Denials of Reproductive Health Care are Inconsistent with Trends in Modern Health Care

Major changes in the health care delivery are underway in the United States. The traditional hierarchical doctor-patient relationship is now viewed as insufficient and out-of-date. Patient-centered care, evidence-based medicine, and prevention are emerging as new paradigms for delivering health care. Patient-centered care responds to both the epistemic limitations of a disease-based model and the organizational limitations of a paternalistic relationship between physicians and patients. Patient-centered care, developed out of the institutionalization of informed consent, can be understood as a means to achieve patient autonomy. Evidence-based medicine responds to the dramatic variability in healthcare delivery regionally and the growing availability of scientific information about health by calling for healthcare decision-making to be based on the best available research. This requirement dramatically re-shapes physician and patient roles and responsibilities as well as the healthcare settings in which these actors are situated. Complementing these approaches is a new framework of wellness and prevention which broadens the attention of care delivery beyond the management of acute disease. In this way the focus in not on harms but on optimizing health outcomes before the onset of disease.

This paper reviews the evolution of health care in the United States including the major trends discussed above. It explores how patient-centered care, evidence-based medicine, and prevention are negated when institutions and individual health care providers deny care to women based on their religious or ideological beliefs.