Excommunication of Margaret McBride
Encyclopedia
The excommunication of Margaret McBride occurred following the sanctioning by the Religious Sister in November 2009 of an abortion at a Roman Catholic hospital in Phoenix, Arizona. Her decision and her subsequent excommunication aroused controversy in the areas of medical ethics
Medical ethics
Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology.-History:Historically,...

 and Catholic theology.

Margaret McBride

Sr. Margaret Mary McBride, R.S.M., is a Sister of Mercy
Sisters of Mercy
The Religious Order of the Sisters of Mercy is an order of Catholic women founded by Catherine McAuley in Dublin, Ireland, in 1831. , the order has about 10,000 members worldwide, organized into a number of independent congregations....

. She received her Bachelor of Science
Bachelor of Science
A Bachelor of Science is an undergraduate academic degree awarded for completed courses that generally last three to five years .-Australia:In Australia, the BSc is a 3 year degree, offered from 1st year on...

 in Nursing and her Master of Public Administration from the University of San Francisco
University of San Francisco
The University of San Francisco , is a private, Jesuit/Catholic university located in San Francisco, California. Founded in 1855, USF was established as the first university in San Francisco. It is the second oldest institution for higher learning in California and the tenth-oldest university of...

. She has served as a board member of several organizations, including Hospice of the Valley, Catholic Charities, Mercy Housing Southwest and Southwest Catholic Health Network.

Decision and excommunication

McBride was an administrator and member of the ethics committee at St. Joseph's Hospital and Medical Center
St. Joseph's Hospital and Medical Center
St. Joseph's Hospital and Medical Center is a hospital in Phoenix, Arizona, USA. It is currently operated by Catholic Healthcare West , one of the largest healthcare systems in the West with 40 hospitals in Arizona, California and Nevada. St...

, which is owned by Catholic Healthcare West
Catholic Healthcare West
Catholic Healthcare West is a California-based not-for-profit public benefit corporation that operates hospitals in California, Arizona, and Nevada. As such, it is exempt from federal and state income taxes...

. On 27 November 2009, the committee was consulted on the case of a 27-year-old woman who was eleven weeks pregnant with her fifth child and suffering from pulmonary hypertension
Pulmonary hypertension
In medicine, pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, and other symptoms, all of which are exacerbated by exertion...

. Her doctors stated that the woman's chance of dying if the pregnancy was allowed to continue was "close to 100 percent".

McBride joined the ethics committee in approving the decision to terminate the pregnancy through an induced abortion. The abortion took place and the mother survived.

Afterwards, the abortion came to the attention of Bishop Thomas J. Olmsted
Thomas J. Olmsted
Thomas Olmsted is an American prelate of the Roman Catholic Church. He is the fourth and current Bishop of Phoenix, having previously served as Bishop of Wichita from 2001 to 2003.-Early life:...

, the bishop of the Catholic Diocese of Phoenix. Olmsted spoke to McBride privately and she confirmed her participation in the procurement of the abortion. Olmsted informed her that in allowing the abortion, she had incurred a latae sententiae
Latae sententiae
Latæ sententiæ is a Latin term used in the canon law of the Catholic Church meaning literally "given sentence".Officially, a latae sententiae penalty follows automatically, by force of the law itself, when the law is contravened....

, or automatic, excommunication. McBride was subsequently reassigned from her post as vice president of mission integration at the hospital.

In May 2010, the incident came to the attention of the Arizona Republic newspaper, which asked the hospital and the bishop for comments. Both the bishop and the hospital provided answers to the newspaper's request, and on 15 May 2010 the two statements were published online.

In December 2010, Olmsted announced that the Roman Catholic Diocese of Phoenix
Roman Catholic Diocese of Phoenix
-History:The Roman Catholic Diocese of Phoenix in Arizona is a particular church of the Roman Catholic Church in the United States. It was established on December 2, 1969 when it was split off of the Diocese of Tucson...

 was severing its affiliation with the hospital, after months of discussion had failed to obtain from the hospital management a promise not to perform abortions in the future. "If we are presented with a situation in which a pregnancy threatens a woman's life, our first priority is to save both patients. If that is not possible, we will always save the life we can save, and that is what we did in this case," said hospital president Linda Hunt. "Morally, ethically, and legally, we simply cannot stand by and let someone die whose life we might be able to save."

