California's largest medical association is joining the fight against Dignity Health over its refusal to allow a woman to get her tubes tied during a C-section.
The lawsuit is one of a number that have been filed by the American Civil Liberties Union across the country over Catholic hospitals' refusals to provide certain types of care because of ethical and religious guidelines issued by the U.S. Conference of Catholic Bishops.
This may be one of the first times a statewide professional medical association has gotten involved in such a lawsuit as a plaintiff.
The California Medical Association filed a motion in state court Wednesday asking a judge to allow it to join the ACLU in the case against Dignity Health. The ACLU alleges in the lawsuit, filed late last year, that Rebecca Chamorro decided with her doctor that she would get a tubal ligation during her scheduled C-section in January at Mercy Medical Center in Redding. But the hospital allegedly wouldn't allow the procedure, citing the Ethical and Religious Directives for Catholic Health Care Services.
Those directives say, “Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.”
But performing tubal ligation immediately following delivery aligns with medical standards of care, according to the ACLU.
Dignity Health said in a statement Wednesday it was disappointed in the medical association's decision to join the ACLU lawsuit.
“Our hospitals are open with physicians seeking practice privileges about the services we offer and do not offer,” Dignity said in the statement. “Our Catholic hospitals make clear that they operate in accordance with the Ethical and Religious Directives for Catholic Health Care Services.”
Dignity has also argued in court documents that Catholic hospitals have a right not to perform sterilization procedures. Dignity has more than 39 hospitals in Arizona, California and Nevada and was the eighth-largest not-for-profit hospital system in the country in 2014 with $11 billion in revenue.
Dignity called Chamorro's arguments “an unprecedented attack on a Catholic hospital, seeking to nullify its 70-year adherence to binding ethical and religious directives for Catholic health care” in court documents. The judge in the case ultimately denied Chamorro's request for a preliminary injunction to stop Dignity from keeping doctors from performing tubal ligations because of nonmedical reasons, saying she was unlikely to win the case on its merits.
Dignity argued that the procedure was not medically necessary for Chamorro and she could have gotten it at a different hospital or used a different product or procedure for contraception.
The ACLU, however, says Chamorro's options were limited since there are no hospitals within a 70-mile radius of her that have birthing facilities that do not follow the Catholic directives.
The ACLU and the California Medical Association argue that Mercy Medical Center's refusal to perform the procedure for religious reasons violates a state law prohibiting the corporate practice of medicine, or allowing corporate entities to make medical decisions based on nonmedical criteria. Many states have corporate practice of medicine laws, though not all states still actively enforce them.
“We really firmly believe that the bar on corporations making medical decisions that should be between a patient and physician is sacrosanct,” said Dr. Ruth Haskins, president-elect of the California Medical Association. “Decisions made between a physician and patient should be made based on medical and safety measures.”
Elizabeth Gill, a senior staff attorney with the ACLU of Northern California, said the California Medical Association's decision to join the case “amplifies our claim that this is a problem.” The association has more than 41,000 members.
“When Dignity Health interrupts the doctor-patient relationship by applying these nonmedical criteria that prevent people from getting basic healthcare, that is a problem for doctors and their patients,” Gill said.
Physicians for Reproductive Health, a group that advocates for improved access to abortion and contraception, is also a plaintiff in the lawsuit.
The ACLU has not had much success with similar lawsuits. A federal judge earlier this month dismissed an ACLU lawsuit in Michigan alleging that Trinity Health's failure to provide certain types of care—such as terminating a pregnancy—for women with related complications violates the Emergency Medical Treatment and Labor Act.
Another Michigan lawsuit filed by the ACLU, against the U.S. Conference of Catholic Bishops, was also dismissed last year. In that lawsuit, the ACLU alleged negligence in the case of Tamesha Means, who sought emergency care at Trinity's Mercy Health Muskegon (Mich.) when she was pregnant and experiencing contractions. It turned out she had a bacterial infection, but Means was never told that early termination was an option or that continuing with the pregnancy could harm her, according to the lawsuit. She gave birth at 18 weeks, and the baby died.
The ACLU has appealed that decision to the 6th U.S. Circuit Court of Appeals.