August 7, 2013

"Plans by three Catholic hospital systems in Wisconsin to deny admitting privileges to doctors who perform abortions would 'be in active violation of federal law'..."

"Attorney General J. B. Van Hollen's Department of Justice said in a court filing last week."
Federal law "provides that hospitals accepting federal funds may not discriminate against a physician because that physician has participated in or refused to participate in abortions," the state Justice Department said in its filing in federal court....
There's a new Wisconsin law that requires doctors who perform abortions to have admitting privileges at a hospital with 30 miles of their clinics.  That law is being challenged in federal court, as an undue burden on abortion rights. And now the state law — oriented toward religious (and moral) objections to abortion — is having this side effect of burdening religious hospitals.
Seven doctors who provide abortions in the state lack privileges, and at least four are applying for them at religiously affiliated hospitals, according to their employer, Planned Parenthood of Wisconsin.
Is Planned Parenthood targeting the religious hospitals? Its lawyers observe that many Wisconsin hospitals have religious affiliations, so this is what they law has driven them into doing.

Note that Van Hollen isn't arguing that federal law requires that the abortions be performed in religious hospitals. It doesn't. He's only saying that the hospitals can't refuse admitting privileges to doctors on the ground that they perform abortions elsewhere.

IN THE COMMENTS: MayBee asks some key questions:
What are the admitting privileges for? To admit a patient in the midst of a botched abortion?

Will a hospital that does so be forced, then, to participate in an abortion? Can they ensure the baby will be saved if the mother is brought in during an abortion that is going wrong? Or will the doctor have the "right" to complete the abortion? 

47 comments:

Mark O said...

If a hospital takes Federal money, it must follow the Federal regulations. Camel, tent, nose, slope, slip slidin' away . . ..

Deirdre Mundy said...

Can you refuse admitting privileges based on "Not abiding by the Hippocratic oath?" or "Bad match with the staff?" or "Not sufficient experience in treating patients long-term?"

I'd think we'd have to know more about how these hospitals choose to deny admitting privileges... I'm sure that they could find reasons besides "He's an abortionist" to deny these guys....

bpm4532 said...

A slippery slope - sponsored by K-Y Jelly.

lgv said...

Seems straight forward to me. The religious hospitals don't have to offer abortions, but neither should they deny privileges to a physician who may offer services they don't agree with.

Should Catholic Hospitals also deny privileges to physicians who write prescriptions for birth control? Would that be OK?

Lost My Cookies said...

I would venture to bet that the religiously affiliated hospitals will lose. And that's unfortunate, because if they do that will be another nail in the coffin of a lot of charity hospitals.

If I was the Shriners I'd be making big expansion plans, could be a fire sale on St Somethingorothers coming up and it'd be a good thing to keep some of them a) open )b non-profit or c) non-"public" (can't make my fingers say what my brain means, it was a late night, but you all can guess why the quotes).

Matthew Sablan said...

This is an unexpected outcome. Thirty miles -seems- like a long range, but it actually isn't once you get out of suburbia/city-ville. I don't see why a religious institution -should- be able to reject an abortion-provider admitting privileges.

It almost makes you think there's a market for non-religious hospitals, but I'm not even sure if that would solve the problem.

Lost My Cookies said...

I would venture to bet that the religiously affiliated hospitals will lose. And that's unfortunate, because if they do that will be another nail in the coffin of a lot of charity hospitals.

If I was the Shriners I'd be making big expansion plans, could be a fire sale on St Somethingorothers coming up and it'd be a good thing to keep some of them a) open )b non-profit or c) non-"public" (can't make my fingers say what my brain means, it was a late night, but you all can guess why the quotes).

Inga said...

Oh my how the worm turns. How many times has the right wing cried out against religious organizations being forced to provide birth control coverage in their health insurance policies? Now a right wing State Attorney General wants to force Catholic hospitals into giving admitting privileges to abortionists?! Oh my, this won't do Walker any favors either.

Perhaps the right wing of Wisconsin and the rest of the county's state houses didn't anticipate the unintended consequences of their new stricter abortion laws.

