Academic journal article Fordham Urban Law Journal

Saving Roe Is Not Enough: When Religion Controls Healthcare

Academic journal article Fordham Urban Law Journal

Saving Roe Is Not Enough: When Religion Controls Healthcare

Article excerpt


Gilroy, California, is a small town about thirty-three miles south of San Jose--the heart of Silicon Valley. (1) Gilroy historically has been an agricultural community. It has the highest rates of poverty and teen pregnancy in Santa Clara County. (2) It has one hospital. (3) There are five Ob/Gyns. (4) The hospital is the only site in Gilroy with the appropriate facilities to perform inpatient and outpatient tubal ligations, as well as abortions. (5) In 1999, Catholic Healthcare West purchased the hospital (6) and immediately told the physicians that they must abide by Catholic teachings; they had to stop performing sterilizations and abortions, and family planning supplies and emergency contraception were no longer available at the hospital or in the emergency room. (7)

The impact on the community was immense. Physicians were outraged at the interference with their medical judgment and the doctor-patient relationship over providing sterilizations. They organized, wrote letters to the editor, voted as a hospital staff to preserve sterilizations, and even appealed directly to the Bishop--all to no avail. (8)

Women, who had the time and could afford transportation, traveled to San Jose to get the services they needed. (9) The Gilroy doctors lost many insured patients, thereby reducing their incomes. (10) Low-income women, who could not manage the thirty-five-mile-each-way bus trip, were left with no alternatives. (11) One woman, pregnant with her ninth child, could not get the voluntary sterilization even though she had already signed her consent form. (12) According to her doctor, another pregnancy would "drastically increase the chance of life-threatening complications." (13)

January 22, 2004 marked the thirty-first anniversary of Roe v. Wade (14) which gave women the Constitutional right to seek abortion services until the fetus is viable. (15) Ever since Roe, many have been battling to keep that legal right. Access to abortion, however, and the broader scope of reproductive health services--from family planning to fertility services to HIV and AIDS prevention--also are threatened by an issue which receives much less public attention. This is the increased role in the health care marketplace of religiously-owned-and-operated hospitals and health care entities.

While our nation struggles with enormous issues of access to health care for millions of uninsured and underserved individuals, consumers of health care services nonetheless have developed reasonable expectations of certain "patient rights." Health care professionals are held accountable to their patients including the paramount principle of the sanctity of the patient-doctor relationship and patient-doctor communication. Patients expect that they will receive full and medically accurate information that will enable them to control their health care choices. (16) Individual health care providers have a reasonable expectation that they will be able to offer complete information to their patients and to make medical decisions for treatment options based on medical research and generally accepted standards of practice.

When a woman decides that the child she is about to deliver is going to be her last, she expects her physician will be able to perform a sterilization; when a woman is raped, she expects that the emergency room to which she is taken will give her emergency contraception to prevent pregnancy; when a woman of child-bearing years is scheduled to undergo chemotherapy that may destroy her future fertility, she expects to be told that she can harvest her eggs for later implantation; when a physician faces a patient with an ectopic pregnancy, she expects to be free to choose the best treatment for the patient; when a dying patient writes advance directives, she expects that they will be honored; when a patient goes to a health care professional, she expects that she will get all of the medically accurate information she needs. …

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