Nel's New Day

March 27, 2016

Authoritarian Christianity Not Healthy or Safe

If your only hospital is Catholic—good luck! Between the Republicans and the Church making the rules about women’s health, women are in danger if anything goes wrong with their pregnancies. In Michigan, for example, at least five women risked death in just 17 months because they could not obtain immediate and appropriate health care after life-threatening miscarriages.

The U.S. bishops’ directive allows medical care if the mother’s life is in danger, but Mercy Health Partners (Muskegon) doctors determined they would wait until sepsis—an advanced infection—or no fetal heart beat. For one woman, it was sepsis as her temperature climbed for eight hours. Doctors didn’t even give these five women, none of them more than 20 weeks pregnant, the option of going to another hospital where they might have received appropriate health care. Mercy Health Partners is the only provider of emergency care in the entire county after a 2008 merger gave control of the county’s secular hospitals to Trinity Health, among the largest healthcare systems in the country.

Marie Hilliard, director of public policy for the National Catholic Bioethics Center, pointed out that the directives make an exception to protect a woman’s health even if the fetus dies. Hospitals ignore this exception. Hospitals claim that they will induce labor if “the mother’s life is in jeopardy,” but there are no clear standards for determining this situation.

At least 10 percent of the hospitals in the U.S. are Catholic, following the same inadequate health care directions for women. The number of Catholic hospitals increased 16% between 2010 and 2011 and is still growing. At the same time, the numbers of public, secular and other religious hospitals all dropped. One out of every nine hospital beds in the US is located in facilities that follow Catholic teachings, and in far more than 30 communities, the only local hospital is a Catholic one.

One of the five women at the Muskegon hospital was prescribed Tylenol for a potentially deadly infection and sent home—twice—where she miscarried by herself on the toilet. Another woman spent three days in the hospital and required additional surgery.  One woman even reported seeing a fetal limb in her toilet but was forced to wait 18 hours.

Former Muskegon County health official, Faith Groesbeck, talked to the hospital about these concerns. After her concerns were ignored, she reported Mercy Health Partners to a division of Health and Human Services, accusing the company of violating the Emergency Medical Treatment and Active Labor Act, a 1986 act of Congress requiring hospitals to provide any patient experiencing an emergency with “stabilizing treatment.” She stated that Mercy Health Partners made unilateral healthcare choices for the five women without their knowledge or their consent. Since blowing the whistle on the hospital, Groesbeck has been transferred from the county initiative to reduce and fetal mortality and transferred to deal with substance abuse prevention.

All the women had had the membranes surrounding the fetus rupture too early, always leading to a miscarriage if it happens before the fetus is viable. When the woman develops an infection, most doctors “absolutely urge” the woman to have delivery induced. All women showed infections, but the doctors either didn’t warn the women or, in the case of one of them, refused immediate delivery.

A federal judge dismissed a lawsuit against the hospital because federal courts in Michigan lack control over the bishops’ mandates. ACLU appealed the dismissal to the 6th Circuit Court in July 2015.

Michigan lawmakers, known for allowing the governor’s administration to poison the state’s water, want to join Catholic bishops in giving orders to doctors. Introduced legislation would ban dilation and evacuation (D&E), the surgical approach to abortion in the second trimester of pregnancy. Women would then be forced to endure painful, expensive, risky labor, fraught with health problems, in order to abort fetuses that are likely to die.

In her protest against this bill, an OB/GYN described the situation of a pregnant woman with life-threatening high blood pressure who was carrying a fetus with a serious heart defect. The D&E allowed her to preserve her fertility. Another patient whose water broke at 18 weeks had had four prior cesarean sections; labor induction was life-threatening for her. Without a D&E, her four children may have been motherless. Other patients had a molar pregnancy, heart failure, kidney failure, uterine or blood infections, and disorders leading to hemorrhage in labor.

The United States is the only developed nation where the maternal death rate has increased: between 1990 and 2013, the maternal mortality ratio rose 136 percent. At the same time, safe abortions have radically decreased as Christian religious beliefs  led to closing hundreds of women’s clinics through GOP-controlled states.

As fundamentalist Christians and Republicans continue to push their personal beliefs on the people of the United States through punitive laws, Christian faith continues to decrease in the nation. In 2014 the percentage of Christian-identified population dropped to 70.6 percent from 78.4 percent just seven years earlier. Thirty percent of millennials don’t support any religion. People like presidential candidate Ted Cruz blame an assault on Christianity, and 17 states introduced “religious freedom” laws this year, laws which negatively affect health care and personal safety. Christian sects promote wife-beating and doctors’ rejection of patients who don’t match personal beliefs.

This self-perception of danger directed toward Christianity comes from its history of martyrdom, but a reason for the decline is the religion’s nonsensical dogmas. Saying “Happy Holiday” doesn’t represent a “War on Christmas”—a cultural holiday taken from pagan rituals on a date when the prophet Jesus wasn’t born.

