CATHOLIC HOSPITALS: Mergers Limit Reproductive Services
The growing number of mergers between Catholic and non-Catholic hospitals is leaving patients with "dramatically reduced access" to reproductive services such as abortion, contraception and sterilization, according to a recent report by Washington, DC-based Catholics for a Free Choice. The Boston Globe reports that the national study obtained information on the status of reproductive health services in 64 of the 84 documented mergers of Catholic and non-Catholic facilities between 1990 and 1997. Some 48% of these 64 mergers resulted in "the discontinuation of all or some" reproductive health services. According to the report, Catholic hospital chains "have recently been growing at a faster rate than even the largest for-profit hospital chain, making Catholic hospitals the largest nonprofit health care providers in the nation." Influence has grown accordingly: the report found that "the number of Catholic facilities serving as an area's only hospital jumped from 46 in 1994 to 76 in 1997."
Doctrine As Doctor
The Ethical and Religious Directives for Catholic Health Care Services, produced in 1994 by the National Conference of Catholic Bishops, "prohibits tubal ligation, vasectomy, contraception, abortion, and some forms of infertility treatment." The Boston Globe reports that although federal Medicaid statutes entitle beneficiaries to family planning services, Catholic facilities are not required by law to provide such services, or even to refer patients elsewhere to obtain them. Critics are concerned about the impact of the Catholic directives on Medicaid patients. Frances Kissling, president of Catholics for a Free Choice, said, "These mergers have an effect on poor women, who disproportionately seek reproductive health care in hospitals." However, Richard Doherty, vice president of public affairs for Boston-based Caritas Christi Health Care System, which last year bought two non-Catholic facilities that subsequently stopped providing abortion, contraception and sterilization services, said, "It's important to realize that not every single hospital offers every single service, and we've made significant commitments to expand" other services. The Boston Globe reports that Catholics for a Free Choice based its report on "an extensive review of a leading hospital industry journal and other accounts of mergers, as well as interviews with hospital and community officials."
End Of Life Rights
The Catholic directives also place limits on patients' refusal of medical treatment near the end of life. Although the directives defer to U.S. and state law by obligating doctors to tell patients of their right to an advanced directive, the policy will not honor a living will "that is contrary to Catholic teaching" (Kong, 4/7).