WASHINGTON — Awash in red ink, U.S. Catholic hospitals are navigating a daunting health-care environment roiled by the 2010 health-care reform legislation and other potential threats to their religious mission and ethical practices.
The shifting scene has further complicated the relationship between Catholic health-care institutions and the bishops charged with securing their adherence to the moral teachings of the Church, as outlined in the U.S. Conference of Catholic Bishops’ “Ethical and Religious Directives” (ERDs). Critics and whistleblowers previously raised concerns about routine sterilizations, contraceptive services and even abortions at some hospitals.
But in the wake of the explosive dispute between Phoenix Bishop Thomas Olmsted and the administration of St. Joseph’s Hospital and Medical Center in Phoenix, many are calling for stronger action to secure adherence to the ERDs.
John Brehany, executive director of the Catholic Medical Association, which defended the conscience rights of physicians in the recent health-care overhaul debate, contends that Catholic health-care ministries should take their cue from the federal government’s aggressive anti-fraud regulations for Medicare and Medicaid.
“It isn’t enough for U.S. hospitals to say, ‘We don’t commit fraud.’ Federal regulations require them to identify areas where abuse might take place and develop an action plan to prevent it,” Brehany noted. “Why not take the same approach to ensure the Catholic identity of our hospitals?”
Paul Danello, a canon lawyer who has worked in the health-care field for over three decades, says he has prodded the National Catholic Bioethics Center, which advises the bishops on a range of issues, to advocate a hard-nosed approach to weeding out abuse.
“The time is long past for Catholic health systems to create a mechanism that will demonstrate their compliance with the ERDs and help avoid non-compliance,” said Danello.
Catholic health-care networks navigate a complex minefield: They answer to Church authorities but also operate in a politicized environment that can misrepresent the Church’s countercultural practices as anti-women, or even anti-life.
Bishop Olmsted alluded to the danger of Catholic health-care networks relying on the judgments of theologians who may agree with them — and not recognizing their bishop’s moral authority in the matter.
In a Nov. 22 letter to Lloyd Dean, president of Catholic Healthcare West, the parent company of St. Joseph’s Hospital, Bishop Olmsted said it was he, as ordinary of the diocese, who had the authority to interpret Catholic moral teachings and the Ethical and Religious Directives governing Catholic healthcare institutions in his diocese.
“Until this point in time, you have not acknowledged my authority to settle this question but have only provided opinions of ethicists that agree with your own opinion and disagree with mine,” the bishop wrote. “As the diocesan bishop, it is my duty and obligation to authoritatively teach and interpret the moral law for Catholics in the Diocese of Phoenix.”
Indeed, the recent national debate ignited by Bishop Olmsted’s decision provides a case study of the competing constituencies and interest groups that keep large hospital networks like Catholic Healthcare West, on the defensive.
“Religiously affiliated hospitals are not exempt from federal laws that protect a patient’s right to receive emergency care and cannot invoke their religious status to jeopardize the health and lives of pregnant women,” charged Alexa Kolbi-Molinas, staff attorney with the American Civil Liberties Union’s Reproductive Freedom Project.
Last spring, the ACLU had already registered similar concerns regarding Catholic “emergency reproductive care” with the Centers for Medicare and Medicaid Services.
Newspaper editorials and media pundits echoed the ACLU’s position. “No one has suggested that Catholic hospitals should be required to perform non-emergency abortions,” stated a Dec. 23 editorial in The New York Times. “But, as St. Joseph’s recognized, the need to accommodate religious doctrine does not give health providers serving the general public license to jeopardize women’s lives.”
Bishop Olmsted confirmed that his decision capped a seven-year evaluation of the hospital’s practices; he noted that “many other violations of the ‘Ethical and Religious Directives’ have been taking place at Catholic Healthcare West facilities in Arizona throughout my seven years as bishop of Phoenix and far longer.”
Sister Carol Keehan
Nevertheless, Sister Carol Keehan, president and CEO of the Catholic Health Association, a trade group, further amplified the drumbeat of attacks against the bishop when she issued a statement asserting that St. Joseph’s Hospital had “correctly applied” the ERDs in the direct abortion case.
