The Increasing Problem of Religious Hospitals

The needless death of Savita Halappanavar last year, after a Catholic hospital refused to terminate her doomed pregnancy, drew a worldwide outpouring of fury against the religious dogmatism that killed her.

But as I wrote at the time, Savita’s story was only the tip of the iceberg. What happened to her wasn’t a fluke or an aberration: it was and is the official policy of the church that if a pregnant woman’s life can be saved by abortion, it’s better to let two die than to save one.

It’s only by a stroke of good fortune that we haven’t had any Savitas in the U.S. (that I’m aware of, at least). It’s certainly no thanks to the church hierarchy. And that makes it especially ominous that the Catholic hospital system is quietly expanding its reach across the U.S., merging with or gobbling up many of its secular counterparts:

“We are starting to see what was rare in the past,” said Lisa Goldstein, who follows nonprofit hospitals for Moody’s Investors Service and predicts more such partnerships… About one-sixth of all patients were admitted to a Catholic hospital in 2010. In many smaller communities, the only hospital within miles is Catholic. (source)

This is still going on today, as Americans United reported in a blog post from last month about Catholic entities seeking to take over public medical institutions in Texas and Kentucky. And when the church takes over, they’re not reluctant to throw their weight around: Irin Carmon reports on Salon that an astonishing 52% of OB-GYNs at Catholic hospitals have reported clashing with church-run ethics committees over the proper treatment of women with complications from pregnancy.

This is bad for men too, since it cuts off their access to procedures like sterilization that these hospitals no longer provide. But as always, the burden of religious oppression falls most heavily on women, since it’s only women who are denied access to literally lifesaving medical care by Catholic dogma (not to mention access to emergency contraception if they’re raped).

I regard this as a more serious problem than most other manifestations of the anti-choice movement. The noisy protesters who cluster outside reproductive health clinics can frighten and harass, but they can’t actually, legally, prevent anyone from getting an abortion there or otherwise making use of the clinic’s services. On the other hand, buying up hospitals does make it possible for religious zealots to cut off women’s access to legal, essential medical care.

There’s only one solution to this, and it has to be a legal one. Just as businesses that serve the public can’t discriminate by religion in whom they hire or whom they serve, so too should hospitals be forbidden to pick and choose which procedures they’ll offer or which medicines they’ll dispense based on the decrees of a religious authority.

We wouldn’t tolerate a Jehovah’s Witness-run hospital that forbade blood transfusions, even for people rushed into the emergency room dying of blood loss. We wouldn’t tolerate a Muslim-run hospital where doctors and nurses refused to wash their hands based on their interpretation of Islamic modesty laws. We wouldn’t tolerate an evangelical Christian-run hospital that turned gay people away at the door. Just the same way, we should refuse to tolerate a Catholic-run hospital where the imperial decrees of a bishop mean that a woman dying of sepsis or eclampsia can’t get a life-saving abortion as long as there’s any detectable fetal heartbeat.

It doesn’t matter exactly how we implement this – the “hospital within a hospital” created in one case in Austin seems like a reasonable compromise. But this is something we have to insist on. Religious individuals can decide what care they want for themselves based on their beliefs. But in a secular nation like America, it should be absolutely illegal for a religious authority to turn any part of the public square into a private fiefdom and exercise power over the lives of people who haven’t voluntarily agreed to abide by those rules.

About Adam Lee

Adam Lee is an atheist writer and speaker living in New York City. His new novel, Broken Ring, is available in paperback and e-book. Read his full bio, or follow him on Twitter.

  • http://stevebowen58.blogspot.co.uk/ Steve Bowen

    Sadly, I suspect it will take a tragedy and a lawsuit for malpractice to get anywhere near the result you want.

  • http://busterggi@aol.com busterggi

    Hospitals are businesses no matter who or what the owner is and must be treated as such – they are not churches.

  • GCT

    There’s only one solution to this, and it has to be a legal one. Just as businesses that serve the public can’t discriminate by religion in whom they hire or whom they serve, so too should hospitals be forbidden to pick and choose which procedures they’ll offer or which medicines they’ll dispense based on the decrees of a religious authority.

