A Bad Deal for Health Care in Illinois

In a little reported local move, Resurrection Health Care, a Roman Catholic health system, is seeking to sell two of its suburban Chicago hospitals to the nonsectarian Vanguard Health Systems. As part of the deal, Resurrection has demanded that Vanguard maintain the religiously-based health care restrictions Resurrection instituted when took control of the hospitals a number of years ago--and Vanguard has agreed to do so.

These restrictions are embodied in the Ethical and Religious Directives for Catholic Health Care Services ("the Directives"), promulgated by the National Conference of Catholic Bishops, and are imposed on all Catholic-owned institutions and the employees who work in those institutions. The Directives prohibit many critical health services--particularly in the area of reproductive health end-of-life care. Under the Directives, patients are denied tubal ligations and vasectomies as well as contraception. In fact, the Directives prohibit many women who have been raped from accessing emergency contraception, which could, if taken promptly, prevent an unwanted pregnancy. Patients' end-of-life wishes are only respected if they are consistent with "Catholic moral teaching." Elective abortions are forbidden, as are abortions that are necessary to preserve the pregnant woman's health. In cases where a pregnant patient's physician believes that she will die if her pregnancy is not immediately terminated, the physician may seek approval from the hospital's ethics committee, who will decide whether the Directives permit termination in that case. Only if that committee allows it, can the life-saving measure be taken.

These restrictions endanger women across the nation, as demonstrated by a recent example from Arizona. In late 2009, a woman went to St. Joseph's Hospital and Medical Center in Phoenix. She was eleven weeks pregnant and suffering from pulmonary hypertension, a condition that limits heart and lung function. This condition is exacerbated by pregnancy and can be fatal. The treating physician believed an abortion was necessary to save the patient's life, and the patient agreed to the abortion. Because the hospital was bound by the Directives, the question of whether the physician could terminate his patient's pregnancy to save her life was presented to the hospital's vice president of mission integration and ethics committee member, Sister Margaret McBride. Sister McBride and the ethics committee agreed to allow the abortion to go forward. However, when the Bishop of the Phoenix Diocese learned of this case, he denounced the hospital's decision, asserting that the Directives do not permit abortion, even where necessary to save the pregnant woman's life. In the wake of that decision, Sister McBride was demoted from her position at the hospital and the Bishop announced she was "automatically excommunicated" from the Catholic Church. Administrators at the hospital have defended their decision, because they believed there was a "nearly certain risk of death" if the pregnancy was not terminated.

The Bishop's message, however, is loud and clear: the Directives do not permit abortion even to save a woman's life. When it comes to interpreting the Directives, the life of an eleven week fetus is "just as sacred as the mother's life, and neither life can be preferred over the other," and anything other than strict adherence to this view can result in severe punishment--including banishment from the Church.

Catholic-affiliated hospitals, bound by the Directives, already make up a significant number of the hospitals in Illinois. The pending sale of Westlake and West Suburban Hospitals would extend the Directives' impact to patients seeking care in institutions that no longer have any connection with a Catholic-run health care system. Before Resurrection purchased Westlake Hospital in Melrose Park in 1998 and West Suburban Medical Center in Oak Park in 2004, both were nonsectarian and neither adhered to the Directives. In fact, the community vocally opposed Resurrection's takeover of West Suburban hospital because of the Directives' limitation on care. The sale of these hospitals to Vanguard Health Systems should be an opportunity for the community to be relieved of these restrictions on patient care, but Resurrection and Vanguard have agreed to the opposite. This harmful agreement should not be permitted.