Judges Are Angry in America—Especially at the Most Vulnerable

When veteran Bill Baker took batteries, discarded outside a business in Ohio, for recycling, it was because the batteries seemed to have been left for the public, with a sign stating “free.” Unfortunately, the sign had been placed there by mistake, and Baker was charged with grand theft. At a pretrial hearing, the judge angrily dismissed the case, lectured the attorneys about how busy he was, and ordered Baker to pay court fees.

When he said he could not afford to, the judge demanded to know how much money Baker had in his pockets. It was fifty dollars. The judge threatened to hold Baker in contempt of court unless he paid all of it. Baker said in an interview with Rewire.News: “It made me realize our justice system has some real holes in it.”

The American Bar Association states under Standard 6-3.4 of its Special Functions of the Trial Judge that the general responsibility of a trial judge is to “remain neutral regarding the proceedings at all times, suppress personal predilections, control his or her temper and emotions, and be patient, respectful, and courteous to defendants, jurors, witnesses, victims, lawyers, and others with whom the judge deals in an official capacity.” But countless examples exist of judges allowing their emotions to control and influence their behavior and decisions when acting within their official capacity.

Although judges often see the worst aspects of human behavior, the service they perform demands professionalism and responsibility, and they must approach their role with a level of detachment to achieve just and fair outcomes. For many people, however, especially in civil and family court, that’s not the kind of judge they face. And the targets of judges’ anger or unprofessional behavior, often vulnerable people, including survivors of violence and the poor, have few options for justice.

Judges behaving badly persists across the country and throughout the courts, from Judge Robert Restaino jailing 46 people in a fury after a cell phone interruption to Judge William Hooks forced to take anger management classes because of his emotional courtroom behavior.

This month, Judge Marvin Adames of New Jersey faces an ethics charge after he jailed a woman in 2016 for nearly a month because he said she was disrespectful. And in May 2017, Judge John F. Russo Jr. was removed from the bench and accused of courtroom impropriety based on the aggressive manner in which he questioned a survivor of sexual assault.

Repeatedly, the targets of judges’ outbursts are survivors of sexual or domestic violence. In October, a judicial commission dismissed an ethics complaint against Judge Kenneth Walker of Oregon, lodged after he had thrice interrupted a domestic violence survivor reading her victim impact statement in his court; he walked out of the courtroom on her before she had finished.

Judge Jerri Collins of Florida became the focus of national media attention in 2015 when she used sarcasm and shouting to belittle a domestic violence victim for failing to testify against her abuser. The victim is seen in a viral video tearfully begging the judge not to send her to jail for failing to appear. Judge Collins’ response to the victim saying her anxiety was a factor in her inability to face her abuser in court? “You think you have anxiety now? You haven’t even seen anxiety!”

She sentenced the victim to three days in jail.

When the tempers of judges flare, the consequences to average citizens can be dire: increased fines, harsher sentences, even jail time. But judges face few, if any, repercussions for their bad behavior in court.

The Florida Supreme Court publicly reprimanded Judge Collins for improper behavior. In the hearing Justice LaBarga stated, “Judge Collins, this is indeed a sad day for you, a sad day for the people of Florida and a sad day for the judiciary upon which our people depend for justice.” Although this reprimand may have been embarrassing, it did not strip her of her position, and does little to ensure that Judge Collins did not or will not berate the next domestic violence victim in her path.

In 2017, the Florida Judicial Qualifications Commission received 593 judicial complaints that argued that a judge could not or was not performing their job properly. But the commission only filed formal charges on two complaints.

When formal charges are entered, an accused judge may face censure from the state Supreme Court or be removed from their position. But because so few cases are investigated, many judges will never face formal charges.

Earlier this year, in a Hamilton County, Ohio, courthouse, Magistrate Michael Bachman was caught on a security video running after a woman whom he felt had disrupted his court proceeding by arguing with staff in the hall. In the video, the judge was red-faced and livid as he hurried out of the courtroom and down the hall. Once he found the woman, he yelled at her, repeatedly pointing, put his hand on her back, and physically forced her to his courtroom where he sentenced her to three days in jail.

In one year alone, 2017, the Ohio Office of Disciplinary Counsel received 491 complaints against state judges, dismissing 350 of them. Between the years of 2013 and 2017, the Disciplinary Counsel investigated only 506 complaints of judicial misconduct.

The agencies tasked to monitor and investigate these complaints against judges are comprised of lawyers. As such, the agencies have an incentive not to investigate. The legal community is a small, tight knit group of people who often must rely on each other for client referrals, judicial appointments, and promotions within the state and federal judicial structure and within private practice.

The first day of law school orientation, professors tell students that to be successful you must network with other attorneys, which requires a lot of nights spent at the bar during happy hour. But what law schools fail to teach is the need to hold your colleagues to a high level of professionalism and conduct. Networking is vital to your success; therefore, you must stay quiet when you see other attorneys—or judges—behaving badly.

This silence against inappropriate anger and misconduct reaches all the way to the Supreme Court of the United States. Countless signs existed that Justice Brett Kavanaugh and Justice Clarence Thomas were unable to control their emotions and exhibited bad behavior on and off the bench, but many witnesses stayed silent, out of fear of reprisal, until these men had reached potential appointments to the highest court in our nation.

Too many times judges fall far short of the standard of impartial arbitrators of the law, and too many statistics show the unwillingness of supervising agencies to investigate and sanction. Judges allow their biases, emotions, and prejudice to color their professional behavior, which can result in life-altering consequences for the people in their courtrooms—and there aren’t a lot places for victims to turn. As Baker said, “the legal system is not here to serve the people.”

The Movement for Human Rights in Childbirth Is Not a ‘Natural Birth’ Movement

“With my nurse, it wasn’t about health or safety. It was a power struggle.”

“The doctor said if I didn’t agree to a c-section, she would dislocate my baby’s shoulders.”

“The midwife shouted angrily, ‘I’m in charge here!’”

“I didn’t know I could complain. They told me it was all my fault.”

As a journalist and maternal health advocate, I listen to people talk about childbirth. The language, usually flawed and often disturbing, is everywhere: at school drop-off, from health-care providers, on social media. The stigma and silence around birth and birth trauma have become so normalized that most people do not realize the impact of their words. Others should know better. Julie Satow’s recent New York Times article, “Why New York Lags So Far Behind on Natural Childbirth” exemplifies how news outlets can perpetuate damaging language around birth. The article’s terminology and tone reflect a mischaracterization of the current crisis in U.S. maternity care, and they reinforce cultural attitudes that shame and misinform birthing people.

