It’s been quite a while since I talked about Catholic hospitals and their Ethical and Religious Directives and how those make people less safe. I wish that meant they’d stopped putting people in danger, but that’s not even close to the case. Here is another case from Michigan.

It was painful to hear but ultimately seemed the best course to Jessica Mann and her family. Because of a dangerous tumor in her brain, her doctor gently suggested that she take steps to make sure that she could not get pregnant again. So Mann, 33, who is due to have her third baby next month, decided that while she was under anesthesia during the birth, she would undergo a tubal ligation — a procedure that would prevent further pregnancies. But her hospital said no. Genesys Regional Medical Center, which is Catholic, denied the request on religious grounds: Catholic mandates forbid procedures that cause sterilization, including vasectomies, and officials said she did not qualify for an exception.

In some ways, Mann is lucky. She lives close enough to a city that can offer her other hospital options, though hospital privileges means she will need to use a different OB-GYN. She also has competent care outside the hospital, so she knows that sterilization is in her best interest. She was given the information she needed to decide on the best course of care.

In some Catholic hospitals, she wouldn’t have been told. Tamesha Means wasn’t told that terminating her miscarriage-in-progress was an option.

According to the lawsuit, Means was 18 weeks pregnant – a little more than four months — in 2010 when her water broke. She made three visits to a Mercy emergency room within a couple of days with pain and other symptoms and was not informed that pregnancy termination was an option. On the third visit, with an infection-induced fever and while about to be discharged again, she delivered a baby who died within three hours. The ACLU lawsuit contended that Catholic doctrine incorporated in the bishops’ policy directives prevented Means from getting appropriate care. The ACLU claims her care was negligent because the policy prevents staff from telling her “that terminating her pregnancy was an option and the safest course for her condition.”

Let me repeat again that these cases are not anomalies. The Ethical and Religious Directives for Catholic Healthcare Services are very clear on this. They require that reproductive health care become an emergency matter before they’ll treat it if treatment might terminate a pregnancy or otherwise violate their religious ideas of ethics. They won’t stop a situation from becoming an emergency. They won’t even consider an infection with fever to be an emergency.

Neither is it an easy thing to just avoid Catholic hospitals. As the situation in Bartlesville pointed out last year, sometimes a Catholic hospital is the only choice in town. If you live in a rural area, they may be the only options in several hours drive. These hospitals also don’t exactly advertise the contents of the directives they claim you accept when you receive care at their facilities.

On top of that, these Catholic hospitals are embedded in a network of hospitals treating health care as a profit center. That means that, even if you choose a doctor who isn’t affiliated with a Catholic hospital, there’s no guarantee that won’t change, or that you won’t end up in a different system with different rules. Change does sometimes happen in the other direction, but that also means you can sometimes find yourself at a non-church-affiliated “Catholic” hospital. Also, all of those changes were announced in the span of about two weeks.

So what are we to do? If you have the resources, you can change doctors, as Mann is, or threaten to sue, as Rachel Miller has apparently successfully done on the grounds of sex discrimination. (I’ll trust it when it happens.) Merger Watch continues to represent patient interests in the business arrangements that are shifting our hospitals into religious hands. But we still need more effective ways to put the medical needs of people before the spiritual needs of Catholic church hierarchy.