Thursday, November 27, 2008

Blowing up hospitals



[Expanded from a comment on Daniel Larison's blog.]

In the last Batman movie, the Joker blew up a hospital to prove some kind of demented point, but he was supposed to be the embodiment of sociopathic evil. I hadn’t realized that the Catholic hierarchy had descended to the same level. Yet they are threating to close all Catholic hospitals if the FOCA bill passes. They are even unwilling to sell the facilities to other healthcare providers, preferring to shutter them. This would deprive millions of people of health care, and almost certainly causing some to die much earlier than they otherwise would have. Yet we are supposed to consider these people “pro-life”.

More here.

13 comments:

TGGP said...

The organization that provides hospitals and doesn't murder people is on the SAME level as the Joker? Perhaps I need to see that movie.

mtraven said...

The church is threatening to disprovide the hospitals unless their demands are met; that is what puts it in Joker territory. I guess it hasn't done much murder recently, although there is plenty of that and sadistic torture in its history.

Also, the Pope looks creepy.

TGGP said...

I don't provide any hospital, so the church is threatening to behave like me. I guess I'm the Joker!

the ashen man said...

This law would make it impossible for Catholics to operate hospitals without violating their own consciences - indeed, without committing what they consider mass murder. Why not blame those pushing the law for the closure of the hospitals? It is a logically inevitable consequence.

Michael said...

Physical assets are generally not just abandoned.

If the Catholic church decides to leave the hospital business because it cannot in good conscience continue in it - whatever it may say now - the hospital buildings will be bought by other organizations (perhaps for uses other than as general hospitals), while those of the staff who have no scruples against abortion will find employment elsewhere. I very much doubt that anyone will be significantly deprived of medical services.

As for individual doctors and nurses, why should they not refuse to commit abortions?

Many general practitioners already refuse to deliver babies, not because they are incompetent to do so or object to doing so on moral grounds, but because the income generated by the occasional delivery is not sufficient to support the high malpractice insurance premiums associated with providing obstetric services. It is easier for them to let full-time OB/GYN specialists do this work, and to charge accordingly. The consequence of this in my state is that there are several entire counties in which no doctor can be found who is willing to deliver a baby.

If a physician can decide not to deliver babies because he can't justify the practice economically, shouldn't he be able to decide not to carry out abortions because he can't justify the practice ethically?

mtraven said...

You folks aren't reading the cited articles very carefully. This is not about individual doctors being able to follow their conscience, or about the Church giving up running hospitals and selling the facilities to someone who is willing to actually practice medicine. This is about the Church (a) threatening to close existing hospitals, and explicitly refusing to transfer them to other parties, and (b) actively buying existing non-Catholic hospitals and shutting down their abortion facilities. See here for more details. This is the only reason my admittedly strained comparision works at all. The problem is institutional, not a matter of individual morality.

If we lived in an ideal market economy, then maybe this wouldn't be a problem. One provider of a needed service stops providing it, so others arise to take its place. The problem is, there is no such thing as an ideal market, and health care provisioning is about as far from an ideal market as you can get.

the ashen man said...

(a) Do you expect people who are morally bound to have no part in the procurement of abortion to sell facilities which they know will be used for that purpose? Again, you seem to find it unacceptable that the religious have a different moral view than you and refuse to act against their consciences.

(b) I'm not sure what you find wrong with that.

The problem is institutional, not a matter of individual morality.

I don't quite know what that means. Is it a problem that a private institution refuses to act contrary to its own moral code? If all you're saying is that their moral code is wrong, you're not saying anything new. But are you suggesting they should break their own moral code?

If, say, a third of the hospitals in your country are run by a religious group which will under no circumstances have anything to do with abortion, what do you expect to happen if you pass a law that all hospitals must provide abortion? They will close up shop; there is no other possibility. Why, it is almost as if you were trying to drive them out of the business...

Of course, it is the religious who will come out of this looking like they want to 'shove their beliefs down other people's throats,' not those passing a law that would force people to act against their consciences.

mtraven said...

I took a closer look at the actual text of the bill, available here. Nothing in it says that anybody is going to be forced to perform abortions. What it might mean is that institutions that receive public funds will be prohibited from discriminatory about which medical procedures they provide. So, Catholic hospitals have a choice: they can refuse public money, they can act like actual medical facilities and dispense reproductive health, or they can sell themselves off to people who will. The Church wants to do neither of these, instead they want to shut the whole thing down.

In my opinion, religous organzations have no business being funded by government money. It's bad for both parties. And they have no business being in the health care delivery business if they can't play by the rules.

