Catholic Bishop Castigates and Threatens Hospital that Saved Woman’s Life

Amie Newman

In November 2009, a young mother of four was given a life saving, emergency abortion from doctors at St. Joseph's Hospital in Phoenix, Arizona. Bishop Thomas Olmstead of the Roman Catholic Diocese of Phoenix called it "immoral" and is now threatening the hospital president in an effort to make sure they never save a pregnant woman's life again.

In November 2009, a young mother of four children was rushed to St. Joseph’s Hospital in Phoenix, Arizona for an emergency abortion. The doctors who cared for her at the Catholic hospital determined that without the emergency abortion, she likely would have died. From a letter sent by the ACLU in July of 2010 about the case:

The woman was eleven weeks pregnant and suffered from life-threatening pulmonary hypertension, which is high blood pressure in the arteries that supply blood to the lungs. As her condition worsened, the hospital diagnosed her with right-sided heart failure and cardiogenic shock, and determined that she would almost certainly die unless she terminated the pregnancy.

I’m sure her husband and children are forever grateful to the surgeons and physicians who saved the life of this woman, a wife and mother.

Not so the Roman Catholic Diocese of Phoenix, however.

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After the life-saving procedure was performed Bishop Thomas Olmstead of the Diocese demoted Sister Mary McBride who acted as the liasion between the hospital Ethics Committee and the physicians. The U.S. Conference of Catholic Bishops agreed with the decision.

Now, in a letter revealed in the media today, Bishop Olmstead is not only castigating Catholic Healthcare West, the group that runs St. Joseph’s Hospital, for saving her life but threatening them in order to force them to promise that doctors will never save a woman’s life if it requires an emergency abortion ever again.

In a letter (PDF) to Lloyd H. Dean, President of Catholic Healthcare West, Bishop Olmstead calls the life-saving procedure “morally wrong” even though he doesn’t deny that it almost certainly saved her life. The ACLU notes that he then “threatens to remove his endorsement of the hospital unless CHW “acknowledge[s] in writing that the medical procedure that resulted in the abortion at St. Josephs’ Hospital was a violation” of the policy that governs all Catholic hospitals and “will never occur again at St. Joseph’s Hospital.”

From the letter it seems as if Dean and CHW have stuck to their position that not only were their actions moral and just, in this circumstance, but that they certainly would not promise not to save a woman’s life or health if presented with a similar case in the future. In fact, they presented both religious and moral ethicists’ opinions as support for the hospital’s actions.

On what planet does Bishop Omstead live that saving the life of a mother of four is unacceptable on a moral or religious scale?

The ACLU claims that Olmstead’s insistence that the hospital must never provide an emergency abortion procedure is actually a violation of federal law. Alexi Kolbi-Molinas, staff attorney for the ACLU, said in a statement this week:

“Religiously affiliated hospitals are not exempt from federal laws that protect a patient’s right to receive emergency care, and cannot invoke their religious status to jeopardize the health and lives of pregnant women. Women should never have to be afraid that they will be denied life-saving medical care when they enter a hospital.”

The federal law, in specific, to which Kolbi Molinas refers is the Emergency Medical Treatment and Active Labor Act. The law protects patients’ rights to receive emergency reproductive health care and Catholic hospitals cannot opt out. The law is necessary given that Catholic hospitals operate 15 percent of all hospital beds, according to the ACLU, and may likely provide the only or closest emergency care in a region. In a letter to the Centers for Medicare and Medicaid Services in July 2010, the ACLU requests an investigation into violations of the federal law – not only as a result of the incident at St. Joseph’s but after numerous reports of horrendous scenarios:

We know that what happened at St. Joseph’s was not an isolated incident. Catholic-owned hospitals across the country have refused to provide emergency abortions, as documented in a recent article in the American Journal of Public Health. For example, a doctor in the Northeast decided to leave a Catholic-owned hospital after he was forced by the hospital’s ethics committee to risk a pregnant patient’s life. The woman was in the process of miscarrying at 19 weeks of pregnancy. She was dying: her temperature was 106 degrees, she had disseminated intravascular coagulopathy, which is a life-threatening condition that prevents a person’s blood from clotting normally and causes excessive bleeding. This patient was bleeding so badly that the sclera, the whites of her eyes, were red, filled with blood. Despite the fact that there was no chance the fetus could survive, the ethics committee told the doctor that he could not perform the abortion the woman needed to save her life until the fetus’s heartbeat stopped. After the delay, the patient was in the Intensive Care Unit for 10 days, and developed pulmonary disease, resulting in lifetime oxygen dependency.

