Are you getting the care you need?
More and more often, the moral and religious beliefs of certain health care providers are limiting the public’s access to health care. Many consumers are unaware that these providers, because of their own religious or moral beliefs, refuse to perform certain services or give out information patients want, even when the law requires that they do so. Reproductive health services are most affected, but end-of-life care is as well. Patients do not find out about limits on such services until they are denied care. By then it is often too late to do anything about it.
Why do you need to know now?
Arming yourself with information before you make health care decisions will increase your chances of getting the care you need. You can choose doctors or drugstores that will give you the services you need. You can also encourage health care providers with religious objections to provide your community with advance notice of their objections and referrals for services you want. In some cases, your community may even get a hospital, doctor, school, employer, insurance plan, or pharmacy to provide the services your community needs.
The National Women’s Law Center may be able to help. Call 1-800-745-5487 or visit www.nwlc.org for more information or for help.
ASK at the Hospital
Many hospitals have a religious affiliation, the most common being Catholic. While some religiously-affiliated hospitals provide a full range of health services, many ban services based on their religious beliefs. These hospitals apply the Ethical and Religious Directives for Catholic Health Care Services, guidance issued by the United States Conference of Catholic Bishops, which are interpreted by the Bishop, Diocese, hospital administrators and staff. Many interpretations of the Directives are more restrictive than the interpretations issued by the Catholic Health Association of the United States, the membership organization of Catholic Hospitals.
As a result of the Directives patients may never know about the full range of medically-appropriate treatment options available for their medical condition. If your doctor has admitting privileges at a hospital with restrictions on certain health care services, you may not be able to get the care you need.
- While all Catholic hospitals forbid non-emergency pregnancy terminations, some hospitals interpret the abortion ban to prohibit the treatment of certain ectopic pregnancies and miscarriages, or deny the treatment that is the standard of care, even though the Directives have been interpreted to allow prompt treatment according to the standard of care. Some hospitals will transfer women, despite their legal duty to provide emergency care or delay treatment until there is no longer a fetal heartbeat or the woman’s life is endangered.
- Some Catholic hospitals still deny emergency contraception (the “morning after pill”) to rape survivors, even though the Directives have been interpreted to allow it since EC has been scientifically proven not to cause an abortion.
- Most Catholic hospitals forbid surgical sterilizations, even for patients for whom it is medically indicated. This restriction means that women who are having cesarean sections have to have a second surgery, incurring additional the risks and recovery time that could have been avoided.
- Most Catholic hospitals refuse to counsel women about birth control, provide them or write prescriptions for them, even when the use of contraceptives is medically indicated or a pregnancy would endanger a woman’s life or health. Most Catholic hospitals also forbid counseling on the use of condoms to prevent the spread of HIV and other STDs.
- Most Catholic hospitals refuse to provide certain infertility treatments. Because these restrictions extend to counseling, information and referrals, this means that people who are having medical procedures that would reduce their fertility may never be told about methods to preserve their ability to have a biologically-related child.
- The Directives were recently revised to make it clear that the U.S. Conference of Catholic Bishops is opposed to stopping artificial nutrition and hydration in certain circumstances. The Directives state that any patients’ end-of-life wishes that are not consistent with the Directives can be ignored.
ASK your Doctor and Other Health Care Providers
While patients are most likely to encounter restrictions on health care access at a Catholic hospital, individual health care providers may also refuse to perform certain services because of their religious or moral beliefs. Some health care providers may not inform you of all of your medically-appropriate options or refer you to another provider for information or services to which they have a religious or moral objection. For example:
- A doctor treating a woman for breast cancer may decide not to tell her that she could have her eggs removed before treatment and saved so she may later have biological children.
- An infertility specialist may think that gay couples or unmarried women should not have children and refuse to provide them with treatment.
- An obstetrician may decide to not order certain tests for a pregnant woman if he or she thinks the woman might end her pregnancy if the tests show genetic problems.
ASK at the Drugstore
Some pharmacists refuse to fill prescriptions they find “morally” wrong, including prescriptions for birth control pills and the morning after pill. Some pharmacists have refused to give the prescription back to the customer, requiring the customer to get another one.
Before you turn over your prescription, ASK if your drug store allows pharmacists to refuse to fill prescriptions on religious or moral grounds. ASK how the drug store makes sure customers get what they need without delay.
ASK on Campus
Some student health plans at religiously-affiliated schools do not cover contraceptives because the school has a religious objection to them. These restrictions apply to everyone, regardless of their age, and apply to all students, married or unmarried. These schools might also deny the morning-after pill to rape survivors and forbid condoms on campus. When you are deciding where to go to school, ASK about your health insurance coverage and services on campus.
ASK at Work
Federal law requires some employers to include contraceptive coverage in health insurance plans, and some states require insurers to cover contraceptives or infertility treatment.
Even in states with laws that require contraceptive coverage, certain religiously affiliated employers (like schools, hospitals and social service agencies) refuse to provide coverage based on their moral or religious beliefs. Some state laws require employers to tell their employees about limits on coverage and options, but others do not.
ASK about insurance coverage when you are considering the benefits at a new job; another family member may have better benefits. Find out if coverage is required by law. ASK if your employer would consider changing the plan, or adding a plan that includes coverage for contraceptives.
ASK when picking a Health Plan
Some health insurance plans are run by religious organizations, which might have a religious objection to contraceptives or infertility treatment. Some of these plans also enroll people on Medicaid. Medicaid requires access to contraceptives, so women are allowed to go outside of their plans to get this service, but many women do not know. Women may face delays in getting the services outside the plan, or not get them at all.
Before you enroll in a health insurance plan, ASK if it covers the services you need. Also find out if the doctors and hospitals covered under your insurance plan will provide the services you might need. Also, make sure your insurance plan lets you go to a hospital that will give you the services you need.