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If a woman asks for a tubal ligation, a Catholic hospital should allow it

To the editor: Although bioethicist and theologian Charles C. Camosy makes some excellent arguments for why the Roman Catholic Mercy Hospital in Redding should be allowed to refuse to allow a woman to have her tubes tied during a scheduled C-section, he appears to be elevating the hospital to the level of a person. ("Why a Catholic hospital shouldn't be obliged to do a tubal ligation," Opinion, Jan. 18)

Sure, some women and doctors can pick their hospital where they deliver, but with insurance networks becoming narrower, allowing Catholic hospitals to forbid a woman (or her doctor) from doing a tubal ligation at the time of a C-section will greatly harm healthcare for women.

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Tubal ligations take a few minutes while the abdomen is already open; forcing a woman to have another surgery increases risk. Tubal ligations lower a women's lifetime risk of ovarian cancer, and if a woman gets pregnant again after a C-section, the risks involved in repeating such procedures are higher than with the primary surgery.

Treating a hospital as if it were a human would increase the number woman who die each year from surgery complications or from ovarian cancer.

Howard C. Mandel, MD, Los Angeles

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To the editor: Pregnancy is a high-risk medical situation. That is why before modern medicine, women would make out their wills as soon as they found out they were pregnant.

Although the complications have greatly decreased, giving birth is still a risky business in many cases.

By preventing subsequent pregnancies, tubal ligations prevent a ruptured uterus from a previous cesarean section that could kill both mother and baby; by preventing subsequent pregnancy tubal ligations avoid postpartum hemorrhage in someone whose uterus won't contract; by preventing subsequent pregnancy a tubal ligation prevents life-threatening bleeding in a patient with a history of abnormal placental implantation; and by preventing subsequent pregnancy a tubal ligation eliminates the chance of a high-risk delivery in a women who has large fibroids and is at risk for extreme premature delivery.

This is hardly a choice between a Burger King hamburger and a chicken sandwich. If the Catholic Church doesn't want to help women with their medical care, it should get out of the business of obstetrics.

Catherine Warner, MD, Anaheim

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To the editor: Camosy attempts to make the point that permitting patients to "demand" services like a tubal ligation would signal the end of medicine as a professional practice.

How about a group of physicians being told what procedures they can and cannot perform because they are associated with a hospital that adheres to directives from bishops of the Catholic Church? Would Camosy have us believe that there are no physicians in that hospital who would have performed a tubal ligation had it been permitted by the administrators?

What happened to their "professional practice" rights?

Arthur Klimeck, San Pedro

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