Reactions

The incident rapidly became a touchstone in the culture wars in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

.

The hospital's spokesperson explained that while the hospital follows the Ethical and Religious Directives for Catholic Health Care Services, these directives do not answer all questions. McBride's supporters have argued that the abortion was licit under the terms of Directive 47 of the "Ethical and Religious Directives for Catholic Health Care Services", issued by the United States Conference of Catholic Bishops. Those who reject this argument note that Directive 47 (which refers to "operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman") applies only in the case of the death of the unborn child as an unintended consequence, according to the "principle of double effect
Principle of double effect
The principle of double effect; also known as the rule of double effect; the doctrine of double effect, often abbreviated as DDE or PDE; double-effect reasoning; or simply double effect, is a set of ethical criteria for evaluating the permissibility of acting when one's otherwise legitimate act...

", while the preceding Directive 45 in the same document explicitly states "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 explanation of how McBride excommunicated herself through her actions, Father John Ehrich, medical ethics director for the diocese, issued a statement that stated "The unborn child can never be thought of as a pathology or an illness. That is, the child is not that which threatens the life of the mother, rather it is the pathology or illness (cancer, premature rupture of membranes, hypertension, preeclampsia, etc.) which threatens the mother's life." Since "no physician can predict what will happen with 100 percent accuracy," Ehrich wrote, "What we should not do ... is lower risks associated with pregnancy by aborting children."

However, critics condemned the decision and suggested that it reflected larger trends. Dr. Jacob M. Appel
Jacob M. Appel
Jacob M. Appel is an American author, bioethicist and social critic. He is best known for his short stories, his work as a playwright, and his writing in the fields of reproductive ethics, organ donation, neuroethics and euthanasia....

, a leading American bioethicist, questioned "if women are safe in Catholic hospitals" following Olmsted's announcement. Appel wrote that, "Like many Catholic hospitals, St. Joseph's has long had two conflicting policies regarding maternal-fetal conflict on its books. One directive states that abortion is never permitted, even to save the life of the mother, while the other notes that 'operations, treatments and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted...even if they will result in the death of the unborn child....Until this recent incident, pregnant women could safely assume that Catholic hospitals would follow both the law and widespread standards of medical ethics in allowing the second directive to trump the first. Suddenly, that time-honored understanding appears to be in jeopardy." Appel warned patients against obtaining obstetrics care at Catholic institutions.

Catholics for Choice, an independent pro-choice
Pro-choice
Support for the legalization of abortion is centered around the pro-choice movement, a sociopolitical movement supporting the ethical view that a woman should have the legal right to elective abortion, meaning the right to terminate her pregnancy....

 organization, also expressed concerns regarding the decision. President Jon O'Brien said, "While not all the facts are available, it is clear that the Vatican's hard line on abortion led to this terrible situation. Sadly, we see situations like this time after time, both here in the US and abroad. The Vatican's outright ban on all abortions is insensitive and reflects an unwillingness to acknowledge the reality of women's lives, including the difficult decisions that often have to be made during a pregnancy."

Reverend Thomas Doyle, a well-known canon lawyer, noted that the bishop "clearly had other alternatives than to declare her excommunicated." Doyle argued that this case highlights a "gross inequity" in how the church chooses to handle scandal. He noted that no priests have been excommunicated for sexual abuse, suggesting a double standard within the Church.

Among those defending the excommunication were The Catholic Physicians Guild of Phoenix led by William H. Brophy. Brophy wrote that "an action which is in and of itself wrong, in that it lacks goodness as discerned by the light of human reason, is never justified by circumstances or intended end."

Theologian Michael Liccone stated, "The Church does not condemn 'indirect abortion': abortion that is a foreseen but unintended side effect of a medical procedure designed to preserve the mother's life."

See also

  • Catholicism and abortion
    Catholicism and abortion
    The Roman Catholic Church opposes all forms of abortion procedures whose direct purpose is to destroy an embryo, blastocyst, zygote or fetus, since it holds that "human life must be respected and protected absolutely from the moment of conception...

  • Abortion in the United States
    Abortion in the United States
    Abortion in the United States has been legal in every state since the United States Supreme Court decision in Roe v. Wade, on January 22, 1973...

  • List of people excommunicated by the Roman Catholic Church
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