Hospital Mergers and Conscience-Based Objections — Growing Threats to Access and Quality of Care

This perspective article examines the growing influence of Catholic hospital mergers in the U.S. healthcare system, where one in six hospital beds is now affiliated with Catholic institutions. The authors highlight how such mergers, often driven by financial necessity, restrict patient access to legally permitted services (e.g., contraception, abortion, medical aid in dying) due to religious doctrines. They critique the 2019 expansion of federal conscience regulations, which allow hospitals not just individual clinicians to refuse care based on institutional beliefs, potentially endangering emergency services, LGBTQ+ care, and end of life options. The article warns of reduced transparency and patient autonomy, particularly in rural areas with limited alternatives. Proposed solutions include state mandated public disclosure of hospital policies, community approval for mergers, and legal protections to ensure access to essential services. The authors argue that balancing institutional conscience rights with patient rights is critical to safeguarding equitable healthcare.

This perspective article examines the growing influence of Catholic hospital mergers in the U.S. healthcare system, where one in six hospital beds is now affiliated with Catholic institutions. The authors highlight how such mergers, often driven by financial necessity, restrict patient access to legally permitted services (e.g., contraception, abortion, medical aid in dying) due to religious doctrines. They critique the 2019 expansion of federal conscience regulations, which allow hospitals not just individual clinicians to refuse care based on institutional beliefs, potentially endangering emergency services, LGBTQ+ care, and end of life options. The article warns of reduced transparency and patient autonomy, particularly in rural areas with limited alternatives. Proposed solutions include state mandated public disclosure of hospital policies, community approval for mergers, and legal protections to ensure access to essential services. The authors argue that balancing institutional conscience rights with patient rights is critical to safeguarding equitable healthcare.