Woman with brain tumors refused life-saving tubal ligation at Catholic hospitals

September 23, 2015 • 9:15 am

At the time of Pope Francis’s visit to the U.S., during which he’ll undoubtedly be acclaimed for his liberality and care for the poor, let us remember that his church still officially refuses to give women their reproductive rights, including contraception. Here’s a particularly noxious case from Genesys Regional Medical Center, a Catholic hospital in Genesee County, Michigan. What they’re trying to do to Jessica Mann is apparently legal, but also both ethically dubious and medically dangerous.

As reported by The Humanist and the Washington Post, Mann has brain tumors (apparently not malignant), is pregnant with her third child, and needs both a Caesarian section and a tubal ligation, the latter recommended by doctors since a further pregnancy would endanger her life. It’s best if both procedures were performed in one operation, but the hospital, while willing do to the Caesarian, refuses to do the ligation, as it’s as an un-Catholic form of birth control. Her only option is to have the procedure done at another hospital or have two procedures, with the ligation done at a non-Catholic hospital. The first option is viable, but Mann’s doctors are at Genesys, and the hospital changed its policy, forbidding tubal ligations only after Mann was already in treatment. The second option endangers her life. As The Humanist notes:

As an arm of the Ascension Health Care System, Genesys is one of many hospitals that operate based on a “conscience exemption” protected by federal law. In 2009 the US Conference of Catholic Bishops issued a set of ethical and religious directives that govern Catholic hospitals, disallowing contraceptives, abortions, and sterilizations. By adhering to these guidelines, medical centers expose women to unnecessary health risks even when procedures are deemed necessary by doctors. Currently, these measures are protected by the Church Amendment, stating that a public health center cannot be made to “make its facilities available for the performance of any sterilization procedure or abortion if the performance of such procedure or abortion in such facilities is prohibited by the entity on the basis of religious beliefs or moral convictions.” This law undermines the medical necessity of such procedures while jeopardizing the health of the patients of these hospitals. And Catholic hospitals are not easily avoided.

Those who say Mann should just find another hospital should heed this:

According to a 2013 report, Catholic hospitals make up ten of the twenty-five largest health-care networks in the United States, and that number is only on the rise. The number of Catholic non-profit hospitals increased 16 percent between 2001 and 2011, even though the total number of hospitals declined during those years.  For people on Medicaid or living in rural areas, Catholic hospitals are sometimes the only option; a full one-third of Catholic hospitals are based in rural areas, and one in ten acute-care hospitals are Catholic or affiliated. Many people are left with no choice but to utilize Catholic medical centers.

The case of Kim Davis in Kentucky reminded us all of the conflict between the civil duty of employees and their religious doctrine.  The Church Amendment, a federal law, allows hospitals to refuse procedures if those procedures conflict with Church doctrine, and prohibits physicians from having to perform services contrary to their religious beliefs:

No individual shall be required to perform or assist in the performance of any part of a health service program or research activity funded in whole or in part under a program administered by the Secretary of Health and Human Services if his performance or assistance in the performance of such part of such program or activity would be contrary to his religious beliefs or moral convictions.

One could argue that yes, individual doctors who are pious Catholics should not be compelled to perform birth control, even when it’s necessary to save a woman’s life. But the Amendment also stipulates that the hospital cannot be compelled to “make its facilities available for the performance of any sterilization procedure or abortion if the performance of such procedure or abortion in such facilities is prohibited by the entity on the basis of religious beliefs or moral convictions. . ”

The “entity” here is not a doctor, but the entire hospital. Even if the doctors aren’t Catholic, then, and willing to do the ligation, they must abide by the law and tell Mann to go elsewhere.

Here we have another conflict between conscience (of a hospital, not a doctor!) and professional duties. For isn’t the duty of a doctor to prevent danger to the mother? The Hippocratic Oath, a principle of ethnical medical procedure, incorporates a version of the dictum, “First, do no harm.”  By refusing to do a tubal ligation during a Caesarian section, the doctors are in fact doing more harm to her than they could.

I can understand an argument that doctors not be personally compelled to perform procedures that are helpful but contrary to their religious sentiments. I can understand that argument, though I don’t completely agree with it. For if Catholic-hospital doctors are the only ones available, their ethical duty is to help the woman rather than harm her simply to appease their faith. But I cannot agree that entire institutions which receive funds from the U.S. government—and Catholic hospitals fall into this category—should be allowed to abstain from such procedures on religious grounds. That seems to me a violation of the First Amendment.

