Should Church control access to health care?

By Nancy Northup
president, Center for Reproductive Rights

Opinion pages of U.S. newspapers lambasted a decision by St. Joseph's Hospital, a Catholic institution in Phoenix, over the excommunication and demotion of a nun. Sister Margaret McBride was a head administrator at St. Joseph's Hospital who compassionately granted a critically ill young woman permission to have an abortion because continuing the pregnancy posed an immediate and grave risk to her life.

While many focused on the Church's "automatic excommunication" of McBride, an action squarely within the Church's religious purview, only a few addressed the secular punishment - her demotion from head administrator. In that action, the St. Joseph's Hospital was acting as a provider to the public of essential health care. As such, it should not be able to penalize an employee who acted within legal boundaries to deliver life-saving medical care, nor should it be permitted to withhold needed care for those who find themselves in its hospital wings. Indeed, a decision to let the young woman die instead would have been medical negligence as well as a grave violation of her legal and human rights.

The St. Joseph's story is, sadly, unsurprising. As human rights lawyers who work around the globe, we repeatedly confront the tragic consequences of the Catholic Church's sustained hostility to reproductive health services when it imposes its theology on public policy and the provision of health services to the public. In countries where the Church wields considerable power, the repercussions for women's lives are palpable.

In Kenya, for example, Catholic leaders are currently threatening to scuttle the adoption of a new constitution-widely seen as critical to ending political bloodshed there-because it contains a clause on abortion. The provision in fact would forbid abortion except in emergencies or when a woman's life or health is in danger. But the Church would prefer to preserve the narrower exceptions on the books today, which criminalize abortion except to save the woman's life. Poverty, a dearth of sexuality education, and sexual violence all fuel an epidemic of unintended pregnancy. Ultimately, Kenyan women ingest bleach, detergent, or other dangerous liquids, insert sharp objects or resort to back-alley abortions . Every year, tens of thousands die or suffer debilitating damage to their health.

In Europe, the Catholic hierarchy has become especially effective in some former Eastern Bloc countries, resulting in backsliding on access to reproductive health services. In 2008, when a Catholic priest in a Polish town found out that a 14-year-old girl was seeking an abortion (for grounds legal under Polish law), he unleashed a campaign of harassment against her and her mother. They were besieged by protests, phone calls, and text messages. The priest cornered the girl alone in her hospital room in an attempt to convince her to continue her pregnancy. He then helped persuade authorities to take her away from her parents and place her in a state-run juvenile center. The girl and her mother are now suing Poland in the European Court of Human Rights. It's the fourth abortion-related case against Poland in the court that we've been involved in over the last six years.

The Philippines, where the government is closely tied to the Catholic hierarchy, provides another example. Not only is abortion is criminalized with no clear exceptions, but due to the Church's influence, the government strongly discourages contraception. In Manila, an order by the mayor pulled every birth control pill and condom off the shelves of public health facilities, and forbade even sterilization.

For the population in Manila, most who live below the poverty line, the policy banning modern methods of contraception causes irreparable damage. It's not uncommon to see families with six or more severely malnourished children, living in one-room shacks surrounded by garbage and streams of sewage, and facing very few prospects for relief. Understandably, without access to affordable contraception, over half-a-million Filipino women in desperate circumstances turn to unsafe abortion each year. As in Kenya, the methods are crude and painful, and the subsequent deaths and complications suffered by women can only be described as a public health crisis.

This year at home, we saw the U.S. government give the Conference on Catholic Bishops veto power over the health-care reform bill, and in the end, millions of American women were left with a policy that restricts insurance coverage for abortion services even for those who pay for their insurance with their own hard-earned dollars.

The Catholic Church promises to serve the interests of the poor and marginalized, but its position on reproductive health is deeply at odds with those laudable goals. Societies thrive when women thrive - when they are able to finish their education, decide the number and spacing of their children, and live in dignity and equality. Depriving women of the ability to control their reproductive health and fertility does not create a moral and just world. It only further traps women, their families, and their communities in poverty and despair.

The Catholic Church, like any religion, is sovereign in the realm of its theology, liturgy, practice, and requirements of membership. But when it chooses to provide health services to the public as in the case of Saint Joseph's Hospital, or enters the realm of public policy debates in Kenya, the Philippines, Poland or the U.S., the governing standard must be the basic human rights of women to control their health and lives.

Nancy Northup, president of the Center for Reproductive Rights.