By Caroline Johnston Polisi
Friday, July 9, 2010
A legal commentator analyzes the possible reverberations of a Catholic nun being excommunicated for authorizing an abortion that saved the life of a young woman and the ACLU's decision to act against what they say is a violation of federal law.
The law governs how and when a patient can be denied medical treatment or transferred to another hospital when she or he is in an unstable medical condition. While the act covers hospitals that receive funding for Medicare or Medicaid, the requirements apply to every patient the hospital treats, not just those using the programs.
"Religiously-affiliated hospitals--which are often the only hospital in a particular area-- are not exempt from providing critical care to patients who come through their doors," said Daniel Pochoda, legal director of the ACLU of Arizona, in a press statement issued last week.
The letter cites an American Journal of Public Health article that documents refusals by various Catholic hospitals to provide urgent medical reproductive care in miscarriage management cases. In each situation described, the letter asserts, the hospital in question placed a woman's life or health at risk in direct violation of federal law.
The ACLU's legal argument hinges on an interpretation of a section of federal law that requires hospitals to stabilize patients with an "emergency medical condition," defined as a situation in which the health of the patient is in serious jeopardy or the patient risks serious impairment to bodily functions or dysfunction of a bodily organ. There are unfortunately countless conditions in which termination of pregnancy will be necessary to stabilize a patient, they argue. They also allege violation of federal law in the various hospitals' failings to provide their pregnant patients with all available treatment options.
"The law rightly requires hospitals to provide life-saving medical care to their patients," said Vania Leveille, ACLU legislative counsel. "The government must ensure that the well-being of the patient does not take a back seat to religious beliefs."
The civil liberties group seeks a comprehensive investigation as well as an explicit clarification of protocol in situations similar to the one that gave rise to Sister McBride's excommunication. They request an immediate in-person meeting with Marilyn Tavenner, an administrator and chief operating officer of the Centers for Medicare and Medicaid Services, which is responsible for the development and enforcement of EMTALA.
In taking a hard-line stance against the violations of the rights of women in religiously-affiliated hospitals, the ACLU provides a morally neutral framework to analyze the situation: hospitals that refuse to provide emergency medical reproductive health care jeopardize the health and lives of women in direct violation of federal law.
While Sister McBride's decision has no doubt caused her immense personal suffering, the uproar surrounding her excommunication has and will continue to resonate publically. It has shed light on a troubling problem that cannot be rectified without government intervention.
Many await the Centers for Medicare and Medicaid Services' response and hope it strikes a proper legal balance between respect for individual religious liberty and patient safety.
Caroline Johnston Polisi is an attorney and freelance journalist in New York City who does volunteer legal work for the ACLU's Reproductive Freedom Project. She wrote this article in her individual capacity.
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