Jessica Mann lives in Genesee County, Michigan, is eight months pregnant with her third child, and suffers from a brain tumor. Her doctors recommended she undergo tubal ligation surgery during a caesarean section scheduled for October 24 to prevent further risky pregnancies, but the procedure was denied by her Catholic hospital, Genesys Regional Medical Center, because religious mandates forbid it.
Mann routinely receives care and monitoring for her neurological condition, as it can lead to blindness, paralysis, and other impairments. Her second pregnancy was considered high-risk by doctors, which is why she was finally advised to undergo tubal ligation during the upcoming caesarean section. Even with a maternal-fetal-medicine specialist’s recommendation, Genesys denied her request for the procedure. Instead, hospital administrators suggested she have her child at Genesys and undergo a tubal ligation elsewhere. Now, at eight months pregnant, Mann must find a new hospital or have the procedure at a later date—an unnecessary risk equivalent to a fourth pregnancy given her brain cancer.
While the ACLU of Michigan is challenging Genesys on Mann’s behalf, she struggles through the extreme stress of the ordeal so late in her pregnancy. “The feeling of the unknown is stressful and disheartening,” Mann reflects, “but I have the support of my husband and my doctor, so I can’t let it affect me too much.” However, Mann’s doctor cannot proceed with the tubal ligation as long as hospital administrators prohibit it. By substituting Catholic doctrine for best medical practices, the hospital grossly demonstrates its inadequacy as well as its disregard of patients in its care.
As an arm of the Ascension Health Care System, Genesys is one of many hospitals that operate based on a “conscience exemption” protected by federal law. In 2009 the US Conference of Catholic Bishops issued a set of ethical and religious directives that govern Catholic hospitals, disallowing contraceptives, abortions, and sterilizations. By adhering to these guidelines, medical centers expose women to unnecessary health risks even when procedures are deemed necessary by doctors. Currently, these measures are protected by the Church Amendment, stating that a public health center cannot be made to “make its facilities available for the performance of any sterilization procedure or abortion if the performance of such procedure or abortion in such facilities is prohibited by the entity on the basis of religious beliefs or moral convictions.” This law undermines the medical necessity of such procedures while jeopardizing the health of the patients of these hospitals. And Catholic hospitals are not easily avoided.
According to a 2013 report, Catholic hospitals make up ten of the twenty-five largest health-care networks in the United States, and that number is only on the rise. The number of Catholic non-profit hospitals increased 16 percent between 2001 and 2011, even though the total number of hospitals declined during those years. For people on Medicaid or living in rural areas, Catholic hospitals are sometimes the only option; a full one-third of Catholic hospitals are based in rural areas, and one in ten acute-care hospitals are Catholic or affiliated. Many people are left with no choice but to utilize Catholic medical centers. While religious organizations undoubtedly perform essential services to vulnerable members of the community, we should not allow that same institution to inflict harm through a denial of care.
Jessica Mann’s story is the latest to draw attention to the debate over religious conscience and the refusal of services. Earlier this month Kim Davis, a clerk in Kentucky, garnered attention by refusing to issue marriage licenses to same-sex couples on the basis of religious conscience. If “freedom of conscience” is not grounds to deny others their right to self-determination, then it most certainly cannot be license to deny a sick patient the right to self-preservation.