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Thursday, October 25, 2012

How Catholic Church influences hospital operation

Posted By on Thu, Oct 25, 2012 at 6:37 AM

click to enlarge FOR CHOICE: Ad from Catholic group interested in hospital merger here.
  • FOR CHOICE: Ad from Catholic group interested in hospital merger here.

FOR CHOICE: Ad from Catholic group interested in hospital merger here.
  • FOR CHOICE: Ad from Catholic group interested in hospital merger here.
Catholics for Choice has taken an interest in the proposal to merge some operations of the public University of Arkanas for Medical Sciences hospital and clinics with those of St. Vincent Health in Little Rock.

Catholics for Choice was founded in 1973 to, as its website says, "serve as a voice for Catholics who believe that the Catholic tradition supports a woman’s moral and legal right to follow her conscience in matters of sexuality and reproductive health." The group, for example, favors access to birth control pills provided by the federal Affordable Care Act.

In that role, it has been an advocate and watchdog of services offered by hospitals that receive operational guidance from the Catholic Church. It provides further cause for concern about giving over to joint operation a taxpayer-financed institution with a much broader view of appropriate and comprehensive health services.

I'd urge a reading of this from the Catholics for Choice about denial of services in other Catholic hospitals, including bishops' punishment of hospitals that provided tubal ligations or approved an abortion to save the life of a mother. The group provided the information to an activist who's working against the UAMS-St. Vincent combine.

Catholics for Choice focuses on the directives issued by Catholic bishops that govern Catholic-affiliated institutions.

Under the Directives, the reality for women who find themselves at a Catholic hospital means they have:

o No access to abortion—even in cases of rape or incest (Directive 45)
o No access to in-vitro fertilization (Directives 37, 38, 39)
o No access to contraception (Directive 52)
o No treatment for ectopic pregnancy (Directive 48)
o None of the benefits of embryonic stem-cell research (Directive 51)
o No respect for their advance medical directives (Directive 24)

The sole exception to the ban on contraception falls under Directive 36, which only allows the provision of emergency contraception (EC) in cases of sexual assault when it can be proven that pregnancy has not occurred.12 This creates an unnecessary restriction, as EC does not interfere with the implantation of a fertilized egg.13 Evidence also suggests that many Catholic hospitals rarely provide EC even under the circumstances approved by the Directives. A 2006 study found that 35 percent of Catholic hospitals did not provide EC under any circumstances, while 47 percent refused to provide referrals to hospitals that did. Of those that provided referrals, only 47 percent of these led to a hospital that actually provided EC.14

UAMS has insisted any combination with St. Vincent wouldn't impair its services for women. But taxpayer money would be unavoidably contributing to the strength of an institution that does impose these religious restrictions on services. And, as Catholics for Choice has noted, hospital mergers elsewhere have created divisions of services where, in large geographic areas, the only alternative for care in a blended system is the Catholic institution, with its limitations. Then, referrals become an important issue. Writes Catholics for Choice:

Even those individuals whose financial status or location may normally enable them to travel to a non-Catholic facility can find themselves reliant upon Catholic hospitals. More than 19 million emergency room visits occurred in Catholic facilities during 2009.38 Women experiencing medical duress due to ectopic pregnancies, miscarriages or rape may not have the time or the luxury of choosing another hospital. A woman in this situation will not have her medical wishes honored, but may instead find herself in a hospital that will allow her condition to dangerously deteriorate out of a strict adherence to the Directives.

Many people are also not aware of the restrictions imposed by the Directives until they are in need of the services that are banned. Often, patients believe the name of the hospital to be a name only and are unaware that it indicates a different standard of healthcare. Even non-Catholics who seek care at a Catholic institution are subject to the Directives, and many will be surprised to learn that the care they require is unavailable.

UAMS promises a close examination of these questions. The fact that its proposed consultant was originally hired by St. Vincent and came up with the merger idea is not particularly reassuring of an even-handed review.

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