Letters & Op-Eds 2015

Catholics for Choice, A Prescription for Discrimination: Catholic Healthcare and the Ethical and Religious Directives

Do you want the Catholic bishops controlling what kind of birth control you use or telling you what medical procedures you can have?

I daresay no one does, but this is exactly what’s happening at Catholic hospitals and other healthcare facilities across the United States. Catholic health systems are already the nation’s largest group of not-for-profit healthcare providers. One in 6 six patients in the US is cared for in a Catholic hospital and, as a result of mergers, the number and reach of Catholic facilities has increased in the last decade.

It is frightening to imagine needing an abortion due to a life-threatening condition, and being denied the care you need because it is against the Catholic hospital’s policy. Similarly, it is infuriating to imagine choosing to have a tubal ligation after a Caesarian delivery, as your doctor recommends, yet be told you cannot have the procedure because of hospital policy. While Catholic hospitals purport “to assure that the right of each person to basic health care is respected” the reality is in the cases of reproductive healthcare, concern with the welfare or conscience of the individual patient is overridden by policy written by the Catholic bishops.

Having consistently failed to convince Catholics to follow its lead in opposing abortion and modern methods of family planning, the United States Conference of Catholic Bishops (USCCB), seeks instead to impose its dangerous and out-of-touch beliefs about reproductive health by other means. The bishops created a set of guidelines, the Ethical and Religious Directives for Catholic Health Care Services (the Directives), which prevent the nation’s 600+ Catholic hospitals from offering much basic reproductive healthcare. Banned services under the Directives include female and male sterilization, most methods of assisted reproduction, modern forms of contraception, as well as abortion—even if medically necessary.

As nonprofit institutions, Catholic hospitals benefit from significant amounts of public funding, including state and federal grants for Title X family planning programs, Medicare and Medicaid. In 2011, they received $115 billion from Medicare and Medicaid—and these programs are not even their only source of government funding. Despite relying heavily on taxpayers’ dollars, however, Catholic hospitals routinely deny basic reproductive health services.

Rather than acknowledging that Catholic hospitals should provide patients with care that meets established medical standards, the US bishops are utilizing Catholic institutions as a space to enforce rules that Catholics have consistently opposed.

Following the revision in 2001, there are now a total of 72 Directives, which forbid Catholic facilities from providing various reproductive healthcare procedures, regardless of the religious beliefs of the patient or those of the medical professional providing them.

Under the Directives, women who find themselves at a Catholic hospital will have:

  • No access to abortion—even in cases of rape or incest (Directive 45)
  • No access to in vitro fertilization (Directives 37, 38, 39)
  • No access to contraception (Directive 52)
  • No treatment for ectopic pregnancy (Directive 48) and
  • No respect for their advance medical directives (Directive 24).

These Directives claim to guide Catholic health facilities to “provide authoritative guidance on certain moral issues that face Catholic health care.” In practice, they are a meager justification for the Catholic hierarchy to secure financial interests in the health field while denying the basic conscience rights of patients and doctors.

It’s time someone took them to task. Thankfully, the American Civil Liberties Union (ACLU) is doing just that.

The ACLU recently announced a lawsuit against Trinity Health, one of the largest Catholic health systems in the nation with over 80 facilities in 21 states. The ACLU submits that because of the Ethical and Religious Directives,

“hospitals within the Trinity Health system have repeatedly and systematically failed to provide women suffering pregnancy complications— including at least one of Plaintiffs’ members—with the emergency care required by Emergency Medical Treatment and Active Labor Act (EMTALA) and the Rehabilitation Act. In fact, in the span of one year, a public health educator found that at just one of Defendants’ hospitals alone, several women suffering pregnancy complications were denied the care they needed and to which they were entitled under federal law. As a result, pregnant women seeking emergency care at Defendants’ hospitals— including at least one of Plaintiffs’ members—have become septic, experienced hemorrhaging, contracted life-threatening infections, and/or unnecessarily suffered severe pain for several days at a time.”

Frankly, the law is clear. It’s also based on common sense and good ethics. Hospital policy should never trump the needs, rights or conscience of an individual or ignore the consciences of the doctors who want to care for their patients according to their medical expertise. Catholic hospitals in the US are part of a pluralistic society and have a moral obligation to respect the religious beliefs and denominations of all those whom they treat and employ, whether Catholic or not Catholic. Likewise, they receive taxpayer dollars and thus should serve the public’s interest.

Ultimately, when the bishops stop writing prescriptions for both individuals’ consciences and their medical care all of us will benefit. The ACLU’s case against Trinity Health is welcome medicine for patients simply seeking to obtain the healthcare they deserve.

As the Affordable Care Act, Medicaid expansion and other initiatives enable access to more comprehensive healthcare for many more people, it is incumbent upon us to ensure that the delivery and quality of health services are not compromised by the bishops and their political allies. Likewise, it is imperative that healthcare continue to be centered on patients’ needs and rights, not the bottom line of a healthcare colossus.

This post originally appeared in Hamilton and Griffin on Rights.

Catholics for Choice