Catholic Hospitals

[zoogs]

By the way, let's be clear that nobody is suggesting Catholic doctors being forced to do things they don't want to.

 

It's doctors, Catholic or not, being forced to act against medical best practice based on the owner operation's doctrine.

 

Incidentally, some of these hospitals are also bound by religious doctrine regarding whether they can even refer women to other services. (Another link)

 

If you're open to the idea that hospitals should be forced to refer, we're already talking about overriding say, bishop's directives. Are religious beliefs being contravened there?

[NUance]

 

 

Maybe the Catholic church should get out of the business of providing medical services. Hospitals should serve their surrounding population.

You're suggesting Catholic hospitals be shut down because there is one somewhat uncommon situation where their religious beliefs interfere with a particular treatment? Are you really suggesting this? lol

 

 

Americans shouldn't have to choose health care based on religious principles - theirs or someone else's.

As Americans we are free to go to any hospital we want.

 

OTOH, Americans shouldn't be forced to act in a manner that contravenes their religious beliefs.

 

 

So you're cool with going to a hospital under Sharia Law?

 

Christians in America have a really bad habit of thinking the only religious freedoms that could affect them are Christian freedoms. This will not always be a Christian-dominated nation. What freedoms are you ready to allow other religions over your life, or the lives of your loved ones? As this country grows more diverse these are questions you're going to have to answer.

 

 

That's exactly the point. I would not likely go to a hospital operating under Sharia Law for anything other than a minor injury (I'd need to do some research to see what prohibitions/policies they have). Just like I wouldn't take my wife to a Catholic hospital for anything dealing with OB/GYN.

 

But let's say it's an emergency situation—say a car wreck that caused my wife to go into labor. If I did end up at a Catholic hospital I would expect them to transfer us to a different hospital as soon as it became clear that they couldn't (or wouldn't) provide the care that she needed. And that did not happen in the youtube video above.

 

And if an emergency situation did occur, I would expect the ambulance crew to be knowledgeable enough to take us to a hospital that could provide adequate treatment.

[NUance]

By the way, let's be clear that these aren't Catholic doctors being forced to do things they don't want to. Unless I'm mistaken and those hospitals only employ Catholic doctors.

 

It's doctors, Catholic or not, being forced to act against medical best practice based on the owner operation's doctrine.

Yes. In fact the woman in the video seemed miffed that she was not allowed to perform that procedure. But as I said above, I suspect she may be at least somewhat to blame in that she apparently delayed in getting the patient transferred. (It's not possible to know the full situation from that one brief clip, and hearing only her side of the story.)

 

 

Incidentally, some of these hospitals are also bound by religious doctrine regarding whether they can even refer women to other services. (Another link)

 

If you're open to the idea that hospitals should be forced to refer, we're already talking about overriding say, bishop's directives. Are religious beliefs being contravened there?

Well, I don't happen to agree with the policy of not referring them to another hospital. In doing that they are forcing their own practices on the patient, perhaps to the detriment of her health. That's just wrong, regardless of what some bishop has to say about it. They could inform her that their religious convictions prohibit that procedure, but they would gladly transfer her to another hospital for treatment. And they shouldn't delay this referral if it allows her condition to deteriorate. /jmho

[zoogs]

I would simply hope to be lucky enough not to be in an area where the accessible options are exclusively Catholic and Sharia.

 

I can choose between eating an apple and eating an orange. Medical care facilities? What choices are available, largely, that's made for me. Perhaps less so than for people who really can choose as freely, but that's not everybody.

 

To turn this "rare occurrence" thing around, I view it this way. One hundred percent of women who encounter a reproductive complications are put at risk if for whatever reason they arrive at a Catholic hospital. Neither event on its own seems all that "rare" or avoidable, to me, but it's quite possible I'll never personally be faced with such a quandary (in fact, I completely expect this to disproportionately affect those more helpless to begin with).

 

That's the status quo we appear to be working with. I feel, again, that it's not unreasonable to require hospitals to act fully as hospitals. There's got to be a way to do that without affecting the religious beliefs of individual doctors who should be free to decline to participate in procedures.

