Pope Francis, Poverty and Women

Here is a piece I wrote for The Guardian's 'PovertyMatters' blog. I have cut and pasted the text here, but if followers of my blog would like to post comments or to contribute to the debate, may I suggest that you do so on The Guardian's comments page, in a way that respects the rules of reasoned engagement and courteous dialogue? Thank you.

Pope Francis has done little to improve women’s lives

Women do not seem to have a place in the pope’s vision of a Catholic church that cares for the world’s poor people

Pope Francis says he wants a church in which the shepherds smell of the sheep. Photograph: Osservatore Romano/Reuters

Pope Francis has repeatedly said he wants a poor church of the poor. At a time when millions of people are experiencing the impact of brutal economic policies and unbridled corporate greed, he has attracted admiration from Catholics and non-Catholics for his condemnation of the economic system and the simplicity of his own life.

He has also acknowledged the need to give women a greater say in the life of the church, though he has done little to achieve this. Yet poverty impacts unrelentingly and acutely on women’s lives, and nowhere does the absence of women’s influence manifest itself so clearly as around the church’s teachings on sexual and reproductive ethics.

While papal encyclicals abound with negative references to contraception and abortion and positive references to motherhood, marriage and the family, one can search in vain for any discussion of maternal mortality. Like his predecessors, Pope Francis has a tendency towards romanticism when speaking about motherhood. This is a dangerous fantasy when it occludes the harsh realities and struggles of women’s reproductive lives.

If the pope wants a church that prioritises the needs of the poor, then addressing women’s reproductive wellbeing is fundamental to that goal. Maternal mortality is often a direct consequence of poverty. Of an estimated 280,000 maternal deaths a year, 99% occur in the world’s poorest countries – mostly in sub-Saharan Africa and south Asia. Good obstetric care would prevent most of these deaths, but issues of contraception and abortion raise more contested ethical issues.

I do not defend the Catholic church’s position on contraception. However, it is important to separate women’s reproductive rights from contraceptive programmes linked to population control policies. Feminists speaking for the global south, such as Kalpana Wilson, argue that these are driven by exploitative economic policies and are often deeply coercive. Paradoxically, when working documents for the 1994 International Conference on Population and Development in Cairo included a heavy emphasis on population control, the Catholic church and the international women’s movement, though deeply hostile to each other, campaigned effectively to refocus the international development agenda away from population control to women’s education and empowerment.

Recent research shows that the most effective way of reducing birth rates is through female education, which also has a significant impact on reducing infant mortality. An educated woman who knows that her children are likely to survive will have fewer children than women in areas with high infant mortality rates and poor access to education. It is also interesting to watch Hans Rosling’s TED talk, in which he shows that birth rates stabilise or decrease when poverty is reduced, irrespective of religious influences.

None of this is to deny that access to safe, reliable and affordable contraception is important if women are to exercise reproductive choices. However, while a change in the church’s teaching on contraception may be long overdue, this must not translate into an uncritical endorsement of contraceptive programmes inflicted on the world’s poor. Rather, the international community must focus on poverty alleviation and the education and empowerment of women and girls, not only because justice demands it but because it has been shown to be the most effective way of tackling the population crisis.

The abortion issue has similar implications, though most Catholics I know regard this as a more complex ethical issue than contraception. I know few who would agree that it is simply a question of individual autonomy and a woman’s right to choose, though that does not mean they support criminalising abortion. The church says abortion is always wrong; feminists say it is always a right, but in the real world we sometimes face complex moral dilemmas where rights and wrongs are not so easily distinguished.

The polemical nature of the debate means that statistics – which are already unreliable – are manipulated by both sides. Opponents of abortion argue that access to abortion does not reduce maternal deaths, pointing to the fact that countries such as Chile and Ireland have very low maternal mortality rates despite abortion being illegal. However, such claims ignore the fact that 40,000 women die every year because they would rather risk an unsafe abortion than carry an unwanted pregnancy to term. While early pregnancy might rarely be a direct cause of maternal death, unsafe abortion most certainly is. These issues must be acknowledged in any debate about the Catholic church and women’s reproductive and sexual rights, particularly with regards to poverty and motherhood.

At a grassroots level, Catholic agencies and religious orders are major providers of education and healthcare to the world’s poor. This includes providing antenatal and obstetric care, dealing with the consequences of botched abortions, and caring for people living with HIV and Aids. However, some of this work goes on under the radar. Catholic healthcare providers are often afraid to publicise some aspects of their work – such as post-abortion care or supplying condoms to those at risk of HIV and Aids – in case their funding is cut off or they are censured by their bishops.

If he is serious about wanting a poor church of the poor, the pope has to create a safe space in which these issues can be discussed. He has said that he prefers “a church which is bruised, hurting and dirty because it has been out on the streets, rather than a church which is unhealthy from being confined and from clinging to its own security”. He has emphasised the maternal character of the church, and he says he wants a church in which the shepherds smell of the sheep. How about a maternal church in which the shepherds smell of bruised, hurting and dirty women dying in childbirth?

