Study shows most Catholic hospitals don't advertise religious restrictions on health care
In a survey of Catholic hospitals throughout the country, researchers at the University of Colorado Anschutz Medical Campus found many did not advertise their religious affiliation and the majority did not explain how that affiliation results in health care restrictions.
The research letter was published today in JAMA.
Maryam Guiahi, MD, associate professor of Obstetrics and Gynecology at the University of Colorado School of Medicine, analyzed the websites of all hospitals listed in the Catholic Health Association of the United States' Health Care Directory.
Out of 646 hospitals examined, 507 or 79 percent reported their Catholic identity. The other 21 percent did not explicitly disclose it on their website. More concerning, only 28 percent specified how their religious affiliation might influence patient care.
"Patients need to know if they are going to a Catholic hospital and if that is going to affect the care they receive," Guiahi said. "They may realize that a Catholic hospital might not provide abortions, but many do not realize that preventative services like contraceptives and tubal ligations are also restricted."
The U.S. Conference of Catholic Bishops expects hospitals affiliated with the Catholic Church to abide by the Ethical and Religious Directives for Catholic Health Care Services. These directives interpret medical care based on the church's moral teachings and limit aspects of reproductive and end-of-life-care.
"A basic cornerstone of medical ethics is to support patient autonomy," said Guiahi. "One way to do this is to be transparent. It was surprising to find that one in five of these Catholic hospitals do not even report their identity and that the vast majority do not explain to patients what being Catholic means."
Guiahi said hospitals may avoid transparency about restrictions to avoid losing patients.
"This means that many patients may waste their time at Catholic facilities when they encounter restrictions to common health services," she said.
At the same time, some Catholic hospitals that openly cite the directives may actually provide restricted services using workarounds.
For example, rather than say they are giving a patient an intrauterine device for birth control, they might say it is being placed for heavy menstrual bleeding.
"There appears to be a lot of variability across Catholic sites in terms of what they provide and whether or not they use workarounds, which compounds health care consumer confusion," explained Guiahi. "Websites provide an opportunity to inform consumers about which services are provided and which ones are restricted and can thereby avoid conflicts in care."
Ultimately, she said, greater transparency about religious affiliation and care restrictions may allow patients to make informed choices.
More information: JAMA (2019). doi:10.1001/jama.2019.0133 , jamanetwork.com/journals/jama/fullarticle/2728476