ProMedica has medical, moral duty to keep city’s only abortion clinic open

8/2/2015

ProMedica can keep the only abortion provider in Toledo open, without expending any money, labor, or extra effort. But for reasons that have more to do with political expediency than women’s health-care needs, the region’s largest hospital system is refusing.

Days after Gov. John Kasich signed the new state budget at the end of June, the state moved to shut down Capital Care Network, the last remaining abortion clinic in Toledo, under a provision that lawmakers sneaked into the budget bill. That medically unsupported rule requires abortion providers to get transfer agreements with hospitals within 30 miles to admit patients in case of medical complications.

Capital Care Network renewed its campaign to sign a transfer agreement with ProMedica two months ago, after learning that the General Assembly could pass a stricter transfer rule.

The clinic has gathered 300 local signatures supporting that effort. It plans to expand its campaign and present petition signatures to ProMedica in coming months, clinic employee Marlena Ainslie said.

ProMedica rebuffed the clinic’s requests for a transfer agreement last year. Company officials say they maintain their policy of avoiding such agreements.

“This issue is between the clinics and state lawmakers ... We do not want to be put into a position of choosing a political position that is only divisive and polarizing,” company spokesman Jen Sorgenfrei said in a statement.

ProMedica officials did not make themselves available for further comment.

Meaningless rules

Lawmakers know transfer agreement rules are meaningless. Federal law requires hospitals to admit patients in emergency cases, regardless of any official agreements.

Such cases are exceedingly rare, because abortion is among the safest medical procedures available. But abortion opponents who design transfer agreement laws concede their real purpose is to force abortion clinics to close.

They’ve been remarkably successful, in Ohio and elsewhere. Half of Ohio’s abortion providers have shut down since 2011.

Capital Care Network contacted every hospital in the area for a transfer agreement two years ago. Only the University of Michigan Health System, 50 miles away, was willing to enter into one.

Ohio’s anti-choice health department wants to shut the clinic down, claiming the Ann Arbor hospital isn’t close enough. Anti-abortion lawmakers designed the new 30-mile limit deliberately to target Capital Care Network.

Unless the clinic finds a local hospital to replace its agreement with the UM system, it likely will be forced to close, leaving northwest Ohio with no abortion provider. The Catholic, anti-abortion Mercy system won’t do it. The University of Toledo Medical Center used to have arrangement with the clinic, but state law barred public hospitals from entering into such agreements two years ago.

Rather than challenge that law, UT officials bowed to pressure from anti-abortion activists, dropping their agreement with Capital Care Network and ending talks on an agreement with Center for Choice, an abortion clinic that used to operate in downtown Toledo. Center for Choice was forced to close, leaving Toledo with Capital Care Network as its sole abortion provider, for now.

That leaves just the ProMedica system and potentially a few smaller hospitals with the ability to save the clinic, and preserve abortion access for northwest Ohio women who may need it. Wood County Hospital in Bowling Green likely meets the criteria for an agreement. But the private hospital’s partnership with Bowling Green State University may make it ineligible under a strict interpretation of state law.

The need for care

It shouldn’t be that hard for abortion clinics, especially those in major cities such as Toledo, to find hospitals that are willing to uphold a legal, constitutionally protected medical procedure. Hospitals are in the business of promoting the availability of medical care, particularly the kind that a great proportion of patients need.

Between one-fourth and one-third of American women will have an abortion in their lifetime, numerous research studies estimate. Most of these women are poor, and have limited ability to travel long distances for medical care.

ProMedica says it rejects transfer agreement requests to avoid becoming entangled in the political controversy surrounding abortion. But it can’t remain neutral on a question of access to basic health care. By refusing to sign a legal transfer arrangement, the company is taking a political position — one that will deny Toledo-area women the right to a safe, legal, and widely used medical procedure, and endanger their health.

ProMedica hospitals still will — as federal law mandates — treat patients who need emergency care, company officials say. That’s no more than a transfer agreement would require it to do. Allowing Capital Care Network to be shut down would only increase the likelihood of emergency cases.

“If Toledo lost its only abortion provider, we know that some women will engage in dangerous activities to end their pregnancies and end up in the emergency room at ProMedica,” NARAL Pro-Choice Ohio executive director Kellie Copeland told me.

The medical community’s consensus on transfer agreement requirements and other invasive abortion restrictions all over the country has been clear: Such laws are contrary to science, and pose a threat to women’s health and to doctors’ ability to do their jobs according to their best medical judgment.

These political rules are unsupported not just medically, but also legally. Next year, the U.S. Supreme Court could strike down state restrictions that impose undue burdens on women’s constitutional right to end an unwanted pregnancy.

Still, anti-abortion activists have made it so costly to be associated with abortion that many health-care providers decide, as ProMedica ostensibly has, that upholding abortion rights is not worth risking their public image. Abortion providers, and those who are perceived to enable abortion through arrangements such as transfer agreements, face relentless harassment, threats, and protests from anti-choice extremists.

The only way for the majority of Ohioans who call themselves pro-choice to reverse the damage done by abortion opponents is to make it costlier for health-care providers to refuse to uphold abortion availability than it is for them to deny it. More Toledoans must be willing to participate in Capital Care Network’s campaign, and to demand to live in a community with safe and accessible reproductive health care. It should be a matter of public outrage that our community’s largest health-care network refuses to sustain an essential medical service.

As a private institution, ProMedica has the right to make whatever business decisions it chooses. But that doesn’t make it immune to accountability on matters of public interest. As a major health-care provider, it has a moral and medical duty to the Toledo community to apply policies that are consistent with need and scientific principles, not the ideology of an extreme minority.

ProMedica cannot justify putting its public relations interests above Toledoans’ health-care needs. If it’s serious about its stated goals to advance public health and increase local access to medical care, it should enter a transfer agreement with Capital Care Network. Until it does, the company risks its own reputation as a responsible corporate citizen.

Marina Bolotnikova is an editorial writer and columnist for The Blade. Contact her at: mbolotnikova@theblade.com or at 419-724-6522 or on Twitter @mbolotnikova.