Hospital mergers: Will they lead to church restrictions on care?



SEATTLE -- As more hospitals in the state merge and partner with Catholic health care systems, there are concerns whether patients will be able to receive procedures or care that goes against the church’s doctrines, such as contraception, abortion and physician-assisted suicide.

“Our concern is that if you’re going to go and get medical care, it should be from a doctor who is looking at your case based on your medical needs, not based on somebody else's religious beliefs,” Jennifer Shaw of ACLU-Washington said.

Hospital mergers became especially heated in Washington after Swedish affiliated with Catholic-based Providence Health Services in 2011. As a result, Swedish stopped performing elective abortions.

The ACLU claims similar consolidations in Washington have restricted access to other important services that also conflict with Catholic doctrine.

“We want there to be a full assessment of the needs of the community before the merger is finalized,” said Shaw.

In May, the ACLU asked Gov. Jay Inslee to stop any new mergers between “secular” hospitals and religious organizations until patient protections are in place.

But last week the governor decided against that step.  He did, however, announce that he is directing the Department of Health to come up with new rules to ensure that hospital mergers don’t result in fewer services.

“I am very concerned for the potential of these relationships to lead to restrictions in constitutionally protected care for Washingtonians,” Inslee said.

With respect to Swedish, while it has stopped performing elective abortions, it has partnered with Planned Parenthood and does refer patients to that organization who want the procedure.

In addition to abortion and contraceptives, the ACLU is also very worried about end-of-life care.  It argues that these mergers threaten those who want to control how they die, since the Catholic religion doesn’t typically recognize death-with-dignity and other end-of-life directives.

“There is a conflict between the doctrine that some of these hospitals are required to follow and the expectations of some patients,” Shaw said.  “It would be pretty surprising to go into a hospital, say with terminal cancer, and then find out that whether you like it or not you are going to be on life support.”

Swedish said Monday that it does honor end-of life requests, but it does refuse to fill life-ending prescriptions for those who seek physician-assisted suicide.

This issue is only going to get bigger.  That’s because there is a wave of hospital consolidation going on across the state, much of it as a result of the U.S. Affordable Care Act, commonly called Obamacare.  The next battle is in Skagit County, where three community hospitals are looking to partner with a larger health care organization.  Two of the four potential suitors are Catholic health care groups.