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In Malpractice Case, Catholic Hospital Argues Fetuses Aren’t People

11:12 am in Uncategorized by RH Reality Check

Written by John Tomasic for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Cross-posted in partnership with the Colorado Independent.

For further coverage of the treatment of pregnant women in Catholic Hospitals, click here.

A fetus at 9 weeks

"This is not a person." --The Catholic Church

Lori Stodghill was 31-years old, seven-months pregnant with twin boys and feeling sick when she arrived at St. Thomas More hospital in Cañon City on New Year’s Day 2006. She was vomiting and short of breath and she passed out as she was being wheeled into an examination room. Medical staff tried to resuscitate her but, as became clear only later, a main artery feeding her lungs was clogged and the clog led to a massive heart attack. Stodghill’s obstetrician, Dr. Pelham Staples, who also happened to be the obstetrician on call for emergencies that night, never answered a page. His patient died at the hospital less than an hour after she arrived and her twins died in her womb.

In the aftermath of the tragedy, Stodghill’s husband Jeremy, a prison guard, filed a wrongful-death lawsuit on behalf of himself and the couple’s then-two-year-old daughter Elizabeth. Staples should have made it to the hospital, his lawyers argued, or at least instructed the frantic emergency room staff to perform a caesarian-section. The procedure likely would not have saved the mother, a testifying expert said, but it may have saved the twins.

The lead defendant in the case is Catholic Health Initiatives, the Englewood-based nonprofit that runs St. Thomas More Hospital as well as roughly 170 other health facilities in 17 states. Last year, the hospital chain reported national assets of $15 billion. The organization’s mission, according to its promotional literature, is to “nurture the healing ministry of the Church” and to be guided by “fidelity to the Gospel.” Toward those ends, Catholic Health facilities seek to follow the Ethical and Religious Directives of the Catholic Church authored by the U.S. Conference of Catholic Bishops. Those rules have stirred controversy for decades, mainly for forbidding non-natural birth control and abortions. “Catholic health care ministry witnesses to the sanctity of life ‘from the moment of conception until death,’” the directives state. “The Church’s defense of life encompasses the unborn.”

The directives can complicate business deals for Catholic Health, as they can for other Catholic health care providers, partly by spurring political resistance. In 2011, the Kentucky attorney general and governor nixed a plan in which Catholic Health sought to merge with and ultimately gain control of publicly-funded hospitals in Louisville. The officials were reacting to citizen concerns that access to reproductive and end-of-life services would be curtailed. According to The Denver Post, similar fears slowed the Sisters of Charity of Leavenworth’s plan over the last few years to buy out Exempla Lutheran Medical Center and Exempla Good Samaritan Medical Center in the Denver metro area.

But when it came to mounting a defense in the Stodghill case, Catholic Health’s lawyers effectively turned the Church directives on their head. Catholic organizations have for decades fought to change federal and state laws that fail to protect “unborn persons,” and Catholic Health’s lawyers in this case had the chance to set precedent bolstering anti-abortion legal arguments. Instead, they are arguing state law protects doctors from liability concerning unborn fetuses on grounds that those fetuses are not persons with legal rights.

As Jason Langley, an attorney with Denver-based Kennedy Childs, argued in one of the briefs he filed for the defense, the court “should not overturn the long-standing rule in Colorado that the term ‘person,’ as is used in the Wrongful Death Act, encompasses only individuals born alive. Colorado state courts define ‘person’ under the Act to include only those born alive. Therefore Plaintiffs cannot maintain wrongful death claims based on two unborn fetuses.”

The Catholic Health attorneys have so far won decisions from Fremont County District Court Judge David M. Thorson and now-retired Colorado Court of Appeals Judge Arthur Roy.

In September, the Stodghills’ Aspen-based attorney Beth Krulewitch working with Denver-based attorney Dan Gerash appealed the case to the state Supreme Court. In their petition they argued that Judges Thorson and Roy overlooked key facts and set bad legal precedent that would open loopholes in Colorado’s malpractice law, relieving doctors of responsibility to patients whose viable fetuses are at risk.

