When you have to make hard medical decisions, who do you want in the room?
Religious belief is on the decline in the U.S., and medical knowledge is on the increase. This makes it particularly ironic that so much of our health care system is accountable at the highest levels not to science or patient preference but to the dictates faith and theology. Metaphorically, more and more medical decisions get made with the Catholic Bishops in the room, regardless of whether the patient wants them there. Not only that, the Bishops have a religious veto that can trump both doctor and patient.
The Bishop’s Veto
James Glickman from Sturbridge, Massachusetts, became a legal witness for aid in dying after watching his father scream for someone to kill him during his last forty-five minutes of life. Darcy Burner chose to end a pregnancy that would have killed her, and then advocated for patient rights during a congressional run. Judy Nicastro risked the life of one twin in utero to abort the other who would have painfully suffocated at birth. These individuals, together with loved ones, wrestled with some of the most difficult decisions any of us can face. In all cases, the response of the Catholic Bishops would have been to deny them options—to fall back on the current position of the Church hierarchy: “we believe life is sacred from conception to natural death.”
Thanks to corporate mergers and laws that privilege religious institutions, many communities across the United States have few or no secular options when it comes to medical care and no legal mandate that patients be told about the full range of medically appropriate services. In Washington State, to cite one egregious example, almost half of hospital beds and affiliated care systems fall under the authority of the Catholic Church, and many counties have no alternative.
Patients and Providers Pay the Price
Let’s be clear why this creates an irreconcilable conflict of interest. A medical system with religious authorities and corporations at the top means the following:
- Patients may be kept in ignorance about the full range of medically appropriate treatments if some of these are judged to violate the theology of the provider or institution.
- Providers don’t get continuing education about medical advances that a religious hierarchy disapproves.
- Pharmacies don’t stock drugs and devices that religious owners disapprove.
- Public dollars are used to promote specific religious beliefs and the notion that “faith” is a reasonable way of determining what medical care should be provided.
- A religious medical culture denies the very methods of science: evidence, hypothesis testing, and accountability.
- Religious institutions or individual believers get a religious veto over the deeply personal medical decisions of individual patients.
- Couples are denied the means to time their childbearing, which leaves more families mired in poverty.
- Women are denied miscarriage management or termination of pregnancy gone wrong.
- Less prenatal diagnosis means a greater percent of children born with birth defects.
- Families are stripped of decision making power after tragic accidents because “every life is sacred.”
- Dead women can be kept on life support as human incubators.
- Families absorb the cost of health treatments that are excluded from insurance by religiously motivated employers.
- Religious health professionals demand to keep their jobs without fully doing their jobs.
- Religious allied health professionals second guess doctors’ orders and patient requests.
- A powerful “religious freedom” lobby undermines anti-discrimination laws that protect queers and females employed in healthcare (and elsewhere).
- A powerful “religious freedom” lobby advocates exemptions to living wage laws and worker rights.
- Public health costs soar as a consequence of religious meddling in end of life and beginning of life decisions.
- Suffering unto death aka “redemptive suffering” becomes the only available option for people who would prefer to manage their own process and die with dignity.
How We Got Here
The fact that religion has the final say in so much of our healthcare system is an artifact of history. Many early hospitals were built by missionary orders who believed that God called them to serve the poor and sick. They provided largely palliative care akin to what Mother Teresa’s order provides in Calcutta. As medicine advanced and government began funding health systems, it was often easiest to simply channel funding through the existing providers, even though these providers ultimately were accountable to Church authorities. It was a marriage of compassion and convenience.
Early on, there was no conflict between religion and medical science because the two were synonymous. Religion provided proto-scientific understandings of illness and death. The role of nurses was to ease suffering where they could and make spiritual meaning of it where they could not. When healing happened, the hand of God got the credit, and when healing failed, faith eased the loss.
