Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, University of Chicago, Chicago.
Institute for Research and Education to Advance Community Health, Washington State University, Seattle.
Perspect Sex Reprod Health. 2020 Jul;52(2):107-115. doi: 10.1363/psrh.12148. Epub 2020 Jun 29.
Abortion is generally prohibited in Catholic hospitals, but less is known about abortion restrictions in other religiously affiliated health care facilities. As religiously affiliated health systems expand in the United States, it is important to understand how religious restrictions affect the practices of providers who treat pregnant patients.
From September 2016 to May 2018, in-depth interviews were conducted with 31 key informants (clinical providers, ethicists, chaplains and health system administrators) with experience working in secular, Protestant or Catholic health care systems in Illinois. A thematic content approach was used to identify themes related to participants' experiences with abortion policies, the role of ethics committees, the impact on patient care and conflicts with hospital policies.
Few limitations on abortion were reported in secular hospitals, while Catholic hospitals prohibited most abortions, and a Protestant-affiliated system banned abortions deemed "elective." Religiously affiliated hospitals allowed abortions in specific cases, if approved through an ethics consultation. Interpretation of system-wide policies varied by hospital, with some indication that institutional discomfort with abortion influenced policy as much as religious teachings did. Providers constrained by religious restrictions referred or transferred patients desiring abortion, including for pregnancy complications, with those in Protestant hospitals having more latitude to directly refer such patients. As a result of religiously influenced policies, patients could encounter delays, financial obstacles, restrictions on treatment and stigmatization.
Patients seeking abortion or presenting with pregnancy complications at Catholic and Protestant hospitals may encounter more delays and fewer treatment options than they would at secular hospitals. More research is needed to better understand the implications for women's access to reproductive health care.
天主教医院通常禁止堕胎，但对于其他宗教附属医疗机构的堕胎限制知之甚少。随着宗教附属医疗系统在美国的扩张，了解宗教限制如何影响为孕妇提供治疗的提供者的实践变得尤为重要。
从 2016 年 9 月到 2018 年 5 月，在伊利诺伊州，对 31 名有在世俗、新教或天主教医疗保健系统工作经验的主要知情人（临床提供者、伦理学家、牧师和卫生系统管理人员）进行了深入访谈。采用主题内容方法来确定与参与者的堕胎政策经验、伦理委员会的作用、对患者护理的影响以及与医院政策的冲突相关的主题。
在世俗医院报告的堕胎限制很少，而天主教医院则禁止大多数堕胎，一个新教附属系统禁止被视为“选择性”的堕胎。宗教附属医院允许在特定情况下进行堕胎，如果通过伦理咨询获得批准。医院对系统范围内政策的解释各不相同，一些迹象表明，医院对堕胎的不适程度与宗教教义一样，对政策产生了影响。受到宗教限制的提供者会转介或转移要求堕胎的患者，包括因妊娠并发症要求堕胎的患者，而在新教医院，直接转介这类患者的回旋余地更大。由于受宗教影响的政策，患者可能会遇到延误、经济障碍、治疗限制和污名化。
在天主教和新教医院寻求堕胎或出现妊娠并发症的患者可能会比在世俗医院遇到更多的延误和更少的治疗选择。需要进一步研究以更好地了解对妇女获得生殖保健的影响。
