Thursday, December 5, 2013

Catholic Hospitals and Women's Needs: Dueling Catholic Perspectives--Phyllis Zagano and Katie McDonough

Two competing narratives in response to the ACLU lawsuit vs. the USCCB re: Mercy Health Care of Muskegon, Michigan, which I discussed yesterday:

At National Catholic Reporter, Phyllis Zagano wants to frame the story of what happened at Mercy Health Care as a narrative about religious freedom--not, however, your religious freedom to ask for medical treatment in accord with your conscience and your doctor's expert advice. The religions freedom on which Zagano is focusing is the religious freedom of the Catholic bishops to override your conscience and deny you best-practice medical treatment if their religious views dictate such a denial. 

Zagano plays the Catholic tribalism card and suggests that the poor good-guy bishops are being beaten up by secular bad guys out to get them in this lawsuit, bad guys ranging from the ACLU to graduates of women's studies programs. She writes:

Descriptions of the Michigan case attempt to mirror the facts in Galway, Ireland, where a woman with the beginnings of a miscarriage eventually died from septicemia. In the cloudy Irish situation, it seems the Galway woman did not get antibiotics soon enough, even as she asked for an abortion. Irish lawmakers went over the top after that one, now allowing abortion if need is certified by one doctor in an emergency, two doctors in a non-emergency, and three doctors where the pregnant woman threatens suicide.

(In what way was Savita Halappanavar's case "cloudy," I wonder? The Irish government certainly didn't see it as in the least cloudy when it enacted the guidelines Zagano finds as "over the top," but which sound eminently reasonable to me: treat women on the basis of expert medical opinion in accord with best-practice standards, and assure that, in non-emergency cases, you have several expert medical opinions to guide your decisions. These are guidelines that have long obtained with ethics committees of any hospital worth its salt.)

At Salon, Katie McDonough takes a very different tack than Zagano does. As Zaganao does, McDonough writes as a Catholic--but a non-tribal one. She writes,

Despite receiving public subsidies, Catholic hospitals regularly deny basic reproductive health services based on religious directives that openly defy medical best practice. Giving bishops with zero medical expertise this kind of discretionary authority is dangerous for patients, dangerous for doctors and an outrageous overstep to many Catholics. 

McDonough notes that a large percentage of Catholics are pushing back against the attempt of the U.S. Catholic bishops to use Catholic hospitals to dictate to the American public what kind of medical services the public can receive. A majority of Catholics are pushing back against this dangerous overreach because a majority of Catholics do not agree with the magisterium on issues like contraception and abortion care:

Not only do a majority of Catholics disagree with their church’s absolutes on issues like contraception and abortion care, they tend to disregard them entirely. Around 98 percent of sexually active Catholic women have at some point in their lives used a form of birth control that the Vatican does not approve of, and they have abortions at the same rate as other groups of women, around 28 percent. Recent data also reveals that 65 percent of Catholics believe that hospitals and clinics that receive public money should not be allowed to deny medical services based on religious doctrine, and 68 percent of Catholic women don’t want a Catholic hospital to be the only medical care option in their communities.

McDonough also observes,

Specifically, the church’s hard line on abortion and other issues of reproductive justice remains as rigid and as dangerous as ever. Which is why the timing of the American Civil Liberty Union’s lawsuit alleging gross medical negligence against the United States Congress of Catholic Bishops, filed just days after the pope released his “Evangelii Gaudium,” felt significant. The suit was a necessary reminder that a church doctrine that refuses to respect women’s bodily autonomy and the medical judgment of doctors — no matter how progressive its economic agenda — is still a dangerous thing. (Related: Economic justice and reproductive justice are not distinct agendas, but I digress.)

The preceding link points to a previous article of McDonough in Salon, which is outstanding. In it, she praises Pope Francis for his strong emphasis in Evangelii Gaudium on the call to Catholics to work against structures of exclusion that dehumanize the poor around the world. But she points out that the critique of exclusion applies as well to gay folks and to women.

