But she did defend St. Joseph's decision to perform the abortion. “They had been confronted with a heartbreaking situation,” she stated. “They carefully evaluated the patient's situation and correctly applied the Ethical and Religious Directives for Catholic Health Care Services to it, saving the only life that was possible to save.”
Sr. Keehan is not a physician, although her official biography mentions “more than 35 years” in “administrative and governance positions at hospitals,” as well as her bachelor's degree in Nursing.
However, two obstetrician-gynecologists from the Diocese of Phoenix's Medical Ethics Department said Sr. Keehan was misrepresenting both the facts of the St. Joseph's Hospital case, and the ethical principles of Catholic health care.
According to those principles, doctors may perform a necessary and non-abortive medical procedure in order to treat a serious illness, even if it has the secondary effect of harming or killing an unborn child. However, the pregnancy itself can never be regarded as an “disease,” nor may a doctor perform an abortion as a means of treating a different condition.
“It goes back to the basic issue that you can never do an evil, to achieve a good,” Dr. William Chavira told CNA on Dec. 22. “The act is inherently evil.”
Dr. Chavira is a practicing obstetrician and gynecologist who also serves on the Phoenix Diocese's medical ethics committee.
Although the hospital maintains that the abortion occurred as part of a “placentectomy” – the removal of the placenta that connects a developing fetus to the mother's uterus – Dr. Chavira explained that the placenta of the woman in the St. Joseph's case “was not diseased,” though it may have been producing hormones that aggravated the woman's heart and lung condition.
“If something's not diseased,” he explained, “then we can't act on it – as opposed to a cancerous uterus, or an infected placenta.”
Nevertheless, Dr. Chavira stated, the “placentectomy” – which killed the woman's child– could not be regarded as a necessary medical treatment. The medical condition threatening her life was not the pregnancy, but the preexisting heart and lung condition.
The removal of the placenta, he explained, could not have been intended to treat that condition. Rather, it was intended to mitigate the effects of the woman's heart and lung disease – by ending her pregnancy through an abortion.
As such, he said, the abortion was direct and intentional, and could not be compared to other necessary medical procedures that might cause the death of an unborn child.
Dr. Clinton Leonard, another OB-GYN who belongs to the medical ethics board in Bishop Olmsted's diocese, stated to CNA on Dec. 22 that Sr. Keehan and other defenders of St. Joseph's were attempting to distract the public from a fundamental moral principle.
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“They're making it too complex,” he said. “It's really a simple issue: the ends never justify the means. And the means that they used was a direct abortion,” Dr. Leonard stated. “That's not a treatment for pulmonary hypertension.”
“I would do everything possible to offer her cardiac support,” Dr. Leonard said, when asked what he would regard as an appropriate treatment under the circumstances. “If it's pulmonary hypertension, generally you use medications that are going to reduce the work that the heart has to do.”
In response to the assertion of Sr. Keehan and others, who regard the woman as having been on the brink of death, Dr. Leonard said it was “in debate, whether or not her life was at that point.”
But, he clarified, even under those circumstances, authoritative Catholic teaching would not have permitted the hospital to consider abortion as a form of necessary medical treatment. Pope John Paul II's encyclical “Evangelium Vitae” stated that “the deliberate decision to deprive an innocent human being of his life is always morally evil and can never be licit ... (even) as a means to a good end.”
Previously, Sr. Keehan and the Catholic Health Association sparred with the United States Conference of Catholic Bishops on the question of health care reform, which the bishops criticized for funding abortion. Some observers have noted the critical role that she played, along with a social justice lobby of sisters called Network, in the bill's eventual passage.
In his farewell address before resigning the presidency of the U.S. Bishops' conference this fall, Cardinal Francis George – who directly opposed the health care bill, for its abortion funding – spoke of unnamed groups he said wanted to “remake the Church according to their own designs or discredit her as a voice in ... public discussions” such as the debate over abortion and health care reform.