Certainly, Satow is correct in pointing out that the closure of hospital birth centers is contributing to a lack of childbirth options that is especially stark in New York state. And as Dr. Laura Zeidenstein says in the piece, media outlets are finally discussing “racial disparities, high maternal and infant mortality rates, [and] the disrespectful treatment of women in obstetrics,” which is a positive step forward.

But the phrase “natural childbirth,” which Satow uses throughout the article, is an outdated term that is indefinable, offensive, and does not apply to modern maternity care. Patients may prefer to have vaginal births, unmedicated births, or births without medical interventions such as pitocin augmentation or episiotomies. But this does not make them “natural”; nor are births that require interventions or cesarean section surgery “unnatural.” How should we judge what constitutes a “natural” birth? If a woman has an ultrasound? If she uses a fetal monitor, required in many U.S. hospitals? If she receives antibiotics because she is running a fever? If she needs treatment for gestational diabetes? If she takes a Tylenol?

Birth is a physiological event, but the term “natural,” meaning “derived from nature,” serves only to imply that a certain type of birth is superior.

This attitude is apparent from the opening of the New York Times article, where we learn about Lisa Binderow’s appalling childbirth experience at New York’s Mount Sinai Hospital. According to Satow’s reporting, Binderow was forced to labor in a tiny triage area on a bed with no mattress and before giving birth in a storage room. Placing this disturbing account at the beginning of an article about “natural” birth centers has a distinctly misleading effect. It equates Binderow’s traumatic experience with the fact that she was denied access to Mount Sinai’s birth center, where she had apparently planned to give birth “naturally.”

To be clear, Binderow’s experience was abusive and unacceptable. But it is medical negligence, unrelated to the type of birth Binderow preferred to have.

This false connection between “natural and fulfilling,” as opposed to “unnatural and traumatic,” effectively labels the growing movement for respectful, evidence-based maternity care as people who all want “natural” births, which is untrue. The evidence is clear: People are traumatized by how they are treated by hospitals and health-care personnel, not by the type of birth they have. The movement for human rights in childbirth is not a “natural birth” movement. Instead, it simply demands that birthing people should be treated like autonomous human beings with the ability to make informed choices about their health care.

The final quote in the article, “a natural birth should be every woman’s right,” is similarly misleading. “Natural birth” is not, in itself, a right. All birth preferences should be respected and supported. But the physical reality of labor, if accurately and truthfully assessed by medical staff, may require intervention, or those preferences may change. This should not be portrayed as a failure on a woman’s part or a violation of her rights.

Claiming the “right” to a certain type of birth is a bit like claiming the “right” to keep your appendix. Your appendix lives inside your body, and you alone should make decisions for it. If you and your appendix are healthy, attempting to interfere with it is unnecessary and possibly dangerous. If you are one of the approximately 280,000 people who develop appendicitis every year in the United States, keeping your appendix could be life threatening, and you would probably choose to have it surgically removed, although no one could legally force you to do so.

But what if you showed no evidence of appendicitis, and yet someone held you down and removed your appendix without your consent? What if they threatened that you would be charged with a crime unless you allowed them to take out your appendix, or obtained a court order to compel you? What if they insisted that by entering the hospital you had already relinquished your right to consent? What if they removed your appendix because it was convenient and then falsified your records to show a medical necessity? What if they performed the surgery and then ignored your urgent medical symptoms for hours until it was impossible to save your life? This is the reality that many, particularly women of color, face in U.S. maternity care every day. There are 700 to 900 maternal deaths every year and over 50,000 near-deaths, often with permanent health consequences. While it is difficult to link the data to specific procedures or interventions, researchers estimate that more than 60 percent of these deaths could have been prevented.

Before you shriek, “A baby is not an appendix!” let me be clear. For a laboring person, a baby’s life truly being at risk might outweigh all other considerations. I use this analogy simply to illustrate that a pregnant patient has not forfeited the rights that any other patient exercises without question.

As a pregnant person, you have rights in childbirth. They include human rights defined by the World Health Organization; civil “patient’s rights,” which can vary by state; and criminal assault and battery laws. You have the right to scientifically accurate, evidence-based health care. You have the right to informed consent and to refuse any medication or procedure. You have the right to equal treatment, without discrimination based on race, ethnicity, religion, age, weight, sexual and gender identity, socio-economic status, or marital status. And you have the right to basic human decency.

Sending pregnant people into hospitals believing that their rights begin and end with “natural birth” does them a great disservice. If a medical issue alters your plans for a specific type of birth, you still have options for your care. Decision-making power still rests with you, and there is still no excuse for abuse, disrespect, or medical malpractice. Failing to empower pregnant people with these facts can only delay the changes in our maternity care system that are desperately needed, the consumer-driven movement that will insist on ethics and accountability.

Let’s start by calling births what they are: vaginal or cesarean. Let’s present all pregnant people with factual, evidence-based, medical information on which to base their maternity care choices. Let’s provide options and support for every birthing person’s preferences, whatever those might be. And let’s stop using the phrase “natural birth.” However you bring your child into the world, you are entitled to be treated with respect, compassion, and dignity. If you were not, know that you are not alone. And I am listening.

How Tumblr’s ‘Adult Content’ Ban Could Hurt LGBTQ Teens

Tumblr, the popular microblogging site, recently announced a ban on “adult content” to achieve a “better, more positive” space. The ban follows a slew of increasingly restrictive policies across other social media platforms cracking down on content perceived to be “objectionable.”

The announcement has been met with outrage from kink, poly, and other subcultural groups with longstanding online communities on the verge of being erased. But the sweeping and unevenly applied nature of these policies also often end up blocking innocuous content from LGBTQ users. Since Tumblr’s announcement, users have begun reporting flagged posts that include line drawings of two men hugging and photos of men kissing. Policies and algorithms that block LGBTQ content on social media—whether intentionally or not—will also have an unfortunate ripple effect on another group of people: LGBTQ adolescents.

Some may think that social media users are simply overreacting, but LGBTQ content being labeled “NSFW” or “adult” on social media platforms is not a recent development. One writer noted that her blog posts about getting married to her wife were flagged on the site earlier in the year. Tumblr was previously under fire for blocking hashtags like “#gay” and “#bisexual” from searches on its mobile app because it considered them adult content. This is not limited to one platform, either: YouTube has been criticized for demonetizing videos by LGBTQ creators.

Certainly, some of these issues result from the fact that social media platforms rely on automated methods of flagging content—it’s time-consuming and impossible for staff to manually review every post, video, or image. But regardless of the cause, the result is the same: These companies are preventing users from seeing LGBTQ content.

