Lesson learned: My Catholic hospital can limit my medical choices

What’s in a choice? Options. In order to make a choice, you must have options. As descendants of those who fled religious persecution, many of our forefathers understood the importance of options and the power of choice. That’s why they guaranteed our right to freely exercise religion in the first amendment. I think we can all agree that’s a good thing.

I read an article the other day that I can’t get out of my mind about reproductive care in Catholic hospitals. As @JillFilipovic reports on Al Jazeera America:

Catholic health care providers are bound by the Ethical and Religious Directives for Catholic Health Care Services, a document issued by the U.S. Conference of Catholic Bishops that governs how health care providers should deal with reproductive issues, end-of-life care, the “spiritual responsibility” of Catholic health care and a variety of other concerns. The range of women’s health care options that Catholic facilities offer is limited — sometimes, like when a pregnancy goes wrong, to a deadly degree. And while most doctors have an ethical obligation to inform patients of all their options, Catholic facilities routinely refuse to offer even abortions necessary to save a pregnant woman’s life; their doctors are also barred from telling a patient with a nonviable pregnancy that there are other, often safer options available elsewhere, lest the patient seek care at another facility. (LGBT patients may also run into problems, whether it is with hormone therapy for transgender patients or simply the right of married same-sex partners to be treated as next of kin in making health care decisions).

Some other particularly disturbing accounts from the article:

Tamesha Means, a Michigan woman, had a different, more terrifying experience. Her water broke at 18 weeks, too early for the fetus to be likely to survive. A friend drove her to the closest hospital, a Catholic facility where medical providers told Means the baby would probably not live, but they refused to terminate her pregnancy. She went back a second time and was sent home, despite being at risk of infection and in excruciating pain. The third time she went back, this time bleeding, in pain, running a fever and suffering from an infection from a miscarriage in progress, she was again directed to go home. She went into labor while filling out hospital discharge paperwork. Only then did hospital employees begin to attend to her. She delivered, and the very premature infant died shortly thereafter.

In one case in Arizona, a pregnant mother of four went to a Catholic hospital’s emergency room with a condition so life-threatening that her chances of imminent death without an abortion were nearly certain. She was too ill to transfer to another facility, so the hospital’s administrator, a nun, approved an emergency termination. The woman lived. The nun was excommunicated. Her standing with the church was eventually restored, but the hospital lost its 116-year affiliation with the Catholic Church.

As a 25-year-old woman, who went to a Catholic hospital only a few hours prior to reading that article, it really resonated. I immediately recalled how the woman checking me in had asked if I’d disclose my religious affiliation — I declined. And upon further reflection I realized that my general practitioner/gynecologist’s office was a part of the same Catholic healthcare system as the hospital. At no point was I informed by my doctor that seeking care at a Catholic facility could affect my access to care.

In outrage, I shared this with a friend. She responded, ”I agree that it’s poor healthcare practice, though I do think private hospitals should have the right to make such management choices….just as I think Catholic or Jewish schools can rightfully teach religion and god in a manner that would be completely unacceptable in public school.” Her school analogy challenged my initial gutteral rage reaction, transforming it into thinking. I must say that it also helped that my friend concluded our email with the prompt, “What do you think?”

 Options and choices

When there’s a choice in the matter (a choice defined by the existence of economically and logistically viable options), I don’t really have a problem with the dogma. If parents or children don’t like the way religion is taught at a private school, they’re free to choose a public alternative (even if the quality of education is worse). In this scenario, parents/children can weigh their options and make the best decision for them. If they choose to attend the private school that teaches a religion different than their own, that’s their choice. They are free to choose the imposition.

With hospitals, I don’t think that these options exist. When the only option is a regional hospital and that hospital has a religious affiliation that prevents its staff from offering certain services, patients are left with no choice but to abide by the rules of a religion they may not even believe in — and with concrete consequences to their health. I think that’s tyranny.

And it’s not just a rural vs. urban thing either. The power dynamic between hospital and patient is different than that between school and child/parent. If a school isn’t good for a child, the parent can transfer the kid to another school – and the parent/child can actually take time to weigh the decision and explore other options. When somebody’s bleeding to death, the only option is the closest hospital. And once the person walks (or is carried) through the hospital doors, they are going to get treated at that hospital.

For instance, if harm befalls a pregnant woman and she’s taken by an ambulance or whomever to the nearest hospital that happens to be Catholic, she literally has no other option but the Catholic hospital. And then if there’s some complication where it’s save the mother vs. save the baby and the mother is not offered lifesaving options due to the hospital’s religious beliefs, that is an infringement upon her religious rights.

 Freedom of religion

Inherent in the freedom to exercise one’s religion is the right to NOT exercise a religion. And in the case of religious hospitals, the religious institution is trampling the right of the individual to not follow the doctrine of a religion he/she doesn’t believe in – and in life and death situations.

I just don’t think hospitals should have religious rights. Perhaps unless they’re exclusively serving those that ascribe to their religious doctrine. If only practicing Catholics were tended to by the Catholic hospitals and then denied certain care that’s deemed anti-Catholic, that’d be a different story. Their religion, their choice. Not tyranny. On the other hand, when the hospital follows its religion to the detriment of its non-religious patient and doesn’t allow the patient to make the tough ethical call, then I strongly feel that that’s the exact type of tyranny our forefathers were trying to avoid with the 1st amendment.

Also what about the ethical implications for non-Catholic doctors, nurses, etc. who work at Catholic hospitals? Surely not all who work at Catholic hospitals are Catholic…

I definitely don’t hate religion, and I understand the need for certain institutions to center the way they run things around a certain religion without fear of reprimand from the government. But where is the balance? What about the individual’s right to follow or not follow a religion?