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In his August 13 article in Commonweal magazine, “The Limits of
Authority,” Professor R. Gaillardetz argued that because of the
complexity of the issues in the recent health care reform debate,
various legitimate prudential judgments could be made. The United
States Conference of Catholic Bishops came to one prudential judgment,
but individual Catholics as well as the Catholic Health Association and
some women religious, could come to other prudential judgments that
are equally valid. All such prudential judgments could be applying
authentic moral principles. In the light of this, Gaillardetz concluded
that the USCCB overstepped its authority by insisting that all
Catholics and organizations that reside under the Catholic umbrella must
agree with its analysis of the health-care reform act and its judgment
that the act did not sufficiently protect the lives of the unborn. I
wish to argue that the bishops did not misuse their authority. Rather,
they exercised it prudentially and in a manner that accords with their
charism as bishops – authentic teachers of faith and morals.
Bishops have the obligation to judge the morality of actions, for example, that the direct killing of an unborn child is always a moral evil. This obligation to judge not only applies in stating the principle, but it also applies to concrete situations where such immoral actions are either directly promoted or legally authorized. Thus, bishops have the obligation to judge the moral content of laws that permit, foster, or require citizens to pay for gravely immoral actions (for example, by paying for insurance policies that cover such actions). The bishops also rightly employ experts in various fields to examine the content of laws, precisely because they can be complex, as in the case of the health-care reform act.
Contrary to Gallardetz’s argument, such complexity does not make an issue less morally compelling or take it out of the moral order. Gallardetz is correct that where there are complex situations or complex laws, where a variety of justifiable approaches could be taken to advance a good end, there can be a variety of genuine prudential judgments. For example, a variety of legitimate prudential judgments could have been made and were made concerning many aspects of health-care reform, such as concerning the funding of healthcare – directly by the government, by some type of employer mandate, etc. On such issues, the bishops only stated the principle that all should be cared for, but the best means by which to accomplish this was open to the prudential judgment of legislators and others, individuals and organizations, who rightfully wished to express an opinion. If the bishops, in this situation, had insisted that their prudential judgment on how best to pay for universal health care was the only correct one and that no Catholic could hold another prudential judgment, they would have overstepped their authority.
However, once the elected officials made the political choice for subsidized insurance policies, the bishops judged the proposal according to whether or not such subsidies would pay for gravely immoral actions, such as abortions, or for health plans that would cover them. Such federal subsidies – for most abortions, and for health plans that cover them – are forbidden already in other federal health programs, so to depart from that standard would be to weaken government policy on respect for unborn human life – and that is itself an immoral action by government. It is no longer a question of making a prudential judgment concerning any number of possibly good actions. Now it is a judgment of whether an immoral action is being permitted and fostered. With regard to the issue of direct abortion, there is not a variety of legitimate prudential judgments. This is a matter of absolute moral prohibition.
That the health-care reform bill subsidizes plans that cover abortion and evades current abortion funding restrictions such as the Hyde amendment when it appropriates large amounts of money for various kinds of health care services, is apparent from the text of the legislation (or rather, from what is missing from it) because it nowhere references or incorporates the full extent of such restrictions. Given the long history of court decisions saying that general health legislation like Medicaid must fund abortions unless Congress says otherwise, an executive order cannot compensate for this serious flaw, and in any case is constantly changeable (as the history of executive orders on the Mexico City policy and embryonic stem cell research makes clear).
The final law’s problems are also apparent from the short experience of implementing it so far. When the law’s transitional program for federal funding of health insurance for “high-risk” individuals (those who have pre-existing medical conditions) was implemented this summer, several states announced that the Administration had approved their plans for using these funds for abortion coverage – and at least one state had already begun to sign up enrollees for federally funded coverage that it said would include “elective abortions.” The ensuing public outcry soon led the Administration to issue new guidelines excluding abortion coverage. But the USCCB’s analysis, that such subsidies for abortion were not prevented by the health care act itself or the President’s ensuing executive order, was confirmed by Planned Parenthood (which had no problem deciphering this complex law) and by the nonpartisan Congressional Research Service.
The public breaking of ranks by Catholic entities, whose decisions were often politically influenced, raises a question of governance in the Church that is still to be resolved. The bishops maintained their intellectual and moral integrity. They were not co-opted by either party – in fact, they often disappointed representatives of both parties who wanted the bishops as part of their coalition -- because they stayed at the level of principle, fostering all that could be good and condemning only what is morally evil. The fact that the bishops’ involvement satisfied neither party was therefore perhaps inevitable.
The Church teaches that one can promote and even vote in favor of a law that expands protection against the direct taking of life, even if it is imperfect because it does not address every possible situation. Such a law is at least going in the morally right direction. However, the present health-care reform act went in the wrong direction regarding the destruction of unborn human life – and, I would add, on creating the prospect for nationwide benefits mandates with no provision for rights of conscience -- and therefore could not ethically be endorsed. The bishops did not abuse their authority; they exercised it as it is be exercised – in truth, and with clarity and conviction, for the sake of the people of God and the good of society. They have affirmed that they will continue that service by supporting what is good and helpful in new health care legislation, while working to change provisions in current legislation that mistreat the precious gift of human life.
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