It was one of those small shocks that come unexpectedly in the wake of a death. Just days after the country had buried Ted Kennedy, Cardinal Sean O'Malley took to his blog to defend himself from critics attacking him for presiding over the funeral of a pro-choice senator.

The cardinal called for civility and then went on to explain how he'd used the occasion to lobby one of the mourners: the president of the United States. He told Barack Obama that, yes, the Catholic bishops wanted universal health care but "we will not support a plan that will include a provision for abortion or could open the way to abortions in the future."

Is there an etiquette for lobbying at a funeral? Unseemly is too mild a word. This politicking during a national outpouring of loss for the last of the Kennedy brothers, a time when tens of thousands of Americans of every religion lined up to say their farewells, was a warning sign.

The Conference of Catholic Bishops was ready and willing to scuttle their longtime support for universal health care in order to roll back women's access to abortion. They were prepared to make common cause with Republicans whose only interest was to defeat Obama.

Out went the careful construction of a congressional bill that was written to be "abortion-neutral." Out went months of careful negotiation. Under intense pressure led by the bishops, a last-minute maneuver forced many in the House of Representatives to choose between a bill that left reproductive health on the cutting room floor or no bill at all.

So, with the Stupak-Pitts amendment hanging from it like an albatross, a bill was passed that would cover millions of uninsured Americans but also strip millions of American women of reproductive health converge. To the uncompromising went the victory.

Is this how it goes these days? By Monday, the president who had campaigned saying that "reproductive care is essential care" was back reminding legislators that "this is a health care bill, not an abortion bill." Some senators were insisting that cooler heads would prevail in their chamber.

But the balance and the burden shifted. It's now abortion rights supporters being told they must make further concessions or lose health care reform.

If pro-choice Democrats turn back reproductive rights, it proves that they can be rolled by intransigent opposition. And once rolled, it's all downhill.

If they vote against the bill and it is defeated, they become the allies of those enemies who want Obama to meet his Waterloo. Without health care reform, Obama's momentum slows to a crawl.

Universal health care was the cause of Kennedy's life. Four Democrats are vying for his seat here. The one woman, Attorney General Martha Coakley, said she would vote against any bill that further restricts reproductive rights. Rep. Mike Capuano dismissed her as naive and then flip-flopped into agreement. The other two have said they would reluctantly put reform first.

But it's fair to ask: What would Teddy do? In public, after all, he was best at framing moral issues so that even abortion opponents might feel compelled to put health care at the top of the 'life' list. In private, he was expert at wrestling his colleagues onto common ground.

As Coakley says, "I can't believe that we are now reduced to saying the only way we can get good health care is by taking steps backward on women's rights. It's a false choice."

She's right. Now we'll see if this false choice becomes the final choice.

Ellen Goodman is a columnist for The Boston Globe. Reach her at ellengoodman@globe.com.