Hospital Mergers and Conscience-Based Objections — Growing Threats to Access and Quality of Care
382(15) NEW ENGLAND JOURNAL OF MEDICINE 1388 (April 9, 2020)
Posted: 21 May 2020
Date Written: April 9, 2020
Abstract
Since 2001, the number of Catholic hospitals in the United States has grown by 22%.One in six U.S. hospital beds is now affiliated with a Catholic hospital system. As non-religiously affiliated rural hospitals merge with Catholic corporations (in some cases because the options were merger and closure, although this situation is infrequent), patients often have no choice but to be treated according to the values of the church. In some cases, they may not know that a hospital is Catholic or that its affiliation may affect the care they receive.Growing consolidation adversely affects both patient safety and access to crucial types of health care.
Instead of improving patient protection regulations, however, the federal government is working to bolster hospitals’ ability to refuse to provide legally permitted health services on the basis of institutional belief structures. We believe such efforts are dangerous. Institutional conscience–based objection (in which a hospital’s religious affiliation or mission influences the services it provides) differs materially from the more familiar concept of individual conscience–based objection.
We argue that new U.S. Department of Health & Human Services regulations along with consolidation of hospitals into organizations that assert conscience-based objections to providing certain services, encroach on patients’ rights and access by diminishing choice and transparency.
Keywords: conscience-based objection, conscience clause, conscience regulations, Centura, Catholic healthcare
JEL Classification: I18, K32
Suggested Citation: Suggested Citation