Catholic hospitals' gag rules under fire

Many Catholic hospitals across the nation are not discussing contraceptive options with rape victims brought into their emergency rooms, according to a recently published Penn study. Despite the nationwide standard of mentioning contraceptive options when discussing treatment with these patients, the results of a Penn pilot study -- published in the September issue of the American Journal of Public Health -- showed that some Catholic medical centers prohibit the discussion, prescription and distribution of emergency contraception in the treatment of rape victims. Women treated at these hospitals "think they have gotten all the standard medical care and in fact they have not," said Jon Merz, a faculty member at Penn's Center for Bioethics and senior author of the study. "Women who have been traumatized cannot make an inquiry, and failure to tell them [about different options] is abandonment." Catholic theology upholds birth control as equivalent to abortion. An exception is typically made in the case of rape victims, who are permitted to use high doses of the "morning-after" pill to prevent the implantation of a fetus. Still, more conservative positions were taken by nearly half of the 27 Catholic hospitals surveyed. Twelve of the respondents had a policy prohibiting the discussion of emergency birth control with the sexually assaulted women, and seven institutions were said to have a policy prohibiting emergency pill prescription by physicians. Out of the 27 surveyed, 17 hospital pharmacies refuse to dispense the emergency pills. The names and locations of the hospitals in the study were not released. However, several local Catholic hospitals follow similar policies. "As a Catholic hospital we will not promote contraceptives," said Bernadette O'Keefe, ER nurse manager at St. Joseph's Hospital in New Jersey. She added that "as medical workers, we will discuss medical options available with the patient." But Merz said he thought that every woman should immediately be offered the drugs. He also said that hospitals with restrictive policies should send the patients to other hospitals rather than neglect to mention all possible treatments. "It is extremely arrogant to impose their view on people coming in their door. Here we have a separation of church and state and we have hospitals that pledge allegiance to God." Emergency Medicine physician James Roberts, who is affiliated with Fitzgerald Mercy Hospital, a Catholic hospital in a nearby suburb, said he has not encountered restrictive policies at any of the hospitals with which he is affiliated. "We discuss it and offer it and give it when we feel it is appropriate to do so," Roberts said. Otis Noble, a Chicago ER case worker, said no anti-contraceptive policy exists at Mercy Hospital Medical Center in Chicago. "When we feel people need the knowledge, we will introduce it to them." In the study's control group of 30 non-Catholic hospitals, none of the institutions were said to have any restrictive policies in the discussion, prescription and distribution of the emergency contraception. Merz, along with researchers Steven Smugar and Bernadette Spina, believe that state legislation requiring all hospitals to meet the standard of care is appropriate.

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