Decoding the Catholic Hospital Debate: Is Care Truly Being Lost?

The Stranger, The Seattle Times and now the The New York Times have devoted a lot of column inches to the growing concern that Catholic affiliated hospitals merging with secular hospitals in rural areas could have serious, negative ramifications on patient care, given the church’s dictates on what kind of services its hospitals can provide.

No doubt it’s an issue deserving of scrutiny. But all three stories left me wondering whether patients are actually seeing care drop off on account of a heavier Catholic hand in health care.

The Stranger piece provided a heart-wrenching case of a woman being denied an emergency abortion on account Swedish Hospital recent merger with Catholic hospital system Providence. But that case was couched in statements from the hospital that the care the woman received broke hospital policy, and that the abortion should have been granted, regardless of what the Pope says on the matter.

The piece in the Times had no examples of patients being denied care on account of a hospital’s Catholic affiliation. Nor did The New York Times.

So, are the fears academic, or are mergers actually affecting patients’ relationships with their doctors as we speak?

If it’s not impossible to tell, it’s really, really hard.

In February, the ACLU of Washington reached out to the public for them to share their stories of being denied care on account of church mandates. Three months later, the group won’t say how many responses they’ve gotten.

“We’re still in that process,” Doug Honig, spokesman for ACLU, said last month.

Dr. Deborah Oyer, medical director at Aurora Medical Services, says access to abortions in rural areas – where the most recent spate of mergers are drawing scrutiny – is limited even without pressure from the Catholic Church. For a long time rural doctors weren’t trained to provide the service, and even after the training became more available, the social stigma made many small town physicians reticent to terminate pregnancies.

“When you’re in a rural area, abortions are going to be a tiny fraction of the services you provide,” she says. “But if you do one, two or three, you are suddenly an abortionist. It can make you life a living hell, depending on where you live.”

However, Oyer says Catholic mergers aren’t a step in the right direction.

“Both rural areas and Catholic hospitals decrease patients’ options. And if in a rural area all you have is a Catholic hospital, you significantly decrease your patients’ options,” she says.

And, following the general theme of the debate, Oyer has reasonable philosophical concerns:

“I’m a huge believer in church and state,” she says. “If other religions were taking over this many hospitals that didn’t believe in blood procedures or surgery, people would be up in arms. But we’re letting this slide.”

A representative of Washington’s hospital industry seemed to suggest worrying about tiny hospitals’ ability to provide abortions, or end-of-life care also opposed by the Catholic Church, misses the point of what rural hospitals’ aim to do.

“Small hospitals don’t offer all services and they handle those needs in different ways. Our critical access hospitals (those with 25 beds or fewer), if you’re in a car accident in the middle of east Grant County, they’re going to have some basic health services to stabilize you, then they’ll get you somewhere else.”

The implication: Abortions? We’re lucky if these hospitals can give patients a physical.

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