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The Phoenix Abortion Case
M. Therese Lysaught's grave doctrinal error

M. Therese Lysaught is Associate Professor and Director of Graduate Studies at Marquette University. She has a Ph.D. in Theological Ethics from Duke University, and an M.A. in Theology from Notre Dame. She specializes in the areas of moral theology and theological reflection on science, biotechnology, and medicine. [Source]

She advised Catholic Healthcare West and St. Joseph's Hospital of Phoenix that the abortion in question was an indirect abortion, not a direct abortion. Her position is contradicted by the determination made by Bishop Olmsted, local ordinary of the Phoenix Diocese, that the abortion was direct, and therefore a grave sin.

She is quoted extensively by National Catholic Reporter online.

Her analysis contains grave doctrinal errors. The fact that these errors are made in the context of a specific case does not imply that her error is merely a misjudgment of the prudential order, as if it were merely an error in the application of doctrine. Her error is doctrinal because her analysis rejects the fundamental and definitive teaching of the Magisterium on the basic principles of ethics, especially that intrinsically evil acts are always immoral, regardless of intention or circumstances.

Lsyaught summarizes the medical situation: "Due to the age of the fetus, there was no possibility that it could survive outside the womb. Nor, due to the mother's heart failure and cardiogenic shock, was there any possibility that the fetus could survive inside the womb. In short, in spite of the best efforts of the mother and of her medical staff, the fetus had become terminal, not because of a pathology of its own but because of a pathology in its maternal environment. There was no longer any chance that the life of this child could be saved. This is crucial to note insofar as it establishes that at the point of decision, it was not a case of saving the mother or the child. It was not a matter of choosing one life or the other. The child's life, because of natural causes, was in the process of ending."

Suppose that, in a particular case of a gravely-ill pregnant patient, no decision is possible that will have any reasonable chance of saving the life of the prenatal child. Does this imply that no action taken by the physician can possibly constitute a direct abortion? Certainly not. The physician is still capable of choosing an act that would directly kill the innocent prenatal.
Pope John Paul II: "Therefore, by the authority which Christ conferred upon Peter and his Successors, and in communion with the Bishops of the Catholic Church, I confirm that the direct and voluntary killing of an innocent human being is always gravely immoral. This doctrine, based upon that unwritten law which man, in the light of reason, finds in his own heart (cf. Rom 2:14-15), is reaffirmed by Sacred Scripture, transmitted by the Tradition of the Church and taught by the ordinary and universal Magisterium.

"The deliberate decision to deprive an innocent human being of his life is always morally evil and can never be licit either as an end in itself or as a means to a good end. It is in fact a grave act of disobedience to the moral law, and indeed to God himself, the author and guarantor of that law; it contradicts the fundamental virtues of justice and charity. 'Nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying. Furthermore, no one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly. Nor can any authority legitimately recommend or permit such an action'." (Evangelium Vitae, n. 57; inner quote from CDF, Declaration on Euthanasia, II).
Suppose that a patient is terminally ill and cannot be saved. Does this justify an act of euthanasia with the intention of sparing the patient severe suffering? No, it does not. The direct killing of even a person who is near death, and whose life cannot in any case be saved, is nevertheless a type of murder. Euthanasia is intrinsically evil (and a type of murder) because the intentionally chosen act is inherently ordered toward depriving an innocent person of life. The intended end to relieve suffering does not constitute or change the moral object. The circumstance that the patient's life cannot be saved, and that grave consequences will result if nothing is done, does not constitute or change the moral object.

There are three fonts of morality: (1) intention, (2) moral object, (3) circumstances. In order to be moral, each and every knowingly chosen act must have three good fonts. If any one or more fonts is bad, the act is immoral. Every act with an evil moral object is intrinsically evil and always immoral, regardless of intention or circumstances.
"It is therefore an error to judge the morality of human acts by considering only the intention that inspires them or the circumstances (environment, social pressure, duress or emergency, etc.) which supply their context. There are acts which, in and of themselves, independently of circumstances and intentions, are always gravely illicit by reason of their object; such as blasphemy and perjury, murder and adultery. One may not do evil so that good may result from it." (Catechism of the Catholic Church, n. 1756).
Suppose that, in a particular case, a prenatal's life cannot be saved, and that, if the physician does nothing, the mother will also die. The physician removes the prenatal from the mother, delivering the child prior to viability. Is the physician's act direct abortion, or indirect? As shown above, the medical fact that the prenatal would die anyway does not determine the morality of the act. An act is direct abortion if the intentionally chosen act is inherently ordered toward the death of the prenatal. If the deliberately chosen act has the death of the prenatal as its proximate end, that act is directly related to that end (its moral object), making the act an intrinsically evil act of direct abortion.

