When Harmonie Perrone arrived at her local hospital, she already knew what was wrong. A 28-year-old with a history of ectopic pregnancies, including one that had ruptured and led to her losing a fallopian tube, she recognized the symptoms immediately. She knew the standard treatment was methotrexate, and she knew that in ectopic cases every minute counts.
In a normal pregnancy, the fertilized egg travels to the uterus and implants there. In an ectopic pregnancy, it implants somewhere else – most often in a fallopian tube. That tube cannot stretch to accommodate a growing embryo, so without treatment, it will rupture, causing internal bleeding that can be fatal. There is no procedure that can move the embryo to the uterus or allow it to develop. An ectopic pregnancy can never result in a live birth. The only options are methotrexate, a drug that stops cell division, or surgery to remove the pregnancy.
Ectopic pregnancies affect roughly one in 50 pregnancies in the US and are a leading cause of death in the first trimester.
Perrone explained her situation. Tests confirmed it. The hospital told her to come back again the next day.
The following morning, Perrone alleges, the on-call OB/GYN she saw declined to treat her. According to a lawsuit she has since filed with the ACLU of Illinois, that doctor, Dympna Coll, told her: "There is a 1% chance that there is a baby in there. I cannot, in good faith, intervene at this time." Perrone was sent away, first to a nearby faith-affiliated clinic that couldn't help. That clinic directed her to another nearby hospital, which did not provide OB/GYN care. She and her husband then travelled 30 more minutes to Northwestern Medicine Huntley, where she received the drug a day-and-a-half after her symptoms began.
Unfortunately by then, it was too late to save her remaining fallopian tube. If she wants to have children, Perrone will need to have IVF treatment. Dr. Coll, who alleges that she did offer options to assist with the ectopic pregnancy, has since filed a defamation lawsuit against Perrone for the TikTok videos she posted describing her experience.
When Conscience and Emergency Care Overlap
This case has drawn national attention for good reason. It sits at one of the most contested intersections in American law: the right of healthcare providers to act on religious conscience, and the duty of those same providers to stabilize patients in emergencies.
Advocate Good Shepherd, where the first interaction took place, is a faith-based hospital with policies on abortion similar to many religiously affiliated health systems across the country. Those policies generally prohibit abortion unless a patient's life is in immediate danger, an approach rooted in the belief that life begins at conception and must be protected from that moment forward. Defenders of religious healthcare argue that institutions like this are expressions of faith in action, founded specifically to bring a spiritual dimension to healing. Compelling a faith-based provider to perform any abortion-adjacent procedure, even in ambiguous circumstances, pits the institution's convictions against the state.
On the other side stands Illinois law, which explicitly names ectopic pregnancy as an acute medical condition requiring emergency stabilization. It also requires that when a provider objects on conscience grounds, they must refer the patient to someone who can help. Perrone's legal team argues neither obligation was met.
A Question Older Than This Lawsuit
The tension here is not new. Religious institutions have shaped American healthcare for centuries. The Catholic Church, in particular, has tremendous control over healthcare in the country. Today, roughly one in six U.S. patients receives care at a Catholic hospital, a share that rises sharply in rural areas where faith-based systems are often the only option available. As these religiously-rooted health systems have grown, the question of what happens when their theological commitments conflict with a patient's immediate needs has become impossible to sidestep.
Advocate Good Shepherd Hospital is affiliated with the Evangelical Lutheran Church of America and the United Church of Christ.
Scripture across traditions holds healing as sacred work. Most religious health systems would say, sincerely, that they are doing exactly that, upholding a vision of the sanctity of life that includes the unborn. The counter-argument is that sanctity of life must extend to the person already alive and standing in the emergency room. Neither position is easy to dismiss.
Those two convictions are not easily reconciled, and no one lawsuit will totally settle the argument. What courts will be asked to decide is a narrower but still urgent question: when a patient presents with a documented emergency and a provider declines to treat on religious grounds, what obligation does that provider bear to ensure the patient reaches someone who will? ULC ministers have wrestled with what it means when doctors weigh their faith against patient care, and whether medical refusals on religious grounds hold up under scrutiny. The Perrone case brings those questions into a very specific emergency room, but the decision rendered could have wider consequences for the future of care.
Where do you stand? When a religious health care provider says they cannot provide emergency treatment without violating their beliefs, what obligation do they have to the patient in front of them?
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