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Catholic Health Care and Women's Health

Guiahi, Maryam, MD, MSc

doi: 10.1097/AOG.0000000000002477
Contents: Current Commentary

Catholic health care facilities account for approximately one sixth of the U.S. health care market, have recently demonstrated successful growth, and serve as the only local hospital in certain remote locations. The Ethical and Religious Directives for Catholic Health Care Services is a set of guidelines created and revised by church leaders that applies the church's teaching, particularly as it relates to concern for human dignity, to modern-day medical practice; all Catholic health care facilities and providers within these facilities are required to abide. Strict interpretation of these directives limits family planning and most infertility services. Many women, however, do not anticipate differences to reproductive health care based on Catholic affiliation, and recent patient reports and legal enactments have highlighted the tension that arises when women are unable to receive medically indicated family planning services. In this article, I demonstrate that reproductive health care services are not consistently prohibited and that clinics often do not inform patients when scheduling appointments when restrictions exist. I highlight ethical concerns about patient autonomy as it relates to modern-day practice and recommend solutions including greater transparency and efforts to improve uniformity of practice at Catholic health care facilities.

Because Catholic health care facilities often limit reproductive health care services, efforts to provide greater transparency about restrictions are needed to support patient autonomy.

Department of Obstetrics and Gynecology, Division of Family Planning, and the Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

Corresponding author: Maryam Guiahi, MD, MSc, 12631 E 17th Avenue B198-2, Aurora, CO 80045; email:

Financial Disclosure The author did not report any potential conflicts of interest.

The author thanks Stephanie Teal, MD, MPH (University of Colorado School of Medicine), Jeanelle Sheeder, PhD (University of Colorado School of Medicine), Patricia Huguelet, MD (University of Colorado School of Medicine), and Marshall Gottesfeld, MD (Saint Joseph Hospital Denver) for their feedback on earlier drafts of the manuscript.

The author has indicated that she has met the journal's requirements for authorship.

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.