Judy Stone at Forbes on a new report by the ACLU and MergerWatch on the Catholic takeover of medical services in the US and what that does to women’s right to get medically appropriate care.

A disturbing new report from the American Civil Liberties Union (ACLU) and MergerWatch, “Health Care Denied,” finds that one in six hospitals in the U.S. are operated in accordance with Catholic religious rules, known as the Ethical and Religious Directives (ERDs).

While perhaps best known for prohibiting abortion, the restrictions go far beyond that, and impact more than reproductive health.

For women, the impact can be deadly.

Abortions are prohibited even if the fetus has no chance of survival and the mother’s life is in danger. Savita Halappanavar died of sepsis in Ireland because her physicians would neither terminate her doomed pregnancy to save her life, nor transfer her to a facility that would care of her. Tamesha Means was luckier. She survived. Despite starting to miscarry at 18 weeks’ gestation, she says that Mercy Health in Muskegon, Michigan, sent her home, denying her appropriate care and putting her life at risk. There are similar, less well-known cases here, detailed in the ACLU report. Not providing emergency care is a violation of the Emergency Medical Treatment and Active Labor Act (EMTALA) requirement for hospitals that receive Medicare funding—and Catholic health systems receive billions in taxpayer dollars.

This shouldn’t be happening. Medical care is secular, and churches should not interfere with it.

In Washington state, data shows that 40% of all hospital beds are in a Catholic hospital. There is no other option for care in entire regions. This is especially true in rural regions, and it is frightening when the only access to healthcare is dictated by someone else’s religious doctrine, rather than medical science.

For example, San Juan Island developed an affiliation with PeaceHealth, a Catholic health system. Now women on the island can’t get necessary reproductive care, a problem on other islands as well. There has been little detail available as to what compromises to patient care and autonomy the University of Washington made when it, too, affiliated with PeaceHealth. Washington’s Swedish Medical Center stopped doing abortions and closed its hospice after making a similar affiliation.

While these reports focused on restricted access to reproductive care, the Catholic directives also may interfere with end-of-life decision-making. Living wills may not be honored if they conflict with the ERDs—but you are likely not to know that before a crisis. Washington state, like Oregon, has a Death With Dignity law which allows “terminally ill adults to request and self-administer lethal medications prescribed by a physician.” But staff may be prohibited from speaking about Death With Dignity options, or from referring patients to organizations that can help provide that option.

They’re determined to get us, the bastards, and they don’t care whether we consent or not. They’re happy to force their filthy religion on us, including when we have no other option and can’t hop up out of the bed. They love their sadistic god and they hate human beings.

I know about these restrictions intimately, in part because I opposed a merger here in Western Maryland between the secular Memorial Hospital and Sacred Heart Hospital, owned by Daughters of Charity.* Part of the plan was to move women’s health to the Catholic facility—which would have meant that women who wanted to have a tubal ligation at the time of delivery would have had to travel a minimum of 1.5 hours over mountain roads to have their baby and surgery. For a safe abortion, I had to refer an indigent patient to Baltimore, three hours away, with no public transportation available. The end-of-life policy was changed to state, “Living wills will not be honored if in conflict with hospital policy”—but no one could tell me what that meant. As in Washington and elsewhere, affiliations or mergers are done behind closed doors and with little to no discussion with the affected community. Patients are often not aware of the restrictions on their care. In fact, despite looking carefully at one hospital’s website, I was unaware that my prospective employer was a Catholic-affiliated hospital until my privileges application asked me to agree to abide by the ERDs. Certainly there was no notice to patients, either, a far more critical issue.

That is simply outrageous.