News Abortion

Colorado ACLU Files Complaint Against Catholic Hospital Over Anti-Abortion Discussion Policy

Jason Salzman

The ACLU of Colorado has filed a complaint with a state agency alleging that a rural Catholic hospital is in violation of both federal and state law by directing its doctors not to discuss abortion with patients, even when pregnancy threatens the life of the pregnant person.

The American Civil Liberties Union (ACLU) of Colorado filed a letter of complaint with a state agency Wednesday alleging that a rural Catholic hospital is violating state and federal law by directing doctors not to discuss abortion with their patients.

The complaint is based on allegations by Dr. Michael Demos, a long-time staff cardiologist at Mercy Regional Medical Center, that a hospital administrator demanded he not, under any circumstances, discuss the possibility of abortion with his patients.

About a year after advising a patient in 2012 that the standard treatment for her possible congenital illness would be abortion, Demos received a letter from Mercy’s chief medical officer stating that, in accordance with the Catholic Ethical and Religious Directives followed by Mercy, he “should not recommend abortion—even to patients who may have serious illnesses,” according to the ACLU complaint.

Later, Mercy Chief Medical Officer Dr. John Boyd went further, telling Demos in a meeting that he shouldn’t mention abortion at all to a patient, even if a pregnancy is a threat to a woman’s life, according to the ACLU complaint and confirmed by Demos to the Durango Herald.

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Demos had suggested the option of abortion to a women who he thought might have Marfan syndrome, a severe illness that can cause a woman’s aorta to rupture during pregnancy. It turned out, his patient did not have the disease, and she later gave birth.

The patient complained to Mercy because she thought Demos had recommended abortion, as opposed to suggesting the possibility of it, triggering Demos’ rebuke from Boyd, according to the ACLU complaint.

“When the medical standard of care would recommend termination, the hospital is inappropriately forcing staff physicians to choose between obeying their employer or following their professional medical and ethical obligations to their patients,” said Mark Silverstein, ACLU legal director, in a statement. “Moreover, following the hospital’s directive deprives patients of the full information they need to make informed decisions about their medical care.”

Mercy hospital did not return numerous requests for comment, but media reports, citing a written statement from Mercy, noted that the hospital believes the ACLU complaint is inaccurate.

Doctors and patients “are free to use all information in the medical literature to make appropriate medical decisions,” according to the statement, as quoted by the Associated Press.

“We feel the statements made in the complaint are based on inaccurate information and look forward to resolving the issue directly with the [Colorado Department of Public Health and the Environment],” said Mercy hospital in its statement, as reported by the Herald.

Upon hearing Mercy’s response, Silverstein at the ACLU speculated perhaps Mercy doesn’t consider abortion an “appropriate medical decision.”

The facts supporting the ACLU complaint, Silverstein argued, based on Mercy’s letter and meeting with Dr. Demos, should not be in dispute.

The ACLU asked the Colorado Department of Public Health and Environment, which sets standards for state hospitals, to respond to its complaint by November 27.

The controversy here in Colorado reflects similar cases of Catholic hospitals trying to dictate some medical treatments in accordance, not with common medical practice, but with directives adopted by the U.S. Conference of Catholic Bishops.

Catholic Health Initiatives and Adventist Health Systems, which own Mercy and other hospitals, follows the Bishops’ directives for health care. The U.S. Conference of Bishops did not immediately return a request for comment. Neither did the Archdiocese of Pueblo, which covers the region in Colorado where Mercy hospital is located.

“This is perhaps one more example in what’s emerging as a series of incidents around the country involving a conflict related to the religious directives of hospital administration and the physicians who practice in those hospitals,” Silverstein told RH Realty Check, citing a recent Mother Jones article documenting the growth in the number of Catholic hospitals in the United States and disputes over women’s health treatment in Arizona and Kentucky, for example.

This is the only dispute of this nature that’s come to the attention of the ACLU in Colorado, Silverstein said.

News Health Systems

ACLU Sues for Complaints Filed Against Catholic Hospitals Denying Reproductive Care

Nicole Knight Shine

A 2012 federal investigation of the Catholic-run St. John Hospital in Detroit found the hospital violated federal law by discharging a miscarrying patient who lost seven pints of blood while the facility refused for six hours to allow an emergency abortion because fetal tones were present.

The American Civil Liberties Union (ACLU) is demanding the federal Centers for Medicare & Medicaid Services (CMS) release complaints against federally funded Catholic hospitals, where patients report being denied emergency medical care in violation of federal law.

In a Freedom of Information Act suit filed Tuesday, the ACLU asked a federal court to force the CMS to hand over complaints alleging violations of the Emergency Medical Treatment and Active Labor Act. CMS is charged with fielding complaints and investigating violations of the law, which requires federally funded hospitals to provide patients with the care required to stabilize a medical condition, such as a miscarriage.

A CMS spokesperson told Rewire in an email the agency does not comment on pending litigation.

Roughly one in six hospital beds are in a Catholic facility, with the top four U.S. Catholic health systems expected to take in more $90 billion from Medicare and Medicaid in 2016, according to the ACLU’s 10-page lawsuit filed in U.S. District Court for the Southern District of New York.

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Catholic hospitals follow religious directives, written by the United States Conference of Catholic Bishops, that forbid doctors at Catholic facilities from performing abortions unless the patient is in grave condition, among other restrictions.

