The Updated Charter for Health Care Workers and Catholic hospitals in the Diocese of Trenton and the Archdiocese of Philadelphia

There is one Catholic hospital in the Diocese of Trenton, St. Francis Medical Center, run by Trinity Health.  In the Archdiocese of Philadelphia are four Trinity Health Mid-Atlantic hospitals (i.e., Mercy Fitzgerald, Mercy Philadelphia, Nazareth, and St. Mary) and Holy Redeemer.

The (Updated) Charter for Health Care Workers

The Vatican's original Charter for Health Care Workers was published in 1995 with an update in 2017.  Like the original, the update has sections on procreating, living, and dying, between its introduction and conclusion.  It is the premier compendium of Catholic medical ethics / bioethics, to be utilized with the best medical information and magisterial teaching. 

INTRODUCTION: MINISTERS OF LIFE

The Updated Charter reiterates that the vocation of health care is to be greatly honored, dealing with the phenomenal good of human life:

"1....[Our] dignity is elevated to a further level of life, that of God’s own life, inasmuch as the Son, in becoming one of us, makes it possible for human beings to become ‘children of God (Jn 1: 12), ‘partakers of the divine nature’ (2 Pet 1: 4)….the respect for the human person that human reason already demands is further accentuated and reinforced….”
"9….the therapeutic ministry of health care workers participates in the pastoral and evangelizing activity of the Church.... Service to life thus becomes a ministry of salvation, or a proclamation that fulfills Christ’s redeeming love. ‘Just such people – doctors, nurses, other health care workers, volunteers – are called to be the living sign of Jesus Christ and His Church in showing love toward the sick and suffering,’ in other words, ministers of life.”

PROCREATING

“11….[That] The inseparable bond between conjugal love and human generation, imprinted on the nature of the human person, is a law by which everyone must be guided and to which everyone is held”

underlies teachings on 

• Fertility regulation; 
• Medical responses to marital infertility;
• Prenatal and preimplantation diagnosis; and 
• Freezing embryos and oocytes.

Yet in comparing directories of physicians at the above facilities with a directory of physicians known to reject contraceptive use, you will find very little corrspondence.  This does not appear to be news to the (arch)diocese(s) or to the National Catholic Bioethics Center (NCBC).  In 2018, the NCBC issued Ethical Principles Concerning Employed Health Care Providers and the Provision or Prescription of Direct Contraception, whose last paragraph states

• "If serious scandal cannot be avoided or resolved by providing appropriate explanations of what is being done or not done, then the cooperation on the part of the Catholic institution would be rendered immoral." 

Now, isn't the only reason that the provision of contraceptives by those associated with Catholic hospitals might NOT cause "serious scandal" that the majority of Catholics (at least in the U.S.) do not accept that contraceptive use is immoral?  The fact that Catholic hospitals include contraceptive providers in their directories will "confirm" mistaken Catholics in their errors. This situation becomes all the more hideous, when we realize how "contraceptives" can be abortifacients  (e.g.,

Systematic Review of Ovarian Activity and Potential for Embryo Formation and Loss during the Use of Hormonal Contraception. Donna Harrison, MD, Cara Buskmiller, MD, Monique Chireau, MD, Lester A. Ruppersberger, DO, Patrick P. Yeung, Jr., MD (Linacre Quarterly, January 3, 2019; pp. 453–469))

While the Church has clearly prohibited  embryo "transfers" from one woman to another, some suggested - even after the Vatican's Dignitas Personae (2018)- that a door might be ajar to consider so-called "snowflake adoptions." Yet, there is absolutely nothing in the Updated Charter to support this.

The "inseparable bond between conjugal love and human generation" also underlies Church teaching on 

• New attempts at human generation and procreation.

LIVING

Church teaching is reviewed, re: 

• Human life inviolable and indisposable;
• Abortion and the destruction of nascent life; 
• Embryo reduction; and 
• Interception and contragestation.

