When religious hospitals, particularly those of the Catholic faith, merge or otherwise affiliate with non-religious hospitals, or those of another faith, religious doctrine almost always influences patient care. Where the affiliated hospital is of a secular nature, its patients are unaware that their health care will be governed by religious dictates they may not share.

Often, there is little that the community can do about such hospital alliances, but when one of the hospitals is owned by a government entity, the First Amendment of the U.S. Constitution can protect against religious entanglement with a publicly owned institution.