The American Civil Liberties Union is intervening against Genysys on behalf of Ms. Mann, but (pardon the expression), given present law I don’t think they have a prayer of success.

And let us remember that although Pope Francis is a step up from his predecessors, his Church has done little more than lip service to truly reform Catholicism’s animus towards gays, women and population control. Although I believe that Francis is sincere in his concern for the plight of the poor, by refusing to sanction birth control (a refusal embodied in his encyclical against global warming), he perpetuates the very poverty he abhors.

111 thoughts on “Woman with brain tumors refused life-saving tubal ligation at Catholic hospitals

  1. I had a conversation with a Catholic man who said that a pregnant 16yo leukemia patient should be denied chemo until she was facing imminent death, as harming the 13wk fetus would be a grave moral sin.

    He also stated that the people who denied her treatment were doing what was “moral and just” and that they would likely go go Heaven. He said that the girl might *not* get to Heaven if she dares to resist dying on behalf of the 13wk fetus.

      1. Catholics are both sick and funny.

        A pro life catholic woman just told me that cows are *not* sentient beings.

        Another fundie just said that the personality, the self, is in the body and heart, not the mind, which is why disconnecting the braindead from their feeding tubes is murder.

        And then she called to a video of an anencephalic baby, gong on about how he was a blessing to his family and that he really had a great, if short life. But he brought joy to everyone he touched.

        I tried to explain that no brain = non sentient, ie, empty sack of human flesh and bone, but they were not buying it. As long as his body was alive, he was thinking and feeling, unlike a cow, because the cow, even though it has a brain, isn’t human.

        1. Last night my children (11 y.o.) and I watched a trailer for the forthcoming movie about investigative reporting of the RCC’s child abuse / rape issue. This one here. They were a bit nonplussed. So I explained briefly. They were taken aback and had to double check, “No, dad, wait a second. Do you mean in real life? Not just in the movie but in real life?”

          This resulted in a 15 minute discussion of the RCC, its age, wealth, political power, its sovereign nationhood, its long and proud history of lying, cheating, stealing, killing torturing, abusing and so on. They can’t understand why the Catholic Church is still allowed to get away with what they do. To them it is like a betrayal of their society that the RCC hasn’t been held accountable.

          But they do have some pretty good ideas about how reasonably decent individuals, like the grandmother that they love, can remain devout Catholics even in the face of exposure of so much corruption within the RCC clergy at all levels including the Pope. They see examples of how that starts with some of their friends that they occasionally go to church with.

        2. And I supposed the handful of cells that exist immediately after conception are sentient in her view? To be consistent, this would entail having many many sentient beings in our bodies at this very moment…

          1. Great question.

            I will ask.

            I told her that she is highly knowledgeable on the subject and that I wish to learn more.

            Oh. Last week she spent hours defending Operation Rescue , the folks behind abortion clinic bombings and murders. See, OR is *not* a terrorist organization because 1) they don’t say that they are on their website 2) they killed people like 20 years ago, ergo, the past is irrelevant.

            1. Just ask her under what circumstances parents should be required — legally, religiously, or otherwise — to enter a burning building to save one of their already-born children. For bonus points, what sorts of sanctions should first responders face for any triage decisions they’re forced to make at the scene?

              b&

              1. I’ll do that too. I can already tell you the answers, though:

                1) the slut had sex so she should take responsibility

                2) pregnancy is *natural* and cannot be compared to a burning building

                3) denial of reality – pregnancy is safe and is all fairy farts and glittter dust unicorns, whereas burning buildings are dangerous

                4) the uterus was specifically designed by God/evolution for the fetus, ergio it is actually the property of the fetus, not the woman

                5) the slut had sex!!!1111!!

                Notice the preponderance of naturalistic fallacies and slut shaming? That is par for the course!!

              2. Then you might also want to ask her how many women she’s stoned after no bloody sheet was produced on the wedding night? She’s making it clear, after all, that death is the proper “reward” for out-of-wedlock sexual relations.

                b&

            2. Wow, if that’s her view, good luck with the sentience question…

              Another point to bring up, it’s well established when babies start becoming self aware, which for the sake of argument we could say is a minimal criteria for sentience. I forget the exact age but it is judged by milestones such as recognizing themselves in the mirror. One thing is for sure, it’s well after birth. Sentience is a spectacularly weak point to build an anti-abortion argument on. I’m sure your friend would also be thrilled to know that people like Peter Singer have seriously used this argument to discuss whether it is ever moral to kill babies after birth, as part of the euthanasia argument in general.

