Sandra Hapenney, a new contributor to the Catholic Thing, has a very useful essay showing that many Catholic hospitals perform sterilizations counter to Catholic teaching as laid out in the Ethical and Religious Directives (ERD) of the U.S. Conference of Catholic Bishops:
My study involved obtaining hospital inpatient data from the departments of health of seven states dispersed geographically (CA, IL, IN, NJ, NY, TX, WA), abstracting records for Catholic hospitals from over 47 million patient records, and comparing sterilization practices at the hospitals from 2007 to 2009.
For the institutions I studied, 48 percent of the 176 Catholic hospitals with obstetric services performed direct sterilizations in clear violation of the ERD. The findings were independently reviewed by the Computer Science Department of Baylor University. Interactive data tables and the dissertation itself are viewable here.
Her solution, which strikes me as sensible, is to more rigorously define unacceptable procedures and enact tighter reporting requirements:
A major difficulty in achieving a uniform application of the ERD is, unfortunately, that the directives make no reference to clinical diagnostic and procedure codes and do not mandate transparent reporting or oversight of a hospital’s actual policies and practices. Nor does the ERD mandate reporting violations within the hospital settings.
The result is that subjective judgments of hospital personnel and ethics committees can readily prevail over the objective clinical situation and the teaching of the Church. Best practices for oversight, such as used in the protection of minors, could be included in future editions of the ERD. Important elements of best practices would include an independent review board, mandatory reporting of violations, objective clinical criteria for defining violations, and authoritative presentations to doctors and staff regarding the requirements of the norms.
This also, she points out, has an indirect bearing on current debates over religious liberty:
Current practice is perilous not only to those sterilized in Catholic hospitals, but poses juridical and legal risks to all Catholic personnel and facilities. Individual Catholics or hospitals objecting to these procedures could find themselves isolated and more easily compelled by the courts or legislation to provide direct sterilizations.
The lack of agreement among the Catholic hospitals also undermines any cohesive defense of religious liberty in this matter by the bishops and the hospitals. Uniform application of the ERD at every Catholic hospital is therefore crucial to the protection of the conscience rights of every Catholic medical professional and of all Catholic health care facilities.
Catholic christians reject sterilizations, of course, for the same reason they reject other forms of contraception like prophylactics and the Pill: it closes off a union of two spouses to new life.
February 23rd, 2012 | 10:54 am
If I am understanding the statistics correctly, almost half of Catholic hospitals perform direct sterilization procedures and, by using the correct coding to report those procedures, make no effort to hide that they do not comply with Church directives. Not reflected in those data would be the Catholic hospitals who perform direct sterilization procedures and report them under codes for indirect sterilization.
So, apparently, some think this is a good time for a crackdown to bring Catholic hospitals back into line. After all, it is somewhat of an embarrassment to be claiming HHS is trying to force Catholics organizations to do things that violate their consciences when they are already doing on a grand scale things that are claimed to violate their consciences.
The result of a crackdown, however, may be that officially Catholic hospitals will choose to drop their official ties to the Church, as in the case of Catholic Healthcare West”>Catholic Healthcare West, which recently became Dignity Health.
February 23rd, 2012 | 11:20 am
Are all sterilizations done strictly as a means of contraception? Is there ever a medical justification for these procedures, a side effect of which is infertility, but that is not the primary reason for the procedure? I really don’t know. I am just asking.
February 23rd, 2012 | 11:56 am
Harry,
To answer your question, in the case of women, YES. Many women (including my mother and all of her sisters) struggle with endometriosis–a condition that can result in tumors that are dangerous to the women, result in miscarriages, and even in fertility.
From womenshealth.gov:
“More than five million women in the United States have endometriosis. It is one of the most common health problems for women. It can occur in any teen or woman who has menstrual periods, but it is most common in women in their 30s and 40s…The symptoms of endometriosis stop for a time during pregnancy. Symptoms also tend to decrease with menopause, when menstrual periods end for good.”
One of my aunts had a grapefruit sized tumor removed from her uterus as a result of endometriosis. Some of the treatments for the condition include removal of ovaries or uterus–indirect sterilization.
So it seems that natural pregnancy does have therapeutic benefits at preventing a common disease. Interesting, isn’t it, David?