What people may not realize is that for LGBTQ teens in particular, social media can be a critical source of education, information, and social support.

According to data from the Centers for Disease Control and Prevention, more than a million U.S. teens identify as LGBTQ—roughly the population size of cities like Dallas or San Diego. In the absence of LGBTQ-inclusive sex education in the United States, the internet offers spaces where these adolescents can anonymously learn about sexual orientation, gender identity, and same-gender relationships and sex. Compared to non-LGBTQ youth, LGBTQ adolescents are five times more likely to have looked for information about sexuality online.

Nearly two-thirds of LGBTQ teens have used the internet to connect with other LGBTQ people, and various platforms have fostered online communities that provide teens with social support. YouTube hosts countless coming-out videos from LGBTQ teens and young adults, with commenters often providing affirmation and sharing their own stories. On Reddit, the r/LGBTeens forum alone has 47,500 subscribers. Numerous Tumblr pages provide support and build community among LGBTQ teens across the globe. Many teens may lack this support offline, particularly if they are not out or if their families don’t approve of their identities.

LGBTQ teens are also more likely than non-LGBTQ teens to find romantic and sexual partners online. In a recently completed study, my colleagues and I found that 60 percent of transgender and nonbinary teens have used the Internet and smartphone apps to look for LGBTQ partners. In another project, we found that 85 percent of gay and bisexual teen boys had looked for partners online; over half had used online dating and sex apps like Tinder and Grindr even though they technically are not allowed to do so as minors under the age of 18.

A primary motivator for such heavy reliance on the internet for social and romantic connections is the difficulty and risk sometimes involved in seeking out other LGBTQ peers in person, especially for those who aren’t out or who live in an environment unsupportive of LGBTQ people. A 16-year-old in our study told us that social media “takes away a lot of the anxiety of meeting someone in person. It also makes it a lot easier to find someone else who is gay instead of playing the ‘are they gay or not gay’ guessing game offline.”

Being able to discuss their sexual orientation and gender identity on quasi-anonymous sites like Tumblr—and seeing themselves represented in others’ content—could also help LGBTQ teens make sense of their experiences, feel more in control of their lives, and promote resilience and well-being.

Not only do increased social media restrictions impact youth themselves, but they affect the ability of researchers to better understand LGBTQ youths’ lives, health, and well-being.

Facebook refused this past spring to approve several advertisements seeking participants for two of my studies about LGBTQ adolescents’ sexual health. These ads (which featured images of fully clothed, smiling youth) were blocked because of policies requiring increased scrutiny of ads related to health and civil rights.

Eventually, a revised version of our ads was approved, but as many scientists who conduct research focused on LGBTQ communities continue to rely on social media recruitment, policies that view diverse sexualities and genders as political or objectionable and therefore worthy of censoring will make it increasingly difficult to shed light on the needs of an already marginalized population.

Of course, social media policies on content are needed, as in the case of hate speech or false news. But social media platforms need to do a better job focusing their efforts on blocking truly problematic content like child pornography and shutting down advertising practices that exploit vulnerable groups.

And certainly, LGBTQ teens’ experiences on social media are not uniformly positive, as these spaces can facilitate cyberbullying and harassment, and platforms need to better enforce rules against this behavior.

But an unfortunate, and perhaps unintended, consequence of increasingly restrictive social media policies is the implicit message that different sexualities and genders (other than the dominant straight and cisgender ones) are inappropriate or even unwelcome in public life. The trend toward implementing overly broad and sometimes arbitrary bans on “adult” or “objectionable” content on social media will continue to result in erasure of spaces that allow LGBTQ teenagers to engage in normal teenage behaviors that their straight and cisgender peers have the freedom to do offline.

That is: to discover who they are, meet friends, and find love.

Democrats Push State Department to Reinsert Reproductive Rights in Human Rights Reports

Democrats in the U.S. House of Representatives introduced a bill Monday that would require the State Department to again include a subsection on reproductive health in its annual human rights report.

The State Department is responsible for producing a report each year detailing human rights abuses in each country receiving U.S. foreign aid. Starting under the Obama administration, reproductive health information such as systemic international issues with access to contraception and abortion care was included in the report. That practice ended this year under the Trump administration.

The bill, introduced by Reps. Katherine Clark (D-MA), Barbara Lee (D-CA), Nita Lowey (D-NY), Eliot Engel (D-NY), and Lois Frankel (D-FL), was filed on International Human Rights Day and the 70th anniversary of the signing of the Universal Declaration of Human Rights. It would require the State Department to recognize reproductive rights in its annual human rights report.

“Documenting and reporting human rights violations is a major part of eradicating their existence,” said Clark in a statement. “This bill would ensure that our State Department maintains its vital role as an international watchdog and protector of women’s rights no matter the ideology of our White House.”

The bill currently has the support of 45 reproductive rights and social justice advocacy groups, including Planned Parenthood and the Center for Reproductive Rights. “Reproductive health care is health care, and health care is a basic human right,” said Dr. Leana Wen, president of Planned Parenthood Federation of America, in a statement. “The Trump-Pence administration’s erasure of reproductive rights from the State Department’s human rights report is an attack on women around the world, and the communities that depend on them.”

In October of this year, 129 Democratic members of the U.S. House of Representatives sent a letter to Secretary of State Mike Pompeo demanding the State Department again include the removed subsection. The bill comes as the Trump administration nominated former Fox News anchor and current State Department spokesperson Heather Nauert to become ambassador to the United Nations. Nauert defended the department’s decision to exclude reproductive health information from the State Department human rights reports.

According to a January Politico report, Nauert said in a statement that the way the department “presents the report’s material has changed from time to time,” and that “this year we are better focusing some sections of the report for clarity.” She added that the department was not “downgrading coverage of LGBT or women’s issues.” The subsection of the report was renamed from “Reproductive Rights” to “Coercion in Population Control,” a move which left advocates concerned.

“This erasure puts real lives in danger,” said NARAL Pro-Choice America President Ilyse Hogue in a statement Monday. “Using backdoor tactics to erase all mention of reproductive rights—including abortion, contraception, and maternal mortality—from vital reports and resources in order to push an extreme, ideological agenda is a true testament to just how dangerous and corrupt this administration is.”

The Center for Reproductive Rights (CRR) filed a lawsuit in early December against the State Department over a failure to produce records regarding exclusion of the reproductive rights subsection requested under a Freedom of Information Act (FOIA) request. “This erasure is tantamount to an outright rejection of the basic principle that reproductive rights are human rights,” said Stephanie Schmid, U.S. foreign policy counsel for CRR, in a statement regarding the suit. “The Center will continue to use the power of the law to hold this administration accountable in order to ensure that the foreign policy of the United States promotes, rather than hinders, women and girls’ access to basic health care like contraception, safe abortion, and maternal health care in order for them to achieve economic, social, and political empowerment.”