The act of removing the prenatal (or, as some would phrase it, removing the placenta, or removing the uterus) causes the death of the prenatal. The non-viable prenatal dies as soon as he or she is removed from the mother. The act of the physician is motivated by the intended end of saving the mother's life. This intention is in the first font of morality. The circumstances whereby the prenatal's life cannot be saved, and the mother will die if the prenatal is not removed from her body, are in the third font of morality. But neither intention, nor circumstances determines the moral object in the second font.

The intentionally-chosen act is the removal of the prenatal from the mother prior to viability, and this act is inherently ordered toward the death of the prenatal. The prenatal dies as a direct result of his or her removal. The inherent moral meaning of this act is the killing of an innocent prenatal. In other words, the essential moral nature of the act is murder. No creative explanation can change the fact that the death of the prenatal results directly from his or her removal and that this removal was intentionally chosen. The good intention to save the life of the mother, and the good consequence that one life is saved instead of two lives being lost, cannot change the moral object from evil to good.

An act with an evil moral object is intrinsically evil and always immoral, even when used as a means to a good end. Direct abortion does not become indirect merely because it is the only means to the good end of saving the life of the mother.
"Since the first century the Church has affirmed the moral evil of every procured abortion. This teaching has not changed and remains unchangeable. Direct abortion, that is to say, abortion willed either as an end or a means, is gravely contrary to the moral law…." (CCC, n. 2271).
In the Phoenix abortion case, the abortion was willed as a means to save the life of the mother; saving a life was the good intended end. And the circumstances were such that the abortion resulted in the good consequence that her life was saved. However, the end does not justify the means. Intrinsically evil acts are never transformed into good acts by intention, no matter how noble, nor by circumstances, no matter how dire.

The Magisterium definitively teaches that intrinsically evil acts are always immoral, regardless of intention and circumstances.
Pope John Paul II: "The negative precepts of the natural law are universally valid. They oblige each and every individual, always and in every circumstance. It is a matter of prohibitions which forbid a given action semper et pro semper, without exception, because the choice of this kind of behaviour is in no case compatible with the goodness of the will of the acting person, with his vocation to life with God and to communion with his neighbour. It is prohibited -- to everyone and in every case -- to violate these precepts. They oblige everyone, regardless of the cost, never to offend in anyone, beginning with oneself, the personal dignity common to all.… The Church has always taught that one may never choose kinds of behaviour prohibited by the moral commandments expressed in negative form in the Old and New Testaments. As we have seen, Jesus himself reaffirms that these prohibitions allow no exceptions: 'If you wish to enter into life, keep the commandments... You shall not murder, You shall not commit adultery, You shall not steal, You shall not bear false witness' (Mt 19:17-18)." (Veritatis Splendor, n. 52)

"But the negative moral precepts, those prohibiting certain concrete actions or kinds of behaviour as intrinsically evil, do not allow for any legitimate exception. They do not leave room, in any morally acceptable way, for the 'creativity' of any contrary determination whatsoever. Once the moral species of an action prohibited by a universal rule is concretely recognized, the only morally good act is that of obeying the moral law and of refraining from the action which it forbids." (Veritatis Splendor, n. 67)

"If acts are intrinsically evil, a good intention or particular circumstances can diminish their evil, but they cannot remove it. They remain 'irremediably' evil acts; per se and in themselves they are not capable of being ordered to God and to the good of the person. 'As for acts which are themselves sins (cum iam opera ipsa peccata sunt), Saint Augustine writes, like theft, fornication, blasphemy, who would dare affirm that, by doing them for good motives (causis bonis), they would no longer be sins, or, what is even more absurd, that they would be sins that are justified?'. Consequently, circumstances or intentions can never transform an act intrinsically evil by virtue of its object into an act 'subjectively' good or defensible as a choice." (Veritatis Splendor, n. 81)
Pope John Paul II taught that there is no room for 'creativity' in the moral determination of intrinsically evil acts; such acts are irremediably evil. In the case of direct abortion, we cannot find some creative explanation that would justify the act and save the life of the mother. We can only evaluate the moral object, and refuse to willingly choose any act of direct abortion, regardless of the cost, regardless of the cost, regardless of the cost.