“We’ve heard heartbreaking stories from women who rushed to a Catholic hospital in an emergency but were turned away because the hospital let religious rules written by bishops dictate what medical care could be provided,” said ACLU Senior Staff Attorney Brigitte Amiri in an emailed statement.

ACLU officials believe CMS is privy to a “number of complaints” alleging federal violations, according to the court filing. Amiri told Rewire in an email that the goal of the suit is to find out how many.

The lawsuit cites a series of complaints filed by patients who said they were denied emergency care for miscarriage in Catholic facilities. In one account, the hospital discharged a miscarrying patient, who later underwent emergency abortion care and treatment for major blood loss at another facility.

In another account, a woman miscarried alone on the toilet, after a Catholic hospital gave her Tylenol to treat a potentially deadly pregnancy-related infection and sent her home twice.

“It is crucial,” the court filing states, “that the requested documents are disclosed so that the public can ascertain whether hospitals receiving federal funds are violating federal laws designed to protect patient health and safety.”

ACLU filed its Freedom of Information Act request with CMS in 2014, but said it received no meaningful response. The ACLU requested, in part, five years of documents “relating to allegations of improper care, violations of [EMTALA], and violations of [CMS] regulation related to pregnancy-related treatment, including, but not limited to, treatment for miscarriage, abortion, and sterilization at hospitals receiving federal funds.”

CMS handed over a batch of documents as a response to the ACLU’s request. But the ACLU argues in its filing that the documents included no complaints related to miscarriage or abortion care.

Amiri told Rewire via email that the ACLU knows of specific miscarriage-related complaints that CMS failed to turn over.

In a statement announcing the lawsuit, the ACLU said it has used complaints to take legal action against Catholic providers, including a lawsuit filed against Trinity Health, the second largest Catholic hospital system in the country.

“With one in six hospital beds in facilities that are bound by the Catholic Directives, we expect there are more stories that will come to the surface,” Amiri told Rewire.

CMS in its own investigations has turned up wrongdoing on the part of Catholic hospitals, according to the ACLU court filing.

A 2012 investigation by CMS of the Catholic-run St. John Hospital in Detroit found the hospital violated federal law by discharging a miscarrying patient who lost seven pints of blood while the facility refused for six hours to allow an emergency termination because fetal tones were present. A family member drove the patient to another facility for an emergency abortion.

Responding to the investigation, a St. John Hospital staff member told CMS: “We are a Catholic institution and we do not perform abortions here if there are fetal heart tones.”

The court filing doesn’t say whether the hospital was sanctioned for violating the law.

Tuesday’s lawsuit is one of many the ACLU has filed over Catholic directives.

California’s largest medical association announced last month that it will join an ACLU lawsuit against the the state’s largest hospital system, Dignity Health, for using religious directives to deny basic reproductive health care to patients. A court hearing is expected Wednesday.

News Health Systems

41,000 Doctors to Join Lawsuit Against Catholic Hospital Over Denial of Care

Nicole Knight Shine

Religious directives, written by the United States Conference of Catholic Bishops, forbid doctors at Catholic facilities from providing birth control and performing common reproductive health procedures.

California’s largest medical association will join a lawsuit against the state’s largest hospital system for using religious directives to deny basic reproductive health care to patients.

The 41,000-member California Medical Association (CMA) filed a motion Wednesday in state Superior Court to join an American Civil Liberties Union (ACLU) lawsuit against the Catholic hospital chain Dignity Health, the fifth largest health-care system in the country.

The ACLU lawsuit stems from the case of a Dignity Health patient who was denied a tubal ligation. The patient’s physician agreed to perform the procedure during her cesarean section, but the hospital refused the doctor’s request, citing religious directives written by Catholic bishops that classify sterilization as “intrinsically evil.”

The ACLU of Northern California and the law firm of Covington & Burling LLP in December filed the lawsuit on behalf of the patient, Rebecca Chamorro, and Physicians for Reproductive Health.

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The plaintiffs argue that forcing doctors to deny basic health care on the basis of religious objections creates a conflict between the medical well-being of patients and the directives of the Catholic hospital system. They also contend that withholding medical care for reasons unrelated to medicine is illegal in California.

A court hearing on CMA’s motion is set for May 25 in San Francisco.

Dignity Health operates 29 hospitals across California. Nationally, ten of the 25 largest hospital systems are Catholic sponsored, according to a statement released by the ACLU. One in nine hospital beds is in a Catholic facility.

Patient health is jeopardized when religious directives at these facilities trump medical judgment, advocates argue.

“The religious directives are bad for both patients and doctors and present a real threat to the medical judgment of these doctors,” Elizabeth Gill, senior staff attorney at the ACLU of Northern California, said in a statement.

Religious directives, written by the United States Conference of Catholic Bishops, forbid doctors at Catholic facilities from providing birth control and performing common reproductive health procedures like tubal ligation, sterilization, and abortion, even when the patient’s health is at risk.

The CMA intends to join the lawsuit because of the larger issues of patient safety represented in Chamorro’s case.

“Patients and their physicians, not hospital administrators following religious or any other non-medical directives, should be the primary decision-makers in each and every case to ensure each patients’ health care needs are met and the most appropriate, highest quality care is being provided,” Dr. Ruth Haskins, president-elect of the California Medical Association, said in a statement.