You can’t expect that every hospital will provide all of the medical services you’ll need. Some procedures are so specialized that you might have to travel to get them done. Conversely, some procedures are so basic that any hospital should be able to perform them. And if you’re in danger of dying, it’s to be expected that any hospital would do all it could to save your life.
Sounds pretty simple, right? It should be, but thanks to the hierarchy of the Catholic Church, it’s getting awfully complex.
Last year, a nun who worked as an administrator at St. Joseph’s Hospital in Phoenix, Arizona, was demoted after she signed off on an abortion for a woman who was eleven weeks pregnant and suffering from life-threatening pulmonary hypertension. With the patient’s heart and lungs in jeopardy, doctors determined that ending the pregnancy was the only way to save her life.
Phoenix Bishop Thomas J. Olmsted was furious. Not only did he demote Sister Margaret McBride, he announced that she had automatically excommunicated herself from the Catholic Church by her actions. McBride, an Irish Catholic deeply involved in her church, is no longer eligible to receive sacraments or participate in other forms of church life.
As outrageous as they were, Olmsted’s actions might have done some good. They aimed a spotlight on an issue that is often overlooked: growing sectarian interference in healthcare.
Healthcare has been in the news a lot lately, but much of the discussion has centered on the bill backed by President Barack Obama that Republicans in Congress are trying to repeal. Americans obviously have different opinions about that legislation. We can hope, however, that most Americans don’t support medical decisions being made subservient to religious dogma.
Yet about a fifth of all U.S. hospitals abide by a series of directives promulgated by the U.S. Conference of Catholic Bishops. The directives ban abortions for any reason, forbid distribution of birth control (often including “morning after” pills for rape victims), deny sterilization operations such as vasectomies and tubal ligations, and nullify advanced directives and “living wills” that conflict with Catholic doctrine.
Catholic hospitals impose these narrow doctrinal views—which are so strict that even most American Catholics don’t support them—while receiving a windfall of public support through direct government subsidies and participation in Medicare and Medicaid programs.
Americans are increasingly finding that medical services they took for granted have evaporated as a spate of hospital mergers across the country has subjected many people to the bishops’ directives. Why is this? Because when Catholic hospitals merge with non-Catholic institutions, the latter are required to accept the directives as part of the deal.
Women’s rights groups and advocates of reproductive freedom have been speaking out, but too often their complaints fall on deaf ears. In Montgomery County, Maryland—an affluent suburb of Washington, DC, with a well educated population that leans toward progressive politics—state regulators recently ruled that a Catholic hospital group could build the county’s first new hospital in thirty years. In making this decision, the board bypassed a rival proposal from a group run by the Seventh-day Adventists. Although both groups are religious, the Adventists had promised to provide the full range of reproductive services.
Asked about the lack of reproductive healthcare at the new facility, one hospital regulator blithely said that people who needed those services could go elsewhere.
It’s an all-too-common attitude. When religion and the rights of those in need clash, it’s often religion that trumps. It’s easy for a well-compensated state hospital regulator to imagine driving twenty-five or thirty miles for medical care. For poor people who may rely on public transportation, the prospect can be daunting.
The group MergerWatch (www.mergerwatch.org) works to rally opposition when Catholic hospitals seek to merge with non-Catholic institutions and curtail services. The organization has done great work with limited resources and has won some important victories, but even as it strives to fend off more mergers, the problem of sectarian control of healthcare keeps growing.
Of course the problem spreads beyond hospitals. Pharmacists are increasingly demanding the right to refuse to fill doctors’ prescriptions that violate their religious beliefs. Some states have actually passed laws codifying this alleged “right.”
In Nampa, Idaho, a pharmacist at a Walgreens recently refused to fill a prescription for Methergine, a medicine used to control bleeding of the uterus. The pharmacist insisted that the medication is an abortifacient—a drug that induces abortion—and demanded to know if the patient had had an abortion. She also refused to provide a referral to another pharmacy.
In fact, the drug is often used to control bleeding after childbirth. But whether the patient had had an abortion is irrelevant. The drug had been prescribed by a doctor who believed the patient needed it. The pharmacist’s phony “right” to avoid handling a drug related to abortion (which, by the way, is a legal procedure) doesn’t trump a patient’s much more meaningful right to access life-saving treatment.
In December 2010 the American Civil Liberties Union wrote to federal officials asking them to ensure that religiously affiliated hospitals provide emergency reproductive care to pregnant women. In its letter, the ACLU cited the situation in Phoenix.
“The Bishop’s drastic and heavy-handed actions send a chilling message to Catholic hospitals throughout the country, as well as their employees: If hospitals comply with federal law and provide emergency abortion care there will be consequences,” observed the letter. “The dioceses cannot be permitted to dictate who lives and who dies in Catholic-owned hospitals.”
It seems remarkable that we would come to the point where federal intervention is necessary to ensure that hospitals will provide the necessary care when lives are in danger, but it looks like that’s where we are. The patient in Phoenix is alive today because Sister McBride was willing to risk her job for her. What if the nun had caved in to the bishop’s pressure?
Hospitals are supposed to be in the business of saving lives. Institutions that want to elevate an adherence to narrow dogma over this mission should consider getting out of the healthcare business.
Rob Boston is senior policy analyst at Americans United for Separation of Church and State and a board member of the American Humanist Association.