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Religious Freedom Has No Place in Hospitals—Even Catholic Ones

Pope Francis is visiting America, and during his trip he'll undoubtedly be acclaimed for his liberality and care for the poor. But amid the celebration, let us remember that his church still officially refuses to give women their reproductive rights, including contraception. Here's a particularly disturbing 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. And it’s a direct result of the policies of Pope Francis’s church.

As reported by The Humanist, Mann has brain tumors, 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, considered an un-Catholic form of birth control. Her only option is to have the procedure done at another hospital or have two separate 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 simply find another hospital might consider the prevalence of Catholic facilities:

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, the Kentucky clerk who was jailed for refusing to issue marriage licenses to gay couples, 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 necessary to save a woman's life. But, as noted above, the Church Amendment also stipulates that a Catholic hospital itself cannot be forced to perform practices sterilizations or abortions. Even if its doctors aren't Catholic, then, and are 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 ethical 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 Mann than they could. Entire institutions whose patient care is subsidized by the U.S. government—and Catholic hospitals fall into this category—should not be allowed to refuse such procedures on religious grounds.

Let us remember that although Francis is a step up from previous Popes, 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 The Pope is sincere in his emphasis on the plight of the poor, by refusing to support birth control (a refusal reiterated in his encyclical against global warming) he not only perpetuates the very poverty he abhors, but supports Church policies that harm women in unexpected ways, as in the refusal of a Catholic hospital to perform a simple procedure that might save the life of Jessica Mann.

A version of this post first appeared on WhyEvolutionIsTrue.

Correction: A previous version of this article stated that the Pope refused to oppose birth control. Pope Francis has not changed the Catholic Church's policy against contraception.