Catholic Church and Health Care Reform

The U.S. Conference of Catholic Bishops (USCCB) supports the proposed current health care reform provided it includes conscience protection clauses and specifically prohibits abortion funding.  But although the USCCB has made statements about "respecting life from conception until natural death," the Conference fails to mention any specific concerns about health care rationing. 

The Catholic Church's opposition to euthanasia (an act just as evil as abortion) is clearly stated in the Catechism of the Catholic Church, #2277:

Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable.

Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator.

Rationing health care could result in the death of a patient.  It would clearly be an example of an omission that may cause death.  Although it may not be direct euthanasia, it is definitely passive euthanasia.

A letter by Bishop William F. Murphy, Chairman of the USCCB Committee on Domestic Justice and Human Development sent to every member of the Congress, includes this statement in its first paragraph:

The USCCB looks forward to working with you to reform health care successfully in a manner that offers accessible, affordable and quality health care that protects and respects the life and dignity of all people from conception until natural death.

This is similar to a letter from Cardinal Rigali, Chairman of the USCCB Committee on Pro-Life Activities to the members of the House Energy and Commerce Committee.  Both Bishop Murphy and Cardinal Rigali address abortion without mentioning anything specific about rationing which could result in passive euthanasia.

In the House version of the health care bill, page 58 includes the following language on lines 7 - 11:

... to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility,

The letter from Bishop Murphy speaks of "universal health care."  If eligibility for a "specific service with a specific physician at a specific facility" is going to be determined, then this is clearly not "universal health care."  However, it is rationing.

When examining pages 425 - 430 of the House bill, it is noted that end of life orders (a living will, for example) must be signed by a physician or other medical personnel as defined by the government (page 429, lines 17-22).  Page 430, lines 23-24 state that the advanced planning document can determine the amount of artificial nutrition and hydration to be given to an individual. 

In an address to the International Congress on "Life-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas," the late Pope John Paul II states:

I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory...

That nutrition and hydration are morally obligatory is further acknowledged by this statement on the USCCB's Pro-Life Activities section of its web site from Rev. J. Daniel Mindling, OFM, Cap.

Living wills should not include a statement that refuses nutrition and hydration in the event that one is diagnosed in a persistent vegetative state. It is, in principle, ordinary and proportionate care which is morally obligatory.

Why are Bishop Murphy's and Cardinal Rigali's letters to Congress omitting discussion about rationing care for those who have been born?  Why is the USCCB not specifically requesting that Congress remove any language similar to the provisions on page 430, lines 23-24 from all versions of the health care legislation?

There are many other portions of the House bill which are not in line with the USCCB's desire for truly "universal health care."  Examples include:

  • Page 253: The government regulates the doctor's medical effort, stress, time, professional judgment, etc.  This will put unnecessary pressure on a doctor and may result in poor treatment as a result.
  • Page 280:  Hospitals are penalized for what the government decides is a preventable readmission.  As human beings are unique, an individual may need to be readmitted through no fault of the hospital.
  • Page 298 (lines 9-11):  The doctor is penalized for a readmission.  See comments regarding page 280.
  • Pages 317 - 318:  Rural facilities may not expand.  This could literally mean the difference between life and death.  If a closer facility does not have the ability to care for a patient, the patient may need to be transported to another facility hours away. 

To be fair to Bishop Murphy, his letter was dated July 17, 2009, three days after the release of the House bill, dated July 14, 2009.  A thorough analysis of this bill could not have been done this quickly.  However, since that time there has been much coverage about rationing and other concerns related to the House bill.  At this point, the silence from the USCCB about portions of this bill which violate (or result in situations that would violate) the Catechism of the Catholic Church, is quite mystifying.

Unfortunately, there is evidence of a naïve and unjustifiable trust of Congress in Bishop Murphy's letter.  On page 2, the bishop writes:

No health care legislation that compels Americans to pay for or participate in abortion will find sufficient votes to pass.

Currently, the majority of members of the House of Representatives support abortion.  For evidence of this, one needs only note that the Pence Amendment to H.R. 3293, which would have stripped Planned Parenthood of taxpayer funding, failed by a vote of 247-183.

Switching to the Senate, a majority of members of the Senate Appropriations Committee voted to permanently eliminate the Mexico City Policy.  (This policy prevented taxpayer funding of foreign abortion promoting organizations.)  With these examples from both houses of Congress, it is fairly obvious that they will not heed a bishop's statement on "respect for life from conception until natural death."   

In the letters to Congress, the USCCB presents a "wish list" about what they would like in the bill.  However, they do not seem to understand the reality that true "universal health care" is impossible in a world of finite resources.  Common sense would indicate that unless the number of doctors, nurses, and facilities are dramatically increased, rationing will be an inevitable consequence.  Add to this problem the fact that increased regulation of doctors will likely result in a number of physicians retiring or otherwise leaving the field.  With a government whose leaders are so antagonistic towards respect for human life, combined with fewer doctors and a need to reduce costs, it is patently clear that medical care will be rationed.  Without direct opposition to the numerous pitfalls in this bill, these problems will reappear in the final legislation.  Merely prohibiting abortion funding and including conscience protection clauses is not enough. 

Finally, the USCCB neglects to discuss the root causes which make health care so expensive in the U.S: taxes on insurance, lack of portability, government mandates, lack of tort reform, and the high cost of education for physicians.  A "quick fix" is absolutely not the answer.  This bill should be rejected and the root causes addressed first.

In the opinion of this writer, the USCCB seems to simply be on the "health insurance reform" bandwagon.  The Conference does not offer any kind of serious critique of the details.  These are the shepherds to whom U.S. Catholics such as myself are supposed to look.  Personally, I am deeply disappointed.