Faith-Based Malpractice
Women who go to religiously affiliated hospitals -- and we're not talking Beth Israel and Mt. Sinai here, but the hospitals run by Catholics and others who base their medicine on irrational religious beliefs rather than science -- are jeopardizing their access to care, according to a National Women's Law Center report:
The ban on services at many religiously affiliated hospitals, nursing homes, managed care companies and insurers go beyond abortions, extending to other arenas of health to include: end-of-life-treatments; research and therapy using fetal and embryonic stem cells; counseling about the use of condoms by HIV patients (and other patients with sexually transmitted diseases); certain infertility treatments; emergency contraception (including for rape victims); certain treatment of ectopic pregnancies; tubal ligations (and other forms of sterilization); and contraceptive services (including contraceptive prescriptions) and counseling.While religiously-affiliated health care institutions can restrict services in certain circumstances, they must warn consumers in a clear, accurate and timely way or face legal sanctions. However, health care consumers are often unaware of these limitations because facilities provide little notice or information about the restrictions, often marketing themselves as providing comprehensive womenís health services when they in fact do not.
In a nationwide survey cited in the report, nearly half of the 1,000 respondents said they believed they would be able to get medical services that may go against Catholic teaching at a Catholic hospital. Less than seven percent were able to identify restricted services such as emergency contraception, sterilization or infertility treatment. Womenís health care is threatened when they must make decisions about their care without knowing about these restrictions. For example, pregnant women who may want to have a tubal ligation during the same hospital stay might not select a doctor who only has privileges at a hospital that prohibits that practice.
Although there are other types of entities that impose restrictions on health care because institutional and or moral objections, Catholic entities usually impose the most rigid limitations on womenís reproductive and other health services, often failing to share information with patients on treatment alternatives and referrals that go against church teachings. Catholic health care entities also have a substantial role in this countryís health care system. Five of the ten largest health care systems are Catholic-owned. And in many rural areas, Catholic hospitals are often the sole health care providers. Also, Catholic health care entities usually impose bans on nonsectarian institutions that merge or affiliate with them, resulting in non-Catholic entities agreeing to comply with religious restrictions. As a consequence, key womenís reproductive and other health services are eliminated for a community with little or no notice to patients and consumers.
In other words, a lot of women -- especially rural women -- are being discriminated against in the name of religion. What should be one of the most basic rights, in a modern society like ours -- access to medical care based on the available science and technology -- is being denied because a bunch of bible thumpers run certain hospitals. Sick, sick stuff. It affects men, too. Just think -- if you have an Advanced Directive, telling doctors you don't want to be maintained as a human turnip, and the ambulance brings you to a Catholic hospital -- your relatives could very well end up in a legal tug-of-war with the hospital to pull the plug.
OK, I'm not Catholic, and I think the archaic views of birth control are ridiculous.
HOWEVER: Where's the competition? This is still a free marketplace. If Catholic hospitals are the only care available to these people, that is not the fault of the Catholic Church. In fact, what would you be saying about the Catholic Church if they refused to go in these areas? They're biased against the poor, or the 'urban-challenged'?
At least the hospitals are there for life-and-death stuff. So rally the Bright troops to go into these areas and offer Women's Health Centers that will provide all the needs that that Catholic hospitals will not meet. If your theory is correct, it should be profitable, since lots of women are going to want access to the services that the Catholic hospitals don't provide. And profitability is the only thing that's going to draw in anyone else.
I know it's popular than rip on the Catholic Church for what they do wrong, but give them a little credit for what they do right: they establish medical care facilities in areas no one else will bother with, since those areas are not 'profitable'. At least the discipline of charity causes them to set up shop in the areas ignored by others.
Should they have to clearly delineate what care they will and won't provide? Sure--but we are talking about health care, an area I know quite a bit about. It is never a marketable idea to tout what you won't do for someone, and that's definitely not limited to Catholics.
Peggy C at December 12, 2003 8:34 AM
Growing up in Ireland, it was common knowledge that if you were pregnant, and life-threatening complications ensued, the Catholic hospital would try to save the baby first, while the Protestant hospital would try to save the mother first.
Emergency contraception should be available everywhere, not just hospitals. Blame the Wal-Mart pharmacies that won't stock it on "religious" grounds (Wal-Mart's religious grounds tend to be somewhat random and hypocritical, as in carrying R-rated movies with nudity and profanity, but banning CDs with lyrics about same).
