In some places — including big swaths of Western Washington — Catholic providers are becoming the only source of health care for an entire region. (Approximately 8 percentof what the federal government calls “sole community hospitals” are Catholic.)
The dilemma is that Catholic hospitals — there are 630 or so in the United States, representing 15 percent of all admissions every year — are not independent entities. They are bound by a 43-page document called the Ethical and Religious Directives for Catholic Health Care Services, which have been around in some form since 1921 and were last revised by the U.S. Conference of Catholic Bishops in 2009.
The 72 directives explicitly ban abortion and sterilization. They restrict other types of care as well, including emergency contraception for rape victims (“It is not permissible… to initiate or to recommend treatments [for sexual assault] that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum”), in vitro fertilization and artificial insemination (“contrary to the covenant of marriage, the unity of the spouses, and the dignity proper to parents and the child”), surrogate pregnancy, and anything that remotely resembles assisted suicide (the bishops’ preferred term is “euthanasia”).
There are a large number of Catholic hospitals in the Chicago area as well, though thankfully still mixed in with private and public institutions. Still, as a person who has had reproductive health issues her entire life, the idea that I might be denied potentially life-saving care in an emergency just because the closest hospital was run by a religious order made me nervous.
We’ve come to accept privatization of all kinds of public services as just some kind of substitution: Your local hospital just has a new name! Your former public park is now a shopping mall! You can still go there and see your doctor, you can still walk around! But the rights and responsibilities of everyone change in those situations. Your religious hospital can choose to save your fetus’s life instead of yours. Your private mall can ban you from certain types of behavior within its spaces.
You ain’t the boss of it anymore. And your health is the kind of thing you want to be the boss of.