News Religion

Hospital Illegally Refused Sterilization Procedure, Pro-Choice Group Charges

Jason Salzman

The Center for Reproductive Rights, in a March 4 letter sent to St. Anthony Summit Medical Center on behalf of the patient, Jennifer Versailles, stated that the Catholic hospital's denial of the tubal ligation procedure violates state and federal laws mandating pregnancy related care.

A Catholic hospital in Colorado’s central mountains has refused the request of a staff doctor to perform a tubal ligation, a sterilization procedure, after a cesarean section that took place on Tuesday.

The Center for Reproductive Rights (CRR), in a March 4 letter sent to St. Anthony Summit Medical Center on behalf of the patient, Jennifer Versailles, stated that the Catholic hospital’s denial of the tubal ligation procedure violates state and federal laws mandating pregnancy related care.

It also constitutes sex discrimination, the letter charged.

James Corbett, Centura Health’s senior vice president for community health and values integration, did not address Versailles’ case when asked for comment, but he alluded to the hospital’s faith-based directives.

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“We cannot discuss specifics about a patient due to federal patient privacy laws,” Corbett wrote in a statement to Rewire. “St. Anthony Summit Medical Center is among the Centura Health hospitals which adhere to the Ethical and Religious Directives for Catholic Health Care Services (ERDs).”

It is CRR’s “understanding” that St. Anthony’s refusal to perform the procedure is based on the ERD directives, which are promulgated by the U.S. Conference of Catholic Bishops, according to the letter from CRR, a national reproductive freedom organization.

The ERD directives state that sterility procedures on men or women are “not permitted in a Catholic health care institution,” unless treatment of an illness would dictate otherwise and alternative remedies are not available.

“We uphold our faith-based mission and strongly respect the patient-physician relationship,” Corbett wrote in his statement.

Autumn Katz, CRR senior staff attorney, told Rewire that this case proves this wrong.

“They say that they value a doctor-patient relationship, but policy suggests otherwise,” Katz said. “This is absolutely interference in a very disturbing way in the doctor-patient relationship, because this is the care that Jennifer’s doctor and she have decided is best for her health. The hospital for other reasons is denying her ability to access that care.”

Corbett wrote that the hospital facilitates the doctor-patient relationship by encouraging alternatives.

“In instances where a patient cannot obtain a requested elective procedure at a Centura Health hospital under Catholic sponsorship, we encourage the patient and physician to work together for a solution,” Corbett wrote.

Asked to explain why Versailles didn’t have the tubal-ligation procedure at a different hospital, Katz said, “My understanding is [Versailles] felt that the safest course for her was to do it at this hospital. That’s the hospital where her doctor practices and where she’s delivered her prior two children. She was not willing at the last minute to find a new doctor and travel, under what could be precarious conditions, to a different hospital where she could have had the tubal procedure.”

“Ms. Versailles, in consultation with her doctor, Dr. Andrew Catron, has decided that immediate postpartum tubal ligation is in her best medical interest, given her age and prior medical history,” the CRR letter states. “Ms. Versailles has two young children—ages two and five, both delivered by C-section—and she and her husband do not wish to have more children.”

The letter points to an American College of Obstetricians and Gynecologists’ recommendation that postpartum tubal ligation should be considered an “urgent surgical procedure” because it reduces medical risks and obviates the need for an additional surgery with anesthesia.

St. Anthony Medical Center, located in Frisco, Colorado, is a member of the Centura Health hospital chain, formed by a 1996 merger of Adventist Health System and Catholic Health Initiatives (CHI) hospitals.

It describes itself on its website as a “faith-based, nonprofit health care network designed to manage and strengthen their hospitals and services.”

“We extend the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities,” the website states.

The CHI network has been criticized for trying to dictate medical treatment in accordance with the religious guidelines of the U.S. Conference of Catholic Bishops.

After Catron requested permission to perform the tubal ligation in December, according to CRR’s letter, the Rev. Godwin Nnamezie of St. Anthony’s Ethics Committee wrote Catron an email stating, “Honestly, you know that we cannot do direct sterilization at this Facility. Procedures that induce sterility are only allowed when it is to cure or alleviate any serious illness of the patient.”

Katz said her organization hasn’t decided how it will respond.

“We will evaluate all options,” Katz said. “We will talk to Jennifer in the next few weeks and see how she is feeling. I don’t expect this to be an isolated incident. And it’s a danger to many women. It has repercussions beyond this procedure, for a hospital to dictate medical care from religious directives rather than what’s the best medicine for patients.”

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.’”

 

Tell us your story. Have religious restrictions affected your ability to access health care? Email stories@rewire.news

News Law and Policy

Anti-Choice Group: End Clinic ‘Bubble Zones’ for Chicago Abortion Patients

Michelle D. Anderson

Chicago officials in October 2009 passed the "bubble zone" ordinance with nearly two-thirds of the city aldermen in support.

An anti-choice group has announced plans to file a lawsuit and launch a public protest over Chicago’s nearly seven-year-old “bubble zone” ordinance for patients seeking care at local abortion clinics.

The Pro-Life Action League, an anti-choice group based in Chicago, announced on its website that its lawyers at the Thomas More Society would file the lawsuit this week.

City officials in October 2009 passed the ordinance with nearly two-thirds of the city aldermen in support. The law makes it illegal to come within eight feet of someone walking toward an abortion clinic once that person is within 50 feet of the entrance, if the person did not give their consent.

Those found violating the ordinance could be fined up to $500.

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Harassment of people seeking abortion care has been well documented. A 2013 survey from the National Abortion Federation found that 92 percent of providers had a patient entering their facility express personal safety concerns.

The ordinance targets people seeking to pass a leaflet or handbill or engaging in “oral protest, education, or counseling with such other person in the public way.” The regulation bans the use of force, threat of force and physical obstruction to intentionally injure, intimidate or interfere any person entering or leaving any hospital, medical clinic or health-care facility.

The Pro-Life Action League lamented on its website that the law makes it difficult for anti-choice sidewalk counselors “to reach abortion-bound mothers.” The group suggested that lawmakers created the ordinance to create confusion and that police have repeatedly violated counselors’ First Amendment rights.

“Chicago police have been misapplying it from Day One, and it’s caused endless problems for our faithful sidewalk counselors,” the group said.

The League said it would protest and hold a press conference outside of the Planned Parenthood clinic in the city’s Old Town neighborhood.

Julie Lynn, a Planned Parenthood of Illinois spokesperson, told Rewire in an email that the health-care provider is preparing for the protest.

“We plan to have volunteer escorts at the health center to make sure all patients have safe access to the entrance,” Lynn said.

The anti-choice group has suggested that its lawsuit would be successful because of a 2014 U.S. Supreme Court decision that ruled a similar law in Massachusetts unconstitutional.

Pam Sutherland, vice president of public policy and education for Planned Parenthood of Illinois, told the Chicago Tribune back then that the health-care provider expected the city’s bubble zone to be challenged following the 2014 decision.

But in an effort to avoid legal challenges, Chicago city officials had based its bubble zone law on a Colorado law that created an eight-foot no-approach zone within 100 feet of all health-care facilities, according to the Tribune. Sidewalk counselor Leila Hill and others challenged that Colorado law, but the U.S. Supreme Court upheld it in 2000.

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