    Or another example that will hit close to home for catholic bigots – adoption agencies that are forbidden to discriminate against gays.

  • http://avoiceinthewilderness-mcc1789.blogspot.com Michael

    “We wouldn’t tolerate a Muslim-run hospital where doctors and nurses refused to wash their hands based on their interpretation of Islamic modesty laws.”

    That’s a new one on me. I thought that Islamic modesty laws highly emphasized personal hygiene.

  • Adam Lee

    Sadly, I didn’t invent that story about Muslim nurses not wanting to wash their hands (because it would have required baring their arms to the elbow, which they believed was indecent to do in public). It was reported as happening in multiple British medical schools in 2008.

  • http://republic-of-gilead.blogspot.com Ahab

    Are you familiar with the organization MergerWatch? They monitor mergers between religious and secular medical establishments, with an emphasis on safeguarding access to reproductive health services.

    http://www.mergerwatch.org/

  • L.Long

    For really important needed medical help my 1st question to a doc would be are you an atheist?
    And hope for a yes. Because the one thing I note from watching a number of delusional dimwits is they put more trust in Cheeses then in anything else. So I would rather put my fate into the hands of someone who studies and practices his skills to make himself a better doc rather then someone who lets a delusion guide their coarse.
    But the law intervention could very well happen in a different way, as the law may have to stop a dad from showing these idiots what ethics is all about when they refuse to treat his beloved kid. SO I hope the court room solution happens soon.

  • http://biblicalscholarship.wordpress.com/ Jayman

    There’s only one solution to this, and it has to be a legal one. Just as businesses that serve the public can’t discriminate by religion in whom they hire or whom they serve, so too should hospitals be forbidden to pick and choose which procedures they’ll offer or which medicines they’ll dispense based on the decrees of a religious authority.

    First, could the Catholic hospital respond that they are choosing their procedures based on ethics and not solely on religion?

    Second, if such a law were pushed through, what are the chances the Catholic hospitals would close, leaving no hospital at all in some areas?

    Religious individuals can decide what care they want for themselves based on their beliefs.

    And should a religious doctor be able to decide what care he wants to give to others?

  • http://gamesgirlsgods.blogspot.com/ M

    I hated, hated having to do this. But the first time I saw my OBGYN (for routine care, not pregnancy), at the end of the appointment I asked him flat out if he was pro-choice and if he’d refer me to an abortion clinic if necessary. I told him my life came first and I wanted my doctors to think so too. It was awkward and uncomfortable. It shouldn’t have been necessary. What kind of world do we live in where a woman has to explicitly tell her doctor, who has taken the Hippocratic Oath, that she would prefer that he actually follow it?

    He agreed, btw, and I didn’t have to swap doctors.

  • Azkyroth

    First, could the Catholic hospital respond that they are choosing their procedures based on ethics and not solely on religion?

    Not credibly.

  • Dianne Leonard

    In my county, an urban county in California, there are only 2 hospitals where you can get a hip replacement on Medicaid, and one is Catholic. I went there because the waiting time was a third of that at the county-run hospital. I shudder to think what would have happened if I’d been going to the hospital for ON-GYN care rather than a hip replacement. BTW, the Catholic hospital has *horrible* reviews on Yelp, for things other than OB-GYN care–which I experienced–like nursing post-surgery care, pain relief, and so on. So the Catholic church doesn’t believe in treating post-surgery–or poor–patients any better than they treat those slutty women who have sex :(

  • Kat

    It isn’t just about women’s issues. Look over the end of life items. Washington State provides for physician-assisted suicide. But not in their facility.

