Catholic health systems, healthcare — March 5, 2015 at 12:15 pm

If your hospital prioritizes religious doctrine over medical standards, your health could be at risk


Catholic health systems aren’t always held to the same medical standards as secular hospitals.

This is the third post in an ongoing series. You can read the other installments HERE.

When you go to a hospital, you have a reasonable expectation that you’ll receive the care you need — whoever you are, whatever your circumstances. After all, there’s a reason there are medical protocols in hospitals. If you’re having a stroke, for example, there are guidelines that tell doctors how quickly they need to act for certain procedures to be effective.

If you find yourself in a Catholic hospital, however, your providers may not be following the same guidelines as those at a secular hospital. In some cases, they’re absolutely not playing by the same rules as non-religious hospitals.

That’s why the expanding reach of Catholic health systems is so troubling. Across the country, entire communities are finding themselves with no option for care other than a Catholic health system — a system that answers first not to medical standards, but to religious doctrine.

As I wrote in previous posts in this series (and this one in particular provides crucial context), Catholic health systems are governed by the Ethical and Religious Directives for Catholic Health Care Services (“the Directives”). The Directives are handed down by the U.S. Conference of Catholic Bishops, not licensed medical professionals.

In some instances, such as abortion, emergency contraception and sterilization, the Directives are clear. Those services will not be performed. The problem is, you may not know that until you’re at the hospital and need that care — possibly in an emergency, a scenario that’s becoming all too common for women having a miscarriage.

In other cases, the directives aren’t so clear. And that’s perhaps even more troubling.
There’s far too much opportunity for a Catholic provider to decide that the care you need — or the life you lead — might not be in keeping with Catholic doctrine. That opens the door for discrimination and refusal to treat patients based on an alarmingly broad range of principles.

When Catholic hospitals are allowed to make care decisions based on religious doctrine, it creates a double standard. One set of medical standards for secular hospitals, and another standard for hospitals affiliated with Catholic health systems.

Brooke Tucker, staff attorney for the ACLU of Michigan, explains.

Secular hospitals have to adhere to certain safety standards that religious hospitals are exempt from if they say it violates their conscience. How is it fair for secular hospitals to be held to a different standard in order for them to be licensed, in order for them to call themselves a hospital?

To fully appreciate the double standard, I urge you to read this powerful, personal story by Natasha Chart over at RH Reality Check. She had an ectopic pregnancy, which means that the embryo has implanted outside the uterus, usually in the Fallopian tubes. Ectopic pregnancies never result in the birth of a healthy baby but can put the mother’s life at risk if untreated.

Fortunately, Chart’s ectopic pregnancy was discovered at a secular health system, where she received the appropriate medical care. But from past experience, Chart knows what can happen at Catholic-affiliated hospitals. Her post clearly explains the difference it made to receive treatment for her ectopic pregnancy at a hospital where medical care — not religious doctrine — comes first.

… the doctor wasn’t required to tell me lies about the risks of removing that life-threatening pregnancy while I was also freaking out about whether or not I was going to wake up missing bits of me again. The ultrasound tech was allowed to be decent and compassionate toward us, instead of being forced to play us the sound of that doomed heartbeat and describe what few anatomical features she might have seen, even as my husband and I were both crying over what we’d suddenly realized was our loss. The only waiting period they had to be concerned about was the safe time they could operate based on when I’d recently eaten. …

I’m grateful that during this medical emergency, my doctors were allowed to follow only their best judgment about what care would keep me healthiest, according to the most current standards of their profession.

Ectopic pregnancy might seem like a situation where healthcare providers would recognize that there’s no chance of a live birth, yet a very good chance that the mother’s health or life is at risk. But, as reported in Mother Jones, many Catholic hospitals will not end an ectopic pregnancy until the mother’s life is “in mortal danger.” A woman’s Fallopian tubes can burst if the embryo isn’t removed in time, which can have serious, if not fatal, consequences.

But that’s not all. Mother Jones summarized some of the other ways Catholic hospitals restrict medical care.

In many cases, doctors are prohibited from prescribing birth control, and hospital pharmacies won’t sell it. Doctors may even be told not to counsel patients about it. Catholic hospitals have been reluctant to offer emergency contraception to rape victims, and when they do, they first require a pregnancy test to ensure the woman was not pregnant before the assault. The bishops’ guidelines forbid tubal ligations and vasectomies. They also extend to end-of-life care: Catholic hospitals may ignore patients’ requests to be removed from feeding tubes or life support, even if those wishes are expressed in living wills. And many states allow religious hospitals to discriminate against gays and lesbians, both as employees and as patients.

In Michigan, the Elliott-Larsen Civil Rights Act — which prohibits discrimination in the workplace, housing market and places of public accommodation — does not include protections for the LGBT community. That makes it perfectly legal for Catholic healthcare providers, or any provider for that matter, to discriminate against members of the LGBT community.

What’s more, the Directives are alarmingly vague, opening the door for providers to make decisions based on “Catholic principles,” which can be subject to interpretation. This lack of clarity could mean the wishes of patients and their families might be overruled by a healthcare provider or even an administrator with no education in medical care.

The Directives state that, “The free and informed health care decision of the person … is to be followed so long as it does not contradict Catholic principles.”

But who decides what those principles are, and when to apply them, especially in a medical emergency when every second can make a life-or-death difference?

Will patients’ requests to be kept off life support be honored, or will a Catholic provider decide that the action violates Catholic principles? Will members of the LGBT community be treated with the same standard of care as any other patient? Does a same-sex partner with a legal document authorizing him or her to make medical decisions have to fight the hospital’s administration to retain those rights?

These are questions no one can answer — in some cases, doctors have complained that they don’t always know how the religious Directives of hospitals where they practice will impact their care decisions.

In Michigan, there is no law to protect the LGBT community and, if the current Legislature has its way, laws enshrining discrimination based on “religious freedom” will make it even easier for Catholic-affiliated hospitals to refuse treatment on religious grounds — not just for the LGBT community but for anyone they object to on moral or religious grounds. (Watch for details on the related impact of legislation on medical care in an upcoming post.)

The clearly stated Directives that oppose abortion, birth control and sterilization are alarming enough. But the vague Directives that could open the floodgates for discrimination against patients and the refusal to provide appropriate care are even more troubling.

When a patient goes to a hospital for care, there should be no question that he or she will receive care based on medical standards. At Catholic-affiliated hospitals, there simply is no such guarantee.

Have you ever been refused care at a Catholic health system on religious grounds? Do you have concerns about the expansion of Catholic-affiliated hospitals across Michigan, including a proposed merger with Rochester’s independent Crittenton Hospital? If so, please contact Brooke Tucker at the ACLU of Michigan.

[CC photo credit: Alex Proimos via Wikimedia Commons]