The United States Conference of Catholic Bishops (USCCB) issued, in 2001, a document calling for all Catholic hospitals to ignore “advance directive[s…] contrary to Catholic teaching.”1 Further, what care may be directed by an injured person’s surrogate (in the event that the injured person cannot make decisions) must also be in compliance with “Catholic teaching”.2 This means that the designated surrogate may be utterly ignored if what the patient wants is contrary to “Catholic teaching”.3
“What does this have to do with me?” You might well ask, “I’m not Catholic.” Unfortunately, the USCCB order applies regardless of your own religious faith (or lack thereof) and applies to all patients in Catholic-run hospital and hospice institutions. Indeed, any partnership entered into by the Catholic institution with a secular (or otherwise non-Catholic) must also comport with “Catholic teaching” and the contract between the two entities must be sure to keep the Catholic institution’s hands clean.4
Catholic-run institutions account for between 10% and 20% of all healthcare (depending on your state)5…and could be even more, depending on your insurance, location, and favorite doctor. As was seen in Washington, DC when the local bishops threatened (and then made good on their threat) to stop all Catholic-based health and social services,6 many [non-Catholic] people are served by Catholic institutions without realizing it.
This scares me for a number of reasons. The first of which is that I don’t know what religious proclivities my local hospital has, 7 but I do know that my prior local hospital was Catholic…and I don’t know where the next-closest one from there would have been. Secondly, it strikes me as profoundly unethical for my own advance directives, carefully written up to be legally binding, and my own husband, who can legally act in my stead if I am incapacitated, could be completely ignored because of the religion of the people who own the building I’m being treated in.8 Finally and, in my mind, most distressingly, what is “Catholic teaching”?
Pope Paul VI issued an encyclical entitled Humanae Vitae (or, On Human Life) in 1968 which put forth official papal teaching about what can and cannot be done to “human life”.9 This was promulgated in 1968 and still comprises the majority of official Catholic teaching on the subject. What most Catholics believe to be moral, however, differs widely. In fact, most Catholics disagree with official church doctrine.10
What, then, will “Catholic teaching” be to the hospital in question? Will it be official papal doctrine, which virtually no American knows, let alone follows? Will it be the personal feelings of the [Catholic] administrator/doctor/provider across whose desk this particular patient happens? Will it be the teachings of the USCCB (which even fewer Americans know and which are not always consistent with Vatican teaching)?
Whatever it will be, we can be assured that it will not be the patient’s choices that will be abided by. American Catholics and non-Catholics alike should be worried about this religious infringement upon our healthcare.
Footnotes:
1 Ethical and Religious Directives for Catholic Health Care Services, Fourth Edition (“Ethical Directives“), Directive #24 (in Part Three).
2 Id, Directive #25 (in Part Three).
3 I’m not using scare quotes to be scary but because, as we shall see, what constitutes Catholic teaching is more variable than, perhaps, the USCCB would like to admit.
4 Ethical Directives, Directives 67-72 (in Part Six).
5 As self-reported by the USCCB’s Catholic Information Project.
6 If you really haven’t heard about this, wow, but here’s a link to just one article, this one from the Washington Post, “Citing same-sex marriage bill, Washington Archdiocese ends foster-care program,” February 17, 2010.
7 Personally, I think that’s scary enough. Do we really think that it’s okay for patients to have to actively think about what religion their hospital is?! Not the religion of their doctor (which, again, should not matter) but the religion that owns a building in which health care is provided. That. Is. Scary.
8 To the best of my knowledge, Catholic hospitals hire doctors, nurses, and support staff of all denominations. Additionally, many doctors may practice medicine at a number of different hospitals, based on contractual arrangements. So it is not simply the religion of the people who are treating you that is at issue (just as it should not be).
9 Official English translation. Wikipedia entry. Cliffs notes version: artificially terminating “life” at any time is bad. Life is defined as including fertilized eggs and persistent vegetative states, including brain-death, and everything in between.
10 American Enterprise Institute for Public Policy Research‘s In Today’s Environment, Contraception Could Become a Big Issue, June 22, 2005: at least 78% of US Catholics disagree with Catholic teaching regarding contraception. (Via Wikipedia‘s article “Religious views on birth control“, note 9.)
See also: “Catholic Directive May Thwart End of Life Wishes” over at Kaiser Health News and “Voluntary End-of-Life Measures Banned at Catholic Hospitals” at NYT‘s the New Old Age blog.
(I was alerted to this by someone whose friend was admitted to a Catholic hospital and whose advance directive was not honored.)
This is filed under “Church and State” because, although hospitals are not technically “the State”, we often think of them as public services and do not expect them to be subject to the capricious religious whims of a group of theologians in Washington, DC.
