PHOENIX — St. Joseph’s Hospital in Phoenix can no longer be considered Catholic.

That is the decision Bishop Thomas Olmsted of Phoenix announced Dec. 21.

Citing seven years of vain attempts to get the institution to comply with Church teachings on abortion, sterilization and birth control, Bishop Olmsted said in an interview with the Register, “What I’ve tried to do is make clear at the present time I cannot assure them St. Joseph’s Hospital is following the ethical directives of the Catholic Church.”

St. Joseph’s administration responded that the bishop’s declaration will not change how it does its work or its claim to be Catholic.

The president of St. Joseph’s, Linda Hunt, said in a prepared statement, “Though we are deeply disappointed, we will be steadfast in fulfilling our mission of care. … Nothing has changed.”

The issue arose in late 2009 when an abortion was performed on a woman with pulmonary hypertension, a condition exacerbated by her 11-week pregnancy. Because Sister of Mercy Margaret McBride, at that time vice president of mission integration at the hospital, concurred with a hospital ethics advisory committee decision to okay the abortion, Bishop Olmsted privately informed her she had thereby automatically excommunicated herself.

But the excommunication was somehow made public.

Bishop Olmsted said that throughout his seven years as the ordinary in Phoenix he has been attempting to bring St. Joseph’s and its parent company, Catholic Healthcare West, in line with Catholic teaching.

“A few [staff] have expressed concern. It’s been difficult to put their complaints in writing because of their fear of losing their jobs,” he said. “There also are patients: A mother goes and her child is delivered, and once the delivery takes place, it is recommended that she have her tubes tied, which is illicit.”

From the start, Bishop Olmsted was concerned that Catholic Healthcare West was operating Chandler Regional Health Center in Chandler, Ariz., in willful disregard of the U.S. bishops’ “Ethical and Religious Directives” (ERDs).

In fact, Father John Ehrich, diocesan director of medical ethics, said the hospital administration seemed more concerned with pleasing various government agencies than following Catholic moral teaching.

“There is no doubt the primary concern was their standing as it relates to licensing of their hospital and their ability to practice medicine,” said Father Ehrich. “I think, unfortunately, they see their ability to practice authentically Catholic health care as extremely difficult given the current laws. They are, no doubt, more concerned about that than following the ethical and religious directives of the Catholic Church.”

$2 Billion at Stake

St. Joseph’s, Chandler Regional and one other Catholic hospital operated by Catholic Healthcare West deliver $2 billion worth of health-care services to Arizona Medicaid through an entity called Mercy Care. These services include elective abortions and sterilizations.

“The state mandates that they have to perform those services,” said Father Ehrich. And even though these procedures are done outside St. Joseph’s, “they are still formally cooperating in this, which is completely contrary to Church teaching, and they know this.”

Father Ehrich said that canon lawyers and moral theologians solicited by the secular media defended the controversial abortion with the Catholic doctrine of double effect. The Church teaches that there is a morally acceptable “double effect” when a treatment of a condition endangering the mother has the “foreseen but unintended” effect of killing the unborn baby.

But this was not what St. Joseph’s said at the time.

“They freely acknowledged that they terminated a pregnancy. They would say, ‘We had to terminate the pregnancy to save the life of the mother.’”

In response to Bishop Olmsted’s announcement, the Catholic Health Association, which represents Catholic hospitals in the United States, supported St. Joseph’s. CHA’s president, Sister Carol Keehan, in a statement, praised St. Joseph’s staff for its “long and stellar history of protection for life at all stages” and defended their actions in the case in dispute with Bishop Olmsted.

“They carefully evaluated the patient’s situation and correctly applied the ‘Ethical and Religious Directives for Catholic Health Care Services’ to it, saving the only life that was possible to save,” said Sister Carol, a Daughter of Charity who was a key supporter of President Obama’s health-insurance reform bill earlier this year.

“But the ERDs themselves state that the diocesan bishop exercises responsibilities rooted in his office,” said John Brehany, executive director of the Catholic Medical Association, representing U.S. doctors committed to practicing medicine in conformity with Catholic teaching. “If they are denying the role of the bishop, they are not following the ERDs.”

Father Ehrich speculated that the operation was conducted to reduce the hospital’s or doctors’ exposure to a lawsuit. But it was unnecessary medically, he claims. “The mortality rate for hypertension is very, very low.”

St. Joseph’s president, Linda Hunt, disagreed. “In November 2009, the woman was admitted to St. Joseph’s Hospital and Medical Center with worsening symptoms,” she said in her prepared statement. “Tests revealed that she now had life-threatening pulmonary hypertension. The chart notes that she had been informed that her risk of mortality was close to 100% if she continued the pregnancy.”

“If we are presented with a situation in which a pregnancy threatens a woman’s life,” Hunt added, “our first priority is to save both patients. If that is not possible, we will always save the life that we can save, and that is what we did in this case.”

Hunt added that the decision to abort the child was made “in collaboration with the patient, her family, her caregivers and our ethics committee. Morally, ethically and legally, we simply cannot stand by and let someone die whose life we might be able to save.”

Will Do It Again

Bishop Olmsted’s action may have no tangible effect. Hunt said, “St. Joseph’s will retain its name, and our Catholic heritage will always be at the core of who we are. Our mission and values will not change, nor do we believe this action will have any impact on our operations.”

The Sisters of Mercy will continue to run the hospital, which will continue to provide facilities for priests to administer the sacraments. It will continue to refuse to perform elective abortions. And if the same condition arises where an abortion is required to save a mother’s life? “We would do it again,” Hunt stated.

Bishop Olmsted admitted there is nothing he can do beyond what he has done. He would not direct Catholics to shun St. Joseph’s as patients or staff.

The problem posed by St. Joseph’s claiming to be Catholic is a broad one, he said. “We are going through a crisis of Catholic identity both in terms of individuals who claim to be Catholic, but neither talking nor acting in accordance with Church teachings, and in terms of institutions such as universities and health-care organizations.”

Brehany said more than the ethics of a particular case is at stake. If it were just a dispute over “a one-off complex case,” it would be possible to give St. Joseph’s “the benefit of the doubt. It seems that it is a more systemic rejection not only of the Church’s teachings but also the bishop’s role in the diocese.” He believes St. Joseph’s “really underestimates the reality and the effects of the rupture that has taken place and the effects of no longer being in living communion with the Church. It gets back to almost a Protestant principle: ‘Of course we’re good Catholics. Of course we’re following Jesus. We just don’t accept that bishop, that successor of Christ.’”

“One of the tools that Christ gave the Church as a service to the experts and laity involved is a structure of authority and guidance to help resolve disputes. … That’s precisely what is in dispute.”

Steve Weatherbe writes from Victoria, British Columbia.