On the heels of Hobby Lobby’s judicial fight against the contraceptive mandate in the Affordable Care Act in the name of “religious liberty,” doctors at a small Oklahoma hospital are now grappling with a new directive that may build on that very theme.
According to confidential sources cited in a report in The Bartlesville Examiner-Enterprise, doctors at Jane Phillips Medical Center in Bartlesville, Oklahoma were informed during a meeting earlier this week that they can no longer prescribe contraceptives if they are to be used as birth control.
If this report is correct, doctors at Jane Phillips are not allowed to prescribe birth control as birth control. The company that own Jane Phillips Hospital, St. John Health System, was recently acquired by the umbrella Catholic health care system Ascension Health.
In an email to TPM, Joy McGill of St. John Health System stated the company’s position:
Consistent with Catholic health care organizations, St. John Health System operates in accordance with the Ethical and Religious Directives for Catholic Health Care Services, and therefore, does not approve or support contraceptive practices. However, only physicians (not institutions) are licensed to practice medicine and make medical judgments. While our physicians agree to abide by the Directives, they also have the ability to prescribe medications, including hormonal medications, in accordance with their independent professional medical judgment. This includes informing patients when they are operating under their own professional medical judgment and not on behalf of St. John Health System.
According to St. John Health System, doctors are not banned from prescribing birth control, but simply agree to abide by the Directives. But the Directives make their position about birth control and abortion quite clear.
The Directives to which Joy McGill references are known as the Ethical and Religious Directives for Catholic Health Care Services, guidelines developed by the United States Conference of Catholic Bishops (USCCB). The Directives strictly state that “Catholic health institutions may not promote or condone contraceptive practices” but encourages natural family planning for married couples. It also prohibits abortion, in-vitro fertilization, as well as other types of healthcare services.
Not inconsequentially, the USCCB is currently dealing with a lawsuit brought forth by the American Civil Liberties Union on behalf of Tamesha Means. The suit alleges that while pregnant, Means miscarried and was subsequently denied adequate medical treatment because the only hospital in her county abided by the religious Directives.
When basic reproductive healthcare is inaccessible or outright denied, women’s lives are at risk.
A simple search of St. John Health System’s website reveals not a single reference to birth control; it’s as if this type of basic healthcare, used by 99 percent of sexually active American women, doesn’t exist.
As for St. John Health System’s new parent company, Ascension Health, proudly boasts its Catholic philosophy as the backbone of how the care that they provide. Unsurprisingly, its website firmly states Ascension’s outright opposition to and prohibition of abortion, and as such, hospitals that fall under Ascension’s ownership umbrella are subject to the company’s ban on abortion care. Ascension also details its support for emergency contraception for rape victims only, but only if “there is no evidence that conception has already occurred already.”
So, is it really legal for Catholic hospitals and other kinds of health care providers to outright violate the constitutional rights to contraception and abortion? Actually, yes, and we have conscientious objection to thank for that. Most states have what are called “conscience clauses” which assert the right of health care providers to opt out of providing certain health care services on moral grounds, most notably abortion. In response to the landmark Roe v. Wade ruling in 1973 which legalized abortion nationwide, conscience clauses proliferated. Ultimately, the right of a physician to deny a certain type of medical care on personal, moral grounds seemingly trumps the right of a woman to access certain kinds of basic reproductive health care.
What’s more, the denial of basic reproductive healthcare isn’t just limited to Bartlesville. One in six Americans rely on a hospital that adheres to the Catholic directives. In fact, the number of Catholic hospitals is growing. While other types of nonprofit hospitals are closing, there has been a 16 percent jump in Catholic hospitals. As secular hospitals close and Catholic hospitals replace them, access to abortion care and even contraception will likely become more and more difficult to access.
Perhaps most surprising is that despite the fact that one in six American hospitals adhere to the Directives that prohibit abortion and contraception, most American Catholics support both. According to a recent global poll, 76 percent of American Catholics said that abortion should be legal in some or all cases. In fact, 28 percent of American women who have had an abortion identify as Catholic. It’s a similar story with contraception. Birth control is broadly popular and widely used among U.S. Catholics, 82 percent of whom say birth control is morally acceptable. According to a study by the Guttmacher Institute, in the U.S., 98 percent of Catholic women who are sexually active have used some form of birth control other than natural family planning.
Contraceptive care and abortion care are common healthcare needs of American women, and both are constitutionally protected rights. Yet, Catholic hospitals openly shirk these rights in the name of religious liberty and refuse to provide access to abortion, emergency contraception, and apparently, now basic birth control.
Religious liberty is a founding American principle, one based in freedom of belief and the ability to exercise that belief. But religious liberty is not meant to be a weapon to be exacted against women as punishment for their sexuality. By prohibiting doctors from providing basic reproductive healthcare, St. John Health System lays bare the ugly truth that seemingly resides under other current claims of religious liberty: they’re not about freedom, but about discrimination.
In the meantime, the right to contraceptive care, a right which we gained a half century ago, remains elusive for far too many American women. For the women of Bartlesville, it just became even harder.
Lauren Rankin is a feminist writer and activist. Her work has appeared at publications such as Salon, RH Reality Check and TruthOut. Currently a graduate student in Women’s and Gender Studies at Rutgers University, she focuses on reproductive politics and the political use of sexual shame. Follow her on twitter at @laurenarankin.