Lysaught's creative solution is to claim that the killing of the prenatal is not direct because the prenatal's life could not be saved. If this were a correct analysis, then euthanasia would also be moral. For the person who is killed in an act of euthanasia is typically terminally ill, a person who is dying with no way to save his or her life.
Pope John Paul II: "Regardless of intentions and circumstances, euthanasia is always an intrinsically evil act, a violation of God's law and an offence against the dignity of the human person." (Letter to the Elderly)

Pope John Paul II: "Despite the intentions or circumstances, direct euthanasia is an act which is always and per se intrinsically evil...." (Speeches, 11 Nov 1993)
The same moral analysis applies to direct abortion. Nothing whatsoever in the intention or circumstances can change the moral object from evil to good.

Lysaught cites a book by Fr. Rhonheimer as agreeing with her approach to abortion when the prenatal's life cannot be saved.

"These cases, he argues, have a distinguishing, morally relevant feature, namely, that 'only the life of the mother is at the disposal of another human being -- the fetus is no longer even subject to a decision between "killing or allowing to live"; the only morally good thing that can be chosen here is to save the life of the mother,' " Lysaught wrote.

But it is not true that the prenatal is no longer subject to a decision to kill or to allow to live. Just as is true for a terminally ill patient, one can decide to kill the patient in an act of euthanasia, a grave crime, or one can refuse to commit any immoral act, and allow the patient to live for as many days, hours, or minutes as he or she has left in life. Lysaught and Rhonheimer speak as if it would be impossible to commit murder if someone is terminally ill and about to die anyway. Their claim is irrational. Every knowingly chosen act without exception is subject to the eternal moral law. If a physician decides to directly kill a patient, whether a prenatal patient, or a terminally ill elderly patient, the act is murder under the eternal moral law. The circumstance that the patient's life cannot be saved does not change the species (the type or kind) of the act deliberately chosen by the physician.

She quoted the priest: "Only if the fetus would otherwise survive could its death be said to be chosen as a means -- and thus caused 'directly' in a morally relevant way. But in our case the death of the fetus is not willed in order to save the mother; as far as the life of the fetus is concerned, it is beyond any kind of willing."

All three fonts of morality are subject to the human will. The intended end is the purpose chosen by the human will of the subject (the person who acts). And in the circumstances, the will intentionally chooses one act or another with knowledge of the reasonably anticipated good and bad consequences. But the moral object is inherent to the chosen act. The moral object does not change with a change in the intention of the subject. Instead, the human will, by intentionally choosing a particular act, necessarily chooses that acts essential moral nature as determined by its moral object.

The physician who chooses an act of euthanasia claims that he is not 'willing' the death of the patient, but is only willing the relief of suffering. But despite this claim, by intentionally choosing an act that is inherently directed toward the death the patient, he is necessarily choosing the act and its inherent moral nature, as determined by its moral object.

When the life of a patient of any age cannot be saved, the will is still capable of choosing the intrinsically evil act of murder, killing the patient by a direct act, rather than simply allowing the person to die (when there is no moral act that can save him or her). It is absurd to claim that the life of the patient is 'beyond willing'. There is no basis in Tradition, Scripture, Magisterium for such an analysis. In morality, human will pertains to the choice of one act or another, to the choice of an act with three fonts of morality. The fact that the patient's life cannot be saved does not imply that the moral law is null and void, nor does it place the physician's actions outside of morality.

Lysaught also cites Germain Grisez, who in his book The Way of the Lord Jesus, justifies some types of abortion which "would fall among procedures classified by the classical moralists as 'direct' killing…." Grisez describes one of the two cases also justified by Rhonheimer, when a child's head is too large to allow for birth, the physician, as Grisez describes it, performs "an operation in which instruments are used to empty and crush the head of the child so that it can be removed from the birth canal…."

How can any Catholic Christian claim to be a follower of the Way of Jesus Christ, while asserting that it is moral before God who is Truth, to deliberately crush the skull of a child during birth, killing that child? Such an act is sometimes called partial-birth abortion, but it is nothing else but infanticide. Rhonheimer and Grisez both justify this type of act. And Lysaught implies that such an act of partial-birth abortion is justified. For she justifies the Phoenix abortion by reference to this type of partial-birth abortion, claiming that both are indirect because the mother's life can only be saved in this way.

