Saturday, December 21, 2013

“Miscarriage of Medicine”: ACLU and MergerWatch report on Catholic hospitals’ interference with medicine


The ACLU and the MergerWatch Project have released a short, informative report about Catholic hospitals and hospital systems* and their terrible effects on women’s health care.

From the 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.

Religious restrictions govern care at Catholic-sponsored facilities. At these hospitals, health professionals are prohibited from providing vital health services or honoring patients’ health care decisions when they conflict with Catholic teaching. Often at these facilities health professionals may not even provide their patients with counseling and referrals for services prohibited on religious grounds. As a result, when it comes to reproductive health care, hospitals operating under these religious rules can provide care that falls short of expected standards of care. Historically secular hospitals or hospitals founded by other religious faiths are often required to adopt some or all of the Catholic restrictions when they affiliate with or are acquired by Catholic hospitals.

This report looks at the increasing number of acute-care hospitals that are Catholic-sponsored or -affiliated and the expansion of Catholic-sponsored health systems in the United States between 2001 and 2011.1 Indeed, 10 of the 25 largest health systems are Catholic-sponsored, with combined gross patient revenue of $213.7 billion. The report discusses the threat this growth poses to patient access to reproductive health services, including information and referrals. It further shows the degree to which these institutions rely on tax dollars, even as they limit medical care based on religious doctrine. At the same time, data also indicate that, despite their claims of service to the poor, Catholic-sponsored and -affiliated facilities actually provide only an average amount of charity care and report a lower percentage of gross patient revenue from Medicaid than any other type of hospital.2

In short, this report reveals how Catholic hospitals have left far behind their humble beginnings as facilities established by orders of nuns and brothers to serve the faithful and the poor. They have organized into large systems that behave like businesses — aggressively expanding to capture greater market share — but rely on public funding and use religious doctrine to compromise women’s health care. We make recommendations about how to ensure Catholic restrictions do not interfere with patients’ rights and protect access to comprehensive reproductive health care.
Even if you don’t have time to read the whole thing, you should at least skim the sample of items from the Ethical and Religious Directives in Appendix A. For example,
44. A Catholic health care institution should provide prenatal, obstetric, and postnatal services for mothers and their children [sic] in a manner consonant with its mission.
One would think a healthcare institution’s mission would be to provide these services.

On assisted dying:
60. Euthanasia is an action or omission that of itself or by intention causes death in order to alleviate suffering. Catholic health care institutions may never condone or participate in euthanasia or assisted suicide in any way. Dying patients who request euthanasia should receive loving care, psychological and spiritual support, and appropriate remedies for pain and other symptoms so that they can live with dignity until the time of natural death.

61. Patients should be kept as free of pain as possible so that they may die comfortably and with dignity, and in the place where they wish to die. Since a person has the right to prepare for his or her death while fully conscious, he or she should not be deprived of consciousness without a compelling reason. Medicines capable of alleviating or suppressing pain may be given to a dying person, even if this therapy may indirectly shorten the person’s life so long as the intent is not to hasten death. Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering. [my emphasis]
This seems inconsistent with recent statements from Francis. Why aren't poor and marginalized people simply helped to appreciate the Christian understanding of redemptive suffering? Problem solved.

* The report also shows the rapid growth of for-profit hospitals, which also poses a threat, if of a different sort. For-profit and healthcare shouldn’t be connected in any way.

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