Treating Both Mother and Child

Ex-CMA Head Discusses Church Teaching in Light of the Arizona Abortion Controversy

RIGHT OR WRONG? Bishop Thomas Olmsted of Phoenix said Mercy Sister Margaret Mary McBride, the former vice president of mission integration at St. Joseph's Hospital and Medical Clinic in Phoenix, automatically excommunicated herself when she concurred in an ethics committee decision to abort the child of a seriously ill woman at the hospital in 2009.
RIGHT OR WRONG? Bishop Thomas Olmsted of Phoenix said Mercy Sister Margaret Mary McBride, the former vice president of mission integration at St. Joseph's Hospital and Medical Clinic in Phoenix, automatically excommunicated herself when she concurred in an ethics committee decision to abort the child of a seriously ill woman at the hospital in 2009. (photo: CNS photo/J.D. Long-Garcia, Catholic Sun)

Dr. Paul Byrne is director of neonatology and pediatrics at St. Charles Mercy Hospital in Toledo, Ohio, and a former president of the Catholic Medical Association. His work in neonatology began in 1963, and he became a board-certified neonatologist in 1975, subsequently developing oxygen masks, an incubator monitor and a blood-pressure tester for premature babies, which he and a colleague adapted from the finger blood pressure checkers used for astronauts. During his interview, Byrne stressed that he was not speaking on behalf of St. Charles Mercy Hospital.

As an experienced neonatologist who has monitored high-risk pregnancies over more than 40 years, what is your reaction to the media coverage of the controversy surrounding Phoenix Bishop Thomas Olmsted’s condemnation of a direct abortion performed at St. Joseph’s Hospital, a Catholic hospital in his diocese? Was there anything missing in the media reports?

I want to stress that I don’t know the specifics of this case that led to the decision to perform a direct abortion. However, the teaching of the Catholic Church is very clear: Life is gift. We are required to protect and preserve the life of every person from conception to natural end. When a mother is pregnant, the physician really takes care of two patients: the mother and the baby. Both lives must be protected and preserved.

In some ways, people are surprised that that is the case. Emotionally, we all love our mothers, and mothers can also speak for themselves. The baby can’t speak for him- or herself. All of us need to stay focused on protecting and preserving the life of both.
The principle that applies here is that we do not impose death on the baby. And judging only by published reports and statements, death was imposed on an unborn child through a direct abortion.

According to reports, the diagnosis of pulmonary hypertension created a medical emergency that required a direct abortion to protect the life of the mother.

I know nothing more about the specifics of this case than the public knows: The mother had pulmonary hypertension. That condition alone will not suddenly take the life of a mother that has been pregnant for 11 weeks. Simple medical treatment, such as bed rest and oxygen supplementation, can be very effective.

The point, again, is to focus on treatment that protects and preserves both the life of the mother and the baby and does not impose death on either one. If the pregnancy reaches 11 weeks, what is to say that it won’t reach 20 weeks? You go day by day, week by week, putting the medical tests and treatment together. Remember, imposing death on that unborn child is a traumatic event for the mother. Over the years, I’ve been consulted about how to protect an unborn child while implementing cancer treatment for the mother. One patient had a tumor on her heart, and the question was raised about doing an abortion. But bed rest and oxygen allowed the physician to wait until her child could survive outside the uterus. Then they treated the mother.

In your experience, how do pregnant patients react during these medical emergencies?

Mothers don’t want something to happen to their babies. But, it’s also true that doctors are leaders, and they possess critical information and experience that the patient lacks. Most of the time, the patient pays close attention to what the physician recommends and follows our guidance.

Good medicine follows good morals. You can’t have good medicine without good morals. Life is a gift, and doctors and nurses are called to protect and preserve human life from conception to natural end.

While acknowledging the lack of specific information regarding the Phoenix case, I cannot recall any similar situation in which abortion was advised to treat pulmonary hypertension. In my experience, when you think your way through a medical problem, you come up with solutions that provide better treatment for the mother, and these solutions allow the baby to grow large enough to survive outside the uterus.

Since you first introduced innovations in the field of neonatology, have physicians’ attitudes changed regarding medical treatment for pregnant patients with potentially life-threatening conditions?

Things are different: Every 20 seconds abortion kills a baby in the United States. That fact has influenced our nation’s culture and has shaped medical ethics, though most doctors do not participate in abortions.

Some physicians use the “principle of double effect” to defend direct abortion when pregnant patients face a life-threatening condition. But I don’t think the principle of double effect applies at all in a case like this. What you have is the mother and the baby: two patients. If you perform an abortion on the baby, you don’t have two effects (such as implementing a medical treatment that indirectly kills the patient’s unborn child); you just have one effect: killing the baby. Some physicians and ethicists are confused. Everyone should just say: “We don’t do abortions; we treat the mother and the baby.”

Not too long ago, I took care of quadruplets. When the mother first went to the expert on high-risk pregnancies, he recommended a “selective reduction,” aborting one or more of the embryos. She said No. Then he said, “Come back at 30 weeks, and we’ll deliver them.” Instead, she came to us. We got her off her feet; she rested, and delivered the quadruplets at 34 weeks. We were set up to use ventilators, but the babies didn’t need them. Each baby weighed more than 5 pounds. This is pro-life obstetrical care.

When physicians recommend direct abortion, they often lack proper educational formation. They lose focus on what is good: justice and charity. The world is very different today compared to when I started my work in neonatology. Back then, many premature babies died, and we were trying to learn how to save them. We focused on saving lives.

Now, most premature babies live. But we live in a culture of death, and that has altered some physicians’ views about saving the lives of premature babies.

Yet, society at large is now becoming more pro-life and concerned about the sanctity of life at its earliest stages. Are other currents at work in the medical profession?

Many physicians and patients are products of an educational system that excludes God. If you acknowledge that God exists and that he is the Creator and we his creatures, you accept the dignity of all human persons in a world governed by a stable moral order. Without that awareness, there is the threat of moral disorder and tyranny by the powerful.

The consequence of an educational system that denies the existence of a Creator and his moral law can be witnessed in our recent debate over a health-care reform bill and its language dealing with abortion.

How can we articulate and defend these fundamental moral principles in a secular health-care system?

You don’t have to mention God. What you can do is give the best information and example, and realize that a man convinced against his will is not convinced at all.

However, most of the parents I work with have faith that God will heal and take care of their baby. They love their baby: That is the Christian approach.

When a baby is born, I present the baby to the parents, and praise and thank God for this beautiful baby. Ten minutes earlier, we struggled to save the baby while it was still in the uterus. I have medical education, training and skills, but the reason they succeed in these difficult cases is because God says Yes to that new life. 

Joan Frawley Desmond writes from Chevy Chase, Maryland.