Standing Up Down Under

The United States isn't the only country in which Catholic institutions of higher learning are being squeezed to conform to the educational culture at large.

Australia's only Catholic medical school has come under fire from an association of secular bioethicists. The group claims the school's Catholic ethos could threaten academic freedom and reduce patients’ options.

The school, Notre Dame Medical School in Fremantle, Western Australia, and local Church leaders have dismissed the accusations, which were made in the Medical Journal of Australia in July by academics from the Center for Values, Ethics and the Law in Medicine, a secular research organization based at the University of Sydney.

The authors are concerned that Notre Dame students won't receive “appropriate education” in areas such as abortion, contraception, assisted reproduction and end-of-life care.

“[D]espite the evident commitment to care by many Catholic institutions and clinicians, it remains the case that there is a problematic tension between the teachings of the Church and the services and information provided by medical institutions and practitioners,” they wrote. “Physicians may limit the health care options available to their patients … especially in rural and remote areas, where choice of medical practitioner is extremely limited.”

Degrees in education and nursing are well established within Australia's Catholic universities, but it wasn't until this year that Notre Dame Fremantle opened the country's first Church-affiliated medical school.

The university is named after its founding partner in the United States, and expects its first doctors to graduate at the end of 2008.

On the other side of the country, plans are underway for medical degrees to be offered at Notre Dame's Sydney campus from 2007.

While all secular medical schools in Australia include some form of ethical studies in their curricula, Notre Dame's course includes compulsory theology and philosophy subjects.

The principal author of the Medical Journal article, Ian Kerridge, told the Register he sees “terrible” problems with the compulsory theology component.

“It's a problem to insist on any particular value set … regardless of whether it's secular or religious,” he said. “Let's say I'm a really devout Muslim. There are some passages [in the Koran] that are very strong about not even tolerating other religious beliefs.”

“It's hard for me to think,” he continued, “that it would be necessarily tolerant of a medical school to say, ‘Now you have to do Catholic ethics, and you have to pass it and you have no option.'”

Catholic Core Values

Notre Dame Fremantle had already addressed these concerns when it applied for teaching accreditation through the Australian Medical Council.

The council itself sought to clarify questions “about the explicit association of a medical school with a set of religious values,” particularly the “potential discrimination” of students who didn't adhere to Catholic beliefs.

However, it commended the proposed philosophy and ethics units within the course, as well as Notre Dame's clear commitment to emphasize the “psychosocial dimension” of health care.

Satisfied that Notre Dame had significant support from the medical and allied health professions, accreditation was granted in 2004.

Notre Dame's dean of health studies, Mark McKenna, said the university rejected claims that Church-affiliated medical schools lack professional competence or oblige students to accept Catholic beliefs.

“We do not consider that the Catholic nature of the Catholic hospitals servicing the Australian population lessens the care provided by them,” McKenna said. “Students are exposed to all aspects of medical care, and are encouraged to explore their motivations and beliefs and the effect of that on provision of care.

“All aspects of medical care means all aspects, including care of a woman presenting and considering abortion,” added McKenna. “It is worth noting that it is the clinical presentation, diagnosis and management of medical issues, and not how to perform the operative procedure, that is the focus of undergraduate education at all medical schools in Australia.”

McKenna also pointed out that students are not expected to have or to develop any particular set of values — “but, like all teachers, we do hope that some of our hopes, beliefs and aspirations are expressed by our students.”

Service of Truth

At last year's announcement of Note Dame's decision to open a Sydney campus, Cardinal George Pell, archbishop of Sydney, commented: “Law and medicine are vitally important professions, and like all professions they need to be taught well and guided by sound values.”

“There is nothing unusual about the Church's interest in tertiary education. The university is a Christian invention, born as Pope John Paul II has said from the heart of the Church in the 13th century,” the cardinal added. “The Church is dedicated, like the university, to the service of truth.”

In an interview with the Register, Cardinal Pell said that, while Catholic values would be proposed to all Notre Dame Sydney students, none would be prevented from graduating if they disagree with Church teaching in any given area.

“In contrast, there have been cases in Canada and other places where otherwise qualified students who are pro-life have not been permitted to graduate from medical school because they dissent from secular dogma in favor of abortion and related matters,” he said.

“It would be most regrettable if this were to happen in Australia,” added the cardinal. “The establishment of Catholic medical schools will help to ensure that it doesn't.”

The Catholic ethos of Notre Dame will extend to marginalized communities: The Sydney school hopes to offer specialist courses in indigenous health and encourage students to practice in less populated areas.

The health of Aboriginal Australians has been described as “third world.” Average life expectancy is 17 years below the rest of the population, and indigenous health is, on average, three times worse than other Australians'.

While a small number of the secular medical fraternity may be concerned about Notre Dame, there is significant support from Catholic doctors.

Dr. Amanda Lamont, president of Western Australia's Catholic Doctor's Association, said Notre Dame students learn the facts about contraceptives, abortion and other procedures, but would also cover ethical questions — material many medical schools neglect.

In her own secular medical training, for example, the pill was seen to be a medical panacea — yet students were never told it was an abortifacient, and ethical issues surrounding it were never discussed.

“What Notre Dame is doing,” said Lamont, “is encouraging students to think, to consider some of the values of Catholicism.”

Under standard practice, the Australian Medical Council will undertake periodic reviews of Notre Dame Fremantle, and the university said it has been and will continue to be judged by that process.

The council is currently assessing Notre Dame Sydney's application for accreditation.

McKenna, Notre Dame's health dean, is hopeful about the outcome.

“There is academic freedom in Catholic universities,” he said. “With their long tradition of inquiry, they have contributed to the development of the Western intellectual tradition for hundreds of years, and continue to include in their ranks some of the first-class medical schools in the world.”

Helen Ransom writes from Melbourne, Australia.