Whether the high court decides to take the case, kick it back down to the appellate court for a second review or accept the decisions as they stand, the details of the arguments the lawyers involved have already mounted will likely renew debate about Church health care directives and trigger sharp reaction from activists on both sides of the debate looking to underline the apparent hypocrisy of Catholic Health’s defense.

At press time, Catholic Health did not return messages seeking comment. The Stodghills’ attorneys declined to comment while the case was still being considered for appeal.

The Supreme Court is set to decide whether to take the case in the next few weeks.

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Kentucky Governor Firmly Rejects Hospital Merger with Catholic Health Initiatives

12:33 pm in Uncategorized by RH Reality Check

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Written by Rev. Matthew Westfox and Carol Savkovich for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Kentucky Governor Steve Beshear said January 9, 2012 for the second time in two weeks that he was rejecting a hospital merger of the publicly-funded University Hospital with a Catholic-oriented consortium, Catholic Health Initiatives (CHI).

The rejection of the Kentucky merger marked a welcome success story for people supporting reproductive options and it shows how concerned citizens, working together, can have a real impact in their communities. It also sends a clear message to Washington D.C. policymakers that ordinary Americans do not want their health care options limited by singular religious views.

The Kentucky Religious Coalition for Reproductive Choice and others objected to the restrictions on reproductive health care that would have resulted from the merger. Particularly affected would have been the needy, for whom University Hospital is the main source of care.

The proposed hospital merger – or its rejection – didn’t generate much attention outside Kentucky, but it was big news in the state. The plan, first raised in the early summer of 2011, involved merging two hospitals in Louisville and one in Lexington into a single entity under the majority control of CHI, a Denver-based chain. In addition to University Hospital, which had been built with public funds, the others joining in the merger plans were Jewish Hospital and St. Mary’s HealthCare in Louisville and St. Joseph Hospital in Lexington.

CHI indicated that it would operate under the Ethical and Religious Directives (ERD) of the Roman Catholic Conference of Bishops, and all of the merging hospitals would be required to conform to the ERDs, even if they or their patients did not subscribe to Catholic beliefs. This created a significant problem for reproductive health care since the ERDs prohibit or restrict a range of medical procedures related to reproductive health, including abortion (even when medically necessary), family planning, contraception, emergency contraception, tubal ligation, vasectomy and stem cell research. Employee health care options at these hospitals would have been similarly curtailed, regardless of employees’ personal religious beliefs.

The Board of the Kentucky Religious Coalition for Reproductive Choice (KRCRC), a state chapter of the Religious Coalition for Reproductive Choice (RCRC), headquartered in Washington D.C., voted unanimously in December to take a stand opposing the merger. In a letter to the editor, KRCRC wrote that the Catholic Ethical and Religious Directives were not compatible with providing the full range of reproductive health care services to the area’s citizens. The letter said: Read the rest of this entry →

In Maryland Hospital Debate, Women’s Health Ignored

8:35 am in Uncategorized by RH Reality Check

Written by Amie Newman for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

It seems another fight is brewing over Catholic hospitals and reproductive health care – this time in Maryland. Adventist Healthcare, based in Rockville, MD, is challenging the recommendation of Maryland Health Care Commission chair Marilyn Moon and with it a Catholic hospital’s request to build a multi-million dollar hospital in the state.

According to Adventist, Moon’s findings were unsubstantiated and flawed – in part as they relate to reproductive health care availability in the state. Holy Cross Hospital’s newest proposed center would not offer the range of reproductive health care women in the community need – including fertility treatments, abortion and hormonal contraception.

The Washington Post reports that, for “two years, the two health-care giants have waged a costly and intense competition for state approval of a new hospital in Montgomery’s fastest-growing region.” Adventist wants to build a hospital a few miles to the north of where Holy Cross has proposed its new center. But Moon says that Holy Cross’ proposal, to build on the Germantown campus of Montgomery College, was superior. She also noted that Holy Cross has “a track record that is equal to or better than that of the Adventist hospitals ‘with respect to quality of care, community benefits, and efficient and effective management.’”

