Disclosure of Restrictions

Patients have the right to be told in advance of any religiously-based hospital policies that would restrict their ability to receive medical information or services.

Disclosure of restrictive hospital policies should be carried out prior to the patient’s admission and repeated following admission in the event of a conflict between hospital policy and the patient’s desired course of medical treatment.  Disclosure procedures should be documented in hospital policies, incorporated into employee training and enforced by hospital administration.

Further, disclosure of restrictive ethical or religious policies should be required and enforced by hospital licensing and accrediting bodies and should be conditions of participation in the Medicare and Medicaid programs.  The current Medicare Condition of Participation regarding disclosure and end-of-life policies can serve as a model for disclosure of other restrictive policies, such as those prohibiting certain reproductive services. That model could be strengthened by more specific language explaining how and when disclosure should be made (such as in written materials for admission and advanced directives).

In addition, disclosure of hospitals’ restrictive policies and bans on provision of certain services should be made in prospective enrollment materials distributed by health insurance plans and government health coverage programs, such as Medicare, Medicaid and subsidized child/family health plans for low-income working families.

Disclosure of religious/ethical restrictions at participating providers is essential to ensure that health insurance enrollees are able to choose plans that include providers of desired services or exercise freedom of choice options under Medicaid.  Any changes to hospital policies, including the addition of new service restrictions, should also be disclosed to enrollees.

The requirement for disclosure should also encompass hospital communications and advertising.  For example, hospital advertisements should be prohibited from claiming to offer “comprehensive women’s health care,” if some reproductive health options are barred by hospital ethical or religious policies.  Some state consumer protection laws concerning misleading advertising may already prohibit such advertisements, and there might offer an avenue for enforcement.