[NUance]

I would simply hope to be lucky enough not to be in an area where the accessible options are exclusively Catholic and Sharia.

 

I can choose between eating an apple and eating an orange. Medical care facilities? What choices are available, largely, that's made for me. Perhaps less so than for people who really can choose as freely, but that's not everybody.

 

To turn this "rare occurrence" thing around, I view it this way. One hundred percent of women who encounter a reproductive complications are put at risk if for whatever reason they arrive at a Catholic hospital. Neither event on its own seems all that "rare" or avoidable, to me, but it's quite possible I'll never personally be faced with such a quandary (in fact, I completely expect this to disproportionately affect those more helpless to begin with).

 

That's the status quo we appear to be working with. I feel, again, that it's not unreasonable to require hospitals to act fully as hospitals. There's got to be a way to do that without affecting the religious beliefs of individual doctors who should be free to decline to participate in procedures.

 

I don't lay claim to being an expert in this area, but I know that medical providers of all sorts—hospitals, doctor's offices, emergency care facilities, etc.—receive accreditation based on the types of services they provide. Not all medical providers are competent to provide every sort of procedure. And I imagine they are free to choose what sort of services they will specialize in, and in return, what sort of accreditation they will receive. I suspect that Catholic hospitals are downgraded in the area of OB/GYN for not providing this type of care. (But, no expert, so I'm not sure if that's the case.) So there's that. :

[NM11046]

 

I would simply hope to be lucky enough not to be in an area where the accessible options are exclusively Catholic and Sharia.

 

I can choose between eating an apple and eating an orange. Medical care facilities? What choices are available, largely, that's made for me. Perhaps less so than for people who really can choose as freely, but that's not everybody.

 

To turn this "rare occurrence" thing around, I view it this way. One hundred percent of women who encounter a reproductive complications are put at risk if for whatever reason they arrive at a Catholic hospital. Neither event on its own seems all that "rare" or avoidable, to me, but it's quite possible I'll never personally be faced with such a quandary (in fact, I completely expect this to disproportionately affect those more helpless to begin with).

 

That's the status quo we appear to be working with. I feel, again, that it's not unreasonable to require hospitals to act fully as hospitals. There's got to be a way to do that without affecting the religious beliefs of individual doctors who should be free to decline to participate in procedures.

 

I don't lay claim to being an expert in this area, but I know that medical providers of all sorts—hospitals, doctor's offices, emergency care facilities, etc.—receive accreditation based on the types of services they provide. Not all medical providers are competent to provide every sort of procedure. And I imagine they are free to choose what sort of services they will specialize in, and in return, what sort of accreditation they will receive. I suspect that Catholic hospitals are downgraded in the area of OB/GYN for not providing this type of care. (But, no expert, so I'm not sure if that's the case.) So there's that. :

 

So The Joint Commission (or JCAHO) is what I think you're referring to for hospitals. They do evaluate standards and safety of institutions. It's an optional accreditation though. One reason why a hospital would do it is that in order to be reimbursed by Medicare/Medicade you must be approved by JCAHO (or the other approved organization NCQA). Being able to take Medicare is the key to other insurance organizations affiliating with a hospital. If a hospital meets the high standards to have Medicare patients others will also hop on. (more $$$)

 

While I know many strive for this accreditation and it's difficult to get (and they brag when they do) I didn't truly know what was evaluated. So thanks for the trigger to make me do some digging! I looked it up and they look at, "patient rights and education, infection control, medication management, and preventing medical errors, to how the hospital verifies that its doctors, nurses, and other staff are qualified and competent, how it prepares for emergencies". Specifically JCAHO has 13 areas they evaluate (I'm sure there are multiple departments and focus within those 13). Perinatal is one, and I did some digging and could find a section detailing "Elective delivery" but it didn't really detail anything along the lines of this topic.

