Catholic hospitals in Germany are told they must treat victims of sexual assaultBMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f580 (Published 28 January 2013) Cite this as: BMJ 2013;346:f580
Hospitals in Germany operated by the Roman Catholic church have come under scrutiny after it was revealed that a woman who may have been sexually assaulted was denied a basic examination by two Catholic hospitals in Cologne.
The incident, first publicised on 16 January in a newspaper article, has triggered almost daily headlines in Germany and sparked debate among politicians, doctors, and women’s support groups on the role of Catholic hospitals.
The first news article on the incident, published in the daily Kölner Stadt-Anzeige,1 quoted Irmgard Maiworm, the doctor who first treated the woman in an emergency centre. Rather than remaining an anonymous source, Maiworm allowed herself to be photographed for the news story and was quoted by name, highly unusual in Germany in an article on such a controversial topic.
On 15 December the 25 year old woman had come to an emergency centre with her mother after apparently being sedated at a party with a drug slipped into her drink. The woman had lost consciousness, but she suspected that she had been sexually assaulted. She complained to Maiworm of pain and difficulty urinating. Maiworm prescribed emergency contraception and alerted the police.
Maiworm then contacted a doctor in the gynaecology department at a neighbouring hospital run by the Catholic church for further treatment and an examination to collect potential forensic evidence. The hospital doctor declined to accept the patient, Maiworm said, because of the potential that she might want to be given the morning-after pill, which is considered an abortifacient by the Catholic church and forbidden. Maiworm told the hospital that she had already written a prescription, but the doctor still refused to see the victim. Maiworm tried a second Catholic hospital, where a doctor also declined to see the patient.
After the news story was published the archdiocese of Cologne issued a statement apologising and saying that the refusal to treat the woman was because of a misunderstanding between management and doctors, who had been told only not to dispense the morning-after pill. “We regret very much that the impression has been given to the public that sexual assault victims are no longer able to be treated in Catholic hospitals,” the archdiocese said. “That is false.”
Despite the apology, the health minister of the state of North Rhine-Westphalia said that the refusal to treat the victim was unacceptable and would be investigated. Rudolf Henke, chairman of the Marburger Bund doctors’ association, also criticised the hospitals during an interview on a popular morning television news programme.
Some MPs in the Bundestag, Germany’s lower house of parliament, have publicly questioned whether hospitals operated by the Catholic church should be allowed to withhold certain treatments, such as the morning-after pill, on religious grounds. Some rural areas are served only by Catholic hospitals, they said.
As the negative headlines from the incident continued, Cardinal Joachim Meisner of Cologne publicly apologised on 22 January,2 saying that he was “deeply ashamed” that the woman was denied medical treatment at the two Catholic hospitals and adding that the refusal was “contrary to our Christian mission.”
The influential German magazine Der Spiegel subsequently published a major article titled “Church and state: where Catholic beliefs and public needs collide.”3 The article questioned the Catholic church’s huge influence not only on hospitals in Germany but on nursing homes and day care centres for children.
The Catholic Hospital Association of Germany has devoted a big portion of the home page of its website (www.kkvd.de) to the issue under the headline “Handling sexual abuse victims in Catholic hospitals.” In addition to a statement about the events in Cologne, the association offered downloads of comments on the issue from Thomas Vortkamp, the head of the association; the moral theologian Eberhard Schockenhoff, a member of the German Ethics Council, which advises the government on various controversial issues; and the medical ethicist Stephan Sahm, chief doctor of the Catholic Ketteler Medical Centre in Offenbach.
Vortkamp admitted that the incidents in Cologne had created “waves nationwide.” He said that it had now been made clear to all Catholic hospitals that they must give initial treatment to women who have been sexually assaulted and conduct examinations for forensic evidence.
Cite this as: BMJ 2013;346:f580