The Catholic Church dictates reproductive health care, even in blue states

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When the devastating Dobbs decision came from the Supreme Court in late June, Americans across the country, the vast majority of whom support Roe v. Wade, they felt a collective wave of anger, frustration and fear. The concern was undoubtedly deepest in those states with trigger laws, where a wave of draconian restrictions had already been implemented. But wherever you live, whether your state is currently red or blue, there is another growing barrier to accessing abortion and comprehensive gynecological services. It is the Catholic Church.

Anyone familiar with the workings of the Catholic church would not be surprised that the Ethical and Religious Guidelines of the US Conference of Catholic Bishops (ERD) prohibit abortion and contraceptives, among other things. services like gender confirmation treatmentmost fertility treatments and physician-assisted death — in a Catholic hospital. But Catholic doctrine is becoming a major issue in more subtle ways: in its expanding role in American health care, and in the confusing and contradictory execution of religious dogma in medical choices that can put Americans at risk. patients without their prior knowledge.

Your own local hospital may be following the Vatican’s lead, and you may not know it.

“Catholic health care is now collectively the largest nonprofit, nongovernmental health care provider in the United States.” Jason T. Eberl, Ph.D.the director of the Albert Gnaegi Center for Health Care Ethics at St. Louis University told me in a recent phone conversation. “In fact, my understanding is, in the world.”

the Catholic Health Association reports that as of 2022, it represents 654 hospitals in the US, including 299 that provide obstetrical services. And if a patient doesn’t seek services that conflict with ERDs, having more health care services in more places can be a win, especially for residents of rural and underserved communities. But if you’re among the half of the population for whom the possibility or reality of pregnancy has ever loomed in their lifetime, then you should know that the US Conference of Catholic Bishops has a lot to say about your care. .

In some areas, Catholic facilities are the only community hospitals — including the California, Colorado, and Illinois regions. People who would otherwise think their reproductive options are secure because they live in a blue state may end up discovering that privilege depends on how far they can drive. And with Nearly 900 hospitals across the country at risk of closuremost of them in rural areas, it could be a very long trip.

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Four of the 10 largest health systems in the country they are catholic. Everyone is indebted to those Ethical and Religious Guidelines. Your own local hospital may be following the Vatican’s lead, and you may not know it. As a 2020 Community Catalyst report on the growth of Catholic health systems titled “Bigger and Bigger” explains, “Historically Catholic hospitals that were bought by for-profit systems may continue to follow the Catholic ERDs [Ethical and Religious Directives] as a condition of sale. Nonprofit, non-Catholic hospitals that have merged with Catholic facilities are often required to adopt some or all of the ERDs. Public hospitals that are being run by Catholic health systems may have accepted remove any services that conflict with the ERDs.”

Where this becomes especially thorny for pregnant patients is in this directive: “No intervention is morally permissible that constitutes a direct abortion. Any procedure whose only immediate effect is the termination of pregnancy before it is viable is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo.

The vaguely positive news for patients with an ectopic pregnancy or a large tumor is that a Catholic doctrine known as the double effect it allows patients to receive life-saving treatment and surgery, as long as the death of the fetus is only an unintended consequence of the procedure. Patients should also, if they have had a miscarriage, be able to obtain the appropriate procedure or medication to expel fetal remains.

The bad news is that in a crisis, patients may not be able to get anyone to risk having the procedure done. It’s not just about Catholic facilities, either. In 2018, Arizona woman Nicole Mone Arteaga’s Walgreens pharmacist refused to fill a prescription for medication after her miscarriage. citing his “ethical beliefsNow, after Dobbs, health care advocates are worried it will become more common practice. cannot get prescriptions for misoprostol.


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Patients with ectopic pregnancies share similar risks. In Missouri, the treatments are supposedly retarded because the state’s activation law allows abortion only if there is “a serious risk of substantial and irreversible physical deterioration.” In other words, doctors can feel comfortable waiting to help patients until they are in a verifiable, life-threatening emergency.

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So while Jason Eberl said “Dobbs shouldn’t change anything” in the way Catholic health care is administered, when I tell him that I fear Catholic health care workers will now be more reluctant to provide some care, even in permitted circumstances, he responded, “I share that fear.”

The medical history of the Catholic church here certainly bears out those apprehensions. Ireland’s long-standing movement towards reproductive rights was fueled in large part by the 2012 death of Savita Halappanavar, a pregnant Galway woman who was denied proper intervention when she suffered sepsis during a miscarriage, as staff from the hospital informed him: “This is a Catholic country.

And it’s not just abroad. A 2008 report in the American Journal of Medical Health found that “American obstetricians and gynecologists working in Catholic-owned hospitals revealed that are restricted in the management of spontaneous abortions … Some doctors intentionally violated protocol because they felt patient safety was compromised.”

In 2011, the ACLU released a report, “The growth of Catholic hospitals and the threat to reproductive health carehighlighting case studies of women denied proper miscarriage care, or not informed of its risks. In 2016, The Guardian published the findings of the former Muskegon County, Michigan health officer Faith Groesbeck, who accused Mercy Health Partners of “forcing five women between August 2009 and December 2010 to have unsafe miscarriages by giving them no choice… In every incident, [Mercy Health Partners] medically indicated treatment and information withheld of pregnant women experiencing emergency situations”.

And patients may not know about this potential harm until it’s too late, because the fact that their care options are being dictated by a team of bishops may not be apparent. The Catholic directives state that “Catholic health care institutions should not provide abortion services, not even on the basis of the principle of material cooperation. In this context, Catholic health care institutions should be concerned about the danger of scandal in any association with providers of abortion services”.

Thus a search for “abortion” in the Catholic health system of ascension the site smoothly redirects to “ablation”. And while they promote “advanced care for high-risk pregnancy” among their obstetric services, they fail to mention that a high-risk patient would not be able to abort if necessary. A search in the catholic health system Dignity returns almost identical results. Emails sent to Ascension and the Catholic health system this week went unanswered. During a brief phone call to a Dignity birthing center, the person who answered the phone told me, “I’d love to talk, but I’m not allowed to,” before wishing me a good day.

The lack of transparency does not seem involuntary. As the New York Times reported in 2018, after reviewing the websites of 652 U.S. Catholic hospitals, “In nearly two-thirds of them, it took more than three clicks from the home page to determine that the hospital was catholic.Only 17 catholic individual hospital websites, less than 3 percent contained an easy-to-find list of services not offered for religious reasons.”

It’s not just about abortion on demand. It is about the impact on the health and safety of pregnant people. It is about the utter absurdity of a group of religious men making great strides in the practice of American medicine and the increasingly prolific aggressive interpretation of their directives. It’s about what could easily happen to you, or someone you love, in a dire medical situation, where your doctors are following your lead regarding your care, not about what’s going on in your body, but about what the bishops have decided is best.

Even for practicing Catholics, it should be chilling. “I am afraid that Dobbs will intersect with a phenomenon that we already have among Catholic doctors or pharmacists and other Christians and even non-religious pro-lifers or other health care workers,” said Jason Eberl. “Being too scrupulous in their assessment of embryonic and fetal life, and occluding respect, the assessment of the life of the pregnant patient in front of them.”

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