Nick Kristof Determines which Hospitals are most Christian

From his piece in the NYTimes about sanctions against Catholic hospitals that are excommunicating nuns and even hospitals for procedures deemed anti-life.

What do you think of Kristof’s reasoning?

The Situation

Yet the person giving Jesus the heave-ho in this case was not a Bethlehem innkeeper. Nor was it an overzealous mayor angering conservatives by pulling down Christmas decorations. Rather, it was a prominent bishop, Thomas Olmsted, stripping St. Joseph’s Hospital and Medical Center in Phoenix of its affiliation with the Roman Catholic diocese.

The hospital’s offense? It had terminated a pregnancy to save the life of the mother. The hospital says the 27-year-old woman, a mother of four children, would almost certainly have died otherwise.

Bishop Olmsted initially excommunicated a nun, Sister Margaret McBride, who had been on the hospital’s ethics committee and had approved of the decision. That seems to have been a failed attempt to bully the hospital into submission, but it refused to cave and continues to employ Sister Margaret. Now the bishop, in effect, is excommunicating the entire hospital — all because it saved a woman’s life.

Kristof speaks..

To me, this battle illuminates two rival religious approaches, within the Catholic church and any spiritual tradition. One approach focuses upon dogma, sanctity, rules and the punishment of sinners. The other exalts compassion for the needy and mercy for sinners — and, perhaps, above all, inclusiveness.

The thought that keeps nagging at me is this: If you look at Bishop Olmsted and Sister Margaret as the protagonists in this battle, one of them truly seems to me to have emulated the life of Jesus. And it’s not the bishop, who has spent much of his adult life as a Vatican bureaucrat climbing the career ladder. It’s Sister Margaret, who like so many nuns has toiled for decades on behalf of the neediest and sickest among us.

Then along comes Bishop Olmsted to excommunicate the Christ-like figure in our story. If Jesus were around today, he might sue the bishop for defamation.

Anne Rice spoke into this situation:

Anne Rice, the author and a commentator on Catholicism, sees a potential turning point. “St. Joseph’s refusal to knuckle under to the bishop is huge,” she told me, adding: “Maybe rank-and-file Catholics are finally talking back to a hierarchy that long ago deserted them.”

About Scot McKnight

Scot McKnight is a recognized authority on the New Testament, early Christianity, and the historical Jesus. McKnight, author of more than forty books, is the Professor of New Testament at Northern Seminary in Lombard, IL.

  • JohnM

    That’s Kristof’s op/ed piece. Anybody know Bishop Olmsted’s side of the story? Anybody know anything about Bishop Olmsted or Sister McBride, apart from the picture Kristof draws? Maybe we ought to know these things before we draw conclusions. For the record, I’m not Roman Catholic.

  • Robin

    I haven’t read the source article, but if what you posted is representative, then it is somewhat misleading. For example, Kristof said that the mother who had the abortion had developed pulmonary hypertension and that without the abortion she “would almost certainly have died otherwise.” It is possible that she would have died, but the most recent research I have seen is that from 1978-2008 78% of pregnant women with PPH have survived. The mortality rate is only 22%, which while high, does not indicate that she “…almost certainly have died….”

    As far as the excommunication, he appears to be following church law. He DID NOT EXCOMMUNICATE HER, he informed her that by her actions, according to church law, she had excommunicated herself. You can check out the wikipedia page on Latae Sententiae “already passed sentence.” According to church law when one of these acts is committed, the punishment of excommunication is automatic. The acts listed include procuring an abortion and “accomplices…without whose assistance the violation would not have been committed.”

    This may be a stupid part of church law, but it appears the bishop has no choice. When I left the catholic church and was baptized, as a believer, in a protestant church, I committed an act that, according to Latae Sententiae automatically resulted in my excommunication. Same as the nurse. If you don’t like that action, take it up with whoever makes the rules.

    As far as the hospital…the didn’t lose their catholic status because of this abortion, but because they said that in the future they would continue to perform abortions whenever they deemed it medically necessary. I imagine the bishop and hospital administrators had legitimate disagreements on the definition of medically necessary, and the diocese probably decided it didn’t want to financially support a couple of hundred abortions per year.