Sister Carol already had already become well known for her support of the health-care reform bill, in spite of the U.S. bishops concerns that the bill would open the door to mandatory taxpayer funding of abortions.
Bishop Kevin Vann of Fort Worth, the episcopal liaison on the CHA board, in a brief comment for this story, said “The U.S. Conference of Catholic Bishops and the Catholic Health Association are in communication, and it is important that we continue to work together.”.”
When Sister Carol was asked to respond to charges that she had undermined Bishop Olmsted’s authority, her spokesman, Fred Caesar, didn’t bother to justify her intervention. The USCCB and CHA wrote Caesar in an e-mail message, “have been having many excellent conversations regarding multiple joint efforts.”
Archbishop George Niederauer of San Francisco — the city where Catholic Healthcare West is headquartered — has vowed to initiate a “dialogue” with the leadership of the health-care network. The archbishop did not elaborate on how that dialogue would be structured or whether he would seek to establish a deadline or a mechanism to secure adherence to the ERDs.
“The controversy has raised the level of discussion between the bishops and hospital CEOs to a new level,” acknowledged Bishop Robert Vasa of Baker, Ore., who recently ended the Church’s sponsorship of St. Charles Medical Center — a “stand-alone” hospital governed by a lay board — after learning it routinely provided tubal ligations and had no intention of discontinuing this policy.
Pope Benedict XVI Jan. 24 named Bishop Vasa co-adjutor bishop of Santa Rosa, Calif. There are several Catholic hospitals in the diocese.
A New ‘Safe Environment?’
In a world of increased transparency, the scope of the problem is becoming increasingly apparent — much to the chagrin of some bishops. In 2008, for example, Wikileaks released files confirming that Catholic hospitals in the Diocese of Tyler, Texas, regularly performed tubal ligations.
Initially, the hospitals said they were in compliance with the ERDs. Later, Jesuit Bishop Alvaro Corrada del Rio of Tyler acknowledged that “subsequent investigation reveals that there had been a serious misinterpretation of the ERDs and that, in fact, many direct sterilizations had been done and continued to be done.”
The bishop’s public admission of his “failure to provide adequate oversight of the Catholic hospitals as regards their protection of the sacred dignity of each human person” began to fuel the search for solutions, though some experts question whether a one-size-fits-all approach can work.
“Some bishops sit on boards of the local [healthcare] ministry; some chair those boards; some have delegates. There are a variety of ways that collaboration can occur,” observed Marie Hilliard, director of bioethics and public policy at the National Catholic Bioethics Center.
She spoke generally about the issue of epsicopal oversight and could not comment about the Catholic Healthcare West controversy.
One promising approach, Hilliard suggested, is to appoint a member of the clergy to chair the ethics committee in the hospital and submit an annual report on adherence to the ERDs. “That seems to be a very effective way of assuring that there is no misunderstanding regarding the application of the ERDs,” she said.
Is the USCCB likely to create a mechanism for overseeing hospital practices, just as they developed a safe environment framework? Would it work?
Bishop Vasa suggested that the first step is for bishops to move beyond formal discussions and initiate a deeper engagement with hospital administrators that specifically targets their practical interpretation of the ERDs.
“Instead of asking, ‘Are you observing the ERDs?’” said Bishop Vasa, “bishops have the obligation to ask, ‘Are you doing tubal ligations, and under what circumstances?’ As Churchmen, we are trained to be forgiving and compassionate, trained to accept that people will tell us the truth. We need to be more vigilant in our evaluations of individuals operating Catholic hospitals.”
Register correspondent Joan Frawley Desmond writes from Chevy Chase, Maryland.
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Interesting article, but I think it all comes back to Catholic Hospitals accepting Federal Funding. This is the problem that Catholic Universities are having, and it is very complex.
Should we be opening both hospitals and universities that we can’t afford without Federal Funding?
This is a very complex situation and theological sound bites in my opinion are not helpful.