Still, Bishop Olmstead and the Roman Catholic Diocese are steadfast in their insistence that physicians and hospital administrators acted immorally when they saved the life of a pregnant mother of four children and are determined to ensure that pregnant women are not safe in the hands of Catholic hospitals across the country.

News Health Systems

Complaint: Citing Catholic Rules, Doctor Turns Away Bleeding Woman With Dislodged IUD

Amy Littlefield

“It felt heartbreaking,” said Melanie Jones. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

Melanie Jones arrived for her doctor’s appointment bleeding and in pain. Jones, 28, who lives in the Chicago area, had slipped in her bathroom, and suspected the fall had dislodged her copper intrauterine device (IUD).

Her doctor confirmed the IUD was dislodged and had to be removed. But the doctor said she would be unable to remove the IUD, citing Catholic restrictions followed by Mercy Hospital and Medical Center and providers within its system.

“I think my first feeling was shock,” Jones told Rewire in an interview. “I thought that eventually they were going to recognize that my health was the top priority.”

The doctor left Jones to confer with colleagues, before returning to confirm that her “hands [were] tied,” according to two complaints filed by the ACLU of Illinois. Not only could she not help her, the doctor said, but no one in Jones’ health insurance network could remove the IUD, because all of them followed similar restrictions. Mercy, like many Catholic providers, follows directives issued by the U.S. Conference of Catholic Bishops that restrict access to an array of services, including abortion care, tubal ligations, and contraception.

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Some Catholic providers may get around the rules by purporting to prescribe hormonal contraception for acne or heavy periods, rather than for birth control, but in the case of copper IUDs, there is no such pretext available.

“She told Ms. Jones that that process [of switching networks] would take her a month, and that she should feel fortunate because sometimes switching networks takes up to six months or even a year,” the ACLU of Illinois wrote in a pair of complaints filed in late June.

Jones hadn’t even realized her health-care network was Catholic.

Mercy has about nine off-site locations in the Chicago area, including the Dearborn Station office Jones visited, said Eric Rhodes, senior vice president of administrative and professional services. It is part of Trinity Health, one of the largest Catholic health systems in the country.

The ACLU and ACLU of Michigan sued Trinity last year for its “repeated and systematic failure to provide women suffering pregnancy complications with appropriate emergency abortions as required by federal law.” The lawsuit was dismissed but the ACLU has asked for reconsideration.

In a written statement to Rewire, Mercy said, “Generally, our protocol in caring for a woman with a dislodged or troublesome IUD is to offer to remove it.”

Rhodes said Mercy was reviewing its education process on Catholic directives for physicians and residents.

“That act [of removing an IUD] in itself does not violate the directives,” Marty Folan, Mercy’s director of mission integration, told Rewire.

The number of acute care hospitals that are Catholic owned or affiliated has grown by 22 percent over the past 15 years, according to MergerWatch, with one in every six acute care hospital beds now in a Catholic owned or affiliated facility. Women in such hospitals have been turned away while miscarrying and denied tubal ligations.

“We think that people should be aware that they may face limitations on the kind of care they can receive when they go to the doctor based on religious restrictions,” said Lorie Chaiten, director of the women’s and reproductive rights project of the ACLU of Illinois, in a phone interview with Rewire. “It’s really important that the public understand that this is going on and it is going on in a widespread fashion so that people can take whatever steps they need to do to protect themselves.”

Jones left her doctor’s office, still in pain and bleeding. Her options were limited. She couldn’t afford a $1,000 trip to the emergency room, and an urgent care facility was out of the question since her Blue Cross Blue Shield of Illinois insurance policy would only cover treatment within her network—and she had just been told that her entire network followed Catholic restrictions.

Jones, on the advice of a friend, contacted the ACLU of Illinois. Attorneys there advised Jones to call her insurance company and demand they expedite her network change. After five hours of phone calls, Jones was able to see a doctor who removed her IUD, five days after her initial appointment and almost two weeks after she fell in the bathroom.

Before the IUD was removed, Jones suffered from cramps she compared to those she felt after the IUD was first placed, severe enough that she medicated herself to cope with the pain.

She experienced another feeling after being turned away: stigma.

“It felt heartbreaking,” Jones told Rewire. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

The ACLU of Illinois has filed two complaints in Jones’ case: one before the Illinois Department of Human Rights and another with the U.S. Department of Health and Human Services Office for Civil Rights under the anti-discrimination provision of the Affordable Care Act. Chaiten said it’s clear Jones was discriminated against because of her gender.

“We don’t know what Mercy’s policies are, but I would find it hard to believe that if there were a man who was suffering complications from a vasectomy and came to the emergency room, that they would turn him away,” Chaiten said. “This the equivalent of that, right, this is a woman who had an IUD, and because they couldn’t pretend the purpose of the IUD was something other than pregnancy prevention, they told her, ‘We can’t help you.’”