How much is it costing the taxpayers of Wisconsin to defend these laws in court?

Mark said...

If you require the providers get admitting privileges for hospitals within _x_ miles of the clinic, the law itself forces the religious hospitals into the game.

Unintended consequences of a dumb law. Gotta pass it to find out what's in it ... that sometimes works against you.

Big Mike said...

I suspect that Planned Parenthood is indeed targeting relgious-affiliated hospitals. Does it matter? If the abortionist meets all of the hospitals' normal criteria for admission privileges then they should be granted those privileges.

Your Van Hollen has previously come across as the south end of a horse trotting north, but this time around I think he's right.

Hagar said...

And the claim now is that these hospitals and clinics "receive Federal funds" because some of their patients are paying their bills with food stamps?

Deirdre Mundy said...

If there was a market for non-religious hospitals, wouldn't they exist?

Many religious hospitals exist in areas where non-religious hospitals won't operate because the profits aren't high enough. (Much like how McDonald's and Walmart are willing to open in remote locations that Target and Panera won't touch.) They make up for operating deficits with large charitable campaigns aimed at believing members of the religions that sponsor them. They base their appeals on their ability to provide compassionate care to the poor.

So...giving privileges to abortionists could very well piss off the donors and force them to close.

It's the whole 'beggars can't be choosers thing.' The sort of people who provide charity care also really detest abortion.

Perhaps the pro-abortion side should start offering more free options for Non-abortive medical care in order to advance its position?

MayBee said...

What are the admitting privileges for? To admit a patient in the midst of a botched abortion?

Will a hospital that does so be forced, then, to participate in an abortion? Can they ensure the baby will be saved if the mother is brought in during an abortion that is going wrong? Or will the doctor have the "right" to complete the abortion?

It seems to me Planned Parenthood is targeting religious hospitals, they could apply to non-religious hospitals, and hospitals could have the right to say, "you will not complete this procedure in our hospital but you have privileges for the procedures you have with inch save lives".

Phaedrus said...

Makes sense to me for the hospitals to deny privileges to these doctors. If they will kill defenseless people before they are born there is no reason to believe they won't kill defenseless people after they are born too.

AustinRoth said...

If they want to deny privileges to those doctors, then they can refuse federal $'s.

Otherwise, I see no way they can possibly prevail in court, and in this case it is the correct outcome I believe.

AustinRoth said...

If they want to deny privileges to those doctors, then they can refuse federal $'s.

Otherwise, I see no way they can possibly prevail in court, and in this case it is the correct outcome I believe.

AaronS said...

Maybee has the right question. Seems that people of goodwill ought to be able to come to an agreement on this issue, unless the point is to force one side or the other to capitulate. If the interest is in serving the citizenry then perhaps one of those waivers I've heard so much about could be obtained.

AaronS said...

And another thing-

From my perspective Catholics have showed themselves willing to work in a world that doesn't comport to all of their values. Has Planned Parenthood?

TosaGuy said...

The WI Attorney General is enforcing the federal law as written; he does not make the law He is doing his duty and sworn oath.

This is the opposite of what the Obama Administration has done...pick and chose which laws to enforce and ignore. Our legal system is designed to weed out the overreach between state and federal laws.

I don't like the law that the WI AG is enforcing but I respect him for doing what he is supposed to do. The other course of action is partisan hackery at best and the road to tyranny at worst.

Those taking a bit of glee in this should pause and ask what if the shoe was on the other food.

Deirdre Mundy said...

Maybee-- good questions. Also, currently if a woman suffers from a botched abortion and goes to the ER, only the abortionist is liable. If the abortionist has admitting privileges and continues to screw things up once she gets there, will the hospital be liable too?

Deirdre Mundy said...

And do you really WANT the guy who just punctured your uterus with his scissors to continue overseeing your care? I mean... he's already screwed up once...... and the actual OBs probably don't want the abortionists participating in the surgeries/follow-up. Real OBs tend to loathe the guys who run abortion clinics....

Something about preferring to see babies alive and wombs uninjured...

Inga said...

