Ethical And Religious Doctrines Agreement -Catholic Health Care Provider
November 16, 2015 11:10 AM   Subscribe

As part of some merger among hospitals, my wife, a primary care physician, is now being asked to sign an agreement to follow the Ethical and Religious Directives of Catholic Health Care Services as a condition for her continued employment. The directives conflict with her own conscience and medical judgement. Is this legal? Does she have any recourse, if she chooses not to sign?

My wife is a doctor working in a practice which is part of a largish hospital in a city. The hospital provides health care services to a largely underprivileged patient community. It teaches residents, draws medical students from local universities - my wife has worked there for eight years, and though every day hasn't been unalloyed joy, she likes it and believes in the work they do.

The directives include things like not providing birth control, not providing or discussing abortion, disregarding end-of-life directives that disagree with Catholic beliefs. These are not little things. She firmly believes that this ERD undermines her ability to give the best care to her patients.

How can it be possible for the new administrators to insist on this as a condition for her employment? It seems to be discriminating people based on their beliefs. Should she make them fire her and then bring a suit? Should she just look for another, secularly-owned hospital?
posted by newdaddy to Law & Government (12 answers total) 2 users marked this as a favorite
For clarity, this is a private hospital owned and operated by a Catholic institution?
posted by janey47 at 11:28 AM on November 16, 2015

Yes, it's legal, albeit questionably so. I encourage you to seek input from ACLU on this given the timeliness of several related court cases.
posted by late afternoon dreaming hotel at 11:36 AM on November 16, 2015 [8 favorites]

This is a complicated question with very high stakes for your wife, she should really see a competent employment lawyer, not internet strangers. Your local bar association likely runs a lawyer referral service that can refer you to someone who can help. It might well cost some money, but it's worth it if the alternative is your wife losing/quitting her job.
posted by Bulgaroktonos at 11:54 AM on November 16, 2015 [9 favorites]

Response by poster: Janey47, it's hard for me to judge whether its public or private - my guess is private. Its mission statement starts out "We are Good Samaritans, guided by Catholic tradition and trusted to deliver ideal healthcare experiences."
posted by newdaddy at 11:56 AM on November 16, 2015

Agreed that you need to see an employment attorney, and also suss out if this is a request or is actually something she's required to sign to work there.

At the moment, this is legal, and also pretty common for Catholic funded hospitals. (FYI, you should be able to tell from their giving and/or fundraising page if they are a) public (ie: funded with tax dollars), b) private for-profit, or c) private non-profit. My guess is if this is a Catholic affiliated hospital they are private nonprofit.) A family member is an OB/GYN nurse at a local Catholic affiliated hospital, and she tells some amazing stories about the ways in which the staff jump through hoops to provide needed care without officially running afoul of the Directives.

Anyhow, yes, she needs to pay for a one-hour consultation with an employment attorney.
posted by anastasiav at 12:02 PM on November 16, 2015 [1 favorite]

I would also send this to your local news media, perhaps anonymously. Not being allowed to provide birth control and disregarding end of life directives are big things, and a lot of people would be angry to find out their local hospital was adopting this as a manner of mandated policy.
posted by Lady Li at 12:38 PM on November 16, 2015 [9 favorites]

Is your wife in a union? Because if she is, her union should be her first stop before any kind of lawyer.
posted by DarlingBri at 12:43 PM on November 16, 2015 [1 favorite]

Response by poster: She is not in any union, but I wonder if any professional societies would have some larger response to this.
posted by newdaddy at 12:49 PM on November 16, 2015

Best answer: I would see if there is an ethics hotline for the state medical board or the AMA (there are such hotlines for lawyers, I don't have specific links for the medical field but I assume they exist). It definitely seems unethical to me to give someone a feeding tube without their proxy's consent -- her/the hospital's medical malpractice insurance may take issue with it as well. I take issue with all of the requests, but this one seems the most clear-cut violation of medical ethics/laws (that is, affirmatively performing a procedure without consent is a different legal issue than refusing to carry out life-saving measures).
posted by melissasaurus at 12:55 PM on November 16, 2015 [1 favorite]

Unfortunately, unless this is a publicly-funded hospital, this is entirely legal. It's a big issue across the country, as hospitals and medical groups consolidate, many of them are being absorbed by private religious health groups, who can (and do) eliminate services that go against their beliefs.
posted by Thorzdad at 1:01 PM on November 16, 2015 [2 favorites]

Unfortunately, this is becoming more and more common. Your wife should try talking to whatever organization represents her specialty. She could also contact MergerWatch, and your state ACLU.

Chances are that she has no choice in this matter. Catholic hospital mergers are a scourge.

If she regularly prescribes birth control to her patients, she might be able to get away with getting a prescription pad that doesn't have the hospital's name on it--I know some physicians who have successfully skirted the rules by doing so.
posted by cowboy_sally at 4:48 PM on November 16, 2015 [2 favorites]

Response by poster: It's hard for me to select any answer here as the 'best' answer. We still don't really have an answer ourselves.

What my wife is learning is that a lot of her colleagues are inclined to sign these documents without really considering them, and then later disregard them entirely when it comes time to interact with and treat patients. I find that to be its own ethical problem - it does allow them to continue to care for patients, as they believe are in the patients' best interests, but on the other hand, they have lied on paper in order to do so. And this erodes whatever support there might have been for someone who is actually concerned about what they are signing from standing up and voicing their protest. There's a kind of "Oh, everybody does it" sentiment that sounds really worrisome coming from people who we're entrusting with our loved ones' health care.
posted by newdaddy at 5:22 AM on November 22, 2015

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