The Christian martyrdom is far more prevalent with whites: 61 percent of white evangelicals believe that their religious liberty is threatened compared to only 37 percent of non-white Christians. As whites lose the culture war, many grasp the straw of religious liberty and attempt to use it as a battering ram against people of color. This loss has led 77 percent of U.S. evangelicals to believe that they are living in the End Times. They may express themselves in hate, but they are motivated by fear of secularization.

Sen. Tom Cotton (R-AR) gained international fame by persuading 46 Senate colleagues to sign a treasonous letter to Iran saying that the United States might not live up to its agreement. He’s back with a bill to give Christians special visas to enter the United States while banning Syrian refugees of other faiths. Most of the others who seek “religious liberty,” however, don’t mention Christians although their rhetoric is obvious. For example, Cruz ranted:

“There is a war on faith in America today, in our lifetime. Did we ever imagine that in the land of the free and home of the brave, we would be witnessing our government persecute its citizens for their faith?”

Cruz followed that up with recommending that people declare their freedom from the law if the law doesn’t allow “religious freedom.” Yet Cruz declared war on Muslims by comparing them Muslims to criminal gangs and wanting police to “patrol and secure Muslim neighborhoods.” He claims that it’s part of the GOP willingness to fight “political correctness.” His strategy is to make people afraid and then capitalize on their fear. With Donald Trump he is a classic example of what Stanley Feldman calls “the classic authoritarian leadership style: simple, powerful, and punitive.” A recent poll shows that over 40 percent of likely voters score “very high” or “high” in authoritarianism.

One place where this “Christian” fear has been manifested is in Bullard Elementary School (Kennesaw, GA). To reduce stress among students, administrators instituted the “mindfulness” of yoga and other practices. Because of parental objections, the school eliminated practices such as the Sanskrit greeting “namaste,” placing hands “to heart center,” and coloring pages with the symbol of the mandala. One mother complained about the school “pushing ideology on our students,” and another parent called this “scary.” Parents are pushing fear of “mindfulness indoctrination.”

Cheryl Crawford explained that the purpose is to help the students be “aware of their breath patterns, their tendencies and habits.” She added that focusing inwardly “helps them if they’re very worried.” Crawford explained that “namaste” is a word like “hello,” that the goodness in me sees the goodness in you.” Yoga’s myriad health benefits also include reducing chronic back pain, improving mobility, and relieving symptoms of anxiety and depression—something that doesn’t come from fundamental Christianity.

Evidently authoritarian Christians have entered a new battleground—the War on Mindfulness.

June 9, 2013

Redemptive Suffering May Come to Your Town

The only hospital within 25 miles of our small town was created by a health “special district” supported by local taxes. Most of the area’s doctors are connected to the hospital. Almost 15 years ago, Providence, a large Catholic hospital wanted to take over the health district. When asked about the Catholic approach toward health care, Providence spokespeople assured people that nothing would change, that the hospital could continue with providing contraceptive medications and procedures to all men and women and that we could continue with the policy of “death with dignity,” legal in the state of Oregon.

When the case went to court, however, hospital officials admitted that they had not told the truth; the hospital and all the doctors connected with it would be required to follow the Catholic directives described below.

More and more people around the country are realizing the loss of patience autonomy if Catholics control their hospitals. Arizona found this out when a pregnant woman suffered from life-threatening heart danger:

“Physicians concluded that, if she continued with the pregnancy, her chances of mortality were ‘close to 100 percent.’ An administrator, Sister Margaret McBride, approved an abortion, citing a church directive allowing termination when the mother’s life is at risk. Afterward, however, the local bishop, Thomas Olmsted, said the abortion had not been absolutely necessary. He excommunicated the nun and severed ties with the hospital, although the nun subsequently won reinstatement when she agreed to confess her sin to a priest.”

Washington state has had an even greater independent view of health care than many other states. Like Oregon, they legalized death with dignity. Washington law mandates that “every individual has the fundamental right to choose or refuse birth control” and “every woman has the fundamental right to choose or refuse abortion.” The state also guarantees an absolute right to privacy around mental health and reproductive issues for teens aged 13 and up. Last year, Washington legalized recreational marijuana use and marriage equality, and their constitution has an Equal Rights Amendment and a stronger wall of separation between church and state than the U.S. Constitution. State law even extended statutes of limitations on child sex abuse—something Archbishop Timothy Dolan successfully fended off in New York and Pennsylvania.

Like Oregon, however, the mergers between independent hospitals with large healthcare corporations mean more Catholic hospitals. Five of the six biggest hospital organizations are Catholic, including the Catholic Health Initiatives, operated by the conservative Franciscans. If all the planned mergers in Washington are successful, 45 percent of the state’s hospital beds will be religiously affiliated by the end of this year. One-hundred percent of hospital facilities in ten counties will be religious, including outpatient clinics, laboratories, and physician practices.

The plus side of mergers is the ability to acquire more expensive equipment, better electronic record keeping, and greater administrative efficiency. The down side is that everyone who is in the hospital or has a health practitioner connected with the hospital will have to follow the religious directives because, in the words of the U.S. Conference of Bishops, Catholic hospitals and healthcare corporations are “healthcare ministries” and “opportunities”:

“New partnerships can be viewed as opportunities for Catholic healthcare institutions and services to witness to their religious and ethical commitments and so influence the healing profession. . . .For example, new partnerships can help to implement the Church’s social teaching.”

