November 15, 2013 — Patient advocates and civil libertarians say a dispute between a Catholic hospital in Colorado and a cardiologist who works there underscores concerns about restrictions Catholic facilities place on what health care providers can tell patients, ProPublica reports.
Catholic health care facilities follow the Ethical and Religious Directives for Catholic Health Care Services, a set of 72 guidelines issued by the U.S. Conference of Catholic Bishops that restricts many reproductive health services, certain end-of-life care options and stem cell research because they conflict with church teachings.
The Colorado case involves cardiologist Michael Demos, who became an employee of Mercy Regional Medical Center in Durango, Colo., in July 2011 after his private practice group was bought by another group that became part of Mercy.
A disagreement between Demos and Mercy over his handling of a pregnant woman's care prompted the American Civil Liberties Union of Colorado on Wednesday to file a complaint with the state Department of Public Health and the Environment. The complaint alleges that the hospital violated state law by telling its physicians and nurses that they cannot discuss abortion with patients, even if a pregnancy puts a woman's life at risk (Martin, ProPublica, 11/14). ACLU also alleges that Mercy's policy violates federal rules stipulating that patients be fully informed about their care.
According to the Durango Herald, Colorado law prohibits hospitals from restricting a physician's professional judgment or interfering with his or her ethical and moral responsibility to a patient (Hanel/Benjamin, Durango Herald, 11/13).
The complaint states Demos in early 2012 met with a patient who was eight weeks pregnant and had a family history and possible signs of Marfan syndrome, a connective tissue disorder that can cause the aorta to rupture during pregnancy. Such ruptures are almost always fatal, and the American College of Cardiology and American Heart Association recommend an abortion if a woman's aorta becomes enlarged to a certain point.
According to Demos, he recommended additional testing and told the woman her treatment options, including abortion, if the results indicated her life was in danger. That was his last encounter with the patient, who went on to have a healthy infant after follow-up tests showed she did not have the condition.
More than a year later, the woman told hospital officials that Demos and other staff members recommended an abortion based on a "presumptive diagnosis of Marfan syndrome," the ACLU complaint said. Demos said the woman misunderstood his recommendations. However, hospital officials reprimanded him and told him he was "not permitted to recommend an abortion, nor is he permitted to even discuss the possibility of terminating a pregnancy with a Mercy Regional patient, regardless of the circumstances," according to the complaint (ProPublica, 11/14).
Mercy Chief Medical Officer Kip Boyd sent a letter to the patient stating that the hospital would "provide education to all our employed providers, reminding them that they should not recommend abortion -- even to patients who may have serious illnesses" (Durango Herald, 11/13). He noted that under the Catholic directives, providers at the hospital are "precluded ... from providing or recommending abortion" (ProPublica, 11/14).
Response to ACLU Complaint
In a statement, Mercy spokesperson David Bruzzese said, "We feel the statements made in the complaint are based on inaccurate information." He noted that, as a faith-based hospital, Mercy is committed to carrying out its mission and ministry "in a manner that is consistent with our religious and ethical directives." Bruzzese added that the hospital's physicians and patients "are free to use all information in the medical literature to make appropriate medical decisions" (Durango Herald, 11/13).
Sheila Reynertson of the MergerWatch, which tracks the impact of Catholic hospital consolidations, said religious restrictions on patient care can be especially problematic in communities like Durango, where other facilities are miles away. She added that providers at religiously affiliated hospitals often become nervous about sensitive cases and "overreact to keep their jobs," which creates a "chilling effect" that limits patient care.
ProPublica reports that the Colorado case suggests that the directives, which typically are associated with limits on ob-gyn care, "have a broader reach than many people realize" and restrict other types of providers (ProPublica, 11/14).