ACLU sues Catholic hospital chain over emergency abortions

The American Civil Liberties Union is suing a Catholic health system for refusing to provide emergency abortions to women whose incomplete miscarriages put them at high risk of serious complications.

In a federal lawsuit filed Thursday, the ACLU said that Michigan-based Trinity Health Corporation, one of the USA's largest Catholic health systems, refused to provide the standard of care to at least five women who miscarried at one of the company's hospitals. Trinity operates more 88 hospitals around the country.

According to the suit, each of the women had suffered a preterm, premature rupture of membranes, a condition in which the amniotic sac breaks and leaves no fluid around the fetus.

When this happens early in a pregnancy, it virtually always results in fetal death, said Sarah Prager, an associate professor of obstetrics and gynecology at the University of Washington, who is not involved in the lawsuit. Premature rupture of membranes is often caused by an infection. "This is a situation where there is virtually no chance that the fetus will survive," Prager said. "The miscarriage has started. It just hasn't completed."

Women in this situation are at high risk of serious infections and dangerous bleeding, Prager said. Terminating the pregnancy is considered the standard of care, Prager said.

"If you delay action until there is no longer a fetal heartbeat, that can often put the mother’s life at risk or risk her future fertility," Prager said.

According to the lawsuit, Trinity hospital staff refused to terminate the women's pregnancies. The women developed serious complications, including life-threatening infections, severe pain and hemorrhaging.

By failing to stabilize the women's medical conditions, Trinity violated the Emergency Medical Treatment and Active Labor Act, known as EMTALA, ACLU attorney Alexa Kolbi-Molinas said.

"Patient welfare must be the No. 1 concern of health care professionals,” Kolbi-Molinas said. “Every pregnant woman who enters an emergency room should be guaranteed that she will get the care she needs, and should not have to worry that she won’t get appropriate care because of the hospital’s religious affiliation.”

Ten of the 25 largest hospital systems in the U.S. are Catholic and nearly one of nine hospital beds in the country is in a Catholic facility, Kolbi-Molinas said. Instructions from the U.S. Conference of Catholic Bishops, called the Ethical and Religious Directives for Catholic Health Care Services, forbid hospitals from performing abortions, even to protect a woman’ s health.

A spokeswoman for Trinity said the lawsuit has no merit.

"A federal court already dismissed a similar ACLU claim, and we will seek dismissal of this suit for the same reason," Trinity spokeswoman Eve Pidgeon said.

The Catholic directives "are entirely consistent with high-quality health care, and our clinicians continue to provide superb care throughout the communities we serve," Pidgeon said. "We are proud that more than 25,000 licensed physicians work directly with our health system and share our commitment to people-centered care."

According to these directives, abortion -- the "directly intended destruction of a viable fetus" -- is never permitted, said John Brehany, director of institutional relations and ethicist at the National Catholic Bioethics Center. But the bishops' directives do allow doctors to treat serious conditions in pregnant women, even if that treatment jeopardizes the fetus, he said. According to the directives, "Operations, treatments and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child."

Arthur Caplan, the director of medical ethics at NYU Langone Medical Center in New York, said hospitals have a duty to inform patients if they refuse to perform certain procedures.

"You don’t want to go to an ER if they will not give you the full range of care that you need," Caplan said. "If you don't state the limit of what you will or will not do, you are violating informed consent."