Treatment at hospital follows ‘Catholic tradition’
Ahospital policy with wide-ranging consequences for patients of Mercy Medical Center in Des Moines, Iowa, was made public recently through a Facebook post on a page for mothers. It came from a woman who was denied a tubal ligation after having a cesarean section because Mercy is a Catholic hospital.
In verifying that prohibition, I discovered other religious-based restrictions at Mercy and 547 other Catholic hospitals across the U.S., which make up 14.5 percent of all acute care hospitals in the country. It raises a question of whether these institutions are fulfilling their legal and professional obligations to their patients and the taxpayers who subsidize them with billions of dollars.
The information is in a year-old national report by the ACLU and MergerWatch called “Health Care Denied.” Using information from patients and doctors at Catholic hospitals, it concludes women’s lives have been threatened by the refusal to perform certain lifesaving functions such as fetal extraction. It notes cases where patients weren’t even told their baby wouldn’t survive or that they could get an abortion elsewhere.
These positions are spelled out in the Ethical and Religious Directives for Catholic Health Care Services provided by the United States Conference of Catholic Bishops. They include at least 53 stipulations that also bar many infertility treatments and direct doctors to notify patients that certain end-oflife directives may conflict with their Catholic teaching.
“We think women should be in charge of their healthcare decisions,” said Veronica Fowler, spokesperson for the ACLU of Iowa. “Those should not be dictated by a group of religious clergy sitting isolated in a room and deciding what should happen.”
A tubal ligation, a surgical procedure to prevent future pregnancies, is optimally done right after a C-section. But Mercy won’t do them at all without prior approval from a board consisting of two doctors, an obstetrical nurse and the chair of the ethics committee, responsible for ensuring Catholic tradition is maintained.
Catholic hospitals including Mercy also will not provide any birth control whether drugs, sterilization, diaphragms, IUDs or vasectomies, except for reasons other than pregnancy prevention, such as hormone treatments. Medical staff are instructed to educate patients on “the Church’s teaching on responsible parenthood and in methods of natural family planning,” the directive says.
If a woman is miscarrying early in her pregnancy, even if her life is endangered, a fetus with a detectable heartbeat will not be extracted. That’s even if it has no chance of living.
The ACLU says such prohibitions can violate the Emergency Medical Treatment and Active Labor Act, which provides emergency care guidelines for hospitals getting Medicare funding (almost all do). Similar requirements exist under Medicare’s and Medicaid’s conditions for participation.
A statement from the Mercy public relations department said, “Mercy and its subsidiaries have a moral responsibility to provide health-care services that are faithful to the teachings of the Roman Catholic Church, and minister to the good of the whole person. In keeping with our Catholic tradition, Mercy does not provide sterilizations for the purpose of contraception. In circumstances where an expectant mother has serious pathology present, Mercy works with obstetricians to review each case individually.”
It’s not just Catholic hospitals that follow Catholic church policies, but also public hospitals managed by Catholic health systems and historically Catholic hospitals now owned by nonreligious health systems. That’s 1 in 6 hospital beds.
It would be one thing if people were informed about these restrictions. But in Iowa, more than 42 percent of hospital beds are in Catholic hospitals, leaving rural women in particular with few options, according to the American Civil Liberties Union of Iowa. Iowa is one of 10 states where more than a third of hospitals are Catholic.
The number of Catholic hospitals has increased 22 percent since 2001. Fowler says, and I would agree, that the public doesn’t generally know about these prohibitions; in a hemorrhaging situation, women would probably go to the nearest emergency room.
Ideally state and federal lawmakers would pass new laws requiring all taxpayersupported hospitals to comply with best practices in patient care. For now, every health care consumer should at least be informed which hospitals will and won’t honor their wishes.