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Do Hospitals’ Religious Affiliations Affect Quality of Care?

Tom Klaus
December 18, 2014
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Religion

December 17, 2014; Medical Xpress and TakePart

A German study of nonprofit hospitals and a lawsuit against the U.S. Conference of Catholic Bishops illustrate the role religious affiliation and beliefs have in providing healthcare in both Europe and the United States.

In the first case, Lapo Filistrucchi and Jens Prüfer of Tilburg University studied the healthcare strategies of Catholic and Protestant hospitals in Germany. At the time of their study, in 2006 and 2008, approximately 830 of the 1,930 hospitals in Germany operated as nonprofits. Of this number, 40 percent identified as Catholic and 23 percent as Protestant. The study found that though the Protestant hospitals were smaller than the Catholic hospitals, they provided relatively more complex treatment procedures to fewer patients. The Catholic hospitals in the study tended to provide less specialized treatment, opting instead to help as many patients as possible. This would suggest, of course, that while in Germany at the next Oktoberfest, you might want to go to a Protestant hospital if you have a gall bladder attack from the over-consumption of bratwurst but a Catholic hospital if you sprain your wrist from drinking beer out of an oversized bierkrug (stein).

The study authors assert this difference in approach is rooted in the theological cornerstones and legacy of the two religious groups. They argue that in both groups, the hospital leadership believes there are spiritual rewards resulting from altruistic behavior, which, in their industry, means maximizing patient benefits. However, there is a difference between the traditions in this behavior. In Protestantism, the focus is on the individual, hence the need to provide the best possible care for individual patients. In the Catholic tradition, there is a stronger focus on the religious believer’s community, hence the efforts to treat many patients.

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In the second case, women’s reproductive health care policies in Catholic hospitals in the United States demonstrate a more direct link between religious beliefs and the available options. The U.S. Conference of Catholic Bishops provides healthcare guidelines for all Catholic medical providers and expects close compliance. This creates difficult choices, even life and death decisions, for some women seeking reproductive health care. A lawsuit filed by the ACLU on behalf of a young mother in Michigan is illustrative. Tamesha Means nearly died because a Catholic hospital in Muskegon refused to perform an abortion, leading to a premature baby that died shortly after birth. According to her attorneys, the hospital did not tell Ms. Means that her baby had virtually no chance of survival and that the safest option would be to induce labor and terminate the pregnancy.

It has been widely accepted that Catholic hospitals are not to perform abortions, even in the case of rape, but only recently have some decided to follow the guidelines’ restrictions on sterilization. As of November 1st, another Michigan Catholic hospital has banned sterilization after caesarean section. Voluntary sterilization is often done during caesarian births because the patient is already prepped for surgery. However, the Genesys Health System has “recently updated its policy on tubal ligations to comply with current Church teaching.” This means tubal ligation will be considered if the hospital determines that there is a medical need for it, but not if it is requested as an elective surgery.

The growth of Catholic-owned hospitals and healthcare systems in the United States suggests increasing challenges for women needing pregnancy terminations and tubal ligations, not to mention those who wish to elect these services. From 2001 to 2011, the number of Catholic hospitals in the U.S. grew by 16 percent. By 2011, ten of the 25 largest hospital systems in the U.S. were Catholic sponsored.

Do religious affiliation and belief have an impact on access to quality healthcare? The answer may be influenced by one’s own religious affiliation and beliefs.—Tom Klaus

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About the author
Tom Klaus

Tom Klaus, PhD is a nonprofit consultant specializing in leadership, program, and organizational development as well as research and evaluation. His clients include local, statewide, regional, and national organizations. He has extensive experience with community engagement, intractable controversy management, nonprofit board development and strategy planning, and the management of government funded health and human services grants and projects that are national in scope. In addition to his consulting practice, he has also managed the creation, development and testing of the Roots to Fruit of Sustainable Community Change model (R2F) with a colleague from the University of Iowa. The R2F model integrates the Collective Impact Five Conditions with other salient theoretical frameworks to present a measurable approach to producing long-term community change. Tom Klaus is also an adjunct professor at Eastern University (Philadelphia) in the School of Leadership Development and Ph.D. in Organizational Leadership programs and a frequent keynote speaker and workshop leader. From 2005 to 2013 Tom was Director of Capacity Building & Sustainability at Advocates for Youth in Washington, DC. During that time he served as a project director and as a technical assistance (TA) provider for a Centers for Disease Control and Prevention (CDC) funded teen pregnancy prevention project. In the role of project director he managed the daily work of the project. As a lead TA provider he created and provided organizational and leadership development training, coaching, materials, and support to local, state, regional and national organizations on a variety of issues, including controversy management, project and organizational sustainability, collaborative partnerships, and organizational change. From 2010 to 2013 Tom led the development of an innovative community mobilization and sustainability framework that is being used by the CDC in its teen pregnancy prevention grantee sites across the United States. Tom Klaus came to Advocates for Youth in December, 2005, from his home state of Iowa, where he had been the executive director and a founding board member of Iowa’s statewide teen pregnancy prevention organization; a developer and master trainer of several teen pregnancy prevention programs that were replicated nationally; a writer of numerous articles and curricula; a youth worker and counselor; and had held local, state, regional, national, and international leadership positions in both religious and public service organizations. Tom has written award winning and award nominated books on adolescent issues for religious publishers. He has also traveled throughout the United States as a speaker in hundreds of schools, colleges, and conferences on topics related to teen pregnancy prevention, adolescent sexual health, male involvement in teen pregnancy prevention, and organizational leadership and change. Tom Klaus is an alumnus of the Greater Des Moines Leadership Institute and a trained facilitator in Appreciative Inquiry, an asset-based change and development model for organizations. He has also received training in the fundamentals of Dynamic Governance, a sociocratic approach to organizational leadership and management. Tom earned degrees in religion and English at William Penn University, a Master of Science degree in counseling from Drake University, and the Doctor of Philosophy in Organizational Leadership (Nonprofit Concentration) at Eastern University. In 2013 Tom began a consulting practice, Tom Klaus & Associates, which is focused on partnering with nonprofit leaders to build greater organizations and programs for good. He is also adjunct faculty in Eastern University's School of Leadership Development and Ph.D. in Organizational Leadership program. Tom's doctoral research examined leadership in an intractable conflict over sexuality education in public schools in the United States. Other recent research and consulting work has included community engagement, reflective leadership, program and organizational sustainability, intractable conflict management, leadership development and coaching, organizational analysis, and board development. Tom is currently working toward accreditation as a leadership and executive coach with MentorCoach LLC and certification by the International Coaching Federation. Tom Klaus is known by his colleagues and clients as an authentic transformational leader; an innovative and focused strategic thinker and planner; a creative problem-solver; a talented trainer, teacher, and motivational speaker; an award-winning writer of numerous books, popular press articles, and professional research publications; and an effective relationship builder with a warm and engaging personality, appreciative management style, and a keen, quirky sense of humor. Tom is also an avid (though not great) ballroom dancer; a frequent (though not often enough) dog walker to his miniature schnauzers; and a practicing (though not perfect) Quaker.

More about: Health EquityNonprofit NewsPolicyReligious/Faith-Based

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