A nun is excommunicated for saving the life of a pregnant woman; doctors point to restrictions placed on their medical judgment as to what is best for pregnant patients. Are Catholic hospitals safe for pregnant women?

The news of the excommunication of Sister Margaret McBride, the nun at a St. Joseph’s Hospital and Medical Center in Phoenix who approved an abortion that was necessary to save the life of a woman, has shocked and angered both the devout and the non-religious alike.

Catholics for Choice condemned the action via press release, stating:

“[I]t is clear that the Vatican’s hard line on abortion led to this terrible situation. Sadly, we see situations like this time after time, both here in the US and abroad. The Vatican’s outright ban on all abortions is insensitive and reflects an unwillingness to acknowledge the reality of women’s lives, including the difficult decisions that often have to be made during a pregnancy. … Sex. Abortion. Parenthood. Power. The latest news, delivered straight to your inbox. SUBSCRIBE Reasonable Catholics the world over acknowledge that access to abortion is sometimes necessary, and our polling and that of other organizations shows that a large majority of Catholics reject the Vatican’s outright ban on all abortions.”

Reasonable Catholics may very well reject the outright ban on abortion, but it seems that these are not the Catholics who often get to make the final decision on medical procedures that occur within hospital walls. Because, unfortunately, situations like the one in the Arizona hospital occur with great frequency, and women’s lives and medical requests are often ignored in the name of religious doctrine.

Earlier this month the Journal of General Internal Medicine released a study showing how rampant the disagreement is between Catholic hospitals and the doctors who provide care for patients. From the American Medical News Association:

Most of the physicians reporting conflicts worked in Catholic hospitals, which account for 12.5% of all U.S. community-based hospitals and 15.5% of hospital admissions, according to the Catholic Health Assn. of the United States. Catholic hospitals are required to follow the U.S. Conference of Catholic Bishops’ religious directives on medical care that bar contraception, abortion and sterilization and, in many instances, rule out ending artificial hydration and nutrition. When conflicts arise, 86% of surveyed physicians said they would encourage patients to seek the recommended care at another hospital. Ten percent said they would offer an alternative treatment that could be delivered at the religious hospital, and 4% endorsed violating the hospital’s policy to provide the care.

The author of the study, Dr. Debra Stulberg, has had her own issues with medical directives being overturned by Catholic hospital administrators, and in one case a woman would have been forced to put her life in danger just to avoid abortion.

Family physician Debra Stulberg, M.D., was completing her residency in 2004 when West Suburban Medical Center in Oak Park, Illinois, was acquired by the large Catholic system Resurrection Health Care. “They assured us that patient care would be unaffected,” Dr. Stulberg says. “But then I got to see the reality.” The doctor was struck by the hoops women had to jump through to get basic care. “One of my patients was a mother of four who had wanted a tubal ligation at delivery but was turned down,” she says. “When I saw her not long afterward, she was pregnant with unwanted twins.” And in emergency scenarios, Dr. Stulberg says, the newly merged hospital did not offer standard-of-care treatments. In one case that made the local paper, a patient came in with an ectopic pregnancy: an embryo had implanted in her fallopian tube. Such an embryo has zero chance of survival and is a serious threat to the mother, as its growth can rupture the tube. The more invasive way to treat an ectopic is to surgically remove the tube. An alternative, generally less risky way is to administer methotrexate, a drug also used for cancer. It dissolves the pregnancy but spares the tube, preserving the women’s fertility. “The doctor thought the noninvasive treatment was best,” Dr. Stulberg recounts. But Catholic directives specify that even in an ectopic pregnancy, doctors cannot perform “a direct abortion”—which, the on-call ob/gyn reasoned, would nix the drug option. (Surgery, on the other hand, could be considered a lifesaving measure that indirectly kills the embryo, and may be permitted.) The doctor didn’t wait to take it up with the hospital’s ethical committee; she told the patient to check out and head to another ER.

Waiting for the ethical committee to approve would not only delay the patient’s care and put her life in danger, it still couldn’t guarantee a positive outcome for the patient. After all, it was Sister Margaret McBride’s ruling on the committee in favor of saving the mother’s life in Arizona that got her excommunicated. How many members of the church are willing to risk what they believe to be their immortal souls to defy the church, even if it means saving a woman’s life?

And truly, many of these are cases of saving a woman’s life. Women who are already in danger due to their pre-existing conditions are being told that not only are they so expendable, and that these hospitals will not perform the abortions that would save their lives, but that they should further risk their lives by seeking out some other place that might provide them care, such as Michelle Lee, who had to travel to a different state to have a necessary procedure performed.

In 1998, the Louisiana State University Medical Center in Shreveport refused to provide an abortion for Michelle Lee, a woman with cardiomyopathy who was on the waiting list for a heart transplant, despite her cardiologist’s warning that the pregnancy might kill her. Hospital policy dictated that to qualify for an abortion, a woman’s risk of dying had to be greater than 50 percent if her pregnancy was carried to term; a committee of physicians ruled that Lee did not meet this criterion. Since her cardiomyopathy made an outpatient abortion too dangerous, she traveled 100 miles to Texas by ambulance to have her pregnancy terminated.

The woman’s risk of dying has to be greater than 50 percent. And even then, who gets to determine if her risk is above 50 percent, if the doctors are being overruled by the Catholic hospital administrators? As Dr. Debra Stulberg’s attending put it to her, “So, it looks like we’re going to be working for the Pope.”

Do you want the Pope deciding on your medical care?