Sunday, May 16, 2010

The nun that okayed the abortion

Nun at Phoenix Hospital Rebuked for Allowing Abortion

A woman was 11 weeks pregnant and had pulmonary hypertension. An ethics committee at a Catholic hospital -- which included a nun -- approved an abortion.

I'm googling "pulmonary hypertension in pregnancy". So far I've found:

  • Primary pulmonary hypertension in pregnancy; a role for novel vasodilators: Patient was 28 weeks pregnant. Both mother and child saved.

  • Primary pulmonary hypertension in pregnancy: Complication presented at 24 weeks; managed for 4 weeks. Child delivered by c-section, both survived. A review of pulmonary hypertension in pregnancy indicates a rarity -- a maternal condition for which medical journals actually mention considering abortion. Risk of death ranges from 30% - 56%, with deaths typically taking place in the third trimester. (Leading me to wonder if "termination" can't take the form it took in this patient's case -- deliver of a live newborn as soon as the baby seems viable, rather than "termination" taking the form of pulling the baby out in bloody chunks so as to cause his death.)

  • Pulmonary hypertension and pregnancy: "Pulmonary hypertension carries a significant risk to mother and child during pregnancy and pregnant women with pulmonary hypertension require careful monitoring within the framework of a multidisciplinary team. Specific targeted therapy for pulmonary hypertension may be required during pregnancy. Many agents are contraindicated because of risks of teratogenicity or secretion into breast milk. The optimum mode of delivery is not clear but early input from the high-risk obstetric anaesthesia team is essential." So this article indicates that doctors might hesitate to use a non-abortion treatment for fear of risking birth defects or making it unsafe to breast feed. I don't see killing a patient (in this case, the baby) as prophylaxis against possible injury or inability to adhere to the preferred diet as making much sense. ER doctors don't just euthanize trauma victims because they might lose a limb or be left unable to eat fresh veggies.

  • Pregnant Patient with Primary Pulmonary Hypertension: General Anesthesia and Extracorporeal Membrane Oxygenation Support for Termination of Pregnancy: For some reason, they decided to do a hysterotomy abortion -- a c-section with the intent of delivering a dead baby rather than a live one. The patient died later. Perhaps a doctor can understand the terminology and explain why, if they were going to kill the baby anyway, they chose such an invasive and high-risk procedure for this patient. In the mean time, I need to add her to the Cemetery of Choice.

  • Case 6--Pulmonary Hypertension in a Pregnant Woman: Patient with PPH in addition to other cardiac problems presented with sudden alarming symptoms. They delivered a healthy baby stat, but the mother subsequently died. Can't see how having killed the baby before or during delivery would have improved this woman's chance of survival, since killing the baby would have delayed delivery and involved additional invasive procedures. Perhaps OC can explain how sending this woman to Kansas to spend three days in a motel room would have improved her chances of survival.

  • Severe Pulmonary Hypertension during Pregnancy: Mode of Delivery and Anesthetic Management of 15 Consecutive Cases: A total of four of the babies and five mothers died. (Two of the pregnancies involved the same woman.) So these doctors saved 11 babies and 9 mothers out of 15 babies and 14 mothers. Had all these babies been aborted, we know there would have been 100% mortality among the children -- 15 dead. Unclear if more or fewer mothers would have survived. Many of these women presented after 16 weeks, the earliest cut-off point at which abortion is, at least in theory, safer for a healthy woman than continuing to term. Has anybody ever done a study comparing the mortality rates of these women when the babies are killed versus when the babies are saved?

  • Pulmonary Hypertension: Recommends tubal ligation for women with PPH, so as to prevent pregnancy entirely.

  • Pulmonary Hypertension and Pregnancy: Why Women Die: A Power Point presentation. I would love to attend this lecture and get what the gist of it was.

  • Pulmonary Hypertension in Pregnancy: Treatment With Pulmonary Vasodilators: Four patients, five pregnancies. "At the time of diagnosis, each had severe, life-threatening pulmonary hypertension...." The first patient died 8 hours after diagnosis, having neither aborted nor delivered her baby. The other patients and their babies survived. Patient 1's poor outcome was linked to a delay in diagnosis.

    So we have that extremely rare situation -- a case where pregnancy actually threatens the mother's life. (Typically, maternal deaths are flukey things that develop suddenly, and there's no real evidence that abortion improves outcome.)

