Nicholas Kristof at the New York Times and other commentators seem surprised that Sister Margaret McBride was excommunicated for her participation in an abortion at St. Joseph's Hospital in Phoenix. The only surprising thing about the episode is that major news media remain unaware of the church's harsh teaching on abortion even after 37 years of vigorous Catholic attempts to overturn Roe v. Wade and to deny the right to choose to all Americans, regardless of their faith. The church has never allowed abortion to save the life of the mother. The church's absolute opposition to abortion, and its efforts to make the law consistent with its views, should be criticized on its own terms, not only because the punishment of Sister Margaret is worse than the treatment accorded to sexually abusive priests, which is what seems to upset Mr. Kristof.
According to Kristof, a 27-year-old mother of four who was three months pregnant arrived at St. Joseph's suffering from pulmonary hypertension, a condition that could have killed her. Sister Margaret, an administrator at the hospital, participated in the decision of the patient, her family, her doctors and the hospital's Ethics Committee to approve an abortion. The local Catholic bishop was correct that Sister Margaret was automatically excommunicated (under canon law) for her participation in an abortion and that the mother's life cannot be preferred over the child.
Catholic teaching on abortion is very technical and rigid. Direct killing of the innocent is never permitted. A fetus is always innocent. The fetus may not be killed to save the mother's life. In theological language, it is never permissible to do evil (kill the fetus) to achieve good (save the mother's life).
Only indirect abortion is permitted. The old Catholic moral manuals told stories of doctors whose pregnant patients had cancer of the uterus. The good Catholic doctor would come out of surgery and announce his joy that he was able to save the uterus but not the child. But what he had done was excommunicable. It is acceptable to take out the whole uterus (therefore killing the child) but not to kill the child and save the uterus. The first abortion is indirect, and the second is direct. It is a very rare abortion that falls into the indirect category, and having an abortion because the mother would otherwise die from pulmonary hypertension is clearly direct.
The same rules apply to sterilization. Direct sterilization is always forbidden. For over 30 years the bishops have fought Catholic hospital administrators in order to enforce the strict sterilization teachings as well.
It is terrible that Sister Margaret was excommunicated and then lost her job. But not at all surprising. Where was the criticism of church teaching on abortion when Catholic hospitals took over leadership of public hospitals in mergers? when government financial aid was given to religious hospitals? when Presidents Bush and Obama extended conscience clause protection to medical personnel and gave more aid to faith-based organizations? when six Catholics were named to the U.S. Supreme Court?
The church's goal has long been to ensure that no woman has access to contraception, sterilization or abortion and other rights of equality. What happened to Sister Margaret is no surprise.