Peter Baklinski

Physician conscience rights still officially protected in Canada, but increasingly threatened

Peter Baklinski
Peter Baklinski

POWELL RIVER, British Columbia, August 28, 2012 (LifeSiteNews.com) – After the Canadian Medical Association (CMA) voted two weeks ago to support the wording of the country’s Criminal Code which states that a baby becomes a “human being” only after being born, LifeSiteNews decided to track down where the CMA stands with regard to conscious rights for doctors who believe that babies are human before being born and want nothing to do with abortion.

CMA’s current 1988 policy for “induced abortion” in relation to doctors states that a physician “whose moral or religious beliefs prevent him or her from recommending or performing an abortion should inform the patient of this so that she may consult another physician.”

The CMA policy moreover clarifies that “no discrimination should be directed against doctors who do not perform or assist at induced abortions. Respect for the right of personal decision in this area must be stressed, particularly for doctors training in obstetrics and gynecology, and anesthesia.”

While the written policy sounds like it does protect pro-life physicians, LifeSiteNews contacted Sean Murphy, administrator for the Protection of Conscience Project (PCP), to find out more about how the policy is applied in practice, and about freedom of conscience for physicians in general in Canada.

LSN: Even the CMA, which holds rigorous views on abortion, still believes in conscience rights, but not completely. In 2007, Jeff Blackmer, executive director of the Office of Ethics for the CMA, wrote a piece titled “Clarification of the CMA’s position concerning induced abortion” wherein he states that a doctor “should not interfere in any way with this patient’s right to obtain the abortion. At the patient’s request, you [the doctor] should also indicate alternative sources where she might obtain a referral.”

PCP: This statement was published because of a controversy that erupted over a 2006 guest editorial in the CMA Journal by Professor Jocelyn Downie of Dalhousie University and Sanda Rogers of the University of Ottawa. They claimed that physicians were obliged to refer for abortion. Responses from the CPC and others are here.

Dr. Blackmer’s statement is not considered an assertion that physicians are obliged to refer for abortion. It would be sufficient for a physician to indicate that if the patient wished to pursue the matter she could contact other physicians or the College of Physicians and surgeons, or consult a telephone book. In my experience, physicians who object to referral for reasons of conscience (not all do) do not normally object to providing this kind of information.

In June, 1977, the CMA revised its Code of Ethics to include a clause that imposed an obligation to refer for morally contested procedures (abortion was not specifically named). The clause was removed the following year because of opposition from CMA members. David Williams, then CMA director of ethics, told me in 2000 that the policy was dropped because there was no ethical consensus to support it. Nothing has changed in this respect.

The issue of referral has appropriately been described as an intractable problem by Holly Fernandez-Lynch in Conflicts of Conscience in Health Care: An Institutional Compromise. See the PCP review here. It was highly controversial for the CMA in 1977, and it still is. Indeed, given Carter v Canada, [a case that recently legalized euthanasia and assisted suicide in Canada but was appealed by the government of Canada] it may become even more controversial. (see below)

LSN: How do you see the state of conscience rights for doctors in Canada?

PCP: ‘Rights’ language is problematic for a number of reasons, not the least of which is the use of rights language to justify ethical aggression and ethical cleansing of professions. The issue is better expressed in terms of fundamental human freedom.

The situation is precarious because much depends upon the attitude of the legal and human rights establishment, which both appear to be developing attitudes that are increasingly hostile to the exercise of freedom of conscience when the exercise expresses what might be termed politically incorrect views.

The underlying problem is disagreement about the nature of human rights. The foundational problem is disagreement about the nature of the human person.

Physicians are in a better position to defend their fundamental freedoms than most other health care workers because of their professional dominance and relative independence. A physician who has completed the educational and regulatory requirements for practice can, if need be, begin to practise independently. A qualified nurse, on the other hand, must find an employer in order to work, and remains dependent on an employer in order to continue to work and advance in the profession. Pharmacists are similarly disadvantaged.

LSN: Do you see an erosion happening with regard to conscience rights for doctors in Canada?

PCP: This is difficult to assess because factors that can contribute to erosion may operate out of the public eye: in law schools, in committees of Colleges of Physicians or associations, in seminars or meetings of ‘rights’ groups, and in government bureaucracies.