This isn’t the first time the State Department has moved against international reproductive health access. The Trump administration reinstituted the “Mexico City Policy”, otherwise known as the Global Gag Rule, immediately after taking office in January 2017. Administered by the State Department, the rule prevents foreign aid from going to organizations which perform, make referrals for, or counsel about abortion care for patients. It has already had a negative effect for pregnant people worldwide.

Brett Kavanaugh Didn’t Save Planned Parenthood Funding, No Matter What Susan Collins Seems to Think

The U.S. Supreme Court on Monday turned away efforts by lawmakers in Kansas and Louisiana to defund Planned Parenthood, refusing to take two cases stemming from the Center for Medical Progress’ trumped-up “baby parts” video scandal.

The decision was a bit of a surprise. Justices Clarence Thomas, Samuel Alito, and Neil Gorsuch all would have taken the cases, presumably to endorse the defunding efforts. But newly installed Justice Brett Kavanaugh joined Chief Justice John Roberts and the liberal justices to cast what was likely the deciding vote to keep Planned Parenthood’s funding in place. The result was good news for Medicaid beneficiaries in Kansas and Louisiana who rely on the reproductive health organization.

The result was also apparently good news for Sen. Susan Collins (R-ME), who said she felt “vindication” of her vote to confirm Kavanaugh—because Monday’s decision somehow shows he won’t ultimately be the deciding vote to upend abortion access in the United States.

This, of course, is total nonsense.

First let’s talk about what Monday’s decision was about—and what it was not about. The decision was about who can sue to enforce Medicaid benefits. The decision was not about the merits of conservative efforts to defund Planned Parenthood. This difference matters.

There were two cases before the Court, one from Kansas and one from Louisiana. Both involved efforts by conservative lawmakers to kick Planned Parenthood out of state Medicaid programs after anti-choice activist David Daleiden and his front group the Center for Medical Progress released in 2015 a series of deceptively edited videos that purported to show Planned Parenthood doctors and staff detailing how they sold fetal tissue in violation of federal law.

Both efforts failed, as trial courts and the Tenth and Fifth Circuit Courts of Appeals ruled that Planned Parenthood and individual Medicaid recipients could sue to block efforts to remove the organization from the Medicaid programs.

That is the essence of what these cases are about: whether providers and beneficiaries can challenge changes to state Medicaid programs. The plaintiffs in these cases just happen to be Planned Parenthood and individual Medicaid beneficiaries, which means the cases implicate both Medicaid coverage and reproductive health care.

The courts also determined that Planned Parenthood had shown it would likely be successful in its claims that the states had unlawfully terminated its Medicaid contracts. This portion of the ruling is also important, because it shows that if put to the test at trial, the states’ political justification for cutting Planned Parenthood out of the program wouldn’t meet the criteria laid out in the Medicaid statute for determining which providers can participate in it. In other words, the Medicaid statute makes it clear that providers can’t be excluded for purely political reasons, which is what the entire “baby parts” defunding wave was about.

The lower courts hadn’t actually ruled on the merits of Planned Parenthood’s challenge, though; they just ruled that those challenges were probably going to succeed. That’s still encouraging! But it’s as close as any courts got to passing judgment on the legality of those efforts, and not the same as a ruling on the merits of those efforts.

Monday’s decision by the Roberts Court to reject the Kansas and Louisiana cases leaves in place the appellate decisions maintaining Planned Parenthood funding. And that’s good news—not just because it means the thousands of Medicaid beneficiaries in Kansas and Louisiana can continue to rely on Planned Parenthood for care. The decision also helps to shore up the growing list of federal courts that have thwarted conservative efforts to kick the reproductive health-care provider out of state Medicaid programs. All of this is important, especially as the legal landscape around Planned Parenthood funding remains uncertain.

But the decision was not on the merits of conservative efforts to defund Planned Parenthood. Kavanaugh’s vote against taking the cases cannot be spun as a vote in favor of reproductive rights. In fact, cases challenging similar actions are currently pending in the federal courts, and Monday’s order has no impact on those cases. One such case out of Ohio, currently pending before the entire Sixth Circuit Court of Appeals, is well positioned to deepen the conflict thanks in part to a flurry of judicial appointments during President Donald Trump’s first term. If the circuit split intensifies, the Supreme Court could very well be asked to step back into the fight over Planned Parenthood funding.

If Collins thinks Kavanaugh’s vote Monday is a vote in favor of reproductive autonomy, she is as delusional as Gwyneth Paltrow claiming she mainstreamed yoga.  All Monday’s vote means is that the Court is not taking these specific cases and it is not diving into the issue of private rights of action under Medicaid at this time. That’s it. Kavanaugh’s vote certainly shouldn’t be read as an endorsement of abortion access, as Collins’ vindication remarks suggest.

Collins almost certainly knows this. She’s just hoping her constituents don’t.

Women: Exposed and Silenced by Asbestos

Across the country, more than 9,000 lawsuits are pending against Johnson & Johnson that accuse the company of not disclosing that its talcum powder products, such as its famous baby powder, were tainted with cancer-causing asbestos. As juries return million-and billion-dollar verdicts against the company, its representatives are moving to discredit and shift blame onto victims. At one recent trial, they called an expert witness to testify—not only that their product didn’t cause plaintiff Rosalind Henry’s mesothelioma, but that the majority of women’s mesothelioma cases were not attributable to asbestos exposure. I was shocked.

Pushing aside women’s health concerns is nothing new. But this attempt to diminish and dismiss women’s asbestos exposure in a desperate bid to sway a jury is a new low. And it’s a lie.

I thought about what the mesothelioma victims I know, June, Debbie, Janelle, Lou, and Stephanie, would say in response. As friends, we had shared our pain, fears, grief, and anger while they struggled with their disease. But they are gone now, and that’s why I must share their words and speak out for them, and for the other relatives whom they’ve had to leave behind.

“Mesothelioma is a miserable disease.” Debbie (1959-2013)

Here’s the truth: For more than a century, asbestos exposure has been known to cause disease and death. It is a known carcinogen and there is no safe level of exposure or controlled use.