  • Robin

    Also, I’m not sure Kristof is displaying “reasoning” here as much as he is crafting a narrative.

  • Robin

    Maybe Dopderbeck or someone else familiar with the intricacies of Catholic Church aw could let us know how much leeway exists when people clearly commit acts that, according to church law, result in automatic excommunication.

    I think one interesting aspect here is that every Catholic woman who has ever had an abortion or any Catholic man who has ever acted as her accomplice has been officially, and automatically, excommunicated from the church, even if they were unaware and even if they never told church leaders.

    It is kind of like saying, we don’t think you even belong to the invisible church anymore, even if your visible church membership is still in tact due to your secrecy.

  • Jeremy

    What I’ve read is that it’s a 30-50% mortality rate and that’s IF they catch it very early. There are way too many questions here, but I would at least initially side with the hospital as they would know the details far better. “Almost certainly” is a big statement. PPH by itself may be survivable (with huge risks), but there may have been other factors increasing chance of death significantly.

  • Robert A

    A NYTimes editorial selectively representing events to shape a view? Nope, that never happens…

    I suspect there is more to this story that meets the eye. Imagine the flames which would come if a pro-life publication came out for the Bishop’s side and recast the players in their light. We live in a hypocritical society.

  • http://azspot.net Naum

    I get the point about the narrative of a Kristof NYT op-ed, but it sure seems messed up the Catholic hierarchy would take this action, yet be so slow to discipline for sexual abuse.

    Some local takes:

    The Silent Hero of St. Joes

    Someday Bishop Olmstead will have to answer for this one….

  • http://LostCodex.com DRT

    I have been continually intrigued by the Moral Foundations study going on at the UVA http://faculty.virginia.edu/haidtlab/mft/index.php

    This study rather strikingly points out that conservatives value Ingroup/loyalty, Authority/respect, and Purity/sanctity much higher than progressives (or do they call them liberals, or not conservatives.) I highly recommend that you take the test and see where you stand.

    The reason I point this out is that this seems to me to be a classic case of a conservative vs. progressive view. Kristof is certainly arguing for the position that the behavior should be dominated by the other two moral indicators, namely, Harm/care and Fairness/reciprocity. Anyone who has read my comments here will clearly see that those are the two categories of Moral Foundation that I consider to be the most important and, of course, I feel those are the ones that Jesus emulated.

    Is there biblical support for the other 3? I don’t see it.

  • http://LostCodex.com DRT

    Are we talking about Pregnancy Induced Hypertension? We went through that where my wife was hospitalized about 2.5 months before expected due date and ended up delivering 6 weeks early. It ended fine, but he is now 18 and causes other problems.

  • http://www.lambpower.net Steve D

    @Robin

    Since none of us were involved in the decision and don’t have access to the patient’s records quoting a 78% survival rate doesn’t really apply. These types of medical decisions are rarely based solely on stats. The condition that the woman was in at the time would have and should have been the primary factor.

    Decisions like this are never made lightly and are part of a committee process. My bet is that there may have been two committees involved. One medical and the other ethical.I have a close friend who is an MD who sits on a medical board who decides the treatment (or non-treatment) of liver cancer patients. It’s not a committee that I would want to sit on.

  • Robin

    Steve D,

    I agree that I don’t have the requisiste knowledge to declare that she had a 78% chance of survival. My point is that neither does Nicholas Kristof have the requisite knowledge to declare that without this treatment she was sure to die, and nothing that I have seen written in the past has a quote from a doctor saying that her chances of survival were 0%. Kristof has imposed his unsupported narrative and I was challenging it.

  • Robin

    Steve D,

    To put it another way, if Kristof had said “mother of four children, who faced possible death from complications with her pregnancy” or something to that effect, then he would have been in line with the statements by the doctors and I never would have brought in statistics.

    When he goes well beyond what her doctors have said, and beyond general statistical outcomes and declares that she “would almost have certainly have died otherwise” then he is just making stuff up to support his narrative.

  • Robin

    Beyond Kristof’s framing, I wonder what Jesus Creeders believe the diocese’s relationship should be with a hospital that has admitted it will perform abortions that are “medically necessary”?

