Standards in conflict: How Catholic health care doctrine interacts with ob-gyn physician practice

We present preliminary findings from a qualitative investigation into the bedside bioethics of religiously-affiliated health care institutions and their physician employees. One of every six hospitals in the United States is religiously-affiliated. Most Americans understand that Catholic-owned hospitals, which comprise 70% of religiously affiliated institutions, do not provide abortions. But it can come as a surprise to many, including physicians working with and within them, that Catholic employers prohibit other standard practices such as sterilization and contraception. In our interviews with ob-gyn physicians around the United States, we find that some are additionally surprised and concerned when life-saving abortion care, miscarriage management, and ectopic pregnancy are also affected by the doctrine. In their interviews, physicians explain how hospital restrictions impact their everyday practice in ways they did not necessarily anticipate when they took the job and how they learn to work around the restrictions in attempt to meet patients' needs.