1. Trinity Mother Frances does not perform direct sterilizations.
2. Medically necessary indirect sterilizations are permitted as provided in the second sentence of ERD #53.
3. Under the second sentence of ERD #53, medical necessity is determined on a case-by-case basis by OB/GYN physicians, duly licensed to practice medicine in Texas, and in consultation with Trinity Mother Frances’ Medical Ethics Committee.
4. Trinity Mother Frances has had ongoing communication on this matter with the representative of the Bishop of the Tyler Diocese since at least July 2008.
5. Most recently, the Provincial Superior of the Sisters of the Holy Family of Nazareth, Trinity Mother Frances’ religious sponsor, has requested a personal meeting with the Bishop.