“Catholic hospitals agree to uphold Catholic values, and therefore we do not provide elective abortion or procedures for the primary purpose of sterilization such as tubal ligations, hysterectomies (when no pathology is present), vasectomies and in-vitro fertilization (the latter two services are not typically performed in hospitals regardless of religious affiliation). Catholic hospitals do not limit availability of emergency or medically-necessary pregnancy care,” the letter said.
The alliance said Catholic hospitals “provide the standard of care for women with pregnancy complications, miscarriages and ectopic pregnancies.” They always provide “urgent and emergent care” to the mother, “even if it results in the foreseen, but unintended, death of the fetus.”
“Our health facilities provide compassionate and comprehensive care to victims of sexual assault, including the provision of emergency contraception,” the alliance said, adding, “More than 10 Catholic-affiliated facilities are designated as the comprehensive rape treatment center or are the sexual assault response team.
Catholic ethics forbid direct abortion and direct sterilization. The U.S. bishops’ ethical and religious directives allow medication to sex assault victims to prevent conception if there is no evidence conception has already taken place. The directives add: “it is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum.”
The Catholic alliance letter described intra-uterine devices, which prevent implantation, as a “multi-purpose device.” If the appropriate care for a patient is “elective sterilizations,’ the letter said, “we expect the physician to ensure that care is provided in a facility that provides that service.”
The alliance’s health systems include 51 acute care hospitals, nearly 15% of all hospitals and 16% of hospital beds in California. Affiliations with the University of California health system are “essential to ensuring and expanding access to quality health care services across our State – especially so for underserved communities,” the alliance’s letter said. University of California Health has estimated the bill would cost millions of dollars in lost revenue currently generated through partnership agreements.
In some parts of California, University of California health care is reliant on its Catholic partners.
The alliance said its health systems played an important role in the response to the COVID-19 pandemic, providing “scarce front-line medical, bed-capacity, PPE, testing and vaccine resources.”
The alliance letter added that its hospitals offer primary, specialty, and urgent care for LGBTQ persons. It added: “specifically for transgender patients, we provide hormone therapy, breast augmentation or reduction, and facial feminization or masculinization”
CNA asked the Alliance of Catholic Health Care why its hospitals provided transgender-specific drugs and procedures. Lori Capello Dangberg, vice president at the alliance, told CNA May 10 that “numerous states in which Catholic hospitals operate have statutes that prohibit discrimination against patients on the basis of sex and gender identity, among other things.”
“Should the hospitals decline to provide a service to one protected class of people that they can morally provide to another class of people, they will be in violation of these statutes. Such a practice cannot be defended on the basis of religious freedom, as the courts will hold that it’s first and foremost a matter of discrimination against a protected class of people.”
Dangberg did not address the question of legislation, but there are concerns that proposals like the federal Equality Act and other decisions advocated by the Biden Administration could further mandate the provision of drugs and procedures which violate Catholic ethics while also stripping religious freedom protections. While Catholic institutions have some protections under existing federal rules and laws such as the Religious Freedom Restoration Act, California has fewer religious protections at the state level.
The letter to the Senate appropriations committee chairman also mentions non-Catholic hospitals under the Alliance for Catholic Health Care umbrella that provide specialty transgender care.
“We are proud to offer the only specialty transgender care center in San Francisco, the Gender Institute at Saint Francis Memorial Hospital,” the letter said. The institute has been established “to deliver compassionate, high-quality, affordable health services to transgender patients and their families.”
The letter noted that St. Mary’s Medical Center in Long Beach is the first in the Dignity Health System to be recognized with health equity leader status by the Human Rights Campaign, an influential LGBT advocacy group.
The Human Rights Campaign has been effective at recruiting major companies to advocate for compliance to LGBT policies and political demands, including for a federal Equality Act stripped of religious freedom protections. It has asked the Biden administration to create accreditation regulations of religious schools that would enforce the recognition of same-sex unions as marriages and other LGBT causes.
In 2014, the campaign launched a lobbying effort linked with the Catholic Church’s Synod on the Family, targeting leading Catholic bishops it said have been “most outspoken in their rejection of LGBT Catholics, their civil rights, and their rightful place in the Church.”
Another proposed California bill, S.B. 642, purports to defend medical staff’s clinical judgement from hospital administration’s “non-clinical” standards, including ethical standards, that hinder a doctor from providing a particular medical treatment. Such treatment could include legal abortion and legal assisted suicide. The legislation would significantly impact the ability for Catholic hospitals to require staff to follow Catholic ethical directives.
“Catholic healthcare is fighting on two fronts here in California,” Dolejsi told CNA.
Joe Bukuras contributed to this report.