Religious facilities limit services - Patient Rights - National Women's Law Center releases guide on law requiring health care facilities to inform patients of services they will not perform

The ban on services instituted by many religiously affiliated hospitals, nursing homes, managed care companies, and insurers goes beyond abortions, extending to end-of-life options; research and therapy using fetal and embryonic stem cells; counseling about the use of condoms by HIV patients and others with sexually transmitted diseases; controversial infertility treatments; emergency contraception (including for rape victims); procedures pertaining to ectopic pregnancies; tubal ligations and other forms of sterilization; and contraceptive services (including prescriptions) and counseling.

While religiously affiliated health care institutions can restrict services in certain circumstances, they must warn consumers in a clear, accurate, and timely way or face legal sanctions. The National Women's Law Center (NWLC), Washington, D.C., has released a guide for consumers and advocates on ways to use the law to demand that health care institutions reveal the services they will not perform because of religious or moral objections. "Truth or Consequences: Using Consumer Protection Laws to Expose Institutional Restrictions on Reproductive and Other Health Care" arms patients with knowledge of disclosure requirements and strategies to encourage institutions to provide appropriate notice to the Community.

"Refusing to inform patients and communities about bans on important medical procedures makes bad medicine, bad community relations, and often violates the law," maintains NWLC Co-President Marcia D. Greenberger. "These religious restrictions are widespread and have serious consequences for women's health. Advocates can use these consumer protection laws to fight back."

Health care consumers often are unaware of these limitations because facilities supply little notice or information, often marketing themselves as providing comprehensive women's health services when they in fact do not. Health care is threatened when individuals must make decisions without knowledge of these restrictions. For example, pregnant women who want to have a tubal ligation during the same hospital stay after giving birth might not select a doctor who only has privileges at a facility that prohibits that procedure.

Although there are other types of systems that impose restrictions on health care because of institutional or moral objections, Catholic facilities usually set the most rigid limitations on women's reproductive and other health services, often failing to supply information to patients on treatment alternatives and referrals that go against church teachings.

Catholic hospitals play a substantial role in this country's health care system. Five of the 10 largest health care systems are Catholic-sponsored. Moreover, in many rural areas, Catholic hospitals often are the sole health care providers. Also, Catholic health care networks usually impose bans on nonsectarian institutions that merge or affiliate with them, resulting in non-Catholic partners agreeing to comply with religious guidelines. As a consequence, key services are eliminated for a community with little or no notice to patients and consumers.

"What is shocking is the silence surrounding these restrictions," notes Elena N. Cohen, NWLC senior counsel and coauthor of "Truth or Consequences." "Unfortunately, many women only learn about these restrictions when they are faced with urgent health care decisions, not when they are planning their care. We trust and expect our health care institutions to provide quality health care and not mislead the public about the scope of their services. Failing to inform patients about restrictions in a timely manner or not at all is a gross betrayal of public trust."

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