Context | Catholic hospitals control a growing share of health care in the United States and prohibit many common reproductive services, including ones related to sterilization, contraception, abortion and fertility. Professional ethics guidelines recommend that clinicians who deny patients reproductive services for moral or religious reasons provide a timely referral to prevent patient harm. Referral practices in Catholic hospitals, however, have not been explored.
Methods | Twenty-seven obstetrician-gynecologists who were currently working or had worked in Catholic facilities participated in semistructured interviews in 2011–2012. Interviews explored their experiences with and perspectives on referral practices at Catholic hospitals. The sample was religiously and geographically diverse. Referral-related themes were identified in interview transcripts using qualitative analysis.
Results | Obstetrician-gynecologists reported a range of practices and attitudes in regard to referrals for prohibited services. In some Catholic hospitals, physicians reported that administrators and ethicists encouraged or tolerated the provision of referrals. In others, hospital authorities actively discouraged referrals, or physicians kept referrals hidden. Patients in need of referrals for abortion were given less support than those seeking referrals for other prohibited services. Physicians received mixed messages when hospital leaders wished to retain services for financial reasons, rather than have staff refer patients elsewhere. Respondents felt referrals were not always sufficient to meet the needs of low-income patients or those with urgent medical conditions.
Conclusions | Some Catholic hospitals make it difficult for obstetrician-gynecologists to provide referrals for comprehensive reproductive services.
Christian Medical and Dental Society prefers ‘total transfer of care’ to other doctors in such cases
The head of the Christian doctors’ group that met recently with Manitoba’s health minister says doctors with religious or moral objections to physician-assisted dying should not be forced to issue referrals to patients but instead allow patients to switch doctors altogether.
The Christian Medical and Dental Society met with Health Minister Kelvin Goertzen on July 11 to lobby for conscience protection for doctors who object to physician-assisted death.
The group is also asking Ontario’s top court to reverse a provincial government policy requiring physicians to refer patients who want an assisted death to another doctor. . . [Full text]
By a vote of 245 to 182 the U.S. House of Representatives has passed the Conscience Protection Act, a bill designed to prevent government discrimination against and prevent the suppression of the freedom of conscience and religion of individuals or groups unwilling to provide or facilitate abortion for reasons of conscience or religion. The bill adds a right of action by victims, the lack of which has prevented victims from defending their freedom in court. President Barack Obama is expected to veto the legislation. [CNS News]
. . . Abortion has developed technologically and now includes medical and surgical methods, but, generally speaking, remains the deliberate killing of a developing human individual at some point between implantation in the uterus and birth, either directly or by premature delivery intended to cause death. The moral arguments against abortion have been refined and somewhat expanded since 1967, but their focus is substantially unchanged. . . Project Submission
QUEBEC — The McGill University Health Centre has repealed its policy exempting the palliative care unit from offering medical aid to die, said Health Minister Gaétan Barrette on Wednesday.
“This morning, I met with Mr. (Normand) Rinfret and he told me that as of this very moment, the policy has been repealed,” Barrette said, referring to the MUHC’s executive director. “As we speak today, no patient can be transferred out of the palliative care unit at the MUHC, and medical aid in dying will be made available in the unit itself.” . . . [Full text]
QUEBEC — The McGill University Health Centre is being forced to backtrack on a policy that exempts its palliative care unit from helping patients die.
Health Minister Gaétan Barrette issued a strongly worded letter to the MUHC’s director general Wednesday, urging him to change the policy, which he says does not respect the law.
“To say that medical aid to die will not be offered in a particular unit … poses a serious problem when it comes to respecting patients’ lawful right to receive end-of-life care,” the minister wrote. . . [Full text]
Physicians’ Alliance Against Euthanasia Open letter to Mme Véronique Hivon
Note: Véronique Hivon, now a member of the Quebec National Assembly, was Minister of Health in the previous government and was responsible for bringing forward Quebec’s euthanasia law.
You label as « ideology » the decision made by the McGill University Health Centre to not euthanize patients on the palliative care ward.
“The patients at the end of life are the ones who should have their rights respected and be at the centre of the organization of care”, you say. If that is what you really believe,
where were you when the number of palliative care beds at the MUHC was reduced for budgetary reasons?
When the specialized geriatrics unit was closed completely?
Why do you not speak out when patients are transferred all over the hospital and the city for trivial reasons, as is regularly done in Quebec?
What other than ideology could make you want to force hospitals, not only to kill patients, but to kill them in the one place where they most need to be protected?
Palliative care professionals are experts in easing the pain and suffering of terminally ill patients, accompanying them to the very end of their lives, with no need to kill them in order to do so. Now they are struggling, all over Quebec, to continue providing the same peace at the end of life in a situation where death is being promoted. Yes, promoted. This law was passed against the better judgment of those who know best how to care for the dying. Now you want to eliminate even the little safe space that is left for patients and professionals. All they ask for is one place in the hospital where there is no risk of being killed.
You got what you wanted when this law passed. Now you want to crush every tiny focus of opposition to your favourite project.
That is more than ideology. It’s intolerance, pure and simple.
We support the freedom of the palliative care professionals at the MUHC (and at every hospital) to ensure there are safe spaces for patients.
The McGill University Health Centre said Monday it will change its policy and allow medically assisted dying in its palliative care unit after coming under fire from Health Minister Gaétan Barrette last week.
The uproar came about after a patient at the Glen site had to be transferred out of the palliative care unit to receive medical aid in dying in April.
Barrette sent a letter to the MUHC’s director general last week, asking the hospital network to change its policy, because it does not respect the new law. . . [Full text]