When one follows God’s plans for procreation, rather than using contraception, the chance of contracting several diseases decreases.
February 23rd, 2012 | 11:57 am
Typo in the last post…should read “result in miscarriages and even in infertility”.
February 23rd, 2012 | 12:30 pm
So it seems that natural pregnancy does have therapeutic benefits at preventing a common disease. Interesting, isn’t it, David?
Artaban,
Not only that, but pregnancy produces babies, which I am wholeheartedly in favor of. I only believe that women who don’t want to get pregnant should be allowed to control their fertility (including being sterilized) according to their own consciences. One of my co-workers recently had twins, and everyone who knew her, including evil New York secularists and atheists, could not have been more thrilled.
February 23rd, 2012 | 3:05 pm
After all, it is somewhat of an embarrassment to be claiming HHS is trying to force Catholics organizations to do things that violate their consciences when they are already doing on a grand scale things that are claimed to violate their consciences.
No, it’s not.
Would you be embarrassed if someone who claimed the same denominational or “group” name as you openly declared a belief that is not only personally repugnant to you, but is also openly in defiance of what your denomination or group teaches? Of course not. You wouldn’t be embarrassed, you’d be angry that someone is pretending to represent you when they’re not.
To the extent that anyone ought to be embarrassed, it’s the ones who call themselves Catholic but don’t practice Catholicism.
Especially when they are taking Catholic dollars. That makes them not only liars, but cheats as well.
February 23rd, 2012 | 3:10 pm
I know we disagree or misunderstand each other sometimes, David, but I don’t believe secularists or atheists are inherently evil. Misguided or shortsighted, yes…
I do appreciate the humor in that post. Your quote was very Chestertonian (as in, G.K.).
“Not only that, but pregnancy produces babies, which I am wholeheartedly in favor of.”
February 23rd, 2012 | 6:03 pm
I only believe that women who don’t want to get pregnant should be allowed to control their fertility (including being sterilized) according to their own consciences.
But why do they not accept that with control and freedom come responsibility?
Why must we class this one case of risk prevention as “basic health care”, when we do not ordinarily view risk-taking as a “right”?
We ordinarily recognize that risk-taking behavior is selfish when you are expecting someone else to pay the tab. This is why we argue about when and whether we have a right to interfere with other people when they choose to engage in activities that are known to lead to unwanted health care outcomes. We harass smokers, pass laws restricting what people can eat, and tell motorcycle riders what sort of helmet they must wear.
Yet when it comes to sex, we act as if the rules were the other way around – it is not only inappropriate for us to be critical of people who engage in reckless behavior, but it is in fact our responsibility to cushion them from their own stupidity.
Is there any reason at all – other than your own selfish preferences – why irresponsible sexual behaviors should be singled out for special treatment, instead of being governed by the same standards we use when judging other types of gluttonous or reckless behaviors?
February 24th, 2012 | 1:44 am
I’d like to read the underlying study but don’t have time to do so. I have been involved with medical cases in which the conventions on coding procedures varies dramatically.
The other thing I would like to know is what it means to say that a “hospital” does sterilizations. If one rogue doctor sporadically provides a procedure that violates the hospital’s policy, does that mean that the hospital “provides sterilizations?” Or does it mean that a hospital did not do enough to ensure that a sterilization took place against its policies? How much policing of its policies is enough, particularly when a single visit can include a number of procedures at the same time.
The other question relates to how these statistics take account of the “firewall” procedure that Catholic hospitals have created when they merge with a hospital that currently provides sterilization. They come up with these procedures whereby the doctors at these hospitals set up an off-site clinic that continues the sterilizations, but they are not supported by the hospital. How does that count in these statistics?
These statistics also don’t jibe well with the Planned Parenthood data that has come out in the last couple of years, premised on the way patients are inconvenienced by having to split their OB/Gyn services between services available at Catholic hospitals and the unavailability of sterilization and contraceptives when a Catholic hospital is the nearest one.
But I am sure that there are doctors at just about every hospital in the world who believe that they know better than those who set the policies at their hospitals and disobey the rules. After all, I’ve watched House and he never does what that poor Cuddy lady tells him to do.
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