Humboldt Judge Weighs Faith, Law, and Patient Safety in St. Joseph Case

Providence St. Joseph Hospital in Eureka [Photo by Ryan Hutson]

The case positions Humboldt County at the center of a legal showdown involving the First Amendment rights of Catholic hospitals vs emergency health care needs of CA citizens – a legal fight that could change the state’s expectations for rural, Catholic-run for-profit healthcare. Humboldt County residents also lose confidence in the only remaining acute care labor and delivery unit in the county.

The hearing centered on whether the court should modify or entirely dissolve an earlier court-approved agreement that directed doctors at St Joes to provide abortions when the treating physician concluded a pregnant patient’s health is at serious risk. Rather than dissolve the agreement entirely, Judge Canning ruled in favor of the defendant, directing the AG’s office to schedule a preliminary injunction hearing within 90 days – effectively giving St. Joes another opportunity to ‘have their day in court’ while also reaffirming that the agreement signed last October will remain “in full force and effect” in the meantime. 

The case originated from Providence’s refusal to provide an emergency abortion to Anna* Nusslock as she suffered a traumatic miscarriage of twins in 2024, the case now proceeds to a Preliminary Injunction hearing and potentially a trial. In the meantime, the hospital is bound to a stipulation and order that was originally intended to preclude full trial proceedings, while safeguarding the public’s right to access emergency reproductive care if needed, according to the AG’s lawyers.

Now, Providence has won the ability to offer additional arguments against the AG’s request – including their First Amendment Right to freedom of religion – when the case moves forward with a preliminary injunction hearing in order to hear the full scope of arguments from both sides. Two lawyers for the Attorney General’s office appeared in person for the hearing, Martine D’Agostino and David Houska. On behalf of St Joseph Health LLC, the Los Angeles based law firm Manatt, Phelps & Phillips LLP sent both Harvey Rochman and Barry Landsberg.

People VS St. Joes – The Reboot!

The hearing opened with a minor outburst from someone in the courtroom gallery after a court reporter asked the judge if a mother with a young baby – who was making quintessential baby sounds in the audience – to leave the courtroom in order to remove distracting noises. In response to the audience member who loudly objected, “NO”, Judge Timothy Canning immediately addressed the interruption, noting that there would be no debate and advising that members of the audience could watch the hearing via zoom from the hallway, but did not ask the mother to exit. With that, the hearing proceeded as both sides presented their statements for and against altering or entirely doing away with the October 29th agreement. 

An art installation in front of Providence St. Joseph Hospital in Eureka memorializes the Sisters of Orange, who are credited with founding the health ministry. [Photo by Ryan Hutson]

In opposition, Providence’s Rochman argued that the court should change the agreement, citing the recently introduced statement by Bishop Robert Vasa, of the Santa Rosa Diocese. Asking the court to “modify or dissolve” the agreement in consideration of Vasa’s opinion, St. Joes writes, “The record clearly shows a material change in the facts in that Bishop Vasa, the diocesan bishop with the specific authority in the Catholic faith to determine compliance with the ERDs in the Diocese of Santa Rosa, reviewed the Stipulation after it was entered and determined that the Stipulation violates the ERDs and must be modified.” 

Arguing that the Hospital is first and foremost bound by Catholic religious canon cannons as well as by California State law, Rochman asserted that the agreement failed to include the Catholic “Ethical and Religious Directives” (ERD’s) by which the hospital group and its contracted healthcare staff are bound by, and was therefore not acceptable. Providence also argued that the agreement oversteps California Law by asking more of the hospital than the legal requirement according to their interpretation of California’s Emergency Services Law (ESL). 

The AG’s counsel denied that the stipulation was flawed, stating that the agreement reflects the spirit and the expectations of the ESL, adding that private parties enter into contracts all the time that require they do more than the legal minimum, suggesting that this agreement is no different. 

Lobbying for another chance at bat, or to have the matter undone entirely, counsel for St. Joes told the court that the AG’s office “seeks to order the hospital to perform abortions,” and in so doing, violates its religious freedoms as a Catholic institution. Rochman told the court that not only was the agreement poorly executed, but that it effectively circumvented the court’s intended system, and effectively violated the hospital’s right to due process. In the courtroom, and in their motion to modify the court’s orders, Rochman asserts that it should not be a doctor who decides if an abortion is necessary, but instead, should be determined by the ethics rules outlined in the Catholic ERDs. Rochman asserted to the court that the AG has attempted to “weaponize” the ESL “into an abortion rights law that can be used against Catholic hospitals.”. In court, he accused the AG’s office of infringing on the hospital’s due process, by asking the court to reaffirm and enforce the 2024 agreement.  