News Health Systems

What Happens When a Catholic-Run Clinic Comes to Your Local Walgreens?

Amy Littlefield

“It causes us great concern when we think about vulnerable populations ... [who] may need to use these clinics for things like getting their contraception prescribed and who would never think that when they went into a Walgreens they would be restricted by Catholic doctrine,” Lorie Chaiten, director of the women’s and reproductive rights project of the ACLU of Illinois, told Rewire.

One of the largest Catholic health systems is set to begin running health clinics inside 27 Walgreens stores in Missouri and Illinois next week. The deal between Walgreens and SSM Health has raised concerns from public interest groups worried that care may be compromised by religious doctrine.

Catholic health systems generally follow directives issued by the U.S. Conference of Catholic Bishops that restrict access to an array of services, including abortion care, contraception, tubal ligations, vasectomies, and fertility treatments.

“We are concerned that the clinics will likewise be required to follow the [directives], thereby severely curtailing access to important reproductive health services, information, and referrals,” MergerWatch, the National Health Law Program, and the American Civil Liberties Unions of Illinois and Missouri wrote in a letter to Walgreens on Wednesday. They also sent a letter to SSM Health.

In a statement emailed to Rewire, Walgreens said its relationship with SSM Health “will not have any impact on any of our current clinic or pharmacy policies and procedures.”

SSM Health emailed a statement saying it “will continue to offer the same services that are currently available at Walgreens Healthcare Clinics today.” If a patient needs services “that are beyond the scope of what is appropriate for a retail clinic setting, they will be referred to a primary care physician or other provider of their choice,” the statement read.

A spokesperson for SSM Health demurred when Rewire asked if that would include referrals for abortion care.

“I’ve got to check this part out, my apologies, this is one that hadn’t occurred to me,” said Jason Merrill, the spokesperson.

Merrill later reiterated SSM Health’s statement that it would continue to offer the same services.

Catholic health systems have in recent years expanded control over U.S. hospitals, with one in six acute-care hospital beds now in a Catholic-owned or -affiliated facility. Patients in such hospitals have been turned away while miscarrying, denied tubal ligations, and refused abortion care despite conditions like brain cancer.

Catholic health systems have also expanded into the broader landscape of outpatient services, raising new questions about how religion could influence other forms of care.

“The whole health system is transforming itself with more and more health care being delivered outside the hospital,” Lois Uttley, director of MergerWatch, told Rewire. “So we are looking carefully to make sure that the religious restrictions that have been such a problem for reproductive health care at Catholic hospitals are not now transferred to these drug store clinics or to urgent care centers or free-standing emergency rooms.”

Walgreens last year announced a similar arrangement with the Catholic health system Providence Health & Services to bring up to 25 retail clinics to Oregon and Washington. After expressing concerns about the deal, the ACLU of Washington said it received assurances from both Walgreens and Providence that services at those clinics would not be affected by religious doctrine.

Meanwhile, the major urgent care provider CityMD recently announced a partnership with CHI Franciscan Health–which is affiliated with Catholic Health Initiatives–to open urgent care centers in Washington state.

“We’re seeing [Catholic health systems] going into the urgent care business and into the primary care business and in accountable care organizations, where they are having an influence on the services that are available to the public and to consumers,” Susan Berke Fogel, director of reproductive health at the National Health Law Program, told Rewire.

GoHealth Urgent Care, which describes itself as “one of the fastest growing urgent care companies in the U.S.,” announced an agreement this year with Dignity Health to bring urgent care centers to California’s Bay Area. Dignity Health used to be called Catholic Healthcare West, but changed its name in 2012.

“This is another pattern that we’ve seen of Catholic health plans and health providers changing their names to things that don’t sound so Catholic,” Lois Uttley said.

 

In the letters sent Wednesday, the National Health Law Program and other groups requested meetings with Walgreens and SSM Health to discuss concerns about the potential influence of religion on the clinics.

“It causes us great concern when we think about vulnerable populations, we think about low-income people… people who… may need to use these clinics for things like getting their contraception prescribed and who would never think that when they went into a Walgreens they would be restricted by Catholic doctrine,” Lorie Chaiten, director of the Reproductive Rights Project of the ACLU of Illinois, told Rewire.

The new clinics in Walgreens will reportedly be called “SSM Health Express Clinics at Walgreens.” According to SSM Health’s website, its initials “[pay] tribute” to the Sisters of St. Mary.

“We are fairly forthcoming with the fact that we are a mission-based health care organization,” Merrill told Rewire. “That’s something we embrace. I don’t think it’s anything we would hide.”

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