This weekend, 10,000 people in Ireland marched to protest the death of Savita Halappanavar, a 31-year old woman who died after a hospital decided not perform an abortion that would have saved her life. "Sad" does not begin to describe her husband's account of the three frightening and agonizing days she suffered before dying of septicemia and E. Coli infection, while asking that doctors save her life. When I first learned of her death, I assumed that the hospital was Catholic, but I was wrong. It's not. This is almost worse. Despite repeated requests for a medical termination, they were told, "This is a Catholic country." She died of an infection resulting from religious misogyny -- which is characterized by women's "limited access to power and decision making" -- and a government's failure to protect her from it.
Ireland's abortion ban is supposed to include exceptions for the life of the mother. But Ireland has no clear procedures for ensuring that this happens. And Irish Catholic Bishops lead the charge in the campaign to make sure that it these procedures are not put into law. International human rights law makes clear a woman's right to access a safe and legal abortion in situations where her life is at risk. As Suzanne Nossel, Executive Director of Amnesty International USA, explains: "Where governments fail to clearly provide this access they are in violation of their international human rights obligations."
And, in the U.S.? Three days ago, New York Cardinal Timothy Dolan, president of the U.S. Conference of Catholic Bishops, explained that the U.S. Catholic Bishops would not bow to the Heath and Human Services requirements regarding women's health care. Doesn't this mean, in addition to the obvious birth control/insurance denial, that for at least the next eight months, religiously affiliated hospitals will continue to compromise doctors' ability to do what they think is right, dangerously turn away pregnant women seeking emergency medical care or deny them life saving abortions if they are unable to be moved. He stressed during the press conference that "It's still not doomsday yet," unless, of course, you are not a Cardinal or a Bishop and instead a woman like Savita.
The question is: How many more women like Savita Halappanavar should we tolerate in our continued privileging of religion's massively gender-informed obsession with sacrifice and innocence, sin and shame?
We don't live in a "Catholic country," but we do live in a country, one of six including Iran, Somalia, Sudan, Vatican City and the small island nations of Nauru, Palau, Tonga, that won't ratify CEDAW (The Convention on the Elimination of All Forms of Discrimination Against Women), where an entire political party wants to extend 14th amendment rights to fertilized eggs, and where U.S. Catholic Bishops are adamant in their refusal to comply with the law.
While freedom of religion is a vital right, it is no more so than freedom from religion. The Irish government failed to protect Savita Halappanavar from the religious beliefs of others -- beliefs she did not share that cost her her life and resulted in her being treated as an incubator for her dying fetus. What Cardinal Dolan, longing to operate Catholic hospitals as sovereign states, expects is that women in those hospitals in the United States be prepared to do the same when faced with similar situations And we are supposed to agree and tolerate the occasional risk and maybe death as the price we pay for the social safety net that the Church has historically provided. This is not a good trade. It never has been for women.
When asked if he was prepared to pay fines, close hospitals or follow the law, Cardinal Dolan answered that the only thing "we are certain to do is not give in." It is hard not to wonder, given the timing of Savita's death and his announcement, if her end was "consonant with the high moral principles" that the Bishops are adhering to.
I'm not being flip and do not doubt in the least that Cardinal Dolan and the Bishops take their task with the utmost seriousness and compassion. But, ethics are informed by experience and, as such, their ethics will remain fatally flawed and their conclusions fatally unjust. His approach, he explained, would have an "enthusiastic unity among the bishops," none of whom, please note, may have sex or can get pregnant, miscarry, give birth or die trying. This is important. The assessment of what constitutes "just" in this equation is ultimately made almost exclusively, if not exclusively, by men. Contrary to what the History Channel would have you believe this month, "Mankind" is NOT the "story of all of us." Humans are made up of two sexes (not genders, not sexualities, etc.) who experience the world differently and are both fully human. Permitting, as most in this country do, the legitimacy of religious considerations, our experiences are meaningful and relevant to moral equations, everything from the Bishops' thinking about the ethics of abortion to the evolution of Just War Theory. As long as these considerations are the result of men's only clubs speaking for all of humanity, they are incomplete and insufficient. That's why organizations with traditional, all-male power structures have zero business being making gender-unilateral decisions about women's lives and health. EVER.
In addition, aside from corporate imbalances in thinking, individual women are not heartless killers or morally incompetent children perpetually in need of guidance. If Christian, including Catholic, not only can they follow the dictates of their consciences but they, morally, must.
While all-male organizations, like the U.S. Conference of Catholic Bishops, work with other practically all-male organizations, like our government, to negotiate "acceptable compromises," women in need of timely, safe, sometimes life-saving medical treatment will continue to be at risk and will not get the treatment they have a right to. There is no shortage of examples, like the ones reported on here, The New Republic, Ms. Magazine. And, there is a reason that the National Advocates for Pregnant Women exists.
