August 26, 2009

Questions a Catholic should ask about health care

By Helen Alvare, J.D.,  & E. Christian Brugger, PhD.

The following column is Part 1 in a series. The piece has been adapted for the Denver Catholic Register. It originally appeared on the Culture of Life Foundation Web site:  culture-of-life.org/content/view/582/1/.

We think that significant moral questions are raised by the universal health debate and would like to formulate several here.  Our purpose is not to draw a one-size-fits-all conclusion about the merits of all current health care bills.  These raise complex questions and there are reasons to support and/or oppose various pieces of different bills. 

The Catholic Church has affirmed for some time a right to a minimum of decent, humane and accessible health care (see encyclicals “Caritas in Veritate,” “ Pacem in Terris Sollicitudo Rei Socialis” and “Quadragesimo Anno”).  This does not imply that a nationalized health care system is a good idea, nor its establishment a fundamental right.  But it does imply that Catholics should work for some kind of improvement or reform in the current system on behalf of those who cannot afford adequate care.

We pose the following 12 questions for your consideration.  Not all are of equal moral “weight.” Those questions pertaining to whether the plan deliberately mandates coverage for intrinsically evil acts (e.g., abortion, infanticide, euthanasia and contraceptive acts) or encourages the commission of such acts (e.g., requires end of life counseling encouraging the removal of food and water for patients for whom such care is necessary and effective for sustaining life) have the highest priority.  This is not to say that questions which involve reasonable calculating of long term consequences are unimportant (e.g., will the costs of implementing and running a universalized  or other new plan put undue stress on the economy in the long run resulting in rebound financial problems for everyone?).  They are very important; but they rarely can be answered with the certitude of the former questions; and they often cannot be answered without special skills or knowledge.  No one needs special knowledge to answer the question: should tax payer coverage for abortion be mandated by law?

Finally, we urge avoiding simplistic conclusions both in opposition or support of the issue.  This debate requires serious practical reasoning on behalf of a morally conscientious citizenry.

12 Questions

1.  Does the legislation sanction wrongful cooperation in the destruction of human life:
• through a nationalized insurance plan which would include the services of abortion, euthanasia, and/or fertility treatments that destroy human embryos?
• through requiring or permitting insurance policies to cover these procedures as part of any package of mandated services?
• through funneling tax payer money to organizations such as Planned Parenthood, which promote and perform abortions? 

Note: The House bill, H.R. 3200, as currently drafted, authorizes the president to appoint the committee of experts (“Health Benefits Advisory Committee”) who will propose the “essential benefits package” that must be included in any public health plan.  The ultimate decision to adopt the benefits proposed by the Committee rests with the Secretary of Health and Human Services (pro-choice) Kathleen Sebelius.  Unless abortion is explicitly excluded from the range of benefits covered under the government plan, it is almost certain that the Advisory Committee and the pro-choice HHS Secretary will include it in the package of essential services.  Abortion will then be a mandated part of the government option of national health care.  Every hospital and practitioner involved in pregnancy care and who participates in the government plan (which will include every full service hospital and most all economically viable Ob-Gyn practices) will be required to offer abortion services.  Opponents in both the House and Senate have offered amendments that would have explicitly prohibited the use of taxpayer dollars to fund abortions.  To date, all such amendments have been defeated in both the House and the Senate. 
Action item: press your U.S. House representatives to vote to explicitly exclude abortion from any national health care plan.

2. Does the legislation encourage certain populations—the elderly, chronically ill or disabled—to forego ordinary care? Or even to consider euthanasia or assisted suicide?

Note: The removal of food and water from a patient who needs them to survive and for whom their administration would not constitute an excessive burden is passive euthanasia (i.e., their removal is done in order to bring about the patient’s death).  This scenario—tragically illustrated in the life and death of Terri Shiavo—has become a routine alternative for end of life decisions in U.S. health care.  It is not presented as euthanasia but rather under the guise of the otherwise legitimate removal of burdensome or futile forms of treatment.  Such provisions are not presently included in H.R. 3200 and are unlikely (because of the strong outcry of seniors) to find themselves in any current bill.  Christians should ask themselves however whether it is likely that a government administrated plan will in the long run begin to include such provisions; or more likely, whether through such a plan a culture increasingly impatient with the weaknesses of the elderly will increase pressure on the elderly, the infirmed, and their families to opt for choices intended to bring about death in end-of-life planning.

Helen Alvare, J.D., is senior fellow in law at the Culture of Life Foundation and is an associate professor of law at the George Mason University School of Law in Arlington, Va.  E. Christian Brugger is an associate professor of moral theology at St. John Vianney Theological Seminary in Denver.