The Bishops and Catholic Hospitals Under Fire

On Monday, December 2 the American Civil Liberties Union (ACLU) filed a federal lawsuit against the United States Conference of Catholic Bishops on behalf of a woman who says that she did not receive adequate care at a Catholic hospital after going into preterm labor at 18 weeks and eventually miscarrying. The ACLU is claiming that the alleged medical malpractice was the result of the hospital’s adherence to the USCCB’s Ethical and Religious Directives for Catholic Health Care Services, and that the woman’s health was endangered because of the hospital’s Catholic affiliation and the bishops’ directives.

Dr. John Haas is president of the National Catholic Bioethics Center, which promotes Catholic teaching on life issues through research, education, and consultation. Haas, who has a Ph.D. in moral theology from the Catholic University of America, has published widely on bioethics and has served as an advisor to the US bishops and other organizations for many years. He recently spoke with Carrie Gress for Catholic World Report on the ACLU’s lawsuit and its implications for Catholic health care in the US.

CWR: The ACLU has brought a lawsuit against the United States Catholic Conference of Bishops. Can you tell us about the details of this?

Dr. John Haas: A suit was filed by the ACLU on behalf of a woman who claims she was not given accurate information or care at a Catholic hospital in Michigan after her water broke at 18 weeks of pregnancy. The ACLU claims that the Ethical and Religious Directives for Catholic Health Care Services issued by the bishops interfere with physicians making medical judgments based on current standards of care. In this case, they claim the physicians did not inform the woman of the risks associated with her condition and did not tell her that some physicians would consider abortion to be “standard of care” in a case such as hers. We do not know exactly what transpired with this case since we are not privy to the facts. The claims are that she developed an infection after her water broke and that the baby was stillborn. 

CWR: So the ACLU is suing because they believe the woman didn’t have informed consent about her treatment due to directives issued by the USCCB, and not because the hospital didn’t provide abortion as a treatment option?

Haas: If the claims of the ACLU are correct, then the fault in this case of possible malpractice does not lie with the Ethical and Religious Directives but with the physician not following the directives. Directive 27 states that physicians should provide “all reasonable information about the essential nature of the proposed treatment and its benefits; its risks, side-effects, consequences and cost…including no treatment at all.” If the physicians did not do that for this woman then they were in violation of the directives. The Ethical and Religious Directives are in place to serve and protect the patients who come to Catholic hospitals for care.

CWR: It seems odd that they are suing the bishops’ conference instead of, say, the hospital or the local diocese. What is the ACLU’s reasoning here?

Haas: If the ACLU had really wanted to seek redress for the injustice this woman supposedly suffered—and being the victim of malpractice is to be the victim of an injustice—then they would have filed a malpractice suit against the physicians and hospital in Michigan. However, by suing the US bishops they were able to bring the suit to a federal court rather than a state court and get so much more exposure for their cause, which is really directed against Catholic health care and the Catholic Church.

CWR: There is certainly confusion among Catholics and non-Catholics about ethical directives used by hospitals to determine cases such as these. Can you talk about some of these that would apply to this case?

Haas: A Catholic hospital should reflect the uncompromising love of Jesus Christ the Divine Physician toward those coming to it for care. The ethical directives for Catholic hospitals are in place to make sure that that love is not compromised in any way and to ensure that the dignity of the patient is always respected. A Catholic hospital provides the guarantee that no violation of human dignity will occur under its auspices. Any professional society, such as the American Medical Association, has a code of ethics to provide guidance to its members when they face complex situations. Why would it be any different for Catholic hospitals?  

CWR: What chance does the ACLU have to win this? If the ACLU does win, what might that mean for both the USCCB and Catholic hospitals? Or, if the ACLU loses, what could that mean in the bigger picture of the battle over religious freedom?

Haas: I am not a lawyer of course, but one law professor whom I know called this a frivolous lawsuit and was confident that the ACLU has no chance whatsoever of prevailing. There is also this pervasive misunderstanding of the Catholic Church, as though it were a big international corporation with the pope as the ultimate president/CEO and the US bishops acting as presidents of the US subsidiary of the Church.  The USCCB has no authority or power itself, but rather assists the various diocesan bishops, who do have authority within their own jurisdictions, to coordinate their activities and to help one another work together to advance the good of the Church in this country. Very, very few hospitals or systems are actually owned by bishops. Most are free-standing corporations or are members of a larger corporate entity known as a health care system. The Ethical and Religious Directives are issued by the bishops to provide moral guidance to those engaged in the health care ministry.

CWR: At the heart of this issue, of course, is abortion. There was news this week of studies done over the course of decades on Chinese women who have had abortions and breast cancer. While the results from these studies aren’t new, they certainly haven’t reached the wider population. Could you talk about these with regard to authentic health care for women?

Haas: We talk about authentic health care for every patient, not just women. Catholic hospitals will not violate the spiritual, moral, and physical integrity of women patients by performing tubal ligations and they will not violate the spiritual, moral, and physical integrity of men by performing vasectomies. Catholic hospitals show the same respect to both men and women and extend their love and respect also to unborn children, who are also considered to be patients.

There are very few procedures that are not done in Catholic hospitals. One can imagine an admissions clerk at a Catholic hospital saying something like the following: “Welcome to St. Mary’s Hospital.  Before admitting you, we must let you know that there are some things we do not do here. We will not kill you, even if you ask us to.  We will not help you kill yourself, even if you ask us to. We will not kill your unborn child, even if you request it. And we will not destroy any healthy functioning system of your body, even if you ask us. Apart from such procedures, which after all, cure nothing, you have the full range of the benefits of modern medicine available to you here at St. Mary’s.”

You are correct with your remark about abortion. It is really the issue of unrestricted access to abortion that is at the heart of the ACLU lawsuit. Such people are unhappy that there are any restrictions on abortion to such an extent that they are not even willing to be open to scientific evidence about the adverse effects for women, to say nothing of the child who is killed. The National Catholic Bioethics Center has also published articles pointing out the correlation between abortion and breast cancer. I do believe the day will come when health care professionals will no longer be able overlook the evidence.