Monday, May 31, 2010

Irish nun pays ultimate price for defying bishop in abortion case

The centrepiece of the drive in front of St Joseph's Hospital in Phoenix, Arizona, is a white marble statue of the saint cradling an infant.

St Joe, as he is known to the locals, has been here since the Irish Sisters of Mercy founded the medical centre back when the area was still part of the old 'Wild West'.

Today he still watches over the faithful of the city.

The sick touch him for good luck and hopeful home-owners bury miniature versions of him in their yards when they are trying to sell their house. He is patron saint, amulet and mascot all in one.

He also stands as a reminder of the strictly Catholic ethos at the hospital and the dogmatism of the Church hierarchy in the city.

In the past few weeks a scandal has rocked this sun-scorched corner of the South-western US, propelling it into the international news and placing it at the forefront of the culture wars in America.

At the centre of it all is an Irish nun who, in attempting to read 21st Century pragmatism into ancient Church doctrine, fell foul of her bishop and became a hero to locals.

Margaret McBride, a medically trained Sister of Mercy and until recently the most senior Church figure at the hospital, has been hailed as "tireless" and "the moral conscience of the hospital" by her colleagues.

Gloria Steinem's feminist Ms Magazine called her "a ray of light in the darkness" and the Washington Post described her as "brave".

"More mother hen than CEO," according to one man who knows her, she is regarded by locals as a woman of great integrity and moral courage. Several of them wrote to local papers in support of her.

To her bishop and senior figures in the Church, however, she is persona non grata and a participant in a "grave moral disorder", and they have fired back with damning counter accusations.

In the process, this softly spoken nun with unmistakably Irish roots has become a lightning rod for an intense social debate.

Last November, a desperately ill 27-year-old mother of four presented herself to the hospital.

The woman was 11 weeks pregnant and suffering from pulmonary hypertension -- a severe heart complaint which can be exacerbated by pregnancy. She faced almost certain death if she continued to carry her child. Doctors put her risk of mortality at "close to 100 per cent".

Although abortions are legal in Arizona, St Joseph's does not perform them as a matter of course.

The hospital has close ties with the Diocese of Phoenix, and the conservative Bishop Thomas Olmsted -- the most senior local church figure -- has great influence on decisions made.

Nevertheless it was thought that an exception could be made: directive 47 in the US Catholic Church's ethical guidelines for health care providers allows, in some circumstance, for procedures that could kill the foetus in order to save the life of the mother.

An emergency meeting of senior figures at the hospital was called and each of those present was asked to give their opinion on the viability of the procedure.

Medical personnel, ethicists and senior administrators at the hospital each in turn said that they felt an abortion was necessary and justifiable to save the life of the mother.

The pregnant woman and her family were also consulted and agreed that a termination would be the best option. Sister Margaret's role was apparently to give the theological perspective.

"They were in quite a dilemma," said Lisa Sowle Cahill, who teaches Catholic theology at Boston College.

"There was no good way out of it. The official Church position would mandate that the correct solution would be to let both the mother and the child die. I think in the practical situation that would be a very hard choice to make."

As it turned out, it was a choice Sister Margaret felt able to make. Mindful that the pregnant woman was gravely ill and deeply distressed, the nun gave her reluctant assent. The abortion was carried out in late November and the woman survived, eventually returning home to care for her four children.

It was thought that that would be the end of the matter, but, in spite of strict patient confidentiality rules, Bishop Olmsted, head of the Catholic Diocese of Phoenix, found out that an abortion had been carried out.

A dogmatically pro-life figure, Olmsted had made himself something of a hero to the US anti-abortion movement.

Olmsted issued a statement saying, "I am gravely concerned by the fact that an abortion was carried out several months ago in a Catholic hospital in this diocese ... I am further concerned by the hospital's statement that the termination of a human life was necessary to treat the mother's underlying medical condition. An unborn child is not a disease. While medical professionals should certainly try to save a pregnant woman's life, the means by which they do it can never be by directly killing her unborn child. The end does not justify the means."

He made the decision that Sister Margaret McBride would become merely Margaret McBride.

This woman, who had served the Church for over 30 years, would be excommunicated, banned from receiving the sacraments and shamed before her peers.

Worse was to follow: Sister McBride was to be moved to a different position at the hospital (widely understood to be a demotion).

Suzanne Pfister, a hospital vice-president, defended McBride's actions but confirmed that she had been reassigned from her job as Vice-President of Mission Integration at the hospital. Pfister wrote that St Joseph's "adheres to the Ethical and Religious Directives for Catholic Health Care Services" but added that the directives "do not answer all questions".

Neither the dioceses nor St Joseph's would comment on whether the bishop had a role in the reassignment.

Writing in the left-leaning Huffington Post, bioethicist and medical historian Jacob M Appel described Olmsted as having a "reputation as a particularly cold-hearted and intransigent figure" who had "gained notoriety for refusing communion to a 10-year-old autistic child who could not swallow".