              1. I haven’t told her this yet, because I am a meanie head, but she is confusing sentience and sapience.

                Self awareness, thinking = sapience

                Basic consciousness, the ability to perceive and to consciously experience life = sentience

                Non sentience = amoebas, venus fly traps – they can react to stimuli, but that is alll reflexive, and does not require conscious awareness.

                I’m not gonna tell her that, though.

                She can go on claiming that animals are incapable of basic awareness. The beauty of it is, she kept linking websites to me that explained *exactly* what sentience is, all the while acting as if *I* am the dumbarse.

    1. At the end of the day, the Roman Catholic Church is concerned about souls, not bodies. Their position has a certain grim logic. If getting into heaven means life-everlasting, then that far outweighs any temporal ills that might befall someone in order to prevent a sin that would prevent that. We have seen, historically, the work the Church itself has done to dispatch souls to heaven individually and en masse. Even if one isn’t an atheist, one may dispute their sectarian view of what constitutes a sin, what the potential “punishment” is, and what the sinner must do to be forgiven. For myself, I think it all the most complete load of medieval horseshit.

      1. The problem is, when they try to impose their beliefs on unwilling people.

        They may want to ‘save my soul’ by forcing me to die a painful death on behalf of a non-viable fetus, but they have no right to legally force that on me.

              1. “I won’t start worrying until it begins to add lines of it’s own to your comments.”

                Or till RAM upgrades you didn’t order start arriving.

    2. It’s a doctor’s job to do what’s medically best for their patient’s health, not get themselves into heaven. They should be doing that in their spare time. The tendency of Catholics to use others as stepping stones to heaven is obnoxious.

      1. It’s a doctor’s job to do what’s medically best for their patient’s health, not get themselves into heaven.

        That’s just crazy talk!

        Put down the crack pipe!

        /s

    3. About 30 years ago a friend of mine found out she had melanoma at just about the same time she found out she was pregnant. Her doctors advised her to terminate the pregnancy in order to treat the cancer, but as a good Catholic she “elected” (I don’t know how much pressure was exerted by the diocese) to complete the pregnancy and then start treatment.

      Her baby was born, but two years later my fiend was dead. As a good Catholic, she’d already had 3 children, so not only did a really nice person lose her life in her 20’s, she left behind 4 young motherless kids as well.

      1. Bloody asshats don’t even get the basic concept of triage. Even if you grant them the “every sperm is sacred” bullshit, that still doesn’t give all the sperms a greater claim to the woman’s body than the woman herself has.

        Unless a moral obligation exists for a parent to rush into a burning building to save a child, even in cases where there’s no chance of saving the child, then there’s no obligation to carry any pregnancy to term.

        b&

  2. She should find another hospital. Inconvenient, but if she cares for her life and the life of her child(ren) she needs to leave. If she is upset she can write the hospital a letter telling them she regrets ever having come to a place that voluntarily promotes harm due to religious convictions.

    1. Or, the ACLU can intervene, as it has, to make this issue a test case. Presumably if that isn’t resolved before the Caesarian she will go elsewhere. But the ACLU would have to drop the case the minute she does it. It will be a few weeks, I think, until the procedure is performed.

    2. I agree. But, I wonder. Does she have strong religious convictions herself? If so she may feel compelled to stay where she is and allow the hospital to mistreat her.

      1. What if her religion and “sincerely held beliefs” says that she must compel the doctors to value her life over the fetus? Or that, like most atheists, she must abort and eat the baby?

        1. I am not sure what you are trying to say, but you may have mistaken me for someone else.

          Just to clarify what I was trying to say, she may be a committed enough believer that she can’t be counted on to be proactive in guarding against mistreatment by the hospital. There are, as I am sure you know, plenty of people that are. Laws and regulations should protect those people as well instead of leaving them to the tender mercies of medical ethics guided by the Christian bible and the Vatican.

          The point seems moot anyway, at least in this particular case. Based on several of the comments here it seems that the woman has been proactive.