Then again, you can't force a store to carry anything, unless it's a state-run store (there's an idea -- if they can do it for liquor in the South, surely they could do it for pills). Emergency contraception available online, anyone? I guess the problem there is it wouldn't arrive fast enough, hence "emergency."
Anyway, more than just hospitals and Wal-Mart should be carrying that stuff. I guess that's my point.
LYT at December 12, 2003 3:16 PM
I have a problem with pharmacies being incorporated into WalMart, Target and the like. I realize they're trying to be all things to all people, but please! What's next? Get your prostate checked while your film develops and your wife buys the kids' school clothes? When it comes to my healthcare, I prefer some specialization.
As far as emergency contraception: Except for rape or incest issues, why the hell aren't people thinking about it BEFORE having sex? Sorry--a little personal responsibility goes a long way. If you're too stupid/lazy/'passionate' to take the appropriate steps beforehand, then you'll just have to go out of your way to take care of it afterwards.
Besides, you can get condoms and spermicide at Target/WalMart/damn near anywhere else. May not be the most reliable birth control, but it's a step in the right direction. If you're too cheap or lazy to take at least that route, you deserve to have to drive out-of-the-way to take care of it afterward.
Of course, I'm fairly cynical, and I do expect people to be too stupid/lazy to take responsibility beforehand. And I would be interested to see the statistics for how often 'emergency contraception' is needed for rape/incest vs. 'Oops! I forgot to take my Pill.'
Peggy C at December 12, 2003 8:55 PM
Patrick says: "Where's the competition? This is still a free marketplace. If Catholic hospitals are the only care available to these people, that is not the fault of the Catholic Church."
Where's the competition? In California, it's being eaten alive by a huge corporation called Catholic Healthcare West, which in our state owns 48 hospitals AND COUNTING. In 1998 alone, CHW received more than $325 million in tax-exempt bonds from the California Health Facilities Financing Authority. Further, 50% of the revenues of religious hospitals in the U.S. come from the General Treasury, excise taxes, and other public sources through the Medicare and Medicaid programs. To those of us who believe that public money should follow public values (as embodied in laws such as, for example, Roe v. Wade), this is nothing short of an outrage. The marketplace may be free, but it's far from perfect.
The following quote is from Reverend Michael Place, President and Cheif Executive Officer of the Catholic Health Association of the United States:
"Our fundamental mission is quite straightforward: to serve those in need and to transform society on behalf of Jesus and the Catholic Church."
Are we getting pissed off yet?
Lena 's going straight to hell at December 12, 2003 10:37 PM
Actually, Lena, that was me, not Patrick. I'm well aware of Catholic Healthcare West. I have several family members that have worked at their hospitals.
I know a tidbit that many may not be aware of--they allow domestic partner coverage on the health insurance offered to their employees. The deal is, they call it 'domiciled adults'--therefore, it is not just domestic partners that can be on your coverage, but any adult living with you and meeting the criteria. Some of their employees have grandparents, aunts/uncles, etc. covered, and many of their straight/gay employees have their domestic partners covered.
So there are definitely ways around their stated religious policies. Not sure if they cover birth control, though.
Still--in areas where a Catholic hospital is the only choice, why haven't others stepped in? Frankly, a lot of the things the Catholic church won't touch aren't necessarily issues that have to be dealt with in a hospital. My suggestion of a non-religious-based health care center would address it.
However, as far as public funding is concerned, there are a LOT of people/institutions that get our money but don't do what we want. That could start an extremely long thread!
Peggy C at December 12, 2003 11:57 PM
"Actually, Lena, that was me, not Patrick."
Oh. Nevermind! Peggy C. is always right, as far as I'm concerned. However...
Peggy C. really did say: "as far as public funding is concerned, there are a LOT of people/institutions that get our money but don't do what we want."
Yes, but there isn't always such an obvious concern about the constitutionality of that funding. To secular dudes like me, our Constitution is a sacred text.
Lena at December 13, 2003 12:27 AM
"If you're too stupid/lazy/'passionate' to take the appropriate steps beforehand, then you'll just have to go out of your way to take care of it afterwards."
I sympathize with the sentiment, but I'd rather they get emergency contraception the next day than have an abortion later (or an unwanted child). Saves them and us a lot of trouble. As I understand it, emergency contraception makes you pretty sick for at least a day, so I doubt it'd be too frivolously used.
It ain't 100% stupidity, though. Condoms can break. Ideally she's on the pill too, but things aren't always ideal.
LYT at December 13, 2003 12:29 AM
LYT said: "Growing up in Ireland, it was common knowledge that if you were pregnant, and life-threatening complications ensued, the Catholic hospital would try to save the baby first, while the Protestant hospital would try to save the mother first."
