Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SATURDAY, November 12, 1994 TAG: 9411170022
SECTION: RELIGION PAGE: B9 EDITION: METRO
SOURCE: DAVID BRIGGS ASSOCIATED PRESS
DATELINE: LENGTH: Medium
Abortion is prohibited, but rape victims may be offered medications that would prevent ovulation unless it appears conception has already occurred.
In proposed new directives for Roman Catholic health care institutions, a committee of bishops grappled with the intricacies of applying religious principles forged over centuries to medical procedures at the beginning and end of life that were unheard of even a generation ago.
The Committee on Doctrine upholds traditional teachings opposing abortion, euthanasia and artificial contraception, but admits the church cannot have a ready answer in every case in the brave new world of modern medical ethics.
In the case of a Catholic hospital considering a joint venture with another health care provider such as a health maintenance organization that does not share the church's ethical norms, diocesan bishops would decide whether the ``possibility of scandal'' might outweigh the benefits of cooperation, according to the proposal.
``The moral life is full of fine distinctions,'' said the Rev. Augustine DiNoia, director of the Office for Doctrine of the National Conference of Catholic Bishops.
The proposed ``Ethical and Religious Directives for Catholic Health Care Services'' - which would update regulations last revised in 1975 - are scheduled to be voted on next week at the annual meeting of the bishops' conference in Washington.
With more than 1,200 health care facilities, the Catholic Church is a large part of the nation's health care system. In 1992, more than 5 million people were admitted to Catholic hospitals, accounting for more than 15 percent of all hospital admissions.
In their proposed directives, the bishops declare all people have a right to adequate health care, and say Catholic institutions should distinguish themselves by service to and advocacy for the poor, uninsured and underinsured persons, addicts, minorities, immigrants, refugees and the disabled.
But when it comes down to individual cases - particularly those at the end of life - the bishops set ethical standards, but leave room for dying patients and their doctors and ethics committees to make the final decisions.
Thus, the bishops, who have led church efforts against legalizing physician-assisted suicide, say Catholic health care institutions can never condone or participate in euthanasia in any way.
However, the bishops also say a person may forgo extraordinary or disproportionate means of preserving their lives if they do not offer a reasonable hope of benefit or pose an excessive burden to the person or family. Even giving a patient food and water by medical procedures is not morally obligatory if they bring no comfort to a person close to death.
In addition, the bishops say, medicines capable of alleviating pain may be given to a dying person, even if the therapy shortens the person's life.
``There's a difference between preventing pain and shortening life intentionally,'' DiNoia said.
In ethical issues at the beginning of life, the bishops say operations or medications to treat a dangerous condition in a pregnant woman are permitted, even if they will result in the death of ``the unborn child.''
And, the bishops say, a female who has been raped should be able to defend herself against a potential conception. Under the proposed directives, unless there is a positive indication that conception has occurred, the assault victim is entitled to medications that would prevent ovulation or fertilization.
At the same time, the bishops say abortion - ``the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus'' - is never permitted in a Catholic health care institution. Nor is prenatal diagnosis permitted ``when undertaken with the intention of aborting an unborn child with a serious defect.''
Further, the bishops state, while joint ventures with other health care organizations can provide benefits, ``Catholic health care organizations need to be concerned about the danger of scandal in any association with abortion providers.''
by CNB