For example:

• Prof. Sanda Rogers was reported to have told a class at the University of Ottawa on 28 October, 2004, that a physician is required by law to refer patients for abortion, even if the physician objects to the procedure for reasons of conscience. The Dean of the Faculty of Medicine denied that the statement was made. However, the CMA Journal editorial she co-authored with Jocelyn Downie in 2006 appears to reflect the position attributed to her two years earlier. We do not know how often this kind of statement is made in post-secondary classrooms across the country.

• In 2008, the Ontario College of Physicians and Surgeons very nearly adopted a policy to prohibit physicians in the province from acting on their moral, ethical or religious beliefs. This was the result of pressure from the Ontario Human Rights Commission.

Most physicians in the province were unaware that this was happening until the day before the deadline for comment on the policy. The PCP issued a news release and alerted its contacts after being called by a physician who discovered the draft policy by accident.

The resulting uproar forced the College to backpedal somewhat. However, its revised draft was completed before the deadline for public consultation had expired, and the College refused to release the revised draft until the eve of the Council meeting that was to consider it, effectively precluding further critical comment on the document that the Council was to consider. Despite calls from the Ontario Medical Association and the PCP to postpone the vote, the policy was adopted. The most blatantly provocative sections were removed, but the amended policy is less than satisfactory.

• Another important consideration is the potential effect of Carter v. Canada, the BC Supreme Court judgement that proposes to legalize physician assisted suicide and therapeutic homicide (the term used by a CMA Journal editorial). The Royal Society of Canada “expert panel” on euthanasia and assisted suicide recommended that objecting physicians be forced to refer for the procedures. Three of the authors of that report were witnesses for the plaintiffs in Carter v. Canada, and a fourth, Joceyln Downie, instructed the plaintiffs’ expert witnesses. 

As noted above, Downie has long been a proponent of compulsory referral for abortion. The PCP does not take a position on the morality or desirability of assisted suicide or therapeutic homicide, but is concerned that legalization of the procedures would threaten freedom of conscience for health care workers. A response to the judgement from the CPC dealing with this issue is in preparation.

LSN: Do we need laws that affirm conscience rights? If so, what should those laws look like?

PCP: Yes, we need laws that affirm conscience rights. Laws can be general or procedure-specific. There are advantages and disadvantages to both approaches. See the Model Statute on the PCP website and examples of other proposed or existing legislation.

LSN: What can a doctor do to keep his job who has made the decision to be no part of a process that ends the life of a child in the womb?

PCP: It is a serious mistake to confine concerns about freedom of conscience to abortion.

• In the case of a morally contested procedure or service, an objecting physician should first ensure that he has a solid understanding of the essential facts concerning it, based on sound science and the latest reliable research.

• Academic discipline requires an ability to distinguish between what lies within the province of science and what lies elsewhere. “Personhood,” for example, can have distinctive philosophical or legal meanings, but it is not a scientific concept at all. Whether or not something “ought” to be done is a subject for philosophy, religion, or ethics - not science. Keeping clear about this is essential for good communication with patients and colleagues.

• Obtain copies of the policies of regulatory and licensing authorities and study them. Do not ignore the policies of specialist associations that may have considerable influence in setting ‘standards of care.’

• Some objectors encounter problems primarily because of the way they communicate with patients, colleagues or others. If it is necessary to explain your position, it must be done so in a way that refers to your own moral responsibility, not that of the patient or colleague. Avoid expressions that impute wrongdoing to others or that might come across as “preaching”.

• Conscientious objection is likely to make colleagues who do not share your views uncomfortable because it implies that what they are doing is wrong. It is unwise to increase their discomfort by making statements that will be perceived as questioning their moral judgement, as they are then likely to become hostile. Take note of their discomfort - “You seem troubled/ disturbed/surprised” and invite dialogue - “Have I offended you?”

• In addition to discomfort, you may encounter a belligerent challenge, contempt or condescension. If you are taken by surprise or become flustered, no harm is done by admitting the fact and suggesting that time should be made for an uninterrupted chat.

• Don’t rush into what might prove to be a contentious discussion simply to counter an offensive or ill-timed remark. Everyone will benefit if even a few minutes is taken to reflect and relax.

• Resist the urge to explain or defend yourself. Instead, ask your interlocutor to explain his concerns. Listen carefully, and ask questions, not to challenge his views, but to clarify the issues and identify any unexamined presuppositions that are governing his approach to them.