    From the PeaceHealth website:

    PeaceHealth does not permit abortion except to save the life of the mother.
    Contraceptive decisions are between the patient and the health care provider.
    Emergency contraception is provided to women who are victims of sexual assault. PeaceHealth requires a negative pregnancy test prior to dispensing emergency contraception.
    RU-486 is an abortifacient and is not dispensed at PeaceHealth.
    PeaceHealth provides quality compassionate care at the end of life. Withdrawal of medical treatment (e.g. hydration and nutrition, ventilator, pacemakers, antibiotics, and blood products) is appropriate if it is non-beneficial in meeting the patient’s goals.
    Physician assisted suicide is prohibited. Physicians are prohibited from participation in the medical and psychiatric consultations on PeaceHealth time and in PeaceHealth facilities or any facility leased from PeaceHealth.​

    http://www.peacehealth.org/about-peacehealth/Pages/catholic-identity.aspx

    St Joe’s (our local facility) is a premier cardiac facility and they recently opened a cancer center. They’re happy to help to you live but ease your death? Nah, ya gotta suffer!

  • Adam Lee

    @Jayman:

    First, could the Catholic hospital respond that they are choosing their procedures based on ethics and not solely on religion?

    That claim wouldn’t be credible if those procedures were within the generally accepted standard of care.

    Second, if such a law were pushed through, what are the chances the Catholic hospitals would close, leaving no hospital at all in some areas?

    If what I propose became the law and a Catholic hospital declared its intention to close rather than provide medically necessary care, then I’d advocate that the government seize that hospital through eminent domain and either sell it off to other investors or run it themselves as a public hospital.

    And should a religious doctor be able to decide what care he wants to give to others?

    No, just as a religious pharmacist shouldn’t be able to decide what medications he wants to dispense. If you have an ethical objection to performing the duties of a job, then don’t take that job.

  • Cheri

    The above comments are revolting to me, but I realize I am not on my own turf here. I am not here to argue, just to ask a question for clarification. Do I understand correctly that people here feel that if someone believes abortion is murder and that there are moral issues with sterilization and contraception, that person has no right to practice medicine? BTW, I recently read that the Catholic Church does allow for doctors to perform necessary procedures on the mother that may endanger the pregnancy. The purpose of the procedure just can’t be to terminate the pregnancy. It would have to be only a possible natural consequence of the procedure.

  • Azura

    This is a problem in Canada too. In Toronto, a girl with Ehlers-Danlos Syndrome was unable to get tubal ligation because the only doctor that said yes to someone her age (30) with her possibilities for complications only had surgical permission at St. Joseph’s and as a Catholic hospital they do not provide contraception procedures. She would die if she got pregnant, and is in and out of surgery all the time for things, but no, Catholic dogma takes priority over her life. This is extra depressing for me, because I have EDS too, and I’m only 22. I want tubal ligation, but at my age it’s not likely a doctor would agree to do it for me if they wouldn’t for her. It’s bad when women with genetic disabilities in Canada aren’t even getting care they need because of the RCC.

  • Adam Lee

    Do I understand correctly that people here feel that if someone believes abortion is murder and that there are moral issues with sterilization and contraception, that person has no right to practice medicine?

    They can practice some other kind of medicine, but if someone has moral objections to performing the duties of a job, then they shouldn’t take that job. Would you accept a Jehovah’s Witness doctor who refused to do blood transfusions, even on people who were dying of blood loss?

    BTW, I recently read that the Catholic Church does allow for doctors to perform necessary procedures on the mother that may endanger the pregnancy. The purpose of the procedure just can’t be to terminate the pregnancy. It would have to be only a possible natural consequence of the procedure.

    That doesn’t address the case when it’s the pregnancy itself that’s threatening the woman’s life and the only treatment is abortion.

  • GCT

    @Cheri

    Do I understand correctly that people here feel that if someone believes abortion is murder and that there are moral issues with sterilization and contraception, that person has no right to practice medicine?

    No. They have no right to force their beliefs upon others. If a racist wants to open a store do they have the right? Sure. Do they have the right to refuse to sell to non-whites? No, they don’t. Same principle.

  • RR

    While I agree that faith-based hospitals can lead to appalling situations, it should be pointed out that secular, for-profit (and non-profit) hospitals often offer deplorable care. My local hospital is part of the Bain Capital-backed HCA, a company who has made millions by figuring out how to “aggressively” bill Medicare. I’ve personally seen cases where they kicked people out of the street because of lack of insurance. Do hospitals run by churches do the same? I would think that is likely. I’m only saying the secular world has much, much room for improvement in medical care. Replacing religion with capitalism is not a cure-all in this area.