Tablet Blog - The Uses and Abuses of Potassium Chloride

Here is the text of a blog I recently wrote for The Tablet:

Why British outcry at Oklahoma's botched execution rings tragically hollow

06 May 2014 by Tina Beattie

The persistent use of the death penalty in North America has brought widespread international condemnation, and never more so than with the so-called "botched execution" of Oklahoma death row inmate, Clayton Lockett. Lockett died of a heart attack some 43 minutes after the administration of a lethal injection using an experimental cocktail of drugs for the first time. Witnesses reported a prolonged struggle before the executioners drew the curtains on the death chamber.

The need to experiment with new combinations of drugs has arisen because some previously-used drugs are in short supply owing to a 2011 embargo by the European Union. This prevented European manufacturers from exporting drugs to the United States that might be used in lethal injections. In the past, this method of execution has used three drugs, including potassium chloride which stops the heart.

In 2010, The Guardian revealed that some British companies had been secretly exporting potassium chloride to America for use in executions. The outcry that followed prompted Britain to ban the export of drugs that might be used in lethal injections.

What has attracted little media attention is the fact that potassium chloride is used in this country to inject the foetal heart in cases of late abortion. The website of the Royal College of Obstetricians and Gynaecologists offers this advice:

For all terminations at gestational age of more than 21 weeks and 6 days, the method chosen should ensure that the foetus is born dead. This should be undertaken by an appropriately trained practitioner. Intracardiac potassium chloride is the recommended method and the dose chosen should ensure that foetal asystole has been achieved … Consideration can be given to abolishing foetal movements by the instillation of anaesthetic and/or muscle relaxant agents immediately prior to potassium chloride administration.

In Britain (excluding Northern Ireland), the time limit of 24 weeks for legal abortion is later than for most countries in western Europe, many of which allow abortion on demand but only during the first trimester. A legal loophole also means that abortions can be performed in Britain until birth in certain circumstances. Of the 190,972 abortions recorded in England and Wales in 2012, 91 per cent were performed in the first 13 weeks of pregnancy, but there were 160 abortions after the twenty-fourth week, of which 28 took place after the thirty-second week of pregnancy.

Few issues are as resistant to informed and reasoned debate as abortion, and any attempt to open up such a debate risks being hijacked by bitter polemicists on both sides. Yet wherever one stands on the legality and morality of abortion these are vital ethical issues. When there is such clear contradiction and denial as there is with regard to the uses and abuses of drugs like potassium chloride, it is in the public interest that such debate should be had, and that voices of reason should seek to be heard over the din of angry rhetoric. The question that will not go away is why the British public would be outraged at the use of a drug for the purposes of capital punishment, when one of our most prestigious medical organisations recommends its use for the purposes of killing a potentially viable baby.

Abortion, Tradition and Compassion

The following article written by me appeared in today's Tablet, which carried three pieces on the controversy surrounding the excommunication of Sister Margaret McBride for her part in the decision to abort an eleven week foetus to save a mother's life:

The excommunication of Sister Margaret McBride has embroiled the Catholic Church in yet another scandal, at least in the American media. Sister Margaret, a senior administrator in St. Joseph’s Hospital, Phoenix, Arizona, was on a committee that agreed to the termination of an eleven week pregnancy to save the life of the mother. The bishop of Phoenix, Thomas Olmsted, announced that Sister Margaret was automatically excommunicated for agreeing to an abortion. His Communications Office subsequently explained that ‘The mother’s life cannot be preferred over the child’s’, and added that not only Sister Margaret but all those involved in the decision were automatically excommunicated.

Some would argue that these teachings are the necessary rigours of a Church which must oppose any deliberate ending of innocent human life. The ethical reasoning behind this is that one may not do evil that good might result, and it has its roots in the belief that the moral value of an action lies in its intention. That is why the Church’s teaching also supports the doctrine of double effect. An action with a good intention might have an unintended but unavoidable negative side effect, in which case it might be morally justified. So, a procedure could be performed with the intention of saving a mother’s life which indirectly caused the death of the foetus (for example, by removing the cancerous womb of a pregnant woman), but the direct, intentional killing of the foetus can never be condoned, even to save the mother’s life.

This kind of argument may appeal to those who value moral absolutes over ambiguity, but many of us regard dilemmas such as the one confronting Sister Margaret and her colleagues as being too complex for formulaic judgements. The intention in this case was not to kill the child but to save the mother, and some may regard the distinction between directly and indirectly destroying the foetus as of little ethical relevance in situations of such tragic complexity. Moreover, many of us are astounded that a hierarchy which has shown such incompetence and moral ambivalence in its handling of the sex abuse crisis, and which has shown greater concern for its own members than for the lives of young people in its care, can act with such ruthless decisiveness with regard to abortion.

