National Catholic Register


When Hospitals Merge

Boston and Others Face Challenges to Pro-Life Policies


Register Correspondent

June 28-July 11, 2009 Issue | Posted 6/19/09 at 10:12 AM


BOSTON — Cardinal Sean O’Malley has once again assured that Catholic hospitals in the Archdiocese of Boston will not perform or refer for abortions.

The cardinal made that pledge June 10 as Caritas Christi Health Care, a network of six Catholic hospitals, prepared to enter a joint venture with a secular health-care company.

In the statement, issued jointly with Caritas Christi, Cardinal O’Malley said, “It has always been clear to me that Caritas Christi has been consistently faithful in its commitment to comply with Catholic moral teaching.”

The cardinal’s statement came in the wake of a months-long controversy surrounding the CeltiCare Health Plan of Massachusetts that begins July 1. CeltiCare is a partnership between Caritas and the Celtic Group, a subsidiary of the Missouri-based Centene Corp., which manages government-subsidized health-care benefits in several states. Under a lucrative state contract, CeltiCare will provide health coverage to low-income residents as part of the state’s universal health-care reform law signed in 2006. Massachusetts now boasts the lowest rate in the nation of uninsured residents — at 2.6%.

Some Catholic and pro-life activists have warned that the plan will include abortions, contraception and sterilizations. Indeed, the plan’s website lists four Planned Parenthood offices and 15 more “reproductive service providers” to which it will refer patients. It also details co-payments for abortion and “family planning.”

According to a June 11 article in The Boston Globe, Centene and Caritas have said that CeltiCare is 51% owned by the Centene subsidiary and 49% owned by Caritas Christi.

The Globe also reported that NARAL Pro-Choice Massachusetts will serve on CeltiCare’s advisory board.

The archdiocese said June 10 that Caritas would not be permitted to profit from the provision of abortion services by other health-care providers, also according to the Globe.

“In any revised agreement among Celtic Group, CeltiCare and Caritas Christi, under no circumstances will Caritas either perform procedures prohibited by the Catholic Bishops’ ‘Ethical and Religious Directives for Catholic Health Care Services’ or refer any patient to other providers who perform or procure such procedures,” the cardinal stated,

Speaking to the Register June 17, Father J. Bryan Hehir, secretary for Health Care and Social Services with the Archdiocese of Boston, recognized that there was a problem that needed to be solved by July 1.

“We tried to solve the first part of it last week,” he said. “Caritas Christi will not do procedures that violate the ‘Ethical and Religious Directives’ and will not refer anyone for such procedures.”

“The second part is the larger framework Caritas Christi has entered into,” Father Hehir said. “That needs to change so that it will accord with Catholic identity.”

Some pro-life activists continued to be skeptical, especially in reaction to the other part of the joint statement, contributed by Dr. Ralph de la Torre, president of Caritas Christi. When a patient seeks an abortion, de la Torre said, “Caritas health-care professionals will be clear that (a) the hospital does not perform them and (b) the patient must turn to his or her insurer for further guidance.”

“The cardinal’s statement is contradicted by that of Dr. de la Torre,” said C.J. Doyle, executive director of the Catholic Action League in Roslindale, Mass. “In sending a patient seeking an abortion back to her insurer, Caritas will be sending Commonwealth Care members to the Caritas/Centene partnership, which will not only procure the abortion, but lists Planned Parenthood as a reproductive services provider.”

Bioethics Center

Cardinal O’Malley had submitted the plan to the National Catholic Bioethics Center for review of its ethical implications, but the opinion of the center has remained confidential.

Asked to comment on the wisdom of mergers in general, Father Tadeusz Pacholczyk, director of education for the bioethics center, advised: “Such mergers can be pursued as long as the Catholic health-care provider is clear about the meaning of its Catholic identity and remains intent on upholding that identity in all the negotiations and arrangements leading to the merger and subsequent to its realization.

“This means that the Catholic institution (and the merged institution later) will be bound by the provisions of the ‘Ethical and Religious Directives,’” he said. “The possibility of scandal must be meticulously avoided.”

Meanwhile, Catholics in the Diocese of Manchester, N.H., are concerned about plans to affiliate the diocese’s Catholic Medical Center in what opponents call “an unholy alliance” with a clinic that’s part of the Dartmouth-Hitchcock health-care system. This secular system, which includes four physicians’ groups and Dartmouth Medical School, among other entities, supports abortion and human embryonic research. Abortions are performed at a Lebanon affiliate of the Manchester clinic. No curtailment in those services is planned under the proposed affiliation, according to Dartmouth-Hitchcock Medical Center statements.

Manchester Bishop John McCormack has said that the Catholic Medical Center would not violate the U.S. Conference of Catholic Bishops’ “Ethical and Religious Directives for Catholic Health Care Services,” which has warned of the dangers inherent in Catholic-secular hospital mergers. “The risk of scandal cannot be underestimated when partnerships are not built upon common values and moral principles,” the directives note.

Bishop McCormack’s communication director, Kevin Donovan, said the bishop “will perform a careful ethical review before making a final decision.” June 30 is the target date for the contract’s conditional approval by trustees.

National Implications

In Rhode Island, the Providence Diocese’s St. Joseph Health Services and Roger Williams Medical Center have joined under the umbrella of a new holding company, which state officials are now reviewing.

Msgr. Paul Theroux, vice chairman of the hospital board of trustees, said, “We were upfront with Roger Williams, and they were willing to make some concessions. They agreed never to perform abortions or embryonic cell destruction. It’s being written into the bylaws of CharterCare Health Partners, the holding company,” he said. “They agreed they would not accept funding for embryonic stem-cell research. If others joined in the future, they’d also be bound by these restrictions.”

Roger Williams could perform other procedures that the Church opposes, such as sterilization, as long as no money flows to or from St. Joseph in connection with those procedures.

“You can’t assume the pieces will come together, so we discussed everything,” Msgr. Theroux said. “We wrote in reserved powers for the bishop in terms of preserving Catholic identity.”

For one observer in Manchester, the local tussles over health-care alliances have a national implication. “Washington is dying to squelch conscience protections,” said Colleen McCormick, an anesthesiologist with a graduate degree in medical ethics. “Once Catholic entities have physicians who have no problems with the culture of death, rights of conscience will be easier to overcome. I think we should be withdrawing from any liaisons at all between Catholic and secular health-care providers.”

Marie Romagnano, founder of Healthcare Professionals for Divine Mercy, an apostolate of the Marians of the Immaculate Conception of the Blessed Virgin Mary, took the view that mergers can be an evangelization opportunity. Said Romagnano, “We should see it as an invitation to the secular community to uphold God’s law.”

Gail Besse writes

from Boston.