By Aram Schvey, policy counsel for foreign policy and human rights, Center for Reproductive Rights
You don’t ask a vegetarian where to get a great prime rib, or a teetotaler for a single-malt scotch recommendation. You don’t ask a bald man where to get a stylish haircut. So why would federal policymakers defer to a cadre of celibate men on the reproductive health services women need? As crazy as that sounds, that’s exactly what’s happening. The chaste all-male club known as the U.S. Conference of Catholic Bishops has criticized the Department of Health and Human Services (HHS) for adopting a rule requiring health plans eliminate copays for contraception and other important women’s health services. The HHS decision, issued in August, adopts the recommendation of a panel of medical experts convened by the prestigious Institute of Medicine. HHS has also asked for comments on a proposed rule exempting churches and other houses of worship from having to cover their employees. But this exemption isn’t enough for the bishops. Instead, they are seeking passage of a bill in Congress, the misleadingly titled, “Respect for Rights of Conscience Act,” which would allow every religiously affiliated institution, including schools, social-service providers, and even hospitals, to opt out of the coverage requirements (the bill’s co-sponsors, Rep. Jeff Fortenberry and Rep. Dan Boren previously proposed an anti-abortion law that would prohibit the federal government from subsidizing abortion coverage for date-rape victims or adult victims of incest). Of course, the bishops themselves won’t be affected by their proposal to gut women’s preventive healthcare. The bill would allow any insurer or healthcare institution to refuse to provide essential health benefits based on its “beliefs.” Leaving aside the fact that only individuals, and not institutions, have beliefs, the bill would imbue professed religious beliefs with the force of law, and allow institutions to deny even life-saving medical coverage – no matter how far-fetched or unscientific the belief might be. Without a trace of irony, the bill invokes Thomas Jefferson to justify bending evidence-based national healthcare standards to dictates of the bishops’ religious dogma. Never mind that it was Jefferson himself who first articulated the concept of a “wall of separation” between church and state. Under the proposed law, a Christian Scientist organization could refuse to cover any medical procedure other than Christian prayer, and an Orthodox Jewish organization might refuse to cover organ transplants. But the real danger from the proposed law comes from extending “conscience” protections to Catholic hospitals, which treat one-sixth of all patients in the United States, millions of whom are not Catholic, or otherwise do not share the bishops’ extreme views.
The proposed law would permit Catholic hospitals not to treat women suffering from potentially fatal ectopic pregnancies, and instead simply leave them hooked up to an IV drip until the embryo dies. Lest this horrifying result sound like exaggeration, in 2008, Dr. Lori Freedman documented a number of instances in which Catholic hospitals refused to help women suffering from life-threatening medical emergencies based on their “conscientious beliefs.” As Freedman explains, one “belief” of Catholic hospitals is that doctors must stand idly by and allow a hemorrhaging pregnant woman to bleed as long as the fetus she is carrying shows any signs of life. In one particularly cruel instance described by a perinatologist, an urban northeastern Catholic hospital demanded that doctors do nothing to terminate the non-viable pregnancy of a woman who was septic, running a 106-degree fever, and bleeding out of her eyeballs because a fetal heartbeat could still be heard. One doctor—whose conscience actually was violated by the hospital’s refusal to provide the care this woman desperately needed—eventually resigned, disgusted that he was unable to practice the medicine he was trained to perform. There is already a built-in right of refusal in our medical system. Healthcare workers who object to providing care due to a religious concern are already protected by federal and state laws. Those who object to a medical procedure or service are under no obligation to use it. But 99 percent of women will use contraception in their lifetime, and religious adherents, including Catholics, use contraception at the same rates as the general population. So the bishops are using their clout to ensure that a health service used by nearly all women is unavailable to many. What the bishops seek is not the freedom to exercise their religious beliefs – it’s the right to veto everyone’s access to needed and desired medical care. This isn’t about conscience, it’s about the enforcement of religious dogma by a small clique of religious and political leaders on society as a whole. But it was Jefferson himself who warned in his Virginia Statute for Religious Freedom of the dangers of the “impious presumption of legislators and rulers, civil as well as ecclesiastical, who, being themselves but fallible and uninspired men, have assumed dominion over the faith of others.” HHS should heed Jefferson’s warning and refuse to give sanction to religious dogma that would trample the conscience rights of patients to obtain, and of doctors to provide, needed medical services.