Reuters Health released a story on Aug. 17 suggesting that Catholic hospitals cannot fully care for women with emergencies during their pregnancies and complaining that physicians at Catholic institutions are unable to make referrals for abortions or sterilization procedures. The venerable news wire apparently did not have the resources to reach a single administrator at one of the 600 or so Catholic hospitals in the United States before it filed this story, so I thought I would help out by speaking with Sister Carol Keehan, D.C., president and chief executive officer of the Catholic Health Association of the United States (CHA).
Sister Keehan saw the Reuters story and was familiar with the report it was built upon. She was not much impressed.
“It’s really not possible to draw any legitimate conclusions from this very small study,” she said. The Reuters Health report details the outcomes of phone interviews with just 27 doctors.
The study’s lead author, Dr. Debra Stulberg of the University of Chicago, has been a frequent and persistent critic of Catholic health care policies in the United States, especially the “ERDs,” the U.S. bishops’ “Ethical and Religious Directives for Catholic Health Care Services,” which guide them. She sounded one of the major alarms in the Reuters Health story, warning that, according to her phone interviews, “‘[e]ven in some emergencies doctors couldn’t provide care they thought the patient needed,’ like giving high dose birth control pills to control heavy bleeding.”
Sister Keehan said that the latest report prolongs a common misperception among a growing and aggressive chorus of critics of Catholic health care that the U.S. bishops’ directives, already denigrated by critics as an encumbrance, prevent Catholic hospitals from acting in the best interests of women, especially those with pregnancies in crisis.
But Sister Keehan points out that pregnancies that endanger the lives of women are indeed terminated at Catholic hospitals “all the time” when that outcome becomes absolutely, if sadly necessary, and nothing in the bishops’ directives prevents that from happening. Instances of ectopic pregnancies, infections arising from ruptured membranes or the above-noted crisis of uncontrolled bleeding—in other words pregnancies that cannot come to term and that endanger the life of the mother—are regularly dealt with at Catholic institutions as well as they are at any other hospital in the country, according to Sister Keehan. Catholic hospitals have to pass the same standards for maternal and neo-natal care as all other hospitals—and like all other facilities are accredited by the Joint Commission—and have to be licensed by their respective states according to the same care standards as all other health care facilities.
And despite the concerns raised by Stulberg, the doctor-patient relationship is just as respected at Catholic institutions as at any other health care facility, according to Sister Keehan. “Doctors, based on their clinical evaluation of their patient and their discussions with their patients, give them the advice and the referrals that they think the patients want; that’s between the doctor and the patient,” she said.
There are, of course, some differences between secular and Catholic institutions. Catholic hospitals will indeed not make abortion referrals or offer sterilizations. But, Sister Keehan argues, “pregnancies with problems don’t need to be referred for abortion, they need to be taken care of at the hospitals, and at Catholic hospitals they are taken care of.”
According to Sister Keehan, many Catholic hospitals, which are often operating in medically underserved communities, are so good at dealing with a crisis during pregnancy that they are rated for “level three” care, meaning that other nearby medical facilities will direct the most acute cases to them. “Many Catholic hospitals are the high-risk maternity facility for their area and have an incredible history” of helping women, she said.
“The obstetrician has two patients,” said Sister Keehan, “the mother and the baby, [and the doctor] feels an obligation for both the mother and the baby.” Parents expect physicians to take that mutual obligation seriously.
“Most of the time when these emergency situations come up, this baby is very much desired and very much looked forward to,” said Sister Keehan, “so this is a tragedy for this family and they have to know that they did everything they could.” She added, “That’s the desire of almost every patient that comes into Catholic health care.”
The Reuters Health article joins a recent line of media reports worrying over the presumed limitations of Catholic health facilities based on their unwillingness to host abortion and sterilization procedures and offer referrals for contraception. The news stories have been fueled by analyses like Stulberg’s, press releases from Catholic health care critics Merger Watch and lawsuits sponsored by the A.C.L.U.
In 2013 the A.C.L.U. sued the U.S. bishops’ conference on behalf of a Michigan woman, alleging that the U.S. bishops’ health care directives led to improper care by Mercy Health Partners in Muskegon, Mich., before the complainant suffered a miscarriage in 2010. The case was thrown out of court by a federal judge in June 2015, but the A.C.L.U. of Michigan and other A.C.L.U. affiliates are actively soliciting allegations of malpractice aimed at Catholic health facilities, presumably as the foundation for future lawsuits or for filing official complaints with state health agencies.