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Problems Brewing for Pro-lifers in Illinois – An ethical assessment of SB 1564

The Illinois General Assembly is considering a bill that will have grave effects on the freedom of conscience of Catholic hospitals and pro-life healthcare workers.  Senate Bill 1564, which passed the Illinois Senate in April and is now before the House, will alter the existing Health Care Right of Conscience Act of the State of Illinois by introducing “protocols” requiring institutions and personnel with objections to abortion to refer abortion-seeking women to providers who will perform them.

Section 6.1 §3 [1] directs that if a woman asks a healthcare provider for an abortion, the provider must either 1) find someone in the facility to abort the child; 2) “refer” her to a facility that the provider reasonably believes may abort the child; 3) “transfer” her to such a facility; or 4) give “information to the patient about other health care providers who they reasonably believe may offer the” abortion of that child.

The first three are obviously morally objectionable.  But some in the pro-life community are in doubt as to whether the fourth would also be wrong.  The remainder of this essay provides an ethical assessment from Catholic moral theology of the fourth provision.

According to Catholic moral doctrine, it is always wrongful to formally cooperate in the evildoing of another.1   We formally cooperate when we assist another’s wrongdoing in such a way as to share the bad willing of the wrongdoer.2   Even if a cooperator has a good end in view, his cooperation is formal if he intends the wrongdoing as a means to achieve that good end.  Formal cooperation may take the form of authorizing evildoing, approving it, giving specific directions on carrying it out, prescribing it, or actively defending it.

It may be the case that healthcare entities and providers that comply with the prescript specified in Sec. 6.1 §3 have a good end in view, namely, complying with State law and avoiding harmful consequences that could follow as a result of the failure to comply.  But pursuing that good end by advising women how to get an abortion is a bad means.  To “reasonably believe” that Dr. X “may offer” an abortion is to believe that Dr. X is willing and able to perform it.  A provider who informs a woman that he believes Dr. X is willing and able to provide her the abortion she seeks advises her on carrying out her wrongful intent.  The provider can hardly claim that he is not intending the woman to do what he has advised her to do.  This is an instance of formal cooperation.

But even (ex hypothesi) if it could be merely material cooperation (i.e., cooperation in which the cooperator does not share in the bad willing of the wrongdoer, and which is sometimes morally licit), given the likelihood that this kind of cooperation would cause scandal in a strict sense (i.e., lead people to sin), it would be immoral material cooperation.  For a doctor to advise a woman on where she should go to ensure she can find someone willing to abort her baby would understandably lead other people to believe that the doctor does not really think that what the woman is doing is gravely wrong.  This could encourage these people to begin supporting, or more firmly support, or worse, to have, or support others in having an, abortion.  Consequently, the doctor’s example would cause scandal.

Moreover, if this provision of “information” occurred in a Catholic healthcare institution, people likely would conclude that the institution’s leadership is insincere in its commitments to moral truth, which could alienate some people from the Church and its sacraments, especially the unsophisticated who are inclined to believe that the actions of a Catholic institution are the actions of the Catholic Church.  As a result, they could be more easily led into sin.

Moreover, since Catholic healthcare organizations are institutional ministries of the Church, they have a duty to “do everything they can to ensure that the witness of the Church is not adversely affected” by instances of cooperation.3   Institutions that cooperate in aborting babies in this way will very likely impair their own ability to bear perspicuous witness to the Gospel and its moral values.  A Catholic apostolate that cannot effectively witness to the Gospel cannot fulfill its defining purpose, which is to bear witness to Christ and His message of salvation to all men and women.4   For an institution to tolerate the compromise of its prophetic witness in this way would be immoral.

Moreover, by complying with the objectionable prescript, pro-lifers advance the purpose of abortion defenders to facilitate more widely women’s access to abortion.  This obviously impedes their own purpose of limiting the odious practice and is likely to embolden their opponents to undertake further and more brazen attempts to coerce them (pro-lifers) to cooperate in abortion.

In my opinion, therefore, institutions and individuals could not comply with the fourth provision stated above without doing evil.

1See Congregation for the Doctrine of the Faith (CDF), Some Principles for Collaboration with Non-Catholic Entities in the Provision of Healthcare Services [2] (2014), principle no. 2; published at The National Catholic Bioethics Quarterly (Summer 2014), vol. 14, no. 2.
2This definition is derived from St. Alphonsus Liguori’s classic definitions of formal and material cooperation, see Theologia moralis, ed. L. Gaudé, 4 vols. (Rome: Ex Typographia Vaticana, 1905-1912), vol. 1, p. 357 (lib. II, §63).
3Quote taken from CDF, Some Principles for Collaboration with Non-Catholic Entities in the Provision of Healthcare Services [2] (2014), “Prologue,” par. 3.
4See Vatican II, Apostolicam Actuositatem, [3] no. 4