Evidence shows a protocol described in the U.S. Conference of Catholic Bishops' Ethical and Religious Directives for Catholic Health Care Services [ERDs] (# 36) to be inapplicable, because so-called Emergency contraception can NEVER be used without the danger of abortion. This is explained in a video by Dr. Chris Kahlenborn.  Dr. Kahlenborn is not alone in announcing the horrific danger: 

• Rebecca Peck, MD, Walter Rella, MD, Julio Tudelo, PharmD, PhD, Justo Aznar, PhD, and Bruno Moznegga, MD, Does levonorgestrel emergency contraceptive have a post-fertilization effect? A review of its mechanism of action, Linacre Quarterly, April 2016
• Rebecca Peck, MD, Chris Kahlenborn, MD and Walter B Severs, PhD, FCP, Mechanism of action of levonorgestrel emergency contraception, Linacre Quarterly, February 2015
• Father Juan Velez, MD and Rebecca Peck, MD, The Postovulatory Mechanism of Action of Plan B, NCBC Quarterly, Winter 2013
• Bruno Mozzanega and Giovan Battista Nardelli, UPA and LNG in emergency contraception: the information by EMA and the scientific evidences indicate a prevalent anti-inplantation effect, The European Journal of contraception and reproductive health care, January 2019

Like Dignitas Personae, the Updated Charter offers NO guidelines for a supposed moral use of an interceptive or a contragestative.  The Catholic Medical Association indicated a need for change in practice in Catholic hospitals in 2015: "The facts now known require that the use of the Peoria protocol be suspended"; and in 2016: "The entailed risk of taking a human life through Plan B's MOA is ethically unacceptable."

In this section, Church teaching is also reviewed, regarding 

• Ectopic pregnancies; 
• Anencephalic fetuses; 
• Conscientious objection; 
• Defending the right to life; 
• Prevention; 
• Prevention and vaccines; 
• Medical prevention and society; 
• Sickness; 
• Diagnosis; 
• Interventions on the genome; 
• Gene therapy; and 
• Regenerative therapy.

Reference #167 might seem to infer a favorable judgment on the use of Induced Pluripotent Stem Cells; Section 30 of Dignitas Personae appears to preclude their use. 

"One of the top researchers in the field of stem cells has said that iPS (induced pluripotent) stem cells, the 'embryo-like' cells hailed by many as the answer to the ethical problems presented by embryonic stem cells, are 'probably' actually already embryos and have already, with the right conditions and treatment in the lab, developed into 'complete animals' in experiments.... LifeSiteNews.com spoke with Dr. Dianne Irving, a former bench biochemist researcher with the National Institutes of Health in the US, who confirmed Dr. Gurdon’s assertion, saying, 'Some iPS cell are potentially embryos'.... Given the ability of cells to be reverted to the embryonic stage, she said, 'any human cell can be used for reproductive purposes,' so pro-life people must start making very careful distinctions about what type of cell is being created and used and the methods used to obtain them...." (LifeSiteNews, 4/23/13)

This section also reviews Church teaching on

• Treatment and rehabilitation; 
• Prescription and appropriate use of pharmaceuticals; 
• Access to available medications and technologies; 
• Sustainable health, pharmaceutical companies, rare or neglected diseases; 
• Pain relief treatments; 
• Informed consent of the patient; and
• Biomedical research and experimentation.

As so well noted in the U.S. Conference of Catholic Bishops' Erhical and Religious Directives for Catholic Health Care Services, “31….the greater the person’s incompetency and vulnerability, the greater the reasons must be to perform any medical experimentation, especially nontherapeutic."

This section also reviews Church teaching on

• Organ and tissue donation and transplantation; 
• Determination of death;

As per former Saint Charles Borromeo moral theologian Dr. Peter Colosi (NOT a physician),

"Some medical doctors and theologians doubt that brain-dead donors are actually dead. This would mean that the removal of the vital organ is the act by which the donor dies, but the Catechism (No. 2296) states, '[I]t is not morally admissible directly to bring about the disabling mutilation or death of a human being, even in order to delay the death of other persons'.... Some hold that the Church has already pronounced in favor of brain death, and they cite...[a] passage from Pope John Paul II’s Aug. 29, 2000, speech to the International Transplantation Society....I always notice that little word 'seem' in the first sentence. If further knowledge reveals that brain death does seem to conflict with a sound anthropology, this would remove the moral certainty referred to later in the quotation, and it would follow that vital organ donations should not be done" (cf., Our Sunday Visitor, 8/8/2012).

