Reviews | Catholic hospitals expand and deny essential health care

Let’s say a patient is considering tubal ligation after a planned C-section because she no longer wants to get pregnant. Here are some factors that relate to this decision: her vision of her reproductive future, her doctor’s advice, state regulations, recommendations from the American College of Obstetricians and Gynecologists, the latest scientific research.

Here are some factors that for most patients are irrelevant: “God’s purposes”, “God’s will”, “the truth that life is a precious gift from God”.

But if our hypothetical patient happens to be in a Catholic hospital, those factors—precisely those words—will control the decision whether or not she or her doctor believes in God’s plan. This is clearly stated in the ethical guidelines of the United States Conference of Catholic Bishops: “Direct sterilization of males or females, whether permanent or temporary, is not permitted in a Catholic healthcare facility.” . She won’t get the operation no matter how medically safe and legal it is, no matter what she wants.

Obviously, she should have chosen another hospital. But with the expansion of Catholic healthcare systems across the country, that might not be an option. A 2020 report by Community Catalyst, a nonprofit health advocacy group, found that four of the nation’s 10 largest health systems were Catholic. The Catholic Health Association says Catholic facilities now account for more than 1 in 7 hospital patients in the United States.

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This number is likely to increase, as Catholic health systems grow by merging with or acquiring secular hospitals and networks. This consolidation is happening near my home in the Albany, NY area. As The Times Union recently reported, one of our large health systems, St. Peter’s Health Partners, which is part of a Catholic network, has begun to merge with the secular Ellis Medicine, which will eventually put the ” will of God” in charge of Ellis Hospital and the Bellevue Woman’s Center, which provides pregnancy and maternity care.

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That would mean no tubal ligations for contraceptive purposes. It would also mean no abortions, vasectomies, IUDs or in vitro fertilization. This would most likely limit end-of-life care choices and end gender-affirming care.

A patient deciding where to have her C-section – even if she still had a choice between hospitals – might not even know. Why would she assume that a nonprofit hospital, backed by large infusions of state and federal funds, could legally deny health care to its patients?

But that’s exactly what happens when the church has the final say in medical decisions. Not just in hospitals either: urgent care centers and medical practices that are part of a Catholic network may well refuse to prescribe contraceptives or provide abortion services or counseling.

New York State has worked to protect reproductive rights, beginning with the Reproductive Health Act of 2019, which codified the right to abortion. As state after state enacts abortion bans in the wake of Roe vs. Wade‘s fall, I often think, selfishly, thank God I live in New York.

But I still live in the Commonwealth of religious deference, where rules can be broken and citizens can be denied basic services as long as someone has decided that is how God wants it.

Some lawmakers are backtracking. A recent bill sponsored by New York State Senator Michelle Hinchey, which has passed the Senate and is awaiting a vote in the Assembly, would require hospitals to publish a list of “exclusions based on policies,” detailing the care they will not provide, on their websites. . In Oregon, a new law gives state officials the power to block hospital mergers that would result in restricted access to health care.

But beneath these efforts lies the unchallenged notion that Catholic hospitals are within their rights to refuse care. That religious organizations, despite their public funding, are not required to adhere to secular standards.

blue states? Secular country? No matter. The most shocking recent evidence that even New Yorkers live in a state where God knows best is a devastating New York Times report on the state’s Hasidic schools, which teach Jewish law and tradition but little English. or math. In 2019, 99% of the thousands of Hasidic boys who took standardized state tests failed. Meanwhile, yeshivas in New York are receiving a lot of funding for education – “over $1 billion” in public funds over the past four years. Religious leaders have consistently denied their students the constitutionally protected opportunity for a “solid basic education,” and political leaders have let it happen.

Or at least they did. The New York State Board of Regents recently voted to require private schools to prove they taught core subjects or risk losing public funding. It remains to be seen whether this rule will be applied. But it’s a start.

I would like to see the New York State Department of Health take the same approach to health care networks: prove that you are providing patients with all the care that modern medicine has made possible, that the law made possible and deemed essential by the Affordable Care Act, and you will benefit from your tax exemptions and Medicaid payments.

What if you happen to have a patient who believes birth control is against God’s will? She can choose not to tie her tubes.

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