“It was a matter of weeks and I went from being healthy to fighting for my life. I was told I would not survive mesothelioma, that there was no cure.” Janelle (1973-2013)

Unsealed documents suggest Johnson & Johnson feared asbestos, the primary cause of pleural mesothelioma, was in its talc—including its baby powder—as early as the 1970s. According to FairWarning, an investigative news organization that focuses on public health, consumer, and environmental issues, a 1971 Johnson & Johnson memo stated, “It would seem more than appropriate that we upgrade the quality control on our talc and baby powder, particularly as to the potential asbestos content” (emphasis mine). A 1973 internal report acknowledged the presence of this carcinogen at its Windsor Talc Mine in Vermont. What’s worse is that the company appeared to know safe, non-lethal substitutes for talc were available, the same memo stated, “Corn Starch is obviously another answer.”

“I’m 58 and I have been murdered in slow motion. There is no safe form of asbestos and no safe level of exposure.” June (1950-2009)

Women get sick and die every year because of asbestos exposure. In fact, it was a woman, Nellie Kershaw, whose case was first documented in medical literature and whose death led to publication of the first Asbestos Industry Regulations in 1931.

From 1999 to 2016, nearly 50,000 Americans died from mesothelioma, 20 percent of them women —the vast majority due to some type of asbestos exposure. It’s true: More men were, and are, exposed to asbestos through their work. However, women still suffer. Some are exposed at on the job, others in their homes. In some instances, their husbands or fathers may have carried asbestos home from work and into the house. In 1987, the International Agency for Research on Cancer reported “a third of the mesotheliomas occurring in the USA may be due to nonoccupational exposure.” Even more heartbreaking are cases that stem from a child who hugged a parent who wore asbestos-contaminated clothing.

My father worked in the building trade in the 1970s and died a terrible. painful death of pleural mesothelioma in 1985 after only six months ….  Being diagnosed with this cancer through no fault of mine has cut my life short!” Lou (1954–2017)

Mesothelioma is just one of many asbestos-caused diseases. Asbestos also causes lung, ovarian, laryngeal cancers, and respiratory diseases such as asbestosis. Women die from this toxic substance. They get cancer because of this toxic substance. No expert, no testimony, can erase that fact.

The author with her friend Debbie, who died of mesothelioma in 2013.

Companies like Johnson & Johnson sold products contaminated with asbestos after studies showed the link between powders containing talc and incidences of disease. In court today, Johnson & Johnson is still trying to shirk its responsibility—to ignore the evidence that these chemicals have had a unique and terrible impact on women’s health.

Enough is enough. Most countries around the world have banned asbestos, yet women and families in America are still exposed to this carcinogen far too often. Johnson & Johnson isn’t alone. In 2015, Colgate-Palmolive faced multimillion-dollar lawsuits for cancers caused by its asbestos-contaminated talc products. These are products that have been specifically targeted toward women, including young women. Without a ban, we also import millions of dollars worth of asbestos-contaminated consumer goods every year. Independent testing found asbestos in children’s toys, crayons, and cosmetics as recently as 2018.

Asbestos also infects our schools. In 1990, EPA reported to Congress that one in four schoolchildren and their teachers are at risk of being exposed in the classroom. Then in September, the EPA Office of the Inspector General noted the situation has worsened, as schools have failed to make and follow plans to keep students safe from asbestos. The full extent of the remaining hazard is currently unknown. We have to take action.

“My physical life is a shadow of what it used to be.” Stephanie (1977-2015)

History is a great teacher to those who listen. June, Debbie, Janelle, Lou, and Stephanie, paid the ultimate price for corporate greed. While there is no rewind button for them, nor their families, there is a way forward: Congress and the EPA can embrace legislation to end the asbestos man-made disaster and spare more families their grief.

Fascists Find Fertile Recruitment Ground in Anti-Choice Movement

Those on the far right who have long discussed and acted upon their desire to dominate women’s sexual and reproductive rights are pushing that agenda into the political mainstream with help from the anti-choice movement.

The traditional right wing in the United States tries to distance itself from fascists, but far-right groups are weaponizing traditionalism and “normie optics” to infiltrate anti-choice platforms to recruit and organize young white men.

Attacks on reproductive rights are nothing new, but fascist groups’ infiltration of anti-choice groups and recruiting around anti-choice organizing in their genocidal agenda is an escalation. Leaked conversations between white supremacist groups using the Discord messaging site show users discussing recruiting members based on their opposition to abortion rights. “March for life never has effect until White Nationalists join [sic],” the Discord user “Commander Davis” said in the Traditionalist Worker Party chatroom, a now disbanded neo-Nazi group. March For Life is a decades old radical anti-choice movement and protest popular among Republicans. President Trump addressed the March for Life rally in January.

Under the Trump administration, a surge in white nationalist organizing and policies has meant an uptick in threats against abortion providers and clinics, creating an even more unsafe environment for patients as Republican lawmakers further erode their rights. Threats of violence against abortion clinics have nearly doubled since 2017, and trespassing incidents have more than tripled, according to data compiled by the National Abortion Federation.

From pipe bombs targeting Democratic leaders and the media, to the fatal shooting of two Black grandparents at a Kentucky grocery store, and the massacre at a Pittsburgh Synagogue, fascists are escalating the use of violence to further their goal of creating a white ethnostate. That goal hinges on the subjugation and elimination of marginalized communities, the sexual domination of white women, and the reproductive control of women of color. 

Anti-choice extremists are responsible for numerous violent attacks on abortion providers and abortion clinics. Between 1993 and 1994, there was a spate of violent anti-choice attacks resulting in several murders. In those two years, two doctors who provided abortions, a clinic escort, and two receptionists at a clinic were murdered by far-right anti-abortionists.

The late 90s saw even more “pro-life” attacks, including murders and assaults against abortion providers, as did the 2000s. Just three years ago in 2015, Robert L. Dear shot up a Colorado Springs Planned Parenthood, killing three people and injuring several others. Dear, who repeated talking points from a discredited anti-choice smear campaign, had a history of attacking reproductive health facilities and railing against abortions.

Not surprisingly, there is often overlap and collaboration between the so-called pro-life movement—typically made up of religious conservatives who oppose a person’s right to safe, legal, and affordable abortion—and racist far-right movements. Myriad activists and journalists have chronicled the short line between hatred of gender and sexual minorities and white nationalism. Gamergate, for example, revealed how easy it is for male supremacists and white supremacists to target common enemies together, and how quickly men who hate women can become radicalized. Not only do misogynists such as “incels” tend to hold deeply racist views and transition to white nationalism, but white nationalists themselves tend to target women and trans people, and have a particular animus for abortion rights.

