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Across the U.S., religious healthcare corporations are absorbing once secular and independent hospitals and in the process imposing religious restrictions that pit standard medical practice against theology.

Recently, a woman was traveling across the Midwest when she developed abdominal pain. She and her husband went to the nearest hospital, where she was diagnosed with a potentially fatal ectopic pregnancy. The doctors recommended immediate surgery to remove the fallopian tube containing the misplaced embryo, a procedure that would reduce by half her future chances of conceiving a child. They failed to mention that a simple injection of Methotrexate would solve the problem, leaving her fertility intact. Why the omission? The Catholic hospital where she got diagnosed was subject to the “ Ethical and Religious Directives” of the Catholic bishops, which state, “In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion.”

According to Catholic moralists, an injection that destroys an ectopic embryo is a direct abortion, while removing the part of a woman’s reproductive system containing the embryo is not. While this may sound strange (or abhorrent) to outsiders, it has its own internal logic. Catholic ethics ultimately are determined by theologically based perceptions of what actions God approves and doesn’t approve. While compassion does matter, the end goal is to improve the spiritual standing or righteousness of the person performing the action. These theological dictates may or may not align with the questions that govern secular medical ethics and practice: how to minimize harm and suffering or maximize wellbeing while respecting patient autonomy.

In 2010, a pregnant Nicaraguan woman with metastatic cancer was denied treatment because chemotherapy could harm her fetus, which doctors refused to remove. Though many Protestants disagree, Catholic theology treats any product of conception as a fully formed human being, with rights equal to a woman from the moment of conception whether or not there is any possibility of it actually becoming a person. This means that abortion is an inherently bad action, regardless of outcomes. Nicaraguan law, rooted in this theology, prohibits all abortion even when a woman’s life is at stake. In 2012, a 16-year-old Dominican girl also was denied treatment for weeks while doctors debated whether chemotherapy would constitute an abortion. She eventually miscarried and later died.

Christianity traditionally has regarded women as vessels–vessels for evil, and for babies. For Adam was formed first, then Eve. And Adam was not the one deceived; it was the woman who was deceived and became a sinner. But women will be saved through childbearing–if they continue in faith, love and holiness with propriety (1 Timothy 2: 13-15). As a consequence, Catholic rules addressing reproduction are particularly convoluted, and sometimes patients pay the price:

A Catholic doctor at a Catholic hospital went against my daughter’s wishes and signed consent to have a hysterectomy because of severe endometriosis. One ovary had already exploded. My daughter had never intended or desired children nor was she in a suitable situation to have a child. She was single, in her late 20s. When she awoke from surgery she learned that the doctor had over-ridden her wishes and consent in an attempt to save her fertility. The operation was botched, leaving my daughter on permanent disability, in pain, with even more health problems than she’d had before. — Comment at Truthout

Secular medical ethics evolved to promote patient welfare and autonomy. As better treatment options become available, providers are expected to keep their skills and knowledge up to date so that they can provide accurate information about the range of options and offer the services most likely to create the best health outcomes for patients. Violation of these norms is considered malpractice.

This article originally appeared on: AlterNet