BTW, not at all clear that the bill would have this effect at all, and it might be that the forced-pregnancy lobby is just engaging in its hysterics.

Also BTW, the Catholic Church's vaunted concern over zygotes is a complete sham, as I argue here. I guess that deserves a post of its own.

the ashen man said...

Have you just discovered that the Catholic Church doesn't like abortion? Really, how do you expect an institution with that outlook to behave in these circumstances?

Who goes to Our Lady of Sorrows and expects to get an abortion?

they can refuse public money

In which case they could only treat those well-off enough to have private insurance.

reproductive health

How Orwellian. What exactly are the benefits for reproductive health of an abortion?

they have no business being in the health care delivery business if they can't play by the rules.

Apparently they agree with you. What's the problem?

The rules currently guarantee them freedom of conscience; if those rules change, they will get out of the business. What exactly do you expect? Again, I can't see what you object to, apart from the fact that they diagree with you on the morality of abortion. Given that, how do you expect them to behave?

Why didn't your post just read "Gasp! Catholic church disagrees with abortion and acts accordingly"?

the forced-pregnancy lobby

Preganancy is only forced in the case of rape; otherwise it a consequence of personal choice.

concern over zygotes

For what it's worth, I'm not particularly concerned over zygotes myself. I am concerned for freedom of conscience, and opposed to everyone being forced to obey progressive mores (to the point of being forced to commit an act which they regard as murder).

I am also repulsed to the core by the American left's disregard for late-term, partially born, and born-alive infants. I would prefer that some reasonable and compassionate compromise were reached (most European countries, for example, would not countenance this kind of abortion extremism), but if I have to pick a side here it will be the one that objects to infanticide.

Michael said...

Many institutional medical practices also decide, as institutions, what services they will and won't provide, purely on an economic basis. So my point is still applicable - if an institution can refuse to provide certain medical services on economic grounds, why should not it be able to refuse to provide given services on moral grounds?

Specialty hospitals are more and more common. My bank helped to finance the building of a center for eye surgery, for example. I am familiar with specialty hospitals in my area that deal respectively with pediatric patients, with persons requiring physical therapy after accidents or illness, and with orthopedic medicine.

Just about all medical practitioners and institutions accept some government funds. It is in the nature of the profession as it is now constituted that they do, and that is not likely to change. There are very few GPs or clinical practices that refuse to treat patients on Medicare or Medicaid. Should a facility that accepts Medicare patients be compelled to offer abortions simply because it is paid by government to treat persons over 65? Should the types of specialty hospitals mentioned above be required to offer abortions, even though they are outside their specialities, because they accept Medicaid patients?

I very much doubt the FOCA bill would be construed to compel, say, an eye hospital, or an orthopedic hospital, to commit abortions on their premises. Such facilities exclude abortions from their services for economic reasons, and would not be targeted. What the legislation is intended to target is those facilities that exclude abortions from their services for moral reasons. It is an attempt to deny their operators the freedom of conscience.

As Ashen Man has observed, there is no such thing as a forced pregnancy except as a result of rape. I find it telling that the advocates of freely available abortion style themselves by the euphemism 'pro-choice.' Apart from rape, all pregnancies are the consequence of a choice made at their beginning.

What abortion advocates really want is the legal ability to change one's mind at the expense of an innocent human life. They are not blunt enough to identify their position for what it is.

mtraven said...

How Orwellian. What exactly are the benefits for reproductive health of an abortion?

Oh, and here I thought John McCain's air quotes and contempt for women's health issues was an aberration. I see it's part of the ideological package now.

You are a fool (and so is McCain). Bringing a baby to term is a very risky business, and there are numerous medical conditions that make it even more dangerous. A doctor or hospital who cannot offer the option of an abortion is one that cannot deliver the full spectrum of medical care, and should not be in the business.

Preganancy is only forced in the case of rape; otherwise it a consequence of personal choice.

Bullshit. Here in the civilized world, women are allowed to control their reproductive systems, including terminating a pregnancy if they want.

There are only two positions in the abortion debate: either a woman is allowed to control her own body, or the state gets to control it. I am constantly amazed by the people who come down on the latter side of this question and still consider themselves advocates of small government or a less intrusive state. The power of self-delusion is very great.

Michael said...

The crucial question about abortion is not really whether a zygote is an independent life, but rather has to do with the duties of parents to their children, which constitute a sort of implicit contract.