          1. From the linked article I get the impression she is a lapsed Catholic. I would expect her to look elsewhere for treatment. I guess she is cooperating with ACLU to help them make their point, but would not endanger her own life for a bunch of men in black.

          2. Oh, I understood your point. I was just (sarcastically) adding on. My point was that say she did have some absurd religious belief mandating eating babies. Obviously, she couldn’t compel the doctor to do so against the law; likewise, the doctor (or institution) should not be allowed to prevent her from doing something legal based on their beliefs.

            Two lessons learned here:
            1) We really need sarcasm tags, though I can only imagine we’d quickly degrade into sarcastic use of sarcasm tags and need a “actually sarcastic” tag…

            2)I should word things more carefully when I’m adding on quick comments during lunch break.

            1. I got it the first time, chris. 😉

              One hopes sarcasm tags will never be necessary for eating-babies jokes. But you never know…

    3. And unless her condition requires some special care or case-specific procedures during the delivery, if the hospital is preventing her obstetrician from performing these operations at another location, then she should go ahead and find new doctors. Heck, have your current doctor give you references.

      Yes its probably very upsetting to give up someone you know and trust for a stranger, but unless you’re a special case, mechanically speaking there should be many many obstetricians capable of doing a caesarian. Find a second for the tubal ligation if needed, and off you go. If the RCC Hospital has a strangle-lock on your current obstetrician(s), find others.

  3. What is it with catholic clinics? They rather let a woman die, instead of doing the medical procedures that would save her life. Remember the woman in Ireland who died because the doctors refused to remove the already dead fetus?

    The hypocratic oath is now called the hypocritical oath!

  4. I agree that a hospital as an institution should not be covered under the religious exemption rule. It’s a matter of conflicting religious beliefs — the beliefs of a patient versus those of the people who run the institution. When beliefs of *individuals* conflict, government should not get involved. But when beliefs of an individual conflict with the “beliefs of an institution” (which actually don’t exist) and that institution is governed by Federal regulations, then I think government should favor the individual.

  5. I’m in the UK. Presumably these hospirals receive some forms of federal / state funding? Given that how are they able to discriminate on religious grounds?

    1. That is a very good question, one that the ACLU is contesting now. Yes, Genysys, and other Catholic hospitals, receive government payment via Medicare and other programs. They should not be allowed as an institution to refuse to perform life-saving procedures, or any procedure that’s good for the patient. I haven’t yet resolved in my mind whether individual doctors should be compelled to violate their religious beliefs (I’m leaning against it IF other doctors can fill in), but not whole institutions!

      By the way, please don’t post as “Anonymous”. Thanks!

      1. I haven’t yet resolved in my mind whether individual doctors should be compelled to violate their religious beliefs (I’m leaning against it IF other doctors can fill in)

        The situation should really rarely come up; we’re talking about a baby delivery, everyone involved should have had at least 8 months’ forward notice to decide whether they want to be involved or not.

        Now IMO, if we’re talking about someone arriving at the hospital, in breach, and you’re the only physician on duty who can deliver it, then IMO no religious exemption allowed. The same goes for the hospital; they get no religious exemption if an ‘immediate emergency’ case presents itself. The time to say ‘no’ is in the months leading up to the procedure, not when someone’s life is in the balance.

        1. Yes, timing is everything.
          In this case the amount of time available to find another hospital and doctors was significantly reduced:

          “and the hospital changed its policy, forbidding tubal ligations only after Mann was already in treatment.”

          Somewhere between 8 months and an emergency.

          1. Here’s a snippet from the referenced news article that suggest the time window was less than a month:
            “The hospital had indicated it would make some exceptions to the policy for medical reasons, so Mann requested one in May. But early this month, her doctor informed her that the hospital had said no.”
            Anyway, you know what they say – religion poisons everything.

            1. Yeah, that’s pretty ethically unacceptable (IMO). If you have a pregnant woman, you don’t take 4 months to decide whether your hospital will do the procedure she’s requested or not. A month I could buy. Four says to me either great administrative incompetence, or they were stringing her along until she had few viable alternatives.

              1. Speaking of stringing her along…a friend of mine was seeking an abortion and asked the resident Ob/Gyn for advice. He told her it was too late, she was past the point where an abortion was legal in this state, so forget it.
                She quickly learned that that MD was a Catholic and had lied to her. She still had a month or so safety. String you along, lying for Christ.

