abortion, even in a potentially life-threatening situation.
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“Not only does the directive violate the Colorado statute that specifically prohibits hospitals from exercising control over a doctor’s professional judgment, it also interferes with physicians’ ethical and moral responsibility to their patients,” writes ACLU attorney Sara Rich in a letter sent to the Colorado Department of Public Health and Environment on Wednesday. The letter asks the state to intervene to stop the hospital from enforcing its policy.
The controversy centers around a doctor's claim that Mercy Regional Medical Center policy forbids employees to discuss abortion, even in cases of medical emergency. The hospital, in Durango, told Yahoo Shine in a written statement that it was following up directly with the state department regarding the ACLU letter, but that it felt the complaint was “based on inaccurate information.”
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The trouble began last year, the letter states, when an eight-weeks-pregnant patient was referred to Mercy cardiologist Dr. Michael Demos for a cardiac evaluation because of a family history of presumed Marfan syndrome. The connective-tissue genetic disorder can lead to fatal pregnancy complications due to spontaneous aortic rupture, and, the letter explains, the Guidelines of the American College of Cardiology/American Heart Association would recommend pregnancy termination based on the condition of the woman’s aorta. Demos suggested further evaluation for the patient and explained that abortion would be the standard of care in a worst-case scenario. The patient wound up being healthy and successfully carried her baby to term.
However, she complained to hospital staff about Demos's mentioning the possibility of abortion. "I was very surprised. Extremely." Demos tells Yahoo Shine in an email about the complaint. In response, Mercy’s chief medical officer, Kip Boyd, informed the patient in an initial letter that the hospital would educate its doctors and remind them not to recommend abortion even to patients who may have serious health problems. A second letter reaffirmed that, “pursuant to hospital policy and the Catholic Ethical and Religious Directives, Mercy Regional medical staff are ‘precluded…from providing or recommending abortion…”
This stated policy, according to the ACLU letter and to a spokesperson, Bridget Amiri, violates not only the Colorado state law, but also federal law. It mandates that patients in any hospital accepting Medicaid or Medicare must “receive sufficient medical information in order to be able to make informed decisions.” (It can even mandate such a hospital to administer an abortion if it’s required to save a woman’s life, Amiri noted.)
Demos added, "Working for religious institutions, they've been very good about not imposing religious restrictions. It's just been this one issue, which came up out of left field."
A spokesperson for the state department of health in Colorado would not comment on the situation for Yahoo Shine, beyond saying that the office was “looking into it.”
The Mercy Regional statement reiterates its commitment to patient care and allowing doctors to make appropriate medical decisions. As a faith-based hospital, it states, “we are committed to carrying out our mission and ministry in a manner that is consistent with our religious and ethical directives.” Those directives, issued by the United States Conference of Catholic Bishops, are at the center of various other recent reports about tensions between the growing number of Catholic hospitals, nationally, and patients’ legal rights.
“The directives do not permit direct referrals to abortion providers or any association with abortion providers,” Lori Freedman, medical sociologist and author of “Willing and Unable: Doctors' Constraints in Abortion Care,” tells Yahoo Shine. “They do allow abortion when a woman's life is at stake, but how this is defined is debated.”
Those approvals are rare, and are often done with the help of hospital ethics committees, which are charged with making difficult decisions. In one oft-cited case, from 2009, a hospital administrator in Arizona who was a nun approved an abortion for a woman who would have otherwise most likely died; as a result, the nun was excommunicated.
A just-published Mother Jones story, “Do Bishops Run Your Hospital?” notes that the number of American hospitals affiliated with the Catholic Church grew by 16 percent between 2001 and 2011 while the number of public hospitals and secular nonprofit hospitals dropped 31 percent and 12 percent, respectively. Those numbers could certainly mean more conflicts like the one in Colorado.
"Pretty soon, people may find that the only hospitals in their area are Catholic. And, regardless of their own religious beliefs, they will be unable to get the care they need," Kelli Garcia of the National Women’s Law Center tells Mother Jones. "It is going to be a real wake-up call."
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