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Are Catholic hospitals bad for women's health? ACLU says yes.

December 18, 2013|Robin Abcarian
  • Demonstrators gather outside Hoag Hospital to celebrate its decision to halt elective abortions at the hospital in Newport Beach on June 20, 2013. Hoag's decision was announced after it partnered with a Catholic healthcare provider, though the administrators said the policy change on abortion was a business move by a hospital that performs fewer than 100 such procedures a year.
Demonstrators gather outside Hoag Hospital to celebrate its decision… (Allen J. Schaben / Los Angeles…)

A word of caution: If you are a woman of child-bearing age, Catholic hospitals may be hazardous to your health.


Because Catholic-affiliated hospitals, which now account for one of every nine acute-care hospital beds in the country, aren’t allowed to provide the medically accepted standard of care if it conflicts with Catholic teachings.

This can include denying a rape victim morning-after pills. Or refusing to give abortions for ectopic or molar pregnancies, which are not viable and may threaten the mother’s health or life. Or refusing to perform tubal ligations during cesarean sections, even when a future pregnancy could put a woman’s life at risk.

“My biggest concern is that the facilities have religious directives rather than medical standards governing care in some instances, and that patients don’t know that,” said ACLU Deputy Legal Director Louise Melling, co-author of a new study raising alarms about Catholic health systems. “The size and scope of the Catholic hospital system isn’t known to many people, and many don’t understand the restrictions that are in play once they step through those doors.”

“Miscarriage of Medicine: The Growth of Catholic Hospitals and the Threat to Reproductive Health Care,” a joint effort of the ACLU and the MergerWatch Project, echoes other reports about the expansion in the last decade of Catholic-affiliated hospital systems, which now account for 10 of the 25 largest health systems in the country, and impose religious standards after acquiring secular hospitals. In Washington state, the report notes, more than a quarter of hospitals are Catholic-affiliated, leaving “entire geographic regions” dependent on institutions that put religious imperatives first.

“As more hospitals are governed by Catholic doctrine,” says the report, “we expect to see more women denied appropriate care.”

Billions of dollars of public funds flow to Catholic hospitals from federal coffers in the form of Medicaid and Medicare payments, subjecting them to federal rules that govern patient treatment, including stipulations that patients must be informed of all options for their care. Yet the U.S. Conference of Catholic Bishops forbids its hospitals to offer care, referrals or even information in situations where a woman might opt for an abortion after rape, incest or to save her life.

The rules are contained in a document known as the “Ethical and Religious Directives for Catholic Health Care Services.”

The directives make a distinction between “direct” abortion, which is never permitted, and an “indirect” abortion, which is.

For instance, a pregnant woman with uterine cancer may have a hysterectomy to save her life even if she’s pregnant. The fetus’ death is a byproduct of treatment not related to the pregnancy and therefore the abortion is "indirect."

But if the pregnancy is, say, causing organ failure, doctors may not perform an abortion, because the fetus is the direct cause of the medical problem. “A good end cannot justify an evil means,” explained the bishops in a 2010 memo after the Catholic affiliation of a Phoenix hospital was revoked because doctors performed an abortion to save a mother’s life.

Even Catholic hospital doctors say this is bad medicine.

In a survey taken last year, more than half (52%) of OB/GYNs working in Catholic hospitals reported that their employer’s religious policies conflicted with sound medical practice.

“For some physicians, their hospital’s prohibition on abortion initially seemed congruent with their own principles,” wrote Lori Freedman and Debra Stulberg in the American Journal of Bioethics, “but when applied to cases in which patients were already losing a desired pregnancy and/or the patient’s health was at risk, some physicians found the institutional restrictions on care to be unacceptable.”

One recent example of allegedly botched Catholic obstetrical care garnered national attention after the ACLU took the unprecedented step of suing the U.S. Conference of Catholic Bishops for negligence.

The lawsuit was filed last month on behalf of Tamesha Means of Muskegon, Mich., who was 18 weeks pregnant when her water broke. She showed up at her local Catholic hospital and was sent home twice with only Tylenol.

According to the lawsuit, Means was not informed that her pregnancy was no longer viable, nor that she risked infection if an abortion were not performed. During her third trip the emergency room, in the grip of a serious infection, her body expelled the severely premature baby, who soon died.

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