              2. Pro lifers lie. The same Catholic pro lifer who today has just told me that animals are *not* sentient ( guess she thinks they are like rocks or something?) told me that ‘the woman and the baby can always be saved, after I asked her this question. Oh, no pro lifer will ever answer this question honestly.

                Rural Africa
                12 year old pregnant girl
                Obstructed labour
                She will die if this goes on much longer
                40 wk viable fetus
                500 miles from medical help

                Do you:

                1) force a c-section on her, killing her but saving the fetus

                2)take the fetus out in pieces, killing it but saving her

                The Catholic lady kept telling me, over and over, that “the Dublin Declaration has stated that it is always possible to save both mother and baby”

                Yeah. That’s what you tell one of the 300,000 women who die of pregnancy complications every year in the developing world. That a bunch of pro life doctors in Ireland said that it is always possible, no matter the circumstance, to save both.

              3. “That a bunch of pro life doctors in Ireland said that it is always possible, no matter the circumstance, to save both.”

                “Save” in the sense of having a priest give the mother confession before she dies, no doubt. [/sarcasm]

                ‘pro-life’ is bullshit.

                cr

              4. @infinite
                I would think she could have filed malpractice against the Catholic Dr. But, I suspect it would have been an big distraction, however, given the urgency of her situation, and witnesses might have been hard to find. Nothing was in writing.

      2. What is incredible is that Catholics have the unmitigated gall to run these hospitals as if they have a right to call the shots, considering the paltry sums they contribute to their budgets.

        It would be a pretty inexpensive proposition to buy them out of their control positions if one cannot litigate them out.

        1. In fairness, the state governments play the same game. To use an example Jerry might find interesting, UVA and W&M each receive less than 20% of their operating funds from the State of Virginia, yet they are ‘state’ schools with all the requirements and rules that go along with that.

          This is not to defend the procedure; it’s shameful. The state should pony up or let the Universities set their own entrance etc. requirements. And the RCC hospitals should do the same: the RCC should either pony up or let the primary funders exercise policy control over the institution.

        2. That’s something I was wondering about. Where does the Church get the money to “buy” the hospitals, and from whom? How can an organization that has diocese declaring bankruptcy settling rape cases afford to take on more infrastructure? You’d think they would spend any excess cash on much needed mental health for their own priesthood.

      3. I am not sure specifically how it should be codified in law, but I am definitely leaning towards individual medical professionals not being able to refuse medically necessary care for a patient.

        The “medically necessary” part needs to be well thought out. My thoughts are along the lines of the what is considered by the medical community as a whole as the best care / procedure / solution possible given the facilities capabilities and the doctor’s knowledge and experience.

        In practice I don’t have any problem with an individual doctor asking another to do something she doesn’t want to do. That is fine with me, for any reason. But, there are always situations where that is not possible without unduly increasing the risks to the patient, and in fact such situations are fairly common in medical care.

        For example, I don’t think pharmacists should be allowed to refuse selling contraceptives. If more than one is on duty and they can work such things out between them, fine with me. If the pharmacist is there alone he should be legally required to sell the contraceptive no matter how sinful it is.

        1. Well, I am astounded that medical professionals aren’t already bound to provide “medically necessary care foe a patient”. Isn’t that what the Hippocratic oath is all about? Hypocritical oath would be a more appropriate description.

      4. The “if others can fill in” is the sticking point. The matter you mentioned came up here in Ontario, which despite being very urban in part is also home to many rural communities and even more sparsely populated people. So the question arises: how close does “fill in” have to be to count?

        I don’t know an easy answer to this question, which is one reason I err on the side of not allowing “ethical” objections to procedures. Of course, this will basically entail that some practioners may well lie about their competence or what not to get out of doing things, but …

        1. I would lean to it needing to be a seamless or practically invisible handover. There should essentially be no disruption in the time, location, or quality of service provided (beyond the unavoidably obvious change of personnel). If that’s not possible, then no accommodation.

  6. There is only one situation in which I can grant a medical professional to refuse to assist in care the professional finds distasteful: vanity cosmetic (non-reconstructive, non-corrective) procedures or treatments.

    In any other circumstances, your choice is to provide the care or quit your job because of your lack of qualification.

    b&

    1. I once had a dermatologist in Austin who if I told I had skin cancer (basal) he would put me in front of six month waiting list of cosmetic care patients.

