Catholic Bishops and Religious Rights vs. Women’s Rights

Submitted by Elaine Magliaro, Guest Blogger

There has been a lot of discussion in the media recently about the HHS contraception coverage mandate. Much of the talk has focused on women’s sex lives and the types of birth control that doctors prescribe for women in order to prevent pregnancy—as well as on the separation of church and state and the mandate’s infringement on religious freedom and the Catholic Church’s First Amendment rights. There has been much less talk about women’s health, women’s rights, and the use of birth control pills to treat certain female medical conditions, including polycystic ovary syndrome and endometriosis. Both of these conditions can cause severe pain and lead to other health problems. According to Bruce Nolan of The Times-Picayune, the Institute of Medicine—which is a non-profit advisory panel—recommended the contraception coverage because “those services are basic to individual health.”

Many Americans—especially women—think that contraceptive coverage and other “female-related” medical services ARE basic to women’s health.  Catholic bishops, however, believe that contraceptive coverage and some hospital services are in conflict with the church’s “moral conscience.” The bishops contend that the church has the right to deny certain types of health insurance coverage for women who work for Catholic institutions. It doesn’t matter to the bishops whether the female employees are members of other religions…are atheists or agnostics. The church’s position is that all female employees of Catholic institutions should be denied access to all forms of contraceptives and not be provided medical insurance that would cover the cost of certain medical procedures. The bishops also believe that certain types of treatment and procedures—including tubal ligations—should not be provided to women at Catholic hospitals.

When I was doing research on an earlier post, The National Women’s Law Center Takes a Position on Contraceptive Coverage & “Extreme” Legislation, I came across some information about Catholic hospitals that caused me great concern. The information left me with the belief that Catholic bishops and the Catholic Church do not seem to value the lives of women as much as they value the lives of men and the unborn. In this post, I will look at the “usurpation of female patients’ rights” at Catholic hospitals. I think after reading my post you will understand why I drew the conclusion that I did.

In January of 2011, the National Women’s Law Center issued a report about women’s health and lives being at risk at some hospitals because of religious restrictions. The NWLC report includes a legal analysis of the implications of its study—which focused on Catholic-affiliated hospitals’ treatment of women with pregnancy complications.

From the National Women’s Law Center:

The Center’s report, Below the Radar: Ibis Study Shows that Health Care Providers’ Religious Refusals Can Endanger Pregnant Women’s Lives and Health, demonstrates that certain hospitals, because of their religious beliefs, deny emergency care, the standard of care and adequate information to make treatment decisions to patients experiencing miscarriages and ectopic pregnancies. The study and report focused on cases where no medical intervention was possible that would allow the patient to continue her pregnancy and where delaying treatment would endanger the woman’s health or even life. These hospital treatment practices violate federal laws and regulations that are intended to protect patients and ensure the delivery of quality health care services at hospitals receiving Medicare funds…

“Most women assume that when they go to a hospital they will be offered the best medical treatment options for their diagnosis,” said NWLC Co-President Marcia D. Greenberger. “But this report paints a chilling picture of women with ectopic pregnancies or suffering miscarriages who are not offered the full spectrum of medically appropriate treatment options because they have gone to a hospital whose religious affiliation conflicts with the provision of those options. To make matters worse, women denied certain medical options may never even be told that these options could, for example, improve their chances of having a healthy pregnancy in the future. Women who fail to receive appropriate treatment or to be informed that preferable options would be provided in another hospital can suffer serious harm with long-term adverse consequences to their lives and health.”

The reports highlight stark cases where doctors noted a discrepancy between the medically-accepted standard of care for miscarriage and ectopic pregnancy and the treatment provided by hospitals due to their religious affiliation. For example, while the standard of care for certain ectopic pregnancies requires patients to receive the medication methotrexate, doctors in the study reported that their hospitals forbade the use of the drug. Instead, patients were either transferred to another hospital or required to undergo unnecessary and invasive surgery to resolve their condition, thereby being denied the standard of care.

