Medicine, Health Care, & Ethics: Catholic Voices

5. Abortion: A Catholic Moral Analysis - Jeanne Heffernan Schindler

Chapter 5 Abortion A Catholic Moral Analysis Jeanne Heffernan Schindler In the spring of 2002 New York City made national headlines when it became the first American city to require abortion training for obstetrics and gynecology residents in its public hospitals.1 Supporters and critics alike recognized the significance of the policy, as New York remains an influential player in the nation’s medical establishment—New York State trains one in every seven doctors nationwide, while New York City runs the country’s largest public hospital system. If the policy succeeds, its supporters hope to duplicate it across the country in order to reverse a reported decline in the number of physicians performing abortions. Just as the state was a forerunner in the liberalization of abortion laws, what happens to public medicine in New York may well be a harbinger of things to come. Other developments in recent years have likewise attempted to render abortion a mainstream element of medical training across the country. In 1996 the Accreditation Council for Graduate Medical Education, for instance , demanded that residency programs in obstetrics and gynecology seeking accreditation provide instruction in abortion techniques.2 While initially an absolute requirement, the revised ACGME mandate included an exemption for individuals and institutions that oppose abortion; but it nevertheless required these institutions to allow their students to be trained in abortion procedures at another site. In effect, the mandate forces Catholic 107 medical programs to compromise their principles by allowing students to violate deeply held convictions that define the identity of the institution. As Dr. Henry Clever incisively observed, “To require of religious institutions such culpability in an act that they abhor shows either incredible ignorance or contempt for the moral and religious principles these institutions uphold.”3 The aggressive measures taken by New York City and the ACGME deliberately normalize what is still a highly morally contentious undertaking.4 The fact that the American public remains deeply divided over the issue of abortion indicates just how radical these measures are; they do not emerge out of a consensus. They also place the burden of resistance upon those who oppose the practice—a dramatic change in policy, as abortion training was formerly considered an elective. Now, however, residents in New York who object to abortion training, for instance, must file a petition for exemption. While there is no formal penalty for non-participation, it is probable that there will be informal liabilities for opting out. Beyond the likely occurrence of peer pressure and stigmatization, residents who resist the training may be at a competitive disadvantage for hiring. On the front end, applicants for New York City residency programs may be screened out on account of their unwillingness to undertake what has now been deemed “integral ” to good medical training. Given the intention of the New York and ACGME measures to render abortion a standard element of medical care, it is conceivable that individuals and institutions refusing abortion training will be categorized as medically irresponsible. These bold attempts to change the climate of American medical practice pose a serious challenge to opponents of abortion. Now, perhaps more than ever over the last thirty years, the burden is upon them to articulate a case against abortion that is publicly intelligible. This burden is candidly acknowledged by an editorial in the New England Journal of Medicine that insists: “Residents who wish to opt out of abortion training should be required to explain why in a way that satisfies stringent and explicit criteria.”5 Fortunately, there is a compelling case to be made against abortion. The Catholic Church has been making it for 2,000 years, and while its teaching is informed by theological reflection, it bears relevance to the debate in the wider culture. As John Noonan has put it: “The moral teaching of a religious body may also embody insights, protect perceptions, [and] exemplify values which concern humanity.”6 108 jeanne heffernan s c hindler Catholic Opposition to Abortion: The Historical Record Insofar as the Catholic Church has been the leading critic of abortion in this country for the past thirty years, most Americans know of its stance. Yet few Americans, even Catholics, know how central, consistent, and longstanding this opposition has been in Catholic moral thinking. Moreover, few understand the deep rationale behind such opposition. Most people do not know that the Church’s pro-life position is a deeply thoughtful one, which finds support...