There are sometimes distinctions between the religious, conservative anti-choice agenda and that of white supremacists. While religious anti-choice activists want abortion to end in all cases, the far right seeks to end abortion for white people while forcing people of color not to have children through measures such as forced abortions and forced sterilization. Still, some U.S. fascists advocate for a full ban on abortion, similar to the mainline conservative position. In some cases, the long-term goal of fascists is a future in which “artificial wombs” replace women altogether. While there’s some difference in the agendas, the common ground shared by conservatives and the far right on abortion leaves a large enough opening for fascists to infiltrate.

“Fascists aligning themselves with anti-choice groups is very alarming,” Lisa Woolfork, an organizer with Black Lives Matter Charlottesville and a professor of English at the University of Virginia, told Rewire.News. Woolfork organized counterprotests in 2017 against the deadly “Unite the Right” rally, where neo-Nazi James Fields drove a car into anti-racist protesters, killing activist Heather Heyer and injuring many more. “Anti-choice ideology legitimizes itself by appealing to religious freedoms, and uses religious views to support that. When fascists slip in under that cover, it’s very easy to promote the whole cause.”

“Normie right wingers who defend the family or oppose abortion or whatever are indirectly our allies,” one Discord poster said on the messaging site in April 2017. “We kind of perceive this innately, but theres a deeper underatanding im trying to point towards here, i guess [sic].” The poster added that fascists could use protectionist patriarchal rhetoric around defending “traditional” family values, and other symbols of traditionalism in art, literature, and music, to recruit “normies” into a “participation in alt-right ideas.”

In its modern form, right-wing authoritarian and white supremacist ideologies have relied on patriarchy and white male supremacy for recruitment and organizing. Now, in an effort to recruit and normalize themselves, fascists have attempted to glom on to more “normie” events and “normie culture,” as they say, by exploiting common ground. They have been spotted over the past year crashing anti-choice events, including marches in Knoxville, Tennessee, and Chicago. An alt-right “KEK” flag was spotted at an anti-choice campaign street stand in Ireland, where alt-right groups made an effort to collaborate with the anti-abortion movement leading up to the country’s vote to legalize abortion.

These incidents created a stir in the anti-choice movement. The right-wing anti-choice website Life Site published an article in January titled “What to do when white supremacists show up at your pro-life rally.” The post’s author repeated the common conspiracy-minded theory that leftists had posed as fascists in order to cause problems for the anti-choice crowd. That is: The author took issue with and assigned blame to those on the left, in addition to a self-described fascist group.

Tennessee Right to Life, a local group that organized the March for Life in Knoxville had a similar response to the fascist presence at their event. When Matt Heimbach, co-founder of the Traditionalist Worker Party, organized a group of Nazis to join an anti-abortion protest in Tennessee in January, Tennessee Right to Life equated the group with anti-fascists.

“Our organization’s march has a single agenda to support the rights of mothers and the unborn, and we don’t agree with the violent agenda of white supremacists or Antifa,” the group said in a statement reported by the SPLC.

But it’s fascists who are using the anti-choice platform for recruitment. In a December 2017 Discord chat, Heimbach told his followers that the March for Life, the largest anti-choice event in the United States, would be an “important” action for his Nazi followers to attend. “Over 1700 white kids are killed a day by abortion,” he falsely claimed, and proceeded to push an anti-Semitic conspiracy theory that “abortion is jewish.”

Even more conservative anti-abortion advocates engage in long-term harassment, intimidation, and propaganda campaigns that make abortion clinics less safe for workers and patients. Consider “Red Rose Rescues,” an anti-abortion tactic that involves entering abortion clinics and harassing patients while they wait for appointments (the anti-choice activists give patients a red rose to start the conversation, appearing friendly). These stealth operations are disruptive to clinic operations and can be intimidating or otherwise unpleasant for patients.

White nationalists and white supremacists will use explicitly racist attacks when they target abortion rights organizations. In 2016, ostensible neo-Nazis targeted an online fundraiser run by the National Network of Abortion Funds (NNAF), a group that raises funds for people who need financial support to receive abortion care. Cyber attackers hacked the NNAF fundraiser and sent messages to donors containing explicit anti-Black and anti-Semitic threats, and made “fraudulent donations” using Hitler’s name, according to the lawsuit filed by the NNAF and other abortion funds providers against the attackers in March.

Due to the violent threats, along with the November 7 release of Rachelle Shannon—the anti-choice extremist who pleaded guilty to a series of bombings in 1995 and shot abortion provider George Tiller in 1993—abortion advocates are concerned about a potential uptick in far-right violence. Tiller was killed years later by another abortion rights foe, Scott Roeder.

The conspiratorial far right has latched on to abortion clinics as a target of far-right bigotry. InfoWars.com, a conspiracy site founded by Alex Jones, frequently publishes disinformation about Planned Parenthood and abortion. InfoWars was one of the leading organizations to push the “Pizzagate” conspiracy theory during the 2016 presidential election. The site’s spread of disinformation culminated in an adherent of the conspiracy showing up to the pizza place with a loaded gun to “investigate” Pizzagate.

In November, a “reporter” for InfoWars showed up to a religious anti-choice rally to cover the event. The presence of InfoWars at an abortion clinic is alarming precisely because it peddles far-right conspiracy theories that have emboldened bigots to show up armed to InfoWars targets.

Further, the now infamous pro-Trump entrapment group Project Veritas (Trump’s foundation made a donation to the group in 2015) secretly recorded conversations with Planned Parenthood workers and doctored the video to make it appear as though Planned Parenthood illegally “sells” fetal tissue for profit. None of this is true, but conservative and far-right media latched on to the story, as did conservative lawmakers, who launched a partisan investigation into Planned Parenthood.

A recent anti-choice victory was the confirmation of Brett Kavanaugh to the U.S. Supreme Court. Kavanaugh is popular among conservatives in Congress who championed the judge while he faced allegations of sexual assault. Kavanaugh also garnered the praise of fascists. In an unpublished log of a Discord server obtained by Unicorn Riot, a user posted, “This Kavanaugh guy seems great.” Another posted, “Kavanaugh for dictator.” Another advocated that conservatives who did not vote to confirm Kavanaugh should be voted out of office during the midterm elections.

During a much-criticized interview with the Today Show this fall, Patrick Casey, leader of the fascist cell Identity Evropa, which was present at the deadly 2017 white supremacist rally in Charlottesville, said he wants fascists to take over the GOP. Arguably, the GOP is already well on the way there: Trump is himself a fascist and the leader of the GOP, and there are myriad other open white supremacists in elected office, and many made a run for office on the Republican ticket during November’s midterms. As fascists praise the confirmation of an anti-choice judge, it’s clear the kind of policies they’re hoping the Trump administration will advance.