      Now, in the southwest/high altitude and more retired people, I tell my dermatologist that I spotted some more skin cancer and she tells me, “Yeah, get in line.”

      1. Triage is another matter. If there’s a waiting list of other people who also have skin cancer, it’s reasonable to give preference to those who’ve been on the waiting list the longest.

        But what the Church is doing is akin to saying that they won’t treat those with excessively dark skins for skin cancer because they suffer the mark of Cain.

        b&

    2. I can, however, easily imagine circumstances in an isolated practice where a patient comes in with an injury or serious condition which the the (perfectly competent) doctor is just not equipped or capable of performing.

      In the borderline case the doctor then has to decide whether to perform some operation at the limit of his competence or not.

      cr

      1. I don’t have any medical education, but I’d be absolutely flabbergasted if one could get an M.D. or equivalent of any sort without some quality time somewhere along the line on the subject of triage. There comes a point where the best try from somebody less than fully qualified is better than nothing — but there are also circumstances where nothing is the better (or, at least, least worst) choice. Being able to navigate those waters with some modicum of skill and compassion is part of the basic competence required of any sort of medical professional.

        b&

  7. This is the sort of evil which results when the religious blithely claim that secular services, organizations, and institutions are really just expressions of God’s love and compassion for the suffering world. On the surface it sounds so much like hey, we’re on the same side, working humanistic ally for a better life for all, regardless of the beliefs of those who are helped. Comrades! Friends and allies! Compatibility!

    Oh, but then the devil’s in the details. They’re not being secular; they’re trying to co-opt secular necessities as religious expressions. Their ultimate motivation mattered after all. Surprise.

  8. “Church has done little more than lip service to truly reform Catholicism’s animus towards gays, women and population control”

    Well, maybe we should give the Church a break. The Pope said if you violate the abortion ban a priest can/might be willing to forgive you. What a relief! But, for that you’d have to be a catholic feeling in need of forgiveness. On second thought, forget about giving the Church a break. They are loathsome.
    BTW, in our town, contrary to trends elsewhere, the Catholic run hospital closed and now we only have a secular one. Nice.

  9. Their stance on birth control is as much an example of cherry-picking as the condemnation of homosexuality. I know of not one Catholic who protests outside of businesses that open on Sunday for toiling on the Sabbath. I know of not one Catholic whom has ever hurled a rock at someone for wearing garments made of two different fabrics.
    They cherry-pick Leviticus 20:13 because they don’t like gay people and they’re needlessly digging their heels in on birth control and abortion because they want to punish women for having sex.

  10. This case demonstrates the danger of religious social services: You have to take the religion with the service. That is the trouble with “faith-based” initiatives. There should be no religious exemption for medical institutions. Allowing institutions to reject certain practices on religious grounds is an imposition of faith on the patient. The fact that there might be other venues for treatment is irrelevant, because there also might not be, and that wouldn’t change the hospital’s policy.

    1. Exactly right. The position the Church has carved out for itself should be eliminated quickly. I only hope the ACLU and others who work this issue can manage to generate enough pressure to get ride of these pathetic unfair laws.

      1. Mao? An humanist? Not hardly. Atheist, yes, but not humanist.

        I’d be astounded if he ever self-identified as an humanist. But, even if so, his political career was the very antithesis of humanism.

        b&

          1. Not sarcasm. I would never be sarcastic about someone who murdered 100 million humans in the name of the greater good. Though to be fair he’d never have denied a woman a tubal ligation for a religious reason, so he’s got that going for him.

              1. Yeah, I seem to me missing where the humanist part of Mao comes into play too…but with regard to sarcasm, I’d like to know who it is msavage here would like to suggest should have the final say in who is allowed to be sarcastic and about which topics. Sarcasm can be an effective literary device and I struggle to see any other context in which humanist could be applied to Mao.

                My response here should probably be qualified with a “don’t feed the troll” tag.

  11. Reading of situations like this causes me to be annoyed when religious folk complain about atheists being ‘strident’, or ‘too outspoken’.

    From now on I’m going to be bloody well insufferable!