No longer will care be dictated by medical science and patient preference. A set of theological agreements call the “Ethical and Religious Directives for Catholic Health Care Services” or ERDs dictate treatment options offered to–or even discussed with–patients.

Gone is the dual patient-doctor relationship. Religious hospitals operate with a trinity—a patient-doctor-church relationship: “The Church’s moral teaching on healthcare nurtures a truly interpersonal professional-patient relationship. This professional-patient relationship is never separated, then, from the Catholic identity of the healthcare institution.”

Providers who work in these religious systems must sign binding contractual agreements to adhere to the religious directives: “Catholic healthcare services must adopt these Directives as policy, require adherence to them within the institution as a condition for medical privileges and employment, and provide appropriate instruction regarding the Directives ….”

Fertility Treatment: “Reproductive technologies that substitute for the marriage act are not consistent with human dignity.” ERDs prevents any in vitro fertilization and related treatments, either for same-sex couples who may use surrogacy or insemination for childbearing of for the ten percent of couples in the United States who have fertility problems.

Contraception: “Catholic health institutions may not promote or condone contraceptive practices …. Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution.” A woman who delivers a baby at a Catholic hospital and wants an IUD inserted or her tubes tied must have a second, separate procedure at a secular facility—if she can find one. State-of-the-art methods like IUD’s are better provided at the time of delivery, because postpartum insertion improves health outcomes; having tubal ligation at a different time than delivery means two surgeries instead of one if the baby was delivered through a C-section. Physicians connected to a religious hospital are prevented from doing vasectomies in their office or clinic.

Abnormal Pregnancies: “In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion.” Catholic practice requires the removal of the entire fallopian tube to end an ectopic pregnancy instead of just taking out the developing fetus. That mandates invasive and fertility-destroying surgery. Catholic “ethics” also forbid abortion even to save the life of the woman carrying the fetus. The recent publicity regarding Beatriz in El Salvador clearly exemplifies this situation.

Advance Directives: “A Catholic health care institution … will not honor an advance directive that is contrary to Catholic teaching.” If patient directives and bishop directives conflict, the directives of the bishops take precedence regardless of a patient’s own religious or conscience obligations.

DNR: “The free and informed judgment made by a competent adult patient concerning the use or withdrawal of life-sustaining procedures should always be respected and normally complied with, unless it is contrary to Catholic moral teaching.” Catholic hospitals refuse to honor a patient’s request of “Do not Resuscitate,” maintaining life support at all costs despite patient orders.

Death with Dignity: “Catholic healthcare institutions may never condone or participate in [Death With Dignity] in any way.” Although three states have now legalized the right of patients to voluntarily end their lives under specific conditions, Catholic hospitals will not allow this right. Physicians are prohibited from even discussing options that exist in other institutions or making referrals.

“Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering.” This theological notion is derived from the crucifixion story—the idea that the blood sacrifice of a perfect being could redeem harm done. Suffering itself has redemptive value, which is why Mother Teresa’s order, for example, practiced self-flagellation and glorified suffering of the poor, ill, and dying.

Not everyone in Washington is accepting the Catholic health care takeover. After Catholic Peace Health got an exclusive contract near her home in the San Juan Islands, advocate Monica Harrington created a website to complement the efforts of the national Merger Watch. Fighting the religious takeover of secular systems across the country for over a decade, Merger Watch has identified a recent surge of Catholic hospital ownership. The ACLU of Washington working toward a state-wide solution, the first in the country. Part of its efforts is soliciting confidentially-protected stories from patients and providers anywhere who have experienced religious interference in medical decisions in the United States.

The Catholic Church provides less than five percent of revenues for Catholic-controlled hospitals. The other 95 percent comes from insurance reimbursement and tax-payer funds in the form of Medicaid, Medicare and capital grants for public services. Yet that five percent gives the Catholic Church total autonomy.

Washington is not the only state in trouble. In Arkansas, the state’s only teaching hospital, UAMS, is negotiating a merger with St. Vincent Health. If that were to happen, medical students would not be taught correct procedures in women’s reproductive needs, endangering the lives of people who go to these students when they become health practitioners.

The following map shows the growing influence of Catholic hospitals, now providing 16 percent of the beds, through the share of admissions to Catholic hospitals in the United States:

1369656508-catholic_hospitals_map_lg

Fortunately, health care in our small town had a happy ending. We affiliated with a group of four other small-town hospitals, each of which kept its religious affiliation. One is Episcopalian, and another is Seventh Day Adventist. The other three are secular. The hospital still honors women’s reproductive rights, advance directives, and death with dignity.

People need to understand that Catholic hospitals prevent much more than abortions and emergency contraception. Catholic hospitals take away the rights of patients to both save their lives and make their own end-of-life decisions. Anyone in a Catholic hospital may discover, up close and personal, the meaning of redemptive suffering.

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