Colorado will now make Catholic hospitals say what services they won't provide
Colorado will now make Catholic hospitals say what services they won't provide
A new law, in effect as of today, requires all health care facilities to publicly say what procedures they won't offer for non-medical reasons
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Today marks an important step on the road to medical transparency.
A new Colorado law has now gone into effect, requiring all hospitals to tell the public up front what procedures they won’t perform for non-medical reasons. That’s especially important for Catholic hospitals, which now have to be open and honest about the limitations of their offerings.
Here’s why this matters.
How Catholic hospitals harm patients
Suppose you’re giving birth and having a C-section. You might decide that you’re also done having kids and you’d like to have your tubes tied so there are no unplanned pregnancies in your future.
The doctor is already performing surgery, so performing a tubal ligation actually lets you kill two birds with one stone. It’s a safe procedure. Medical professionals even say that if you want to get your tubes tied, doing it during a C-section is a good idea because it doesn’t require an additional surgery. Nearly 30% of married adult women in the U.S. have had the procedure done. Not a big deal!
But what if you’re at a Catholic hospital?
Doctors there will perform a C-section, no problem, but they will not perform a tubal ligation. Why not? Because their directives don’t come from medical professionals, but rather the United States Conference of Catholic Bishops. And since anything involving contraception is forbidden in the faith, even a normal procedure like tubal ligation isn’t permitted. This rule applies even if future pregnancies would put the woman’s life in danger.
By and large, and with very few exceptions, the USCCB does not allow Catholic hospitals to perform any procedures that violate Catholic doctrine. Hospitals that violate those rules risk getting shut down. Even if the doctors and nurses who work there know that a procedure is necessary for the health of the patient, their expertise takes a backseat to the whims of religious leaders.
A lot of people know that Catholic hospitals won’t perform abortions, but fewer know how radical that policy is. Even if you set aside elective abortions, patients who have ectopic pregnancies (and whose lives are at risk) would be in danger if they went to a Catholic institution.
A normal hospital could give that patient a drug to induce an abortion... or just remove that fertilized egg through surgery. Not Catholic hospitals, though. They might make doctors remove a woman's entire fallopian tube to prevent something fatal, reducing her ability to get pregnant in the future, even though it's medically unnecessary, because that's what their faith dictates.
What if a woman has a miscarriage? That's already emotionally draining, but Catholic hospitals make things worse. Normal hospitals might induce an abortion to make sure the embryonic tissue is removed from a woman's body to prevent infection. Not Catholic hospitals. They require doctors to wait until a woman is infected before providing treatment.
What about contraception? Catholic hospitals won’t dispense it. If a victim of sexual assault needs birth control immediately, and a Catholic hospital happens to be the one nearby, it may not help her. If there's any chance the victim is already pregnant when the hospital sees her, that help is even less likely.
Catholic hospitals also won't perform vasectomies on men because those would interfere with natural pregnancies in the future.
Nor will they help women who want to get pregnant by using a sperm donor.
They also won’t help couples use a surrogate mother to give birth to their biological child because that would also be seen as "gravely immoral."
Catholic hospitals are equally awful at the other end of life. What if you're an elderly person who is dying of a terminal disease, constantly in pain, and eager to end life on your own terms, peacefully, while you are able to make those kinds of decisions?
That ability to end your life, known as euthanasia or death with dignity, is legal in Colorado, but if you're in a Catholic hospital, too damn bad. You will just have to suffer. They will not assist you in those cases.
Catholic hospitals will also not help you if you're a transgender person who wants (or needs) hormone treatment, or a hysterectomy, or a mastectomy.
In short, Catholic hospitals have an obligation to the Catholic Church, not their patients. The people they hurt the most tend to be low-income people, women, and LGBTQ individuals—people who may not be able to decide in advance which hospital they want to go to due to emergencies, or a lack of insurance, or because they simply don’t know about these restrictions in advance. Even if they have insurance, it's possible their policies require them to go to a Catholic hospital, where their options are severely limited.
If we were just talking about a handful of hospitals, that would be one thing. But Catholic hospitals are taking over the country. According to the health advocacy group Community Catalyst, as of 2020, the 10 largest Catholic health care systems now "own or control 394 short-term acute care hospitals." They also own or control 864 urgent care centers, 385 ambulatory surgery centers, 274 physician groups, and more than 1,100 hospitals overall. Four of the 10 largest health care systems in the country are affiliated with the Catholic Church.
More than 30% of births in the U.S. now happen in a Catholic hospital.
How Catholic hospitals hide their policies
Here's what's really sneaky about this. Much like evangelical Christian bakers who don't advertise their bigotry with a sign on the door saying who they will or won't bake a cake for, Catholic hospitals don't always advertise the services they won't perform—or the fact that they’re Catholic.
Sometimes, these hospitals are named St. Something or Mercy Hospital and there's a cross in the logo and it's easy to figure out the connection. But often, their names are ambiguous on purpose. Like Dignity Health. You wouldn't necessarily know that's a religiously affiliated hospital.