  • James

    The healthcare that these hospitals are providing is a service, not a right. They do not have an obligation to provide any kind of known treatment to anyone that walks in the door. All people that enter are being served equally when they enter the hospitals, so there is no discrimination. They just may not offer the same services as their secular counterparts. Their position is very clear: murder is wrong, and abortion under all circumstances is murder. There are many very difficult situations, like the ones mentioned, however none of those allows someone to take the life of an innocent child.

  • Elvenfoot

    Adam, I do not believe for a moment that anyone has a “duty” to murder an unborn child, just because a patient wants it–nor to violate any other moral belief. Because it’s legal the patient can go elsewhere, but a hospital that opened on certain moral grounds–legally–should not be forced to violate its moral stance. Emergencies are quite different, because as I said, the RCC allows for procedures to save the life of the mother if the purpose is not an abortion. As for the comment that the pregnancy itself can endanger the life of the mother, I would like to see an example of where the actual pregnancy is the cause of a life-threatening situation, not a companion condition that, were it to be healed, would render the pregnancy safe. Since when is a pregnancy a disease that must be healed? I do not deny that there are difficult situations, and there are some, I’m sure, that would be sufficient conundrums that I would to seek advice from a priest, but if there are, they are very rare. If someone faces serious consequences by getting pregnant, there are two options: NFP, which is scientifically sound (no arguments here, please–I’ve been around the block and back with this one) and abstinence. Abortion is not the only option.

    GCT’s comment comparing abortion denial to racism is also way off the mark to me. Both are wrong, but abortion is murder in the eyes of millions of people. I think it’s shocking that someone would force me, if I were a physician, to agree to murder someone and if I wouldn’t, they’d kick me out of my profession. People can go elsewhere for procedures they want that a religious hospital can’t provide.

    All these comments in this thread are not only shocking and repulsive, they are also incredibly unpatriotic.

  • Elvenfoot

    Ah, I do apologize. I told myself I wouldn’t argue, and here I am. I will withdraw from this conversation at this point. This isn’t where I belong. I really just wanted clarification, and my anger got the better of me. Peace.

  • BradC

    Another specific example of how Catholic doctrine can (and does) endanger the life of patients under their care:

    An ectopic pregnancy is non-viable, and if left untreated, the tube would rupture, endangering the life of the mother. The standard medical treatment for this condition is to administer methotrexate, which chemically terminates the pregnancy, leaving the fallopian tubes intact and leaving the patient with a good chance of conceiving again.

    Despite the fact that the end result is the same, the Catholic church teaches that treatment using methotrexate or surgery to remove the implanted egg (salpingostomy) is immoral, and instead insist that the entire fallopian tube should be removed (salpingectomy), unnecessarily reducing
    the patient’s later chances of conceiving. (Because the loss of the zygote is a a side effect of surgery, not a direct result, or some such nonsense.)

    In practice, though, doctors in Catholic hospitals face a clear conflict between the wishes of the church and the best interest of their patient. Some deliver the medication without hospital approval, others transfer the patient to another facility. One dangerous but surprisingly common approach (described as “expectant management”) is to simply wait and allow the tube to rupture, then rush the patient into emergency surgery.

    See the research study published at http://www.ncbi.nlm.nih.gov/pubmed/21353977

    FINDINGS: Participants from three Catholic facilities reported that medical therapy with methotrexate was not offered because of their hospitals’ religious affiliation. The lack of methotrexate resulted in changes in counseling and practice patterns, including managing ectopic pregnancies expectantly, providing the medication surreptitiously, and transferring patients to other facilities. Further, several physicians reported that, before initiating treatment, they were required to document nonviability through what they perceived as unnecessary paperwork, tests, and imaging studies.

    CONCLUSION: Our findings suggest that some interpretations of the Directives are precluding physicians from providing women with ectopic pregnancies with information about and access to a full range of treatment options and are resulting in practices that delay care and may expose women to unnecessary risks.

    A good article about this issue:
    http://drjengunter.wordpress.com/2012/11/05/ectopic-pregnancies-exploding-gifts-from-god-at-some-catholic-hospitals/

  • GCT

    @RR

    I’m only saying the secular world has much, much room for improvement in medical care. Replacing religion with capitalism is not a cure-all in this area.

