Head of Catholic Health Association says “excessive treatment” burdens patients, families

ROME — Pope Francis this week called for a “withdrawal of ‘overzealous treatment’,” saying that it “responsibly acknowledges the limitations of our mortality.” Sister Carol Keehan, president of the Catholic Health Association, praised the speech, acknowledging that sometimes, in an attempt to prolong someone’s life, the “burden-benefit” equation is ignored.

“There are people in the Church who believe you must do absolutely anything you can do [for the infirm],” Keehan said in an interview with Crux. “And that is not right. You must do everything that might be helpful and not burden the patient.”

In her view, the pope brought together benefit and burden in a “brilliant” exposition.

Keehan also said that she gets “aggravated” when people insist on putting feeding tubes in patients while tying their arms down so they don’t pull the tubes out, adding “excessive treatments” that burden the family and the patients but in the end don’t change the results.

Keehan was in Rome for a conference organized by the Vatican’s Dicastery for Integral Human Development titled “Addressing Global Health Inequalities,” and also to participate in a dialogue with pharmaceutical companies and representatives from low-income countries organized by Cardinal Peter Turkson, to talk about the struggle of children who have HIV.

The dialogue was about “the challenges of preventing, identifying, treating, finding medications that are compatible with children.”

When it comes to the fight against this epidemic, Keehan answered those who see the Catholic Church’s ban on condoms as part of the problem, saying that the Church is “very much part of the solution.”

During the Nov. 16-18 conference in Rome, many spoke about the high percentage of young women for whom their first sexual encounter is a rape.

“Sometimes people define the use of a condom as responsible sexuality,” Keehan said. “There’s nothing responsible in raping a young girl. Many of these young girls, before they even reach an age in which they can think about responsible sexuality, already have been raped time and time again, and have AIDS.”

She told Crux that if the Church lifted its ban on condoms tomorrow, “we would still have the same problem we have today.” The Church’s stance on them, she said, didn’t cause the problem and it will not solve it either.

“We have a much bigger challenge to fix the problem,” Keehan said.

Keehan spoke with Crux on Friday, and what follows are excerpts from that conversation.

Crux: We heard yesterday about a need for a global healthcare reform, but you’re in the middle of one on the homefront. You have insider access to it, so can you give us an update on healthcare reform in the United States?

Keehan: The Affordable Care Act, with its many flaws, accomplished an incredible amount. As imperfect as it was, and believe me, I’m the easiest person to tell you of the imperfections of the ACA, it also advanced many things. Over 22 million people who did not have insurance, do.

We were able to get preventive care with no copay. The low-income mother with two children who’s barely making ends meet, doesn’t have to choose between spending $25 on a copay for a mammogram or fill her child’s prescription or have enough money to put food on the table until the next pay day.

When you think about a little child with a serious heart condition or who has cancer, easily, before they’re an adolescent, would have run out of their limit in the old system. Now, insurance companies can’t do that to them. And when they become an adult, or when their parents change jobs, insurance companies can’t say that’s a pre-existing condition.

For many, many people who make comfortable income ordinarily speaking, this lifting of the limit insurance companies have to pay has been a life saver. If you look at states like West Virginia or Kentucky, which basically reduced their uninsured to nothing, it has been a huge step forward.

It has a lot of things that need to be fixed, but it has also accomplished so much. And now it’s come under an incredible threat. Behind this, when you start to look at it, is a passion to do a massive tax cut, particularly for corporations. And the early bills that came out, would have given billions and billions of dollars, according to the Congressional Budget Office and the Joint Committee on Taxation, which are non-partisan groups, to the wealthy one percent.

Can we say that the contraceptive mandate was one of the flaws of the law?

At the time of the passage, we all thought contraception would be in it, but abortion would not. And that’s what happened. But we all thought that we would have, as we’ve always gotten, an exemption from the contraception. And we had good reason to believe that.

Then, the president got, in my opinion, very, very bad advice and took it. It was not in the law itself that there was a flaw on this, but in the regulations that were put out. We should have had an exemption. If they wanted to say, “you have to offer another service if you’re not going to pay for contraception,” that would have been fine.

Instead, they not only said that we wouldn’t get an exemption, but they then wrote a justification that took the designation of whether you are Church ministry or not, away from the Church. It was just incredibly bad advice that the president got.

I believe that you need to be civilized in the way you differ with people, and you need to understand that people of good will can have differences of opinion. The important thing is to find ways to work those differences out. I spent a good deal of time trying to work things out.

The accommodation worked very well for our members, because quite frankly, we’ve always done what we’re doing now. We’ve always said we’re not covering abortion, and we’re not covering contraception. Period. We don’t cover it. The fact that the government gives it to you or has the insurance company give it to you. It has always given contraception to many people through the Title 9 program, or through federal clinics.

There are other ways to getting contraception than forcing Catholic clinics and hospitals to give it …

Right. And we said, “We want the freedom to say we’re not buying it.”

It wasn’t about money for you…

No. Contraception is so inexpensive … On abortion, it was very clear. I personally said to the president, we support this bill because people need it so badly, and because you do not fund abortion. That would have been the show stopper for us.

Contraception is an artificial way of preventing conception. The Church doesn’t mind preventing conception, it doesn’t approve of artificial ways of doing so. You can argue that forever. Irrespective, we follow the teachings of the Church, therefore, we don’t pay for it.

In the case of abortion, it’s a profound human issue that attacks life. It would have been the ultimate break for us. It would have been a killer.

Do you have any hope whatsoever regarding the ongoing healthcare reform in the United States?

We have to either live in hope or die. I have to live in hope. But I’m very frustrated.

Over 50 percent of personal bankruptcies in the United States are because of medical expenses. Why would you go after those deductions in order to help the richest one percent? It doesn’t make sense. It is un-American.

In your talk at the conference, you spoke about caring for life in the other “extreme” and assisted suicide. Pope Francis, at a different event, spoke about it on Thursday.

It was magnificent.

However, a lot of people in the media, particularly Italians, portrayed it as the pope opening the door to assisted suicide. Did you see it like that?

No. What I liked about it is the same thing I like about Pius XII’s talk to the anesthesiologists. There are people in the Church who believe you must do absolutely anything you can do [for the infirm]. And that is not right. You must do everything that might be helpful and not burden the patient.

Francis brought together the benefit and burden in a brilliant exposition. I get aggravated by these people who insist with feeding patients intravenously or with feeding tubes in their nose and tying their arms down so they don’t pull the tubes out. I get so aggravated and say, “It is not the Catholic teaching that everybody has to go to heaven on a full stomach.”

Sometimes, we add burdens to families and patients that we shouldn’t add by excessive treatment and we don’t recognize that burden-benefit equation is also important.