Contraceptives, Religion and Insurance Coverage

The government requirement that religious institutions provide health insurance for their employees, which includes coverage for birth control, is played out within the context of a campaign for the White House. The stakes are thereby intensified.

The debate is usually framed as pitting religious freedom of employers against the rights of women, especially, to have access to health care.

But there is another way to look at the issue and frame the discussion. As a member of the ethics committee of a Catholic hospital (who is not a Catholic) I have a close view of how such a hospital resolves disputes that involve the interests of non-Catholics, both employees and the public at large.

Unlike churches, which are clearly private institutions providing religious instruction to a homogeneous constituency of insiders, hospitals and schools under religious auspices serve a public beyond religious congregations. They therefore are religiously pluralistic with regard to those whom they serve and whom they employ to fulfill their mission. In this sense, they are hybrid organizations, and their policies reflect this hybridity.

For example, the hospital with which I am affiliated does not perform artificial insemination, in vitro fertilization (nor abortions or tubal ligations) or engage in surrogacy arrangements, as violative of Catholic doctrine. The question inevitably arises, what if one of the staff physicians, who is not Catholic, institutes these approaches in his or her office? Will the hospital permit the recipient of these services to deliver in the hospital?

The answer is “yes,”: and it is the rationale for this positive response that opens the door to the provision of medical insurance covering birth control for the employees of religiously-based institutions whose doctrine forbids it.

The hospital prides itself on being a progressive institution that serves a diverse public. In addition, in order to maintain standards of excellence, it must solicit staff doctors, nurses and other professionals from beyond the Catholic faith community. The hospital could not otherwise function if it dod not have non-Catholics on its staff. It is this dependence that broadens its practice and norms beyond the narrowing strictures of doctrine. As such, the standing of the hospital and its revenues are dependent on the labor and commitments of those who are not of the faith.

Just as this eclectic reach shapes the hospital’s policies and norms, so it should broaden its provision of providing access to conception to its employees, recognizing that as individuals they can choose to use that access or not as a matter of conscience. To deny such coverage is to solicit and profit from the professional talents of its non-Catholic employees while denying them access to the health services that other citizens enjoy. It is a  policy that quickly fades into unfairness.
Joe Chuman 2012