In response to Moon’s recommendations, Adventist filed a 105-page document of exceptions today with the Maryland Health Care Commission, asking them to “reopen the comparative review of upcounty hospital projects because…the recommended decision…” is flawed.

In direct response to Adventist’s concerns that Holy Cross does not provide critical reproductive health care services to women, Moon wrote, “I do not find that approval . . . would have a substantial negative impact on the availability or accessibility of the services that [Holy Cross Hospital-Germantown] will not provide, because it will be adhering to the doctrines of the Roman Catholic Church.”

A host of local and national women’s groups had raised concerns about Holy Cross’ refusal to provide many health care services the women of Maryland need including the Maryland Coalition for Sexual Assault, Planned Parenthood of Metropolitan Washington, The MergerWatch Project, and the National Women’s Law Center. Read more

USCCB Clarifies: Only Some Lives Worth Saving

7:55 am in Uncategorized by RH Reality Check

Written by Kathleen Reeves for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

In the wake of the "automatic excommunication” of Sister Margaret McBride, a nun who was part of a committee that granted an abortion to a woman whose pregnancy threatened her life, theologians are splitting hairs over excommunication, intention, and conscience. In order to clear things up, the U.S. Conference of Catholic Bishops has released a statement articulating the difference between “direct” and “indirect” abortion.

Direct abortion is a “procedure whose sole immediate effect is the termination of pregnancy,” including when the mother’s life is in danger.

Of course, there’s another effect, which is that the mother’s life is saved. Perhaps it’s not immediate enough?

Indirect abortion happens as follows:

"Operations, treatments and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman” that “cannot be safely postponed until the unborn child is viable” and may “result in the death of the unborn child.”

The second is okay by the Church; the first, no.

Are you confused? If so, it’s because there is NO SUBSTANTIVE DIFFERENCE between these two scenarios. In order for a woman to live, her pregnancy must end.

The USCCB’s Committee on Doctrine provides these helpful examples:

The first involves a pregnant woman who is experiencing problems with one or more of her organs, apparently because of the added burden of pregnancy. In this case, the doctor recommends an abortion to protect the woman’s health.

In the second example, a pregnant woman develops cancer in her uterus. In this case, the doctor recommends surgery to remove the cancerous uterus as the only way to prevent the cancer from spreading. Removing the uterus also will result in the death of the unborn child.

The only difference I see in these cases is that in case two, the fetus is hidden away in the uterus, so the doctors removing it can pretend it’s not there.

And thus it is that a rich theological tradition is reduced to garbage. And unfortunately, this reasoning, reminiscent of “How many angels can dance on the head of a pin?,” is medical policy.

The USCCB has not had a good year. But, as Nicholas Kristof pointed out, at least it didn’t have to excommunicate any child molesters.

Are Catholic Hospitals Safe for Pregnant Women?

6:33 am in Uncategorized by RH Reality Check

The news of the excommunication of Sister Margaret McBride, the nun at a St. Joseph’s Hospital and Medical Center in Phoenix who approved an abortion that was necessary to save the life of a woman, has shocked and angered both the devout and the non-religious alike. 

Catholics for Choice condemned the action via press release, stating:

"[I]t is clear that the Vatican’s hard line on abortion led to this terrible situation. Sadly, we see situations like this time after time, both here in the US and abroad. The Vatican’s outright ban on all abortions is insensitive and reflects an unwillingness to acknowledge the reality of women’s lives, including the difficult decisions that often have to be made during a pregnancy.

Reasonable Catholics the world over acknowledge that access to abortion is sometimes necessary, and our polling and that of other organizations shows that a large majority of Catholics reject the Vatican’s outright ban on all abortions."

Reasonable Catholics may very well reject the outright ban on abortion, but it seems that these are not the Catholics who often get to make the final decision on medical procedures that occur within hospital walls.  Because, unfortunately, situations like the one in the Arizona hospital occur with great frequency, and women’s lives and medical requests are often ignored in the name of religious doctrine.

