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Jane Ahlin, Published December 01 2012

Ahlin: When religious priorities harm the care of patients

When Dr. Savita Halappanaver, a dentist pregnant with her first child, died unnecessarily in an Irish hospital, Ireland erupted in demonstrations against the nation’s strict abortion laws – laws blamed for the postponement of medical care that caused her death.

Noting the Irish outburst of protests, vigils and marches, scores of Americans shuddered. No pregnant woman should be treated so callously. For that matter, no human being should be treated so callously. After all, even Irish law allows for abortion if the mother’s life is at risk. What went wrong? As Americans watched, their accompanying emotion was pity rather than empathy. In America, such heartless treatment and unnecessary death could not happen.

Or could it?

Here is the short version of what happened to Halappanaver. Seventeen weeks pregnant and experiencing severe back pain, Halappanaver was taken to the Galway University Hospital by her husband. Within a short amount of time, doctors determined that she was having a miscarriage and nothing could be done to save the pregnancy. The news was devastating to the couple; however, they accepted it, and because Halappanaver was in terrible pain, requested that the fetus be aborted. The doctors refused. They were in a “Catholic hospital” and although doomed, the fetus would not be aborted until fetal heart tones could not be detected. It seems the doctors were more worried about adhering to religious constraints than they were about patient care. Certainly they knew that an incomplete miscarriage could cause life-threatening infection, not to mention that Halappanaver’s excruciating pain would go away only with the completion of the miscarriage. After three days of refusal by doctors, Savita Halappanaver developed sepsis (blood infection), went into septic shock, and died.

Now to the question of whether it could happen here. In 2009, the National Women’s Law Center instigated a study that was handled by Ibis Reproductive Health, a study called, “Assessing Hospital Policies & Practices Regarding Ectopic Pregnancy & Miscarriage Management.” More specifically, the study included interviews with medical personnel and examination of records to determine “whether and how doctors’ treatment decisions regarding (ectopic pregnancy and miscarriage) … are affected by working in religiously affiliated hospitals.” For those of us who want to believe the Halappanaver tragedy could not happen in the U.S., the study results released in 2011 are sobering, to say the least.

Four problems in religiously affiliated hospitals stood out:

To be clear, this study did not involve cases of pregnancies with any possibility of being sustained. All were cases where the survival of the fetus was not medically possible. Yet, over and over again, religious doctrine still stood in the way of care. Put another way, we aren’t as far removed from Ireland as we’d like to think we are.

In 2010, hospital administrator Sister Margaret McBride OK’d an abortion as medically necessary to save a woman’s life at St. Joseph’s Catholic-affiliated hospital in Phoenix. For that, she was forced to resign and also was excommunicated by her church. She saved a woman’s life but suffered mightily for doing so.

In our diverse society, respect for religious belief, either of individuals or institutions, can’t be allowed to compromise patient care. In the words of the American College of Obstetricians and Gynecologists, “religious objections ‘should be accommodated only if the primary duty to the patient can be fulfilled.’ ”

Ahlin writes a Sunday column for The Forum.