So Lysaught supports her claim that the Phoenix abortion case was indirect based on similar opinions for similar procedures that are justified by Rhonheimer and Grisez. But Grisez admits that his position is contrary to the explicit teaching of the Magisterium: "not only classical moralists but the magisterium regarded it as 'direct' killing: a bad means to a good end," and he gives the following citations:
The magisterial teaching is in nineteenth-century decrees of the Holy Office, regulating what can be taught safely in Catholic schools; see DS 3258/- (the 1889 decree), which refers to a prior, similar decree, confirmed by the pope (ASS 17 [1884] 556); DS 3298/1890a (confirmed by the pope, 25 July 1895).
Lysaught's citation of Rhonheimer and Grisez only shows how profound are the problems in the field of moral theology in the present time. Why does Rhonheimer justify abortion on the basis that it is the only means to save the life of the mother, in contradiction to the magisterial teaching that the end does not justify the means? And why does he explain the moral object in terms which derive the moral object from intention and circumstances, not from the inherent moral nature of the act? Why does Grisez, throughout his massive three volume (so far) series called The Way of the Lord Jesus, ignore the teaching of Veritatis Splendor, and repeatedly justify acts that "classical moralists" call intrinsically evil and always immoral?

The answer seems to be found in the abandonment by many present-day moral theologians of the classical system of analyzing the morality of any act by the three fonts of morality. Pope John Paul II explicitly stated that he wrote Veritatis Splendor in order to address a grave problem among moral theologians at universities and in seminaries, which was the abandonment of the classical approach to morality.
Pope John Paul II: "Today, however, it seems necessary to reflect on the whole of the Church's moral teaching, with the precise goal of recalling certain fundamental truths of Catholic doctrine which, in the present circumstances, risk being distorted or denied. In fact, a new situation has come about within the Christian community itself, which has experienced the spread of numerous doubts and objections of a human and psychological, social and cultural, religious and even properly theological nature, with regard to the Church's moral teachings. It is no longer a matter of limited and occasional dissent, but of an overall and systematic calling into question of traditional moral doctrine, on the basis of certain anthropological and ethical presuppositions."

"At the root of these presuppositions is the more or less obvious influence of currents of thought which end by detaching human freedom from its essential and constitutive relationship to truth. Thus the traditional doctrine regarding the natural law, and the universality and the permanent validity of its precepts, is rejected; certain of the Church's moral teachings are found simply unacceptable; and the Magisterium itself is considered capable of intervening in matters of morality only in order to 'exhort consciences' and to 'propose values', in the light of which each individual will independently make his or her decisions and life choices."

"In particular, note should be taken of the lack of harmony between the traditional response of the Church and certain theological positions, encountered even in Seminaries and in Faculties of Theology, with regard to questions of the greatest importance for the Church and for the life of faith of Christians, as well as for the life of society itself."

"Given these circumstances, which still exist, I came to the decision…to write an Encyclical with the aim of treating 'more fully and more deeply the issues regarding the very foundations of moral theology', foundations which are being undermined by certain present day tendencies. " (Veritatis Splendor, n. 4)
Out of all the magisterial documents in the history of the Church, Veritatis Splendor stands above them all as the most comprehensive and definitive explanation of the basic principles of morality. How do most moral theologians respond to this attempt by a holy Pope to use the teaching authority of the Church in order to correct severe problems in the field of moral theology? They simply ignore it.

In its place is a new approach to moral theology which looks at particular cases of acts, determines the desired outcome of the moral analysis, and then invents entirely new principles of ethics as needed to reach that conclusion. If there is no way to save the life of the mother without directly killing the prenatal, they redefine 'direct' and find a new way to determine the 'moral object'. They assert a new principle, that if an act is the only way to save an innocent life, then that act cannot be intrinsically evil; it must have a good moral object. Of course, this new principle is promptly abandoned by them when the next case presents itself. It is not really a principle of ethics, but an excuse of the moment.

What would happen if we were to apply these newly-invented principles of ethics to other cases?

Suppose that a wife has no way to save the life of her husband in a concentration camp during World War II, except to bribe one of the guards with sex? Her sexual act with the guard is adultery, and is therefore intrinsically evil and always gravely immoral. But her husband will die if she does not do so. Would Lysaught justify her act of adultery? If so, she contradicts the ten commandments, and the teaching of Christ Himself in the Gospels. If not, she in effect admits that the clever new principle of ethics that she invented (or borrowed from other ethicists) to justify the murder of an innocent prenatal is not really a principle of ethics at all. It does not apply generally, but is applied only when the ethicist wishes to justify a particular act.