Clarify this for me please, anyone. Where is Planned Parenthood driving AG Van Hollen's stance on admitting privileges for abortion doctors in Catholic hospitals? Isn't the right wing trying to shut down Planned Parenthood? Why would Van Hollen take direction from them?

I tend to think Van Hollen's stance is based on the desire to prove to the a federal court that the law is sound.

Edmund said...

My wife is an anesthesiologist at a freestanding surgicenter. All of the surgeons there are required to have admitting privileges at the adjacent hospital, or have a "I will admit on their behalf" statement in writing from a physician that does. It is needed if a case goes wrong (either at the surgicenter or after) and the patient needs to be admitted for treatment.

Such a requirement is standard at surgicenters. In Texas, a similar law to the WI one was just passed, with the provision that teh abortion clinic must also be equipped and certified as a surgicenter. (Which isn't as hard as it's made out to be. My wife did some cases for a plastic surgeon that has an OR in his office that would meet surgicenter standards.)

cubanbob said...

So abortionists are now a newly protected class? Diversity for abortionists? Everything has some nexus however remote to federal funds so ultimately the reasoning of the AG comes down to everything within the State nothing outside the State. Might as well resurrect Benito and put him in charge. At least he got the trains to run on time which is more than the current gang is capable of doing.

WaitingToBuy said...

For what are the hospitals getting Fed funds? If its reimbursement for services rendered, then it should not bar the hospital for refusing admitting privileges for Dr who perform abortions.

Jason said...

Fuck the First Amendment and Freedom of Association, including the freedom not to associate with people one considers to be anathema to one's founding principles.

This is an outrage. Not that the AG is enforcing the law. But that the law exists and has not been struck down as unconstitutional on first amendment grounds.

Abortionists are not a federally-protected class and they should not be.

Jason said...

Fuck the First Amendment and Freedom of Association, including the freedom not to associate with people one considers to be anathema to one's founding principles.

This is an outrage. Not that the AG is enforcing the law. But that the law exists and has not been struck down as unconstitutional on first amendment grounds.

Abortionists are not a federally-protected class and they should not be.

cubanbob said...

As noted above if federal funds always require federal strings what will become of Planned Parenthood when the Congress and Executive change hands? Imagine a reactionary Congress and Executive requiring PP to provide ultrasounds and adoption counseling prior to performing an abortion.

Freder Frederson said...

What are the admitting privileges for? To admit a patient in the midst of a botched abortion?

Good question. Why don't you ask the authors of the bill. I bet they lie to you and tell you it is out of concern for the health of the woman.

The real reason is it is a transparent back-door attempt to make it difficult, if not impossible, for doctors to perform abortions.

tim maguire said...

A good question a few people here are hinting at: what constitutes "receiving federal funds"? Are we talking about a grant from Uncle Sam? Fine, refuse the grant. But the poor will suffer most.

What if we're talking about treating a medicaid patient? Is that "accepting federal funds"? Then, when the hospitals place their ideals ahead of government diktats, the poor will suffer most.

I notice a theme here (as I usually do when the topic is lefty do-gooder programs).

Graham Powell said...

Looks like "admitting privileges" is just a proxy for some other standard of doctor professionalism. Would you go to a doctor who's admitting privileges had been revoked?

And I expect the 30 mile rule is to prevent a hospital setting up as sort of a privilege mill.

hombre said...

"Oh my how the worm turns. How many times has the right wing cried out against religious organizations being forced to provide birth control coverage in their health insurance policies? Now a right wing State Attorney General wants to force Catholic hospitals into giving admitting privileges to abortionists?! Oh my, this won't do Walker any favors either."

Of course, Igna, it's all about "left and right wings" and who benefits politically. It can't be that the AG takes his oath to uphold the law seriously and that his position is based on his interpretation of the law regardless of the politics.

There is no substance in the sociopathic Democrat worldview, only political manipulation.

garage mahal said...

State Sen. Mary Lazich (R-New Berlin), the bill's author, said she was not aware of the Church Amendments of the 1970s, after initially asking whether they were part of Obamacare.