However, conflict was inevitable. One part of the religious-medical mindset is compassionate service, but another part is passive acceptance of divine will. Consequently, over the centuries as medical science has emerged, first in the rudimentary trials and errors of folk practitioners and then as an actual scientific endeavor, institutional Christianity has had mixed reactions.
When push comes to shove, religion is designed to help us transcend our mortal condition in a world to come, not to help us overcome it in this one. Consequently, in religion-based healthcare the ultimate good is actually the health of the soul, as understood by a specific authoritarian tradition and set of practitioners. Suffering, in this view, may be a test, a punishment, or a way of cleansing sin. In any case trying to discern and obey God’s will is supremely important. Our lives belong to God.
Contrast this with the worldview of medical science—that human suffering is a natural phenomenon; that our experience in this world is controlled by physical and biological laws; that by understanding these laws we have the power to prevent illness and cure it or to limit suffering when both of those are impossible. In medical science, it is the health of the body and the quality of this life that matters, and our lives are our own. Medical ethics place a supreme value on patient autonomy and preference.
Sometimes the priorities of religious practitioners and the objectives of secular medicine align, but sometimes they don’t. In particular, the religious edicts controlling any given medical institution may clash with the moral, spiritual or physical priorities of a person seeking care. When that happens, who should get to decide? This question is being played out in the courts, with the big money coming from religious institutions. This illustrates the very heart of the problem with religion controlling healthcare, the ability of powerful institutions motivated by theology to impose their will on vulnerable individuals who simply need help or want to offer it.
Medical Advances Past and Present “Playing God”
Christians haven’t burned midwives as witches in a long time, but in the last century Christian clerics fought against polio vaccines (just as some conservative Muslims do today) because immunizing children was “playing God.” More recently, Christian authorities opposed HPV vaccines that prevent cervical cancer (as have conservative Jewish groups in Israel). Some perceive that sexually transmitted illnesses are divine punishment for unsanctioned sex and eliminating the threat of cancer might (God forbid!) increase promiscuity. Others see mandatory vaccination as an intrusion on divinely appointed hierarchy in which a man decides what is best for his own wife and children.
Today Catholic and Evangelical authorities are going all in to fight against universal access to contraception. Giving women the ability to delay, space and limit childbearing subverts God’s intention, which is, as the New Testament writer puts it, “women shall be saved through childbearing.”
The Church is also throwing weight and dollars into opposing aid in dying. Antibiotics and assistive technologies increasingly are removing some of the easiest ways to die of old age—pneumonia, for example. As baby boomers witness the drawn-out deaths of their parents, they increasingly are looking for ways to manage their own end of life experience. But Catholic theology and authorities insist that life is sacred, “from conception to natural death.”
Religion may not poison everything, as the late Christopher Hitchens alleged, but it does poison healthcare. And from there the poison seeps into society more broadly, because in order to maintain their privilege in the healthcare system, Churches and Religious corporations fight legal battles that undermine human rights in society at large. They have argued that the conscience rights of institutions and corporations should be able to trump individual conscience. They have challenged anti-discrimination laws, and won, effectively establishing legal precedent that freedom from discrimination is not a constitutional right. They have argued that they should be exempt from labor organizing because giving workers the right to organize impinges on their sovereignty. Driven by dogma, lawyers find circuitous arguments and judges uphold “rights” that under any other light would look patently immoral.
New Powers, New Opportunities, New Responsibilities
Compassion and justice, individual responsibility and freedom, health and wellbeing—values like these require that we constantly wrestle with hard questions. The values themselves may be timeless, even rooted in human biology, but our understanding of how best to enact them evolves as technology and population growth bring us into contact with new ideas and dilemmas. Our ancestors had no moral responsibility to cure malaria, for example, or maternal mortality, because they had no power to do so. Similarly, they had no responsibility to prevent birth defects, because they couldn’t know in advance whether a fetus can grow into a healthy baby. But now that we have this knowledge and power, a new set of ethical questions and moral complexities arises.
