BOSTON — If a joint venture between Catholic and non-religious health-care systems goes through, doctors in Boston’s Catholic hospitals may have to point patients toward abortion after July 1.

Indeed, state officials and abortion advocates would check to make sure they do.

This development did not arise from President Obama’s proposal to jettison conscience rights for medical personnel. Rather, the six-hospital Caritas Christi Health Care system, in conjunction with the St. Louis-based health network Centene Corp., recently sought and won a lucrative state insurance contract that requires the joint venture, the Commonwealth Family Health Plan, to make available all “reproductive services.”

After state regulators accepted the Caritas-Centene bid March 12, Boston Cardinal Sean O’Malley issued a statement saying that the deal, set to begin July 1, can’t be considered final until the National Catholic Bioethics Center can assure him it’s faithful to Catholic principles. He had requested an opinion from the bioethics center March 5. It had not been made public as of press time.

According to Dick Powers, spokesman for the Massachusetts Health Connector Authority Board, which awards the contracts for state-subsidized insurance for low-income residents, the board unanimously accepted the Caritas-Centene bid after regulators received written assurances that medical staff will inform people of all options, including abortion.

Powers said that if a Caritas hospital didn’t provide a service, the patient would be referred back to Commonwealth Family Health Plan, which would then refer the person to another facility. Commonwealth Family Health Plan would also provide a 24-hour toll-free phone line to inform women about where they can get contraception, sterilization, and other family-planning services. A service representative will arrange transportation to the nearest appropriate facility “in an emergency.”

The cardinal in a March 5 statement said, “As archbishop I have the responsibility to insure that Caritas Christi Health Care adheres to the ‘Ethical and Religious Directives’ established by the United States Conference of Catholic Bishops.”

At issue is whether the initiative involves cooperation in actions that are intrinsically immoral.

“Formal cooperation in an abortion constitutes a grave offense,” says the Catechism of the Catholic Church (No. 2272). “The Church attaches the canonical penalty of excommunication to this crime against human life. ‘A person who procures a completed abortion incurs excommunication latae sententiae,’ ‘by the very commission of the offense,’ and subject to the conditions provided by Canon Law.”

The hospital chain is run by an independent board of governors, but the archdiocese retains authority on issues of its Catholic identity, mission and ethics. Father J. Bryan Hehir, Cardinal O’Malley’s secretary of health and social services, is archdiocesan liaison on the board.

Caritas spokeswoman Teresa Prego declined comment to Register questions, as did the president, Ralph de la Torre, and James Karam, chairman of the board of governors. According to Federal Election Commission records, both officials have given generously to politicians who support abortion: Last year, de la Torre gave $2,300 to Barack Obama; from 2007-08, Karam gave $6,900 to Hillary Clinton for president and $2,000 to Sen. John Kerry.

‘Nobody More Attentive’

At first, Cardinal O’Malley defended the hospital chain’s proposal on his blog, CardinalSeansBlog.org, March 6: “To be perfectly clear, Caritas Christi will never do anything to promote abortions, to direct any patients to providers of abortion or in any way to participate in actions that are contrary to Catholic moral teaching.”

The cardinal could not be reached for comment.

Spokesmen for the National Catholic Bioethics Center — ethicist Father Alfred Cioffi and education director Father Tadeusz Pacholczyk — said their consultations must be kept confidential.

If Caritas-Centene proceeds with its plan, state regulators and abortion advocates will be watching. “How compliance will be monitored is just being worked out now,” Massachusetts health authority spokesman Powers said March 16.

Andrea Miller, executive director of NARAL (National Abortion Rights Action League) Pro-Choice Massachusetts, said her abortion advocacy group “vows to monitor” the Catholic hospitals to ensure that people have access to services to “protect them from pregnancy and disease …” In the past, NARAL operatives have made covert calls to hospitals, including Catholic ones, to see if personnel complied with a law to offer the abortifacient “morning after” pill.

Sister Carol Keehan, president of the Catholic Health Association, told The Boston Globe March 11: “Nobody is more attentive to life issues than the cardinal-archbishop of Boston.” Sister Carol said that she had reviewed key provisions of the Caritas-Centene deal and that “Caritas has done more than one would usually see” to avoid being involved with abortion and other services opposed by the Catholic Church.

“As I look at the way Caritas Christi has structured this arrangement,” she said, “it allows them to be participants with the state in the care of the poor and the most vulnerable citizens of the state of Massachusetts in a way that brings the richness of their system and the caring nature of that system to the poor, without in any way violating any of the religious directives or the moral imperatives of our faith.”

But pro-lifers were worried. “We are now facing the end, in Massachusetts at least, of Catholic medical resistance to abortion and contraception,” said C.J. Doyle, who as director of the Catholic Action League of Massachusetts has headed opposition to the plan. “This will drive Catholics out of the medical profession.”

William Cotter, head of Boston’s Operation Rescue, believes the archdiocese was taken off guard by the Caritas move. “But,” he said, “there’s been a terrible loss of credibility for the archdiocese. It must forgo the potential financial gain and refuse this pact with the devil.”

Gail Besse writes