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USA: Religious Hospitals Probed for Denying Women Care

Friday 9 July 2010, by siawi2

By Caroline Johnston Polisi

WeNews commentator

Friday, July 9, 2010

A legal commentator analyzes the possible reverberations of a Catholic
nun being excommunicated for authorizing an abortion that saved the
life of a young woman and the ACLU’s decision to act against what they
say is a violation of federal law.

(WOMENSENEWS)—Late last year, when a young mother of four came
through the doors of St. Joseph’s Hospital and Medical Center in
Phoenix, Sister Margaret Mary McBride made a difficult decision. The
choice she made would turn out to be the definitive one of her

Because of it, she suffered a very public excommunication at the hands
of Bishop Thomas J. Olmsted, was held up by the Roman Catholic Church
as an example of a former “woman religious” turned apostate
and resigned at the request of the bishop from her position as vice
president of mission integration at the hospital.

While details of the case remain hidden by federal privacy laws, the
maelstrom of media attention generated by the incident has provided
some information concerning the events that took place.

The woman, age 27, was 11 weeks pregnant and suffered from a serious
condition called pulmonary hypertension, which ultimately led to a
diagnosis of right-sided heart failure and shock. In consultation with
her family and a team of doctors, the ethics committee of the
hospital—on which Sister McBride sat—voted to allow an emergency
abortion in order to save the life of the woman.

In a statement released shortly after the incident became public, the
Roman Catholic Diocese of Phoenix proclaimed it a "scandal that a
Catholic hospital would perform such a reprehensible act" and
insisted that a set of ethical and religious directives, to which St.
Joseph’s and countless other public Catholic hospitals adhere,
prohibit direct abortions under any circumstances—even, apparently,
if that means almost certain death for the mother and fetus.

Representatives at St. Joseph’s Hospital responded with a statement of
their own, firmly reiterating that the procedure was necessary to save
the woman’s life.

Attention Focused on Murky Questions

Much of the attention over the past few months has centered on murky
questions of ethical and religious significance, with popular
reactions ranging from outrage at the Catholic Church for its
treatment of Sister McBride to a renunciation of the hospital for
opposing church directives.

With attacks so virulent coming from both sides of the political
spectrum, it’s important to recognize the situation for what it is,
and what it is not. It is not a platform to criticize members of the
Catholic Church for their deeply held religious beliefs. They are
entitled to them. Nor is it a time to delve into the complex moral and
political arguments so often associated with the practice of elective

Rather, it is an opportunity to identify and rectify a troubling and
dangerous violation of federal law potentially taking place in
Catholic hospitals across the country.

Last week, members of the American Civil Liberties Union’s Washington
legislative office did just that, along with the ACLU of Arizona and
the New York-based ACLU Reproductive Freedom Project. Together, the
civil liberties organizations sent a letter addressed to the Centers
for Medicare and Medicaid Services, a division of the Department of
Health and Human Services. In it, the organizations raise possible
systematic violations by religiously-affiliated hospitals of the
Conditions of Participation of Medicare and Medicaid and the Emergency
Medical Treatment and Active Labor Act (EMTALA).

EMTALA became law in 1986 and applies to hospitals that accept federal
dollars for Medicare and Medicaid services, which, in practical terms,
is almost every hospital in the United States.

Act Applies to All Patients

The law governs how and when a patient can be denied medical treatment
or transferred to another hospital when she or he is in an unstable
medical condition. While the act covers hospitals that receive funding
for Medicare or Medicaid, the requirements apply to every patient the
hospital treats, not just those using the programs.

"Religiously-affiliated hospitals—which are often the only
hospital in a particular area— are not exempt from providing critical
care to patients who come through their doors," said Daniel
Pochoda, legal director of the ACLU of Arizona, in a press statement
issued last week.

The letter cites an American Journal of Public Health article that
documents refusals by various Catholic hospitals to provide urgent
medical reproductive care in miscarriage management cases. In each
situation described, the letter asserts, the hospital in question
placed a woman’s life or health at risk in direct violation of federal

The ACLU’s legal argument hinges on an interpretation of a section of
federal law that requires hospitals to stabilize patients with an
“emergency medical condition,” defined as a situation in
which the health of the patient is in serious jeopardy or the patient
risks serious impairment to bodily functions or dysfunction of a
bodily organ. There are unfortunately countless conditions in which
termination of pregnancy will be necessary to stabilize a patient,
they argue. They also allege violation of federal law in the various
hospitals’ failings to provide their pregnant patients with all
available treatment options.

"The law rightly requires hospitals to provide life-saving
medical care to their patients," said Vania Leveille, ACLU
legislative counsel. "The government must ensure that the
well-being of the patient does not take a back seat to religious

Group Seeks Investigation

The civil liberties group seeks a comprehensive investigation as well
as an explicit clarification of protocol in situations similar to the
one that gave rise to Sister McBride’s excommunication. They request
an immediate in-person meeting with Marilyn Tavenner, an administrator
and chief operating officer of the Centers for Medicare and Medicaid
Services, which is responsible for the development and enforcement of

In taking a hard-line stance against the violations of the rights of
women in religiously-affiliated hospitals, the ACLU provides a morally
neutral framework to analyze the situation: hospitals that refuse to
provide emergency medical reproductive health care jeopardize the
health and lives of women in direct violation of federal law.

While Sister McBride’s decision has no doubt caused her immense
personal suffering, the uproar surrounding her excommunication has and
will continue to resonate publically. It has shed light on a troubling
problem that cannot be rectified without government intervention.

Many await the Centers for Medicare and Medicaid Services’ response
and hope it strikes a proper legal balance between respect for
individual religious liberty and patient safety.

Caroline Johnston Polisi is an attorney and freelance journalist in
New York City who does volunteer legal work for the ACLU’s
Reproductive Freedom Project. She wrote this article in her individual