The Bishop was CORRECT in removing the title “Catholic” from this hospital. They approved an abortion and chose to KILL a baby/fetus/preborn because they thought the Mother could die from it. I’m in the healthcare industry and I call this pure B.S. The Bishop was very good in his actions by prohibiting Mass to be celebrated there, as well as removing the Blessed Sacrament until this Hospital repents the severity of their actions. We, Roman Catholics must NOT compromise our religious beliefs for the sake of the worldly actions that deviate from the FIRM teachings of the Church. That is how the Devil will win and Satan has already entered our church in 1962.
The title of this piece is exactly correct. The hospitals should trust that their local bishops are correct, but should first verify the bishops’ pronouncements with educated theologians before any action.
I see liberals quoted as saying that our religious rights don’t give us the legal right to refuse to perform these services. Excuse me, but if this is the law of the land, it is time to close our hospitals, permanently; to begin a campaign of civil disobedience; to speak out publicly and loudly that our religious rights trump the left’s right to abortion and sterilization; and that if, need be, we will all go to jail together rather than submit to an out-of-control dictatorship. Yes, dictatorship!! Finally, there is provision in Catholic teaching for armed resistance—if we ever get to that point. Who built the hospitals to begin with? Who owns them?
Had the woman at the Phoenix hospital died due to it following Bishop Olmsted’s directive, would he be guilty of a crime? He would have forced a hospital to deny someone, without their permission or consent, standard medical care for an emergency. Bishops need to think about the legal consequences of killing someone merely to satisfy an ERD.
I’m no attorney, but do volunteer as a First Resonder on an ambulance. I don’t relish the idea of bypassing a local hospital with a patient just because I think they won’t get good treatment due to their ‘Catholic’ status.
AS a Catholic physician who has tangled with a “Catholic” hospital which permitted the use of the “morning after” pill in its ER for “victims of rape” (please be aware that this claim can be loosely aplied) I very much support Bishop Olmstead who bravely stood up for Catholic moral values. As for Sister Carol and her ilk, I feel their activities and verbal statements are more dangerous to Catholic healthcare workers than are those of blatant pro-abortionists.
Since when does Teaching go hand in hand with Authority/Dominance?
Somehow he’s missed Jesus’ whole idea of Servant Leadership,
Love, and Compassion.
And I think sadly, he actually believes he’s right.
Hospitals should trust that their local bishops are correct, but first verify bishops’ pronouncements with educated theologians? If I had tried telling my earthly father that I would only submit to his authority after checking with some educated person first, I could now be giving you first-hand information whether there is a heaven or hell. And if any of those uneducated bishops alluded to ever get wind of that post, perhaps they’ll become upset as well. The bishops are the ones with the authority, not the self-annointed experts.
We need to defend the true Catholic identity of our hospitals as Bishop Olmstead did or the government, not our bishops, will be saying that our hospitals are not Catholic institutions like they did with that college in New York. For too long we Catholics have been luke warm and wishy washy. When we stood firm together, people may have been against us, but they respected us. It’s past time for a Catholic revival. It is about time we started cleaning house instead of living with the clutter of mediocrity.
We are MOVEMENT, not an organization. Stand together, yes, not in Domination and Exclusion, but Love and Inclusiveness as Jesus.
Hierarchy has lost sight of the original mission and it was NOT to perpetuate an institution!
Teachings of the Church
Surely if there ever was a perfect catch-all phrase,
it is “teachings-of-the-Church”.
It includes everything from defined dogmas,
items in the Apostle’s Creed,
1752 Canon laws,
opinions of the Pope (like steam locomotives are the work of the devil), every one of the 2865 items in the Catechism,
to the thoughts of cranky old bishops like Burke and Molino.
It has become a universal cliché of the hierarchy to discourage dissent. Falling into the same catch-all basket of against
“The Teachings of the Church”
are those who disagree with pre-Vatican II liturgical norms and language, contraception,
mandatory celibacy for priests,
collective bargaining,
just war and torture,
women’s ordination,
slavery,
same sex unions,
the resurrection of Jesus,
the nature of the Trinity,
and if God really exists.
Note that some “Teachings of the Church” are slippery,
time-bound, and culturally-colored.