He added, "Thanks to men like Mr Olmsted, obtaining obstetric care at a Catholic hospital has become a dangerous game of Russian roulette."

The Reverend Thomas Doyle, a canon lawyer, said last week that the bishop "clearly had other alternatives than to declare her excommunicated".

Doyle said that Olmsted could have shown her some mercy. He added that this case highlighted a "gross inequity" in how the Church chose to handle scandal.

This, too, is a sticking point for many locals in Phoenix. By the beginning of last week, a Facebook page -- Allies of Sister Margaret -- had been set up in support of the nun, with many of its hundreds of members drawing a sharp contrast between the swift and sure judgement against Sister Margaret and the rather more lenient approach taken against paedophile priests.

Olmsted himself replaced Irish-American Bishop Thomas O'Brien, who, according to an official report, "allowed priests under his supervision to have contact with minors after becoming aware of allegations of criminal sexual misconduct" and acknowledging "transferring offending priests to situations where children could be further victimised."

O'Brien was also later convicted of leaving the scene of a fatal accident, after running over a man in Phoenix.

There was no evidence that O'Brien had been excommunicated or that Olmsted considered this a necessary step.

McBride's support in the community is perhaps to be expected. An Irish-American, she achieved a bachelor's degree in Nursing and a Master's in Public Administration from the University of San Francisco, in addition to her religious training.

"She is, in my long experience of her, one of the most upstanding, capable people you could hope to meet," Dr William Bohnert, former Chief of Staff at St Joseph's, told the Sunday Independent.

In a letter to the Arizona Republic, a local newspaper, he wrote: "I have witnessed countless hours of devotion and caring by her and her colleagues attending critically ill patients and dealing with the stress of their families."

Speak to others in Arizona, however, and a more critical picture of Sister Margaret emerges. As a senior hospital administrator in a part of the US with more than its share of illegal immigrants, she was no stranger to making difficult, controversial choices.

According to the New York Times, St Joseph's focuses on keeping down the cost of the uninsured and repatriates about eight uninsured patients per month.

One of these people was 18-year-old Joe Arvizu, an undocumented, poor Mexican boy, who suffered from leukaemia and had to have surgery to stop bleeding on his brain. His family, however, had no insurance and couldn't afford the treatment.

"They said they knew that we couldn't pay the bill, so they couldn't continue with the treatment anymore," his mother Rosa told local press.

"I asked for a payment negotiation, but they said that no, we couldn't make it with the income we have. I didn't want to make any decision by myself, but they told me the ambulance was ready."

Despite his mother's objections, Joe was transferred to a hospital in Mexico. Joe died on December 3, 2007 -- the hospital was unable to supply the blood for a transfusion.

Sister McBride was quoted by local press as saying that the hospital's charity committee reviewed Arvizu's case but decided he would be able to get adequate treatment in Mexico.

"We're trying to be good stewards of the resources we have," she told the New York Times.

"We're trying to make sure that the acute-care hospital is available for individuals who need acute care. We can't keep someone forever."

"You're dealing with high risk, high pressure, life-and-death decisions at the hospital," one former colleague of Sister McBride said last week, on condition of anonymity.

"Nobody is infallible. But most people in the hospital are 100 per cent sure she got it right with regard to this abortion case. And I imagine the four children of this woman, who get to grow up with their mother around, would agree that she did the right thing."

The Diocese of Phoenix last week released a statement saying that the Catholic Church in fact excommunicated all those who were involved in the abortion, not just Sister Margaret. It added,

"Anyone who has been excommunicated knows that by their own evil actions they have removed themselves from communion within the Church."

"This is a kind of a power play too," says Annie Loyd Bachand, a supporter of McBride.

"This was a woman who was considered by locals to be one of the most senior figures in the Church. Part of this can be seen as the Church patriarchy again putting women in what it considers is their place."

The options for Sister McBride are limited. According to some commentators, she can appeal to the Vatican. Or she can go to confession and, through the absolution of the bishop or a priest, be readmitted to the Church.

According to the diocese she would also have to "assist in efforts to repair the scandal they have created".

However, some have urged her not to do this. In a piece on America's National Public Radio website last week, author Julianna Baggott urged Sister Margaret not to confess: "Dogma isn't faith. Dogma can't look a child in the eye and explain that health care providers let her mother die -- but for a dogmatically correct reason."

Whether McBride's career at the hospital can be repaired is not known. Some locals say that as long as Bishop Olmsted remains in office there will be a black mark against her name.

Her colleague, urologist Dr John Garvie, who still works at the hospital, summed up much of the local mood when he wrote: "What she did was something very few are asked to do; namely to make a life-and-death decision with the full recognition that in order to save one life another life must be sacrificed. Try to imagine the agony involved in such a decision. People not involved should reflect and not criticise."

Whether his words make a difference to Sister Margaret's career remains to be seen.

She has become an ironically totemic figure for the pro-choice movement in the States -- a religious figure with roots in a country where abortion is still illegal, standing up to Catholic dogmatism and quietly championing the rights of women.

America, and the world, are watching.