One doctor in the study reported several instances of potentially fatal tubal ruptures in patients with ectopic pregnancies at her Catholic-affiliated hospital. She said that her hospital subjected patients with ectopic pregnancies to unnecessary delays in treatment, despite patients’ exhibiting serious symptoms indicating that a tubal rupture was possible. These patients, therefore, were denied emergency care to which they were legally entitled.

In some of the miscarriage cases described in the Ibis Study, the standard of care also required immediate treatment. Yet doctors practicing at Catholic-affiliated hospitals were forced to delay treatment while performing medically unnecessary tests. Even though these miscarriages were inevitable, and no medical treatment was available to save the fetus, some patients were transferred because doctors were required to wait until there was no longer a fetal heartbeat to provide the needed medical care. This delay subjected these patients to further risks of hemorrhage and infection and could have violated their right to receive emergency medical treatment under federal law.

Early last year, the NWLC filed a complaint with the Centers for Medicare and Medicaid Services in which it identified violations of health care provider obligations “under the Medicare Conditions of Participation (CoPs) resulting from these practices.” The complaint urged “HHS to issue a notification reminding hospitals that they are bound by all CoPs; to require hospitals to institute policies and procedures to protect patients’ legally enforceable rights; to investigate the failure of hospitals to provide standard of care and informed consent, and to take corrective action to prevent further violations.”

Jill Morrison, Senior Counsel for NWLC, said that religious dictates should not “trump bedrock legal protections that entitle patients to the standard of care and informed consent in the American medical system.” She claimed that hospitals had been allowed to disregard their obligation “to prioritize women’s health and lives” for too long. Morrison added, “It’s time to shine a light on these serious violations and make hospitals accountable to protect the lives and health of the patients they serve.”

I think it is of great import for women to read the study. According to the National Catholic Reporter, “Catholic health care facilities form the largest not-for-profit health service sector in the United States, caring for nearly one-sixth of all U.S. hospital patients each year.”

In his article in the March/April 2011 issue of The Humanist, Rob Boston wrote about Catholic Hospitals’ usurpation of patients’ rights:

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.

An Example of Catholic Courage

It is good to hear stories about people of conscience who work as administrators and doctors at some Catholic hospitals. These are individuals who choose to provide life-saving medical services frowned upon by bishops to pregnant female patients in emergency situations.

Sister Margaret McBride, a nun who worked as the administrator of St. Joseph’s Hospital and Medical Center in Phoenix, Arizona, chose to sign off on an abortion “for a woman who was eleven weeks pregnant and suffering from life-threatening pulmonary hypertension.” The woman was twenty-seven-years-old and the mother of four children. Doctors at the hospital had determined that terminating the woman’s pregnancy was the only way to save her life because her heart and lungs were in jeopardy. The nun’s action did not sit well with Phoenix Bishop Thomas J. Olmsted. The bishop was “furious” and demoted Sister McBride. He also announced the she had automatically excommunicated herself from the Catholic Church by her actions. Olmsted also stripped the hospital of its affiliation with the Roman Catholic diocese.

In his New York Times column Tussling over Jesus, Nicholas Kristof said that Sister McBride appears to be the individual in this story who “emulated the life of Jesus” and not the bishop. Kristof wrote that Bishop Olmsted had spent much of his life “as a Vatican bureaucrat climbing the career ladder.” He added that what happened at St. Joseph’s Hospital “is a bellwether of a profound disagreement that is playing out at many Catholic hospitals around the country.” Kristof believes that we are likely to see more clashes like the one between the bishop and the hospital in Arizona in the future “as the church hierarchy grows more conservative, and as hospitals and laity grow more impatient with bishops who seem increasingly out of touch.”

Click here to watch a PBS video on the subject of Catholic-Secular Hospital Mergers. The video is just under ten minutes long.

