Patients' Rights at Catholic Hospitals: Take Phoenix for Example

I hope it's a good omen for 2011 that Becky Garrison's article for The Guardian about the excommunication of Sister Margaret McBride is getting such attention. Perhaps the crisis of patient's rights that results when health care is provided with a denominational bias will be addressed?

Here's the nitty-gritty of the story: Sister McBride and her colleagues approved an abortion to save the life of a pregnant mother of three. The local Bishop, Thomas Olmsted, objected to the procedure, saying that the hospital and sister were treating an unborn child as a disease. That was last November. Last week, Olmsted revoked the hospital's Catholic status.

This rift between practitioners of health care and the Catholic Church is not about to go away any time soon. There are about 624 Catholic hospitals in the U.S. The Catholic Healthcare Association, state laws, and individual doctors and practitioners are increasingly at odds with the more conservative bishops who enforce adherence to the Church's 72 Ethical and Religious Directives. These directives, written by the United States Conference of Catholic Bishops, are enforced by the bishop in the area where hospitals operate. If the bishop is opposed to certain medical practices and highly involved with the hospital's operations, the rights of patients can be grossly curtailed.

Here are just a few scenarios that take place across the country every day:

- a rape victim is not told that she can prevent pregnancy by taking emergency contraception, nor is she referred to a doctor or emergency room willing to provide EC

- women are denied tubal ligations at the time of birth (or any other time and are not referred to alternative services), when the procedure would be easiest and not require a second invasive operation

- patients are not informed of how to prevent STDs, AIDS, or unwanted pregnancies, nor are they referred to appropriate services

- the hospital retains the right to decide when a dying patient should be removed from artificial nutrition and hydration, not the patient, the patient's advance directive, nor their family

As Becky writes, CHA broke with the USCCB by supporting the Obama Administration's health care bill, despite the latter's claim that the new bill would skirt the Hyde Amendment (which prohibits use of federal funds for abortion; the amendment is an annually renewed clause applied specifically to Medicaid funding).

The rift between bishops and medical practitioners can only widen as the Church works to bring hospitals in line with their doctrine, doctrine that often runs afoul of federal and state laws protecting patients' rights.

Read comments at Episcopal Cafe

Hiring Pledges and Faith-Based Initiatives in DC.

Worldwide Religious News reports on the new requirement at Catholic Charities in Washington DC that incoming employees sign a pledge that they will not "violate the principles or tenets" of the church. While Catholic leaders deny that this new requirement is a result of the DC ruling that Catholic Charities can't discriminate against same sex couples, the article notes:

Catholic Charities, one of the region's largest nonprofit organizations, has been trying to develop a way to continue its multimillion-dollar social service partnerships with the District while not recognizing the city's same-sex marriage law, which the D.C. Council approved in December. Employees were told this month that the agency was changing its health-care coverage to avoid offering benefits to its workers' same-sex partners.

And here's the rub of faith-based delivery of social services. How do (federally funded) organizations justly serve a pluralistic society when their employees are asked to pledge discrimination against those individuals the very organization is charged with serving? (As well, denying health care coverage to all employees to avoid inadvertently treating a queer couple who's slipped through the hiring process any bit of equality is absurd and hateful.)

But here is the very position that our governmental reliance on faith-based organizations has put Catholic Charities (and World Vision, see below) and every other doctrinal provider of health care or other social services in: how to serve a society that does not abide by your discriminatory world view? The Catholic Church's conservative leaders have decided to dig in their heels.

From the article:

Salmi said the new language "is more of an expectation than a condition. It's letting people know this is the culture." Asked if that meant employees could speak or act against the church without being fired, Salmi said: "We can't speculate on the hypothetical. It's handled on a case-by-case basis."

A former vice president of the organization's human resources department, however, said the new language appeared to be a change.

"Putting it in a letter and requiring a signature, that's a condition of employment. There's no way to dance around that," said Wayne Swann, who served 3 1/2 years on Catholic Charities' board of directors and an additional four years as its vice president.

On the basis of Supreme Court rulings, President George W. Bush issued executive orders allowing faith-based social service groups that receive public money to discriminate in their hiring practices. As a candidate, President Obama sided with those opposing such hiring limits and vowed to stop them. But since Obama took office, the issue has remained under study by the Justice Department.

Federal and D.C. laws explicitly give religious groups exemptions from bans on religiously based employment discrimination, but some church-state experts point to federal funding statutes -- including those for Head Start and the Workforce Investment Act -- that ban such preferences. The Establishment Clause of the Constitution prohibits discrimination in government-funded programs, they say.

"Taxpayers shouldn't have to pay for positions to which they can't apply, solely on the basis of their faith," said Dan Mach, director of the ACLU Program on Freedom of Religion and Belief.

There is no hard data on the percentage of faith-based social service groups that have religious hiring requirements in an effort to maintain their faith identity. World Vision, one of the largest Christian relief organizations in the world, requires U.S.-based employees to sign a statement saying they agree with the organization's tenets or the Apostles' Creed.