But there are grounds for reconsidering the Catholic Church’s present position on abortion by appealing to the wisdom of its own tradition, which is less rigid than the present hierarchy would have us believe. The claim that all abortion is tantamount to murder finds little support in pre-modern theology. Until the late nineteenth century there was widespread debate as to the morality of early and late abortion, with a widespread consensus that early abortion was a less grave sin than late abortion. This was informed by the belief that ‘ensoulment’ was not simultaneous with conception, but that the early foetus went through various stages of pre-human development before it acquired a soul and became fully human. Moreover, while debates about the sinfulness of early abortion were sometimes concerned with the unborn child, they often focused more on the sexual morality of the pregnant woman.

The idea of ensoulment serves as a reminder that the coming into being of a human person is not an instantaneous event but a gradual process, not only in terms of the biological process of fertilisation, implantation and cellular division, but also in terms of the developing consciousness of the mother and her relationship to the child. Given that in Christian theology the understanding of personhood is fundamentally relational because it bears the image of the triune God, it is hard to see how an embryo can be deemed a person before even the mother enters into a rudimentary relationship with it. As many as one in four pregnancies may spontaneously abort during the first eight weeks of pregnancy, often without the woman knowing that she was pregnant. It is morally nonsensical to attribute personhood to the contents of the womb in such situations and, as some Catholic ethicists point out, the logical corollary of this position is that a woman should baptise every menstrual period – just in case.

As a result of abandoning the distinction between early and late abortion, modern Catholicism has become the most absolutist of the world’s religions on this issue. Both Islam and Judaism teach that the life of a woman always takes precedence over that of the unborn child. In less clear-cut situations, they adopt casuistic approaches in which principled opposition to abortion is weighed against particular circumstances, at least in the early stages of pregnancy. So, for example, a fatwa was issued which allowed Muslim victims of the Serbian rape camps to have early abortions. This casuistic method of moral reasoning has much in common with the pre-modern Catholic tradition.

It is right that the Church should be a voice of conscience which speaks out against the commodification of human life, and this must include a concern for abortion. Britain’s abortion rates remain unacceptably high – even although there has been a downward trend in recent years – and it is hard not to conclude that abortion is sometimes used as a form of contraception. This does not, however, lend support to those who argue that contraception is responsible for high abortion rates. Statistics show that, when women have ready access to contraception and abortion laws are liberal, as in northern and western Europe, abortion rates are lower than in the largely Catholic countries of Central and South America, despite the fact that abortion in such countries is often illegal and poses a significant risk to a woman’s life. If the Catholic hierarchy seeks to defend the dignity of all human life – including women’s lives – it would do well to pay more attention to what actually works and what does not work in terms of reducing the incidence of maternal mortality and abortion. In this respect, it is regrettable that Pope Benedict XVI’s most recent encyclical, Caritas in Veritate, refers repeatedly to issues of reproduction and abortion but it makes no mention at all of maternal mortality, despite the fact that nearly 350,000 women die every year of childbirth-related causes, 99% of them in the world’s poorest countries. An estimated 60,000 of these are abortion-related deaths. This suggests that outlawing abortion, far from saving lives, drives desperate women to risk their own lives rather than continuing with unwanted pregnancies.

These are complex issues and they do not lend themselves to easy answers. However, not least among the many challenges facing the Catholic hierarchy is the urgent need to respect the moral authority of women themselves in these areas. It is unacceptable in today’s world that a religious hierarchy made up exclusively of celibate men should claim the right to make authoritative decisions regarding these most intimate areas of women’s lives. If it is to have any moral credibility in the modern world, the magisterium must include women theologians and ethicists in the formulation of its teachings and doctrines.

To acknowledge that there are cases when early abortion is the lesser of two evils is not to be pro-abortion, any more than to acknowledge that sometimes war may be a necessary evil means that one is pro-war. There is a pro-life position which refuses all forms of violence, including abortion and war, and it finds near-unanimous support in the very early Christian tradition. If one really believes that the intentional taking of innocent life is never permitted, then surely one must be pacifist as well as anti-abortion, given that the methods of modern warfare mean that the vast majority of casualties of war are now civilians? This pro-life position also entails a commitment to martyrdom if necessary – the martyrdom of a woman who accepts a pregnancy which poses a potentially deadly threat to her own life, or the martyrdom of a person who chooses to die rather than kill when confronted by an aggressor. But martyrdom cannot be imposed, it has to be willingly accepted, and to insist that the life of a young mother of four existing children should be sacrificed to preserve an eleven week foetus would strike many as a particularly brutal form of imposed martyrdom. There has to be greater wisdom and compassion in the ways in which the Catholic hierarchy responds to the kind of moral dilemmas faced by Sister Margaret and her colleagues.