• There is no point exasperating a colleague by attempting to argue from incorrect assumptions about what he knows or believes. Let him tell you. Identify points of agreement and points of contention, and work together from there.

• The notion of working together with your critic is important. The goal is authentic and respectful communication, even if it involves serious argument and fundamental disagreements.

• If you are uncertain about how to reply to facts or an argument presented by your critic, you should simply admit it and promise to continue the discussion after you have had time to think further about it or research the problem. Offer your critic the same courtesy, unasked for, if need be. There is no need to resolve everything at once. In fact, it may prove difficult to resolve even preliminary matters in the first encounter.

• Long before a crisis looms you should seek the fellowship of students and professionals from other religious traditions (or none) who have a common interest in securing freedom of conscience in health care. You may be surprised to find that someone from a completely different faith and culture is more supportive of your views than a co-religionist who lives down the street.

Dr. Will Johnston, president of Canadian Physicians for Life recently told LifeSiteNews that Canadian doctors who want a “serious alternative” to the conversation provided by the CMA “can find it in Canadian Physicians for Life.”

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Cardinal Renato Martino
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Church doctrine on marriage ‘cannot change’, but some bishops will try: Cardinal Martino

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By Hilary White

In a lengthy interview in an Italian Catholic paper, a former Vatican ambassador to the UN has said that any change to the Catholic doctrines surrounding marriage and sexuality is impossible. Cardinal Renato Martino has joined an impressive list of high-ranking prelates to say that the Synod cannot alter Catholic doctrine.

The cardinal told La Nuova Bussola Quotidiana there will “certainly” be presentations from bishops at the Synod “that do not correspond with the doctrine of the Church, but in the end, it will not be able but to reaffirm what the Church has always said about the family.”

“The Church cannot change what it has always proclaimed,” said Martino, a veteran of many battles to defend the unborn and the natural family at the international level.

“I believe that the Synod will be an opportunity to throw down the challenge – the Church’s traditional teaching on the family will be made clear,” the cardinal said.

He said he is “tranquil” as to the outcome of the Synod, which normally results in an apostolic exhortation, written in the name of the pope, but expressing the opinion of the assembled bishops.

A meeting of cardinals in February sparked an ongoing uproar throughout the Church when Cardinal Walter Kasper, who had been hand picked by Pope Francis to present the keynote address, suggested a “solution” for Catholics who are divorced and civilly remarried, to allow them to return to the reception of Communion without changing their lifestyles.

The Church, however, has always taught, in keeping with the words of Jesus in the Gospel, that marriage is a permanent state that can only be dissolved by the death of one of the spouses. A civilly remarried person is, in the eyes of the Church, in a state of mortal sin as an adulterer, and cannot receive Communion until he has repented and received the sacrament of reconciliation. The suggestion has since been furiously denounced by leading prelates as impossible and a “solution” that would be disastrous for both the Church and for the spiritual state of the Catholics involved.

Martino affirmed that he knows the pope well, saying, “I believe that Francis is a lot like John Paul II, in faithfulness to the Church’s teaching. For Francis, the family is fundamental too. Moreover, a Pope cannot do new things, never before heard of. It is only the style that changes, but the doctrine is what it is and the pope must proclaim it.” 

Catholic teaching and Catholic practice are two different matters, however, and some are expressing concerns that a de facto change could be achieved simply by attrition. Patrick Archbold, a Catholic blogger and columnist for the National Catholic Register, warned that the application of the teaching is likely to be left in the hands of the very bishops and national conferences who have been agitating for change.

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Archbold expressed fears, coming from many quarters, that the Synod could easily be a replay of the debacle over the Church’s teaching on contraception. In 1968, Pope Paul VI clearly laid out the doctrine on birth control in the encyclical Humanae Vitae, but it was ignored and undermined in practice by bishops at the local level for the next five decades, with the pulpits remaining silent as the Sexual Revolution charged forward.

Archbold writes at his blog, Creative Minority Report, “When introducing doctrine-undermining change into the Church, the last thing you want is to be clear that is what you are doing.”

Instead of any explicit departure from the Church’s teaching, he said he expects a document that will “include language about the pastoral care of souls in troubled situations, but it will be generally orthodox.”

