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Ethicist: The ACLU is Right to Sue Catholic Hospitals

The ACLU is right in suing a chain of Catholic hospitals that refuse to perform abortions, argues bioethicist Arthur Caplan.
Image: Pope Francis
Pope Francis blesses the bread while preparing communion during a Mass Sunday, Sept. 27, 2015, in Philadelphia. Matt Slocum / AP

The visit to the United States by Pope Francis left a lot of goodwill behind. But there are areas where that goodwill slams into a church-state wall. The views of the church are completely out of step with American law and values when it comes to health care for women.

The American Civil Liberties Union (ACLU) has just announced a lawsuit against Trinity Health Corporation, one of the largest Catholic health systems in the country.

The suit highlights a key area where the Catholic Church and the law of land are colliding.The lawsuit says Trinity is failing in its duties to provide proper care to women in rare emergency situations when an abortion is required to save the life of the mother.

Trinity requires that its 80 hospitals around the country abide by rules advanced by the United States Conference of Catholic Bishops. The Ethical and Religious Directives say that no doctor working at a Catholic hospital can terminate a pregnancy even if the mother’s life is in danger.

Abortion isn’t the only sticking point between the bishops’ directives and sound medical care for women. Patients with cancer whose disease might be made worse should they become pregnant or for whom treatments might pose terrible risks to a fetus cannot have their tubes tied. And emergency contraception or even a discussion of it even post-rape is off limits too.

The restrictions on what doctors can do in Catholic facilities impacts many female patients, Catholic and non-Catholic. Catholic hospitals account for one in nine hospital beds nationally and as many as 1 in 6 in some states. Ten of the 25 largest hospital systems in the U.S. are Catholic. In the past decade mergers have led to a 16 percent increase in the number of Catholic-sponsored hospitals. In some communities there is no other option for emergency care.

The Catholic Church’s contribution to the health of every American is enormous. But for some patients it comes at far too high a price—putting religious doctrine over sound, proven medical practice. And not putting the health of women first and foremost is not consistent with medical ethics.

Some may argue that Catholic facilities should be free to determine what is medically consistent with Catholic values? But it’s a false argument.

For one thing, Catholic hospitals are not private entities. They took in $115 billion in 2011 alone from Medicare and Medicaid. They also get tax exemptions and other public money.

They are also bound by Federal laws such as the Emergency Medical Treatment and Active Labor Act (EMTALA). This is a federal law requiring that anyone coming to an emergency department be stabilized and treated, regardless of their insurance status or ability to pay. The ACLU argues that means performing an abortion if that is the standard of care in an emergency when the mother’s life is on the line.

The ACLU is right. Patients should expect their medical care to be determined by standards set by doctors not bishops, rabbis, ministers or imams. Hospitals awash in public funds are duty bound to follow the law not religious directives. There is room for conscience in health care but not when it means women patients will die in the ER.