Dr. Debra Stulberg: Did you hear we're going to be working for the Pope?

Catholic hospitals and health-care networks are thriving while other non-profit and community hospitals are struggling. As many hospitals try to stay afloat amidst continued turmoil in the health care industry, some merge with Catholic health-care networks, which follow the ethical and religious directives of the Church. As a result, about 20 percent of the hospital beds in the United States are owned by the Catholic Church, according to NARAL Pro-Choice America.

Patients at Catholic hospitals might not be aware of how the Church's ethical guidelines might affect the quality of care they receive. When the hospital that employed Dr. Debra Stulberg as a resident merged with a Catholic health-care system, she worried it would affect the abortion training she sought and expected to receive. Then she learned that the Catholic directives affected much more than that, potentially putting patients lives in danger.

Conscience and refusal clauses >allow people and institutions such as hospitals, pharmacists, employers, and insurers to refuse to provide, pay for, or refer for medical treatment. These laws went into effect in 1973, after Roe vs. Wade legalized abortion in the United States, and there has been a resurgence of similar legislation in the last decade.

After Dr. Stulberg learned more about these laws, she was surprised by the lack of data regarding the difference in care and patient outcomes at a Catholic hospital compared with a nonsectarian hospital. The Catholic hospital takeover became the defining moment of her residency, and one that continues to inform her research and practice.

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