    Do you think that it is sinful that abortionists like Dr. Tiller had to operate private practices and not be employed by Christian hospitals? After all, every single partial birth abortion he ever completed, at least after the semi-ban went into effect, EVERY SINGLE ONE, was declared medically necessary. Is that the only standard?

    I have no reason to believe that these particular doctors didn’t truly believe that this was a medical emergency, but neither do I quite believe that every time someone performs an abortion and calls it “medically necessary” that they are being completely honest.

  • http://www.lambpower.net Steve D

    Robin

    The fact that her case made it to an ethics committee would indicate to me that she was in bad shape. This was not a 1 or 2 doctor decision.

    Four and a half years ago I received a liver and kidney transplant. My case was monitored by doctors, nurses, and a social worker to determine the best method of daily treatment as well as if I would even get the transplant. I have followed this case for a while and I remember that this woman’s case was reviewed by a committee that the nun was a member of.

  • http://www.lambpower.net Steve D

    I will grant you that “medically necessary” can be abused and stretched beyond recognition. However, I believe that we need to make those decisions on a case by case basis. Frankly, I believe that the staff was faced with either saving the mother and losing the baby or losing both. It’s a difficult choice, but four other children would be motherless.

  • Scot McKnight

    Robin, the one thing you don’t know is if Kristof is accurately representing the hospital staff’s decisions or if he did have the requisite knowledge. You are just accusing without any kind of requisite knowledge yourself.

    I suspect he did get info from them … but … I don’t know. So I withhold judgment. It’s clear from me that he thinks he can discern which is the most Christian view and it so happens to align with his own views.

    I’m strongly against abortion, but you may remember before evangelicals totally politicized abortion Carl Henry and the common belief was that abortions were wrong except in medical emergencies.

  • Robin

    Scot,

    Here is my intuition on what Kristof really knows. If the doctors had told him that she had less than a 50% chance of survival, he would have printed that, and cited the doctors as his source of his knowledge. He would have written it that way because it would have added drama to say “her doctors said her chances of survival were less than 50%.” If the doctors told him she had less than a 50% chance of dying, he might not have printed it because “she had a 40% chance of dying” implies that she had better than a coin-flip of a chance, and it just isn’t as dramatic and doesn’t hammer home the narrative quite as well.

    So, my hypothesis is that either he didn’t talk to the doctors and had no reason to attach any probability, or he did talk to them and the percentage wasn’t high enough to make the story extra-juicy, so he omitted the actual likelihood and spiced it up with “almost certain” death.

    Maybe I’m too cynical, but that it is the lens I see it through. For the record, with any substantial likelihood of the death of the mother I support both the doctor’s and the nurse’s decision, but I also don’t fault the diocese for breaking a relationship with a hospital that has openly declared it will continue to perform “medically necessary” abortions. There is just too much gray area there to feel comfortable.

    I would also love for Dopderbeck, or another Catholic legal scholar, to opine on the ability of the bishop to exercise discretion in cases of “Latae Sententiae”

  • http://www.lambpower.net Steve D

    Robin

    The doctors would have been banned from discussing the case in much detail under HIPPA without the patient’s express permission. Frankly, I think that we need to trust that the doctors and staff acted in an ethical and moral manner. This was not some abortion mill, this was a major hospital. There were several people involved in the decision including a nun. I can understand your skepticism, however, this story has been around for several months. Most of the Roman Catholic arguments that I have read go along the line that no one should have touched the child since that involved human agency in the death of the child. Also, the child was about 11 weeks old and in no way could have survived without the mother.

  • Robin

    Scot,

    I too believe that abortions are justified in cases of medical emergencies, it is just that I don’t always believe doctors are honest about labelling things medical emergencies, and apparently the diocese didn’t trust the physicians at this particular hospital to be truthful in their assessment of medical emergency status.

    It is very much a trust issue when abortion is the topic for debate.

    I went to the Kansas Department of Health and Environment webpage to look up statistics on Dr. Tiller. By law, every single partial birth abortion he completed was required to be “medically necessary” and he performed 250-300 abortion per year on babies beyond 22 weeks gestation. And in 9 years of data (2001-2009) there is not a single late-term abortion where Dr. Tiller testified that it was necessary to perform the abortion in order to save the life of the mother. So what is that, 2,000-3,000 babies whose lives were terminated after 22 weeks of gestation, every single one considered “Medically Necessary” and not a single, solitary case in which the life of the mother was in danger.