LOL. These morons don't think anything through. I doubt they are bright enough to read the bills that were written for them.

Lyssa said...

I can answer a few legal questions here:

Deirde asked Currently if a woman suffers from a botched abortion and goes to the ER, only the abortionist is liable. If the abortionist has admitting privileges and continues to screw things up once she gets there, will the hospital be liable too?

It can be a really fact-dependent and complicated area of law, but generally speaking, doctors working in hospitals are independent contractors, not employees of the hospital. This means that the hospital is not responsible for their bad acts, even if they happened in the hospital. If you read the fine print of the 1000 and one documents they make you sign in a hospital, it says that in there somewhere. Most of the time, if a person receives bad treatment in a hospital, they have to sue both the doctor and the hospital (and have to try to find something that the nurses or other hospital employees did wrong to keep the hospital's deep pockets on board).

Tim asked what constitutes "receiving federal funds"?

Federal funds in this case means Medicare and Medicaid. It's an ugly area of law and regulations. The gov't can basically dictate any darn thing they want to hospitals on that basis, because it is virtually impossible for a hospital to function without accepting those programs. Yes, the poor would suffer, but everyone would suffer, as the hospitals would likely shut down, not just not accept poor people.

wildswan said...

If abortion doctors insist on using Catholic hospitals those hospitals could collect accurate statistics on abortions and compare them with the Potemkin village statistics the government accepts.

What I mean by Potemkin village statistics is this: There a little known fact about abortions which is that infections resulting from abortions are listed as unrelated if the infection is reported more than ten days after the abortion. Most infections take about two weeks become serious and be reported and so they get listed as something else. And then the abortionist doesn't treat them.

If abortionists had to treat the consequences of abortion and if statistics were collected on infections related to abortions in the same way and under the same rules as all other post-op problems, then abortion in this country would be revolutionized. Because abortion is much worse for women than the present statistics say.

What if Kermit Gosnell had had admitting privileges to a hospital that collected honest statistics?

I think abortionists should stay out of Catholic hospitals but if they insist on getting in then Catholics could use the situation to document the abusive medicine these doctors practice and get their licenses lifted. When you're handed a lemon ...



n.n said...

Their concern should be two-fold. First, to save human lives. Second, to not be accessories to a murderous act. As long as the abortionist is not requesting to commit murder in their facilities, then their concern should be that human lives are preserved or saved.

The matter of reversing a progressive devaluation of human life should not be resolved at the expense of human life. It will require either a majority consensus or another civil war to reset people's priorities.

hombre said...

garage: "LOL. These morons don't think anything through. I doubt they are bright enough to read the bills that were written for them."

Sorta reminds you of the Dems in Congress, doesn't it? Only these bills are far less important than, say, Obamacare and the Immigration Bill.

MayBee said...

Freder:Good question. Why don't you ask the authors of the bill. I bet they lie to you and tell you it is out of concern for the health of the woman.

------

Getting to a hospital *would* protect the health of the woman.

West Texas Intermediate Crude said...

Clarifying Lyssa's post (I am a physician, not a lawyer, but I don't think that her post was entirely clear):
A hospital has a duty to ensure that the physicians on its staff are qualified. Mere possession of a medical license does not entitle anyone to hospital privileges. Case law establishes that a hospital is responsible if it knowingly allows a substandard physician to continue to practice, or does not adequately vet applicants to its staff and bad stuff happens. Essentially, a hospital, by offering admission of a doc to the medical staff, is vouching for that doc's qualifications. It matters not whether the doc is a hospital employee, private practitioner, or independent contractor- all are treated identically when they apply for privileges, or re-apply, which is required every 2 years.

A hospital at which an abortionist is applying for privileges would therefore be justified (?obligated) to evaluate the clinical records of the applicant. At my hospital, every prior hospital and clinic that every medical staff applicant has ever worked at is independently queried to ensure that there are no skeletons in anyone's closet. I believe that that process is standard at most, if not all, American hospitals.

Freder Frederson said...

Getting to a hospital *would* protect the health of the woman.