Several anti-choice organizations, including March For Life and Students For Life, met with the president in the White House at the end of November, encouraging him to push more anti-choice legislation as soon as possible. As threats to reproductive choice and other human rights escalate under Trump, Lisa Woolfork warns that the feminist movement must respond to the rising fascist threat with true intersectionality: “It is going to take all of us.”

The March for Life, Tennessee Right to Life, and March for Life Chicago did not respond to requests for comment.

Reproductive Justice Advocate to Request Political Asylum as Trump Administration Tries to Deport Her (Updated)

UPDATE, December 11, 6:00 p.m.: On Tuesday, the social justice organizing network Mijente announced that a federal immigration court ordered Alejandra Pablos to be deported. In a statement, Pablos said this is not the end of her fight. “We will appeal this decision and urge Arizona Governor Ducey to issue a pardon for the arrests that led to my detention in the first place. Getting a pardon from the Governor would significantly increase my chances to be able to continue to fight to stop my deportation and allow me to stay home with my family and community,” she said.

An undocumented reproductive justice and immigrant rights activist targeted by federal immigration agencies for her humanitarian work is set to attend court Tuesday, where she’s seeking political asylum.

Alejandra Pablos’ hearing comes after years in immigration limbo. Her case is all the more complicated because of her criminal history. Five years ago, Pablos was placed in deportation proceedings after a drug-related arrest and DUI charge in Arizona, a state known for passing anti-immigrant laws and doling out harsher sentences for immigrants. Pablos was a legal permanent resident at the time, but the arrest and subsequent charge stripped her of her status and landed her in Arizona’s Eloy Detention Center, notorious for in-custody deaths and human rights abuses. Her two years at Eloy politicized her, she said, and upon her release she committed herself to fighting for reproductive justice and immigrant rights.

Pablos told Rewire.News that she had defied deportation for eight years, but her political asylum hearing was the end of the line for her. There are no more pathways for her to remain in the United States, unless Republican Arizona Gov. Douglas Ducey grants her a pardon.

“Everything is complicated by my previous record, I’ve been criminalized again and again. Some of us it seems like don’t have the privilege to move on, to show we’ve changed, to be given a second chance. Nothing about my past defines me, and I want to look the government in the eyes and tell them I deserve to be here,” Pablos said.

Tuesday’s hearing could end for Pablos in one of three ways: She could be granted asylum; she could be denied asylum and possibility detained; or the court may take time to consider her case, leaving her in limbo once again. The organizer said that if her asylum is denied, she will appeal the decision, even if she is detained.

The organizer is seeking political asylum because, she says, who she is, what she stands for, and the work she does puts her in danger if she were to be deported to Mexico, a country she has not been to since her family immigrated to the United States when she was a baby.

“I have no family in Mexico and I’m an abortion advocate. In Mexico, abortion is illegal in many states and women who are advocates are subjected to violence and sometimes death,” Pablos said. “People who have lived most of their lives in the U.S. are especially at risk because they have no support system there and can’t transfer any of the skills they have developed here in the U.S. That’s how deportation works, they force you to start over from nothing in a country you do not know.”

In the years since her initial arrest in Arizona, Pablos has become a prominent member of We Testify, an abortion storytelling leadership program of the National Network of Abortion Funds. She has worked closely with the social justice organizing network Mijente, crisscrossing the United States as part of their “Chinga La Migra” tour.

In January, when she was the Virginia Latina Advocacy Network field coordinator for the National Latina Institute for Reproductive Health (NLIRH), Pablos was arrested while peacefully protesting deportations outside the Department of Homeland Security (DHS) in Virginia. This, advocates say, put her on Immigration and Customs Enforcement’s (ICE) radar. In March, during a check-in with ICE, Pablos was detained. Her supporters said her detainment was a reproductive justice issue, calling it an act of “retaliation” by the federal immigration agency. Pablos was released after 43 days in detention and making an $8,000 bond. The charges stemming from the protest were eventually dropped, but the detainment derailed her life and stripped her of her ability to work in the United States, which is how she lost her job with NLIRH.

On Friday, Pablos told Rewire.News she was preparing for her hearing. Hearings for political asylum can be brutal, she said, forcing people to relive the most traumatic moments of their lives in front of a courtroom. While she will have a large number of supporters in the room, including her mother and chosen family, she said she was still nervous. The activist’s case may have larger implications for others doing similar work, especially under the Trump administration, which has taken unprecedented steps to criminalize the right to claim asylum.

Pablos is one of many activists targeted by ICE under the Trump administration. In January, the co-founders of the New Sanctuary Coalition of New York City, Jean Montrevil and Ravi Ragbir, were detained in the same week in what advocates say was a targeted attack that included government surveillance. Ragbir’s deportation has been stayed, while Montrevil was deported to Haiti. In Memphis, immigration reporter Manuel Duran was arrested in April with eight others following a protest. The eight activists were released on bail while Duran was transferred to ICE custody and remains detained.

“Human rights defenders experience the same kind of targeting [by the government] that journalists do. I am a very public activist and reproductive justice advocate that has spoken out on many issues in national and international media,” the activist said. “For so many of us doing this kind of political work, the real lucha is pushing for permanent protection when the government doesn’t want to provide us with it. It’s about shifting the narrative to protect freedom fighters. So, how do we defend people who are advocates, especially women? These attacks on activists are really attacks on working people and women, and that is why my story is not just mine; it’s all of ours.”

Supporters from the reproductive justice and immigrant rights worlds have rallied around Pablos, helping to support a website highlighting her case, gathering over 200 letters of support and more than 24,000 signatures on a petition calling for her release when she was detained in March. Some of her closest supporters will be in the courtroom with her on Tuesday. While being subjected to immigration enforcement and criminalization for nearly a decade has taken a toll on Pablos and her family, the reproductive justice organizer said something unexpected has resulted.

“This whole process of seeking political asylum has re-opened a lot of wounds for my mom, who never wanted to see me detained again,” Pablos said. “But because of this, my family is having tough political conversations and letting go of a lot of trauma. We’ve been talking about how the immigration system wasn’t designed to sustain families; it was designed to break families apart. I think for a long time my mom took on a lot of blame and thought this was all her fault because she didn’t understand the system when she got here. We are fighting my deportation as a family, and working together to free ourselves of shame. Through this oppression, we’re also being liberated and healed.”

