Women's Health & Lives at Risk Due to Religious Restrictions at Hospitals, New Center Study Shows

For Immediate Release

National Women s Law Center
Contact: 

Andrea Maruniak or Maria Patrick, 202-588-5180

Women's Health & Lives at Risk Due to Religious Restrictions at Hospitals, New Center Study Shows

National Women’s Law Center Files Complaint with Department of Health and Human Services

WASHINGTON - The
National Women's Law Center (NWLC) released two reports today that
reveal that certain religiously affiliated hospitals put women's health
and lives at risk by restricting doctors' ability to provide the best
medical care to pregnant women experiencing miscarriages and ectopic
pregnancies.  The Center also filed a complaint with the
U.S. Department of Human and Health Services' Centers for Medicare and
Medicaid Services urging immediate action to ensure that laws designed
to protect patients' health are properly applied and enforced. 

The Center's report, Below the Radar: Ibis Study Shows that Health Care Providers' Religious Refusals Can Endanger Pregnant Women's Lives and Health (http://www.nwlc.org/resource/below-radar-health-care-providers-religious-refusals-can-endanger-womens-lives-and-health
), demonstrates that certain hospitals, because of their religious
beliefs, deny emergency care, the standard of care and adequate
information to make treatment decisions to patients experiencing
miscarriages and ectopic pregnancies. The study and report focused on
cases where no medical intervention was possible that would allow the
patient to continue her pregnancy and where delaying treatment would
endanger the woman's health or even life. These hospital treatment
practices violate federal laws and regulations that are intended to
protect patients and ensure the delivery of quality health care services
at hospitals receiving Medicare funds. The Center's report also
presents a legal analysis of the implications of a study it commissioned
from Ibis Reproductive Health, a clinical and social science research
organization, Assessing hospital policies & practices regarding
ectopic pregnancy & miscarriage management: Results of a national
qualitative study
(http://www.nwlc.org/resource/assessing-hospital-policies-practices-regarding-ectopic-pregnancies-miscarriage-management
), that it also released today. While the study concentrates on
Catholic-affiliated hospitals' treatment of pregnancy complications, the
Center's findings, legal analysis and demand for corrective action
apply to any institution or individual delaying or denying treatment
based on religious beliefs rather than medical considerations.

"Most
women assume that when they go to a hospital they will be offered the
best medical treatment options for their diagnosis," said NWLC
Co-President Marcia D. Greenberger. "But this report paints a chilling
picture of women with ectopic pregnancies or suffering miscarriages who
are not offered the full spectrum of medically appropriate treatment
options because they have gone to a hospital whose religious affiliation
conflicts with the provision of those options. To make matters worse,
women denied certain medical options may never even be told that these
options could, for example, improve their chances of having a healthy
pregnancy in the future.  Women who fail to receive
appropriate treatment or to be informed that preferable options would be
provided in another hospital can suffer serious harm with long-term
adverse consequences to their lives and health."

The
reports highlight stark cases where doctors noted a discrepancy between
the medically-accepted standard of care for miscarriage and ectopic
pregnancy and the treatment provided by hospitals due to their religious
affiliation. For example, while the standard of care for certain
ectopic pregnancies requires patients to receive the medication
methotrexate, doctors in the study reported that their hospitals forbade
the use of the drug.  Instead, patients were either
transferred to another hospital or required to undergo unnecessary and
invasive surgery to resolve their condition, thereby being denied the
standard of care.

One
doctor in the study reported several instances of potentially fatal
tubal ruptures in patients with ectopic pregnancies at her
Catholic-affiliated hospital.  She said that her hospital
subjected patients with ectopic pregnancies to unnecessary delays in
treatment, despite patients' exhibiting serious symptoms indicating that
a tubal rupture was possible.  These patients, therefore, were denied emergency care to which they were legally entitled.

