Your Religion, My Body….

There has been another attack on a Planned Parenthood clinic–this time, in Colorado. I’ve never quite understood how ostensibly “pro life” men (and they are almost always white Christian men) justify killing for life, but however they understand their Deities to compel these acts of domestic terrorism, their incidence has been growing since the release of the doctored Planned Parenthood tapes.

Ironically, these murderous attacks are far less effective at limiting abortions than the considerably more mundane and seemingly inexorable consolidation of hospitals around the country.

For example, the experience of women needing medical care in Michigan is increasingly being replicated throughout the U.S.

In October, the ACLU and the ACLU of Michigan filed a federal lawsuit on behalf of their members against Trinity Health Corporation, one of the largest Catholic health systems in the country, for its repeated and systematic failure to provide women experiencing pregnancy complications with appropriate emergency abortions as required by federal law.

In response to the lawsuit, the hospital submitted a brief arguing that state and federal law allow Trinity to “refuse to allow abortions to be performed on hospital premises,” in the context of emergency miscarriage treatment when the woman’s life or health is at risk.

Trinity is legally exempt from having to perform elective abortions. But emergency situations such as those that triggered the ACLU’s lawsuit are another matter; indeed,  refusing to provide emergency care in these situations is medical malpractice. (I couldn’t find any information in a cursory search, but I would be surprised if doctors refusing to adhere to a medical standard of care in such situations aren’t being sued.)

The policy question is simple, although the appropriate resolution is anything but.

Virtually all hospitals depend for their existence upon federal dollars. Those dollars come from taxpayers of all religions and none. Are such institutions entitled to deny people medically appropriate care on the basis of their own religious doctrine? The question is gaining urgency as more and more of the nation’s hospitals have become part of Catholic health-care systems–currently, 10 of the 25 largest hospital systems in the U.S. are Catholic. As the ACLU’s Reproductive Rights project newsletter noted

We know, for example, that the U.S. Conference of Catholic Bishops, which sets the rules for all Catholic hospitals, has said that its hospitals should let a woman die rather provide an emergency abortion. The bishops made their policy crystal-clear when a Catholic hospital in Phoenix defied the bishops’ rules and saved a woman’s life by providing an abortion. The bishops excommunicated a nun who was on the committee that approved the abortion, and the hospital was stripped of its Catholic status.

There are plenty of doctrinal questions raised by such examples, but those are matters for internal Catholic debate. The question for the rest of us is the same question that is raised in other conflicts pitting civic equality and access to public services against the religious beliefs of people claiming their faith exempts them from treating others as they would wish to be treated–as autonomous persons entitled to make their own moral decisions.

That question is: at what point do the obligations of citizenship in a diverse nation that celebrates civic equality override the “sincerely held religious beliefs”of those who believe they are entitled to be more equal than others?

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Not Your (Founding) Fathers’ Definition of “Religious Liberty”

Sunday Sermon time….

It’s not just the fight over RFRA.

Increasingly, defenders of “religious liberty” are insisting that what their liberty requires is the right to dictate the behaviors and prescribe the rights of others. Any effort to remind these theocrats that non-Christians and nonbelievers are entitled to equal treatment by government is met with outrage and accusations of “political correctness” and “waging war on faith.”

Think I’m exaggerating? These three examples all crossed my desk on a single day:

In Michigan, a Catholic hospital repeatedly refused to perform a medically-necessary tubal ligation, despite the doctor’s strong recommendation.

Weeks after learning she would give birth to her third child, Jessica Mann was faced with a difficult decision: because she was stricken by a life-threatening brain tumor, her doctor recommended she have her fallopian tubes tied at the time of her scheduled cesarean section delivery, later this month….

Mann’s doctor advised her that tubal ligation during the C-section it would be the safest route, consistent with long-established standard of care, and prevent the need for another surgery.

The hospital cited its Catholic affiliation–and its liberty to follow the teachings of  the Church, even if that meant it was sufficiently in conflict with the medical “standard of care” as to be considered malpractice– as justification for the denial.

In Tennessee, self-identified “Sovereign Citizens” are refusing to buy license plates or to register their automobiles. From the Marty Center at the University of Chicago, we learn that

While the sovereign citizen movement is often represented as a collection of scofflaws creating elaborate interpretations of the American legal system in order to scam it, the reality is more complex…

The majority of sovereign citizens conceive of and engage in their claims and practices as religious.

