“The Underground Railroad was a network of secret routes and safe houses used by 19th- century black slaves in the United States to escape to free states and Canada with the aid of abolitionists and allies who were sympathetic to their cause. The term is also applied to the abolitionists, both black and white, free and enslaved, who aided the fugitives.” – from Wikipedia
“Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted.” – Directive 45 from the Ethical and Religious Directives for Catholic Health Care.
Today, in Washington State, many physicians are forced to provide abortions and other medical services in secret. For a latter-stage abortion, the method of choice is first to inject the fetal skull, which stills the fetal heartbeat, and then to treat the abortion as a miscarriage where the fetus has died “naturally.”
The reason this happens secretly is because official Catholic doctrine, which binds all Catholic hospitals, forbids abortion under any circumstances, even when a woman’s life is in danger. And fortunately, so far, doctors at Catholic hospitals here in Washington State are refusing to let women die when they have the power to abort a troubled pregancy and save a life.
But this approach to saving women’s lives and protecting patient health brings with it secrecy, shame, and intimidation in ways that hurt physicians, patients, and societal trust in our medical systems.
Last year, a patient at Swedish hospital (which is now a brand/division within Providence) began miscarrying past her 24th week and the physicians involved told her they could not terminate the pregnancy. When her story was first told in The Stranger, one observor said it was likely a “training issue.”
Reading between the lines, the physicians involved did not know that there was a “secret” method for how to provide an “abortion” after a miscarriage has begun. In essence, they didn’t know the handshake or secret code. Researchers at UCSF have documented what happens when physicians cannot manage miscarriages effectively in Catholic hospitals.
When physicians become employees of Catholic hospitals, they are typically required to sign agreements that they will abide by the Religious and Ethical Directives for Catholic Health Care. So before the secret handshakes get worked out behind the scenes, physicians have no idea how or when Directives will be enforced. No one can talk about these issues publicly or with certainty because they don’t want to arouse the ire of activists or attract the attention of the local Catholic bishop.
I thought about this yesterday when I saw PeaceHealth CEO Nancy Steiger assure a roomful of people at the Bellingham CityClub that PeaceHealth doesn’t interfere in the doctor/patient relationship and that PeaceHealth provides methotrexate in cases where a woman has been diagnosed with an ectopic pregnancy. The implication seemed to be that PeaceHealth physicians could provide services in violation of the Ethical and Religious Directives. But in a very public meeting held last Fall in Friday Harbor, Sister Kathleen Pruitt, who serves on the board of PeaceHealth, declared in a discussion about the directives, “We will not disobey the bishop.” So perhaps the takeaway is that PeaceHealth will provide some services now until the bishop asks them to stop. And no one will know when the services stop, because the only way they can be provided now is if everyone understands that they can only be provided if we all agree to keep some things secret.
The Catholic health care ministry approach of declaring publicly that they follow the Ethical and Religious Directives for Catholic Health Care and then whispering behind the scenes that they don’t really follow them all (wink, wink) causes mistrust and anxiety. Apparently, “elective abortions” are always out, but whether contraception and sterilization (tubal ligation, vasectomies) will be provided or end-of-life Directives followed depends on the secret handshakes worked out among hospital staff and between the hospital administration and the local Catholic bishop.
Last year, for example, when PeaceHealth approached Planned Parenthood in Bellingham to say that the bishop had asked them to quit doing labs for Planned Parenthood patients, they gave some insight as to how conversations between the bishop and hospital administration happen. The bishop’s word is final, but apparently, sometimes, if the community outcry is strong enough, even a bishop will back down. This seems to have happened up in Bellingham this time. In other areas, including Eugene, Oregon, the bishop’s edict against providing lab services to Planned Parenthood patients has been followed.
Secrecy, shame, and backroom dealings that involve Catholic bishops or any other religious clergy should be the stuff of novels, not mainstream health care supported with public tax dollars.
Voters in Washington State have made clear that patients have a right to Reproductive Privacy and, in the case of a terminal illness, to exercise rights consistent with Washington’s Death with Dignity Law. Where health services are supported with public tax dollars, all Washington citizens should have the right to access services free of religious interference.
Because Catholic health care systems are so powerful in Washington State, some people would prefer that we ignore the elephant in the room and allow the whispering and back-room dealing to continue. But, that does all of us a disservice even as it erodes confidence and trust between patients and doctors, between doctors and their employers, and between voters and the public officials who let all of this go on unchallenged.
It is the official stance of the Catholic Church that birth control is immoral, sex separated from the “marital act” or from a procreative purpose is immoral, all abortion–even to save the life of a woman–is an intrinsic evil, and that suffering brings a person closer to God.
The vast majority of Catholics disagree with Church doctrine as laid out in the bishops’ directives. (Ninety-eight per cent of Catholic women use birth control at some point in their lives and 74% of Catholics want to see abortion kept legal.) The overwhelming majority of Washington voters disagree as well. It’s time we tell our policy makers that we will not stand for a situation where because almost half our health care system is subject to the “moral” authority of religious extremists, the rest of us have to lie and slink in shame for services that are legal, medically appropriate, and totally in keeping with our own moral values.
Bishops, what you want is not what Washingtonians want. Washington State officials must say No to your inappropriate and unlawful meddling in our health care.
An earlier version of this post has been corrected to omit comments that were inaccurately cited. Info from researchers at UCSF is now cited and documented using published source material only.