  12. There was a similar situation here in Northern California a month ago, where a woman who was to give birth by Caesarean section also wanted a tubal ligation – no brain cancer, just a desire for permanent contraception. Her doctor was fine with it, but the local hospital (Mercy Hospital in Redding) is part of “In”Dignity Health (formerly Catholic Healthcare West), and they said “no, not in our hospital”. She threatened suit, aided by the ACLU, and the hospital backed down – I suspect to avoid the risk of losing. See http://www.sfgate.com/health/article/Catholic-hospital-backs-down-on-tubal-ligation-6463205.php

  13. Let’s not forget that during all this, the conservatives in America are damning the Pope for being too liberal.

    When you’re to the right of a guy who considers wearing a condom to be on par with committing mass murder in terms of the appropriate punishment, it may be time to re-evaluate. When you’re to the right of a guy who leads an institution, who on their own authority, shuffled child molesters around for centuries because they will have no outsiders intruding into their fascist hierarchy, it’s time to reconsider where you lie on the political spectrum.

  14. In New Zealand, the Catholic Church is not in the hospital business because our single-payer government-run system means there’s no profit in it. Therefore we don’t have these problems. (We don’t have religious universities either for similar reasons.) I wonder if the Catholic Church would be in the hospital business if the US system didn’t mean they make so much money out of it.

    Doctors here can refuse to perform certain procedures on conscience grounds, but they are legally required to refer the patient to another doctor who can and will perform it.

    We have some private hospitals where people can go if they choose for some elective procedures plus unnecessary cosmetic procedures. Some cosmetic procedures are considered necessary though e.g. you can choose to have a breast augmentation after a mastectomy for cancer via the public system.

    There’s some cross over too if the public waiting list for a procedure gets too long. (The maximum considered too long is six months.) I had my last basal cell carcinoma removed in a private hospital but paid for by the public system because of a long waiting list.

    NZers consider quality health care just as much a human right as education. We think it should be available to all no matter what. The cost of health care in countries like ours is much lower than the US. It’s almost all included in our income tax, our taxes are lower, and most of us pay no medical insurance because we genuinely don’t need it. It’s basically a status symbol.

    1. I wouldn’t be quite so sanguine on the “doctors are legally required to refer the patient to another doctor who can and will perform it” Following the Hallagan decision (a case where anti-abortion doctors challenged Medical Council guidelines) the only obligation is the minimal statutory one that they “must inform the person who requests the service that he or she can obtain the service from another health practitioner or from a family planning clinic.” In other words get out and find another doctor!

      1. I stand corrected. I thought the requirement was stronger than that. I’ve obviously been out of the health sector too long! I thought they had to give them the name of a GP who would help them if there’s no family planning clinic locally.

        1. This case was around 2010/2011 and was a challenge to a draft Medical Council requirement that stated
          “While the council recognises that you are entitled to hold your own beliefs, it remains your responsibility to ensure that a pregnant woman who comes to you for medical care and expresses doubt about continuing with the pregnancy is provided with or is offered access to objective information or assistance to enable her to make informed decisions on all available options for her pregnancy, including termination.”

          This was held to go beyond the strict statutory formulation.

          The older formulation was (and still seems to be)
          “If you feel your beliefs might affect the advice or treatment you provide, you must explain this to patients and tell them about their right to see another doctor. You must be satisfied that the patient has sufficient information to enable them to exercise that right.”
          I possibly exaggerated the bit about “get out and find another doctor” but as yet there has been no clarification as to exactly what is required unless the H&DC has made some decisions.

    2. I can vouch for the NZ medical system. While traveling there I experienced a retinal detachment and found myself operated on by a professor of ophthalmology. Excellent treatment and the cost was very reasonable.

      1. As a visitor they would, I think, have presented you with the bill afterwards.

        As I understand it the policy (in NZ) is, if it’s an emergency operation in a public hospital, they operate first and worry about the bill later. (If you’re a NZ resident the public health system normally picks up the bill). If you’re a visitor and uninsured / unable to pay, I believe they normally waive it.

        cr

        1. “If you’re a visitor and uninsured / unable to pay, I believe they normally waive it.”

          I wouldn’t bet on it. The hospitals are expected to chase up the medical costs incurred by non-eligible patients and will recover it if possible. This of course is not always easy to do so a lot has to be written off as the patient has skipped the country or is unable to pay.

          1. In a civilized world, all countries would offer universal health care for their citizens, and each country would have hassle-free reciprocal agreements with each other. An American who needed care when visiting Britain would just give a passport number to the hospital, and NHS would bill Medicare without the patient ever being any the wiser.

