A Michigan woman is suing the U.S. Conference of Catholic Bishops (USCCB), claiming the bishops’ anti-choice directives are negligently affecting the medical care delivered at Catholic-owned and -sponsored hospitals.

Filed by the American Civil Liberties Union (ACLU), the lawsuit, believed to be the first of its kind, argues that patients’ lives are put at risk by unnecessarily denying pregnant women in crisis proper medical care.

In 2010, a then-18 weeks pregnant Tamesha Means showed up at Mercy Health Partners in Muskegon, Michigan, in the middle of having a miscarriage. Her water had broken and she was experiencing severe cramping. Mercy Health, a Catholic-sponsored facility, told Means there was nothing it could do for her and sent her home. Means came back the next day, this time in more pain and bleeding and was again told the course of action was to wait and see.

It wasn’t until Means, a mother of three, returned to Mercy Health a third time, this time suffering from a significant infection as her miscarriage persisted untreated. In response, the hospital gave Means some aspirin to treat her fever and prepared to send her home. Before the hospital discharged Means for a third time, she started to deliver. It wasn’t until then that the hospital decided to admit Means and to treat her condition. Means eventually delivered a baby who died within hours of birth.

Mercy Health is required to adhere to the “Ethical and Religious Directives,” a set of rules created by the USCCB that govern the delivery of medical care at Catholic-run hospitals. The directives prohibit a pre-viability pregnancy termination, even in cases when there is little or no chance that the fetus will survive, and the life or health of a patient is at risk. The rules also direct health-care providers not to inform patients about alternatives inconsistent with the directives, even when those alternatives are the best option for the patient’s health.

According to the ACLU, that is exactly what happened to Means at Mercy Health, where attorneys claim the directives are put above medical standards of care. According to the complaint, at no point in the three times Means showed up at the hospital did anyone tell her that she had little chance of a successful pregnancy. The ACLU also alleges that the hospital, as a direct result of the bishops’ directives, failed to tell Means that her health and life were at risk if she tried to continue the pregnancy, and that the safest course of care for her was to end it. “They never offered me any options,” said Means in a statement. “They didn’t tell me what was happening to my body. Whatever was going on with me, they discussed it amongst themselves. I was just left to wonder, ‘What’s going to happen to me?'”

The lawsuit alleges that because she received neither the information nor the care appropriate for her condition, Means was unable to direct her course of treatment, and suffered unnecessarily. “A pregnant woman who goes to the hospital seeking medical care has the right to expect that the hospital’s first priority will be to provide her appropriate care,” ACLU Deputy Legal Director Louise Melling said in a press call. “Medical decisions should not be hamstrung by religious directives.”

According to the ACLU, Means’ story is not unique. In support of their complaint, attorneys representing Means point to research showing that other patients have been denied information and appropriate care at hospitals bound by the bishops’ directives. “The best interests of the patient must always come first, and this fundamental ethic is central to the medical profession,” Kary Moss, executive director of the ACLU of Michigan, said on the call. “In this case, a young woman in a crisis situation was put at risk because religious directives were allowed to interfere with her medical care. Patients should not be forced to suffer because of a hospital’s religious affiliation.”

But, according to the ACLU, patient care does suffer, significantly. The group’s research shows that over half of OB-GYNs working in Catholic-sponsored hospitals have run into conflicts with the directives. In one example, a doctor describes a miscarrying patient who was gravely ill and who was carrying a fetus that had no chance of surviving. Even though this patient had sepsis and a 106-degree fever, the hospital’s policy would not allow the doctor to treat the patient by terminating the pregnancy until the fetal heartbeat ceased on its own. In another example cited by the ACLU, a cardiologist was reprimanded for telling a patient with signs of a potentially fatal condition that if it worsened, the American College of Cardiology and the American Heart Association would recommend terminating the pregnancy in order to save her life.

Because this lawsuit is believed to be the first of its kind, there are a lot of unanswered questions, like whether or not the bishops can be sued for negligence in this way, and the effect, if any, a ruling on the issue would have for other Catholic-owned and -sponsored hospitals.

More importantly, though, the lawsuit forces a look at the question of what role, if any, religious doctrine should play in the delivery of medical care. And it does so in the venue of negligence and malpractice claims, which is far more patient-centered than any intellectualized debate about medical ethics, religious faith, and the First Amendment. Notably, Means’ attorneys don’t claim that her constitutional rights were infringed on in any way. Instead, they argue the bishops are negligent in putting forward directives they know will endanger patients’ health and conflict with professional standards of care. In some ways, it’s a much more straightforward claim to make, and one that, presuming the lawsuit is allowed to move ahead, will require the bishops to defend the directives on the merits and against claims they violate the standard of care for pregnant patients. With Catholic-owned or -sponsored institutions making up a significant percentage of health-care providers in this country, these are questions that need answers.