Anatomy of a Thorny Decision

Anchorage Archbishop Roger Schwietz told the Register in an e-mail that he turned to the National Catholic Bioethics Center in Boston for help to solve the thorny issues of induction.

The center asked him to submit a specific policy to comment on, and the archbishop sent the Providence Policy. It states:

“The pre-term induction of the delivery of a fetus is allowable only under the following conditions:

• if there is a serious risk to the health of the mother (Ethical and Religious Directives, Nos. 47,49) or

• if the fetus has a lethal condition. ‘Lethal condition’ is defined as a disease or a combination of abnormalities that, even with medical treatment, will not allow the fetus to live.

• if the fetus has reached 24 weeks of gestation (currently accepted as the stage of viability) or later (Ethical and Religious Directives, No. 49).”

The bioethics center told the archbishop that Providence's policy as stated “was morally problematic.” That judgment was made in a letter from a staff ethicist, Conventual Franciscan Father Germain Kopaczynski, a copy of which the Register has obtained.

“Its lapidary formulation certainly does not appear to be an adequate protocol for a hospital policy,” the letter said.

The archbishop then asked Providence for a more detailed policy “regarding guidelines for interpreting the Ethical and Religious Directives Nos. 45, 47 and 49.”

Those directives state:

“45. Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo. Catholic health care institutions are not to provide abortion services, even based upon the principle of material cooperation. In this context, Catholic health care institutions need to be concerned about the danger of scandal in any association with abortion providers.

“47. Operations, treatments and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.

“49. For a proportionate reason, labor may be induced after the fetus is viable.”

“Being concerned about the procedure itself,” the archbishop told the Register, “I wrote a second letter at that time asking that the procedure be suspended until I could study the guidelines” in Providence's new policy.

When he received the new guidelines, he said, “it seemed to me that they were in keeping with the [Ethical and Religious Directives] and that the [Providence] system was seriously considering each case through its ethics committees in the light of the Ethical and Religious Directives.”

He then told Parrish the system could again use the procedure.

The archbishop has received further comments from the bioethics center on Providence's detailed policy, and he sent those comments to “the local and Seattle directors of the Providence System for incorporation into their policy. These comments and suggestions [from the National Catholic Bioethics Center] were meant to make the [Providence] policy more clear and specific than it had been.”

Tom Szyszkiewicz