Opinion | Catholic hospitals are expanding — and denying essential health care

Let’s say a patient is considering tubal ligation after a scheduled cesarean because she doesn’t want to get pregnant again. Here are some factors that influence this decision: your vision of your reproductive future, your doctor’s advice, government regulations, the recommendations of the American College of Obstetricians and Gynecologists, the latest scientific research.

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

But if our hypothetical patient happened to be in a Catholic hospital, those factors—those very words—will drive the decision as to whether or not she or her doctor believes in God’s plan. The U.S. Catholic Bishops’ Conference ethical guidelines make it clear: “Direct male or female sterilization, whether permanent or temporary, is not permitted in a Catholic health facility.” She will not have the surgery, no matter how medically safe and legal it is is no matter what she wants.

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She definitely should have chosen a different hospital. But with Catholic healthcare systems expanding across the country, that may not be an option. A 2020 report by Community Catalyst, a nonprofit healthcare advocacy group, found that four of the country’s 10 largest healthcare systems were Catholic. The Catholic Health Association says Catholic facilities now account for more than 1 in 7 US hospital patients.

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This number is likely to increase as Catholic health care systems expand through mergers with or acquisitions of secular hospitals and networks. This consolidation is happening near me, in the Albany, NY area. As the Times Union recently reported, one of our major healthcare systems, St. Peter’s Health Partners, part of a Catholic network, has begun merging with secular Ellis Medicine, ultimately adopting “God’s will” for Ellis Hospital and the hospital becomes Bellevue Woman’s Center, which provides pregnancy and maternity care.

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

A patient deciding where to have her cesarean — even if she still had a choice of hospitals — might not even know it. Why would she assume that a nonprofit hospital supported by large state and federal funds could legally deny healthcare to its patients?

But that’s exactly what happens when the church has the final say on medical decisions. Not just in hospitals: emergency centers and doctor’s offices that are part of a Catholic network may refuse to prescribe contraceptives, offer abortion services or counseling.

New York State has made efforts to protect reproductive rights, beginning with the Reproductive Health Act of 2019, which codifies abortion rights. As state after state passed abortion bans in wake Roe v. calfFall, 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 it is God’s will.

Some lawmakers are pushing back. 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 post a list of “policy-based exclusions” on their websites detailing the services not provided by them are listed. In Oregon, a new law gives state officials the power to block hospital mergers that would result in limited access to health care.

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

Blue States? secular country? Doesn’t matter. The most shocking evidence that even New Yorkers live in a state that knows God 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 percent of the thousands of Hasidic boys who took state-standard tests failed. Meanwhile, New York’s are receiving yeshivas lots of education funding – “more than $1 billion” in government money over the past four years. Religious leaders systematically denied their students the constitutionally protected opportunity of a “healthy basic education”, political leaders allowed it.

Or at least they did. The New York State Board of Regents recently voted to require private schools to prove they teach undergraduate subjects or risk losing public funding. Whether this rule will be enforced remains to be seen. But it is a start.

I wish the New York State Department of Health would take the same approach to healthcare networks: Prove that you provide patients with all the care that modern medicine has made possible, state laws have made possible, and the Affordable Care Act deemed essential, and you will receive your tax exemptions and your Medicaid payments.

What if you happen to have a patient who believes contraception is against the will of God? She can choose not to have her hoses tied off.

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