Welcome to our chat this evening as we discuss the important issue of Catholic healthcare.

It seems that secular interests are trying to push the Catholic Church out of health care -- with contraceptive mandates in inusrance plans and demands that we refer to abortion in Catholic hospitals. Do you see any signs of hope?

I think there is hope. Take for example the fact that 79 percent of Americans support conscience exemptions on abortion for health care workers, and this includes 64 percent of those who identify as strongly pro-choice. Americans have a great deal of respect for the First Amendment, for religious freedom, and certainly we should work to continue - in word and in deed - to preach the ethical values of the Gospel.

Right now is a very improtant time for Healthcare reform. We have to be particularly vigilant. We need to have conscience protection language and legislation with protections that would not result in mandated coverage for abortion. If we can get that then we have hope.

One of the biggest dangers to Catholic Healthcare is the Freedom of Choice Act. Here thankfully, it has not passed. If it has passed the Archdiocese of Chicago announced that they would close all Catholic Hospitals as a result (pull permission for them to call themselves Catholic, etc.) I can just imagine what would happen on the National level if a Federal FOCA were to be passed. Do you know of anything that the US Bishops would do if this were to happen?

I think that it is very important that Catholics pay attention to the important life issues that confront us as a society. It is our job to build a culture of life, to build a civilization of love, and we must make sure that both on the local level, and on the national level, we are aware of what legislation is being considered, and how it affects Catholics. Then, as informed citizens, and people with well-formed consciences, we must make sure our voice is not absent from the legislative process.

The United States Conference of Catholic Bishops website http://www.usccb.org/prolife/ has information on all issues on respect for life as well as proposed legislation for your review so that you can become informed and involved to advocate for the right legislation.

what have been the most recent, positive advances in the political sphere you've seen regarding health care and conscience?

Nothing recent has been all that positive. The Department of Health and Human Services has indicated that they are moving ahead with the protection of conscience recision that had been adopted by the Bush administration. FOCA has not been introduced, but health care reform legislation still poses a significant threat to Catholic Healthcare.

I do not have a question, but would like to make a commment: Thank you for this excellent book. This has helped me to realize that there is a little more complexity to the issues of Catholic healthcare then the soundbites I hear on television, or the briefs in the newspapers and various blogs. A few years ago I heard a Father Tad of the Bioethics Center speak at a Respect Life Conference. He is an awesome teacher!! I recommend his DVDs that take very complex issues and bring them to a level that everyone can understand. Thanks, again, for this wonderful book.

Thanks so much for your comment. Anything that is published by Father Tad or the National Bioehtics Catholic Center will be very helpful in understanding the issues on Cathiolic healthcare.

The NY Knights go to Albany once a year to lobby about life issues but there seems to be no progress. How do we make progress when lawmakers are so much against us?

I think two things are very important here. First, we must lead by our example as Christians. Second, we must not let our culture tell us that our conscience and belief belongs on the margins. It is important that we bring our well-formed consciences to bear in the public square. Finally, I think it's important to understand that we have made progress, enormous progress, in the area of public opinion. 86% of Americans now support significant restrictions on abortion according to our recent polling. By wide margins Americans don't want abortion covered in the government healthcare proposals, according to two polls. Americans now think abortion hurts a woman more than it helps her. There are many indications that we have reached an important tipping point here, and we should take heart and continue to make sure our voice is heard, because people are hearing it.

You might want to use the website for the National Commitee for Human Life Amendment Action Center http://nchla.org/actiondisplay.asp?ID=276 for important information and an easy way to send email to your senators and representatives.

My question might be a little off topic from the book, but it's something I've struggled with as the debate over health care reform continues. I understand the Church's position on urging universal health care for all people. But how do we balance that -- particularly when we're talking about the proposals now in Congress -- with the principle of subsidiarity? How can the Catholic health system model that balance?

Current proposals don't necessarily align with the principles of subsidiarity. The Catholic Medical Association plan does incorporate the principle. It has a savings account for routine medical expenses with a high deductible that would cover major medical expenses. The policy under their proposal could be offered by an organization that promotes Catholic valules under their insurance plan. Refundable tax credits can be used to move toward universal coverage.

It seems the Catholic stand on contraception is being treated by some legislatures as bizarre and irrational as a religion that refuses blood transfusions because of some strange reading of the Bible. Are Catholic ethics to be relegated to a curiosity -- how come no one you hear has a good explanation on the sin of contraception?