SOURCES

Women’s Health and Lives at Risk Due to Religious Restrictions at Hospitals, New Center Study Shows: National Women’s Law Center Files Complaint with Department of Health and Human Services (National Women’s Law Center)

Below the Radar Fact Sheet: Religious Refusals to Treat Pregnancy Complications Put Women in Danger (National Women’s Law Center)

Assessing Hospital Policies & Practices Regarding Ectopic Pregnancies & Miscarriage Management (National Women’s Law Center)

Commentary: Dust-up over contraceptive rule ignores rights of employees (The Kansas City Star)

Catholic hospitals serve one in six patients in the United States (National Catholic Reporter)

U.S. Catholic Bishops Major Force Behind War on Women: Statement of NOW President Terry O’Neill (NOW)

The Men Behind The War On Women (Huffington Post)

Prescription For Disaster: Hospital Mergers And Heavy-Handed Tactics Are Giving The Catholic Hierarchy An Increasingly Problematic Role In American Health Care (Americans United for Separation of Church and State)

House Passes H.R. 358, the “Let Women Die” Act of 2011 (RH Reality Check)

Catholic Death Panels Coming to a Hospital Near You (Ms. Magazine)

Employees Need Birth Control Coverage Mandate (The Nation)

Hospital merger limits medical options: Catholic rules will bar tubal ligations at University hospital (Courier-Journal)

Catholic-Secular Hospital Mergers (PBS)

Medical Emergency: Catholic Hospitals Usurp Patients’ Rights (The Humanist)

Merger Watch

Tussling Over Jesus (New York Times)

Americans almost evenly split over conscience exemption in birth control coverage (The Times-Picayune)

Contraception and Separation (Turley Blawg)

110 thoughts on “Catholic Bishops and Religious Rights vs. Women’s Rights

  1. Bad Back? Take a Break. Pregnant? Take a Hike.
    Posted on March 05, 2012 |
    Posted by:
    Emily Martin, Vice President and General Counsel
    National Women’s Law Center
    http://www.nwlc.org/our-blog/bad-back-take-break-pregnant-take-hike

    Excerpt:
    The Pregnancy Discrimination Act (PDA) requires that employers treat pregnant employees at least as well as they treat employees “similar in their ability or inability to work”—so Peggy Young, a part-time UPS driver who needed to avoid lifting more than twenty pounds during part of her pregnancy, might have thought that her employer was bound by law to make that accommodation, given that UPS had a policy of giving light duty to various other employees who were physically unable to do their usual job. Under UPS’s policy, employee who had been injured on the job were entitled to light duty, as were employees with a qualifying disability under the Americans with Disabilities Act (ADA), and employees who were injured off the job and failed a Department of Transportation medical exam. But UPS disagreed and forced her to take unpaid leave for the duration of her pregnancy. As a result, she also lost her medical coverage, months prior to the birth of her child. Then, she lost her pregnancy discrimination case, when the district court ruled that UPS could adopt “pregnancy blind” rules that allowed some employees similar to Peggy Young in their ability to work to go on light duty, while blocking Peggy Young from receiving the same accommodation.

    The National Women’s Law Center joined the ACLU Women’s Rights Project and others today in a friend-of-the-court brief urging the Fourth Circuit Court of Appeals to take the language of the PDA seriously and reverse the district court. Congress adopted the PDA in 1978, forcefully rejecting Supreme Court decisions that concluded that discrimination on the basis of pregnancy did not constitute unlawful sex discrimination, but rather discrimination between “pregnant and nonpregnant persons.” The PDA states that discrimination on the basis of pregnancy, childbirth, or related medical conditions constitutes sex discrimination and further provides that pregnancy cannot be treated worse than other disabilities that similarly affect an employee’s ability to do the job. In passing the PDA, one of Congress’s targets was employee benefit programs that provided insurance coverage, for example, to cover a host of disabling conditions, but not pregnancy.

  2. There are some lessons here. Advise your kids, friends and neighbors not to attend a Cathjolic school, iuniversituy. hospital, day care center, old folks home or gambling casino.