            I wouldn’t be surprised if some form of this exists somewhere already, but it’s certainly not applicable to us Americans….

            b&

            1. We have reciprocal arrangements with a lot of other countries that have similar systems to ours.

              Treatment is provided before we ask where you come from, and the bill is presented afterwards if you come from a country we don’t have a reciprocal arrangement with. They’re chased up as much as possible, but it’s obviously not easy once someone’s left the country. A lot end up getting written off, but most people are more respectful than coming here to take advantage.

              Most visitors from countries with no reciprocal arrangement have insurance.

              1. “A lot end up getting written off, but most people are more respectful than coming here to take advantage.”

                I do agree, nobody goes on holiday with the intention of getting sick. Since we rely a lot on tourism, it’s to NZ’s advantage not to give people a hard time if they do have an accident or fall ill.

                cr

        2. That sounds about right. I received the bill after returning to the States. It was below my insurance deductible, so I happily payed.

  15. “In New Zealand, the Catholic Church is not in the hospital business because our single-payer government-run system means there’s no profit in it. Therefore we don’t have these problems.”

    That is, broadly, correct.

    The biggest private hospital in Auckland, Mercy Hospital, originated as Mater Misericordiae run by nuns in 1936. I think it’s still nominally Catholic but not visibly so.

    I went there for a heart valve operation a few years back. I could have had it done a few months later for free on the public health system (the exploratory angioscopy was done in Auckland Hospital), but since I had medical insurance I chose to ‘go private’ for that. It cost about $42,000, my insurance was limited to $35,000 which would have been enough anywhere in NZ but Auckland, after some indecision I chose to ‘go private’ and pay the extra $7K myself because 1. my specialist told me sooner was better though it wasn’t a life-or-death thing; 2. I could choose my time for it, so I chose late August so I’d be recovered for the summer; and 3, I could afford it and it freed up a place on the public list for someone who needed it more.

    I was a little surprised that the hospital asked for their accommodation deposit (around $8k) up-front. The others – the surgeon, anaesthatist, heart specialist – all sent individual bills later, along with the hospital’s 5-page itemised surgery bill which, much to my amusement, listed everything down to surgical tape, disposable gloves and paracetamol.

    cr

      1. It’s interesting – I’d love to know how much the same thing would cost in the US. I heard somewhere that the cost of a knee replacement is 3x the cost in the US compared to South Korea, which also has a pretty good system.

        1. In 2013, I went into afib, and after the obligatory 24 hour waiting period with conversion-pills I didn’t convert, so went to the emergency room. They administered an intravenous converter and after a half hour, that didn’t work so they gave me the paddles. That did the trick and I’ve been in sinus rhythm since. But the entire process took about 3 hours and cost around 7k. Based on my own anecdote, I’d say a heart valve operation would far exceed 42k in the US.

          1. We had twins born 2 months premature. They spent 1 month in NICU. Thankfully they had no troubles beyond acid reflux and needing to be reminded to breath every now and then. Though they were subjected to a truly impressive number of tests & evaluations to check for all the things that can go wrong with premature babies.

            The one number that I still clearly remember is the cost of staying in the NICU. That was $180,000 per child. That didn’t include the long list of tests, the delivery itself or any of the care for their mother. All told it was over $500,000. Luckily we had very good medical insurance at that time so it only took us about 5 years to pay off the costs we were responsible for.

          2. In the U.S. I suffered chest pain and spent a night in the hospital. I underwent blood tests, CAT, treadmill evaluation, etc. and spent a night in the hospital. It turned out to be , probably, muscle strain. The bill was $17K.
            In NZ I had a similar episode of chest pain. I went to a clinic and had blood tests and instead of the CAT scan, a manual exam. Nothing fancy. It turned out to be, probably, muscle strain. The bill was $500.

  16. Get yourself a National Health Service you wallies! This is disgusting – the U.S. really does treat the sick poorly, especially the poor sick, & as for the self righteous bloody Roman Catholics, who the hell are they to judge?!
    Grrr….

    1. I think we treat the poor AND middle class sick very badly, and arguably the middle class gets hit harder simply because they have the resources to get hit harder. Hospitals write off a lot of cost when people can’t pay it, and I suspect write-offs occur more for the poor than the middle class. The homeless guy who racks up a $100,000 bill will simply be written off; the middle class parent who does so will be asked to pay it, and may end up going bankrupt to do so.

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