Certainly Pope John Paul II in Evangelium Vitae, and in his theology of the body, and Pope Paul VI in Humanae Vitae, both provided important and compelling reasoning behind the Church's position on contraception. And it is very important, as Pope Benedict XVI made clear in the Czech Republic this past week, that religious liberty be safeguarded. He also said this last year in the United States while at the UN, when he stated that "the rights associated with religion are all the more in need of protection if they are considered to clash with a prevailing secular ideology or with majority religious positions of an exclusive nature."

Unfortunately we live in a culture where certain elites have rejected the notion of absolute moral norms particularly in the area of sexual conduct. Thus any claim that sexual conduct is wrong is rejected by that group as idiosyncratic personal preference or a product of religious fanaticism unworthy of legal protection.

How do you think these issues intersect with the larger issue of a right to freedom of conscience and freedom of religion?

Clearly, the issue of freedom of conscience is critical in this context, and goes beyond it as well. The point of religious freedom and freedom of conscience is precisely to protect a religious view that is not universally held from being pushed aside. This is the reason that freedom of religion is enshrined in the US Constitution, the UN Declaration on Human Rights, OAS statements, etc., and this is the reason that the Catholic Church has been so outspoken on the need for freedom on conscience and freedom of religion.

The attempt to force Catholic institutions to engage in immoral procedures strikes at the heart of religious liberty.

According to the August 21, 2009 edition of the National Catholic Reporter, Cardinal Justin Rigali has "urged that the legislation be amended to assure that it would not become 'a vehicle for promoting an abotion rights agenda'" Aside from prayer and writing to their elective represenatives, are there any other actions Catholics can take to insure that the provisions concerning abortion are not included in the current form of this legislation?

As Pope Benedict said at the United Nations last year: "It is inconceivablehat believers should have to suppress a part of themselves their faith in order to be active citizens. It should never be necessary to deny God in order to enjoy one rights." In other words, it is a part of our duty as citizens to bring our beliefs into the public arena, to educate our fellow citizens, and to make sure our voice is heard.

Elections have consequences. Our focus has to continue to be on prayer and contacting our representatives. Those are the tools we have at our disposal.

What do you think is the best example of Catholic healthcare done right in the United States? How could that be modeled by other Catholic health providers?

There are a number of Catholic hostpitals that follow the Catholic religious ethics and directives. It is difficult to single out specific institutions as part of this particular forum but they do exist.

Are there constitutional grounds for asserting a right of religious conscience? After all, if the court can discover an implied "right to privacy" that covers a right to kill, surely they can find a right to obey one's own conscience.

Surely the First Amendment provides some protections that have not always received the weight they deserve in these discussions. But we should remember that the United States Constitution makes the following quite clear: "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof..." In addition, we have a strong common law tradition in this country, and there is certainly precedent there too for protecting conscience (as there is conscientious objection to fighting in a war for Quakers, for instance). William Blackstone, one the famous commentators on common law and a man to whom the foundational documents of the United States owe a great debt wrote: if any human law should allow or injoin us to commit it [an act contrary to divine or natural law], we are bound to transgress that human law, or else we must offend both the natural and the divine.

Unfortunately recent Supreme Court cases have held that general laws of neutral application are not subject to the compelling state interest test. The religious Freedom Restoration Act passed by Congress would however subject laws resricting religious freedom to such a test. Congress can repeal or modify it at any time. In addition, Congress can require hospitals to perform abortions and sterilizations as a condition of receiving federal funds. This would probably be constitutional even as applied to Catholic hospitals.

Are there countries that do a better job of protecting the rights of conscience that we might use as a model in this debate?

It is worth noting that several international conventions, agreements, and declarations, including the UN Declaration on Human Rights, and the OAS's American Convention on Human Rights have excellent language on these issues. Today, however, there is no absolute standard - even in common law countries - with reference to exemptions on behalf of conscience for medical or pharmacy personnel confronted with issues of conscience. However, in some of these countries laws to protect conscience have been passed, which we might consider as a useful model in one area or another.

The Australian and Britain debates on healthcare provider conscience protections are currently in progress as we are. The bottom line is that the Catholic population has to be engaged and vocal to promote a culture of life to make that critical difference.

Thank you all for joining us this evening as we discussed one of the most pressing issues facing our nation today.