Public Comment: RU-486

The St. Joseph County Council met on Tuesday evening, December 5. During the public comment period at the close of the meeting, about 30 healthcare workers and concerned citizens spoke out against the possibility that a new facility would open in South Bend offering chemical abortion (RU-486). My contribution was a brief review of maternal physiological risks associated with this heinous practice.
____________________________________________

All medical interventions are accompanied by risk, and we accept those risks when they’re outweighed by the potential benefits. Even a simple Band-Aid can present the risk of injury for those with very fragile skin, or even an allergic reaction, but we don’t think about it too much because the risk is so small.

The same rule applies to medications – like a simple dose of Tylenol, that we take without much thought because the risks are so minimal. But we can be allergic to Tylenol and other drugs, or we can experience a variety of adverse reactions if those drugs interact with our bodies in unexpected ways.

Most drugs have been used and/or studied so long that their side effects and risks are well known. Such is the case with mifepristone and misoprostol, the two drugs that together make up RU-486, the chemical (or medical) abortion procedure under consideration tonight.

Among the side effects that women who take these drugs may experience are these:

• Nausea, vomiting, and diarrhea
  
• Significant cramping and pelvic pain
  
• Insomnia, anxiety, and dizziness
  
• Headaches, along with back and leg pain

More serious complications, while uncommon, include the possibility of:

• Heavy bleeding, lasting day, weeks, and even months, and sometimes requiring blood transfusions
  
• Large uterine blood clots or even incomplete expulsion of fetal remains from the uterus
  
• Infection, including the possibility of sepsis (or whole body infection), which can be deadly
  
• Additional complications associated with an undetected ectopic (or tubal) pregnancy, which would be a medical emergency 

Proponents of medical abortion argue that these risks, even the serious ones, can be handled if and when they arise, but keep in mind that women only receive the first dose of the two-dose regimen in a clinical setting. She’ll return home after that – or, if she’s from out of town, to a motel room – to take that second drug, and then face any complications or problems on her own.

Consider, too, that these possible side effects and risks are grave enough that women must be warned about them and sign an informed consent before receiving the abortion drugs. Like I said, all medical interventions have risks, and we have to weigh risks against benefits.

But the risks associated with medical abortion are high, too high, even if you want to argue that abortion is a “benefit.” RU-486 is a dangerous regimen, and it has no place in our community.
___________________________

Required for Survival: Food & Water as Moral Default

The May-June 2005 issue of Liguorian Magazine featured an article by Mark Miller, CSsR, entitled “The Controversy Surrounding Feeding Tubes.” I sent the following letter in response. It was not printed, and I never received a reply.
__________________________________

Editor:

The May 2005 issue of Liguorian includes several beautiful tributes to Pope John Paul II, for which I commend you. His life of love and service, particularly in his role as Pope, was marked by holiness, fidelity to Truth, and tireless efforts on behalf of the world's most vulnerable.

The quality of your memorial section devoted to our beloved John Paul II makes the brief article by Fr. Mark Miller, CSsR, on feeding tubes all the more jarring. Fr. Miller rightly refers to the Pope's March 2004 allocution making it clear that the provision of food and water – even through a tube – must always be considered a part of ordinary care. But then Miller completely undermines the weight of the Holy Father's teaching by contrasting it with the work of “other moral theologians” who see food and water as optional – depending on “context and circumstances.”

This is pure relativism and is exactly the kind of muddled moralizing that John Paul was addressing. The last paragraph of Fr. Miller’s essay refers to “no swallowing ability, no awareness, and no sensation” – an apt description of a person in a persistent vegetative state, or any unconscious state for that matter. Where Fr. Miller makes a serious error is in following that description with the phrase, “the body slowly shuts itself down in a painless process.” This would occur only if there were an underlying and untreatable pathology that would inexorably lead to death, or if the individual were denied the ordinary elements required for survival – including, namely, food and water.

That is the crucial point: When food and water are withheld such that a person dies as a direct result, the only conclusion possible is that a willful homicide has occurred. How can it be otherwise? Obviously, when the provision of nutrition and hydration are no longer serving any purpose at all, and in fact become burdensome – even to the recipient – then it may be discontinued. But such a situation was not being addressed by the Pope’s allocution in the spring of 2004; he was addressing a narrowly prescribed set of circumstances, and it seems providential that, almost exactly a year later, the exact circumstance he had referred to burst into the public eye with the battle over Terri Schiavo.

Of course consideration must be made for the particular circumstances of individual cases, but what the Holy Father did (and admirably well, in my own opinion) is to help us know the limits of what can be debated, even in the hard cases. No one is claiming that food and water must be provided at all costs until the very last breath has passed one's lips; what the Pope declared is that no one should ever die from starvation and dehydration – and that is precisely what happens when feeding tubes are discontinued in the absence of underlying pathologies that naturally lead to death.
________________________________