UPDATE: May 21 -- According to CNN, the Sister of Mercy involved in the case is no longer excommunicated but has met the religious requirements to again be eligible to receive the sacraments.

ORIGINAL POST

Here's a horrific choice: OK an abortion for a pregnant woman facing heart failure or let her die?

Now, make that question tougher: You're a Catholic sister charged with standing for the teachings of the Church in the administration of the biggest hospital in town, one that adheres to Catholic teachings forbidding any cooperation with the intrinsic evil of abortion.

And the woman, mother of four, is in crisis. She can't be moved to another hospital. Now what?

What happened at St. Joseph's Hospital in Phoenix, according to the Arizona Republic's Mike Clancy, is that Sister of Mercy Margaret McBride interpreted the bishops' health care directives to permit a life saving procedure when doctors said there was no other choice. The directives include a provision for procedures that could kill a fetus if essential to save the life of the mother. For someone with pulmonary hypertension, the only treatment is to take the strain of pregnancy off her heart.

Wrong answer, ruled the diocese.

Abortion is the one procedure that directive paragraph would not include, in the eyes of the Bishop Thomas Olmsted. McBride was publicly dressed down and declared excommunicated. Olmsted decreed that she stepped outside the community of Catholics who may take the core sacrament of the faith, the Eucharist, by her action.

The Rev. John Ehrich, the medical ethics director for the Diocese of Phoenix, tells National Public Radio:

She consented in the murder of an unborn child. There are some situations where the mother may in fact die along with her child.

Ehrich thinks she should be drummed out of her religious order as well but that's a decision up to the Sisters of Mercy.

The diocese has posted a Q & A on the St. Joseph's situation that essentially says everyone who had anything whatever to do with consenting to the abortion, including the desperately ill woman, also excommunicated themselves by participating in the decision. And Catholics for Choice, which supports abortion rights, responds with a point by point dispute that this is a misreading of canon law.

(No word on whether there have been any repercussions -- religious, professional or even criminal -- for the unnamed hospital employee who violated federal privacy laws by giving information about a patient to the Church, which then disclosed it publicly.)

It's not known if the young mother is Catholic herself, like 15% of Phoenix. But in a Catholic hospital, that's not relevant.

All physicians and staff, of any faith, are expected to adhere to the ethical guidelines that come with the Catholic brand on the door. The bishops don't view these the way, say, the Supreme Court justices look at the Constitution -- a document that can be subject to different interpretations.

The Phoenix incident -- pitting Sisters of Mercy, who stand by McBride, against Olmsted -- is roughly parallel to tensions between the U.S. Conference of Catholic Bishops and dozens of nuns including the head of the Catholic Health Association, who supported health reform legislation. The sisters said it was "life-affirming legislation" that clearly blocked federal funding for abortion. The bishops see loopholes that will allow evil to go forward with taxpayer support.

You may think this is not your concern if you're not Catholic. Not so.

Catholic hospitals hold about 17% of the nation's hospital beds and Catholic health systems are the largest provider of care to the poorest outside of the government. In many communities, it's the only choice for care for hundreds of miles.

Few patients, counting on their reputation for excellent care, have a moment's thought about the implications of the Catholic brand -- its deep and historic commitment to caring and its clear, specific views on the ethical boundaries defined by the faith.

Do you give up your medical autonomy in a Catholic hospital? Will the bishop excommunicate the mother as well as Sr. McBride for consenting to this? Does one bishop's view holds for all?

NOTE: This is a place for civil discussion. All views respectfully presented are welcome. Please, watch your tone.