Ethical and Religious Directives come under fire again
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The American Civil Liberties Union lost a case against the US Bishops’ healthcare policy earlier this year, but they are trying another front.
And they appear to have won a small victory.
According to the San Francisco Chronicle, Mercy Medical Center in Redding, Calif., agreed to allow a doctor to perform a tubal ligation on a 32-year-old woman after she gives birth next month.
The medical center, owned by Dignity Health of San Francisco, California’s largest private health care company, had initially refused to allow Rachel Miller to undergo a sterilization, citing the Ethical and Religious Directives for Catholic Health Care Services.
After attorneys with the American Civil Liberties Union said they would file a discrimination suit if Miller was being denied “pregnancy-based care” on religious grounds, the hospital notified her doctor that it was reconsidering based on additional information the physician had provided. On Monday, the deadline the lawyers had set for a response, the ACLU said Mercy Medical Center had agreed to the surgery.
ACLU attorney Elizabeth Gill said Miller “is just one of many women who risk being denied care because Catholic bishops are telling medical professionals how to operate.” She said that under California law, the withholding of pregnancy-related care is a form of sex discrimination.
Rick L. Grossman, general counsel for Dignity Health, disputed that charge, saying in a message sent to Gill that the hospitals’ policy against sterilization applies to both men and women, the Chronicle reported.
Miller, a 32-year-old lawyer in Redding, said Mercy Medical Center’s refusal to let her doctor perform the sterilization procedure, communicated to her in April, would have required her to travel 160 miles to UC Davis, the closest hospital that would perform both procedures and would accept her insurance.
Tubal ligation, also known as “tying the tubes,” is a sterilization method used by about 600,000 women in the United States each year, according to the American College of Obstetricians and Gynecologists. The organization says a tubal ligation immediately after a woman’s last intended pregnancy is such a safe and effective procedure that it should be considered “urgent” medical care.
In a statement issued to Aleteia, Dignity Health’s Mercy Medical Center Redding said it could not comment on specifics about Miller’s case. But a spokeswoman for Dignity Health, Lauren Davis, referred a reporter to Directive 53 of the Ethical and Religious Directives.
That directive says that “procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.”
Dignity Health’s statement said that “tubal ligations are not performed in Catholic hospitals except on a case-by-case basis where a formal review by a committee of physicians and others gives permission to perform the procedure. When a service is not offered by Dignity Health, the patient’s physician makes arrangements for the care of his/her patient at a facility that does provide the needed service.
“The hospital has always and will continue to operate in accordance with the Ethical and Religious Directives for Catholic Health Care Services and the medical staff bylaws,” the statement concluded.
The ACLU shared a copy of Grossman’s communique with Aleteia. In it, he said that Miller’s physician applied a second time for permission to perform the ligation, this time supplying “additional clinical indicators.” Grossman said that permission was then granted, but that ultimately, the decision would be made by the physician at the time of Miller’s Caesarean section, based on whether it is medically necessary.
Gill, the ACLU lawyer, wrote in a blog post on the organization’s website: “Rachel [Miller] and her husband have one small child in their family and are eagerly expecting the arrival of their second baby next month. They have always known that their family would be complete with two children, so at the recommendation of her doctor, Rachel decided that she would like to get her tubes tied—a safe, standard and highly effective form of contraception—after she gives birth to their second child in late September. Her doctor fully supports this plan, as performing the procedure at the time of a C-section is the standard of care.”
Whether or not Miller has a medical need for sterilization, it’s clear from Gill’s blog post that the ERDs are going to continue to be a target for the ACLU:
While this is certainly a win for Rachel, there remains a clear conflict between the best interests of patients and the directives of the Catholic hospital system. All women should be able to make the medical decisions that are best for them, in consultation with their doctors. And religious institutions that provide services to the general public should not be allowed to claim religion as an excuse to discriminate or deny important health care.
In June, a federal district court in Michigan dismissed a case brought by the ACLU that challenged the Ethical and Religious Directives. The judge said that resolution of the case would involve reviewing religious doctrine.