“But at some point…they will recommend the Bishops conferences to study and implement pastoral guidelines to help those in this situation.” These are the same bishops conferences, he said, who have made laxity in teaching on sexual morals the norm throughout the Church.

He expects, “No mandate, no direct assertions on what to do, but just a call for Bishop conferences to study the problem and implement pastoral practices in line with the synodal documents. That is when the horse will be permanently out of the barn.”

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Gov report: 1,036 ObamaCare plans illegally fund abortions

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By Dustin Siggins

Co-written by Ben Johnson

An internal government watchdog agency has found that – despite promises from President Obama and legal language in the Affordable Care Act (ACA) – some 1,036 ObamaCare insurance plans are illegally paying for elective abortions.

The Affordable Care Act requires that insurance companies take up a separate, $1 surcharge to cover abortion. However, the majority of the issuers examined by GAO violate the payment structure, and use federal health care subsidies to cover elective abortions.

“Every ObamaCare taxpayer subsidized health insurance plan in New Jersey, Connecticut, Vermont, Rhode Island and Hawaii pays for abortion-on-demand,” said the office of Congressman Chris Smith, R-NJ, the co-chairman of the Bipartisan Congressional Pro-Life Caucus.

On Monday, the Government Accountability Office (GAO) reported that out of 18 insurance issuers it sampled for the report, 15 "indicated that the benefit [of abortion] is not subject to any restrictions, limitations, or exclusions." The issuers provide "nearly one-quarter of [qualified health plans] covering non-excepted abortion services" in 28 states that do not restrict abortion coverage via health insurance plans more than the ACA.

The pro-life movement expressed outrage at the violation of the law.

Mary Harned, staff counsel for Americans United for Life (AUL), said that the ACA's language "is unambiguous – 'separate payments' are required. Yet insurance issuers are not collecting separate payments. In fact, the Obama administration is telling issuers that they do not need to collect two checks. When issuers seek guidance from the Centers for Medicare & Medicaid Services (CMS), they are told that they can merely itemize the amount of a premium that will be used to pay for abortions."

The Department of Health & Human Services (HHS) responded to the GAO's revelation by saying it will try to offer clearer explanations of the rules.

But Harned said the government is deliberately allowing states to skirt the law. "GAO uncovered evidence that at least one state department of insurance was unaware that issuers needed to file their plans for segregating the abortion premium from taxpayer funds with the state. At least two issuers indicated that they had not filed segregation plans, and at least one was not aware of any direction by the state to file such a plan.”

Americans should not have to finance abortion unwittingly through their insurance premiums, pro-life leaders said – a fact already codified into law.

“The American people should not be forced to purchase an Obamacare health care plan before they are able to find out what is in it,” said Tony Perkins, president of the Family Research Council. “Americans should not be forced to play a game of moral Russian roulette when they select a health care plan.”

Susan B. Anthony List president Marjorie Dannenfelser said that “ObamaCare breaks from the long tradition of the Hyde Amendment, which has prevented taxpayer funding of abortion with broad public support, and was not included in the law.”

She added that the disclosure proves that several vulnerable Democratic senators "voted for taxpayer funding of abortion in ObamaCare."

National Right to Life Committee Legislative Director Douglas Johnson agreed, “Those really responsible for this scandal are the lawmakers, such as Mary Landrieu of Louisiana, Kay Hagan of North Carolina, Mark Begich of Alaska, and Mark Udall of Colorado, who voted against the pro-life amendment that would have prevented this massive federal funding of abortion-covering plans, as well as those who voted to enact the bill after the amendment was rejected, such as Mark Pryor of Arkansas.”

Dannenfelser, Perkins, and others says that Congress should correct this situation by passing the "No Taxpayer Founding of Abortion Act," introduced by Congressman Smith.

In a series of statements, Republican House leaders condemned the government funding of abortion.

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House Speaker John Boehner said that the Obama administration “repeatedly denied congressional requests for its public release.”

House Majority Whip Steve Scalise of Louisiana said, "Many of us argued at the time ObamaCare passed that it would funnel taxpayer dollars to elective abortions, despite President Obama’s repeated broken promises to the contrary. This independent report validates our claims and proves that yet another ObamaCare promise has been broken.”

He called the news "the most recent in a string of ObamaCare broken promises to the American people."

