In 2011, one in ten acute care facilities were associated with the Catholic Church, a number that is growing thanks to an aggressive merger policy — health care is a big industry, and a very profitable one, and religious organisations like to get involved with it every bit as much as other groups do. Investing in hospitals is smart business, and with the overall number of hospitals shrinking, Catholics are capturing a larger market share each year, in some cases being the only acute care facility for tens or hundreds of miles, forcing patients to get emergency care there rather than at a neutral facility.
‘What does it mean to be a Catholic hospital?,’ UPMC asks in a document outlining their mission. Much of the document sounds perfectly reasonable: Catholic facilities don’t turn people away for lack of funds (only actually they’re just complying with the law, and in fact public hospitals offer nearly twice as much charity care), they believe in engagement with the surrounding community, and they defend dignity for their patients. Oh, and:
There is one fundamental commandment for a Catholic hospital: All life, from conception to the moment of natural death, is profoundly sacred. All life must therefore be treated with awe, respect, and dignity. This fundamental commandment comes without a ‘but,’ ‘if,’ or ‘however.’ There is no qualification, no exception.
UPMC, like other Catholic facilities, follows the Ethical and Religious Directives laid out by the United States Conference of Catholic Bishops. These detailed guidelines determine what kind of care a hospital can offer in order to remain affiliated with the Catholic hospital system and avoid censure, and every care provider must comply with them, regardless of religious affiliation. Among those directives, there are strict rules against abortion, tubal ligation (a topic of repeated litigation), medical research that violates ‘religious principles,’ and other practices that the bishops argue are at odds with the values of the church.
So, discriminatory and gross, but maybe the solution is to avoid going to Catholic facilities, which, by the way, enjoy a federal exemption that allows them to discriminate against patients? (Funny how the church can generate tremendous profits and dictate even minute details of other people’s lives and enjoy preferential treatment from the government, including but not limited to a tax-exempt status and allowances that permit it to revoke bodily autonomy from the patients they claim to respect and treat justly.) That’s not really a solution in any situation, because people shouldn’t have to choose a hospital on the basis of whether they will receive the medical care they want, but it’s really a tremendous issue with acute care.
Backwards impositions of religious values on patients in an emergency setting can be actively dangerous, as seen for instance in patients having miscarriages who cannot receive interventional gynecological procedures because the hospital bars care providers from performing them. Even when a gynecologist and medical team know how to perform a medical procedure and are aware that it’s the best option for a patient, they’re powerless to do anything about it unless they want to lose their jobs — and it may not be possible to transport the patient to a facility that doesn’t allow hidebound moral guidelines to dictate what kinds of treatment patients receive.
Devoted Catholics and other people with value systems that align with the church even though they aren’t necessarily members may find the care at such facilities perfectly adequate. In fact, some may even appreciate that in an emergency situation, a medical team will not perform procedures that go against their values, and won’t advise medical decisionmakers to make compromising choices if they are unable to articulate their own wishes. But it’s simply not fair to put that imposition on all patients, suggesting that everyone who visits an ER do so in a situation where they may be put in a position of danger and disempowerment.
Emergency responders are trained to take injured people to the closest medical facility, regardless of affiliation, the patient’s insurance plan, or any other factors. The goal is to get the patient stabilised and figure the rest out later, because the risks are simply too high if you need to spend more time transporting a patient to a different hospital. But some patients arriving at Catholic hospitals are denied treatments that could stabilise them, or deprived of health care choices that could lead to serious repercussions — for example, a rape victim/survivor could be put in the terrible position of needing emergency medical care but not being offered emergency contraception because Catholic providers refuse to make it available. Given the short window of efficacy, it’s important to get EC sooner rather than later, and patients who don’t get it in time may be faced with an unwanted or extremely traumatic pregnancy.
I have never been a fan of the special treatment the church receives from the government — I absolutely support the freedom to practice religion without interference, but I do not support it when it infringes on the faith and lives of others. If a hospital wants to provide medical care, it needs to provide comprehensive services to all who want them. Given that the number of medical facilities in the US is shrinking despite the fact that a generation of baby boomers is aging and in need of acute and long-term care, we cannot afford to allow some hospitals to operate under a different standard. It’s unjust and hateful, and we must continue to challenge the privileged role that Christianity occupies in US society.
Image: Fredericksburg Catholic Church, Bill Erickson, Flickr