OLYMPIA, WA, August 21, 2013 ( – Public hospitals that receive  funds to deliver babies must also provide abortion and contraception, even if they are absorbed by Catholic health care providers, according to a legal opinion delivered Wednesday by Washington State Attorney General Bob Ferguson.

“Public hospital districts may not administer or fund programs to provide 'maternity care benefits, services, or information to women' without also making provision for” contraception and for women “to voluntarily terminate their pregnancies,” Ferguson wrote.

The opinion came after Democratic State Senator Kevin Ranker of Orcas Island raised concerns about public hospitals potentially merging with Catholic health care providers who oppose abortion, contraception, and physician-assisted suicide.


The U.S. Conference of Catholic Bishops (USCCB) has issued Ethical and Religious Directives forbiding faithful Catholics from engaging in such practices. The First Amendment protects conscience rights.

However, Ferguson wrote that in 1991 Washington state voters passed Initiative 120, which stated, “Every individual has the fundamental right to choose or refuse birth control,” and “to choose or refuse to have an abortion.”

The attorney general ruled that since public hospital districts represent the state, they cannot “discriminate against the exercise of these rights,” nor can organizations that absorb them – even if such procedures violate their religion.

Ferguson did not say whether Catholic hospitals must provide such procedures or if they could contract with other providers. However, he said hospitals could avoid a conflict by refusing to provide maternity care.

With a rise of public hospitals becoming “allied” with Catholic health care providers, the state chapter of the ACLU called on the state to insure that hospitals provide all “lawful medical care, including reproductive health services, end-of-life services, and care for LBGTQ families, without restrictions based on religious doctrine.”

The group complained:

  • When Swedish Medical Center (secular) in Seattle affiliated with Providence Health & Services (religious), it stopped performing elective abortions.

  • When Highline Medical Center (secular) in south King County affiliated with Franciscan Health System (religious), it prohibited information about and referrals for aid-in-dying and restricted a wide range of reproductive health services, including contraception, tubal ligations, and elective abortions.

  • After San Juan County Public Hospital District affiliated with PeaceHealth (religious) for the construction and operation of a new hospital in Friday Harbor, PeaceHealth imposed restrictions on an OBGYN who formerly could freely counsel and serve women, including schedule tubal ligations and abortions.

In a letter to the ACLU, Democratic Governor Jay Inslee wrote that, while he had not heard of anyone being denied any procedure as a result of Catholics exercising their faith, he was “very concerned for the potential of these” mergers “to lead to restrictions in constitutionally protected care for Washingtonians.”

“We trust the foregoing will be useful to you,” Ferguson concluded his analysis on Wednesday.

Ferguson is also suing elderly Christian florist Barronelle Stutzman for refusing to provide flowers to a same-sex “marriage.”


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“I fully expect all public hospital districts to comply with this opinion,” he said while unveiling the opinion, according to the Seattle Post-Intelligencer.

The decision is not the first time state lawmakers have tried to link the right to life with the right to an abortion.

The ruling echoes the debate over the “Reproductive Parity Act,” which would have forced any insurance company that offers prenatal coverage to also pay for elective abortions. The bill passed the House but died in the state Senate this spring.

Human Life of Washington warned in an e-mail the bill would lead to “the taking of human life in violation of conscience for the first time in the history of our nation.”

Archbishop J. Peter Sartain of Seattle called the bill “utterly indefensible” and “a grave infringement on the rights of conscience.”

Americans United for Life President and CEO Charmaine Yoest agreed, “Clearly, Big Abortion’s agenda has effectively moved from ‘choice’ to coercion as they focus their legislative efforts on forcing Americans – including those in the health insurance industry – to acquiesce to their radical agenda or face severe consequences.”