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Obviously, women and their reproductive choices face the most immediate problems when their hospital is governed by Vatican rules. In ostensibly or formerly secular institutions which have merger agreements with Catholic institutions, contraception counseling and the dispensing of birth control pills or devices are not allowed:
#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.
The only general exception is for "natural family planning methods" - leaving us with the image of secular counselors attempting to instruct patients on the "rhythm method" with a straight face. Doctors aren't even permitted to recommend condom use to patients at risk of contracting or transmitting HIV.
This also has an impact when female patients want to participate in trials which require evidence that females are using contraception. A doctor's ability to prescribe contraception in an hospital-based office or to have patients receive contraceptive shots at hospital outpatient clinics will be eliminated if the hospital follows the Catholic Directives.
Vatican regulations will also anyone wishing to avoid future pregnancies by sterilization (vasectomies or tubal ligations):
#53 Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution when its sole immediate effect is to prevent conception. Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present pathology and a simpler treatment is not available.
Don't for a minute think that this policy does not have a traumatic impact on real people. As reported in the Spring 2000 issue of Social Policy, 34-year-old Zina Campos was a mother of nine in Gilroy, the poorest community in Santa Clara County, California. After her ninth child, she decided that "nine is way more than enough" and wanted a tubal ligation to prevent further pregnancies.
Unfortunately, the only hospital in Gilroy had recently been purchased by the Catholic Healthcare West system, a rapidly growing network of hospitals in the western United States. As a result, all voluntary sterilizations for the prevention of birth were banned because they are contrary to Catholic moral principles. Thus this woman's attempt to be safe and responsible was thwarted by the Church.
Infertility
Birth control isn't the only reproductive issue which is affected. A wide range of infertility services are prohibited, including in vitro fertilization:
#40 Heterologous fertilization (that is, any technique used to achieve conception by the use of gametes coming from at least one donor other than the spouses) is prohibited because it is contrary to the covenant of marriage, the unity of the spouses, and the dignity proper to parents and the child.
#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 (e.g., any technique used to achieve extra-corporeal conception).
A prohibition on "material cooperation" (see below in abortion issues) applies here, meaning that counseling and referrals to other providers where patients may obtain such services are prohibited. Thus a person seeking modern infertility treatments will not only not get them, but may not even be told that they exist and where they could be found.
The same continues long into the future, because all future technologies are subject to review by local Roman Catholic bishops. They will determine what is and is not acceptable, and then they will inform the local hospital which technologies it may or may not use.
It is fine if the Roman Catholic Church wishes to tell its members that their procreation is not to be separated from the "maritial act" (sex), but it is unacceptable that the Church should be making such decisions for non-Catholics.
Keep reading: Affects on Abortion.
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