At stake here is the power and authority,
originating from the community of the Church
and appropriated by unelected leaders to set the rules
for who is in and who is out.
By voting a certain way,
you could be considered “out”
according to “The Teachings of the Church”.
By not behaving/believing according to the bishop’s instruction,
you are obviously against the Teaching of the Church.
Some (bishops?) believe good teaching is the attempt to influence,
even coerce,
the faithful into believing what is being taught.
But the criteria for effective teaching
involves rather if the teaching makes sense
and is received by the faithful.
If you do not accept that all contraception is sinful,
or legalizing same-sex unions are wrong,
or only men can be ordained,
or contributors should have a say in how their money is spent and who should be responsible,
or the language of prayer should be strange or contorted,
or bishops should tell us how to vote,
you are dissenting against “the teachings of the Church”.
Without careful and intelligent scrutiny,
accepting every “teaching of the Church”
is similar to checking the box
“I agree” to observe every privacy/usage rule
for downloading new software/ upgrades.
Study the reasoning behind Church teachings,
consult and observe how your Catholic community receives them,
and judge for yourself.
Follow your own well-formed conscience,
as fallible as it may be.
Who is going to save the church? Not the bishops, not the priest and religious. It is up to you the people. You have the minds, the eyes, the ears to save Her.” Archbishop Fulton J. Sheen
John Chuchman wrote, on Friday, Jan 28, 2011 12:52 PM “We are MOVEMENT, not an organization. Stand together, yes, not in Domination and Exclusion, but Love and Inclusiveness as Jesus. Hierarchy has lost sight of the original mission and it was NOT to perpetuate an institution!”
Cradle Catholic replies:
The purpose of our church leaders is to teach and preach The Deposit of Faith, in context and in its totality. The DOF is the body of saving truth left by Jesus, and handed down by His apostles, to the early Church. It is evangelization. It is to perpetuate the Faith.
“Thou shall not kill” is an imporant part of our Deposit of Faith. Abortion ends life. So we must ask ourselves, “What is it we’re killing?”
When anyone is shown a sonogram, even teenagers, they see a baby. We are not to kill babies- in the womb, or outside of the womb.
What is needed is proper teaching about birth control for the many. In this case, there needs to be in place a system that would reach out to other health experts, that would help the Catholic staff weigh the pros and cons and make an intelligent decision that could stand up to scrutiny.
Was it the ONLY way to save the life of the woman? I don’t know.
But no bishop/shepherd in his right mind would expect a woman to die, carrying a child that could not survive outside her womb. Yet this is the way THIS bishop is being portrayed now. It’s happening because no “best practices” were put into place, PRIOR to this happening.
A nun, not even if she is a nurse, should be part of making ANY decision about abortion. She should run the hospital staff, and leave the medical decisions to her health experts, Catholic, non-Catholic, or otherwise, those on staff, and those in other hospitals that could be consulted. Each life is important - the life of the mother, as well as the life of the baby.
The bishop and the Vatican would be wise to read Sacred Scripture - in context, and in its totality - to be able to TEACH and PREACH it to their flocks. Even with THEM, Magesterium included, the average Catholic pew person is prudent to “trust, but verify” - and we get our verification by reading His Word, the Bible.
The result of our leaders NOT obeying the Bible as a group, and an institution, is that they cannot be trusted. All they do and say comes across as self-serving, or authoritarian, and while they may be correct, they will be second-guessed.
I believe this bishop did the right thing. But it could have been done SO much better, and without hard feelings and bad press, drama, if only they had a “Best Practices” plan in place, years ago. It’s never too late - perhaps other bishops will learn from this case.
Oh so Un-Christlike . . .
sigh
The abortion condemned by Bishop Olmsted was necessary to save the woman’s life (the placenta posed the actual danger and, its removal being necessary, unborn baby had to be removed, too). This case was a bona fide application of the principle of self-defense. Unborn child with its placenta posed genuine danger to its mother’s life, and the mother exercised her God-given right to protect her life against the aggressive presence of her unborn 11-week-old child. Trained surgical staff enabled the mother’s self-defense. This was a morally acceptable abortion.
