Crisis of conscience: Reconciling religious health care providers' beliefsand patients' rights

In this note, Katherine A. White explores the conflict between religious he alth care providers who provide care in accordance with their religious bel iefs and the patients who want access to medical care that these religious providers find objectionable. Specifically, she examines Roman Catholic hea lth care institutions and HMOs that follow the Ethical and Religious Direct ives for Catholic Health Care Services and considers other religious provid ers with similar beliefs. In accordance with the Directives, these institut ions maintain policies that restrict access to "sensitive" services like ab ortion, family planning, HIV counseling, infertility treatment, and termina tion of life-support. White explains how most state laws protecting provide rs' right to refuse treatments in conflict with religious principles do not cover this wide range of services. Furthermore, many state and federal law s and some court decisions guarantee patients the right to receive this car e. The constitutional complication inherent in this provider-patient confli ct emerges in White's analysis of the interaction of the Free Exercise and Establishment Clauses of the First Amendment and patients' right to privacy . White concludes her note by exploring the success of both provider-initia ted and legislatively mandated compromise strategies. She first describes t he strategies adopted by four different religious HMOs which vary in how th ey increase or restrict access to sensitive services. She then turns her fo cus to state and federal "bypass" legislation, ultimately concluding that i ncreased state supervision might help these laws become more viable solutio ns to provider-patient conflicts.