Earlier this month the Journal of General Internal Medicine released a study showing how rampant the disagreement is between Catholic hospitals and the doctors who provide care for patients.  From the American Medical News Association:

Most of the physicians reporting conflicts worked in Catholic hospitals, which account for 12.5% of all U.S. community-based hospitals and 15.5% of hospital admissions, according to the Catholic Health Assn. of the United States.

Catholic hospitals are required to follow the U.S. Conference of Catholic Bishops’ religious directives on medical care that bar contraception, abortion and sterilization and, in many instances, rule out ending artificial hydration and nutrition.

When conflicts arise, 86% of surveyed physicians said they would encourage patients to seek the recommended care at another hospital. Ten percent said they would offer an alternative treatment that could be delivered at the religious hospital, and 4% endorsed violating the hospital’s policy to provide the care.

The author of the study, Dr. Debra Stulberg, has had her own issues with medical directives being overturned by Catholic hospital administrators, and in one case a woman would have been forced to put her life in danger just to avoid abortion.

Family physician Debra Stulberg, M.D., was completing her residency in 2004 when West Suburban Medical Center in Oak Park, Illinois, was acquired by the large Catholic system Resurrection Health Care. "They assured us that patient care would be unaffected," Dr. Stulberg says. "But then I got to see the reality." The doctor was struck by the hoops women had to jump through to get basic care. "One of my patients was a mother of four who had wanted a tubal ligation at delivery but was turned down," she says. "When I saw her not long afterward, she was pregnant with unwanted twins."

And in emergency scenarios, Dr. Stulberg says, the newly merged hospital did not offer standard-of-care treatments. In one case that made the local paper, a patient came in with an ectopic pregnancy: an embryo had implanted in her fallopian tube. Such an embryo has zero chance of survival and is a serious threat to the mother, as its growth can rupture the tube. The more invasive way to treat an ectopic is to surgically remove the tube. An alternative, generally less risky way is to administer methotrexate, a drug also used for cancer. It dissolves the pregnancy but spares the tube, preserving the women’s fertility. "The doctor thought the noninvasive treatment was best," Dr. Stulberg recounts. But Catholic directives specify that even in an ectopic pregnancy, doctors cannot perform "a direct abortion"—which, the on-call ob/gyn reasoned, would nix the drug option. (Surgery, on the other hand, could be considered a lifesaving measure that indirectly kills the embryo, and may be permitted.) The doctor didn’t wait to take it up with the hospital’s ethical committee; she told the patient to check out and head to another ER.

Waiting for the ethical committee to approve would not only delay the patient’s care and put her life in danger, it still couldn’t guarantee a positive outcome for the patient.  After all, it was Sister Margaret McBride’s ruling on the committee in favor of saving the mother’s life in Arizona that got her excommunicated.  How many members of the church are willing to risk what they believe to be their immortal souls to defy the church, even if it means saving a woman’s life?

And truly, many of these are cases of saving a woman’s life.  Women who are already in danger due to their pre-existing conditions are being told that not only are they so expendable, and that these hospitals will not perform the abortions that would save their lives, but that they should further risk their lives by seeking out some other place that might provide them care, such as Michelle Lee, who had to travel to a different state to have a necessary procedure performed.

In 1998, the Louisiana State University Medical Center in Shreveport refused to provide an abortion for Michelle Lee, a woman with cardiomyopathy who was on the waiting list for a heart transplant, despite her cardiologist’s warning that the pregnancy might kill her. Hospital policy dictated that to qualify for an abortion, a woman’s risk of dying had to be greater than 50 percent if her pregnancy was carried to term; a committee of physicians ruled that Lee did not meet this criterion. Since her cardiomyopathy made an outpatient abortion too dangerous, she traveled 100 miles to Texas by ambulance to have her pregnancy terminated.

The woman’s risk of dying has to be greater than 50 percent.  And even then, who gets to determine if her risk is above 50 percent, if the doctors are being overruled by the Catholic hospital administrators?  As Dr. Debra Stulberg’s attending put it to her, "So, it looks like we’re going to be working for the Pope."

Do you want the Pope deciding on your medical care?