SURVEY OF CONNECTICUT CATHOLIC HOSPITALS CONCERNING EMERGENCY ROOM DISTRIBUTION OF PLAN B TO RAPE VICTIMS - 2006

Background:

     The four Catholic hospitals of Connecticut issued a new protocol concerning the treatment of rape victims with emergency contraception (Plan B) effective January 1, 2006. The purpose of this protocol was to insure that all Catholic hospitals were providing quality, consistent and compassionate medical care to rape victims, while acting within Catholic teaching concerning the sanctity of all human life.

     Legislation was also proposed in 2006, at the same time this protocol was being implemented, that would have required Catholic hospitals to provide Plan B in all situations, even when it would act as an abortifacient. This legislation would have forced Catholic hospitals to violate one of its most basic tenets of faith concerning human life.  The legislation was not acted upon by the Public Health Committee.

     Since the end of the 2006 legislative session, the FDA has approved over-the-counter distribution of Plan B to woman over 18 years of age. This regulatory change makes Plan B easily available to woman in the 18 and over age group.

Protocol Summary:

-         Adheres to Directive 36 of the Ethical and Religious Directives for Catholic Health Care Services, “Compassionate and understanding care should be given to a person who is the victim of sexual assault…A female who has been raped should be able to defend herself against a potential conception from sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction or interference with the implantation of a fertilized ovum.”

-         The victim is tested to determine a prior pregnancy. (No hospital will administer Plan B to a woman who is already pregnant)

-         Plan B will be given to a patient if other medical history or existing conditions do not dictate otherwise, and, if requested by the physician, a LH urine dip test indicates she is not ovulating (indicating conception could not have occurred). Based on medical history the LH test may not be required.

-         When ovulation has not occurred or is highly unlikely the patient will receive the first dose of Plan B in the emergency room and provided a second dose to be taken 12 hours later.  The clinician may also provide Plan B to a victim for psychological comfort, even in situations where it is not possible for the patient to have conceived.

-         When ovulation cannot reasonably be ruled out the patient should be informed why anovulatory medications cannot be administered by the Catholic hospital. and provided information on where they can be obtained.

-         Should transfer be requested, the emergency department shall facilitate that transfer under existing hospital policies.

-         (Note: Outside of this specific protocol, it is the existing policy of Catholic hospitals to call for the services of an outside rape crisis counselor when the patient agrees to such service.)  

Purpose of Survey:

       This survey was undertaken to evaluate the results and impact of the new protocol instituted by Connecticut’s Catholic hospitals.  Additionally, many unsubstantiated accusations and facts were presented by those in opposition to the Catholic hospitals position on this issue during the 2006 legislative session. This survey was also an effort to add substantiated factual information to the debate.

Scope of Survey:

     All four Catholic hospitals were presented a set of questions in August, 2006. The questions were designed to answer questions raised by legislators during last year’s debate. The original request was for information covering the first six months of 2006. Since the nature of the questions required a review of case files, the effort was time and labor intensive.  Due to this fact, several hospitals did not respond until later in the year. All the hospitals provided more then the six months of data initially requested. None of the hospitals provided data for the full year.

                

Survey Summary:

       Reporting Periods – Saint Vincent’s Medical Center   1/1/2006 thru 7/31/2006

                                           Hospital of Saint Raphael            1/1/2006 thru 9/30/2006

                                           Saint Francis Hospital                  1/1/2006 thru 10/30/2006                                

                                           Saint Mary’s Hospital                  1/1/2006 thru 7/31/2006

      1)      Number of rape victims treated in the emergency room?

                        Total victims:  73          

                                         Walk-in:  46 

                                          Arrival by ambulance: 27

       2)      How many were denied Plan B based on pregnancy/ovulation testing provisions of    
      protocol?

                        Total:  0   

3)      How many were provided Plan B based on protocol?

                        Total:  26 

4)      How many did not received Plan B due to other factors (i.e., refused treatment, on birth control, post-menopausal, 5 days post assault, tubal ligation, sodomized, no evidence of rape, penetration with an object, youthful age of victim, etc.)?

                         Total: 47        

5)      How many were assisted by rape crisis counselors from outside agencies at the hospital (patient must agree to service)?

                         Total: 24 ( note: additional patients were provided follow-up

                                         Referrals or other support information)

6)      How many patients requested transfer to another hospital?

                          Total: 1 (Transfer of rape victim was not related to Plan B administration