 

What I also found was Doe V. Bolton which was a case presented to the supreme court in GA that said requirements stating that a termination of pregnancy must occur at a JCAHO Accredited Hospital were considered inappropriate (among other things that GA laid out as requirements like getting 3 doctors to agree on the procedure, getting a hospital board to review and approve it etc)

 

If you have some time this study details a lot of what we've discussed here, and mentions the dictating directives that Catholic Hospitals work under (The Ethical and Religious Directives for Catholic Health Care Services )... if I end up with time tonight I'll try to go find it, but this looks at Catholic vs. non-Catholic vs.recently merged hospitals and their outcomes and directives on pregnancy terminations. I "get" to read clinical and medical studies all day, so this was of interest to me, but if you don't have the time or need to dig into the details just read the Background, Objectives and Summary & Discussion sections:

 

http://www.nwlc.org/sites/default/files/pdfs/ibis_rh_-_nwlc_qualitative_study_report.pdf

 

 

​

[NM11046]

This discussion reminded me of a great Fresh Air NPR interview done with a Bioethics doctor ... not on abortion but on healthcare decisions and when you do what's "prescribed" in a situation or make a different ethical decision. I found this to be one of the better interviews I've listened to as far as what it got me thinking about. So if you have time ...

 

http://www.npr.org/2014/05/13/312169818/good-doctor-puts-past-medical-practices-under-an-ethical-microscope

[zoogs]

NUance and NM, you both make good points in areas you clearly know more about than I do. I guess I'd clarify my position this way:

 

1. A hospital that offers reproductive care, but with gaps determined by religious mandate, is not a 1:1 analog of the general truth that not all hospitals are able to provide every service.

 

2. It seems to me that a completely not trivial amount of people get caught up and put through a lot as a result of this. That, I think, is very clearly not on them, but on the reality they are given.

 

So, I come back to this being a case of nonmedical mandate constricting the range of medical care options chosen to be provided. It's not clear there can be any legal basis to enforce a change. But I just wish it weren't so.

[NM11046]

I agree with you 100% Zoogs.

 

I'd love to better understand proximity of non religious to religious hospitals, and how ambulances can reroute ... I know between contracts and zip codes etc there are a lot of politics involved. Seems like that in and of itself would be the solution in my mind, asking patients (who are able to respond of course) or their caregivers, "Are you ok with being admitted to a religious institution where your care options may be limited due to religious beliefs?" They may very well have to pay an additional cost to go to another hospital, but honestly I believe many would choose to do that.

 

The study above made a great point about the next step they need to do is survey patients to see how this care impact their decisions and etc. THAT would be interesting, and the only real way there can be a proper gauge on whether change is needed.

 

In my mind (like yours I think) this is a very real and significant problem, but I don't know that my thoughts necessarily reflect the general population. I'm betting it's somewhat regional, based on ethnicity, eduction and etc.

[NUance]

As it stands, privately owned hospitals cannot be forced to perform procedures that they feel violate their religious beliefs. (I think this is true, anyway.) So a solution might just come down to one of these: 1) Force hospitals to perform the procedure through legislation or court decisions; 2) Shield hospitals from performing the procedure through legislation or court decisions; 3) Allow tort suits in the event anyone is harmed, and there was a reasonable expectation of care.

 

I don't like option #1 or #2. Less gov't is better, IMHO. Option #3 is problematic, but may be the solution. If someone is harmed due to the hospital's refusal to perform a procedure widely accepted in the medical profession, then maybe the hospital should be culpable for the harm. OTOH, it's problematic because this gets back to whether hospitals should be allowed the freedom concentrate their efforts in one area or another, and decline to provide some services that are available elsewhere. This is a thorny thicket you have entered into, Zoogs.

[knapplc]

I wonder how many of those privately-owned hospitals accept federal funds, and how that would/should change the equation?

 

I know I said religions should not be in the healthcare business. I don't hold very firmly to that stance - it was mostly thinking out loud.

[NM11046]

I wonder how many of those privately-owned hospitals accept federal funds, and how that would/should change the equation?

 

I know I said religions should not be in the healthcare business. I don't hold very firmly to that stance - it was mostly thinking out loud.

If they take Medicare and Medicaid patients they accept federal funds ...

 

It might be a leap (and one I might regret typing out here), but one might make an educated point of saying the number of women needing emergency prenatal care are often those who perhaps haven't had care (or sex ed, birth control options) leading up to the moment there is a problem. Often times these patients would fall into a Medicaid population.