    I've written about these situations before:

  • When Pregnancy Threatens a Mother's Life: A guide for prolifers.

  • Abortion to Save the Mother?: Worth reprinting in part here:

    From a Christian perspective, is abortion okay to save the mother's life? So asks a poster in the Pro Life Forum.

    Here's where we get to the difference between simple social justice and imposing one's religion on others.

    The law can require us to refrain from killing, but it can not deprive us of life without due process, which requiring a woman to continue a life-threatening pregnancy would do. Although one's own religious faith might require one to sacrifce one's life for another, the law can not force this.

    The best way to handle it legally is to attempt to protect both mother and fetus from being deprived of life without due process. Because of the emergency nature of most life-threatening pregnancies, the doctor would have to make a call that ending the pregnancy (and therefore, if the fetus is too young to survive, the life of the fetus) is necessary, just as a policeman often must make the decion that a suspect has to be shot dead to protect the public.

    The way to handle these emergencies isn't to grant broad judgment to doctors (or cops) to just kill people at their descretion; rather, it is to allow for the prosecutor to not pursue the case if it appears that the doctor (or cop) proceeded on good faith, believing that such a drastic measure as killing was necessary to protect the innocent life of the mother (or public).

    A Christian mother would reflect on Biblical principles:

  • Jeremiah 7:6 - ... do not shed innocent blood in this place...
  • Matthew 19:19 - your neighor as yourself...
  • Matthew 25:40 - ...whatever you did for one of the least of these brothers of mine, you did for me.
  • Romans 12:1 - ...offer your bodies as living sacrifices, holy and pleasing to God...
  • 1 Corinthians 10:24 - Nobody should seek his own good, but the good of others.
  • James 2:26 - As the body without the spirit is dead, so faith without deeds is dead.

    A Christian mother would demonstrate love for God and trust in God by doing everything in her power to save her child. She would not use abortion to reduce her own risk. Likewise, she would not shed innocent blood -- have the child directly killed. If ending the pregnancy became the only way to prevent both mother and child from dying, she might then consent to have the unborn child removed from her body. But she would not sign the unborn baby's death warrant. But these are the requirements Christian faith puts upon a woman. These are not principles that can be forced on unbelievers, or people of other faiths, who can not be expected to put faith and trust in Christ.

    To require that the woman risk her life for the unborn child is no more just than to require that a man risk his life to save his child from a burning building. We would hope that parents would love their children that much, but we can not legally require anybody to die for somebody else.

    This means that we can not prosecute the mother or doctor if abortion is resorted to as a desperate measure to save the mother's life. But it also means that we can't write a "life of the mother" exception into abortion law, because then we would be legally requiring the fetus to die to save the mother -- again, depriving someone of life without due process.

    The brave mother who puts her life on the line for her child should be supported and admired, as we admire those who rush into a burning building to rescue trapped children. But we can't legally require it.

  • Now, what do you do with a nun that okays an abortion?

    Good question.

    Certainly it should deserve at least as much deliberation -- if not more so -- than a situation in which a police officer kills somebody in the line of duty. We don't just let cops say, "I thought there was a danger so I shot him" and let it go at that. They can't just let the nun say, "I thought the mother's life was in danger so I okayed the abortion" and let it go at that.

    You'd have to look not just at this situation, but at the nun's history. Is she a rebellious nun who clearly has just been looking for a justification for an abortion because she wants to challenge the Church's pro-life stand? Or has she been faithful, and only cleared this abortion as an act of desperation? Did she consult with others in the Church? Did she consult with specialists who had brought women in similar circumstances safely through pregnancy before?

    That rare instance -- an abortion decision that's not just black and white. Have at it, kids.

    Christina said...

    Her actions mean automatic excommunication.

    See here for more explanation:

    Christina Dunigan said...

    But she is allowed to ... what's the word? Appeal it.

    Christina said...

    I doubt any "appeal" on her part will meet with success. Catholic Church Law is pretty clear on this issue.

    OperationCounterstrike said...

    RE: "Can't see how having killed the baby before or during delivery would have improved this woman's chance of survival, since killing the baby would have delayed delivery and involved additional invasive procedures. Perhaps OC can explain...."

    If the docs had done an abortion, they could have sucked out the fetus' brains (as right-to-lifers like to say) and reduced the size of the fetus' skull. Then the patient wouldn't have had to push so hard to get it out. Smaller skull equals less pushing needed, equals less stress and strain, equals patient more likely to survive.