From the moment of its birth until it reaches the age of majority, parents have a legal obligation that is well-nigh irrevocable to provide for their child in a manner consistent with their resources. The marital status of the parents matters not. If a man fathers a child on a woman not his wife, he can be compelled to provide a share of its support. Neither does the dissolution of a marriage end the obligation; typically the child will be placed with one parent as its custodian, and the non-custodial parent has to pay his or her moiety of its support. Payment of child support can be compelled under penalty of incarceration, and this is about the only private financial obligation remaining in which imprisonment for debt is still an available remedy. In those cases where parents are absolutely incapable and unwilling to meet their responsibilities to their child, they are not permitted to escape them by murdering it. The child is ordinarily placed in foster care or put up for adoption.

Under the assumption that a woman has an absolute right to control her reproductive system, on the other hand, it is possible for a viable child to be killed right up until the moment of its natural delivery, by the gruesome process known as dilation and extraction, a.k.a. partial-birth abortion. The absolutism of the pro-abortion advocates on this point is well documented. It amazes me how insistent they are on such 'rights' given that they are found only in 'emanations and penumbras' of the Constitution. The Bill of Rights guarantees in fairly straightforward terms a right to keep and bear arms, and the Supreme Court has recently ruled that it is indeed an individual right. However, even the NRA does not insist that the Second Amendment allows a private citizen to possess fragmentation bombs or heavy artillery. The position of NARAL and allied groups on partial-birth abortion seems to me to be as extreme as such an interpretation of the Second Amendment would be.

Does 'here in the civilized world' include western Europe? Most western European countries do not permit late-term abortions, as Ashen Man has noted.

The question of when life begins should not be approached from the initial union of spermatozoon and ovum forward, but from the point before natural delivery backward. The old common-law standard for the beginning of independent life was 'quickening,' the point at which an unborn child became capable of motion in its mother's womb on its own, unbidden by the mother's conscious volition. This criterion was developed long before even such rudimentary diagnostic instruments as the stethoscope had been invented. With more recent technology we can discern independent life at much earlier stages.

Moreover, the point at which an infant is viable outside the womb has been moved farther and farther back. Prematurely-born babies that would have been impossible to save twenty or thirty years ago now routinely survive.

Surely it is not an unreasonable extension of the duties of parents to their children to say that abortion is no longer an option at a point when an unborn child is potentially viable outside the womb. There is little to distinguish morally between a late-term dilation and extraction and the deliberate murder of a premature baby in its bassinet. Both constitute infanticide. To use euphemisms like 'terminating a pregnancy' for such an act is an evasion. The advocates of such things at least should be courageous enough to describe them in unvarnished language.

In medicine there is an ancient aphorism, 'primum est non nocere' - the first thing is not to do harm. In the case of an innocent and potentially viable life it is better to err on the side of caution. Even small-government advocates agree that state power is used appropriately to protect innocent life.

mtraven said...

The crucial question about abortion is not really whether a zygote is an independent life, but rather has to do with the duties of parents to their children, which constitute a sort of implicit contract...From the moment of its birth until it reaches the age of majority, parents have a legal obligation that is well-nigh irrevocable to provide for their child...

Well, yes. And that's why the choice of not entering into that contract if one is not prepared to fulfill it, or does not want to fulfill it, is so important.

Under the assumption that a woman has an absolute right to control her reproductive system, on the other hand, it is possible for a viable child to be killed right up until the moment of its natural delivery...

Let's not resort to cheap linguistic tactics -- it's not a child until it's born, or unless the parents decide to treat it as such.

But I'll grant you that the entire framework of individual rights is not really adequate to address a whole host of questions that arise from biological reality, preganancy foremost among them. That makes it an interesting issue.

The position of NARAL and allied groups on partial-birth abortion seems to me to be as extreme as such an interpretation of the Second Amendment would be.

Maybe. Unfortunately the abortion question is so polarized that the two sides are forced to take up extreme positions, because they can't afford to give any grounds to their opponents. The opposing view (that a single-celled unimplanted zygote is a full-fledged human being) is just as extreme, and inconsistent with the reality of how people actually act.

The question of when life begins...

is the wrong question. Life began 4 billion years ago and is continuous. The biology of human life is not in question. The question is when does personhood start. Personhood is a moral and social construct and there is hard and fast rules for when it begins.

Many traditional cultures, who lacked the ability to perform abortions, practiced neonatal infanticide for essentially the reason above -- not all children are going to be viable in a subsistence economy. There is some evidence that the human mind is structured to confer personhood not at birth, but shortly after following a period of doing an evaluation of the neonate's chances for survival and thriving.

Moreover, the point at which an infant is viable outside the womb has been moved farther and farther back.

That is a good argument for not making viability the criterion for allowing abortion. Does it mean if we develop an artificial womb technology that could gestate an embryo at any stage, then no abortion would ever be permitted? Seems like a ridiculous conclusion.