John Livingston

St. Al’s is not a Catholic Hospital

Any discussion about abortion should be proceeded with the following statements: “There is no sin greater than God’s Providential Mercy and forgiveness” We should all examine the “logs in our own eyes before being critical of the slivers in the eyes of others”. And finally, we are called to remember that “he who is without sin should cast the first stone”. Not a stone caster—I. I am not a Catholic Religious—Priest, Deacon or member of an order nor do I have any formal training as an Apologetic. I have been a physician for almost 50years—almost 30 of those years at St. Alphonsus in Boise. The issue of Providential truths and sectarian authority in the private sector vs secular humanistic autonomy and government authority is as old as the history of our country and in Medicine dates to founding of many of our greatest medical institutions—Mayo Clinic, the Johns Hopkins and thousands of local Community Hospitals founded by Catholic Sisters, most under control of a Diocese— a Bishop, or the Order that Founded it. St. Alphonsus today does not fall into any of these categories.

On July 11th, 2022, The Centers for Medicare and Medicaid Services (CMS) promulgated a statement giving guidance to providers and hospitals regarding emergency treatments pursuant to the Emergency Medical Treatment and Labor Act (EMTALA) :

If a physician believes that a pregnant patient presenting at an emergency department is experiencing an emergency medical condition as defined by EMTALA, and that abortion is the stabilizing treatment necessary to resolve that condition, the physician must provide that treatment. When a state law prohibits abortion and does not include an exception for the life of the pregnant person—or draws the exception more narrowly than EMTALA’s emergency medical condition definition—that state law is preempted.”

On August 18th, 2022, Michael Born MD MBA FACHE sent out a memorandum to the medical staff at St. Al’s entitled UPDATE ON EMTALA COMPLIANCE POLICY. The purpose of the update was to incorporate guidance from CMS stating that a ‘hospitals requirement to stabilize a pregnant woman’s medical condition may include terminating the pregnancy. The list of conditions given as being legitimate medical indications for termination of pregnancy was boiler plate and universally is within “the standard of medical practice” or the “standard of medical care” in our State. One does not need to be a lawyer to understand those standards and the difference between the two, and attorneys routinely deploy those relatively low bar standards in either mounting a malpractice defense or as plaintiff attorney for suing a doctor. The point is that the standard is already present in law. Two points that I am concerned about in the memo. At the end, the statement “the list of conditions being described is not exhaustive”. And any duty of the mother to the unborn child and of the doctor to the unborn child is not mentioned. Why not? I can understand an argument being made as to why such a statement in the memorandum of the rights of the unborn child would not be included in a statement at a state institution, but to not include that in a Catholic institutional directive is beyond my comprehension. The sanctity of life is a Catholic tenant and can be found under the obligations of the virtue of justice. Is the hospital protecting the mother, the doctor, themselves or the unborn baby boy or baby girl? Do the rights of the mother under the law supersede her duty to protect her baby?

The final statement in the Memorandum is beyond belief coming from an executive of a Catholic Hospital. “Physicians have an obligation to follow EMTALA even if it is not allowed under State Law”. What about if the physician refuses to perform an abortion because the indications in his professional and Catholic opinion do not justify such a violent act. Are accommodations made for her/his moral beliefs? Why was that not addressed in the memo? The Qualified Medical Practitioner (QMP) is who makes the final determination. Can patients “shop for the “OMP” that will give them the outcome they want? In THE SCREWTAPE letters by C. S. Lewis, one of the themes is that the Devil will use any tactic to separate Christians from each other and most importantly from Christ. This single issue is one of the most volatile of our times. There is no political party and no political philosophy that is 100% aligned with the teachings of the church. There are PROVIDENTIAL issues where the church will not compromise. Abortion is such an issue. There are ‘prudential matters” usually disagreements regarding process that Catholics can disagree about, and each side will possess a moral predicate for their argument. For example, we can all agree that taking care of the poor is a moral responsibility of everyone, but how that is accomplished is a prudential matter. Abortion and the sanctity of life is a PROVIDENTIAL ISSUE. 95% of the 80million abortions that have occurred in our country since Roe v Wade have NOT had emergent indications. The two-memorandum cited above leaves room for the prudential argument that “emergent” is simply in the eye of the beholder.

I have a few questions regarding this issue and how it pertains uniquely to St. Al’s as a Catholic Institution:

  1. Was the Catholic Bishop of Boise or the Diocesan Ethicist consulted prior to the writing of the St. Al’s Memorandum, or did only non-Catholic lawyers have input?
  2. Does the Catholic Bishop of Boise have an opinion about the memorandum and has he made his opinion known to Catholics in our State?
  3. Does St. Al’s still consider themselves to be a Catholic institution, or are they more of a secular corporation flying under the cover and flying the color of The Catholic Church?
  4. When was the last time daily Mass was offered at St. Al’s?

The answer to the last question may be the answer to all the other questions.

Christians are all confronted with the duty to discern which policies are consistent with Biblical Principles, most importantly the teachings of Jesus, and the teachings of the Church Fathers throughout the ages. What is consistent with those teachings and what is not. I challenge any person of faith to show me where the killing of little baby boys and girls in their mother’s womb is justified in the Bible:

Mary said yes, and that should be our model for the sanctity of life. The duty of the mother to her child supersedes anything and everything else.

“I knew you before you were in your mother’s womb” Jerimiah 1:5

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