A federal complaint recently filed by the ACLU alleges that a Catholic hospital in Grand Blanc, Michigan, effectively discriminates against women. The complaint is on behalf of Jessica Mann, a woman who sought to have her tubes tied at Genesys Hospital. Mann needed the procedure due to a pre-existing brain tumor that could threaten her life if she were to become pregnant. But since the hospital follows directives from the Catholic church that deem all reproductive services "intrinsically evil," it denied her request.
According to her lawyers, Mann was pregnant at the time and was scheduled to have a cesarean section at Genesys, a health care facility that she has been going to for 16 years. Because of her tumor and the danger another pregnancy would pose, Man's OB-GYN, Dr. Wang, recommended that she undergo tubal ligation during her delivery so that she would not have to have an additional surgery.
A subsidiary of the largest Catholic healthcare system in the world, Respondent Ascension Health, Genesys follows the Ethical and Religious Directives for Catholic Health Care Facilities. These directives state that "direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution," unless "their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available." In addition, the guidelines also prohibit contraception and abortion.
Mann's doctors—Wang and Dr. Ivana Vettraino, her maternal fetal specialist—had to send a letter to the hospital's ethic's board asking for an exemption. Mann's life would be significantly at risk if she were to have an unintended pregnancy, they wrote, and "she should not become pregnant again." They also noted that anesthesia posed a risk to Mann. "To undergo a separate procedure requiring an additional episode of anesthesia when the tubal ligation can be performed with the anesthesia required for the cesarean delivery does not appear to make any sense in regard to patient safety," they argued.
Unconvinced, Genesys denied her request three months after receiving it. So at 36 weeks pregnant, the complaint alleges, Mann had to search for another hospital that would deliver her daughter and provide the care that she needed. The 34-year-old had delivered her first two children at Genesys, but now all of her plans were in flux; Dr. Wang, who had delivered one of Mann's previous pregnancies and provided Mann's prenatal care up to this point, only had admitting privileges at Genesys.
"Mann had to change her provider from a doctor who was very familiar with her brain tumors and her underlying health condition," Brigitte Amiri, a senior staff attorney at the ACLU, told Broadly over the phone. "She had to find another OB-GYN who had admitting privileges at the hospital where she was able to get her tubal ligation. She's been going to Genesys for so many years, and she suddenly had to find a new doctor and deal an insurance, red-tape nightmare." This was all a few weeks before she was about to give birth.
The ACLU alleges that Genesys and Ascention are in violation of a provision in the Affordable Care Act that "prohibits discrimination on the basis of sex in any health care program or activity receiving federal funds." (Genesys accepts both Medicare and Medicaid funding.) "Ultimately what we would want is for Genesys to provide tubal ligations to their patients and to not discriminate against women who seek that critical reproductive care service," Amiri said.
Genesys is a Catholic institution and one of 548 hospitals that refuse to provide reproductive services on religious grounds. This affects women across the country, and especially rural women for whom a Catholic hospital may be the only service provider in their area. "I don't want other women to be turned away from hospitals that let their religious views trump their patients' serious medical needs," Mann said in an interview with the ACLU.
"These hospitals agree to take federal funds on the basis that they agree to follow certain rules. By accepting federal funds they have to play by federal rules," Amiri added. "If these hospitals don't want to abide by the anti-discrimination rules, they don't have to take the federal funds."