And how, pray tell, does having admitting privileges help get someone to the hospital. Admission to a hospital following an abortion is in the rare case of complications. Admission would most likely be through the ER whether or not the physician had admitting privileges. The primary purpose of admitting privileges is so that doctors can utilize a hospital's facilities (e.g., operating rooms, labs, scanners, etc.), not for emergency admission of patients.

JohnG said...

If these abortionists are granted privileges, I wouldn't at all be surprised to find out some years later that, while in the hospital, they had been surreptitiously sprinkled with Holy Water, had been blessed by a priest who rode in the elevator with them, found holy cards had been slipped into in their coat pockets, and had been the subject of other rites and happenings. Who knows? Maybe one or more of them will be changed by the experience. Wouldn't that be ironic?

Deirdre Mundy said...

Freder- I think the issue (based on conversations with friends of mine who did rotations through ERs with a high degree of botched abortions) is that often the clinic sends the woman to the hospital without calling ahead, passing on relevant details, etc. Sometimes, they even instruct the woman not to mention that it's a botched abortion.

This handwashing and lack of communication actually endangers women, as the ER docs don;t have all the background on the case and can't treat as promptly as if the abortionist came along and gave information. And there's no sharing of records between the clinics and the ERs.

There's a reason that a lot of people who've done ER rotations near an active abortion clinic decide that abortionists are not 'real doctors' and just 'quacks and butchers.'

Paul said...

"Plans by three Catholic hospital systems in Wisconsin to deny admitting privileges to doctors who perform abortions would 'be in active violation of federal law'..."

I doubt that. The word 'privilege' does mean things, but thing it does not mean is it's a RIGHT. The doctor has no right to perform operations at that hospital, only a 'privilege' given to him by the hospital, who owns the land and buildings.

cubanbob said...

Deirdre Mundy said...

From your last comment it would appear those abortionist could be held liable, perhaps criminally liable for knowingly not passing on the information to the ER.

In all this back and forth I'm a bit confused. Are the only hospitals in Wisconsin that could perform abortions Catholic hospitals? Is there any area in the state that doesn't have a public hospital or private hospital that performs abortions or would accredit abortionists within a thirty mile radius? If this isn't the case then why is the AG pursuing this? It would appear to me until the courts rule that Catholic hospitals must allow abortion and allow abortionists to be accredited the presumption would be that the hospitals have a right to say no.

Big Mike said...

Hmm. I seem to have mixed up Van Hollen with Secretary of State Doug LaFollette when I said he was the south end of north-facing horse. I regret the mistake. The one's a young man who cleaned up the mess with the Wisconsin DNA testing and other is an old fart who thinks the state should be deep blue forever.

As I understand it, the law does not require the hospital to perform an abortion, nor does it require the hospital to automatically give admitting privileges to doctors who don't meet their normal criteria for admitting privileges. It says that the abortionists must apply for admitting privileges and that the hospital cannot deny them solely because they do abortions. If the abortionist spits in open wounds or doesn't wash up and then scratches his groin before performing surgical procedures, that would be something else.

Am I wrong about that, too?

Deirdre Mundy said...

Big Mike-- I guess the problem would be PROVING that abortion wasn't the deciding factor in not granting privileges.

Cubanbob-- the problem is that the women who show up at urban emergency rooms with botched abortion are usually poor, uneducated, and minorities. Unless someone offers to sue on their behalf, they're not likely to KNOW what they're entitled to from a doctor. They're use to crummy treatment, which is how they end up in the clinics in the first place.

I mean, people always use the 'what if you have preeclampsia! You need an abortion clinic" argument. But the fact is, if you're having complications with a pregnancy, you also have an OB. Who can discuss options and try to save everyone.

Women who have choices don't end up with botched abortions from dirty clinics.

Dr.D said...

Hospitals should have the right to deny admitting privileges without any need to justify their decision. Their thought processes should be allowed to be private (just like ours are at the present moment, at least). If they do not want to allow Dr. X to utilize their facility, that should be the end of it. They make this decision, knowing that denying will lose them some trade, but so be it.