Conform or Crumble? Would staunch Catholics in Ireland destroy hospitals to buck new law?

After a landslide vote to repeal Ireland’s thirty-five-year constitutional ban on pregnancy terminations, all publicly funded hospitals in Ireland, including Catholic hospitals, will now be required to perform abortions.

Irish Prime Minister Leo Varadkar made the announcement during a June 12 speech to the Irish Parliament, stating,

Conscientious objection provisions will apply to individual doctors, nurses and midwives who do not want to participate in providing abortion services, but it will not be possible for publicly funded hospitals, no matter who their patron or owner is, to opt out of providing these necessary services, which will be legal in the state once the legislation is passed by the Dáil and the Seanad [the lower and upper house].

The government is presently drafting new legislation modeled after Ireland’s Protection of Life During Pregnancy Act of 2013, which legalized abortions in extreme medical circumstances and allowed individual medical professionals to opt out on religious grounds. But is this clause enough to satisfy the largely Catholic population of Ireland where the church is highly influential in state activities?

After achieving independence in the 1920s, Ireland outsourced public services that it couldn’t afford (like healthcare and education) to religious institutions, with lasting effects. Today, Catholic hospitals still greatly outnumber secular hospitals in the country, and as of 2016 nearly 97 percent of state-funded primary schools were under the control of the Catholic Church, which favors Catholics over non-Catholics in admissions.

But the tide is changing in Ireland. According to their 2016 census, the number of people who identify as Catholic is at a record low. In 2015 Ireland became the first Western country to legalize same-sex marriage. And earlier this month, the lower house of the Irish Parliament passed a school admissions bill that bars Catholic primary schools from discriminating in favor of children that have been baptized. Although the bill is criticized for not addressing the inherent religiosity of public schools, where nontheist children and children of other faiths are still subject to prayer, Catholic education, Mass, and preparations for Catholic rites during school hours.

As public opinion continues to shift in Ireland, tension is expected. Opponents of the new legislation are calling for the destruction of the institutions completely and for the Vatican to intervene, rather than provide women with adequate medical care. As of right now, it’s unclear what actions, if any, will be taken to protest Varadkar’s recent announcement.

As headlines focus on progress in Ireland, we must be aware of the Catholic hospitals here in the United States, which can deny medical care outright. They operate based on a federally protected “conscience exemption” that states 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.”

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 patients to unnecessary health risks and emotional trauma even when procedures are deemed medically necessary by doctors.

As in Ireland, Catholic hospitals in the United States are not easily avoided. They make up ten of the twenty-five largest healthcare networks, over a third of hospitals are Catholic in ten states, and one-third are based in rural areas. Faced with a lack of access to public transportation or an emergency requiring immediate attention, patients have no choice but to go to the nearest facility. And even when women do seek non-emergency OG/GYN medical treatment at Catholic hospitals, over one-third aren’t aware of the hospital’s religious affiliation.

When it comes to Catholic hospitals, many people are left with no choice but to seek services there even though these facilities oppose providing life-saving care when it conflicts with religious doctrine. Ireland has taken a great first step in ensuring that publicly funded healthcare centers cannot refuse medically necessary treatment on religious grounds, but is it enough given the context?