  3. PatricParamedic: “Although his co-pay was a mere $1,100 on a $19,000 bill, he was fretting over some of the charges. Of course he had every right to, since his coded bill included, among other cute little ditties, $98 for an egg-crate foam bed pad; $128 dollars for rolls of Transpore IV tape; and something like $27 for ‘mucous recovery systems’ (that would be a box of Kleenex)”
    ——

    I have read that this as was a response to insurance company’s rules regarding reimbursement and too-low caps on payments for the cause of the treatment. As well, the added cost is too make up emergency care for non-insured patients and non- reimbursable costs (from various levels of government) for the same.

    I have also read on the AMA’s site some discussion that the requirement for multiple operations are to satisfy insurance company reimbursement requirements and the discussion was not in favor of this practice. It puts the patient at risk and generates needless work.

    It also makes it easy to pad the books with multiple operations not all of which are necessary if that’s the inclination.

    I was doing research on the multiple operation thing the last time the better half was ill so its been a couple of years but i came away with the conclusion that doctors hate insurance companies and that insurance companies are in the driver’s seat regarding much of the treatment a patient gets and how it is provided.

    I’m a ‘universal coverage’ advocate; It may well have many of the same problems but the overhead would be less, more people would have access and coverage would be more consistent.

  4. Elaine, Thanks for posting so many great links and articles, I’d like to respond to “Murkowski Regrets”.

    I’m sick of hearing this from elected officials, it’s a way for them to have it both ways. They get to support bad legislation and reap whatever benefit comes from that as well as pacifying voters unhappy with their vote by saying ‘I didn’t know’, ‘that’s not my understanding’, I’m too busy to read everything’ and ‘I wouldn’t have done it if I had known’.

    That’s all BS and becoming more and more common. Fire them for incompetence if not their actual position IMO, they should at least know what they are voting on. Would you retain a worker in a position of responsibility in your company that didn’t read a proposed contract or didn’t understand it before signing it as your fiduciary? Not more than once and not once if it worked a hardship on my company, but that’s just me.

  5. Raf, LOL, I read your comment and my first, reflexive thought was ‘how did Palin get in this conversation?’ Srsly, it’s getting tough for some of us to keep the hypocrites straight.

  6. Murkowski just pulling a Limbaugh. Sh got enough bad feedback she hd to backtrack. What hppens when it is for a bill like this that passes? Then an apology will be even more worthless. Thanks for postig that.

  7. I believe the time will come, that if women want to keep their rights, and the general, NORMAL, population of sexually active humans wants to get the church out of their bedrooms, they’ll have to start killing, or otherwise eliminating, Catholic Bishops…… Old men in dresses, with no sexual experience, and no responsibility for raising children, should have no say at all on the subject. They can fantasize all they want about their imaginary ghod, Jesus, but about reproduction, they need to just STFU!!!! They don’t posses the necessary information.

  8. (First sorry about all the typos, my keyboard wants to censor a lot of my letters ((*_*)) )
    I just left the post about Holder and presidents not having military and war experience. Maybe we need to round up all the people who have no experience in the areas in which they profess knowledge and righteousness, or send others to do in their name (our name) and force them, for the pres and congress, etc, to put on the outfit and take the guns, and for the bishops, make them have sex. (and maybe a baby that they do not want, cannot afford to acknowledge or cannot afford or take care of. Maybe a fetus that is found to have tay sachs or incompatible with life deformities on ultrasound early on. Sure would change a lot of sensibilities, and a lot less ‘do what I say, not what I do’ (or rather have not done.).