These sovereign citizens claim–and fervently believe–that the law as they espouse it always supersedes other interpretations of the law. Their “liberty” to follow the “real” law is thus more important than the government’s interpretation of the law.

But this is my favorite: In Washington, D.C., a church is actually claiming that the location of a proposed bike lane adjacent to its property would “infringe on its constitutional right to religious freedom.” (You really can’t make this shit up.) As a post at Think Progress pointed out:

Currently, D.C. provides the church with a benefit that is paid for by taxpayers: a road near the church which does not include a bike lane. D.C. proposed offering the church a different benefit which would also be paid for by the city’s taxpayers: a road near the church which does include a bike lane. The church, in effect, is claiming that it has the right to dictate which taxpayer-funded benefits the District of Columbia shall provide, solely because it happens to be a religious organization.

These assertions of “religious liberty” would have baffled the men who drafted America’s Constitution. They are certainly inconsistent with the libertarian construct that emerged from the Enlightenment and influenced America’s founders: the notion that each individual has a right to make his or her own moral choices–follow his own telos–so long as he does not thereby harm the person or property of a non-consenting other and so long as he is willing to accord an equal right to others.

To put the philosophy of the Bill of Rights into modern terminology, it’s pretty much “live and let live.” (Again, so long as you aren’t harming anyone else–and “harming” is admittedly a contestable definition.)

That philosophy definitely isn’t “I get to do what I want, and since I have a direct line to God and Truth, I also get to make you behave the way my religion thinks you should.”

We are each entitled to liberty, not privilege.

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Whose “Religious Liberty” Do We Protect?

A couple of years ago, the website Raw Story had a troubling report about a conflict between religion and individual rights that is both accelerating and less visible than the high-profile conflicts (think Kentucky clerk) that make the news.

Healthcare providers and institutions are increasingly consolidating. In Washington State, for example, if all of the mergers planned when the Raw Story article was written were consummated, all hospital beds in nine counties are tied to religious institutions. That includes the University of Washington system.

Why should we care? Why is this is medically problematic?

Recently a woman was traveling across the Midwest when she developed abdominal pain. She and her husband went to the nearest hospital, where she was diagnosed with a potentially fatal ectopic pregnancy. The doctors recommended immediate surgery to remove the fallopian tube containing the misplaced embryo, a procedure that would reduce by half her future chances of conceiving a child. They failed to mention that a simple injection of Methotrexate could solve the problem, leaving her fertility intact. (In fact, at a secular hospital she found on her smart phone, it subsequently did.) Why the omission?

According to Catholic teaching, an injection that destroys an ectopic embryo counts as an  abortion; removing the part of a woman’s reproductive system containing the embryo is not.

The article has several other examples of situations, both in the U.S. and abroad, where theological commitments have trumped sound medical practice. In 2012, for example, a 16-year-old Dominican girl was denied cancer treatment for weeks while doctors debated whether chemotherapy would constitute an abortion. She eventually miscarried and later died.

An angry father shared his daughter’s experience:

A Catholic doctor at a Catholic hospital went against my daughter’s wishes and signed consent to have a hysterectomy because of severe endometriosis. One ovary had already exploded. My daughter had never intended or desired children nor was she in a suitable situation to have a child. She was single, in her late 20s. When she awoke from surgery she learned that the doctor had over-ridden her wishes and consent in an attempt to save her fertility. The operation was botched, leaving my daughter on permanent disability, in pain, with even more health problems than she’d had before.

When we go into a hospital, most of us expect our doctors and other healthcare providers to honor our expressed treatment directives. Many of us have Living Wills or other healthcare documents that reflect our own considered, deeply-held beliefs.

When a patient’s wishes are disregarded because they are inconsistent with someone else’s religion, that’s an unjustified denial of religious liberty–a denial that is particularly egregious because the  “bargaining power” of the parties is so unequal.

In a diverse society committed to civic equality, hospitals dependent upon government funds (Medicare, Medicaid, etc.) should be required to respect the decisions of adult, competent patients.

And medical practices consistent with accepted standards of care should never take a back seat to doctrine.

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