    I fail to see the relevance here. Whether or not secular hospital X is a good hospital or not is irrelevant to whether catholic hospitals should be allowed to engage in behavior that forces their morals upon others by denying medical treatment to people who don’t share their views – and potentially causing serious harm up to and including death in the process.

    @James,

    The healthcare that these hospitals are providing is a service, not a right.

    While I would argue this point, even if I accept it it’s not a good argument. Restaurants provide service as well, but they are not allowed to discriminate against customers. So, why would we allow discriminatory service against customers at a hospital?

    They do not have an obligation to provide any kind of known treatment to anyone that walks in the door.

    Actually, they do, by law. There’s also that small matter of the Hypocratic Oath that doctors take, which isn’t legally binding, but does put a crimp in the idea of a professional refusing to do their job for the sake of pushing their religious agenda on others.

    All people that enter are being served equally when they enter the hospitals, so there is no discrimination.

    As if discrimination can’t occur unless you can point out an instance where one person is treated differently? That’s an overly simplistic view, and besides you’re still wrong. Xians are being treated according to their religious wishes, whilst others are not. It’s religious discrimination. Catholic hospitals are trying to enforce their religion upon others.

    There are many very difficult situations, like the ones mentioned, however none of those allows someone to take the life of an innocent child.

    That’s your religious opinion and you have every right to it. What you don’t have a right to is to force other people to live to your opinion and follow your dictates. This is especially true given that the law stipulates otherwise.

    @Elevenfoot

    Adam, I do not believe for a moment that anyone has a “duty” to murder an unborn child, just because a patient wants it–nor to violate any other moral belief.

    So, if a doctor doesn’t like gay people, then she can refuse to perform any services on that person? If a shop owner hates blacks, can he refuse to sell anything to them? Sorry, but that’s not how it works. If one wants to be a professional in the public sector, then one has to act as a professional and not discriminate and force their religious beliefs on others.

    As for the comment that the pregnancy itself can endanger the life of the mother, I would like to see an example of where the actual pregnancy is the cause of a life-threatening situation, not a companion condition that, were it to be healed, would render the pregnancy safe.

    Savita Halappanavar
    There was also the case that Adam wrote about a couple months ago where a woman who already had three or four children was going to die without an abortion. The catholic hospital allowed it and the actors got excommunicated.

    If someone faces serious consequences by getting pregnant, there are two options: NFP, which is scientifically sound (no arguments here, please–I’ve been around the block and back with this one) and abstinence. Abortion is not the only option.

    Ah, no, NFP does not work. But, what you are doing here is basically slut shaming. Those dirty sluts need to face the consequences of being dirty sluts.

    GCT’s comment comparing abortion denial to racism is also way off the mark to me.

    How so? You don’t go into any detail. The comment was about denial of service. Just as store owners are not allowed to enforce their racial mores on others, doctors are not allowed to enforce their religious mores on others.

    All these comments in this thread are not only shocking and repulsive, they are also incredibly unpatriotic.

    Oh, please, please, please give us some detail on this…this should be good.

  • BradC

    The idea of whether Catholic doctors can refuse to participate in certain procedures because of their own conscience is an interesting one (and one addressed by several comments above), but that’s not the only concern here (and not even the primary concern, I would argue).

    In several of the linked articles in Adam’s original post, we are talking about non-Catholic patients being served by non-Catholic doctors and nurses in (originally) non-religious hospitals. A Catholic organization comes in and buys up one (or sometimes many) hospitals in a community, and then enforces their “ethical guidelines” on all of their non-catholic doctors, nurses, and patients.

    And in this economy, is “if you don’t like it, just get another job” really that viable an option?
    (Or, in the case of a patient, “just go to another hospital”.)

    I found myself in this exact situation a few years ago. My wife and I were having our third child, and meeting with my wife’s doctor, talking about her scheduled c-section (due to unrelated reasons). We said that while she was in there, we’d like to get her tubes tied, as we didn’t intend to have any more kids.