Hey, Luke. You lived in Ireland? I guess you saw that movie "the Magdalene Sisters." Sometimes, someone growing up in Ireland who was pregnant -- but not married -- would be locked up as a slave laborer in a convent where life-hating nuns would sometimes beat them until they bled -- all for the love of God, of course.
Lena at December 13, 2003 12:33 AM
Peggy C: "The deal is, they call it 'domiciled adults'--therefore, it is not just domestic partners that can be on your coverage, but any adult living with you and meeting the criteria."
This isn't a justification to receive tax-exempt support to acquire and set up shop in dozens of hospitals restricting access to services that many taxpayers need and want.
That said, I think that "domiciled adults" coverage sounds amazing. I first read about it in a book called "Queer Family Values" by Valerie Lehr. She argues that a lot of gay rights rhetoric doesn't question the ways in which we privilege or at least overvalue "the sexual family" (of which heterosexual marriage is our main example). Martha Fineman is worth quoting here:
"To a large extent, the new visions of the family" [as articulated by gay marriage proponents] "merely reformulate basic assumptions about the nature of intimacy. They reflect the dyadic nature of the old (sexual) family story, retaining the centrality of sexuality to the organization and understanding of intimacy [...] The dominance of the idealized sexual family in social and legal thought has restricted real reform."
For me, this book was such an eye-opener. Of course, families matter! But families take forms that frequently differ from the model where two people at the center of the arrangement bonk each other with much love while the kiddies (or, if we're talking lesbians, the Labradors) sleep quietly.
Gay marriage rights activists would probably gain so much support from the general public if they'd recognize that individuals in all sorts of families need and deserve the benefits reserved for married couples.
PS: When I was a kid, my best friend was named Peggy. For this reason, I will always love all Peggies of the World.
Lena at December 13, 2003 9:52 AM
Thanks, Lena! I'm glad you didn't hate her, or I'd be in for a written reaming sometimes.
I work in the healthcare industry, but I don't think all aspects of healthcare are a protected right. I think life-saving medical care should be a right, but technically, emergency contraception (right after intercourse, realizing that something went 'wrong') is NOT life saving. And don't tell me I've never been in that position--how would you know? Just 'cause I don't tell you guys everything doesn't mean I haven't been through it.
I know that many clinics offer emergency contraception services, so why the fuss about the hospital not doing it? Think about how expensive it is to get ANY sort of care at a hospital. Why don't we reserve their time and resources for what they should truly be used for, and outsource the rest of it to less costly clinics and centers? The issue then comes down to those clinics and centers NOT being run by religious organizations.
And I think that if other organizations besides the Catholic Church were willing to set up and run these hospitals, our government's money would be going to them instead. It still comes down to the free marketplace issue. If there was adequate competition for the needed services, the money wouldn't be poured into the institution that wasn't complying with government standards.
Peggy C at December 13, 2003 11:26 AM
"Didn't hate her"? I ADORED Peggy. I'd love to track her down and give her a big hug for being such a great pal. Peggy was my first Amy, I guess.
Lena at December 13, 2003 2:34 PM
Lena: I did indeed see The Magdalene Sisters. Society was past that particular treatment by the time I was there (though divorce, abortion, and homosexuality were all illegal), but vestiges of that cruel disciplinarian side of Catholicism were everywhere to be found in the education system, which, much like boot camp, treats you all as scum and breaks you down mentally so you can better memorize stuff you don't always understand.
Not to bash Catholics overall -- their sense of charity is quite admirable, and I did undergo surgery in a Catholic hospital while there, which went without a hitch. Ireland has national health care, though.
LYT at December 13, 2003 2:34 PM
The last Magdalene Laundry closed in 1996, I believe (if not later).
My parents are Irish immigrants, and you wouldn't believe the stories of what they went through as children in the Irish school system. On the bright side, we Irish have good humor, a way with words, and really bitching church architecture.
What part did you live in, LYT?
Lena McLeena at December 13, 2003 4:01 PM
I would believe it. I probably have stories to match.
I grew up first in County Kildare, and later Dublin (for secondary school).
I blame my utterly retarded dating abilities in large part on Ireland.
LYT at December 14, 2003 1:53 AM
You're right about our retarded dating skills. We're also petrified by physicians, because they might ask us to undress.
I spent all my summers in Ireland as a kid. Two months a year for many years.
Lena O'Cuisinan at December 14, 2003 10:22 AM