Biomedical science is presenting us with questions like these at a faster and faster pace, and they are precisely the kind of questions that religion is poorly equipped to answer. In fact, they are the kind of questions to which religion has given the wrong answer time and time again. Religion is inherently regressive. Religion takes a snapshot of a given cultural-moral nexus, sanctifies it, and then tries to defend it against all comers. Christianity puts God’s name on cultural agreements that were made in the Iron Age, long before medicine became a science. Small wonder, then, that some of the “Ethical and Religious Directives” that govern Catholic healthcare cause harm rather than helping people to flourish.
Out of the Iron Age
We need a medical system with one singular mission—to ensure everyone has affordable, easy access to effective care. To maximize the ability of American women, men, and children to live and die as well as we can. We need a system that respects our individual ideas about what that means, a system in which decisions are made based on medical science and our preferences, a system where no institution or provider gets a religious veto over another person’s most intimate decisions.
Today, thanks to science, modern health facilities looks nothing like those early hospitals where care was limited to brow wiping and bed changing and prayer. They are also different from those early missions in another way: today, the dollars that fund Catholic health care come from us. Almost half of the funds flowing through religious hospitals come from taxpayers, with the next largest chunk coming from private pay patients or their insurance companies, often in situations where patients have no choice about where to go. And contrary to popular myth (and the Catholic hospitals’ own self-promotion), Catholic hospitals provide less charity care than the industry average. We pay for these institutions, and we have the right to expect medical care that respects our personal ethical and religious priorities, including the right to manage our own bodies. It’s time to get religious institutions out of the healthcare business.
Valerie Tarico is a psychologist and writer in Seattle, Washington. She is the author of Trusting Doubt: A Former Evangelical Looks at Old Beliefs in a New Light and Deas and Other Imaginings, and the founder of www.WisdomCommons.org. Subscribe to her articles at Awaypoint.Wordpress.com.
Will the Catholic Bishops Decide How You Die?
On Loving Life and Leaving It
Eight Ugly Sins the Catholic Bishops Hope Lay Members and Others Won’t Notice
The Difference Between a Dying Fetus and a Dying Woman
Catholic Hierarchy Lobbies to Suppress Religious Freedom
Self-Flagellation and the Kiss of Jesus–Mother Teresa’s Attraction to Pain
Anti-Contraception Cardinal Paid Pedophiles to Disappear
VIDEO: Catholic Healthcare – Legal Trauma!, Moral Politics Television (28 min. video). Is your health care subject to “The Bishops’ Rules”? Today, three Catholic bishops oversee almost half the medical care in Washington State. The Bishops’ Rules forbid contraception, abortion, participation with Death with Dignity, and any treatments developed through embryonic stem cell research. The University of Washington is helping to fuel the expansion of bishop-controlled health care, and the WA Supreme Court just gave the bishops free rein to fire gay physicians and nurses. Join guest Monica Harrington, of CatholicWatch.org, and host Valerie Tarico for a discussion of publicly-financed Catholic health care and why its growth endangers your health and your rights. February 28, 2014.
Valerie, just want to thank you for your posts, in general and on this topic, in particular. They are always thought provoking. You are the first to educate me on this topic and it represents a major issue. I suspect most people will ignore the issue and many will suffer the consequences.
There was a time when I assumed, incorrectly, that one would receive better and more empathetic care in a Catholic based hospital. However, having witnessed the last days of both my mother and father, years ago in the same Catholic hospital the care was neither competent nor empathetic. It was run as though it were any other cut throat for profit hospital with too few nurses. Family members had to be available to be sure that my parents needs were being met and required frequent intervention with staff. That is not to say that all for profit hospitals don’t provide great care.
I had not considered the religious implications until you started writing on the subject.
What can the public do to stop this? It seems unlikely that writing our state and national congresscritters would result in much.
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Thank you for the kind words. I’m very sorry to hear about your experience at the end of life with your mother and father. The best places I know for getting involved are mergerwatch.org (nationally) and the ACLU of Washington (in Washington State). Both are fighting hard to ensure that patients can have access to the care that best serves their own values and priorities.
