Where nature and authentic nurturing meet.

“The whole modern world has divided itself into conservatives and progressives. The business of progressives is to go on making mistakes. The business of conservatives is to prevent the mistakes from being corrected.” - G.K. Chesterton

Sunday, March 20, 2011

Specifically Catholic - a call to charity among the non-contracepting

Many people have claimed to me that the Catholic Church teaches that Catholic married couples can only avoid pregnancy for "grave reason."  

The Church does not teach that “grave reasons” are needed before using NFP to avoid pregnancy.   That is a mistranslation, however commonly repeated it may be.  And it is a line spouted over and over again.   

Humanae Vitae is the most authoritative and arguably most important statement of the Magisterium about this.  In the official Latin it cites seriis causis (“serious causes” or “serious reasons”) as necessary for the intent of a married couple to avoid conception to be licit.  That is, a couple needs something more than a trivial or selfish reason to avoid pregnancy.  This reason does not have to rise to the level of super-serious or life-threatening, which is what most English-speaking people imagine when they hear the word "grave."  

In addition to Humanae Vitae, there is also Pius XII’s October 29, 1951 address to Italian Catholic midwives.  The most relevant paragraph – in the original Italian – first mentions serios motivos – “serious motives.”  The text does also, at the end of the preceding paragraph and later in the relevant one, mention "grave motivo" and "graves razones."  The translation of the Italian grave(s) as “grave” is more excusable than the translation of the Latin seriis or the Italian serios as “grave.”  However, it is still a mistranslation.  The Italian grave (and the Latin gravis) essentially mean “heavy” or “weighty” – as opposed to “light” or “trivial”.   In other words – “serious.”  Furthermore, it is fairly clear from the wording of the paragraph that Pius is using graves as a synonym for serios – i.e., “serious.” In addition, one has to read that address in the context of his November 11, 1951 address to the Congress of the Family Front and of the Association of Large Families.  There he says that the moral limits surrounding the avoiding of pregnancy by natural means are “truly very wide."  Thus, they would encompass all those reasons that would be called “serious” – not merely a small subset of such super-serious reasons that would in English be called “grave.”

The Church calls couples to be generous to life, but also to discern how many children to have based on their relationship with God, spouse, and with children already born, and their obligations to society.  The answer will be different for each couple.  For some, a family of 13 children is both responsible and generous.  For others a family of one child is both responsible and generous.  

What I see displayed in the Catholic blogosphere and discussion boards is a lack of charity amongst the respective smaller or larger sized families.  Those with smaller families sometimes deride their large family counterparts as freakishly irresponsible.  Those with larger families sometimes deride their smaller family counterparts as selfish.  Both sides forget that selfish/generous and responsible/rash will display differently depending on the individuals involved and their personal circumstances, of which most of us have very limited knowledge at best.

Let's play nice, kiddywinks.  

(Thanks and credit go to Professor Kevin Miller of Franciscan University for the translation points.)

Monday, March 14, 2011

Courting Controversy


There.  I said it.  

The terminology surrounding abortion debates has been bothering me.  Anti-abortion, pro-abortion, pro-choice, pro-life, anti-life, anti-choice.  I mean, come on.  It's at the stage where the labels are meaningless.

I wonder how it started?  I imagine it began with the pro-abortion vs. anti-abortion duo.  Then the pro-abortion side figured it sounds a lot more marketable to be pro-choice (perhaps after the anti-abortion side began casting disparaging comments about those happy-baby-murderers on the other side.)  Then the anti-abortion side said, ok, you're pro-choice?  Well, we can one-up you because we are pro-life!  How's that for marketable?!  Then each side fully adopts their different paradigm, casting aspersions on the other as anti-choice or anti-life.  This seems like a feasible order of events, but I don't really know what transpired.  What I do know is the current rhetorical situation is useless.

I've heard those who support the legal availability of abortion object to the description of their position as "pro-abortion."  The objection is that they are not enthusiastic about abortion, not advocating some kind of wild baby-killing spree at all and so are not really "pro" abortion.  Just pro-choice.  But they're not.  Not really.  Are they pro-choice-in-general?  All choice is good, even if someone chooses evil?  Are they ok with their children choosing to do crack?  (As in, they may disapprove of their child's actions, but would defend to the death their child's right to legally choose to do it?)  Are they ok with legislative approval for any choice whatsoever as long as the person really thought deeply about it first?  Not usually, no.  They are not pro-choice-in-all-circumstances.

Nor does it make sense to call their opponents anti-choice.  I've never yet met a person who is ideologically opposed to the concept of choice.  Nor have I met anyone who is against all availability of choice in all circumstances.  Continuing in this vein, I have not met anyone who is anti-life in general, although I have encountered a few who fervently believe that the world would be better if humans died out.   Those who support abortion may have a warm and fuzzy approach to all life, plant, animal and human, outside this case of human life in the womb.  They might donate to charities, feed the poor, care for the sick and elderly, campaign to rescue those threatened with death for political reasons or in situations of armed conflict.  A pro-life person in the abortion debates may not be pro-life absolutely.  They may not be vegetarian (in which case a more accurate descriptor may be pro-human-life.)  They may support the death penalty in certain circumstances.  They may concede the necessity for war at times.

Each side is trying to claim a larger slice of the values pie.  It is ridiculous and it ought to stop.

Let us be very clear with our terminology.  What is happening now simply fogs the debate and many on either side descend into hysterical name calling.  Yes, the issue of abortion touches on other, wider issues, but dialogue is hindered by the way those issues stand in for detailed and precise communication.