In a debate with former Catholic Medical Association president Dr. Paul Byrne, Saint Charles Borromeo moral theologian and then National Catholic Bioethics Center president Dr. John Haas (NOT a physician) indeed seems to imply that Pope John Paul II (2000) unequivocally endorsed so-called brain death criteria (cf, Kresta in the Afternoon, 1/8/2014, move to 22:35).  Pope Emeritus Benedict XVI (2008) had been much more cautious:

"individual vital organs cannot be extracted except ex cadavere....In these years science has accomplished further progress in certifying the death of the patient. It is good, therefore, that the results attained receive the consent of the entire scientific community in order to further research for solutions that give certainty to all. In an area such as this, in fact, there cannot be the slightest suspicion of arbitration and where certainty has not been attained the principle of precaution must prevail....the principal criteria of respect for the life of the donator must always prevail so that the extraction of organs be performed only in the case of his/her true death (cf. Compendium of the Catechism of the Catholic Church, n. 476)"]

The National Catholic Bioethics Center did the English language translation of the Updated Charter, which quotes the pope emeritus' words of caution (See also, Is there Moral Certainty that "Brain Dead" Organ Donors are Dead? (Healthcare Advocacy and Leadership Organization, 4/23/19; Brain Death, Part One, 7/29/19).

This section also reviews Church teaching on 

• The removal of organs from pediatric donors; 
• Xenotransplants; 
• Transplantation and personal identity;
• Abuses in transplantation; 
• Forms of dependence; 
• Drug dependence; 
• Alcoholism; 
• Tobacco dependence; 
• Psychotropic drugs; 
• Psychology and psychotherapy; 
• Pastoral care and the sacrament of the Anointing of the Sick; 
• Ethics committees and clinical ethics counseling; 
• Health care policies and the right to preservation of health.

DYING

Church teaching is reviewed, re:

• Dying with Dignity;
• Civil laws and conscientious objection;
• Nutrition and hydration; 
• The use of analgesics in the terminal stage;
• Telling the truth to the dying person;
• Religious care of the dying person;
• Destroying life; and Euthanasia.

" The three paths to imposed death and dying that defy God’s plan—euthanasia, assisted suicide, and palliative care abuses—are tactics that disregard the inviolable dignity of the human person" (Judie Brown, 9/6/19).

Are Our Catholic Hospitals Up to the Charter's Call?

Treating each and every person with utmost dignity requires much more than a smiley face:

• Will our Catholic hospitals love people enough to practice care in a manner which is truly in accord with God's truth about marriage/family/sexuality - proclaiming that truth and steering them away health care providers who do not understand that truth?
• Will they cease all provision of so-called "emergency contraception"?
• Will they discontinue all association with those providing smorgasboards of prohibited services in their outside practices?
• For example, Holy Redeemer lists Stephen G. Somkuti, Larry I. Barmat, and Jennifer Nichols as specialists in "reproductive endocrinology." Those are the first three physicians listed at Abington Reproductive Medicine, which openly advertises its involvement with prohibited services, including IVF, egg donation, and surrogacy.
  
(In addition to ''reproductive endocrinology'' do any of our Catholic hospital directories presently lack trustworthiness for specialists in "perinatology" and ''maternal fetal medicine"?  Doesn't this at least merit a closer look?)
• Will our Catholic hospitals recognize that the Church has NOT spoken definitively on brain death criteria?
• Will our Catholic hospitals only provide information on living wills and advance directives which is uncompromisingly consistent on Church teaching regarding nutrition and hydration?

"Art. 11. – The diocesan Bishop is obliged, if necessary, to make known to the faithful the fact that the activity of a particular charitable agency is no longer being carried out in conformity with the Church’s teaching, and then to prohibit that agency from using the name “Catholic” and to take the necessary measures should personal responsibilities emerge"  (Apostolic Letter Issued 'Motu Proprio' of the Supreme Pontiff Benedict XVI on the Service of Charity, 11/11/2012).