MISCARRIAGE OF MEDICINE:
The Growth of Catholic Hospitals and the Threat to Reproductive Health Care

Written by: Lois Uttley and Sheila Reynertson of the MergerWatch Project, and Lorraine Kenny and Louise Melling of the American Civil Liberties Union

INTRODUCTION
All across the country, an ever-increasing number of acute-care hospitals are Catholic- sponsored or are affiliated with a Catholic health system, with one in nine beds now in one of these facilities. Many of the largest health care systems in the country are Catholic-sponsored and they are expanding rapidly, in part by acquiring non-Catholic hospitals. In some states, such as Washington, one quarter or more of the hospitals are Catholic-sponsored or -affiliated, and entire geographic regions have no other choice for hospital care.

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Catholic Restrictions and the Risk to Patient Health
When it comes to reproductive health care, religious doctrine can override medical standards of care or patient wishes at Catholic-sponsored facilities. These hospitals are governed by the Ethical and Religious Directives for Catholic Health Care Services (the Directives), which are issued by the U.S. Conference of Catholic Bishops and enforced by local bishops. The Catholic Directives prohibit a range of reproductive health services, including contraception, sterilization, many infertility treatments, and abortion, even when a woman’s health or life is threatened by a pregnancy.

For example, the Directives state plainly:

• “Catholic health institutions may not promote or condone contraceptive practices.”

• “Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted.”

• “Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution.”

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

• “Prenatal diagnosis is not permitted when undertaken with the intention of aborting an unborn child with a serious defect.

• “Heterologous fertilization (that is, any technique used to achieve conception by the use of gametes coming from at least one donor other than the spouses) is prohibited because it is contrary to the covenant of marriage, the unity of the spouses, and the dignity proper to parents and the child.”



Hospital staff and physicians with admitting privileges must comply with the Directives:

• “Catholic health care services must ... require adherence to [the Directives] within the institution as a condition for medical privileges and employment.”

• “Employees of a Catholic health care institution must respect and uphold the religious mission of the institution and adhere to these Directives.”

When non-Catholic hospitals affiliate with Catholic-sponsored hospitals or health systems, they are usually asked to adopt all or some of these religious restrictions. All business partnerships involving Catholic and non-Catholic hospitals are subject to approval by the local bishop.