One is that there is a rather long, loud morning prayers on the intercom every day (usually at a time when we're rounding on patients). It's not just, "let's take a moment of silence" or something else equally nonspecific... rather it is usually a five-minute sermon on what Jesus or some saint said. Even though it's a rural part of the country, not everyone is Christian or religious (and they're definitely not all catholic). The last thing I'd want to hear when I'm sick in bed (especially if it's during the five minutes that my doctor is talking to me) is what Jesus wants me to do.
What really bothers me, though, is the fact that church doctrine dictates medical decision making. Catholic-affiliated hospitals (which care for approximately 20% of the patients in the US) all follow the US Conference of Catholic Bishops' Ethical and Religious Directives . Since it affects a fifth of patients in the country, it's a must read for healthcare workers. Some of the more striking parts are:
- #24: The institution ... will not honor an advance directive that is contrary to Catholic teaching.
- #25: Each person may identify in advance a representative to make health care decisions as his or her surrogate in the event that the person loses the capacity to make health care decisions. Decisions by the designated surrogate should be faithful to Catholic moral principles.
- #36: A female who has been raped should be able to defend herself against a potential conception from the sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum.
- #41: Homologous artificial fertilization (that is, any technique used to achieve conception using the gametes of the two spouses joined in marriage) is prohibited when it separates procreation from the marital act in its unitive significance
- #45: Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo.
- #47: Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child. (pleasantly surprised about this one)
- #48: In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion.
- #52: Catholic health institutions may not promote or condone contraceptive practices but should provide, for married couples and the medical staff who counsel them, instruction both about the Church's teaching on responsible parenthood and in methods of natural family planning.
- #53: Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution. Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.
- #54: Genetic counseling may be provided in order to promote responsible parenthood and to prepare for the proper treatment and care of children with genetic defects, in accordance with Catholic moral teaching and the intrinsic rights and obligations of married couples regarding the transmission of life.
- #61: Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering.