Apr 23, 2019

Americans United for Separation of Church and State urged the University of California at San Francisco Board of Regents to end or alter any affiliation agreements between UCSF Health and the Dignity Health network of religious health care providers that require the university’s publicly funded medical center and its employees or students to comply with religious tenets.

In a letter sent yesterday to the board and UCSF Health President and CEO Mark Laret, Americans United explained that any agreements that restrict how UCSF employees or students provide medical care based on religious rules – including those known as the Ethical and Religious Directives (ERDs) for Catholic Health Care Service – violate both the U.S. and California Constitutions.

“UCSF Health is a public institution that cannot enter into an agreement that requires its employees or students to abide by any particular religious beliefs. That is a fundamental violation of religious freedom,” said Richard B. Katskee, AU’s legal director. “Furthermore, it’s unacceptable that UCSF Health would consider an affiliation agreement that would endorse the use of religion as the basis for discrimination, particularly against women and the LGBTQ community.”

According to published reports, two of the four San Francisco Bay Area hospitals included in the UCSF-Dignity Health affiliation agreement are subject to the ERDs, which would bar UCSF employees and students from providing abortion care, contraceptives, fertility treatments, sterilization, physician-assisted end-of-life decisions and gender-affirming treatment for transgender patients. Two other hospitals in the affiliation are subject to the “Catholic statement of common values,” which also limits abortion, fertility treatments and physician-assisted end-of-life decisions.

“The University of California cannot legally enter into an agreement that binds the University, its employees, or its medical students to conform to religious doctrine in either the services that they provide or the information that they present to patients,” said the letter sent by Katskee and AU Staff Attorney Ian Smith.

The letter details several ways in which the affiliation agreement may be unconstitutional:

  • Under the First Amendment to the U.S. Constitution, government cannot concede its decision-making authority to a religious organization.  
  • Government also cannot promote practices because they are required by a particular religion or prohibit practices because they are disfavored by a certain religion.
  • Under Article 1, section 4, of the California Constitution, government cannot have even the appearance of showing a preference for a particular religion.

AU’s letter requests that UCSF deny the requested affiliation agreement and sever any existing affiliation or alter these agreements so that UCSF does not agree to abide by the ERDs or any other religious tenets and does not enforce them in any way.

Americans United is a religious liberty watchdog group based in Washington, D.C. Founded in 1947, the organization educates Americans about the importance of church-state separation in safeguarding religious freedom.