Hospital of St. John's and St. Elizabeth London

Is the tragic situation which has taken place at the Catholic hospital of St. John's and St. Elizabeth in London a preview of what we can expect in this country if FOCA or similar legislation ever passes here? It should be noted that several members of the previous Board were members of the Order of Malta's British Association who fought vigourously to maintain a Catholic ethic with the Hospital but were nevertheless removed by the Cardinal when he dissolved that Board last year.

A little background on this story courtesy of Fr. Finegan (who has a great blog BTW, The Hermeneutic of Continuity).

The Hospital of St John and St Elizabeth in St John's Wood is a Catholic hospital, founded in 1856. In 2003, the Hospital invited the St John's Wood Medical Practice to become a part of the hospital. At the time, Catholics familiar with the present workings of the National Health Service warned that such an invitation would present problems for a Catholic hospital since an NHS medical practice is bound to offer "sexual health services" which conflict with Catholic moral teaching.

Last week, the Hospital Board approved a new Code of Ethics which, on the surface, looks good. It specifies that such things as euthanasia, sex-change operations, the fitting of intra-uterine devices, and IVF are forbidden. However, the Code does not mention abortion referrals or the prescription of the (abortifacient) Morning After Pill.

Today, there are two articles in the National Press which highlight the Linacre Centre's criticism of the Code of Ethics: in the Daily Telegraph Celebrity hospital in abortion row and in the Daily Mail Cardinal caught up in Catholic row... Abortion referral is a "hot button" issue for Catholics in Britain today. Catholic doctors and others who will not kill unborn children cannot in conscience refer patients to other doctors who will. Many secularists would like to try and force them to do so or leave the profession.

It cannot be acceptable for a Catholic hospital to allow such referrals, nor can these referrals in any way be "approved by the Catholic Church."

Fr. Finegan received the following letter from Mr. Luke Gormally, Honorary Fellow of the Linacre Centre for Healthcare Ethics

Dear Fr Tim,

The situation at John&Lizzies is one of grave scandal. The Cardinal has the authority in the constitution of the Hospital to determine the ethical norms that should govern clinical practice there. When objections where referred to the Cardinal in 2004 to admission of the St John's Wood Medical Practice, which is contractually committed to providing the full range of 'family planning services', including referrals for abortion, he in turn referred the matter to the Congregation for the Doctrine of the Faith (CDF) - though in truth the issue was clear cut.

The Hospital Management (which has long been non-Catholic) argued that there was no clear prohibition in the existing Code of referrals for abortion. The case was presented in somewhat unsatisfactory terms to the CDF who asked the Cardinal to establish a Committee to enquire into practice at the Hospital and what might be required to render the existing Ethics Code unambiguous in its directives. The Cardinal after some delay established the Brennan Committee (under Lord Brennan), a Committee which included Professor John Finnis in its membership.

This Committee eventually reported to the Cardinal in early 2006 and on 6 March that year following the advice of the Committee the Cardinal wrote to the then Chairman of the Hospital Board, Lord Bridgeman, requiring specific additions to the Code which made it unambiguously clear that no doctor practising at the Hospital was to refer for procedures, including abortion, which were contrary to moral truth as identified in the teaching of the Church. He asked that the Code be revised along these lines by the end of 2006, and that the following year the Hospital should set up a system of ethical governance to ensure that the Code was being observed. Lord Bridgeman disbanded the previous Ethics Committee, three of whose members,including Dr Helen Watt, had been at the forefront of complaining about unethical practices at the Hospital (it had, among other things, become the major centre in the UK for female to male transgender surgery), and established a new Ethics Committee.

This first met in September 2006 and I was, somewhat to my surprise, recruited to the Committee in October 2006. Lord Bridgeman's chosen Chairman of the Ethics Committee was extremely reluctant to proceed to the revision of the Code as required in the Cardinal's letter to Lord Bridgeman, but some of us managed to produce a revision of the Code in early 2007 precisely along the lines specified in the letter of 6 March 2006. This revised Code was then formally agreed by the Ethics Committee. Before it was presented to the Hospital Board however it was presented at the insistence of Management and Lord Bridgeman to the Medical Advisory Committee (MAC) of the Hospital. This is composed of a group of doctors not one of whom is a Catholic. They rejected the Code.

It subsequently emerged at a meeting with this Committee that they regarded the Code as having no authority over them and indeed viewed the Hospital as already a secularised institution. The view of the MAC was then invoked as a reason for non-acceptance of the Code by the majority of those on the Board with a secularising agenda for the Hospital. However, in the later part of 2007 there were a number of resignations from this group and towards the end of the year those members of the Board who had been faithful to the terms of the Hospital's Trust Deed and had sought to retain its catholicity found themselves in a sufficient majority to approve the Code.

At this point the Cardinal intervened and demanded the resignation of those faithful few. Though he had no legal authority to do so, his wishes were complied with by a number who felt obliged to defer to his moral authority. Lord Guthrie was then installed as the new Chairman of the Board and he accepted this position on condition that he would be able to re-populate the Board with his own nominees. One of these is Sir Mark Allen who from a career as a spy master has now assumed Chairmanship of the Hospital's Ethics Committee. He has produced a Code which to anyone who knows about the controversy over the past 4 years about the ethical norms which should govern clinical practice at the Hospital is manifestly a complete capitulation to the demands of the MAC that certain key demands of Catholic moral teaching should have no authority over what they decide and do with their patients in consulting rooms in the Hospital. What happens in the operating theatres may be more restricted than hitherto, but the most striking thing about the new Code is the complete absence of any prohibition of referrals for abortion. I began by saying that the situation is one of grave scandal. It is so because the Cardinal has given his approval to this new Code. The Church's teaching about the grave wrongness of abortion and cooperation in abortion has been sacrificed for essentially financial interests. How can the Church in this country effectively defend the sanctity of life when its Chief Shepherd is prepared to approve a Code which effectively accommodates referrals for abortion? A spokeswoman for the Brook Advisory Centres is reported as welcoming the liberalization of the Hospital's Code. That tells us pretty cleary where the Cardinal has got us to. Urgent prayers, and action by some, are needed to reverse this situation.

Luke Gormally

Today I received a newsletter published by the Restituta Group, which is campaigning to restore the Hospital to Catholicity, recapping further developments between October and December. I will post on that as soon as I can condense it down.

One item that is conspicuously missing from the 2008 Code of Ethics is the preamble from the 2007 Code,

“The following are therefore not permitted in any facility within the Hospital, its precincts or its ownership and may not in any such facility be the subject of referrals with a view to obtaining them elsewhere”.