    Remind me again why I should take doctors seriously when they throw around the term “medically necessary.”

  • Robin

    Sorry, here is the link the the Kansas statistics. Dr. Tillers partial birth abortion reasons are on page 9 of most of the summaries.

  • Jim L.

    I have been following this story from its beginnings thru a catholic resource. The NYT have the story correct for the most part. I believe a catholic ethics person / maybe panel has ruled in favor of the hospital and the bishop still persists in his ruling. My comment is FYI only.

  • http://LostCodex.com DRT

    Robin, as much as I would like to oppose what you are saying I can’t because I don’t have the info. I also don’t believe you have the info to make the case you are making.

  • Robin

    Steve,

    just to be clear, my main problem is with Kristof’s framing. He had a point he wanted to drive home, and I just don’t think he had any facts to back it up.

    The doctors might have concluded she had a 20%, 40%, 60%, or 80% chance of survival and still been justified, in my eyes, for their actions. I just don’t think Kristof had the requisite knowledge to claim, accurately, that without the abortion she surely would have died.

    Statistics about the condition don’t support that conclusion, and nothing I have read from her doctors has supported that conclusion. They both have supported the conclusion that there was some probability, even an unacceptable high probability, that she would not survive. But not “certain death”. And if he got that “certain death” nugget straight from the horse’s mouth I think he would have mentioned it to reinforce his conclusion and his narrative.

  • Robin

    DRT,

    Let me be clear. I don’t have the info to say conclusively that Kristof is lying in the way he characterizes the story, but neither does he demonstrate that he has the information to support his claims. I just don’t trust him.

    I do support the actions of the doctors and the nurses involved, I just don’t trust the accuracy of Kristof’s reporting.

  • http://www.lambpower.net Steve D

    Robin

    You are taking Dr Tiller and superimposing him on a totally unrelated case. The case in AZ wasn’t just one person’s decision. It was a multidisciplinary team that made that decision. In my book, a big difference.

  • Robin

    Sorry, I failed to included the Kansas link again. Last try, here it is.

    http://www.kdheks.gov/hci/absumm.html

  • Robin

    Steve,

    I think that by talking about the bigger issues around Kristof’s piece I have obscured my position.

    I believe that these particular doctors and nurses made an informed decision, and that they believed the risks were too great, and that they made an appropriate decision.

    I also believe that the bishop did not excommunicate the nurse, but explained to her the clear implications of catholic doctrine – I am more than willing to be corrected on this point by Dopderdeck regarding the level of discretion possessed by the bishop.

    Lastly, I believe that there is no reason for the diocese to believe that every time a group of doctors at this particular hospital decided something was “medically necessary” that the diocese and the doctors would have a common understanding as to what constitutes medical necessity. Dr. Tillers records are just publicly available documents that demonstrate that medical necessity doesn’t always mean “save mom’s life”. If the diocese doesn’t trust that the doctors share their view on medical necessity, well then there is no reason to expect the diocese to continue in that relationship.

  • http://www.lambpower.net Steve D

    Robin,

    Here’s a link to an article that ran in the Arizona Republic

    http://www.azcentral.com/arizonarepublic/news/articles/2010/05/15/20100515phoenix-catholic-nun-abortion.html

    From the article :

    “In a statement, Suzanne Pfister, a hospital vice president, said that the facility adheres to the Ethical and Religious Directives for Catholic Health Care Services but that the directives do not answer all questions.

    “In this tragic case, the treatment necessary to save the mother’s life required the termination of an 11-week pregnancy,” Pfister said.”

    Kristof’s description sounds within reason to me.

  • Robin

    Regarding the excommunication issue, I would appreciate further commentary on “Latae Sententiae”. I am not a catholic legal scholar so I defer to those that are.

    It appears that when someone commits an act on the “Latae Sententiae” list, that excommunication is automatic. So when I converted from catholicism to protestantism and became an apostate in the eyes of the church, my priest and bishop didn’t have to do anything, my actions had excommunicated me automatically.