The Obama administration has side-stepped the issue of which ObamaCare plans fund abortion since the passage of the ACA. Last October, and again in December, then-HHS Secretary Kathleen Sebelius was grilled by pro-life Congressmen about whether Americans would be able to determine if their insurance plan funds abortion.

“I don’t know," Sebelius answered. "I know exactly the issue you’re talking about. I will check and make sure that is clearly identifiable.”

Penny Nance, president of Concerned Women for America, said, “For a president who claims to pursue the most transparent administration, he continues to reject calls to shed light on what exactly is in plans on the health care exchange.”

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Lisa Bourne

Catholic Relief Services: We’re ‘proud’ that we don’t discuss faith

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By Lisa Bourne

While some pro-life activists are criticizing Catholic Relief Services (CRS) after a high-ranking executive said last month that the agency is “proud” they do not discuss faith with the people they serve, CRS itself is defending the statement, saying it was misinterpreted. 

The controversy began when Bill O’Keefe, CRS’ vice-president for government relations and advocacy, told CNN’s Belief Blog, “We assist people of all backgrounds and religions and we do not attempt to engage in discussions of faith."

“We’re proud of that. We like to say that we assist everybody because we’re Catholic, we don’t assist people to become Catholic,” he added in the August 9 piece.

“We assist people of all backgrounds and religions and we do not attempt to engage in discussions of faith."

The statement drew criticism from Catholic pro-life and pro-family groups, who said the comments are another sign that the U.S. Bishops’ foreign relief agency has shed its Catholic identity and effectively operates as a secular NGO.

“How great is it that Catholic Relief Services is serving the poor and marginalized in dangerous areas of the world,” Father Shenan Boquet, president of Human Life International, told LifeSiteNews. “Yet how sad that CRS spokespeople again boast that they do not preach the Gospel love of Jesus Christ, as a matter of policy.”

“This is so radically out of line with what Pope Francis has repeatedly said,” Father Boquet added, “and is something that Pope Benedict warned against in both Deus Caritas est and Caritas in Veritate.”

“For CRS to be ‘proud’ of the fact that it doesn't evangelize may help it to get grants from the federal government," said Steven Mosher, president of Population Research Institute. "After all, such activities are specifically forbidden to federal grantees. But it is an abdication of their responsibility as Catholics - really everyone's responsibility as Catholics - to spread the Gospel."

Michael Hichborn, director of American Life League’s Defend the Faith project, agreed.

“The bottom line is that there can be no division between charity and the work of evangelism,” he said.  “But CRS just stated that it is ‘proudly’ doing just that.”

Hichborn told LifeSiteNews he believes the statement highlights the fact that for CRS social works supersede evangelization.  

But in reality, he argued, charitable works “are the loving tools by which we evangelize. Any act to divorce evangelization from works of charity neuters the Church and relegates charity to mere philanthropy. Catholic Relief Services, by their own admission, is content to feed bodies and starve souls."

CRS responds to criticisms

Paul Eagle, CRS’ communications director, suggested that O'Keefe's statement was misunderstood, telling LifeSiteNews that their work is a clear example of not proselytizing, but preaching the Gospel through works.

“We are indeed proud that we witness the Church’s mission and the call of the Gospel to care for those in need, regardless of who they are or what they believe, through the work that CRS does every day,” he said. “This is a central part of the Church’s evangelizing mission, but it does not include proselytizing or requiring that people become Catholic to receive our assistance.”

Eagle told LifeSiteNews that CRS follows St. Francis of Assisi, who has been reflected in the leadership of Pope Francis. He pointed to a famous quotation that is often attributed to St. Francis, which goes, "Preach the Gospel at all times. When necessary, use words."

“Our work is a clear example of not proselytizing, but preaching the Gospel through what we do,” Eagle said.

Eagle directed LifeSiteNews to a CRS web page which states that CRS “rejoices in” the encyclical Caritas in Veritate, and has grown in a deeper understanding of its mission through study and reflection on Benedict’s earlier encyclicals Deus Caritas Est and Spe Salvi

Eagle also pointed to the CRS initiative, “Impact Investing,” saying it contains a response to Pope Francis’ Evangelii Gaudium.

Pro-life critics cite papal support

But Father Boquet said a policy banning discussions of faith or preaching the Gospel is clearly opposed to Catholic teaching on charity.

