Religious Restrictions Put Health Care Rights at Risk

Tuesday, May 7, 2013

Health care facilities open to the general public should provide access to a full range of health care services. Religious ideology should not determine what health care services are available to patients.

But the ability of patients to obtain the medical care they need and their rights to access lawful health care are at risk because of a growing trend in the control of health care facilities. Medical facilities tied to religious institutions are playing an increasingly large role in Washington.  Currently, 40% of hospital beds statewide are in religiously affiliated institutions, and that could rise to nearly 50% by year’s end. Already in certain counties and parts of Washington, the only hospitals or health care facilities serving the public are religiously affiliated.

Hospitals are merging because of pressures to improve coordination of patient care, modernize health care systems, and make health care more affordable for all. As a result, many of our state’s hospitals in small and rural communities are looking to partner with large health care corporations. The health care partners with the capital and resources to help keep struggling hospital doors open are affiliated with Catholic institutions. 

When a secular medical hospital partners (or merges or affiliates) with a religiously affiliated health care corporation, it limits the ability of patients to choose critical medical services they may need.  Catholic hospitals are required to abide by the Ethical and Religious Directives for Catholic Health Care Services (ERDs). The ERDs restrict a patient’s right to access all lawful and medically appropriate health care services, counseling, and referrals.  As a result, many residents may not be able to exercise their reproductive and end-of-life health care choices or access health services free from discrimination.

It’s not just hospitals that are affected—physician practice groups, medical laboratories, medical clinics, and medical education are also impacted by the rise in religious restrictions on health care.

The growth of religiously controlled medical care is threatening legal rights. Washington is a progressive state that has led the nation in championing bodily autonomy and health care choice. The Reproductive Privacy Act, enacted by voters statewide in 1991, establishes as public policy of the state of Washington that “every individual has the fundamental right to choose or refuse birth control,” and “every woman has the fundamental right to choose or refuse to have an abortion.” In 2008, voters enacted the Death with Dignity Act which allows terminally ill adults seeking to end their life to request lethal doses of medication from medical and osteopathic physicians.

Washington has also been a leader in advancing and protecting the rights of LGBT citizens. In 2006, the legislature passed the landmark Anderson Murray Anti-Discrimination Law; it prohibits discrimination based on sexual orientation and gender expression or identity, including discrimination by providers of medical services. This past fall, Washington voters removed the state’s prohibition on marriage for same-sex couples.

What the growth of religious facilities operating according to the ERDs means for patients is that denials of critical health care services that we’ve seen in other states are happening here in Washington.

The ACLU of Washington is working to ensure that everyone can make health care decisions without religious interference.  We are seeking to learn more about the extent of religious restrictions on health care in our state.

We invite patients and providers to complete our confidential questionnaire to share their experiences accessing or providing reproductive and end-of-life health services, counseling, and referrals in Washington state. We also would like to hear about any experience of discrimination on the basis of sexual orientation or gender identity and expression in seeking or accessing health care services, counseling, or referrals in Washington state.

To learn more about what the ACLU of Washington is doing, please visit