On the 29th anniversary of the Roe v. Wade decision, advocacy groups called for Roman Catholic hospitals to ease restrictions on emergency abortions and contraceptive procedures _ and urged politicians to threaten the facilities with funding cutoffs.
In reports released Tuesday, the American Civil Liberties Union and MergerWatch said certain policies at the hospitals infringe on employees and patients with different religious beliefs.
The reports note that America's 618 Catholic hospitals _ with 16 percent of community hospital beds _ serve people of all faiths, including many patients whose bills are paid by Medicaid and Medicare.
``If you're operating in the public sphere, receiving public money, you must play by public rules,'' said Catherine Weiss, director of the ACLU's Reproductive Freedom Project.
The leader of a Catholic health care organization dismissed the reports as an attempt by abortion rights supporters to press their agenda.
The ACLU supports the right of doctors and nurses to refuse to provide health services that contradict their beliefs. But its report says hospitals, and church-run health care networks, should ease religious restrictions if they serve the general public.
``Every rape survivor ought to be offered emergency contraception,'' the report said. ``A doctor, nurse or pharmacist who cannot in good conscience participate in abortions or contraceptive services should be allowed to opt out, so long as the patient is ensured safe, timely and financially feasible access to treatment.''
MergerWatch, which monitors mergers involving church-run hospitals, said such facilities rely on public funding for nearly half their revenue. The Albany, N.Y.-based group said public officials were too quick to grant ``conscience clauses'' to these hospitals so they can receive public funds while keeping restrictive policies.
Among MergerWatch's recommendations:
_Policymakers should consider withholding public funding unless church-run hospitals tell patients in advance about religious restrictions on services or treatment choices.
_Patients should be informed of all treatment options, including those not allowed at the religious hospital.
_Patients whose right to informed consent has been violated should be advised about the possibility of filing malpractice suits.
_Hospitals should be required to provide care in urgent cases, such as emergency contraception for rape victims.
The Rev. Michael Place, president of the Catholic Health Association, said concerns raised in the reports disguised the true aim of the advocacy groups.
``Their ultimate objective is that abortion be on demand, in every hospital in the United States,'' he said. ``They will pick whatever method will contribute incrementally to that goal.''
Place also said the criticism ``leaves the false impression that Catholic health care gets funds it isn't entitled to.''
``There's no rule that any hospital that receives government funds should provide every service,'' he said.
The ACLU and MergerWatch reports, by targeting fundamental policies of all Catholic hospitals, represent a broadening of criticism that surfaced during a wave of hospital mergers in the 1990s. Dozens of the mergers linked Catholic and non-Catholic hospitals, often resulting in wider application of religious restrictions on reproductive health services.
The pace of mergers has slowed since 1999, but communities nationwide have become entangled in debates over whether restrictions at Catholic hospitals deprive women of important health services.
One of the most complex disputes is in Austin, Texas, where authorities leased city-run Brackenridge Hospital _ the main provider of care to low-income patients _ to Catholic-run Seton Medical Center in 1995.
The agreement appeared in jeopardy last year when the city said it couldn't allow Brackenridge patients to be governed by Seton's restrictions on sterilizations and emergency contraception.
Officials eventually reached a tentative compromise in which the city will provide those services in a ``hospital-within-a-hospital'' on Brackenridge's fifth floor, reached through a new entrance and elevators separate from the rest of the hospital.
``The past eight months have been pretty hard,'' said Peggy Romberg of the Women's Health and Family Planning Association of Texas. ``To suddenly have to fight tooth and nail so low-income women have access to tubal ligation and birth control is disheartening.''
Place said Catholic health officials are prepared to seek partnerships with those holding other beliefs, as long as church doctrine is respected.
``Catholic hospitals are present in communities where no one else would be, because we feel we have to be there,'' he said. ``We're not seeking to impose our beliefs aggressively on anyone _ but give us the space to do what we believe.''