At one point, Rochman’s comments were met with immediate groans and scoffs from the gallery in response to D’Agostino’s assertion that without St. Joseph’s acute care and labor and delivery room emergency services reliably available that there would be nowhere else locally to go for Humboldt families. When Rochman suggested that Mad River Hospital could “find funding” for their labor and delivery services rather than St. Joseph’s Hospital being expected to cover its shortcomings in that area of care, several members of the audience reacted causing the judge to interject, saying any further outbursts or rancor from the audience and he would clear the courtroom. 

Attorneys Landberg and Rochman (left) and D’Agostino (Houska not shown, right) make their case to Judge Canning, with a nearly full house of observers in the gallery behind them. [Photo by Ryan Hutson]

While Rochman asserted that the Hospital’s religious freedoms were violated, Judge Canning asked the Attorney General’s office why they had not followed through with setting the preliminary injunction hearing before. Attorney D’Agostino explained that the State took St. Joseph at its word, and having had an agreement and court order in place, that the AG’s office saw no need for continuing the litigation against the hospital.

Reiterating that St. Joes’ legal team had filed several declarations asserting opinions and ethical quandaries related to oversight from the Catholic Church, including that of Bishop Vasa, the state objected across the board, citing hearsay, relevance, and also disputed the timing and the way these points were raised, after the agreement was already on record.  

The state objected to the hospital’s reliance on Bishop Vasa’s statement, calling it hearsay and irrelevant since it was raised after the agreement was entered.  Still, the hospital group lobbied for their position that, as Rochman told the court, this was “a freedom of religion issue.” 

Although he insisted that the hospital does provide emergency care in line with the ESL, Rochman asserted that deciding what is or isn’t emergency care, according to the Catholic ERDs, “cant” be left “up to the decision of the doctor” in a situation where a pregnancy was in crisis.

Lead Attorney Harvey Rochman for St. Joseph Health glances back at the press seated in the front row as the proceedings come to a close. [Photos by Ryan Hutson]

Looking at the ERD’s cited by the hospital’s counsel, it reads, “Abortion… is never permitted.”  The hospital also contended that the Emergency Services Law does not specifically require abortion as emergency health care and that Nusslock’s life was not immediately at risk.

The Attorney General’s team also addressed the medical facts of Anna  Nusslock’s case being disputed by the Hospital, noting that by the time she arrived at Mad River Hospital, she was “hemorrhaging at an alarming rate,” in stark contrast to St. Joes’ characterization that she was “stable” when she was assessed at St. Joes in Eureka. As Canning weighed the arguments silently, D’Agostino asserted, “if the court agrees” with St. Joes’ motion to modify or to dissolve the agreement, it “will leave women of Humboldt without a Labor & Delivery unit” that respects CA’s Emergency Services Laws. 

Judge Splits the Baby

The Judge questioned both sides, asking whether the stipulation lacked an end date, and whether there had been any factual changes that would justify modifying the agreement. D’Agustino confirmed that it was the AG’s intent to have the stipulated agreement be enforceable even after a trial. The state also objected that the hospital’s attempt to incorporate religious directives now—after voluntarily entering the stipulation—does not provide legal grounds for modification. “There is no fraud, no mistake of fact, and no change in circumstance,” D’Agostino for the Attorney General’s office said, adding that “the stipulation is enforceable as written.” 

“People are entitled to the benefit of their agreement,” D’Agustino said, emphasizing that the original order was designed to ensure patients in Humboldt County receive necessary emergency care, adding, “even if the People re-file the motion [for preliminary injunction], it will put Humboldt women in danger.” In response, Rochman reassured the court that St. Joes has, and would continue to abide by the law, and by the agreement despite their contention that it was adverse to their religious freedom – but reiterated that the hospital wanted an opportunity to address the “constitutional issue at hand” in the future. 

The Hon. Judge Timothy Canning, asking a question during the proceedings. [Photo by Ryan Hutson]

As to cooperation from the other side, D’Agostino said that despite AG’s attempts to gain compliance from St. Joes’ legal team with the required discovery process, having made formal requests for information and documents in April, the AG claimed they were “rebuffed” in those efforts. With that feedback, Judge Canning instructed the parties to resolve ongoing discovery disputes prior to the next hearing. 

The AG’s case against the hospital – stemming from the experience of Anna Nusslock – is putting a magnifying glass on the balance between religious liberty and personal healthcare rights, as rural healthcare access and patient safety in Northern California hospitals takes center stage. 

The unfolding legal battle could have broad implications for one of the largest not-for-profit Catholic run hospital groups in the nation, as Providence angles for a First Amendment freedom of religion claim that, according to the California AG, puts a religious belief system above the immediate healthcare needs of California’s families.

Note: This article has been updated to correct the spelling of Ms. Nusslock’s first name.