UAMS, St. Vincent collaboration 

Devil's in the details, bishop says.

Bishop Anthony Taylor of the Catholic Diocese of Arkansas, commenting on the proposed affiliation between St. Vincent Health System and the University of Arkansas for Medical Sciences, left the door open to the idea, saying that cooperation "that does not violate the ERDs [Ethical and Religious Directives for Catholic Health Care] or otherwise undermine the Catholic identity" of St. Vincent "could be acceptable."

A draft term sheet of how the affiliation could work was released last week at the meeting of the University of Arkansas Board of Trustees. That draft, prepared by Hogan Lovells law firm, said that large hospitals such as UAMS and SVHS must "perform their special roles as part of larger networks." The model envisions a "network collaboration" that would not only consolidate some of the hospitals' services, like heart and cancer care, but would establish affiliations with hospitals across Arkansas "to achieve a level of financial alignment and clinical integration such that they will be able lawfully to jointly contract with payers for certain services." The term sheet envisions a third entity overseen by a council, half from UAMS and half from SVHS.

After the release of the term sheet, activist Jo Ann Coleman e-mailed the Diocese asking for the bishop's reaction to a "blended Little Rock institution, jointly governed, that included a public affiliate offering services to patients or employees which the church does not approve — birth control pills, abortion, in vitro fertilization, patient directives on end of life decisions, tubal ligations, vasectomies, morning after pill dispensation to rape victims in emergency rooms, abortion training at UAMS and more." The bishop responded to Coleman personally, writing that "I will not allow any affiliation that implicates St. Vincent in any jointly governed institution that would result in our material cooperation with any of the immoral medical practices you describe."

While UAMS and SVHS have repeatedly stated that their affiliation would not affect UAMS' ability to offer such services as outlined in Coleman's letter, the term sheet says the Network Collaboration "will provide world-class care to communities throughout Arkansas, and do so in a manner that is accessible, responsive, and respectful of the dignity of the individual human being." Since the church defines human being as the embryo, the language suggests that St. Vincent might require affiliated hospitals outside Little Rock to abide by its Ethical Directives.

After being provided the bishop's correspondence with Coleman, the Times asked Taylor if his response to Coleman meant that he would "disapprove of a cooperative venture with UAMS even if it offered such enumerated services independently and outside of the collaborative network proposed this week in draft form for the two institutions?"

To the Times, Taylor wrote that "I do not automatically oppose as a matter of principle every conceivable model of affiliation between Catholic and secular hospitals," but that he would oppose an affiliation that would "implicate" St. Vincent in violations of the Catholic Directives and undermine the Catholic identity of St. Vincent. Taylor added that the " 'devil' (so to speak) is always in the details.' "

Among the details to be worked out would be whether a patient seen in a clinic operated under the "network" could be referred to UAMS over SVHS' objections for a service the Catholic church considers "immoral." If so, would the referral constitute "material cooperation"? If not, would the patient be denied a legal service previously available at UAMS?

In an affiliated heart clinic, for example, what happens to the pregnant woman who, unless she terminates her pregnancy, could suffer heart damage or even death? If the cancer clinics affiliate, what would happen to the cancer patient who wishes not to be kept alive artificially?

The Times was unable to reach St. Vincent CEO Peter Banko for comment. Banko told the Times a couple of weeks ago that he believed he and the bishop had a good relationship and could "work through anything together." To not find a way to grow the hospital, Banko said, would "diminish the Catholic ministry" of St Vincent.

Margaret Preston, spokeswoman for St. Vincent, did respond, saying in an email that "Since the beginning of our discussions with UAMS in August 2012, we have been clear that we will not enter into any affiliation model that impacts our Catholic identity or UAMS' identity as a public, academic institution. That has not changed and will not change. As a Catholic ministry, we work closely with Bishop Anthony Taylor, the Catholic Diocese of Little Rock, and other Church leaders on all aspects of our strategic development. We require that at least one representative of the Church is a member of all of our governing bodies (fiduciary and advisory). We received a first draft of a proposed affiliation model from UAMS yesterday and will be actively negotiating with UAMS over the next month or two. We will be simultaneously engaging Bishop Taylor, the Diocese, and other Church leaders in our review and approval of potential models. Again, St. Vincent Health System will engage in no activities that compromise our Catholic identity."

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