Context | Catholic hospitals control a growing share of health care in the United States and prohibit many common reproductive services, including ones related to sterilization, contraception, abortion and fertility. Professional ethics guidelines recommend that clinicians who deny patients reproductive services for moral or religious reasons provide a timely referral to prevent patient harm. Referral practices in Catholic hospitals, however, have not been explored.
Methods | Twenty-seven obstetrician-gynecologists who were currently working or had worked in Catholic facilities participated in semistructured interviews in 2011–2012. Interviews explored their experiences with and perspectives on referral practices at Catholic hospitals. The sample was religiously and geographically diverse. Referral-related themes were identified in interview transcripts using qualitative analysis.
Results | Obstetrician-gynecologists reported a range of practices and attitudes in regard to referrals for prohibited services. In some Catholic hospitals, physicians reported that administrators and ethicists encouraged or tolerated the provision of referrals. In others, hospital authorities actively discouraged referrals, or physicians kept referrals hidden. Patients in need of referrals for abortion were given less support than those seeking referrals for other prohibited services. Physicians received mixed messages when hospital leaders wished to retain services for financial reasons, rather than have staff refer patients elsewhere. Respondents felt referrals were not always sufficient to meet the needs of low-income patients or those with urgent medical conditions.
Conclusions | Some Catholic hospitals make it difficult for obstetrician-gynecologists to provide referrals for comprehensive reproductive services.
Christian Medical and Dental Society prefers ‘total transfer of care’ to other doctors in such cases
The head of the Christian doctors’ group that met recently with Manitoba’s health minister says doctors with religious or moral objections to physician-assisted dying should not be forced to issue referrals to patients but instead allow patients to switch doctors altogether.
The Christian Medical and Dental Society met with Health Minister Kelvin Goertzen on July 11 to lobby for conscience protection for doctors who object to physician-assisted death.
The group is also asking Ontario’s top court to reverse a provincial government policy requiring physicians to refer patients who want an assisted death to another doctor. . . [Full text]
By a vote of 245 to 182 the U.S. House of Representatives has passed the Conscience Protection Act, a bill designed to prevent government discrimination against and prevent the suppression of the freedom of conscience and religion of individuals or groups unwilling to provide or facilitate abortion for reasons of conscience or religion. The bill adds a right of action by victims, the lack of which has prevented victims from defending their freedom in court. President Barack Obama is expected to veto the legislation. [CNS News]
. . . Abortion has developed technologically and now includes medical and surgical methods, but, generally speaking, remains the deliberate killing of a developing human individual at some point between implantation in the uterus and birth, either directly or by premature delivery intended to cause death. The moral arguments against abortion have been refined and somewhat expanded since 1967, but their focus is substantially unchanged. . . Project Submission