National Partnership for Women & Families

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Report: Number of Catholic hospitals up more than 20 percent in 15 years

The number of hospitals in the United States that are Catholic-owned or affiliated increased by 22 percent over the past 15 years, posing problems for the provision of reproductive health care, according to a report released on Thursday, Reuters reports (Mincer, Reuters, 5/5).

Background

Catholic hospitals operate under the Ethical and Religious Directives for Catholic Health Care Services, which ban Catholic facilities from performing abortion, sterilizations and certain other procedures (Women's Health Policy Report, 4/12).

The American Civil Liberties Union (ACLU) has filed several legal challenges against Catholic hospitals that have applied the U.S. Conference of Catholic Bishops' religious directives when treating pregnant patients (Women's Health Policy Report, 10/27/15).

Report details

The report was released by MergerWatch, which advocates for patient rights amid hospital mergers, and ACLU (Somashekhar/Zauzmer, "Acts of Faith," Washington Post, 5/5). ACLU published the findings in a separate report (Wisconsin Gazette, 5/5).

According to Reuters, the new report expanded the count of Catholic hospitals to include those that are operated by Catholic health systems but do not declare an affiliation, as well as Catholic hospitals that continue to follow the directives despite having been acquired by secular health systems (Reuters, 5/5). In its previous reports, MergerWatch and ACLU assessed only Catholic not-for-profit hospitals ("Acts of Faith," Washington Post, 5/5).

Key findings

According to the new data, in the United States, one out of every six hospital beds is located in a Catholic-owned or affiliated facility. Overall, 14.5 percent of short-term, acute-care hospitals comply with the directives. Nationwide, 548 hospitals operate under the Catholic directives (Wisconsin Gazette, 5/5). In comparison, 449 hospitals followed the directives in 2001 (Reuters, 5/5).

According to the latest report, the federal government has identified 46 regions in the country where a Catholic-owned or affiliated hospital is the "sole community hospital" ("Acts of Faith," Washington Post, 5/5).

Further, the report found that Catholic hospital beds accounted for more than 30 percent of all hospital beds in 10 states and more than 40 percent of all hospital beds in five of those states (Uttley/Khaikin, MergerWatch report, 2016). States with at least 30 percent of hospital beds located in Catholic hospitals included Colorado, Missouri and Washington (Reuters, 5/5).

ACLU report

The ACLU report features accounts from patients for whom Catholic hospitals refused to provide appropriate care (Wisconsin Gazette, 5/5). According to the ACLU, women might not know a hospital's religious affiliation when they present for emergency reproductive care (Reuters, 5/5).

One woman featured in the report, Jennafer Norris, was denied a tubal ligation at a Catholic hospital in Arkansas after she experienced serious complications from delivery. A subsequent pregnancy would threaten Norris' life. Norris said, "A Catholic hospital denied me necessary care in the midst of the worst medical emergency my family and I have ever experienced." She said, "My family and I should have been reassured that the hospital would do everything it could to protect my health and safety. But instead, they prohibited my doctor from providing the care I desperately needed. I don't want other women to have to go through what I did."

The ACLU report also features testimony from physicians who could not provide care under the directives and from providers who treated women denied care at Catholic facilities.

David Eisenberg, a physician featured in the report who works at the Washington University School of Medicine, said, "The sickest patient I've ever treated came to me after a Catholic hospital denied her the most appropriate care because the procedure was prohibited by its religious policies." He noted, "As medical professionals, we have a responsibility to follow medical standards of care and do what's best for our patients -- period. It is unconscionable that some hospitals will deny a patient life-saving care because of their religious affiliation" (Wisconsin Gazette, 5/5).

Recommendations

ACLU has urged CMS to issue a statement that clarifies that federal law bars hospitals, regardless of religious affiliation, from refusing emergency reproductive care. In addition, ACLU recommends that CMS review cases in which Catholic hospitals have broken federal law regarding the provision of emergency care. ACLU says CMS should promise to take necessary corrective action where it discovers violations.

Further, ACLU calls for "a change in our public policies, to protect women in need of reproductive health services and the practitioners who are prohibited from providing this essential care" (ACLU release, accessed 5/5).

Comments

Julia Kaye, a staff attorney with the ACLU Reproductive Freedom Project, noted that while the directives have posed problems for a long time, the issue recently "is gaining more national attention." According to Kaye, there has been an increase in litigation and complaints regarding the directives since 2013 (Reuters, 5/5).

Louise Melling, deputy legal director at ACLU, said, "When a pregnant woman seeks medical care at a hospital, she should be able to trust that decisions about her treatment will be based on medicine, not religious policies." Melling added, "Distressingly, in an increasing number of hospitals across this country, that is not the reality. We all have a right to our religious beliefs -- but that does not include the right to impose those beliefs on others, particularly when that means closing the door on patients seeking medical care" (Wisconsin Gazette, 5/5).