Prior to Veritatis Splendor, many Catholic moral theologians, such as Lisa Sowle Cahill, taught that no type of act is always immoral. As a matter of principle, even if one cannot think of a particular example as to when an act would be moral, they asserted that no act is always immoral: not genocide, not rape, not abortion, not contraception, not any type of sex, not theft, not lying, etc. This approach was condemned by Veritatis Splendor. And so, subsequently, some moral theologian began to seek other ways to justify intrinsically evil acts. One of the most popular approaches at the present time is to claim that the act is no longer intrinsically evil, due to some good intention, or some dire circumstance. The moral object is re-envisioned as having its basis in the intended end of the will. Or the font of circumstances is described as if it can, in dire cases, determine the moral object, transforming an intrinsically evil act into one that is good. Using this approach, they justify various intrinsically evil acts, despite the teaching of the Magisterium that intrinsically evil acts are always immoral.

And this is the approach used by the administration and the ethics committee at St. Joseph's hospital in Phoenix. Were they sincere in their mistaken judgment that an abortion was indirect and therefore permissible? Not at all. For as a matter of longstanding policy, they also authorized direct abortions in cases of rape and incest, and direct sterilization, and they distributed every form of contraception, including abortifacient contraception (oral contraceptives, and the IUD).

Bishop Olmsted was more than justified in declaring that this hospital is not a Catholic healthcare institution. In fact, it is not. An institution that continually commits the form of murder called abortion (and abortifacient contraception) cannot be considered a Catholic or Christian institution. And he was correct in his determination, according to the 'classical' approach -- or we should say, since Veritatis Splendor was promulgated, the 'magisterial' approach -- to intrinsic evil, that the abortion in question was direct abortion, not indirect.

Was Lysaught in good conscience in her moral analysis that the abortion was indirect? If she were, then she would have subsequently accepted correction when the Bishop in charge of the hospital she was advising, and the USCCB Committee on Doctrine, taught, with the authority of the Magisterium, contrary to her opinion. But she did not change her position. Is Lysaught solicitous to teach sound moral theology, in accord with the Magisterium, and to avoid any scandal to the faithful? If she were, she would have publicly rebuked the hospital for its use of direct abortion in cases of rape or incest, and for distributing abortifacient contraception (oral contraceptives, the IUD). She has not done so.

Direct abortion is murder, and those moral theologians who find clever new explanations to justify direct abortion, are committing the sin of formal cooperation by approving of the acts. They intend to justify acts that they know are considered intrinsically evil and always gravely immoral by the Magisterium. It is not a case of the misapplication of a doctrine to a particular case, but rather a case of the rejection of doctrine. For the Church's teaching as to what constitutes an intrinsically evil act is clearly and definitively taught in Veritatis Splendor. It is not an open question. It is not a matter of speculative theology. It is the definitive teaching of Christ.

Would Christ instruct his disciples to crush the skull of a child while the child is being born? Would the Blessed Virgin Mary approve of such an act? Would Christ teach a physician that murder becomes moral when there is no other way to save a life? Not at all! Yet Lysaught, Grisez, and Rhonheimer all approve of this type of partial-birth abortion. And Lysaught uses it as one basis for approving of the Phoenix hospital abortion.

Here is what Christ said about those who merely lead astray little children:

{18:6} But whoever will have led astray one of these little ones, who trust in me, it would be better for him to have a great millstone hung around his neck, and to be submerged in the depths of the sea.
{18:7} Woe to a world that leads people astray! Although it is necessary for temptations to arise, nevertheless: Woe to that man through whom temptation arises!

What would our Lord say about those who directly kill the innocent in the womb, or about those moral theologians who make clever excuses to justify the murder of these holy innocents, even during the process of childbirth itself?

{7:23} And then will I disclose to them: 'I have never known you. Depart from me, you workers of iniquity.'

by Ronald L. Conte Jr.
Roman Catholic theologian and Bible translator
23 December 2010

For more on the topic of contraception, see chapter 22, 'Abortion and Contraception,' in my work of moral theology: The Catechism of Catholic Ethics. For my translation of the Clementine Vulgate Bible from Latin into English, see SacredBible.org.

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