In fact, in 2018, the New York Times looked at the websites of 652 Catholic hospitals (gift article) and found that two-thirds of them didn't make clear they were Catholic. You needed at least three clicks from the home page to confirm that. Only 3% of those hospitals listed what procedures they do not perform.
What that means is that patients may not know which hospitals are Catholic, and most of them won’t have any idea what procedures are banned until it's way too late.
How Colorado is fixing this problem
Last year, Colorado State Reps. Kyle Brown and Brianna Titone (a non-theistic legislator) and State Sen. Sonya Jaquez Lewis sponsored House Bill 1218, also known as the “Patients’ Right to Know Act.” The bill required all hospitals and community clinics to post a detailed list of what procedures “are not generally available… or that are subject to significant restriction” for non-medical reasons.
That would allow patients to know beforehand what the hospitals offer. Doctors would also be encouraged to share that information with patients.
The bill would also task the state’s Department of Public Health & Environment with creating a form for health care facilities to fill out documenting which services, for non-medical reasons, “are not generally available… or that are subject to significant restriction.” The department would then publish those forms on their website, update the information every two years, and investigate any complaints regarding non-compliance. (Update: To be clear, the hospitals don’t have to share this information on their own websites, but all the forms will be available through the state’s website.)
Basically, the bill forced hospitals to be honest and transparent, giving patients more complete information if they’re in the position of making a choice about where to get treatment.
Many Catholic hospitals, as we’ve seen, can’t be trusted to do that on their own.
When I spoke to Rep. Brown last year, he told me he was compelled to sponsor this bill because he believed every Coloradan deserved access to comprehensive health care. “Part of that is understanding which providers can provide care when they need it,” he added.
Noting that it may not be easy for patients to change facilities, and citing anecdotes from constituents who have found a lack of clarity at local hospitals, he said, “You shouldn’t have to wait till you’re in the hospital to find out certain kinds of health care are not available.”
This was also the kind of legislation promoted by groups like American Atheists for nearly a decade. In 2015, they even offered model legislation to any lawmakers willing to take up the cause. One staffer at the time defended the move by saying, “Patients must be able to make fully informed decisions about their health care… This legislation would help patients get the information they need to navigate the increasingly complicated—and increasingly religious—health care marketplace.”
And that’s what happened in Colorado. In fact, when the bill was in front of the House Health & Insurance committee, American Atheists’ Vice President for Legal and Policy Alison Gill spoke at the hearing (at the 1:48:45 mark). In addition to pointing out how this bill gave patients informed consent, Gill noted that, in the wake of the Dobbs decision, more patients were seeking abortion care and needed to know where they could receive it.
The bill eventually passed in the State House 44-18 (with 3 abstentions) and the State Senate 21-12 (with 2 abstentions). Governor Jared Polis signed it into law last May.
And as of today, it’s a reality. You can even see the completed “health facility service availability” forms here.
To give you an example of what patients can now see, here are two forms filled out by a decent secular hospital (on the left) and a Catholic hospital (on the right).
The hospital on the left offers plenty of pregnancy-related procedures (marked with a “Y” for “Yes”), but even when their abilities are limited (“L”), they offer referrals for those services.
On the right, the Catholic hospital will not provide (“N”) genetic testing or abortions—and they might not refer you to a place that will.
As far as money goes, this isn’t a burden on taxpayers. For this fiscal year, the cost of implementing this law will be just under $80,000 for a not-quite-full-time employee.
American Atheists is taking a well-earned victory lap today. Sheryl Kallivrousis, the co-chair of the group’s Colorado Secular Advocacy Team, said this in a statement:
I’m proud to live in a state that will serve as a model for legislatures and boards of health across the country… This law will protect all Coloradans, but it’s especially important for our state’s most vulnerable populations, those who are harmed the most by denial of care, including women, LGBTQ folks, and people who live in rural areas.
The group’s president Nick Fish added:
Colorado has proven it’s possible to pass common-sense health care transparency legislation with bipartisan support… Our work isn’t done, though. In too many places, the law still allows for non-medical denial of care, so we’re going to continue advocating for transparency legislation and patients’ right to know policies across the country — wherever Americans are being denied life-saving services and the information needed to make informed decisions about their well-being.
As he alluded to, this was never an anti-religious bill. This was always about transparency, not religious persecution. If a faith-based hospital didn’t want to offer certain services, nothing in this law required them to violate their religious beliefs. It merely asks them to tell the whole truth for the sake of their patients.
It’s long overdue and other states should now imitate what Colorado is doing.
(Portions of this article were published earlier)
A sane country would bar all religious institutions from operating hospitals. It is one of my deepest fears that I would find myself in a church-owned hospital and being unable to make my own decisions. The Catholic Church's stand on contraception does not elevate the status of life . . . it trivializes it.
No doubt Bobert and other conservatives will assert that trying to get Catholics to be honest is some form of oppression.