National Catholic Bioethics Center: A House Divided Against the Common Good

May 23, 2010

By Marie T. Hilliard, Ph.D., J.C.L., R.N, NCBC Director of Bioethics and Public Policy, March 23, 2010. For more information on the National Catholic Bioethics Center (NCBC), visit their web page here:

When the common good takes a back seat to political and corporate interests, all, especially the vulnerable, are at risk. As the largest provider of non-governmental, non-profit health care in this country, the Catholic Church, and those who work as Catholic agencies and organizations, have a special obligation to vulnerable populations, such as the unborn, those with disabilities, and those at life’s end. These populations cannot be compromised in an effort to secure “the greater good.” This is utilitarianism, seeking the greatest good for the greatest number, and never equates to the common good.

It is undeniable that the enacted Patient Protection and Affordable Care Act includes public funding of programs that provide abortion on demand. No accounting practices, or requiring enrollees or employees to write separate checks for abortion coverage, changes that fact. The plan would mandate that in each regional Exchange only one of the qualifying plans not include abortion. Furthermore, there is no restriction on coverage of assisted suicide costs. President Obama’s executive order cannot override federal law. 

In fact, his Order merely requires adherence to the Act. Specifically, it states: “This Executive Order is not intended to, and does not, create any right or benefit, substantive or procedural , enforceable at law or in equity against the United States.” While he attempts to assure us that the seven billion new dollars for Community Health Centers will be applied consistent with the Hyde Amendment, the placement of that language within the Act does not make it subject to the cost-sharing provisions for abortion coverage. Most significantly, Beal v. Doe, 432 U.S. 438 (1977) dictates that, without statutory provisions for the Hyde amendment within each enacted law, “essential services” are to include abortion.

Both individuals and employers will be penalized for the absence of health care coverage. There is no evidence of conscience protections for individuals or employers, who may find themselves having to write separate checks for undesired abortion procedures that happen to be in the plan of choice. There is limited evidence of conscience protections for providers, and the legislation does not provide for protection against coercion of health care providers and employers related to contraceptives or abortifacients. Here we see, most significantly, that a house divided eventually will pay the price for taking compromising positions. Yet, unfortunately, in public opposition to the US Conference of Catholic Bishops’ call for rejection of this legislation as it was written, the Catholic Health Association and fifty-five women religious urged its passage.

The Act will establish a Medicare Commission, which is to develop Medicare cost-saving measures. Providers to Medicare beneficiaries will be rewarded if they reduce the cost of health care services, while maintaining quality. This could foster care disincentives toward some individuals who are elderly or disabled. Broad authority is given to federal agencies to impose binding regulations. Mandates, with penalties, for failure to meet such requirements, could be imposed. The potential impact upon Catholic health care in areas where it is the sole provider, and refuses to engage in procedures destructive to life or natural human functioning, could be ominous.

Nothing is as intimately linked to fostering affordable health care as a moral approach to a global economy. Last year Pope Benedict XVI issued Caritas in Veritate (“Love in Truth”), offering the world a means to evaluate secular economic and social systems through the moral lenses of charity and truth. This new social encyclical focuses on integral human development. Economic activity is called to be people-centered: “This needs to be directed towards the pursuit of the common good.” (N.36). Most notably, Benedict states, “When a society moves towards the denial or suppression of life, it ends up no longer finding the necessary motivation and energy to strive for man’s true good” (N. 28). Attacks upon life spare no generation: “To the tragic and widespread scourge of abortion we may well have to add in the future – indeed it is already surreptitiously present – the systematic eugenic programming of births. At the other end of the spectrum, a pro-euthanasia mindset is making inroads as an equally damaging assertion of control over life that under certain circumstances is deemed no longer worth living. Underlying these scenarios are cultural viewpoints that deny human dignity.” (N. 75).

One is left to ask, does this health care legislation truly advance the common good? More importantly, when members of a divided house make compromises with principle, has the common good been advanced? The answer is contained in Caritas in Veritate, within which all of the hallmarks of a sound health care reform policy are contained: integral human development; fundamental rights to life and religious freedom; charity with truth; humanistic synthesis; the common good; earth as a gift to humanity to use and protect; civilizing the economy; subsidiarity; a person-based and community oriented culture; people-centered development programs; cooperation of the human family; recognition that every migrant is a human person; and bioethics and human responsibility in human technology. As the encyclical states, in charity and truth, “when a society moves towards the denial or suppression of life, it ends up no longer finding the necessary motivation and energy to strive for man’s true good.”(N. 28)

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