The only hospital within 25 miles of our small town was created by a health “special district” supported by local taxes. Most of the area’s doctors are connected to the hospital. Almost 15 years ago, Providence, a large Catholic hospital wanted to take over the health district. When asked about the Catholic approach toward health care, Providence spokespeople assured people that nothing would change, that the hospital could continue with providing contraceptive medications and procedures to all men and women and that we could continue with the policy of “death with dignity,” legal in the state of Oregon.
When the case went to court, however, hospital officials admitted that they had not told the truth; the hospital and all the doctors connected with it would be required to follow the Catholic directives described below.
More and more people around the country are realizing the loss of patience autonomy if Catholics control their hospitals. Arizona found this out when a pregnant woman suffered from life-threatening heart danger:
“Physicians concluded that, if she continued with the pregnancy, her chances of mortality were ‘close to 100 percent.’ An administrator, Sister Margaret McBride, approved an abortion, citing a church directive allowing termination when the mother’s life is at risk. Afterward, however, the local bishop, Thomas Olmsted, said the abortion had not been absolutely necessary. He excommunicated the nun and severed ties with the hospital, although the nun subsequently won reinstatement when she agreed to confess her sin to a priest.”
Washington state has had an even greater independent view of health care than many other states. Like Oregon, they legalized death with dignity. Washington law mandates that “every individual has the fundamental right to choose or refuse birth control” and “every woman has the fundamental right to choose or refuse abortion.” The state also guarantees an absolute right to privacy around mental health and reproductive issues for teens aged 13 and up. Last year, Washington legalized recreational marijuana use and marriage equality, and their constitution has an Equal Rights Amendment and a stronger wall of separation between church and state than the U.S. Constitution. State law even extended statutes of limitations on child sex abuse—something Archbishop Timothy Dolan successfully fended off in New York and Pennsylvania.
Like Oregon, however, the mergers between independent hospitals with large healthcare corporations mean more Catholic hospitals. Five of the six biggest hospital organizations are Catholic, including the Catholic Health Initiatives, operated by the conservative Franciscans. If all the planned mergers in Washington are successful, 45 percent of the state’s hospital beds will be religiously affiliated by the end of this year. One-hundred percent of hospital facilities in ten counties will be religious, including outpatient clinics, laboratories, and physician practices.
The plus side of mergers is the ability to acquire more expensive equipment, better electronic record keeping, and greater administrative efficiency. The down side is that everyone who is in the hospital or has a health practitioner connected with the hospital will have to follow the religious directives because, in the words of the U.S. Conference of Bishops, Catholic hospitals and healthcare corporations are “healthcare ministries” and “opportunities”:
“New partnerships can be viewed as opportunities for Catholic healthcare institutions and services to witness to their religious and ethical commitments and so influence the healing profession. . . .For example, new partnerships can help to implement the Church’s social teaching.”
No longer will care be dictated by medical science and patient preference. A set of theological agreements call the “Ethical and Religious Directives for Catholic Health Care Services” or ERDs dictate treatment options offered to–or even discussed with–patients.
Gone is the dual patient-doctor relationship. Religious hospitals operate with a trinity—a patient-doctor-church relationship: “The Church’s moral teaching on healthcare nurtures a truly interpersonal professional-patient relationship. This professional-patient relationship is never separated, then, from the Catholic identity of the healthcare institution.”
Providers who work in these religious systems must sign binding contractual agreements to adhere to the religious directives: “Catholic healthcare services must adopt these Directives as policy, require adherence to them within the institution as a condition for medical privileges and employment, and provide appropriate instruction regarding the Directives ….”
Fertility Treatment: “Reproductive technologies that substitute for the marriage act are not consistent with human dignity.” ERDs prevents any in vitro fertilization and related treatments, either for same-sex couples who may use surrogacy or insemination for childbearing of for the ten percent of couples in the United States who have fertility problems.
Contraception: “Catholic health institutions may not promote or condone contraceptive practices …. Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution.” A woman who delivers a baby at a Catholic hospital and wants an IUD inserted or her tubes tied must have a second, separate procedure at a secular facility—if she can find one. State-of-the-art methods like IUD’s are better provided at the time of delivery, because postpartum insertion improves health outcomes; having tubal ligation at a different time than delivery means two surgeries instead of one if the baby was delivered through a C-section. Physicians connected to a religious hospital are prevented from doing vasectomies in their office or clinic.
Abnormal Pregnancies: “In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion.” Catholic practice requires the removal of the entire fallopian tube to end an ectopic pregnancy instead of just taking out the developing fetus. That mandates invasive and fertility-destroying surgery. Catholic “ethics” also forbid abortion even to save the life of the woman carrying the fetus. The recent publicity regarding Beatriz in El Salvador clearly exemplifies this situation.
Advance Directives: “A Catholic health care institution … will not honor an advance directive that is contrary to Catholic teaching.” If patient directives and bishop directives conflict, the directives of the bishops take precedence regardless of a patient’s own religious or conscience obligations.
DNR: “The free and informed judgment made by a competent adult patient concerning the use or withdrawal of life-sustaining procedures should always be respected and normally complied with, unless it is contrary to Catholic moral teaching.” Catholic hospitals refuse to honor a patient’s request of “Do not Resuscitate,” maintaining life support at all costs despite patient orders.
Death with Dignity: “Catholic healthcare institutions may never condone or participate in [Death With Dignity] in any way.” Although three states have now legalized the right of patients to voluntarily end their lives under specific conditions, Catholic hospitals will not allow this right. Physicians are prohibited from even discussing options that exist in other institutions or making referrals.
“Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering.” This theological notion is derived from the crucifixion story—the idea that the blood sacrifice of a perfect being could redeem harm done. Suffering itself has redemptive value, which is why Mother Teresa’s order, for example, practiced self-flagellation and glorified suffering of the poor, ill, and dying.
Not everyone in Washington is accepting the Catholic health care takeover. After Catholic Peace Health got an exclusive contract near her home in the San Juan Islands, advocate Monica Harrington created a website to complement the efforts of the national Merger Watch. Fighting the religious takeover of secular systems across the country for over a decade, Merger Watch has identified a recent surge of Catholic hospital ownership. The ACLU of Washington working toward a state-wide solution, the first in the country. Part of its efforts is soliciting confidentially-protected stories from patients and providers anywhere who have experienced religious interference in medical decisions in the United States.
The Catholic Church provides less than five percent of revenues for Catholic-controlled hospitals. The other 95 percent comes from insurance reimbursement and tax-payer funds in the form of Medicaid, Medicare and capital grants for public services. Yet that five percent gives the Catholic Church total autonomy.
Washington is not the only state in trouble. In Arkansas, the state’s only teaching hospital, UAMS, is negotiating a merger with St. Vincent Health. If that were to happen, medical students would not be taught correct procedures in women’s reproductive needs, endangering the lives of people who go to these students when they become health practitioners.
The following map shows the growing influence of Catholic hospitals, now providing 16 percent of the beds, through the share of admissions to Catholic hospitals in the United States:
Fortunately, health care in our small town had a happy ending. We affiliated with a group of four other small-town hospitals, each of which kept its religious affiliation. One is Episcopalian, and another is Seventh Day Adventist. The other three are secular. The hospital still honors women’s reproductive rights, advance directives, and death with dignity.
People need to understand that Catholic hospitals prevent much more than abortions and emergency contraception. Catholic hospitals take away the rights of patients to both save their lives and make their own end-of-life decisions. Anyone in a Catholic hospital may discover, up close and personal, the meaning of redemptive suffering.