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Hospital mergers threaten reproductive choice and end-of-life care

By Mike Andrew 

In the past year, ten hospital mergers have been initiated in Washington state, which may result in private Catholic healthcare organizations taking over formerly public hospitals.

Concentration of medical services in the hands of fewer and fewer providers is never a good thing, and in this case the mergers threaten basic patient rights, including reproductive choice and end-of-life care.

The ACLU has threatened to file suit to block the latest merger, reported in February, on the grounds that hospital policies should “be based on medical ethics and state law, not religious doctrine.”

At issue is the decision of Skagit County hospital commissioners to hand over operations of their United General Hospital to the Catholic PeaceHealth group for the next 50 years.

“We are deeply concerned that PeaceHealth’s religiously-based policy of restricting access to reproductive and end-of-life healthcare services violates the Washington constitution and state law,” ACLU says in a letter to the Skagit commissioners dated February 8.

“As a government entity, the Skagit Public Health District No. 304 is bound by the Washington Constitution. The Washington Constitution provides that no public money or property shall be used to support any religious establishment.” (Article 1, Section II) The letter goes on to say, “By providing an annual subsidy to PeaceHealth and charging only nominal rent to lease United General Hospital and other public health facilities to PeaceHealth, the Hospital District is impermissibly supporting the religious restrictions on reproductive and end-of-life services.”

The letter also states that the United General Hospital merger would violate the state’s Reproductive Parity Act, which empowers every individual “with the fundamental right to choose or refuse birth control,” and every woman the right to have an abortion.

Catholic hospitals now account for more than 12% of health-care institutions in the United States, according to the Catholic Health Association of the United States, which means that roughly one in eight Americans seeks treatment at one. In the Northwest, our percentage of Catholic hospitals is much higher — 44% and growing.

Three of the largest health-care systems in the Northwest — PeaceHealth, Providence Health and Services, and Franciscan Health System — are Catholic entities, and they’re busy making new deals in our state. According to MergerWatch, a nonprofit that tracks Catholic hospital mergers across the country, PeaceHealth currently operates nine Northwest hospitals and 73 medical centers.

Already, nearly half of all patients who seek hospital treatment in this state will go to a Catholic hospital, whether they know it or not. For example, Swedish Medical Center, Seattle’s largest non-profit health care provider, has been working in partnership with Providence, a Washington-based Catholic institution, for the last year. Providence now operates 32 hospitals in Alaska, California, Montana, Oregon, and Washington.

As a condition of this relationship, Swedish agreed to stop performing abortions except in emergency situations where the mother’s life is at immediate risk. Fortunately for Seattle women, Swedish will refer patients to a Planned Parenthood clinic in a neighboring building, but not all Catholic-operated hospitals are so liberal.

The problem is not that Catholics have religious views that may or may not be shared by patients who seek treatment at Catholic hospitals. The real problem is that, unlike public hospitals, church institutions incorporate their religious views into Ethical and Religious Directives (ERDs), drafted not by medical prfessionals but by Catholic bishops, that determine who gets what kind of treatment.

The church monitors the implementation of these directives through hospital ethic committees overseen by regional bishops like Seattle Archbishop Peter Sartain, and doctors are required to accept his direction.

“Any partnership… must respect church teaching and discipline,” one directive states.

“Catholic health institutions may not promote or condone contraceptive practices,” another directive says, and “Abortion… is never permitted.”

Common medical procedures like vasectomies and tubal ligations are also prohibited. Egg and sperm donors are deemed “contrary to the covenant of marriage,” surrogate motherhood is prohibited because it denigrates “the dignity of the child and marriage,” and doctors at Catholic hospitals cannot help infertile couples conceive artificially — using their own eggs and sperm — because test-tube babies “separate procreation from the marital act in its unitive significance.”

PeaceHealth CEO Nancy Steiger also stated flatly that she would not assist terminally ill patients who ask for help in dying with dignity and a minimum of pain.

“Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering,” Steiger said.

These regulations not only contradict standard medical practices and the rights of patients, but also the clear will of Washington citizens. In 1970 Washington voters decided to legalize abortions, three years before Roe v. Wade, and we have consistently upheld a woman’s right to access abortion services since then.

In 2008, 59% of Washington voters approved a statewide “Death with Dignity” initiative.

Sen. Kevin Ranker has introduced a bill that would require new or expanding hospitals to prove that they provide for all women’s health care, family planning, and end-of-life services. SB 5586 has 11 co-sponsors.

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