Claire Dawson
Catholic hospitals are a common feature of the US healthcare landscape, with more than half a million babies delivered each year in Catholic-run hospitals, accounting for about 16% of all hospital births. The presence of so many Catholic hospitals has significant implications for reproductive healthcare, as these institutions often adhere to religious directives that restrict certain medical procedures and treatments, including contraception, sterilization, abortion, and some infertility treatments. These restrictions can create ethical dilemmas for healthcare providers and put patients' lives at risk, particularly in emergency situations or when dealing with pregnancy complications. The expansion of Catholic hospitals has sparked debates about religious freedom, conscience rights, and the role of religion in shaping healthcare policies and practices.
| Characteristics | Values |
|---|---|
| Number of Catholic-run hospitals in the US | 548 |
| Percentage of all short-term acute care hospitals in the US | 14.5% |
| Number of babies born in Catholic-run hospitals each year | More than half a million |
| Percentage of all hospital births each year | 16% |
| Number of people with only Catholic or Catholic-affiliated birth hospitals within an hour's drive | Nearly 800,000 |
| Percentage of hospital beds in Washington State that are in Catholic hospitals | Over 40% |
| Number of states with more than 30% of hospital beds in Catholic facilities | 10 |
| Number of states with over one-fifth of hospital beds in Catholic facilities | Nearly half |
| Religious directives that Catholic hospitals follow | Ethical and Religious Directives for Catholic Health Care Services |
| Organization that sets forth the directives | U.S. Conference of Catholic Bishops |
| Prohibited reproductive health services | Contraception, sterilization, many infertility treatments, abortion |
| States where Catholic hospitals dominate | Washington, Oregon, Colorado |
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What You'll Learn
Religious rules vs medical standards
In the United States, there are over 600 Catholic general hospitals and roughly 100 more managed by Catholic chains that place some religious limits on care. This means that if you face a medical complication, you have a one in ten chance of landing in a Catholic hospital.
Catholic hospitals follow the Ethical and Religious Directives for Catholic Health Care Services (ERDs), a publication that sets policy in Catholic hospitals and health systems. The document is written and published by the United States Conference of Catholic Bishops, deriving medical and healthcare policy from Catholic theology and church teachings. The directives prohibit common reproductive health services, including contraception, sterilization, many infertility treatments, and abortion care, even when a woman's health or life is in danger. They also restrict the ability of hospital staff to provide patients with full information and referrals for care that conflict with religious teachings. For instance, doctors in Catholic hospitals were not allowed to intervene in anything theologians considered a natural part of the reproductive process, even if deadly, such as ectopic pregnancy.
In some states, more than 40% of all hospital beds are in Catholic-run facilities, leaving entire regions without any option for certain reproductive health care services. In ten states, more than 30% of all hospital beds are in Catholic facilities, and in nearly half the states, more than one in five hospital beds is in a Catholic facility. This means that for nearly 800,000 Americans, there is little choice—they have only Catholic or Catholic-affiliated birth hospitals within an hour's drive.
The Catholic Health Association maintains that the ERDs do not prevent physicians from providing medically indicated care, especially in situations involving very serious, potentially life-threatening pregnancy complications. In a pregnancy crisis when a person's life is at risk, the ethical and religious directives allow clinicians to provide medically necessary treatments in emergencies. However, critics argue that patients can find themselves caught between accepted medical standards and the religious-based policies of Catholic-run facilities.
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Catholic hospitals and reproductive health care
In the United States, there are a significant number of Catholic hospitals, with 548 hospitals or 14.5% of all short-term acute care hospitals adhering to the Ethical and Religious Directives for Catholic Health Care Services (the Directives). These Directives are based on the Catholic Church's theological and moral beliefs and prohibit a range of reproductive health services, including contraception, sterilization, abortion, and many infertility treatments. This can result in patients being denied critical reproductive healthcare, even in emergency situations, and restricts the ability of hospital staff to provide full information and referrals for care that conflicts with these religious teachings.
The impact of these policies is felt across the country, with nearly 800,000 people having only Catholic or Catholic-affiliated birth hospitals within an hour's drive. This lack of alternative options can put pregnant women at higher risk, as they may need to travel farther to access reproductive healthcare, especially in emergency situations. For example, patients experiencing miscarriages or pregnancy complications may not receive timely and appropriate treatment due to the restrictions on abortion and miscarriage management in Catholic hospitals.
In some states, the concentration of Catholic hospitals further exacerbates the challenges in accessing reproductive healthcare. For instance, in Washington State, more than 40% of hospital beds are in Catholic hospitals, leaving entire regions without alternative options for certain reproductive health services. Similarly, in Michigan, the presence of Catholic hospital chains like Trinity Health can make it difficult for individuals like Sullivan to obtain reproductive healthcare, even with abortion rights enshrined in the state constitution.
The restrictions on reproductive healthcare in Catholic hospitals have raised concerns among reproductive rights groups, medical organizations, and patients. Some physicians have intentionally violated protocols, prioritizing patient safety over religious directives. Additionally, efforts have been made to protect physicians who act against Catholic hospital restrictions, such as the state law enacted in Washington in 2021.
While the Catholic Health Association defends its position, stating that the Directives do not prevent physicians from providing medically indicated care, investigations and firsthand accounts from patients, doctors, and other healthcare providers highlight the limitations and impact of these policies on patient care. As a result, there is a growing spotlight on Catholic-run healthcare, particularly as abortion access becomes more restricted nationwide.