    Furthermore, it appears that when an act of “Latae Sententiae” occurs, the church doesn’t even have to know about it, the excommunication is automatic and SPIRITUAL. The only role of the church, or its officers in these cases, is, once they become aware of the act, to DECLARE it.

    That is why it looks to me, as an outsider, that the bishop didn’t excommunicate her, her action did, and he only made her aware of the automatic excommunication that had already occurred.

    Lastly, it isn’t clear to me that the bishop even had the authority to absolve the nurse of the excommunication once the action had occurred. It seems that an absolition from excommunication in an “Latae Sententiae” may only be performed by the pope, but that point is unclear.

  • Scot McKnight

    Robin, one of your statements says too much: You say you just don’t trust him.

    That’s all you’ve got on Kristof.

    You may be right, but you’ve got no evidence. Neither do I. So I suggest we not accuse Kristof of something we don’t know.

    And brother I know you are a numbers guy; we’ve got no numbers in this case. Suspicion isn’t enough to make accusations.

  • Robin

    Fair enough. Any comments on Catholic doctrine and whether dioceses should automatically trust that doctors share their views on medical necessity?

  • Scot McKnight

    Robin, I’m with you: no need automatically to trust the doctors. I’m sure you are right that doctors use false (but legal) reasons, but my own experience would say those doctors are the corrupt few and not at all a norm.

    I have no comments on Catholic doctrine.

  • Robin

    Scot,

    Do you agree that if the hospital says “we will continue to perform abortions when they are medically necessary”, and if you, as the bishop, don’t trust that you have a common understanding of what thresholds meet medical necessity, then maybe it is good if the diocese and the hospital sever their relationship.

  • Scot McKnight

    Yes, that’s reasonable and evidently what they did. No?

  • Randy Gabrielse

    For what it is worth, I have read Kristof’s work over the last ten years. In my experience his work is top notch and very reliable. He is usually very fair to evangelicals and Roman Catholics, although he has been harder on the Catholic hierarchy, especially on the sexual abuse issue.
    Peace,
    Randy Gabrielse

  • johnfouadhanna

    In this case, it could have been that the best judgment was made under the circumstances. However, in terms of Kristof’s approach overall, this quote expressses his thinking: “One approach focuses upon dogma, sanctity, rules and the punishment of sinners. The other exalts compassion for the needy and mercy for sinners — and, perhaps, above all, inclusiveness.” As Scot says, Kristof “thinks he can discern which is the most Christian view and it so happens to align with his own views.”

    The problem is Kristof has created a false dichotomy. He can’t see that “compassion for the needy and mercy for sinners” is itself a “dogma.” That belief doesn’t just come from “nowhere,” nor is it, nor can it be, simply the product of “pure” reason. Also, because he doesn’t seem to have much (any?) regard for the life of the unborn child, he doesn’t figure compassion and mercy towards the baby as part of what should be considered. Why can’t the “inclusiveness” that Kristof considers to be “above all” be inclusive of the child? In addition, if we don’t have regard for the “sanctity” of the mother’s life, what’s the big deal about her dying anyway. The sanctity of her life is exactly the basis for the defense of the medical judgment in this case.

    As for “punishment of sinners,” it seems there’s a “sinner” here that Kristof is at least willing to publicly excoriate – and that is the bishop, who’s deeply offending Kristof’s sense of justice.

    Again, the point is not to defend the bishop or even to disagree with Kristof’s opinion in this case in particular. It is however to point out that judgments are being made, dogma of a certain kind is being upheld, and strongly held moral beliefs are advanced, in a manner totally lacking any self-awareness, and as those on the “other side” of the same issues are strongly derided for making “judgments,” proclaiming “dogma” and advancing “morals.”

  • Theo

    If the Roman Catholic church were serious about reducing abortion, they’d have supported universal health care. We might drop our world-class rate down to something approaching Canada’s, even. Punishing nuns and putting crosses on the church lawn is pointless.

  • Randy

    It is amusingly protestant of us to be second guessing the decisions of a Catholic bishop from a distance (which we are; as well as analyzing the moral issues on their own terms).

    But why have we shifted the burden to the bishop to prove that his actions were warranted? We’re operating under the framing presented by Kristof (who goodness, described the bishop as “a Vatican bureaucrat climbing the career ladder”) instead of assuming that the bishop (who is actually on the ground in Arizona and holds responsibility and authority for the diocese of which he is the steward) investigated these things and his decision accordingly deserves deference.