The Catholic Church has a major and growing presence in the U.S. health care market. Twelve point six percent (12.6 percent) of U.S. hospitals are Catholic and they account for 15.6 percent of hospital admissions. In addition, the Church's penetration of the market is increasing, through mergers which often result in dangerous confusion. We don't know the extent of the problems women and their doctors encounter because doctors and patients are going to dire lengths to work around other people's religious beliefs and Catholic hospital prohibitions.
Catholic institutions are required to function according to the Catholic bishops' Ethical and Religious Directives for Catholic Health Care Services, often administered through ethics panels. Women cannot know that they will not face similar death in these circumstances and doctors are put in the position of putting themselves at risk and violating established either church protocols or someone's religious conscience. There are 63 million women of childbearing age in the U.S. Given the risks of pregnancy and our country's religiosity, no woman should think, "it will never happen to me." There are 456 Bishops and a handful of Protestant patriarchs, regularly aided and abetted by ambitious politicians, deciding when it will happen next.
After Sister Margaret McBride a Catholic nun -- was excommunicated in the Phoenix case above, for allowing an abortion that saved the life of a 27-year-old mother of four, NPR report quoted a Boston College Catholic theology professor who explained, "They (the hospital) were in quite a dilemma... The official Church position would mandate that the correct solution would be to let both the mother and the child die."
First, the person with the "dilemma" is the dying woman. Not the hospital. Not the priests. Not the nuns. Not the panel deciding whether she should live or die because she has the misfortune of being in a Catholic hospital, pregnant and in medical distress.
Second, these situations aren't the result of "God's will" or some absolute moral law, but men's choices regarding theological preferences. And that is exactly what they are: preferences. The Church's current position on abortion (like opinions on birth control) isn't static, despite its roots).
Third, there is so much misinformation regarding the real risks of pregnancy and childbirth. The idea that Savita's situation is rare is a common, reality-defying myth. Somewhere in the world, every 90 seconds a woman dies from pregnancy related illness. An additional 10 million women each year are injured through pregnancy. Not to be left out, our country has one of the highest maternal mortality rates in the developed world and is on the rise. This idea of rarity is often accompanied by another that is patently false: "women don't need abortions to save their lives," so expertly articulated by recently defeated Republican Joe Walsh. Women do need abortions to save their lives and they are denied emergency medical care in ways that increase risk and the likelihood of death in religiously affiliated facilities. Like Savita.
We haven't had our "own" case in the U.S. because our maternal mortality reporting is shockingly unsystematic and murky. We don't know how many women are experiencing traumatic eventsin these ways. We need to be better about investigating hospitals for violations of The Emergency Medical Treatment and Active Labor Act (EMTALA).
There are two key religious ideas that drive our ideas about abortion: innocence and sacrifice. The central act of Christianity is sacrifice (John 3:16), and a defining characteristic of humanity is loss of innocence, often portrayed as Eve's fault. Catholicism is most obvious about these ideas. Priestly celibacy, the Catholic mass, motherhood -- all are the practice of sacrifice and self-sacrifice. In addition, abortion would not be an issue if not for the "innocence" of fetal life. Fetal innocence trumps maternal life in this milieu. All of this, in turn, is complicated by the conflation of human "life" with moral "personhood." In any case, a religiously informed recipe for tragedies like Savita's.
As for the"war on religion" argument the real and practical applications of that idea in the provision of health care, and insurance for that matter, ends up in obvious absurdities. The Catholic Church will not comply with the law and provide insurance coverage for birth control. Do Jehovah Witnesses likewise not comply and refuse to pay for insurance coverage of blood transfusions?
Which is why it's important to remember that health care is not a religion and should not be governed by any one or another. If Catholic bishops and Protestant evangelical leaders want to salve consciences and reduce abortions, then they should first focus on the morality of lying to children about sex, teaching them how to be homophobic, sexist bullies, and inculcating them with debilitating shame.
As far as the good work that Catholicism does and the millions of people it legitimately helps, the church should continue and do more. Just not in hospitals. Similar transitions have happened in the past. Cardinal Dolan and the bishops should devise a migration strategy to get out of the hospital business sooner rather than later and dedicate their substantial time, energy and money to charitable enterprises that do not allow living, breathing women to die in pain and suffering when they ask to live and can indeed be saved.
Bioethics are complex and rarely covered well in media. For example, issues such as philosophical debate over "life" and what constitutes "personhood" don't often make it into mainstream press. But, this much is simple: the continued exclusion of women in moral and ethical decision making, particularly when it is focused on pregnancy, is unconscionable. Mainstream media fails there as well. If all-male rule churches and their passionate adherents are unable to adhere to policies requiring hospitals to treat women in ways that do not exacerbate harm and to save their lives when possible, then they should not be in the business of providing degraded and dangerous health care.
Until laws are enforced that make sure this happens, women like Savita Halappanavar will die in vain... whether the hospitals are Catholic or not.
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