John Brehany, executive vice president and director of institutional relations at the bioethics center, said that the bishops’ directives “outline the responsibilities of Catholic health care institutions to assess the potential for scandal, to consult with the local bishop, and to respect his resolution regarding the need to avoid or resolve any theological scandal given.”
“If this work was not done before taking some of the actions reported upon in the Lepanto report, then it should be done in a timely manner,” he said.
“Catholic identity, and Church teachings, and the principles of the Catholic moral tradition should provide ultimate guidance for Catholic health care institutions,” Brehany added. “By that I mean that Catholic health care institutions should follow all laws and regulations unless they conflict with Catholic teachings. Ascertaining when they conflict or not can be complex.”
Michael Vacca, director of ministry, bioethics, and member experience at the Christ Medicus Foundation, a Catholic health-sharing network, said that while all Catholic health care facilities are supposed to comply with the ERDs, “there are Catholic institutions that struggle to apply them.”
As transgender procedures become more common, Vacca feels that the bishops have seen the need to be “more specific and clarify that this is a violation of the natural moral law, and it’s a violation of the teaching of the Church, which says that sexual identity is good and willed by God.”
In their March doctrinal note, the bishops wrote that “any technological intervention that does not accord with the fundamental order of the human person as a unity of body and soul, including the sexual difference inscribed in the body, ultimately does not help but, rather, harms the human person.”
Regarding Catholic hospitals joining with secular hospitals, Vacca said that if the secular institutions are openly providing abortions and transgender procedures, then the Catholic institution “would have a moral obligation not to partner with a secular institution that was going to be harming the human person.”
Louis Brown, executive director of the Christ Medicus Foundation, believes there should be a “wholesale reevaluation of the manner in which these mergers between Catholic health care systems and secular institutions are done, such that they can be consistent with the Gospel and the teaching of the Church on faith and morals.”
While not speaking to any specific merger, he said “it is clear that, at least some of these mergers between Catholic health institutions and secular health care systems” have not been done in a manner based on Catholic teaching, and there is a risk for scandal.
What is the Lepanto Institute?
The Lepanto Institute presents itself as a fact-finder that scrutinizes Catholic organizations that act contrary to Catholic teaching and ethics. It has produced reports critical of Catholic institutions and apostolates, but it has not escaped criticism itself.
In 2016, Catholic Relief Services corrected a Lepanto report that it said wrongly claimed that the U.S. bishops’ international relief organization was involved in contraceptive distribution in the Democratic Republic of the Congo.
In August 2015, the Lepanto Institute reported that a member of the World Meeting of Families organizing team had made political donations to pro-abortion political candidates.
This drew a critical response from the event host, the Archdiocese of Philadelphia, which said the Lepanto Institute showed “that it is not interested in presenting information in any useful way” and suggested that its reports are “not to be taken seriously.” Then-Philadelphia Archbishop Charles Chaput described the group as “sincere, but also destructive.”
Hichborn said the Lepanto Institute stood by its research on the World Meeting of Families. He said the Philadelphia Archdiocese “ignored our concerns” about political figures on the event’s leadership committee who rejected Catholic teaching on abortion and LGBT issues. He referred to a Sept. 24, 2015, blog post on the Lepanto Institute website for background. He also defended its reports critical of Catholic Relief Services.
The Lepanto Institute’s latest report charges that since the 2019 merger, distinctions between Catholic and non-Catholic hospitals have been “blurred to the point of obscurity.”
The Lepanto Institute said it was motivated to look at the health system after its unnamed sources indicated that CommonSpirit was opposed to the U.S. Conference of Catholic Bishops’ March 2023 “Doctrinal Note on the Moral Limits to Technological Manipulation of the Human Body,” which rejects surgical or chemical techniques that purport to change a patient’s sex.
Thirteen of the CommonSpirit-aligned non-Catholic hospitals in Washington and California scored a perfect 100/100 rating from the LGBT advocacy group Human Rights Campaign’s (HRC) Healthcare Equality index, which rates health care organizations’ compliance with LGBT goals. This designation requires employers to provide employee health plans that are fully “transgender-inclusive,” the report says. This includes hormone therapies and puberty blockers and also coverage for “gender-reassignment” or “sex-change” surgeries and related reconstructive procedures for the chest and genitals.
Another 14 Catholic hospitals in the CommonSpirit network fell short of a perfect score on the HRC’s index but still achieve LGBT-complaint health plan coverage, including purported transgender drugs and procedures. The Lepanto Institute says it confirmed the HRC evaluation through its own review of health plan documentation. Other covered services include elective sterilization for women.
One hospital, Mercy San Juan Medical Center in Carmichael, California, was deducted 25 points on the HRC index for unspecified “large-scale official or public anti-LGBTQ blemish on their recent records.” The Catholic hospital is being sued for declining to perform a hysterectomy on a woman who identifies as a transgender man because doing so would violate Catholic ethics. The plaintiff’s attorneys argue that refusal to perform a hysterectomy on a self-identified transgender man constitutes illegal discrimination based on sex. The lawsuit is seeking a court order that would force the hospital to perform elective hysterectomies in the future.
Bishops looked at mergers in 2018
At their spring 2018 general assembly, the U.S. bishops approved updates concerning hospital mergers to their “Ethical and Religious Directives.”
“Assessing material cooperation can be complex, and legitimate disagreements may arise over which factors are most relevant in a given case. Reliable theological experts should be consulted in interpreting and applying the principles governing cooperation,” the directives say.
They also note the “danger of scandal.” For Catholics, scandal does not mean simply controversy. Rather, it means that one does or says something that leads others into sin.
The 2018 directives bar Catholic health organizations from engaging in “immediate material cooperation” with “intrinsically immoral actions,” including abortion, euthanasia, and direct sterilization. They also bar referring for procedures considered immoral by the Church and establishing another entity to oversee immoral procedures.