As always, how right you are!
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Just finished reading ‘Trusting Doubt’ and as an ex-Catholic and ex-Evangelical, I found it quite accurate. I do think you give “science” in general too much credit though, as if you switched “gods” from the Christian god to “Darwin’s”… I see “science” as having become just as much a prostitute of power as Christianity, (the inquisition or the nuclear holocaust of Hiroshima-Nagasaki?) though I can see the lesser points, that science has stepped way past religion in understanding the physical realm. I have a personal saying, “Believe all things, believe in nothing” which serves well in living compassionately without entanglement in emotional issues. Where emotional decisions are made, logic and common sense go out the window. Power and profit are emotional issues. Religion is an emotional issue. Health care is an emotional issue. I have read the above article and it is probably factual (hard to say, being Canadian now, and Canadian health care appears to be quite different, more secular, than what you write about Washington state) but what I find in modern “rich” societies is a growing dependence on the System to take care of everything. Too much is being made of “health care” when health is a personal responsibility, and not as dependent on economic conditions as touted. Those who take responsibility for their bodies live relatively healthy lives. Too much focus on “health care” (and of course, that’s where the profits lie) and not enough on taking personal responsibility for oneself. I haven’t seen a doctor in over 30 years and attribute it to these simple facts: no media-TV, radio or newspapers. A life committed to helping and giving as opposed to taking. Rejection of external controlling forces of any kind, and eneregizing my human sense of life as infinite (not eternal!) and “me” as part of that infinity that carries on beyond this body. The concerns expressed in your article are real enough for those caught in the gears of the System, but fade if one transcends it. Will mankind ever learn to do that? To stand on his own feet without the overarching supporting claptrap evolved from a dubious civilization now threatening to swallow him and his world whole?
Thank you for sharing these thoughts. It sounds like you are creating a life well lived. To clarify regarding science, I believe that the scientific enterprise is populated with fallible humans who seek influence and “stuff” and happiness like we all do. The system puts in more safeguards than religion, but it fails. One upside of science is that many scientists are attracted to knowledge for its own sake. That is also a downside, in that someone needs to be asking the moral spiritual values-based questions about what we do with that knowledge.
Reblogged this on nursewithbigears.
Very well said. This is exactly why my family doesn’t go to the local mega corporation that is in our city. My doctor chose to “move on” when his practice was swallowed up by the religious hospital, & we had to make sure the one we switched to wasn’t affiliated. My daughters don’t need the clergy anywhere near their uterus’.
I work at Swedish. The line between pretending we’re partners with Providence is now completely gone. Services have been shifted to the Catholic agenda. We are forced to listen to prayer at many meetings. They also now own, unofficially, PacMed, PolyClinic, Group Health. And, they are taking over Virginia Mason contracts. Only the VA and UW are non-Providence now. Why are anti-monopoly laws not being called into play?!
Again, the business of America is business! Are “anti monopoly laws” being applied to any other corporate entity? Gas and oil companies, for example? Time for Americans to smell the coffee that’s boiling over and realize the whole “she-bang” was always nothing more than propaganda instilled from kindergarten to whatever level of college and university the believer managed to climb to. America is a bunch of rich and powerful individuals lording it over masses of brainwashed and poorly educated followers. The power lies in money, government and religion and these three big systems have, if perhaps temporarily, chosen to work together rather than fight each other: there’s more profit in that and they’re too closely balanced for any one power to gain over another without losing the game. The answer for the rank and file is not in confronting these megaliths, but in turning away from them; in personal, one-on-one boycott of everything they claim or stand for. No church attendance (an easy one); silently curse when made to pray – oh yes, that works! – refusing to be bought out by ads; no more voting (that’s a big and very easy one) and controlling one’s conversation with others, i.e., no talking about this or that pretender to the throne as if it mattered because it doesn’t. The way out of this horror show is through self-empowerment, which means self-re-education in order to understand the forces arraigned against the individual under globally dominant capitalism. Some self-help would-be guru once said, “Don’t sweat the small stuff, and it’s all small stuff.” I used to mock that, but as a self-empowered individual, I now understand what s/he meant. If I don’t engage it because I’m “bigger” than a pick-up truck, a bought and paid for senator, a presidential hopeful, a pope or anything else belonging to the Matrix, then yes, it’s all small stuff to me, bottom line. I give myself plenty of room to burst out laughing at how people take their cartoony system so seriously. One more thing: self-empowerment means you can be compassionate. You’re in “health care” so what really matters here? Compassion. Individuals rely on you as an individual to do what you can, as an individual, for them, also as individuals. And when you focus on doing that because that is your own personal choice, that’s when the System begins to crumble. You may not see it but you’ll know it is happening and that removes the worry. A compassionate being doesn’t fear anything.