  9. Expanding Catholic Hospitals Put Reproductive Care, Women’s Health at Risk
    3/8/12
    http://www.dailykos.com/story/2012/03/08/1072479/-Expanding-Catholic-Hospitals-Put-Reproductive-Care-Women-s-Health-at-Risk

    Excerpt:
    For the last several weeks, all eyes have been focused on the high-profile clash between Catholic bishops (if not their parishioners) and the Obama administration over mandated insurance coverage for contraception at their non-church institutions. But in cities and towns across the country, a second battlefront is jeopardizing access to essential reproductive care for millions of American women. As the New York Times and the New Republic each recently documented, the expansion of Catholic hospitals nationwide is putting women’s reproductive care – and in some cases, their lives – at risk.

    For over a hundred years, Catholic hospitals have been one of the cornerstones of the U.S. health system, providing care to tens of millions of Americans of all faiths, races and ethnicities. TNR’s Jonathan Cohn explained just how big a role they play and the public support they enjoy in return:

    Today, Catholic hospitals supply 15 percent of the nation’s hospital beds, and Catholic hospital systems own 12 percent of the nation’s community hospitals, which means, according to one popularly cited estimate, that about one in six Americans get treatment at a Catholic hospital at some point each year. We now depend upon Catholic hospitals to provide vital services–not just direct care of patients, but also the training of new doctors and assistance to the needy. In exchange, these institutions receive considerable public funding. In addition to the tax breaks to which all nonprofit institutions are entitled, Catholic hospitals also receive taxpayer dollars via public insurance programs like Medicare and Medicaid, as well as myriad federal programs that provide extra subsidies for such things as indigent care and medical research. (Older institutions also benefited from the 1946 Hill-Burton Act, which financed hospital construction for several decades.)

    But increasingly, Cohn cautioned, “the dual mandates of these institutions–to heal the body and to nurture the spirit, to perform public functions but maintain private identities–are difficult to reconcile.” For many communities, a Catholic facility is already the only choice. And with the accelerating trend of hospital mergers and partnerships, policies forbidding contraception, abortion and sterilization are becoming the norm at formerly public hospitals. In cities around America, the result is growing confusion for physicians and greater risk for their patients.

  10. Oro Lee, I’m coming in here very belatedly to read (Thank you very much Elaine M, for this invaluable article) and peruse comments on this post. I want to vote with Gene H, Mike Spindell, and the others who have weighed in to show their appreciation to you and for you. Especially, thank you for being a conscientious guardian ad litem for at risk and abused children — how much that is a mission above all others! (Who knows: choosing a divine savior during one’s adult life may very well start with having had mortal human beings reach out to you first, when you were a child.)

  11. 43 Catholic Institutions File 12 Separate Lawsuits Against Obama’s Birth Control Rule | The University of Notre Dame, Catholic University of America, the Archdiocese of Michigan, and the Archdiocese of New York have filed a lawsuit against an Obama administration regulation requiring employers and insurers to offer preventing health services — including contraception — without additional cost sharing. The suit, one of 12 filed Monday, argues that the requirement violates the Catholic institutions’ religious freedom– even though regulators have includes an accommodation for religious organizations. Planned Parenthood President Cecile Richards has called the challenges “unbelievable” and claimed, “This isn’t a religious or political issue – it’s a medical issue, and that’s where we should keep it.” An overwhelming majority of Americans — and Catholics — support the coverage rule.

    http://thinkprogress.org/health/2012/05/21/487861/catholic-institutions-file-13-lawsuits-against-obamas-birth-control-rule/

  12. How long and how many damaged and dead women will it take for a government mandated investigation of all Catholic affiliated Hospitals to take place. The upholding of draconian Roman Catholic religious dogmas should not be the basis for proper health and lifesaving medical decisions.

    Why is it that when it is already known that women are dying or suffering serious health damage in those Catholic affiliated Hospitals that this is allowed to go on? Is that not criminal or murder when women are allowed to suffer or die from the withholding of lifesaving services? What are Hospitals for? Religious Dogmas have no place in Hospitals. Also, those physcians who are against all those lifesaving priocedures for women should never become OBGYNs. Those against contraceptives, etc. should also not become pharmacists.

    When are we going to enforce the Establishment Claluse of the First Amendment to save women’s health and lives?

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