Misericordia et Misera (Mercy with Misery) was a letter written by Pope Francis and published in Rome, Italy, on 20 November 2016. Through the letter, Pope Francis gives priests the ability to grant forgiveness for abortion. Before Pope Francis’s letter, priests had some ability to grant forgiveness for the Catholic sin of abortion, but bishops had to grant that ability to the priests individually. Prior to the letter, the official rules of the Catholic Church did not state that priests could forgive abortion-related sins. The extension provided in the letter did not change the status of abortion as a grave sin that could result in excommunication. By extending that ability to priests, Pope Francis made forgiveness through the Catholic Church more accessible for women, doctors, and those who take part in an abortion, which started a discussion about the status of abortion in the Catholic Church in the twenty-first century.

In 2010, the Catholic Church excommunicated Margaret McBride, a nun and ethics board member at St. Joseph’s Hospital and Medical Center in Phoenix, Arizona. McBride was excommunicated latae sententiae, or automatically, for approving a therapeutic abortion, which is an abortion that is required to save a pregnant woman’s life. McBride approved an abortion for a woman who was twenty-seven years old, eleven weeks pregnant with her fifth child, and suffered from pulmonary hypertension, a life-threatening condition during pregnancy. Following McBride’s decision, St. Joseph’s lost its affiliation with the Catholic Church, which it had maintained since the late 1800s. Affiliation with the Catholic Church required that the hospital abide by Canon Law, which is the law of the Catholic Church. Under Canon Law, abortion is serious wrongdoing that could result in excommunication, as it did in the case of McBride. McBride’s excommunication illustrated the impact that affiliation of Catholicism with hospitals had on patients’ ability to receive comprehensive reproductive health care.

Simone Campbell is a Roman Catholic sister, attorney, and poet who advocated for social justice, especially equal access to healthcare in the US in the twentieth and twenty-first centuries. Campbell worked as a lawyer and served the working poor in California. As of 2018, she works for NETWORK, a lobbying group in Washington DC that focuses on broadening access to healthcare by lowering costs. In response to proposed federal budget cuts that would disproportionately affect the poor, Campbell organized Nuns on the Bus, a group of nuns who traveled across the US to publicize the potential effects of the budget cuts. She also organized the Nun’s Letter that supported the passage of the Affordable Care Act. Campbell advocated for the Affordable Care Act that, once passed, increased access to affordable healthcare for women and children, and started a national dialogue about poverty in America.

In 2013, Lois Uttley, Sheila Reynertson, Larraine Kenny, and Louise Melling published “Miscarriage of Medicine: The Growth of Catholic Hospitals and the Threat to Reproductive Health Care,” in which they analyzed the growth of Catholic hospitals in the United States from 2001 to 2011 and the impact those hospitals had on reproductive health care. In the US, Catholic hospitals are required to abide by the US Catholic Church's Ethical Guidelines for Health Care Providers, also called the Directives. The authors of the article argue that the Directives threaten reproductive health because of their limitations on contraception, sterilization, some infertility treatments, and abortion. The report demonstrated an increase in Catholic hospitals and an associated impact on reproductive health care, which formed the basis for lawsuits the American Civil Liberties Union brought against various Catholic hospitals and health care networks during the early 2000s.

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