Tangled Up in Dogma

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Religious free­dom or reproductive freedom? 8 SOCIALIST ACTION MARCH 2014 If there weren’t already enough problems involved in the start-up to the Affordable Care Act (ACA), here come the Little Sisters of the Poor to further complicate matters.

Whatever charity work the sisters do, their lawsuit chal­ lenging the contraception mandate in the new health-care law reveals the fanaticism at work in the group’s think­ ing about reproductive rights. Unfortunately, the order of nuns and other religious groups started the New Year with a victory of sorts, winning a temporary U.S. Su­ preme Court injunction to the ACA’s provision that em­ ployer health plans cover contraception (with no co-pay)

under its preventive medicine requirements.

If you think fanaticism is an unfair description, consid­ er that the ACA already allows for a religious exemption for employee group coverage of contraception and relat­ ed reproductive services. A religious organization simply has to sign the form, requesting an exemption. But the Little Sisters of the Poor object to even signing the ex­ emption form. That’s because employees would need the form if they want to get birth control directly through their insurance provider.

Ironically, the insurance provider for Little Sisters of the Poor, the Christian Brothers Employee Benefit Trust, already excludes contraception as a covered benefit.

Such “church plans” are also allowed by law to opt out of contraception coverage. But Little Sisters of the Poor object even to the hypothetical possibility that their thirdparty insurer might be obligated to provide contraception benefits, which they claim signing the exemption makes possible. Thus, the Little Sisters of the Poor refuses to participate in a health-care arrangement they view as ul­ timately designed to enable the “sin” of artificial contra­ ception to occur.

“Miscarriage of Medicine”

Importantly, challenges to reproductive health care rights posed by archaic religious ideology are hardly a fringe threat. In a new report [December 2013]. “Miscar­ riage of Medicine: The Growth of Catholic Hospitals and the Threat to Reproductive Health Care,” the American Civil Liberties Union (ACLU) and the advocacy group MergerWatch document the impact in recent decades of the growth of Catholic health systems on community ac­ cess to reproductive care.

As the report explains, since the 1980s the days of tra­ ditional stand-alone hospitals have mostly gone away, as investor money and market pressures drive new business mergers and affiliations, creating ever-larger health-care hospital systems. Catholic health care organizations are ... Immigrants (continued from page 11: “Immigrants ask: “When will deportations stop?’”)

Broward Transitional Center, is one of the largest for-profit prison companies in the U.S., which along with Corrections Corpo­ ration of America, had a combined profit of $296.9 million in 2012. Many immigrants in detention get so discouraged that they sign their self-deportation papers rather than facing more months in jail fighting to stay with their families.

But some groups of DREAMers, undocu­ mented students and youth who are fighting for their right to stay in the United States are resisting in creative ways. Bogado re­ ported that the National Immigrant Youth Alliance (NIYA) recently decided to defend the case of Claudio Rojas, a 47-year-old undocumented immigrant who was facing deportation in Florida after he had helped his son pick up his car when he was stopped over for driving without a license. Under guidelines issued by ICE in 2011, judges are allowed prosecutorial discretion for low-priority detainees (those without a criminal record, which make up the ma­ jority of undocumented detainees). NIYA believed that Rojas should be eligible for release under these guidelines.

Marco Saavedra, a 23-year-old undocu­ mented activist who works with NIYA, vol­ untarily turned himself in to ICE in order to very much savvy players in these market rearrangements. Accordingly, 10 of the 25 largest health systems in the United States are now under Catholic management. In Washington State, for example, Catholic health systems now comprise more than a quarter of all health care or­ ganizations. In some rural regions, a Catholic-affiliated health care system may be the only health resource serv­ ing the public.

While formally “non-profit” and excluded from pay­ ing taxes, these days religiously-affiliated health-care systems operate almost indistinguishably from for-profit health care. They are different, however, in one important aspect of the medicine they deliver—or more accurately, don’t deliver. Abortion, assisted suicide, sterilization, contraception, and infertility treatments are all prohib­ ited at Catholic hospitals. These prohibitions are mandat­ ed in the “Ethical and Religious Directives for Catholic Healthcare Services” adopted by the U.S. Conference of Catholic Bishops.

In some instances, warns the report, health-care facili­ ties may not even provide counseling about condom use to prevent transmission of sexually transmitted diseases. Decisions about end-of-life care can also be compro­ mised, such as when religious doctrine won’t honor a family’s wish to refuse or remove a feeding tube. In the future, treatments derived from embryonic stem cell re­ search could also be banned.

