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A C: She allowed an abortion to be performed on a woman who doctors say would have died if she carried to term.

Her case is prompting some to ask why this nun is being punished so severely while priests who abuse children are not. NPR's Barbara Bradley Hagerty has the story.

BARBARA BRADLEY HAGERTY: On November 3rd, 2009, a woman was admitted to St. Joseph's Hospital in Phoenix. She was 11 weeks pregnant with her fifth child, and she was gravely ill. According to a hospital document, her heart was failing, and her doctors told her that if she continued with the pregnancy, her risk of mortality was, quote, "close to 100 percent."

The doctors recommended an abortion, and the patient agreed. But that created a dilemma for the Catholic hospital, says Lisa Sowle Cahill, who teaches theology at Boston College.

: There was no good way out of it. The official church position would mandate that the correct solution would be to let both the mother and the child die. I think in the practical situation, that would be a very hard choice to make.

BRADLEY HAGERTY: The hospital felt it could proceed because of an exception in Catholic teaching that allows, in some circumstances, treatments that could kill the fetus to save the mother. Sister Margaret McBride, a hospital administrator and its liaison to the Catholic diocese, gave her approval.

The patient survived. But when Bishop Thomas Olmsted heard about the abortion, he declared that Sister McBride was automatically excommunicated, the most serious penalty the church can give.

F: She consented in the murder of an unborn child.

BRADLEY HAGERTY: Father John Ehrich is the medical ethics director for the Diocese of Phoenix.

F: There are some situations where the mother may in fact die along with her child. But - and this is the Catholic perspective - you can't do evil to bring about good. The end does not justify the means.

BRADLEY HAGERTY: He says of course the circumstances of this case were difficult.

F: But there are certain things that we don't really have a choice. You know, I mean, if it's been done, and then there's public scandal, the bishop has to take care of that because he has to say: Look, this can't happen.

F: He clearly had other alternatives than to declare her excommunicated.

BRADLEY HAGERTY: Father Thomas Doyle, a canon lawyer, says the bishop could have looked at the situation, realized that the nun faced an agonizing choice and shown her some mercy. He says this case highlights what he calls a gross inequity in how the church treats scandal. He says no pedophile priests have been excommunicated.

F: In the case of priests who are credibly accused and are known to be guilty of sexually abusing children, they are in a sense let off the hook.

BRADLEY HAGERTY: When priests have been caught, Doyle says, bishops protected them, and it's taken years or decades to defrock them, if ever.

F: Yet in this instance we have a sister who was trying to save the life of this woman, and what happens to her? The bishop swoops down, declares her excommunicated before he even looks at all the facts of the case.

BRADLEY HAGERTY: Father Ehrich of the Phoenix Diocese agrees that abuse cannot be tolerated. But he says neither can Sister McBride's actions.

F: She said: Yes, you can kill that unborn child. That's a heinous act. And I'm not going to make a distinction between what's worse. They're both, you know, abhorrent.

BRADLEY HAGERTY: Father Ehrich says Sister McBride can be admitted back into the Catholic community by going to confession and repenting. She still works at the hospital in another position. And now she's waiting to hear whether she will be expelled from her religious order.

Barbara Bradley Hagerty, NPR News.

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