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Catholic Hospitals By Their Rules Cannot Perform Any Contraceptive Services

In my previous article Religious Employers Must Provide Health Care Plans That Cover Contraceptives, I wrote that faith-based hospitals must not be allowed to endanger the life of patients because of their religious beliefs.

Some of my readers left comments doubting that a Catholic hospital would do such a thing. Reader Brett_McS wrote: "Isn't the issue abortion on demand? I'm pretty sure a Catholic hospital would save the life of a woman if it meant aborting the baby."

Sorry Brett, you may be sure, but you're wrong: the following peer-reviewed article from the American Journal of Public Health (October 2008, Vol 98, No. 10 - full PDF here) documents numerous instances where Catholic hospitals endangered their patients’ lives by refusing life-saving, medically necessary abortions.

Here is the intro to that article:

Lori R. Freedman, PhD, Uta Landy, PhD, and Jody Steinauer, MD, MAS

As Catholic-owned hospitals merge with or take over other facilities, they impose restrictions on reproductive health services, including abortion and contraceptive services. Our interviews with US obstetrician–gynecologists working in Catholic-owned hospitals revealed that they are also restricted in managing miscarriages.

Catholic-owned hospital ethics committees denied approval of uterine evacuation while fetal heart tones were still present, forcing physicians to delay care or transport miscarrying patients to non–Catholic-owned facilities. Some physicians intentionally violated protocol because they felt patient safety was compromised. Although Catholic doctrine officially deems abortion permissible to preserve the life of the woman, Catholic-owned hospital ethics committees differ in their interpretation of how much health risk constitutes a threat to a woman’s life and therefore how much risk must be present before they approve the intervention.



Read the article, physicians they interviewed who worked with or within Catholic-owned hospitals admitted that they were constrained by hospital policies in their ability to undertake urgent uterine evacuation. "They reported that Catholic doctrine, as interpreted by their hospital administrations, interfered with their medical judgment."

What right does a religious committee have to interfere with medical judgment?

Another reader, Bruce Hall wrote:

An interesting concept and an interesting example which presumes that 1) there is no alternative and 2) the hospital would allow the woman and the child to die. It is a perfect red herring argument. 

Can you provide examples where this actually occurred? Oh, anything is possible you say. Certainly, but it is also possible that the Catholic hospital is providing superior health care on a charity basis [which private corporation hospitals might not] that would preclude many life-threatening situations.



As for an alternative, Bruce, once a Catholic hospital merges or buys out the only hospital in town, there is no alternative:

THE PRO-CHOICE ACTION NETWORK, Mergers Mean Less Access to Abortion Services

In the United States, Catholic hospitals have been merging with secular ones in financial trouble. The result? Less access to reproductive health services for thousands of Americans. Between 1990 and 2000, there were 159 such mergers or affiliations. These mergers have often left a Catholic hospital the only game in town. If you want an abortion, or if you’re a rape victim needing the emergency contraceptive pill, too bad. Chances are you won’t get it.

When a secular hospital merges with a Catholic one, about half of the time it is forced to follow the Ethical and Religious Directives for Catholic Health Care Services, established in 1994 by the National Council of Bishops. The Directives deem immoral such services as tubal ligations, vasectomies, contraceptive counselling, and of course, abortions. That means many formally secular hospitals that provided these services are no longer permitted to do so, and patients who relied on those services no longer have access to them. This is a sticky problem when there is no other hospital in town, and getting to the closest one costs time and money many disadvantaged women don’t have.

In 1998, the Catholic Church was the sole provider of emergency medical care in 91 communities in the United States, communities with only an estimated five percent Catholic population.



I know what you are going to say Bruce, why can't the women just get in a cab and ride 90 miles to another hospital. In the PDF cited above, the study reported of such a trip: a 14-week pregnant woman with ruptured membranes was forced by the Catholic Hospital to travel 90 miles to another hospital to receive a life-saving abortion. How nice, isn't Bruce, that there was an alternative - and pardon my sarcasm. Is that an example where Catholic Hospitals provide superior health care? Superior to whom, Vlad the Impaler?

Read the PDF, this isn't just one example of medical brutality towards women for religious reasons.

But aren't there some Catholic Hospitals where emergency abortions are performed? Yes, rare, but see what happens to those poor shlubs who defy Catholic Hospital rules:

NPR, 19 May 2010, Nun Excommunicated For Allowing Abortion


Sister Margaret McBride was excommunicated after allowing an abortion to be performed on a woman who doctors say would otherwise have died.
Sister Margaret McBride was
excommunicated after allowing 
an abortion to be performed on
a woman who doctors say would
otherwise have died.
Last November, a 27-year-old woman was admitted to St. Joseph's Hospital and Medical Center in Phoenix. She was 11 weeks pregnant with her fifth child, and she was gravely ill. According to a hospital document, she had "right heart failure," and her doctors told her that if she continued with the pregnancy, her risk of mortality was "close to 100 percent."

The patient, who was too ill to be moved to the operating room much less another hospital, agreed to an abortion. But there was a complication: She was at a Catholic hospital.

"They were in quite a dilemma," says Lisa Sowle Cahill, who teaches Catholic 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."

But the hospital felt it could proceed because of an exception — called Directive 47 in the U.S. Catholic Church's ethical guidelines for health care providers — that allows, in some circumstance, procedures that could kill the fetus to save the mother. Sister Margaret McBride, who was an administrator at the hospital as well as its liaison to the diocese, gave her approval.

The woman survived. When Bishop Thomas J. Olmsted heard about the abortion, he declared that McBride was automatically excommunicated — the most serious penalty the church can levy. 



That should put a chill in any Catholic's heart.

By the way, the woman has to have an almost 100% chance of dying without an emergency abortion in order for Directive 47 to kick in. Poor women who only have a 50-50 chance of dying will just have to find another hospital - if it's not too late or too far away.

Did you read that Bruce? "The official church position would mandate that the correct solution would be to let both the mother and the child die." Superior health care my ass.

I know Bruce, perhaps the NPR article is misrepresenting the Church position. Okay, let's hear it directly from the horse's mouth, from Father John Ehrich, the Medical Ethics Director for the Diocese of Phoenix: "abortion “can never be justified under any circumstance,” including situations that threaten the pregnant woman’s life, or in cases of rape or incest. In Ehrich’s view, pregnant women should embrace death rather than “having to live the rest of her existence knowing that she had an abortion.” From his article Catholic Morality and Pregnant Mothers Who are at Risk (2010) PDF. So much for red herrings.

Because there is such a thing as the Ethical and Religious Directives for Catholic Health Care Services, I would fight any effort to ever allow a Catholic Hospital in my home town.