August 30, 2018
This issue's contents Current issue My Back Pages Search The Ethical Spectacle

Religion and Malpractice

by Jonathan Wallace

This month's ethical spectacle is the phenomenon of Catholic hospitals with non-Catholic sounding names, abruptly telling a patient there is a treatment they don't offer:

To ensure that she would never again be at risk, she asked her obstetrician to tie her tubes immediately following the delivery. The doctor’s response stunned her. “She said she’d love to but couldn’t because it was a Catholic hospital,” Ms. Norris, 38, recalled in an interview. Experiences like hers are becoming more common, as a wave of mergers widens the reach of Catholic medical facilities across the United States, and the Trump administration finalizes regulations to further expand the ability of health care workers and institutions to decline to provide specific medical procedures for moral or religious reasons.....Many patients across the country are unaware that a hospital is Catholic to begin with... [O]ver the past decade or so, a number of Catholic hospitals have changed their names to something less obviously Catholic. In 2012, for example, Catholic Healthcare West became Dignity Health. “At the end of the day, it appears that Catholic systems want to diminish their Catholic identity to be more marketable,” Professor Freedman said.Katie Hafner, "As Catholic Hospitals Expand, So Do Limits on Some Procedures", The New York Times August 10, 2018

This is stunning, egregious, morally indefensible, and can be proven so by a simple demonstration which is logically unanswerable. And I rarely say that something is that simple and binary.

Start from the premise that any belief sincerely held qualifies as a religion. Courts will not go behind the screens to decide which religions are "better" or more "true" or "humane" or "honorable" than others. Laws like the Religious Freedom Restoration Act and the Religious Land Use and Institutionalized Person Act are intended to treat all religions equally--and Congress could not do anything else without establishing a particular religion in violation of the First Amendment.

Premise number 2 is that religions hold some damn strange beliefs about human health. Christian Scientists and certain other religions do not believe in a wide variety of medical interventions, such as surgery.

Premise three is that people adhering to a religion have a right to utter and even practice their beliefs in classic Libertarian terms-- so long as they are not hurting others. This is why you may not be able to extend your beliefs as far as declining medical treatment for your child.

Premise four is that no adherent of a religion should be permitted to impose her beliefs on someone else without the other's consent.

Premise five follows: your belief that surgery is immoral or unGodly should allow you to decline it yourself, but not intervene so as to prevent me, a nonbeliever, from having surgery.

Premise six: that it is socially A Good Thing to have standards for professional practices, including medicine and law, in furtherance of determining who may practice disciplines, how they are to be practiced, and to aid in determinations as to when malpractice has occurred.

Premise seven is also derived from the foregoing: If I have a sincere belief that law should be practiced only by people have have read, studied and can exhaustively quote Scripture, and no other qualification should be required, my belief does not obligate the state to give me a law license.

Let's work some changes on that. Your religion may hold that a guilty plea is the first step towards the forgiveness of God. Fine, if you are charged with a crime, you can choose to plead guilty. But a public defender who refused to take clients to trial should be fired.

Imagine a a religion that had a sincere belief that asthma is an affliction of the faithless and selfish and can only be cured through prayer, not albuterol. An adherent having a breathing crisis might, if she had the foolhardy courage, decline an albuterol treatment. But it is a very long leap from that proposition to allowing that anti-albuterol religion to operate an ambulance service whose EMT's declined to offer albuterol to patients whose airways have closed up.

That is precisely what this "religious freedom" excuse promotes. Catholic hospitals are increasingly permitted to refuse treatments that are required by protocols. As a result, they can even refuse to save lives. The Times article relates that "Mindy Swank['s] water broke in her second trimester, endangering her health. Her local hospital in Silvis, Ill., refused to remove the fetus for two months." This is reminiscent of the 2012 death of a pregnant Irish woman:

Savita Halappanavar, 31, was 17 weeks pregnant when she developed back pain and tests revealed that she would lose her baby. But despite her repeated pleas over three days, doctors refused to perform a termination as they could still hear the foetus’s heartbeat, reportedly telling her: "This is a Catholic country." Mrs Halappanavar’s condition rapidly deteriorated and she died after developing septicaemia four days after the death of her baby.

It is horrifying enough that Catholic hospitals want to withhold care demanded by protocol--as a natural next step, they now wish to conceal the fact that they are Catholic hospitals and will withhold care. This is not about conscience at all; it is about forcing patients, against their will, to live (or die) by Catholic beliefs. This intentional malpractice is not religious "freedom", but an establishment of religion.

Why, given how clearly and starkly this is so, are the hospitals getting away with it? The simple answer, beside the fact that our world is going crazy and sinking into consummate irrationality and inequality, is that this is being done to women. Most Americans fail to see the gross unfairness because they are used to the health needs of women being disregarded. Some women are so baffled, so successfully tricked by the rhetoric, that they support these deceptions. It's all very shameful and should never happen in a nation of free speech, equality, and Enlightenment values.