One morning in November 2010, an ambulance brought a woman who was 15 weeks pregnant to the emergency room at Sierra Vista Regional Health Center, 70 miles outside Tucson, Arizona. She had been carrying twins and had miscarried one at home in the bathtub. The chances of the second fetus making it were ‘minuscule,’ Dr. Robert Holder, the OB-GYN on call that day, later recalled in an affidavit [1]. He told the woman and her husband that trying to continue the pregnancy would put her at risk of severe bleeding and infection. In short, she needed an emergency abortion.

But there was a problem: Sierra Vista was in the midst of a trial merger with a Catholic hospital company, Carondelet Health Network, which required its doctors to abide by the church’s ethical and religious directives. Hospital administrators told Holder that because the surviving fetus still had a heartbeat, he could not perform an abortion. Holder had to send the patient to a hospital in Tucson-a three-hour delay that he believed put her at risk for life-threatening complications.

The doctors at Sierra Vista aren’t the only ones to struggle with submitting their medical decisions to a higher authority. A growing number of patients […]