Catholic hospitals, which represent a growing share of health care in the United States, prohibit staff from providing many common reproductive health services, including ones related to sterilization, contraception, abortion, and fertility. While professional ethics guidelines recommend that clinicians who deny patients reproductive services for moral or religious reasons provide a timely referral to prevent patient harm, a new study shows that some Catholic hospitals make it difficult for clinicians to do so.
For the study, investigators interviewed 27 religiously and geographically diverse obstetrician-gynecologists who were currently working or had worked in Catholic facilities. In some hospitals, physicians reported that administrators and ethicists encouraged or tolerated the provision of referrals, but in others, hospital authorities actively discouraged referrals or physicians kept referrals hidden.
Interviewed physicians felt that the best interests of their patients were not always served by the church's ethical directives for health care. Most affected were women with limited financial resources, those needing certain kinds of emergency care, and those who would like to undergo sterilization at the time of a cesarean section or immediately after a vaginal delivery.
"Women deserve access to comprehensive reproductive health care. When a hospital restricts what services its doctors can provide based on the hospital's religious affiliation, it's vital that patients receive full information about their options and a timely referral to a facility where they can receive the care," said Dr. Debra Stulberg, lead author of the Perspectives on Sexual and Reproductive Health study. "The ob-gyns we interviewed said that at some Catholic hospitals, referrals to Planned Parenthood, public health clinics, or non-Catholic hospitals were commonly offered, but other Catholic hospitals discouraged these referrals, or doctors had to provide them in secret. Ob-gyns also reported that some Catholic hospitals provided patients with full information and helpful referrals for a range of services but left patients to fend for themselves in seeking an abortion."
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