Civil war in the church!: Catholics tell bishops to stop playing doctor

Catholics are among a growing number of people of faith who want American bishops to keep out of their medical care

Published December 5, 2013 12:45PM (EST)

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Pope Francis last week issued an expansive document outlining the mission behind his papacy, including a strongly worded indictment of free market economics and the government leaders and corporate executives who are the system's greatest beneficiaries. The pope's declarations on poverty and economic justice may have been a new turn for the church, but the rest of the 84-page document was a regurgitation of the same old doctrine.

Specifically, the church's hard line on abortion and other issues of reproductive justice remains as rigid and as dangerous as ever. Which is why the timing of the American Civil Liberty Union's lawsuit alleging gross medical negligence against the United States Congress of Catholic Bishops, filed just days after the pope released his "Evangelii Gaudium," felt significant. The suit was a necessary reminder that a church doctrine that refuses to respect women's bodily autonomy and the medical judgment of doctors -- no matter how progressive its economic agenda -- is still a dangerous thing. (Related: Economic justice and reproductive justice are not distinct agendas, but I digress.)

The lawsuit was filed on behalf of Tamesha Means, a 27-year-old mother of two who presented at the emergency room of a Catholic hospital in Michigan -- the only hospital within 30 miles -- after her water broke while she was 18 weeks pregnant. According to the suit, Means' fetus had virtually no chance of survival, but the hospital did not tell her this information, nor did it tell her that the safest treatment option would be to induce labor in order to terminate the doomed pregnancy.

Instead, she says she was sent home with Tylenol. When she returned later that same night, bleeding and with an elevated temperature, she says the hospital attempted to send her home a second time. Means experienced a painful miscarriage while the hospital staff was in the process of filing her discharge papers. (Mercy Health Muskegon has declined to comment.)

“Each time I went into the hospital, the same thing happened,” Means said in a statement. “They should act like it’s their mother or sister or daughter they’re treating. I pray to God someone stops this from happening again. My life could have been taken. I was in a very dangerous situation.”

Notice that Means said she prays that this doesn't happen to anyone else. She is part of a growing number of people of faith who believe that the Ethical and Religious Directives for Catholic Health Care Services -- the religious guidelines that dictate what care can and cannot be administered in a Catholic hospital -- are dangerously at odds with quality medical care.

The movement against the religious directives enforced at Catholic hospitals includes many Catholics who want comprehensive healthcare for themselves and their neighbors -- without interference from American bishops or the Vatican.

"Most people are shocked to learn about the impact that the bishops have on everyday healthcare, and that absolutely includes healthcare that takes place at Catholic hospitals," Meghan Smith, a domestic program associate at progressive advocacy group Catholics for Choice, told Salon.

And while the bishops may govern the care available at Catholic hospitals, the American public pays for it. These hospitals benefit from significant amounts of public funding, including state and federal grants for Title X family planning programs, Medicare and Medicaid. Despite receiving public subsidies, Catholic hospitals regularly deny basic reproductive health services based on religious directives that openly defy medical best practice. Giving bishops with zero medical expertise this kind of discretionary authority is dangerous for patients, dangerous for doctors and an outrageous overstep to many Catholics.

"There are 68 million Catholics in the United States, and only 250 of them are bishops," Smith continued. "The vast majority of Catholics disagree with the bishops on sex, sexuality and reproductive healthcare."

Not only do a majority of Catholics disagree with their church's absolutes on issues like contraception and abortion care, they tend to disregard them entirely. Around 98 percent of sexually active Catholic women have at some point in their lives used a form of birth control that the Vatican does not approve of, and they have abortions at the same rate as other groups of women, around 28 percent. Recent data also reveals that 65 percent of Catholics believe that hospitals and clinics that receive public money should not be allowed to deny medical services based on religious doctrine, and 68 percent of Catholic women don't want a Catholic hospital to be the only medical care option in their communities.

All of which explains why so many Catholics are pushing back against the expansion of Catholic hospitals, which currently serve one in six people seeking medical attention. In Baltimore last year, a group of Catholic doctors led protests against the University of Maryland Medical System's merger with a Catholic hospital, explaining that it was because of their faith -- not in spite of it -- that they wanted their community hospital to provide comprehensive care to all patients, including birth control, miscarriage management and abortion care. In a letter opposing the partnership, the group wrote, "Our faith's call for social justice for all ... compels us to speak out against the disproportionate impact the continued influence that the [American bishops'] directives ... would have on our neighbors."

Catholic legislators in Louisville, Ky., were also among the loudest voices opposing a Catholic hospital merger with their local hospital, explaining that a partnership with a Catholic Health Initiatives-affiliate would mean less care for the people of Louisville, who, they said, "have a right to be worried" about religious doctrine interfering with their care.

"St. Mary's is a division of Catholic Health Initiatives, which means the hospital will soon be playing by different rules," wrote Rep. Thomas J. Burch and Rep. Mary Lou Marzian in an editorial opposing the merger. "The Ethical and Religious Directives for Catholic Health Care Services govern Catholic-owned or affiliated institutions, including hospitals, and they follow a different calculus for patients' treatment. According to Michael Rowan, executive vice president of Catholic Health Initiatives, the merger 'will mean greater access to care.' In reality, the directives will assure women less access to reproductive health care."

Like the doctors in Baltimore and Louisville, many Catholics ground their support for comprehensive healthcare -- and opposition to the expansion of Catholic hospitals that enforce the bishops' directives -- directly in their faith. "When Catholic hospitals aren't providing the services that a community needs, they are not providing the services that Catholics want," Smith explained.

Talk to a rank-and-file Catholic, and they will likely tell you the same thing. Judith Ceja, a Catholic nurse from Queens, N.Y. (who also happens to be my aunt), told Salon, "Every woman has a right to make a decision about her body, and the right to safe medical care. There is no church, no man, no president to stand in the way of that.

"The Catholic Church, the way it is now, if we don't come to terms with our doctrine, we are going to lose people," she continued. "People will practice Catholicism -- they will practice their faith to be good kind people -- but they will not be going to church."

And she's right. Only 41 percent of American Catholics attend Mass regularly, and that number drops to 30 percent among younger Catholics, who are increasingly at odds with the entrenched positions of church leadership.

When asked if she believed her views on reproductive rights make her any less of a Catholic, Ceja responded with a definitive "no."

"You have to live your faith, you have to be kind, you have to be compassionate, you have to be respectful," she explained. "Being pro-choice is a compassionate position. I believe in it because I am Catholic."


By Katie McDonough

Katie McDonough is Salon's politics writer, focusing on gender, sexuality and reproductive justice. Follow her on Twitter @kmcdonovgh or email her at kmcdonough@salon.com.

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