“This is a radical departure from how the Church has always understood her essential charitable and missionary work,” he said.

He quoted Pope Francis in his first homily as pope: “We can walk as much as we want, we can build many things, but if we do not profess Jesus Christ, things go wrong. We may become a charitable NGO, but not the Church, the Bride of the Lord,” the pope said.

Pope Francis has repeated this theme several times, most recently in June of this year, said Father Boquet. At that time, “he said that the Church cannot just be a ‘well organized NGO,’ or just some institution with people who are ‘fans’ of being Catholic.”

Boquet and the other pro-life critics pointed out that several recent popes have written at length on the need for evangelization to remain at the heart of its charitable work.

“This is a radical departure from how the Church has always understood her essential charitable and missionary work."

In Evangelii Nuntiandi Pope Paul VI wrote that generous Christians are often tempted to reduce the Church’s mission to the realm of the temporal, downgrading it to be man-centered. The Holy Father said in that document that this reduction to a focus on material well-being would mean the Church would lose her fundamental meaning.

Pope Benedict XVI echoed this teaching in Deus Caritas Est, stating, "The entire activity of the Church is an expression of a love that seeks the integral good of man: it seeks his evangelization through Word and Sacrament."

In Caritas in Veritate, Pope Benedict cited Pope Paul VI, writing that Christian charity is “part and parcel of evangelization,” because, “Jesus Christ, who loves us, is concerned with the whole person.”

Many CRS employees not Catholic

Mosher also highlighted Pope Benedict’s motu proprio titled ‘On the Service of Charity,’ which he said “is quite clear in that the work of Catholic charities should be grounded in the Mass and the Sacraments, which implies evangelization.”

The CNN Belief Blog article also reported that CRS “doesn't even like” to be labeled missionary because of the word's association with evangelizing, stating:

Though Catholic Relief Services says it is motivated by the Gospel to embody Catholic social and moral teaching, it does not preach to the people it helps.

In fact, you don't even have to be Catholic to work for Catholic Relief Services. Among its 4,500 workers are many Muslims, Hindus and members of other religions, said Bill O’Keefe, the organization’s vice president of advocacy.

Eagle told LifeSiteNews CRS is proud as a Catholic agency that it works collaboratively with all people regardless of faith, which is especially important in communities where the majority of people are not Catholic.

He added that CRS takes steps to ensure Catholic identity in preparing employees for work with CRS, referencing a tutorial, "Protecting Life,” which was reviewed by the USCCB.

At the same time, experience has shown that what CRS cannot account for is the personal opinions of its non-Catholic employees, which, according to Mosher, inevitably affect the way they perform their jobs. A May 2014 LifeSiteNews article reported on public campaign records showing that since 1990 CRS employees have donated tens of thousands of dollars, 98.1 percent of their political donations, to elect pro-abortion politicians to office.

LifeSiteNews has also reported on the fact that numerous CRS employees in key policy positions have in previous jobs advocated for activities that violate Church teaching.

For example, Daphyne Williams, who has worked for CRS since 2008 and helped to develop a controversial policy whereby CRS would provide “complete and accurate” information on condoms, was hired after working at a series of pro-abortion organizations. One, which she listed on her LinkedIn page until LifeSiteNews reported on it in 2012, was called Pro-Choice Resources.

In another more dramatic case, a CRS employee was charged and convicted after deliberately ramming her car into a crowd of pro-life activists at the March for Life.

“As far as the claim that they somehow ‘evangelize’ by not preaching the Gospel, by not hiring Catholics … this simply makes no sense,” Mosher told LifeSiteNews.

“They say that ‘they help people because they're Catholic.’ But CRS employees, including very senior employees, are often - as the organization itself proudly admits - not Catholic at all,” said Mosher. “So it is hard to take this defense seriously.” 

Mosher said that statements indicating CRS is proud that is does not evangelize raise the question of whether CRS's donors are being defrauded by an organization that claims to be "Catholic," but distances itself from the Church in its actual programs and practices.

“If Catholic Relief Services is not going to hire practicing Catholics, work through the local Catholic Church around the world, and preferentially serve Catholic populations,” Mosher said, “then it has no business calling itself ‘Catholic.’ For it is not. It is just another humanitarian NGO which can make no special claim on Catholics.”

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