Separation of Church and Exam Room: The Implications of Catholic Hospitals on Women's Healthcare

Background and Purpose:

In the wake of the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, which triggered abortion bans and restrictions across the nation, ensuring the equitable distribution of quality reproductive healthcare institutions has never been more critical. This presentation sheds light on how Catholic healthcare institutions exploit the legal protections established by the Religious Freedom Restoration Act of 1993 (RFRA) to deny women access to essential health services and referrals. These restrictions are grounded in the Ethical and Religious Directives (ERDs) issued by the United States Conference of Catholic Bishops (USCCB), which bar medical providers from implementing interventions based on evidence-based standards of care.

Methods:

This presentation employs a descriptive and critical policy analysis approach to examine the structural and legal mechanisms through which Catholic healthcare institutions restrict reproductive care. Drawing from existing scholarly literature, legal case studies, and policy documents, the analysis explores the implications of Supreme Court decisions, the RFRA, and the ERDs issued by the United States Conference of Catholic Bishops. Through a feminist lens, these sources are used to trace the development of this issue and assess the real-world consequences of religiously motivated care restrictions.

Results:

Key issues addressed include the refusal to provide abortion care, contraception, emergency contraception, and tubal ligations, particularly in a post-Roe landscape. This analysis highlights the role of intersecting factors that heighten risk for certain groups of women, including the overrepresentation of Catholic hospitals in low-income and rural areas, the lack of exceptions even in life-threatening circumstances, and the specific vulnerabilities of sexual assault survivors seeking care in emergency rooms.

Conclusions and Implications:

Women face inequitable and often invisible barriers to accessing a full range of life-saving healthcare services. The undetected influence of religious authorities in clinical settings marks a troubling departure from the foundational American principle of separation of church and state, a shift that has been legally sanctioned through mechanisms like the Religious Freedom Restoration Act (RFRA) and the resulting Conscience Clauses. These developments not only undermine patient autonomy but also institutionalize religious doctrine in public healthcare delivery, with profound implications for reproductive justice and health equity.