We do not need to determine whether one side is made up of gleeful baby-killers and the other of dour woman-haters.  What needs to be determined is whether abortion should be legally available.  Making something legal provides it a governmental, and therefore societal, stamp of (moral) approval.  Thus, the moral status of the unborn human (a.k.a. the fetus) must be addressed and weighed, in addition to questions regarding women's bodily integrity.

When it comes to this, the only two standpoints are pro-abortion and anti-abortion.  These two labels encompass the spectrum of views in a concise and precise manner.  This is a political discussion with specific applications.  Think of it with the missing words:
PRO-the-legal-availability-of-ABORTION, and ANTI-the-legal-availability-of-ABORTION.  Thus, the pro-abortion side includes those who support the legal availability of abortion in limited circumstances (for example, in cases of incest or before 13 weeks gestation.)  We do not need to know how much or to what extent a person in their camp loves all life or accepts all choice.  It is inconsequential.  So let's stop it with the great meta-labels.

 So, whatever side you're on... take a stand for clarity.  Take a stand for the precision with language that will actually enable discussion and decision.  

And, for the love of all that is holy, please do not use scientific terms if you don't understand what they mean.  (I'm talking to you, pro-abortion people who use the term "zygote" willy-nilly.) 

Saturday, March 5, 2011

Trust No-One. (Ok, trust no medical practice, provider, or facility with your records.)

Yesterday I received my medical records from my postpartum hospital stay in January this year.

I make a point of requesting copies of my records.  Too often have they been misplaced or lost by medical providers over the past.  The first time this happened, I was a tender 18 years of age and in hospital, totally paralyzed, with Guillain-BarrĂ© Syndrome.  I had a tracheotomy performed, as I needed to be put on artificial respiration.  The first tube they used was a size too small for my throat size, so a couple of weeks later they had to change the tube for a larger size.  Since this did not require an operation, it was done in my room in the ICU by the nurses.  My parents waited outside for what should be a very quick procedure - they had been told their wait would be 15 minutes, maximum.   They ended up waiting for hours, not knowing what was happening.  Their anxiety was not relieved when finally, a nurse burst through the doors and said, "That was close!"  
(That scene wouldn't be out of place in an episode of House.)

After they had changed the tube, the ventilator was not inflating my lungs; the air was going into my stomach instead.  The nurses tried inserting the tube five times, but each attempt was unsuccessful.  They called over the ICU doctor who manually inspected my throat, finding a hole where none should be.  There was a tracheoesophageal fistula (a hole between my trachea and esophagus that made it impossible for the machine to properly work.  On one side it was 1 centimeter long, on the other side a whopping 3 centimeters.  They inserted a larger tube through my mouth and manually pumped air into my lungs as they rushed me to emergency surgery.  
(That scene would be *perfect* for an episode of House!)

Finding out what happened was difficult.  The hospital staff led us to believe that the initial damage was done by the surgeon who originally performed the tracheotomy, and had been masked by the placement of the first tube.

Our requests for apologies and further information were met with evasiveness.  I could tell something was not on the up-and-up.  I was paralyzed, not stupid!  My trust in my carers was shot and the relationship between my family and the staff was strained.  The doctors and nurses were often hostile.  (My mother saved me a number of times from being given incorrect medication or dosage by nurses who hadn't read my chart that day; a behavior that did not endear her to the nursing staff.)  We wanted another hospital, and the hospital wanted to be rid of us, but because of the complication of the fistula, no other hospital would agree to my transfer.  The ICU staff were more accustomed to dealing with patients in a coma, not a fully aware young girl with a lively intellect who would make demands on their time with requests for physical needs that could only be communicated laboriously through an alphabet system.  It was a happy day when, after 4 months in hospital, I was finally wheeled to the ambulance to rehab.  
(Saying "rehab" makes me feel like a celebrity/socialite [or Gregory House!]  My rehab was more about physiotherapy than addiction counseling, however.)

I contacted a lawyer and obtained my medical records through the Freedom of Information Act.

It transpired that the fistula was created by the nurse doing the tube-change, who was not using the guidewire and sheath that, for safety, is included in every packet of tracheotomy tubes.  The manufacturer strongly recommends using the guidewire and sheath, but it wasn't legally required and I guess the nurse, having done many tube changes, felt complacent.  Oops.

It also turns out that the hospital had "lost" the page of my medical record that noted which nurse performed the procedure, and crucially, how many minutes I was without oxygen.

In addition to this outstanding episode, my pre-natal records have been lost by two different medical practices, one in Australia and one in the USA.  One American obstetrical clinic also managed to input someone else's details over my own.  From one appointment to the next a week later, I had apparently gained 40 pounds, was on Zoloft, and goodness knows what else.  Before leaving Australia after my first child's birth, I asked my OB for a copy of my records.  He refused, pooh-poohing me and declared that the discharge report I had been given by the hospital would be sufficient for my needs.  Foolishly, being a tired new mother, I just let it go.  After getting to the USA, I found the hospital discharge summary was not at all sufficient.  I then had to jump through a number of hoops to get all the information my American OB required.

Now I keep my complete records at home, and can give copies to the providers when necessary.  I recommend everyone else do the same.  That way you always have your records, and you'll be sure to care for them with more diligence than many professional practices, simply because you have only one set of records to keep track of, and they're more precious to you personally.  There is an added bonus that by insisting on copies yourself, you can review them for errors.