An Arizona hospital's decision to reject the moral authority of the Bishop of Phoenix raises troubling questions about the future of Catholic health care, according to two experts in the field.
Bishop Thomas J. Olmsted revoked the Catholic status of St. Joseph's Hospital and Medical Center in Dec. 21. The move came after several months of discussion and negotiation over an abortion that took place there in 2009.
The hospital and its parent company, Catholic Health Care West, continue to maintain that the abortion was medically necessary. Bishop Olmsted had insisted that the hospital acknowledge that Catholic teaching never permits direct abortion as form of medical treatment, but the hospital refused.
“The bishop tried to bring them back,” explained John Brehany, executive director of the Catholic Medical Association. He commended Bishop Olmsted for seeking to apply “a clear standard” of “what counts as Catholic identity, Catholic ethics, and Catholic medicine.”
But, he explained, Catholic hospitals –like Catholic schools and universities– often face pressure to make compromises in areas where the broader public may not understand or accept the Church's moral authority.
Bishop Olmsted's investigation found that St. Joseph's Hospital and its parent company were involved in a pattern of behavior that violated Catholic ethical directives for health care. These activities included creating and managing a government program that offers birth control, sterilization procedures, and abortion.
Brehany believes that these kinds of involvements reflect a larger crisis of identity and purpose in Catholic health care. Many providers, he said, have “grown apart” from the main body of the Church, and lost a sense of what their religious identity once meant.
He compared the situation between the bishop and St. Joseph's to a child who decides to break off contact with his parents. “Both the hospital and the Catholic Healthcare West system effectively said, 'We don't want you in our life'.”
But in describing the larger implications of the hospital's break from Church authority, Brehany employed a more striking metaphor.
“Jesus said, 'I am the vine, and you are the branches,'” he noted. This worldview had historically been the basis for an “organic structure” connecting institutions like schools and hospitals with parishes, local bishops, and the universal Church.
However, Brehany noted that in recent years, some of these “branches” have lost their connection with the “vine” from which they had grown. “That has tremendous implications,” he said, “because their Catholic faith and identity ought to be ultimate.”
This identity, he suggested, cannot simply function as a general source of inspiration for caregivers, since it also demands a complete commitment to the Church's teachings and authority.
While the St. Joseph's abortion case drew national attention, it was not the only recent instance of a Catholic hospital parting ways with Church authority. In Feb. 2010, Bishop Robert F. Vasa revoked the Catholic status of St. Charles Medical Center in the Diocese of Baker, Oregon, because of its insistence on performing sterilizations – up to 250 of them per year, he discovered.
Bishop Vasa publicly warned at the time that some Catholic hospitals, while claiming to abide by Catholic ethical guidelines, “are not being as transparent with their bishops as they should be.”
He also cautioned at the time that “if a bishop trustingly accepts that Catholic hospitals in his jurisdiction are following the (ethical) directives in accord with his proper interpretation of those directives, he may be surprised to learn this may not be the case.”
During the fall of 2008, Bishop Alvaro Corrada of the Diocese of Tyler, Texas acknowledged that two hospitals in his diocese had performed “a large number” of sterilizations, despite their claim to be “in compliance with the Ethical and Religious Directives for Catholic Health Services.”
Bishop Corrada admonished both hospitals for their “serious misinterpretation” of those directives, and reached agreements with the hospitals to ensure their compliance in the future. However, the bishop also admitted his own “failure to provide adequate oversight of the Catholic Hospitals” in the Diocese of Tyler.
Leonard J. Nelson, a legal scholar and author of the book “Diagnosis Critical: The Urgent Threats Confronting Catholic Healthcare,” said Church-affiliated hospitals in some parts of the U.S. had become accustomed to minimal oversight, and often interpreted Catholic health care guidelines very differently from their local bishops.
Professor Nelson asserted that cases of sterilization at Catholic hospitals, or even abortions deemed “medically necessary,” are not necessarily rare.
“A lot of times, when I suspect this has happened, the bishops don't know about it. If (hospitals) are inclined to do those kinds of 'therapeutic' abortions, they're probably not going to tell the bishop.”
Nelson's allegations, if correct, could explain the reaction to the Phoenix case by the Catholic Health Association– a trade group that made headlines last year by strongly lobbying for a health care overhaul opposed by the U.S. bishops.
Sr. Carol Keehan, President and CEO of the trade group, issued a strong defense of the Phoenix hospital's decision to perform the abortion, and said the facility and its parent company were “valued members of the Catholic Health Association.”
Sr. Keehan's response “really stakes out some new territory,” Nelson observed.
Brehany, too, was struck by the tenor of Sr. Keehan's statement. It could indicate, he suggested, that the health association might be trying to position itself as a rival authority or “competing magisterium” to the U.S. bishops on issues of health care ethics.
Nelson and Brehany noted that the bishops may not have many practical options for calling the Catholic Health Association or its individual members to accountability. They could most likely continue to use the “Catholic” label, no matter what Church authorities might determine, they said.
Following Bishop Olmsted's allegations against Catholic Healthcare West, Archbishop George H. Niederauer of San Francisco –where the company has its headquarters– announced on Dec. 23 that he was seeking to “initiate a dialogue” with the company accused of cooperating with the government to provide birth control, sterilization, and abortion.
Bishop Olmsted noted on Dec. 21 that Catholic Healthcare West and St. Joseph's Hospital “have made more than a hundred million dollars every year from this partnership with the government.” St. Joseph Hospital's parent company is the eighth-largest healthcare company in the U.S.
A spokesman for Archbishop Niederauer indicated to CNA that no additional information about the purpose or timetable for the discussions with Catholic Healthcare West would be provided at this time.