In some
of the miscarriage cases described in the Ibis Study, the standard of
care also required immediate treatment. Yet doctors practicing at
Catholic-affiliated hospitals were forced to delay treatment while
performing medically unnecessary tests.  Even though these
miscarriages were inevitable, and no medical treatment was available to
save the fetus, some patients were transferred because doctors were
required to wait until there was no longer a fetal heartbeat to provide
the needed medical care. This delay subjected these patients to
further risks of hemorrhage and infection and could have violated their
right to receive emergency medical treatment under federal law.

The Center's complaint to the Centers for Medicare and Medicaid Services (http://www.nwlc.org/resource/center-medicare-and-medicaid-services-complaint-january-2011
) identifies the violations of health care provider obligations under
the Medicare Conditions of Participation (CoPs) resulting from these
practices.  The complaint urges HHS to issue a notification
reminding hospitals that they are bound by all CoPs; to require
hospitals to institute policies and procedures to protect patients'
legally enforceable rights; to investigate the failure of hospitals to
provide standard of care and informed consent, and to take corrective
action to prevent further violations.

"Religious
dictates do not trump bedrock legal protections that entitle patients
to the standard of care and informed consent in the American medical
system," said Jill Morrison, NWLC Senior Counsel and an author of Below the Radar.  "But
for too long some hospitals have been allowed to disregard the
obligation to prioritize women's health and lives. It's time to shine a
light on these serious violations and make hospitals accountable to
protect the lives and health of the patients they serve."

Some
doctors at religiously affiliated hospitals are speaking out. Dr. Robert
B. Holder, an ob-gyn at Sierra Vista Regional Health Center, a
Catholic-affiliated hospital in Sierra Vista, Arizona told the Center:
"A couple came into the ER after the wife had miscarried one of her
twins at home. When I determined that the remaining twin was in a
hopeless situation, this couple faced a tragic, heart-wrenching
decision. After helping them make the medically appropriate decision to
complete the miscarriage, I contacted the hospital's administration to
seek permission to perform a uterine evacuation. I wasn't granted
permission and I was told to inform this already traumatized couple that
their decision was seen as "unethical" per the Directives.

"I was
ashamed and angered when I transferred this patient by ambulance to a
secular hospital in Tucson, 80 miles away to get proper care," he added.  "This
patient was successfully treated in the end, but ultimately she didn't
receive the treatment she was entitled to in her local community
hospital."

A
doctor who works at a nonsectarian hospital in New York City and who
asked to remain anonymous, told the Center about a woman in her 20s who
came into the emergency room after having been diagnosed with an ectopic
pregnancy the day before at a religiously-affiliated hospital.  "The
doctor [at the religious hospital] told her that the embryo wasn't
viable but since there was a fetal heart beat they would need to delay
treatment," she explained, adding that the woman was told to go home and
return if she felt pain, started bleeding or developed a fever. "A day
later the woman began to worry why nothing had been done to treat her
and decided to come to our hospital.  I examined her and confirmed that she had an ectopic pregnancy.  I had been trained that you never let the sun set on this condition.  I explained all of the treatment options and recommended that we go with methotrexate.  She agreed.  Things turned out okay for her, but I was haunted by her situation.  What if she had waited too long to go to a second hospital?  What if she had done nothing and woke up some night with a ruptured fallopian tube?  I haven't been able to get over all the ‘what ifs.' "  

"There
have been no studies quantifying how many women are harmed each year by
limited treatments or by never even being told which treatments are
being denied them because of hospitals' adherence to religious
dictates," said Greenberger. "But this report demonstrates the
devastating consequences that could flow from the failures of  hospitals
around the country to ensure appropriate treatment and informed
consent, even when dealing with the dangerous conditions of ectopic
pregnancies and miscarriages when women's health and lives are on the
line. We call on the Department of Health and Human Services to
investigate these serious lapses and order immediate corrective action
where violations are found. We also call upon religious and nonsectarian
hospitals alike to ensure that their practices comply with federal law
and to serve the patients' health needs." 

###

The National Women's Law Center is a non-profit organization that has been working since 1972 to advance and protect women's legal rights.  The Center focuses on major policy areas of importance to women and their families including economic security, education, employment and health, with special attention given to the concerns of low-income women.  For more information on the Center, visit:  www.nwlc.org.

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