The American Civil Liberties Union (ACLU) has filed two lawsuits against the Catholic Mercy Hospital and Medical Center in Chicago for refusing a bleeding woman critical medical care to remove her birth control device.
The case is only the latest in a series of suits by the ACLU against Catholic hospital networks, which often deny reproductive care based on a set of religious rules that all of their doctors are required to follow.
The rules, called the Ethical and Religious Directives, are set by the US Conference of Catholic Bishops. In addition to banning abortions under most circumstances, even when the mother’s life is in danger, the ERDs prohibit doctors from offering or discussing birth control options, certain prenatal tests, or sterilizations.
“We’re really concerned that the Directives are substituting the views of religious leaders for the needs of patients,” Jenna Prochaska, a staff attorney with the ACLU of Illinois, told BuzzFeed News.
The woman at the center of the new suits, 28-year old Melanie Jones, had fallen down on a wet bathroom floor, causing her copper intrauterine device (IUD) to get dislodged from her uterus. When she got to Mercy, she was in severe pain and bleeding heavily. According to the complaints, the doctor who saw her confirmed that the IUD was partially expelled and needed to be removed.
On June 30 the ACLU filed two suits, one with the Department of Health and Human Services Office of Civil Rights, and another with the Illinois Department of Human Rights. According to the complaints, the doctor refused to remove the device because Mercy’s “Catholic initiative” prevented her from providing any care relating to the contraceptive device.
Because the copper IUD is non-hormonal — and therefore is only used for pregnancy prevention and doesn’t have secondary uses like easing cramping or heavy periods — the doctor said her “hands were tied,” the suit states. Jones was turned away and told to find a different hospital that offered secular care.
“I walked away from the doctor’s office feeling shocked and stigmatized,” Jones said in a statement released by the ACLU. “Hospitals and doctors’ offices should be places for healing and not judgment.”
A spokesperson for Mercy Hospital denied Jones's claims.
"This claim has no merit. The treatment Ms. Jones received at Mercy was entirely consistent with the standards of high-quality care," said Eve Pidgeon, a spokesperson for Trinity Health, a Catholic hospital network that includes Mercy.
"Ms. Jones described to our clinical team a dislodged or troublesome IUD. When our Mercy physician followed our protocol and offered to remove the IUD, Ms. Jones declined the removal and left the clinic."
But according to the suits, Jones then contacted her insurance provider, Blue Cross Blue Shield, which began the process of switching her to another provider. It took two weeks before she had the IUD removed. Her new doctor told her that she may have suffered cervical or uterine lacerations and possibly an infection, so did not immediately replace the device.
The policies at Catholic hospitals affect many people. One in six hospital beds in the US is part of a Catholic institution. In Illinois, that number is closer to one in three.
“Depending on where you’re at in the state, there could be women who are geographically prevented from seeing secular providers, or can only see Catholic health care providers because of their insurance providers,” Prochaska said.
Catholic hospitals have been expanding since the 1990s, but have picked up significantly in the last 10 years as more small clinics merge with large Catholic networks.
“The Affordable Care Act has really brought in this new dimension where there’s a lot of incentive to collaborate,” said Lori Freedman, an assistant professor of medical sociology at the University of California San Francisco who studies religious restrictions on reproductive care. “While they were already growing and merging and attaching the Directives to new hospitals, now we’re seeing them attaching the Directives to clinics and other smaller institutions.”
As part of her research, Freedman has anonymously interviewed dozens of doctors who work within Catholic hospitals to understand how they balance providing quality medical care while also operating under the ERDs.
Some doctors, she found, see the ERDs as just another kind of red tape. “But some of the doctors saw the Directives as very offensive and very upsetting. The feeling of having your hands tied was very common,” she said.
But in Jones’s case, she added, the ERDs may not have actually tied the doctor’s hands, as there is no explicit rule against removing a birth control device. So the doctor’s decision may have come from a general fear around ERDs, she said, rather than an edict from the bishops.
“There’s so many points in which the Directives have to be interpreted in practice,” she said. “I haven’t heard a story like this before.”
In the last four years, the ACLU has filed at least nine lawsuits against Catholic hospital networks for denying women reproductive care.
In 2011, a pregnant woman named Tamesha Means had her water break at 18 weeks. After she was rushed to her local Catholic hospital in Michigan, also within the Trinity Health network, doctors refused to complete the standard procedure in such cases, which would have included terminating the pregnancy to protect the mother’s life. Instead, they sent her home with painkillers. The next day, Means miscarried.
The ACLU tried to sue the US Conference of Catholic Bishops on Means’s behalf, but the suit was dismissed this June because the judge claimed he could not rule on church doctrine. He suggested that Means file an ordinary malpractice claim. (The decision is currently under appeal.)
In Jones’s case, like several others the ACLU has filed in the last few years, the organization has avoided the bishops and taken a different legal strategy: arguing that these hospitals are discriminating against female patients based on their sex.
“Because Melanie is a woman who is trying to prevent pregnancy, she was told they would not care for her,” Prochaska said. “They could have provided the care, but they refused to for that reason — and they told her it was for that reason.”
This post has been updated to include a response from Trinity Health. It has also been updated to include that Tamesha Means miscarried at a hospital in the Trinity Health network.