Some things, like abortion, are just plain evil, and no noble intention can ever make them good.
It must feel safe and secure to live in a world of black and white, good or evil, in or out. Too bad it’s not the real world. Judge not . . .
I’d rather side with love and compassion, inclusiveness. The Bishop’s decision was based on power and control, dominance, and authority, none of which were espoused by Jesus. He was inclusive, non-bureaucratic, and disruptive. Institutional Church?
Stay in the box and you’ll ne’er grow.
Olmsted and his compatriots are doing Catholics an unintended but inevitable favor: hastening the demise of the institution as it was. Thirty Million American Catholics have “moved on” and more now will see the idiocy of trying to live in the church’s medieval world.
Vatican II was and is the major council of the Church moving it forward, but the good ole boys have refused ti implement it and in fact are undoing it thus hastening their institution’s demise. Let’s Hospice our church; it IS dying in its present form.
“Some things, like abortion, are just plain evil, and no noble intention can ever make them good.”
If you were walking down the street and saw a deranged person running directly toward you with an axe, would it really matter what “intent” the deranged guy had in mind? He’s yelling at you, swinging his axe, and you conclude he has a very good chance—- and the intent—- of killing you. God, however, knows full well that this mad individual merely wants to subdue a Martian, not kill or otherwise seriously harm you. You, however, are not a mindreader so you use your concealed-carry pistol to stop him. You end up killing the poor fella. Your intent was self-defense, not homicide or murder. And the deranged guy’s intent was subduing a Martian, not killing or hurting you. In this scenario (just as in the Phoenix case), the words ‘innocent’ and ‘unjust’ have no real bearing in moral resolution. Self-defense is self-defense, whether you ended up killing the deranged guy or a police officer did the job for you by enabling your self-defense.
Beware of Shepherds wearing Mitres!
And what do we do with Bishops who are neither accountable (to us) nor transparent?
Quit pushing your religious dogma down on me! Catholic hospitals and schools get plenty of federal and state monies (my taxes) and I’m tired of it. But, when you push your ridiculous dogma laws, like zero intolerance for birth control in an overpopulated world, I disagree. In fact, I’m writing my congressmen and women to REALLY scrutinize all federal monies going to Catholic schools and hospitals. Shut up or quit using my tax money to shove your ridiculous dogman down my throat.
The catholic church needs to think very, very carefully about what they are doing here. They would like religious belief to exempt them from having to follow the law, even to the point of endangering lives. Catholicism is not the only religion whose views sometimes conflict with the law. To avoid hypocrisy then, I presume that the Catholic church also supports the “rights” of those people whose religious beliefs dictate medical intervention of any sort is immoral and evil, and that faith healing is the only acceptable means of treating hemophilia, influenza, etc? How many children does the catholic church want to see die every year, because their parents truly believe that medical care is of the devil and so faith healing is all they will allow for their children? Or is the catholic church so hypocritical that they only think THEIR beliefs should trump the law?
Additionally, any Catholic Hospital that takes federal or state funding, has an additional responsibility to the tax-paying public to use the taxpayer’s money in accordance with the law - which may indeed mean providing insurance which will provide birth control to employees who are not Catholic and who want it. The public knows that the catholic church is incredibly wealthy, so if they don’t like this arrangement then they should separate themselves financially from the government, and fully fund their medical centers themselves. But I suppose their love of (taxpayers) money s too great for them to want to do this.
Though it might not sound like it from above, I actually do sympathize to a great extent with the catholic church on this issue. But when I take a clear, hard look at the issue, they have gotten themselves into this mess by “accepting” (more like, diligently seeking out) funding from outside sources. Did they think there would be no strings attached? Really? What does the Bible say about love of money? Because it certainly seems right now, that it is love of (taxpayer) money and unwillingness to give it up, that is really at the root of this particular controversy. And the Public knows it. The public would not want taxpayer money funding Muslim hospitals who impose their religious views on the public, nor do we want taxpayer money funding Catholic Hospitals which impose their religious views on the public. It’s time the Catholic church made a tough choice between taxpayer’s money, or adherence to their beliefs? You can’t hold on to them both.
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