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Humboldt County Superior Court Judge Timothy Canning this week rejected a motion from attorneys for St. Joseph Health Northern California asking him to dismiss a state lawsuit that accuses Providence St. Joseph Hospital in Eureka of denying medically necessary emergency abortion care due to its religion-based policies.

Attorneys for the hospital, which is owned and operated by the Catholic not-for-profit organization Providence Health & Services, filed a demurrer (a legal term meaning a request to dismiss the charges), arguing that the state had failed to allege facts sufficient to justify a cause of action. They claimed that the matter should be investigated by the California Department of Public Health (CDPH) before coming to court, and that the Free Exercise Clause of the First Amendment protects care providers at Catholic hospitals.

In his ruling, filed Monday, Canning rejected those arguments, allowing the case to proceed.

To briefly recap the facts, the office of California Attorney General Rob Bonta sued St. Joseph Health Northern California last September, alleging that hospital staff violated multiple California laws through their refusal to provide emergency abortion care to people experiencing obstetric emergencies.

Specifically, the suit accuses the Catholic health care organization of violating California’s Emergency Services Law (ESL), the Unruh Civil Rights Act and the Unfair Competition Law by refusing to provide medically necessary abortion services to Anna Nusslock, a Eureka chiropractor. 

The complaint says Nusslock was 15 weeks pregnant with twins when the amniotic sac for one twin broke prematurely. After arriving at St. Joseph Hospital’s emergency room, per her doctor’s direction, a doctor determined that the twins could not survive and that an abortion was necessary to save Nusslock’s life. 

One of the twins still had a fetal heartbeat, however, and due to Providence’s religious prohibition on performing “elective” abortions, the complaint says, the emergency room doctors refused to perform the procedure until either the heartbeat stopped altogether or there was a more immediate threat to Nusslock’s life.

The complaint further alleges that hospital staff told her she could either take a medical transport flight to San Francisco, at great personal expense, or her husband could drive her to Mad River Community Hospital, 20 miles north. She chose the latter option, and staff at Providence St. Joseph Hospital provided her with a bucket and towels to wipe up blood on the drive, according to the complaint.

Canning rejected the defense attorneys’ argument that the case should first be investigated by CDHP, saying the state’s Emergency Services Law expressly authorizes the Attorney General and anyone harmed by violations of that law to bring civil actions, such as this lawsuit.

Providence’s attorneys also argued that Nusslock was transferred to Mad River Community Hospital for medical reasons, which would negate the state’s argument that hospital staff violated ESL provisions regarding non-medical transfers. Canning disagreed, finding that the state offered “sufficient factual allegations to support a claim of a non-medical transfer.”

“The allegations in the complaint reflect the only reason that the emergency services were not performed by Providence’s emergency room physicians was because of Providence’s faith-based policies,” Canning’s ruling states.

As for the allegation that Providence violated the Unruh Civil Rights Act by denying Nusslock full and equal care because she was pregnant, Providence’s attorneys argued that its actions were motivated by “neutral religious directives” rather than Nusslock’s medical condition or sex. Canning dismissed that defense, as well.

Providence’s lawyers also sought to stand behind federal “conscience clause” legislation, which prohibits making the acceptance of federal funds conditional upon whether or not a facility performs abortion procedures. Canning found that this matter was not relevant in the case.

Lastly, Canning’s ruling tackles the constitutional question of free exercise of religion. Providence’s attorneys argued that the ESL interferes with that right by forcing its employees to perform procedures that contravene the tenets of the organization’s religion-based policies, as laid out in the Catholic Ethical and Religious Directives.

Legal precedent (Fellowship of Christian Athletes v. San Jose Unified School District Board of Education) says any law that burdens religious exercise must be both neutral and generally applicable. Canning found that the ESL complies with that requirement. He writes, “[A]llowing a hospital that is fully able to care for a patient to choose not to do so due to its religious doctrine would undermine the purposes of the ESL.”

That state law serves a specific and compelling government interest, Canning says: “to provide a comprehensive and high quality system of emergency medical services for the protection of the health and safety of Californians.”

None of the findings in this ruling prevent Providence from mounting these same arguments as the case proceeds. Rather, Canning rejected them as a basis for dismissing the suit ahead of trial. 

In a statement issued Thursday, Bonta applauded the decision.

“There was no legal basis to dismiss our lawsuit against Providence, and we are grateful that the court agreed with us on every ground,” he said. “California is committed to protecting reproductive rights and let me be clear: that includes emergency abortion care. … Denying emergency abortion care to pregnant patients who need it is both traumatic and unlawful under multiple laws. My team and I look forward to seeing this case through and holding Providence accountable.”  

The Outpost reached out to Providence seeking a comment on the ruling but did not immediately hear back. We’ll update this post if and when we do.

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UPDATE, 1 p.m.: 

Shortly after this post was published, a Providence spokesperson sent along the following statement:

Serving the residents of Humboldt County is a privilege we don’t take for granted. That’s why we are deeply committed to providing high-quality, compassionate care, just as we have been for more than 100 years. 

We strongly disagree with the California Attorney General’s allegations against Providence St. Joseph Hospital Eureka. The denial issued by the judge simply means that the Attorney General may proceed with litigating their allegations as originally filed. The denial is not a judgment that Providence has been found liable for any of the Attorney General’s allegations. We are deeply committed to delivering care in accordance with federal and state law. This includes providing life-saving medical interventions that may indirectly result in fetal death.  

As a Catholic health care organization, we are transparent that we do not perform elective abortions. However, in emergencies, our care teams provide medically necessary interventions to protect pregnant patients who are miscarrying or facing serious life-threatening conditions. 

This is consistent with the California Emergency Services Law and the Emergency Medical Treatment and Labor Act. It is also consistent with the Catholic Ethical and Religious Directives, which include discussion of the importance of the physician-patient relationship as well as the circumstances in which certain medical procedures that could result in fetal death may be allowed in a Catholic hospital. 

As part of this commitment, we recently enhanced our training, education and escalation protocols to further ensure the best possible care. 

We take our responsibility as a vital safety net incredibly seriously and are committed to continuing to meet the needs of our community, just as the Sisters of St. Joseph of Orange did when they established health care in the region more than a century ago.

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DOCUMENT: Ruling on Defendant’s Demurrer to Complaint

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