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by Patricia A. Gabow (Author), Donald M. Berwick (Foreword by)
Do you know if your hospital is Catholic? Do you know what that means for your care and your community? The answers are most probably "No."
This book will answer these questions and pose many others in an expansive examination of the Catholic healthcare system in the United States. This well-researched volume delves deep into the origins, evolution, and the present-day implications of the Catholic healthcare system in the U.S. It traces Catholic healthcare's lineage from its biblical foundation to the role of courageous women religious in providing care to those in need, to the modern era of bishops' control over hospitals, doctors, and their clinical practice, determining the care that will be provided to millions of Americans.
In the U.S. in 2021, six of the 25 largest healthcare systems were Catholic. Forty-six states have Catholic hospitals, with 14% of the hospital beds under Catholic ownership - exceeding 40% of the beds in some states. These hospitals, their other healthcare components, and all their providers must follow 77 rules established by the bishops - the Ethical and Religious Directives for Catholic Health Care Services (ERDs). These rules cover a huge swath of healthcare for Catholic and non-Catholic patients, including almost every aspect of reproductive and end-of-life care. The ERDs take precedent over a physician's oath or judgment. A number of laws permit physicians and institutions to provide care in accordance with their beliefs, independent of a patients' own beliefs or choices. Physicians, healthcare providers, policymakers, and patients need to understand this dynamic in the face of the reach of Catholic healthcare. Yet, there is a surprising lack of institutional transparency. Patients often do not know if their hospital is Catholic and what care is prohibited.
This book illuminates the noble origins of the Catholic healthcare system and explores how Catholic nuns, with a deep-seated commitment to service to the most vulnerable, laid the foundation of the Catholic healthcare. It immerses readers in inspiring tales of compassion and dedication, where care was not a financial transaction, but a selfless act of mercy.
As the narrative unfolds, it examines the shift from these humble beginnings to a system now characterized by broad reach, wealth, and power with important ramifications for hospitals, doctors, patient autonomy, and patient care. The book examines these institutions' fidelity to the Catholic Church's commitment to the poor and most vulnerable and their stated missions to care for that population. The hospitals' not-for-profit status affords them tax exemptions, but do these institutions give back the same amount to their communities?
More than just a historical overview or a critique, this is an enlightening guide that underscores Catholic healthcare's contributions and uncovers its weaknesses. It makes a compelling argument for re-examining policies and practices to ensure the Catholic health system stays true to its roots of service and charity.
Intended for policymakers and funders, politicians, healthcare leaders, physicians, insurers, patient advocacy groups, ethicists, investigative journalists, legal scholars, Catholic leaders, academics, and students in health administration, the book offers a comprehensive understanding of a critical facet of American healthcare. It will open your eyes to the history, rules, reach, and healthcare implications of Catholic healthcare in America. It will ask you to consider how transparent healthcare institutions should be with their patients. It will ask you to examine what it means to be a not-for-profit healthcare institution. Finally, it will ask you to examine the boundaries between the exercise of beliefs by hospitals and physicians and the delivery of healthcare in America's pluralistic society.