    The doctor apologized, but said that while she wasn’t Catholic (and neither were we), she wasn’t allowed to do that in the Catholic hospital where the surgery was scheduled. Sure, we had the option to find a different doctor at another hospital miles away, but we were very close to delivery (and hadn’t thought to ask the question before). For us, this was mostly an inconvenience, although it did cost us time and money to do a totally separate procedure (a vasectomy) that has its own risks, vs a (nearly trivial) procedure that could have been done as part of another surgery.

    In other situations (Savita Halappanavar), this kind of thing is much more than just an inconvenience.

  • Louise

    @ GCT
    “Oh, please, please, please give us some detail on this…this should be good.”
    Yeah, I am waiting for this one too. Shocking, repulsive and not to mention unpatriotic to give women control of their reproductive organs? How is this unpatriotic? This is the first time I heard that one… I guess this person would rather let women give themselves abortions and die or be injured. Those slutty slut women having sex not for procreation, how dare they??

  • Figs

    This is an issue that strikes close to my heart. My wife and I recently learned that our pregnancy was going to be non-viable (hormone levels were simply too low to sustain the pregnancy, even if supplemented), and that it was possibly ectopic as well. Methotrexate was administered to terminate the pregnancy. In one sense it was a hard decision, because we’ve been trying for a child for a little while and we were very excited only to have our hopes dashed.

    On the other hand, though, the decision was very easy. The pregnancy was never going to be viable even if it wasn’t ectopic. It was going to end in a miscarriage. And the risk of its being ectopic was not one worth bearing. Essentially, the circumstances made it so that the embryo did not even factor into the decision, because there was no way for it to survive.

    The idea that somebody would tell me and my wife that we made the not just the wrong decision, but an immoral decision, is SICKENING.

  • David Hart

    Elvenfoot:

    I do not believe for a moment that anyone has a “duty” to murder an unborn child

    I’ve said it before, and I’m sure I’ll say it again. In the normal course of development, an egg and sperm fuse to form a zygote, the zygote becomes an embryo, the embryo becomes a foetus, the foetus becomes a baby, the baby becomes a child, and the child becomes an adult. Note that this means that an embryo or a foetus is not a child, and if you pretend to be unable to understand that, you are pulling a dishonest bait-and-switch.

    Don’t do that; it isn’t a good look. You know that we afford different legal rights to children from what we afford to adults, and that there are good reasons for doing so. If you therefore want to argue that we should afford the same (or, arguably, greater) rights to embryos and foetuses than we do to children, you are welcome to present a reasoned case why you think so. You are not welcome to declare by fiat that an embryo or a foetus is a child and then claim that your position wins by default.

    An embryo and a foetus are different from a child in several important ways, and you know it. Now please state your case in terms we can respect.

  • http://ragingleftie.blogspot.co.uk/ Raging Leftie

    Absolutely appalling, but it is not really surprising. Religious hospitals should be outlawed along with faith schools. They are bad for everyone involved except the people making m0ney from it and the people who get to indoctrinate and exploit vulnerable people (children and the ill).

  • Snap

    “The healthcare that these hospitals are providing is a service, not a right.”

    And that, right there, is, IMO, the biggest problem with healthcare in the US; it is not an unalienable right. Oh well, at least you still have liberty and the pursuit of happiness……

  • Azkyroth

    I would like to see an example of where the actual pregnancy is the cause of a life-threatening situation,

    Ahem.

  • Azkyroth

    Also:

    All these comments in this thread are not only shocking and repulsive, they are also incredibly unpatriotic.

    What.

  • L.Long

    OK Elvenfoot Lets say you are a woman, in an accident, laying in the street, bleeding to death.
    You have less then 5min to live. A fundamentalist muslin male doctor is only one there.
    He says it is immoral for me to treat you cuz you is wiman.
    So you smile up at him and say thank you I understand and die happy cuz he was being moral.
    Yea! Right!
    As to hospitals…If they will put up a big sign out front stating…
    We all here are a bunch of bigoted assholes who think (fill in) is immoral and will not treat it
    but we will pray for you while you are dying.
    Then I would be OK with what they do.


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