California DOJ Allows Catholic Hospital Groups to Merge, Raising Questions About Patient Access

Imagine lying in an operating room, bright fluorescent lights shine in your eyes as a blur of health providers move around you preparing the room for emergency surgery. In the midst of this chaos, a nurse asks you why your chart says female when you present as male. The reality sinks in that you have to “out” yourself as transgender to this stranger. The nurse looks you up and down and starts in with warnings about your endangered soul and singing religious hymns at every opportunity. Later, as you are waking after surgery, you hear a nurse say to your spouse, “We don’t treat your kind here. You’re making the staff and other patients uncomfortable.” Your spouse is escorted out by security; the nurse shoves a pain pill down your throat and puts you, groggy and nauseated, into a wheelchair to send you home.

In the car home, you feel feverish and begin vomiting so violently that your stitches burst open. The hospital will not let you return, telling your insurance company, “We don’t know what he, she, it—whatever the f*** it calls itself wants or needs from us. We’re done. We did our job.” Eventually an ambulance takes you to a hospital 40 miles away for treatment of life-threatening complications.

This really happened to Dannie Ceseña at a Dignity Health hospital in California. Dannie bravely shared this experience in his public testimony at one of the California attorney general’s 17 hearings statewide on the impact of the merger between Dignity and Catholic Healthcare Initiatives (CHI).

Today’s health-care landscape is rapidly shifting. Medical systems are increasingly consolidating care into larger and larger merged entities. All signs point to the likelihood that we will see more of these mergers over time, with religiously affiliated health systems merging with either secular or other religiously affiliated health systems.

Each one of these mergers raises critical questions about how to help preserve access to care for patients who are treated at these facilities, and how to help ensure that the care they receive is based on medical training, expertise, and standards of care. Barring that, Catholic and other religiously affiliated health facilities should at the very least be required to affirmatively disclose these facts ahead of time to a potential patient. Only in this way can patients make informed choices about whether they want to continue receiving care at a facility that is basing its patient care at least in part on religious or moral doctrine rather than the medical standard.

Dignity has 39 hospitals in three states, while CHI has 103 hospitals in 18 states. Our organization, the National Health Law Program, along with many reproductive health, health consumer, LGBTQ organizations, and others, raised concerns about this merger both at the public meetings as well as in a coalition letter signed by 22 organizations.

California Attorney General Xavier Becerra approved the merger on November 21, paving the way for the creation of a new entity called CommonSpirit Health to become the largest nonprofit hospital system in the nation. Sean McCluskie, a chief deputy to Becerra, said in a statement about the merger that the California Department of Justice “is committed to improving the well-being and health of families across the state by increasing the accessibility and availability of care in our communities. Our office carefully reviewed this transaction to protect patients and our communities here in California, and our office will monitor compliance with the conditions.”

Those conditions, according to the statement, include requiring CommonSpirit to “preserve the accessibility and availability of health care services to communities who have been served by Dignity Health hospitals.” They also require CommonSpirit to maintain emergency services and women’s health-care services for ten years. If CommonSpirit officials want to change these services in the second half of those ten years, they must notify the California Department of Justice so regulators can assess the impact such moves would have on health care in the region.

The National Health Law Program’s analysis found that the decision includes strong language prohibiting discrimination against LGBTQ patients and requiring hospital policies to explicitly include language prohibiting discrimination based on sexual orientation or gender identity. Becerra’s decision to include provisions prohibiting the affected hospitals from discriminating against LGBTQ patients is commendable. We will see whether this provides sufficient protections to prevent patients like Dannie from horrible discrimination moving forward.

Whether these stipulations alone will be sufficient to preserve women’s health-care services for the long term, let alone allow for advancements in medical care, is unclear. As has been covered by Rewire.News, Catholic hospitals have a long history of routinely denying patients critical life-saving care, including abortion care, access to birth control, and medication for individuals living with HIV. In one widely publicized lawsuit, the American Civil Liberties Union of California sued Dignity Health for withholding medical care because of a patient’s gender identity when they refused to allow a transgender man to receive a hysterectomy upon discovering his gender identity.

Many Catholic hospitals and health systems follow the Ethical and Religious Directives (ERDs), a series of rules promulgated by the U.S. Conference of Catholic Bishops. The ERDs are intended to govern health-care delivery in Catholic health systems, including Catholic hospitals, clinics, and managed care organizations. Among other things, the ERDs forbid many reproductive health services, including birth control, sterilization, some miscarriage management, abortion, the least invasive treatments for ectopic pregnancies, and some infertility treatments. The ERDs provide no exceptions for risks to a patient’s health or even life. The ERDs were recently updated to include more restrictive provisions related to mergers and transactions between Catholic hospitals and other entities.

The full impact the provisions could have on these types of transactions is unclear, and the new provisions have the potential to make it even harder for these services to be maintained in future business arrangements involving Catholic entities. Despite these changes, however, the Catholic Church signed off on the Dignity Health and CHI merger.

The Conference of Catholic Bishops is not a trained medical provider; it is group of religious leaders from the Catholic Church. Thus, the ERDs are grounded not in medical knowledge and understanding, but on a particularly conservative strain of Catholic religious doctrine. In spite of the fact that the ERDs fly in the face of medical standards of care, doctors, nurses, and other health-care workers employed at many Catholic hospitals are required to follow them.

The problem is that most patients who receive care at Catholic facilities have no idea about the existence of these restrictions, and indeed are not told about them until it is too late. For example, pregnant people have gone or been taken by ambulance to Catholic hospitals while miscarrying, but hospital officials have refused to take action to terminate the pregnancy until there is no fetal heartbeat or until the pregnant patient’s life is in serious jeopardy due to infection or other complication. In other instances, patients have gone to a Catholic hospital for labor and delivery and have requested a postpartum sterilization but have been told the hospital will not conduct the procedure.

On the face of it, it seems reasonable for patients to expect that they will receive at least the same medical standard of care regardless of the hospital where they are treated. So too, it is reasonable for doctors, nurses, and other medical providers to expect to be able to make decisions about the care of their patients based on their medical training and experience and accepted medical standards of care in their fields of practice. But this is not the case at Catholic hospitals that follow the ERDs. At these facilities, it is instead a set of conservative religious doctrines that can ultimately guide life-or-death decisions about patient care.

There is no question that we will continue to see hospital mergers in the future, both between Catholic health systems as well as between Catholic and secular or other religiously affiliated health systems. In the face of these Catholic hospital mergers, it remains to be seen how effectively we will be able to protect patient access to care. Health advocates and community members should continue to push Attorney General Becerra to ensure that any future proposed mergers involving Catholic or other religiously affiliated health systems be approved only with enforceable conditions in place that will truly preserve access to the full range of health-care services, including reproductive health services, and ensure these services are provided equally to all with dignity and respect.