Monday, December 20, 2010

Catholic Church's role in care at Ariz. hospital hotly debated

St. Joseph'<a href=s hospital's Catholic status is in debate after the hospital's decision last fall to terminate a pregnancy that posed serious health risks to the mother.">By Michael Clancy, The Arizona Republic

As the Catholic Diocese of Phoenix and St. Joseph's Hospital and Medical Center continued to talk Wednesday about the church's role in medical decisions, the national debate escalated over whether the local bishop's threat to remove the hospital's Catholic status was appropriate.

Several national observers questioned whether Bishop Thomas Olmsted, who oversees matters concerning the Catholic Church in the Phoenix diocese, should be allowed to impose upon a hospital's potentially life-saving medical practices. The issue stems from the hospital's decision last fall to terminate a pregnancy that posed serious health risks to the mother.

Other observers, however, said the bishop's move underscores the beliefs of many patients.

MORE: Bishop threatens hospital's Catholic ties

IN MAY: Hospital nun rebuked for allowing abortion

NUNS: Break with bishops on abortion

"The faith, the mission to witness Christian love through excellence in health care, is very strong," said Dr. Jim Sabin, a professor at Harvard Medical School and author of the blog Health Care Organizational Ethics. "They have a deep sense of mission. To a Catholic person, that is hugely meaningful."

The diocese and the hospital on Wednesday confirmed that they are discussing the bishop's demands that the hospital agree to several conditions to ensure it is adhering to church teaching. Both parties declined further to discuss publicly the status of the situation. Olmsted, in a letter to the hospital's parent company in November, set a deadline of Friday for the hospital to comply.

"St. Joseph's and Catholic Healthcare West continue to be in dialogue with Bishop Olmsted, and we hope to achieve a resolution," said Suzanne Pfister, vice president of communications for the hospital. "We believe that all life is sacred. In this case, we saved the only life we could save, which was the mother's."

Rob DeFrancesco, diocese spokesman, said the bishop is working with the hospital to find a resolution.

"The bishop and his staff are working together with Catholic Healthcare West and St. Joseph's Hospital to find the best way to provide authentic Catholic health care in accordance with the church's teaching," he said.

In his November letter to Catholic Healthcare West, the bishop said discussions over the case had gone on long enough. The hospital terminated the pregnancy because the mother had pulmonary hypertension and the condition with the pregnancy posed a threat to her life. Doctors conducted the procedure after consulting with Sister Margaret McBride, a member of the hospital's ethics committee. Olmsted later said that McBride and any Catholic involved in the procedure faced excommunication from the church.

Olmsted, in the letter, demanded that the hospital submit to his authority by acknowledging he was correct in declaring the procedure an abortion, that the hospital allow him to conduct a review and certification to guarantee compliance with Catholic teachings, and that hospital staff receive training from the diocese or another Catholic agency on the church's Ethical and Religious Directives, a document from the national bishops council that explains Catholic moral teachings for health-care providers.

Failure to comply, he said, would result in his declaration that the hospital was no longer Catholic and would no longer be allowed to hold Mass or keep on site communion wafers used during Mass. Priests and church ministers still would be able to care for patients at their request.

Olmsted made it clear that he was the final authority on Catholic Church matters in the Phoenix diocese.

A church's role in a hospital's health-care protocols is generating debate outside of Phoenix.

The American Civil Liberties Union on Wednesday renewed its appeal to the federal Centers for Medicare and Medicaid Services for an investigation of religious hospitals over concerns that they could deny potentially life-saving care.

Alexa Kolbi-Molinas, staff attorney with the ACLU Reproductive Freedom Project, said a hospital's first responsibility must be to its patients, not to a religious leader.

"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," she said. "Women should never have to be afraid that they will be denied life-saving medical care when they enter a hospital."

Lois Uttley of MergerWatch, a New York organization that reviews issues that arise when secular and religious hospitals merge, said that in her opinion, St. Joseph has "tried mightily to balance its religious heritage with its provision of medical care." She said Catholic Healthcare West generally handles such issues well.

"They know better than the bishop how to do this," Uttley said.

She said similar issues arise frequently at Catholic hospitals.

"If protecting patients' rights and access to quality care means St. Joseph's has to relinquish its Catholic identity, it would be an unfortunate but inevitable outcome," she said.

If the bishop were to follow through on his threat, the hospital still could retain its name, one of the most established and widely recognized hospital names in Arizona.

Lisa Fullam, professor of moral theology at the Jesuit School of Theology at Santa Clara University, blogged at commonwealmagazine.org that the hospital ought to stand up to the bishop.

"Why don't they simply point out to Bishop Olmsted that, while under church law he can restrict who uses the appellation 'Catholic,' he does not have a copyright to the term under U.S. law? If the administrators at St. Joseph's believe it to be a Catholic hospital, they should continue to use the name and let the canonical chips fall where they may. The bishop does not own Catholicism, in his diocese or elsewhere."

However, Harold G. Koenig, director of Duke University's Center for Spirituality, Theology and Health, said spirituality may be very important to patients, especially Catholic patients.

"If they are withdrawing that spiritual atmosphere in some way, that could definitely impact the comfort level and care and whether the needs will be met for Catholic patients," he said.

Contributing: Ken Alltucker, The Arizona Republic

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