In this September photo, California Attorney General Rob Bonta announces a lawsuit against St. Joseph Hospital as Eureka chiropractor Anna Nusslock looks on. | Image via Rob Bonta’s X account.

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PREVIOUSLY

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In a case that pits California’s constitution against the religious directives of Catholic hospitals, Providence Health & Services this week leaned into its identity as a faith-based institution in its official response to a state lawsuit concerning women’s access to emergency abortion care at Eureka’s St. Joseph Hospital.

On Monday, attorneys representing St. Joseph Health Northern California, LLC, a subsidiary of Providence, filed a motion to dismiss the lawsuit filed by Attorney General Rob Bonta in September. That suit seeks an injunction and criminal penalties against St. Joseph Hospital for its alleged refusal to provide abortion care to people experiencing obstetric emergencies.

While the U.S. Supreme Court overturned the nationwide right to abortion in June of 2022, the procedure remains broadly legal in most states, including here in California, where voters explicitly enshrined abortion protections in the state Constitution later that same year.

But attorneys for St. Joseph Hospital say hospital employees are bound by a higher law, a religious doctrine that deems abortion immoral.

“Forcing [St. Joseph Health Northern California] to allow procedures to terminate a pregnancy that are not permitted by the Catholic faith would unquestionably impede SJH’s constitutionally protected ability to communicate its faith-based message that such procedures are intrinsically wrong,” argues attorney Harvey L. Rochman, a partner in the Los Angeles-based firm of Manatt, Phelps & Phillips, LLP, on behalf of Providence.

The dismissal request submitted to Humboldt County Superior Court on Monday neither denies nor admits to any of the specific facts outlined in the state’s case. Instead, Rochman argues that the Attorney General’s complaint “does not allege facts sufficient to state a cause of action,” citing a series of procedural, jurisdictional and legal grounds, including the hospital’s constitutional rights to free exercise of religion and free expression.

“Like all Catholic hospitals, [St. Joseph] is required to follow the Ethical and Religious Directives for Catholic Health Care Services issued by the United States Conference of Catholic Bishops,” Rochman’s filing argues.

Those directives state in no uncertain terms, “Abortion … is never permitted,” adding, “Catholic health care institutions are not to provide abortion services, even based upon the principle of material cooperation.”

There’s a caveat to that doctrine in Ethical and Religious Directive No. 47, which is cited by Rochman. It says, “Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.”

Regardless, Bonta’s office says the hospital’s policy on emergency abortion care violates California law and discriminates against pregnant patients by making their health care choices for them. Despite rule No. 47, Bonta’s office says St. Joseph Hospital policy bars doctors from providing life-saving emergency treatment when doing so would terminate a pregnancy, even when the pregnancy is not viable.

The Attorney Generals’ suit accuses St. Joseph Hospital of violating California’s Emergency Services Law (the state-level analogue to the federal EMTALA statute), the Unruh Civil Rights Act and the Unfair Competition Law.

With Monday’s dismissal request, St. Joseph Health effectively seeks to sidestep the complaint via a series of demurrers. In legal jargon, a demurrer challenges the adequacy of a complaint without disputing the facts. In other words, the hospital’s legal counsel is arguing that, even if all the facts in the complaint are true, there is no legal basis for the suit.

To briefly recap those alleged facts, the Attorney General’s suit centers on the experiences of Eureka chiropractor Anna Nusslock, who, in February 2024, arrived at St. Joseph Hospital bleeding heavily after her water prematurely broke during the 15th week of her pregnancy with twins.

A doctor at the hospital diagnosed Nusslock with Previable Premature Pre-labor Rupture of Membranes (Previable PPROM) and confirmed that her twins would not survive, the suit alleges. According to state prosecutors, the hospital’s medical staff refused to treat her, citing a policy that prohibits them from providing such emergency care as long as either of her twins had a “detectable heartbeat.”

Instead of helping her, the suit alleges that St. Joseph Hospital discharged a still-hemorrhaging Nusslock with instructions to drive herself to Mad River Community Hospital. “On the way out the door, Providence handed Nusslock a bucket and towels ‘in case something happens in the car,’” the AG’s Office said in a news release.

In filing its demurrers this week, St. Joseph Hospital’s attorneys contend that this dispute should properly be handled by the California Department of Public Health [CDPH], not the courts. The dismissal request argues that Attorney General Rob Bonta’s office is improperly trying to usurp that department’s authority over alleged violations of the state’s Emergency Services Law.

Secondly, the hospital’s attorneys argue that the complaint cites an irrelevant section of California Health and Safety Code, one that places limits on the transfer of emergency room patients for non-medical reasons, whereas the state’s complaint itself “alleges that [Nusslock’s] transfer was for medical reasons.”

The attorneys also dispute the state’s discrimination claim, saying the Catholic hospital’s alleged “faith-based limitation on certain procedures … does not constitute intentional discrimination against any protected group.” In other words, they argue that the complaint fails to allege discrimination against a protected class (women, presumably); instead, it merely alleges that the hospital “did not provide a specific procedure because of the nature of that procedure,” which isn’t relevant to the Unruh Civil Rights Act.

The hospital’s filing goes on to challenge the case on other procedural and jurisdictional grounds but ultimately returns to the matter of religious liberty, saying Bonta’s office cannot use certain state laws “to penalize a Catholic hospital for applying faith-based policies and procedures.”

The filing further argues that the injunction requested by Bonta’s office, which seeks a court order guaranteeing that patients receive prompt emergency medical care including abortion care, unjustly asks care providers to violate their sincerely held religious beliefs.

“SJH could not comply with such an order without forsaking its Catholic identity — the ultimate burden in a religious freedom case,” the filing says, later adding, “There is universal agreement among courts, legislators, and regulators that the conscience rights of health care providers must be respected.”

In a statement released to news outlets earlier this week, Providence said this:

Our motion raises several procedural legal arguments for dismissal while also affirming both our Catholic identity and our commitment to providing safe, high-quality emergency care for pregnant patients in accordance with state and federal law. Our commitment to both the health of our community and our faith-based tradition remains unwavering.

We have served as a vital safety net in Humboldt County since the Sisters of St. Joseph of Orange founded the ministry more than 100 years ago, and we remain deeply committed to continuing to be here for patients when they need us most. As part of that commitment, we are providing additional training and education to our OB and Emergency Department medical staff and caregivers to support them in the delivery of safe, high-quality emergency care for pregnant patients in the context of our Catholic identity and the requirements of state and federal law. 

With the closure of Mad River Community Hospital’s Birth Center in October, St. Joseph Hospital is now Humboldt County’s only licensed medical facility offering labor and delivery services. Earlier this month, attorneys representing a second plaintiff filed a new lawsuit with very similar allegations, accusing St. Joseph Hospital of denying emergency abortion care to a woman in 2022 due to its religious prohibition on giving such care when there’s a detectable fetal heartbeat.

The Outpost reached out to civil rights organizations, attorneys and medical professionals for input on this latest filing but has yet to hear back from most of them (understandable, given the holidays). We will continue to follow this case. 

The next hearing date is scheduled for Jan. 27, 2025, at 10:30 a.m. in Courtroom 4 of the Humboldt County Courthouse.

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DOCUMENT: Defendant St. Joseph Health Northern California, LLC’s Notice of Demurrers and Demurrers to Complaint