Over and over we see the U.S. Conference of Catholic Bishops confuse the right to exercise their religion with a right to impose their religion on Americans who don’t share it. This is not a subtle difference.

And, as Bill Moyers points out in the context of their intransigence on access to birth control, the bishops aren’t content with an exception from the rule that, like other employers, they provide birth control coverage to workers in their hospitals and universities. They also want to be able to keep their employees from obtaining birth control pills from a third-party insurer, at no cost to themselves.

This stance grossly abuses the rights and privileges of American business owners. Let’s face it: Hospitals are money-making operations, dominant in the economy and relying in great measure on government Medicare contracts and employer-based health plans. To allow one very large employer to dictate private healthcare decisions of its employees would distort the American ideal of freedom of religion into a very un-American practice of religious tyranny. The bishops want to control everyone’s moral decisions, Catholics and non-Catholics alike.

In the context of end-of-life choice, the bishops enforce Ethical and Religious Directives for Catholic Healthcare. This document instructs doctors to ignore advance directives that conflict with Catholic moral teaching (ERD #24), requires patients in permanent vegetative states to overcome a presumption in favor of indefinite tube feeding (ERD #58), disallows as “euthanasia” a patient’s refusal of treatment such as kidney dialysis if intended to advance the time of death (ERD’s #59 and 60), and urges employees to offer religious teaching on the redemptive power of suffering when standard comfort care fails (ERD #61).

With regard to Oregon and Washington’s Death with Dignity Acts, the bishops use the machinery of Catholic healthcare to withhold information and support for aid in dying, a legal end-of-life choice. Catholic hospitals, hospices and healthcare systems in those states often impose a draconian gag rule on their employees to deprive patients in their care of comprehensive knowledge of end-of-life choices. As noted by The Seattle Times, the Sisters of Providence healthcare system imposed policy that employees can’t discuss the issue with patients, even if asked. In response, Steven Saxe, director of the state’s Office of Health Professions and Facilities, reassured healthcare workers that all healthcare providers, including those at Providence, have a “protected right to offer basic information” about the law to patients.

An oppressive gag rule not only violates a cardinal rule of informed consent in healthcare, it also tramples the free speech rights and professional ethics of hospital employees and physician contractors.

As with contraception, a free society must find the middle ground. Catholic Bishops must be free to exercise their religion, yet we cannot allow them to deny that same freedom to the rest of us.