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October 12, 2004
Discover What's Current in Law and Policy for Women
In this issue…
1. Three NWLC Projects Help Women Speak Out Against Health Care Refusals
2. Pharmacy Access Project
3. Hospital Merger Project: Lessons Learned From West Suburban Hospital
4. “ASK!” if the Moral or Religious Beliefs of Your Health Care Providers Will Limit Your Access to Health Care
Three NWLC Projects Help Women Speak Out Against Health Care Refusals
The moral and religious beliefs of some health care providers are limiting access to health care. Many consumers, however, are unaware that providers—because of their beliefs—may be refusing to perform certain services or give information that patients want, even when the law requires that they do so. These kinds of refusals are showing up with greater frequency in settings ranging from health plans to hospitals, college campuses to drug stores. The affected services span the life cycle, from reproductive care to end of life care.
The National Women's Law Center, working in coalition with other organizations has launched a series of outreach and advocacy projects to protect a woman's right to choose and to receive an array of information services:
Pharmacy Access Project
Recently in Laconia, New Hampshire, 21-year-old Suzanne Richards, working hard running her own house-cleaning business to support herself and her son needed to have her prescription filled for emergency contraception (EC)—a time-sensitive Food and Drug Administration (FDA)-approved form of birth control. The pharmacist at the local drug store refused to fill it, lecturing her about his religious beliefs and her irresponsibility. At least a dozen states have now considered legislation to give a specific right of refusal to pharmacists. In addition, three states, Arkansas, Mississippi, and South Dakota have already passed such laws giving pharmacists the right to refuse to dispense drugs if they have a religious or moral objection.
The Pharmacy Access Project addresses pharmacy refusals through a variety of strategies. The Center is developing legal approaches to secure the right to have prescriptions for contraception filled; providing technical assistance to individuals who have been denied their prescriptions; aiding state and federal advocates in establishing policies protecting access to prescription contraception; and educating the public about the issues of pharmacy refusal.
As part of this project, we are compiling a register of pharmacy refusal incidents from across the nation to document the scope of the problem. If you or someone you know has been denied a prescription for EC or another contraceptive, please contact Lisa LeMair at llemair@nwlc.org.
Hospital Merger Project: Lessons Learned from West Suburban Hospital
Hospital mergers can also have a harmful impact on women's health because of restrictions the merging hospital's religious or moral tenets place on reproductive or other critical health care. Throughout 2003, the Center worked with a coalition of community activists, doctors, and reproductive rights and civil liberties groups in Chicago to fight the takeover of a local community hospital (West Suburban Hospital) by a Catholic health system (Resurrection). The hospital serves a diverse community including many low-income women. With the merger, the hospital would have to follow the Ethical and Religious Directives for Catholic Health Care Services, which forbid contraception and sterilization, and restrict rape victims' access to emergency contraception.
When the takeover went through in March 2004, the coalition secured access to some services at an outpatient clinic that arranges for emergency contraception for rape victims who arrive at West Suburban. Doctors at West Suburban help patients who have delivered a baby and who want a post-partum tubal ligation to prevent further pregnancies to get that service at a nearby hospital. While these arrangements are not ideal, doctors have reported that these women are generally getting what they need.
However, there are still serious lapses in care. Recently, a doctor reported she was forbidden to treat a woman with an ectopic pregnancy. These pregnancies develop in the fallopian tube, are never viable, and may actually result in the woman’s death if the tube ruptures. However, according to the U.S. Conference of Bishops’ Directives—a set of treatment guidelines that administrative and medical personnel at Catholic hospitals must follow as a condition of employment—treatment would have amounted to an abortion, so the doctor was not allowed to intervene. The patient was transferred to another hospital, delaying her care and putting her health at risk.
Examples such as this abound. Dr. Debra Stulberg, a Family Practice resident physician with West Suburban, tells NWLC that a lot has changed since the Resurrection takeover. According to Dr. Stulberg, “Patients are going to their own doctors for birth control and are being turned away. Rape victims seen in the emergency room are being sent to an outside facility if they need emergency contraception. The community we serve is already struggling for basic health care. Now, when it comes to many of the services that West Suburban used to provide, community members have one less place to turn.”
The coalition formed to fight the takeover continues to monitor the hospital and is working with authorities to make sure that no more women’s lives are placed in danger, and that doctors can meet the standard of care all women deserve. If you or someone you know has information about a pending hospital merger or have been denied access to reproductive health care at a hospital or clinic on a religious or moral pretext, contact Lisa LeMair at llemair@nwlc.org.
“ASK!” if the Moral or Religious Beliefs of Your Health Care Providers Will Limit Your Access to Health Care
The National Women’s Law Center has launched a public effort to inform citizens about potential limitations to their health care services because of the moral or religious beliefs of their health care providers. NWLC’s “ASK!” initiative includes a health care brochure designed to increase public awareness of religious limitations on critical health services and provide women with the right questions to ask their health care providers.
The brochure, entitled “ASK!: Will the Moral or Religious Beliefs of Your Health Care Providers Limit Your Access to Health Care?,” encourages the public to ask questions, such as:
• Will my drug store fill a prescription for the morning-after pill?
• My mom has written an advance directive that says she doesn’t want artificial nutrition and hydration – will you honor her wishes?
• Chemotherapy will make me infertile; does my doctor support saving my eggs?
NWLC’s “ASK!” brochure is a way for you, your friends, colleagues and networks to know what to ask your health care providers before it’s too late. We encourage you to get the brochure, put it to use in your community, and tell us about the responses you and those you know are getting from the use of the brochure. For more information about the “ASK!” brochure, to receive hard copies of the brochure for distribution, and to share with us the responses your health care providers are giving you, contact Lisa LeMair at llemair@nwlc.org.
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