospital, and Carrington stopped performing sterilizations. Men and women seeking sterilization as birth control now get an explanation of the hospital's policy and a referral to a doctor certified in natural family planning.

To critics of Catholic teachings on sexuality, this is a classic example of a heavy-handed bishop laying down the law to deprive patients of health care. But in practice, said Father Gregory Schlesselmann, diocesan director for Catholic education and formation, many patients are interested to learn about natural family planning.

Dr. James Craig shows couples how to do natural family planning at Carrington. Craig stopped performing sterilizations and prescribing artificial contraceptives after going to lectures on the subject held by the diocese.

Now, when a patient comes in seeking birth control, he discusses the reasons he won't prescribe it. He often has “30- or 40-minute-long” conversations with these patients, he said.

Father Schlesselmann said that many patients are “grateful [to Craig] for taking the time” to talk with them, and for “avoiding a procedure that mutilates a healthy organ, at times permanently with no possibility of reversal.”

Cody Stangeland is one of the grateful ones. She went to Craig last August, after other doctors had prescribed birth-control pills, which she refused to take. Craig “found what the problems were instead of covering them by prescribing birth-control pills,” she said.

She said Craig was more concerned with the “health of the woman” than previous physicians had been.

“I have told my friends about Dr.

Craig and Ann [his wife, also trained in natural family planning],” she said.

Stangeland added that some of those friends, who “did not know that there was anything else out there,” have since decided not to use contraception.