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Religious-based policies in emergency care
The Ethical and Religious Directives for Catholic Health Care Services, issued by the U.S. Conference of Catholic Bishops, set forth standards for care at Catholic health facilities. These directives often conflict with accepted medical standards, particularly in emergency situations involving pregnancy complications.
The Directives prohibit a range of reproductive health services, including contraception, sterilization, many infertility treatments, and abortion, even when a woman's life or health is at risk. They also restrict the ability of staff to provide full information and referrals for care that conflict with religious teachings. This can result in patients being denied critical emergency care during miscarriages or other serious pregnancy complications. For instance, Catholic hospitals often prohibit doctors from performing tubal ligations at the time of delivery, leaving patients to undergo additional surgery elsewhere.
In some states, more than 40% of hospital beds are in Catholic-run facilities, and nearly 800,000 people have only Catholic or Catholic-affiliated birth hospitals within an hour's drive. This lack of alternative options can put patients at serious risk when they require emergency care that conflicts with religious directives.
The impact of these policies is felt not only by patients but also by healthcare providers, who may be forbidden from providing care that aligns with accepted medical standards. Furthermore, the expansion of Catholic hospitals and their receipt of taxpayer funding have led to debates about the role of religious institutions in delivering public goods like healthcare.
While the Catholic Health Association asserts that their directives do not prevent physicians from providing medically indicated care, investigations and firsthand accounts from patients and clinicians suggest that religious-based policies can restrict access to reproductive healthcare and impact patient outcomes in emergency situations.
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Taxpayer funding for Catholic hospitals
Catholic hospitals in the United States receive billions of dollars in taxpayer funding. A 2002 study of nearly 600 religiously affiliated hospitals in the country found that they received over $45 billion in public funds. A more recent report puts the figure at $47.8 billion in net patient revenues from Medicare and Medicaid, a 76% growth since 2011. This is a significant increase compared to the 25% growth experienced by all hospitals during the same period.
Despite this substantial taxpayer funding, Catholic hospitals often restrict access to reproductive health services, denying patients critical care. The hospitals are governed by the Ethical and Religious Directives for Catholic Health Care Services, or ERDs, which prohibit a range of reproductive health services, including contraception, sterilization, many infertility treatments, and abortion, even when a woman's life or health is at risk. These directives also restrict the ability of hospital staff to provide patients with full information and referrals for care that conflict with Catholic religious teachings.
The American Civil Liberties Union (ACLU) has highlighted cases where patients have been denied appropriate care at Catholic hospitals due to these directives. In one instance, a woman experiencing a miscarriage was not informed of the risks to her health and was sent home without proper treatment, resulting in an infection. In another case, a woman was forced to continue her pregnancy despite medical advice that it was unsafe, due to the hospital's religious policies.
The impact of these restrictions is significant, with up to 16% of births occurring in Catholic-run hospitals and over 40% of hospital beds in some states belonging to Catholic facilities. This leaves many individuals, especially in rural areas, with little choice but to seek care at these institutions, where their medical treatment may be influenced by religious doctrine rather than medical standards.
The funding of Catholic hospitals with taxpayer money raises questions about the role of religion in public services and the extent to which religious beliefs can influence the provision of healthcare. While the Catholic Church defends its directives as essential to upholding moral principles, critics argue that the denial of reproductive health services violates patients' rights to comprehensive healthcare and infringes on the autonomy of medical professionals.
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Staff experiences in Catholic hospitals
The existence of Catholic hospitals in the US is rooted in the Catholic Church's historical role as a provider of healthcare services, dating back to the establishment of the first church hospitals in the East and later in the Latin West. In the context of the United States, Catholic hospitals were established during the colonial era, with Charity Hospital in New Orleans being one of the earliest examples, founded around 1727.
Over time, the Catholic Church became a prominent provider of healthcare in the United States, accounting for a significant proportion of hospital beds, admissions, and expenses. This prominence in healthcare extended beyond the United States, with the Church managing 26% of the world's healthcare facilities as of 2010.
One notable aspect of working in a Catholic hospital is the impact of religious policies on patient care. Catholic hospitals are known for their restrictions on certain procedures, particularly in the areas of reproductive and OB/GYN care. These restrictions can sometimes limit the options available to physicians and affect the services they can provide to patients. For example, Catholic hospitals generally do not perform abortions or provide certain contraceptive services. Additionally, Catholic hospitals have been associated with anti-Catholic sentiments and acquisition rushes of previously secular hospitals, which can impact the experiences of both staff and patients.
However, it is worth noting that patient satisfaction and perception of care in Catholic hospitals are generally similar to those in non-Catholic hospitals, with Catholic hospitals maintaining a slight advantage in specific areas, such as nurse communication and quietness of rooms at night.
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Frequently asked questions
Catholic hospitals are involved in delivering healthcare, a public good.
Catholic hospitals are bound by the Ethical and Religious Directives for Catholic Health Care (the Directives), issued by the U.S. Conference of Catholic Bishops.
The Directives prohibit a range of reproductive health services, including contraception, sterilization, many infertility treatments, and abortion care, even when a woman's health or life is in danger.
There are 548 hospitals that comply with the Directives, making up 14.5% of all short-term acute care hospitals in the U.S.
The expansion of Catholic hospitals leaves patients at the mercy of the church’s religious directives, which are often at odds with accepted medical standards.