    Next stupid question?

    Christina Dunigan said...

    And for his next trick, OC will explain how abortions would have saved all the pregnant women who died during the 9/11 attacks! Abortion cures EVERYTHING!

    OperationCounterstrike said...

    Only some things. Like, for instance, problem preganancies.

    OperationCounterstrike said...
    This comment has been removed by the author.
    Christina Dunigan said...

    OC, we already know that you'd consider a doctor obligated to perform an abortion if during the delivery, if for some reason the mother requested it prior to the child drawing breath. The baby crowned and had a full head of hair, while mom wanted a baby with no hair like her beloved little sister; her husband farted and she just thought that ruined the moment, and if she couldn't have a perfect birth she wasn't going to have one at all; she just wanted the power trip of forcing the doctor to do it against his own personal reservations, etc.

    We're talking about under what circumstances people who recognize children as having inherent worth could okay killing one, not under what circumstances a psycho who thinks kids are vermin would justify killing one.

    OperationCounterstrike said...

    This case raises once again the question: should pious religious devotees with strange medical dogmas (such as Jehovah's Witnesses, who oppose blood transfusions, and Catholics, who oppose abortions) be allowed to practice medicine? At very least the Medical Oath (formerly Hippocratic) should be amended to include an explicit pledge never to allow any religion or religious leader to interfere with practicing good medical ethics in the patient's best interest.

    OperationCounterstrike said...

    So Christina are you saying this woman should have been forced to give birth, which would likely have killed her?

    Christina Dunigan said...

    OC, you argue that anybody who disagrees with you shouldn't be allowed to practice medicine. I argue (and HAVE argued) that what we need to do is establish clear schools of medical practice, so that patients can CHOOSE a medical practitioner that shares their world view.

    Those of us who hold to a Hippocratic, "first, do no harm" worldview can go to Hippocratic practitioners. Those of you who are Progressives can go to Progressive practitioners who will push for lots of prenatal testing and give the opportunity to abort at any sign of anything less than perfection in a fetus.

    The Amish have their own medical providers within their community, and I don't see why JWs, Christian Scientists, Hare Krisnas, etc. can't have their own medical practitioners as well.

    As for your second question -- did you even read the post? I answered that question.

    L. said...

    I have been Googling this case compulsively since I heard about it.

    I'm with the nun.

    OperationCounterstrike said...

    RE: "Hippocratic practicioners"

    There are no Hippocratic practicioners alive today.

    True Hippocratic practicioners could not be Christian, because the Hippocratic Oath was sworn in the name of the Greek pagan god Apollo.

    True Hippocratic practicioners would train the sons of other physicians for free, as the original Oath demands.

    True Hippocratic practicioners would never do any kind of surgery, because the original Oath includes a pledge never to "wield the knife", even on suffers from stone.

    Pat said...

    OC says: "True Hippocratic practicioners could not be Christian, because the Hippocratic Oath was sworn in the name of the Greek pagan god Apollo."

    There weren't any Christians in the 5th Century BC either, so it's somewhat of an odd statement to make.

    OC says: "True Hippocratic practicioners would train the sons of other physicians for free, as the original Oath demands."

    The text actually reads:
    "To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art."

    "Free training" is stated.... where? It actually states that the person who was trained should make consideration to the person that trained them.

    It actually states EXACTLY THE OPPOSITE of what you claim it states.

    OC Says: "True Hippocratic practicioners would never do any kind of surgery, because the original Oath includes a pledge never to 'wield the knife', even on suffers from stone."

    The "full" text is:
    "I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art."

    So, in effect, a general practioner would not attempt surgery on a patient when that was not his field of practice or expertise. He would refer the patient to a surgeon.

    It actually states EXACTLY THE OPPOSITE of what you claim it states.

    LOL, OC, you crack me up.

    Pat said...

    I see other translations where it does include "to teach them this art, if they shall wish to learn it, without fee or stipulation".

    So the trained should hope to support the trainer. And the trainer should train "without fee or stipulation."

    Of course, back then they did not have building and equipment loans, advanced medicine, etc. Today's medicine and medical training is a costly endeavor. We don't train persons in any advanced field, in accredited educational institutions, without cost or compensation. Is this a failure of the Oath, or a cause of significant advances in medicine?