What’s insidious about the merger trend is that secular or otherwise affiliated health-care systems that join with Catholic health systems are typically expected to adhere to the Church’s ethical and religious directives. When Swedish Medical Center’s seven hospitals in the Seattle area affiliated with Providence Health & Services, for ex­ ample, the large Catholic health system serving Washing­ ton and Oregon, the former was required to discontinue elective abortions.

Nor are the religious objections to abortion or contra­ ceptive care limited to an abstract refusal to offer these services. As “Miscarriage of Medicine” documents, it is about the inherent prejudice that Catholic health policy can introduce into the ongoing delivery of health care. Consider the report’s description of the experience of Tamesha Means at Mercy Health Partners in Muskegon, Mich.: “In 2010, a pregnant mother of three suffered un­ necessarily and her health was jeopardized because Mer­ cy Health Partners, a member of Trinity Health, put the Directives above her health needs. “Tamesha Means arrived at Mercy Health Partners after her water broke and she began having contractions. She was 18-weeks pregnant. The hospital diagnosed her with infiltrate the Broward Transitional Center.

Once inside, Saavedra worked with Rojas to make lists of detainees in similar situa­ tions, which they passed along to NIYA.

NIYA eventually defended almost 70 cases, securing the release of several prisoners in­ cluding Rojas. Saavedra was also released, but is facing deportation hearings.

Deportation cases like the ones defended by NIYA and other immigrant rights groups across the country expose the hypocrisy of the Obama administration.

On the one hand, undocumented immi­ grants are being offered a chance at citi­ zenship that they desperately need. But the price that they have to pay is high—more deaths on the border, guest worker visas “By failing to inform her about her options, the like­ lihood that her baby would not survive, or the risks of delaying treatment, Mercy Health Partners unnecessarily put Ms. Means’ health at grave risk and ultimately, failed to follow medical standards for PPROM with signs of infection.”

Notably, Mercy Health Partners was the only nearby hospital for Ms. Means. The ACLU, which has docu­ mented a pattern of similar cases across the country, has filed a negligence lawsuit against the U.S. Conference of Catholic Bishops, blaming its Directives for putting pa­ tient health at risk. They’re also calling for an investiga­ tion by the Centers for Medicare and Medicaid Services. Under the law, hospitals receiving government funds can­ not deny patients required health care in an emergency. Such experiences may indeed be just the tip of a larger iceberg. According to a 2012 study in the American Jour­ nal of Obstetrics and Gynecology, 52 percent of obste­ tricians and gynecologists working in Catholic-affiliated institutions report having experienced conflict with their employers over religiously based policies.

Birth control is a human right It’s hard to believe it’s been almost 100 years since Margaret Sanger championed birth control as a human right. Yet still advocates of modern reproductive medi­ cine must fight the political battle for the rights of women to such care.

In fact, last year 22 states enacted 70 new provisions to further restrict access to abortion services, according to a recent Guttmacher Institute report. Since 2011 there have been 205 new abortion restrictions passed by state legislatures, more than in all the previous 10 years. Should hospitals run by religious groups using public funds be allowed to impose their religious beliefs on medical staff and patients, regardless of whether they share those beliefs? Should hospitals be allowed for re­ ligious reasons not to fully explain to a patient what all of her medical options are? The answer to both questions should be No.

While in recent years there’s been something of a sea change for gay and lesbian marriage rights, and evidence of more tolerance and respect in the popular culture for transgendered rights, too. Compared to decades past, women have also made many social advances. There is also widespread public acceptance of the value of contra­ ception, including even among Catholic women. According to the Centers for Disease Control and Pre­ vention, 88 percent of women of reproductive age be­ tween the years 2006 to 2010 have used “a highly ef­ fective, reversible method such as birth control pills, an injectable method, a contraceptive patch, or an intrauter­ ine device.”

But progress in human rights hardly ever proceeds in clear, straightforward fashion. Women’s reproductive rights remain under assault, fueled by entrenched reli­ gious and right wing ideology. n that will legalize on-the-job exploitation of immigrants, and thousands of dollars spent to gain an uncertain second-class status that could last for decades while they “go to the back of the line.”

In the meantime, there is no end in sight for the detainees who are daily being torn from their families to await their deporta­ tion in for-profit detention centers. The government expects these undocumented workers and their families to be too afraid to fight back, but groups like NIYA are proving otherwise.

Immigrants proved their power in the streets in 2006, and they will do so again. When they march, we must all be ready to join the fight. n