McDonough is arguing, in other words, against that old dysfunctional Catholic game of exceptionalism that I critiqued in my response to Evangelii Gaudium. This is a game which pretends that gay folks and women don't count as we deplore the damage that exclusion does to those shoved to the margins of society. There are rights. And then there are legitimate rights.

This game permits Catholics who claim to buy into the critique of exclusion to pretend that women and gay folks simply aren't in the room, as these Catholics apply their critique of structures of exclusion to the world around them. And to their own church, where everything the pope has just said about the damage that exclusion wreaks in human lives applies to a shocking number of gay people who have lost their jobs in Catholic institutions in recent years, solely because they refused to hide their identities. And it applies to every woman around, when entrée to governing power in the Catholic church requires ownership of a penis.

It is impossible to make a compelling case for the call to Catholics to overcome structures of exclusion and mend the damage done by such structures if the church itself practices exclusion in certain roped-off areas--there are rights, and then there are legitimate rights--of its own institutional life. It's impossible to call on Catholics to begin seeing and hearing the poor, if the very call we issue to urge that folks begin seeing and hearing the poor refuses to see and hear the marginalized who are right in our own room

As Sister Joan Chittister stated recently to a group at the meeting of the American Academy of Religion and the Society of Biblical Literature, 

Pope Francis has won the heart of the world by being humble, simple and pastoral -- a warm and caring face of this church, a man like Jesus who is a man of the poor. But no one can say that they are for the poor as Jesus was and do nothing, nothing, nothing for the equality of women.

A footnote to the Zagano-McDonough discussion above: this discussion is now being mirrored in a Commonweal blog thread in which Grant Gallicho asks whether the public is able to get accurate information about which health care plans under the Affordable Care Act provide abortion coverage. The question is, specifically, whether you as a Catholic will be helping to subvent abortions via your healthcare coverage under the ACA plan you happen to choose. 

As several respondents have already noted, most of us have already long had insurance plans that provide coverage for abortion. Many Catholic institutions have long participated in insurance arrangements that provide both contraceptive and abortion coverage somewhere in the exchanges handled by the insurance company providing coverage to the Catholic institution. Many Catholic institutions have, in fact, provided contraceptive coverage to their employees.

Suddenly, when it became politically expedient to push this point--against a federal administration they did not like and have intended to undercut in every way possible--the U.S. Catholic bishops began to discover that these arrangements required Catholics to "cooperate with evil." And Catholic institutions allied with the bishops in their political attack on the Obama administration discovered, to their surprise and horror, that they had been covering contraception in their insurance plans.

I haven't yet heard a peep from the bishops or those institutions about the cooperation with evil in which American Catholics have long been involved as we pay our taxes funding production of military weapons and war, have you? Living in a pluralistic secular democracy requires us to rub shoulders with all kinds of people who do not share our particular beliefs. It requires us to make the best moral decisions we can in the most mixed of circumstances, in which many of our choices do not involve black or white, but areas of gray.

It requires us to support collaborative arrangements--e.g., insurance exchanges--in which we may not need certain treatments for ourselves and our families (e.g., erectile dysfunction drugs or contraceptives), but someone else in that exchange may well need such treatments. Living in a pluralistic secular democracy with others who do not necessarily share our religious outlook requires us to refrain from trying to throttle others into accepting our beliefs as we threaten to tear apart the frail collaborative institutions that hold us together, in order to score sectarian points against despised others.

The bishops, to their discredit, have been all about tearing things apart ever since their chosen political candidates have no longer won at the ballot box in recent years. Their behavior mirrors that of their chosen political party in Congress, and it should be of great concern to Catholics who are listening carefully to what Pope Francis is saying and who care about working collaboratively with many other types of people to build a better world for all of us.

To Catholics who want to move beyond the defensive tribal gestures and begin engaging the world around them in honest, respectful dialogue for a change, as we try to build together for a change . . . . Many of whom increasingly refuse to see either our bishops or their tribal cheerleaders/gatekeepers in the Catholic media and academy as uniquely positioned to dictate to the rest of us about moral issues--or, that is, to dictate in any credible way . . . .

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