This is such an non-issue article. Please state specific examples in specific hospitals, where the doctors don’t do their jobs. This article is full of speculation and no hard facts. If you want to stir controversy, at least do some research, and give us some evidence, where the decision of the doctors caused harm. They own the hospital and they run the hospital, who are you or anyone to say that they can’t. As long as they do their jobs, i don’t see a problem. You make it sound like that the doctors don’t have the same educational background or experience as every other doctor. You make it sound like they’re still using leeches. Please give your readers some intellectual credit.
Perhaps you missed the story of the Irish woman who died because the Catholic hospital refused to remove the fetus she was miscarrying until the heartbeat stopped? https://valerietarico.com/2012/11/20/the-difference-between-a-dying-fetus-and-a-dying-woman/ Or maybe you missed this less dramatic story from Canada: http://www.cbc.ca/news/canada/saskatchewan/woman-given-settlement-after-being-denied-tubal-ligation-1.690078; or maybe you missed the one last week about the woman with cancer being denied a post-partum tubal ligation here in the U.S.? http://www.opposingviews.com/i/society/pregnant-mother-brain-tumor-denied-tubal-litigation; Or maybe you missed the story about the Arizona nun who was excommunicated for granting a pregnancy termination to save the life of a mother of 4? I myself also find it relevant, if tangential, that over 200 American woman die each year from unintended pregnancy and yet many Catholic healthcare corporations refuse to stock the most effective contraceptives (IUDs and implants) so that women can better manage their fertility. –If you’re interested in more examples of theology interfering with healthcare, you might peruse CatholicWatch.org (Please give this writer some intellectual credit.)
I think it is high time the word BUSSINESS gets out of Healthcare.
Totally agree. Business, i.e., monetary profit, i.e., financial gain, stands diametrically opposite to the concept of health care, hence why so much chaos and horror is being perpetrated upon individuals by this “for profit” monstrosity. But of course, “health care” is such a highly profitable business, it has become, like public education (another “for profit” business) a sacred cow. People have bought into the religion of capitalism; of profit as the final arbiter of what’s right and wrong; good and bad, and can no longer see how damaging to society these predatory systems have become and how huge they have grown. Why doesn’t “capitalism” come out in force against rabid anti-abortionists? Because every mouth that needs feeding is a potential consumer and without consumers, where’s your profit under a totalitarian consumer system? That’s the bigger picture, of course. This struggle here is like ISIL in Iraq – let’s see where the potential for profit lies; which side is the most profitable, and let’s give the weapons (support) to that side and let’s keep our options open. “Bad” religion is good for business: it hides the evils within the corporate health and welfare for profit system, by making people focus on the wrong issues and put their trust in the apparently opposing camp. That’s called misdirection. Why are extreme murderous crazies allowed to run free and advertise the killing of health care workers? It’s a psyop, pure and simple, nothing to do with freedom of speech which no longer exists in “America” in any case, at least not where it could be damaging to the plutocrats’ business.
Who was it said, “The business of America is business”?