Sunday, December 9, 2007

Catholic & Secular Values in the British National Health Service

Four days ago I discussed the conflict over reproductive health care at Lutheran Health Center in Wheat Ridge, Colorado. This posting is about a similar conflict currently unfolding at “John and Lizzie’s” in north London.

The Hospital of St. John and St. Elizabeth, founded by the Sisters of Mercy in 1856, is known as a celebrity hospital. Cate Blanchett, Emma Thompson, Kate Moss and Heather Mills-McCartney have all had babies there. The media describes John and Lizzie’s as "the poshest place to push." The hospital is under the governance of the Catholic church, but has been operating as an independent entity, funded by the NHS, self-paying private patients, private health insurance companies, and charitable donations.

Debate about abortion has been much less virulent in the U.K. than the U.S. Last year a British journalist wrote, with some satisfaction, “Over here [in comparison to the U.S.], abortion can be a medical issue and a psychological issue; it can be an issue of social ethics.”

For reasons unclear to me on this side of the Atlantic, the tone of British debate is heating up. Cardinal Cormac Murphy O’Connor, head of the Catholic Church in England and Wales, laid down the law to John and Lizzie’s: “There must be clarity that the hospital, being a Catholic hospital with a distinct vision of what is truly in the interests of human persons, cannot offer its patients, non-Catholic or Catholic, the whole range of services routinely accepted by many in modern secular society as being in a patient's best interest."

In response, Dr Martin Scurr, founder of the Portobello Clinic in Notting Hill, and a director at the hospital, shot back a strong response: “I am convinced that the Cardinal has been badly advised, as so often has happened with the Catholic Church. Expert advisers have been chosen who give the hierarchy of the church the answers they wish to hear ... in the matter of modern medical care the cardinal has chosen to listen to individuals who have no specific expertise in that arena…we are now in an era where the Catholic Church must withdraw from involvement in frontline healthcare here in the UK, as it appears to be unable to reach the degree of tolerance that has been reached elsewhere in the world." When the hospital adopted the code of ethics demanded by the Cardinal, Scurr and another director resigned. The board chair is expected to join them next week.

Notice two things about the British debate. First, the Cardinal acknowledges that the reproductive services current church teachings preclude are “routinely accepted by many…as being in a patient’s best interest.” He acknowledges that his opponents are seeking to serve the patient’s interests, not to commit murder. And, Scurr insulates the Cardinal, by construing him as having “been badly advised.” Their positions keep the debate at the level of social ethics and leave room for further discussion.

I think the Brits, with their tradition of sharp-edged but civil debate, are likelier to advance the Catholic/Secular standoff than we Yanks are. We oscillate between politically correct vapidity and hate-laden rhetoric that encourages terrorists like James Kopp to commit murder on behalf of “right to life.” An ethically governed health system requires societal ability to debate contentious, value-laden issues, without loss of social cohesion. I hope to come back to the conflicts at Lutheran Health Center and John and Lizzie's in a future posting.

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