    I see little reason to think such a shift in burden is warranted or even proper and even less to think that Kristof’s analysis deserves to be the starting point in any consideration of the case. In accepting his framing (including his framing of the actors), we’ve ceded too much ground.

  • PLH

    Theo-the Bishops DID support universal health care and have pushed for it for years. Unfortuntaely, it’s not a “sexy” topic for the New York Times and thus doesn’t get coverage like the sex abuse scandal and the Catholic Church’s hard line on abortion. The Times, of course, does not report that the Church operates the largest charity network aroudn the global and does more to deliver health care to the poor than any other organization.

    I also take issue with Kristof’s implication that Catholic Bishops are wealthy and powerful. The Bishops have very little power other than that of persuasion and a pulpit. Being a Bishop is not glamarous and most serve as Bishops well beyond the normal retirement age. These are man who devoted their entire lives to serving God and the Church. I’m sorry but I don’t see the analogy that Kristof is trying to get. perhaps it was true in the 1950s that Bishops when clergy where viewed with respect by general society but not anymore.

  • PLH

    Sorry, I should add the I am Catholic and frankly disgusted with the often biased reporting of the Catholic Church in the NYT and other secular media outlets.

  • http://cboye.wordpress.com Colleen

    You’re either second-guessing the bishop or second-guessing the hospital in a case like this, assuming you take sides at all.

    I think the bishop has the easier position, though. The hospital and doctor had to actually make a difficult choice in a life-or-death situation. The bishop can sit back and pronounce judgment with the knowledge that lives aren’t resting on the result. (That is, even if it were 100% sure that the mother would have died otherwise, the bishop’s condemnation of the act won’t kill her, so it’s a win-win for him.)

  • Theo

    I stand corrected. If the RC church supports universal health care that is a very consistent pro-life stance.

  • Grupetti

    It looks to me like Robin and the other anti-Kristofians (Kristofites? Kristofarians?) are arguing whether the decision is in line with the teachings of Rome, whereas Kristof is arguing whether or not the decision is in line with the teachings of Jesus of Nazareth.

    Scot wrote: “It’s clear from me that he thinks he can discern which is the most Christian view and it so happens to align with his own views.”

    Is there anyone here not doing that? Or does it work the other way around, as it appears when DRT wrote “…I feel those are the ones that Jesus emulated.”

    johnfouadhanna wrote: “The problem is Kristof has created a false dichotomy. He can’t see that “compassion for the needy and mercy for sinners” is itself a “dogma.””

    That sounds like a false equivalence between various kinds of dogma. He’s criticising a dogma he believes is much too rigid – and I agree – and offering a more generous and flexible dogma instead.

    “Also, because he doesn’t seem to have much (any?) regard for the life of the unborn child, he doesn’t figure compassion and mercy towards the baby as part of what should be considered.”

    Wow. That’s harsh…but I’m not entirely unsympathetic to your reasoning, as I’ve come to believe almost the complete opposite. One reason I’m grateful for the internet is that I’ve had the opportunity to listen carefully to countless horror stories of pro-choice women. I’ve gone from being pro-life to pro-choice – note that that’s not the same as pro-abortion.

    Regarding Catholics, universal health care, and the NY Times, I suspect that if it was covered, conservatives would find a way to complain about liberal bias. It seems that conservatives have a selective respect for Catholic dogma.

  • johnfouadhanna

    Grupetti (#43), you write:”He’s criticising a dogma he believes is much too rigid – and I agree – and offering a more generous and flexible dogma instead.”

    If that’s what he were doing, then I think it would be more palatable. Though again, usually those who argue for something being “too rigid” often have their own rigidity. But Kristof isn’t doing that. He’s arguing between “dogma” on the whole and he’s “obviously” “non-dogmatic” viewpoint. He can’t see that he has his own dogma.

    Your reaction to my take on Kristof’s regard for unborn life is to exclaim, “Wow. That’s harsh.” I’d be glad if that were in fact a harsh criticism of Kristof, not reflective of his views. However, how do his views reflect “mercy and compassion” for the unborn?


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