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Why Do The Feminists Rage?

HOSPITAL MERGER RAISES MORAL QUESTIONS

By Hippocrates Waechter

Catholic Healthcare West (CHW), operated under the guidance of the Sisters of Charity of the Incarnate Word and the Daughters of Charity of St. Vincent de Paul, has completed the purchase of eight non-Catholic Southern California hospitals, December 4, from the Burbank-based Unihealth, according to a report found on the Catholic Healthcare West website. The eight hospitals join six other hospitals in the Catholic Healthcare West Southern California region.

In an interview with the Los Angeles Times, Jim Yoshika, Unihealth's hospital division president, said the merger occurred because "we want to make sure all of these hospitals have a fighting chance in the marketplace." Yoshika indicated that a Catholic Healthcare West affiliation will give the eight hospitals an advantage in negotiating with managed-care companies. Because managed-care companies have authorized shorter hospital stays, he said, California hospitals have been losing money and operating with only half their beds full.

Feminist groups were not happy with the merger. On Monday, November 16, one hundred feminists staged a one-hour candlelight demonstration in front of Northridge Hospital Medical Center. Instigated by the Women in Today's Society club at Cleveland High School in Reseda, statewide and national feminist activists decried Catholic ownership of the eight hospitals, saying that women's health services would be jeopardized. Northridge Hospital Medical Center, included in the merger, offers one of only two San Fernando Valley rape crisis centers, according to the Times.

Debbie Cantu, Director of Communications and Marketing for Catholic Healthcare West in San Francisco told the Los Angeles Times that the eight acquired hospitals "will not become Catholic hospitals." Joyce Hawthorne, Southern California regional director of communications, told the Mission that under the aegis of Catholic Healthcare West the acquired hospitals will perform no abortions and no assisted suicide. However, abortions to save the life of the mother and "emergency" contraceptive service (giving rape victims a "morning after pill") will still be offered.

What life-saving abortions will be offered at these hospitals? Carol Bayley, Ph.D., Director of Ethics and Justice Education for Catholic Healthcare West in San Francisco told the Mission "Our agreement with the hospitals says that direct abortions are not performed." Certain "indirect" abortions are permitted by the National Conference of Catholic Bishops, according to a fax received from Catholic Healthcare West. Directive 47 in the 1994 Ethical and Religious Directives for Catholic Health Care Services issued by the National Conference states: "Operations, treatments and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot safely be postponed until the unborn child is viable, even if they will result in the death of the unborn child." An example of such a condition, according to the Catholic Healthcare West fax, would be "if a woman has cancer of the uterus, and she is pregnant... removing the uterus, with the unborn child in it (thus aborting the pregnancy) is morally acceptable."

But what of morning after pills, which are known to be abortifacients? Carol Bayley said that it is "unfair to call the morning after pill an abortifacient." They work in two ways, she said. "If they're given within a certain period of time after ovulation, they can work as an abortifacient; but nobody really knows how the medicine actually works... If they are given within a certain period of time, [and] the woman has not ovulated, they don't work as an abortifacient... The primary way, the way it most often works, and the way that it works (which is why we authorize its use), is not as an abortifacient. It is as an anovulent. So, the reason why a woman will get a morning after pill is because it can actually inhibit ovulation so that a rape victim does not become pregnant. That is the understanding with which we give it."

Futher, said Bayley, "it's very unlikely that a woman will become pregnant as the result of a rape; therefore it is very unlikely that a pill given to her will act as an abortifacient." However, is not an anovulent an artificial contraceptive? It is, agreed Bayley, but a victim of rape has a right to such a contraceptive. "I don't remember if the Ethical and Religious Directives actually underscore this," she said, "or if it is the opinion of a lot of theologians and bishops... that a woman who has been raped has not consented to a sexual act, and is therefore not responsible for the result of it."

Catholic Healthcare West's agreement with Unihealth, however, does not forbid the prescription of contraceptives in the acquired hospitals. Contraceptive prescription, said Bayley, "is not something that typically gets done in a hospital. That's something that happens in a doctor's office. In a non-Catholic hospital, which some of these hospitals, these new affiliates, are, if they are currently prescribing contraception, for whatever reason, they could continue doing that. It's just very unlikely" they will.

Sterilizations, too, will be permitted. "Those are worked out at the local level," said Bayley. However, she noted, all sterilizations will be in accord with strict state rules that protect individuals from being sterilized against their will.

Why does Catholic Healthcare West insist that the new hospitals cease performing abortions, in accord with Catholic teaching, but not sterilizations, when the Church condemns those too? "The pope himself," said Bayley, "distinguishes between the evil of sterilization and the evil of abortion. They are different. And so do the Catholic bishops, and bishops have said to us, 'CHW, you know, if you need to cooperate with providers who provide sterilization, if you need to do that to make your hospital system secure, to be sure that your mission goes forward into the future, about that you can negotiate, about that you can cooperate. Abortion is a different story. And we actually didn't wait for the bishops to tell us that [i.e., that abortion is 'different']; they didn't tell us that. We decided that ourselves. So, that's really a non-negotiable."

The difference between abortion and sterilization, too, said Bayley, is "partly a numbers matter. When you think of all the women in the United States, and you think of all the women of child-bearing age, that's a subset; and you think of all the women of childbearing age that are actually pregnant, that's yet a smaller subset; and then you think of the women of child-bearing age who are pregnant, who do not want to be pregnant, that's a really small number. And all of those people, [those] who seek an abortion in a hospital is a really small number. So, we have been able to say to our partners, 'you may be doing abortion, now, but take a look and see how important that service is to you. Or, is your affiliation with us, with our access to economies of scale, with our access to managed care contracts, with our values that we share with you, with our care for the poor-- you trade it off, you see which is more important. And if abortion's more important to you, those few procedures that you do, then you have to find another partner. We think you're going to go another way.' And, of course, they do.

"Sterilization is an entirely different thing. According to the Center for Disease Control, sterilization is the most widely used form of birth control in the United States-- bigger than the pill. So, when you're talking about hospitals that have been founded in response to perceived needs of their communities, not founded because of the impulse of a Catholic religious order to serve the poor or carry on the healing mission of Jesus, but hospitals like these Unihealth hospitals that are founded to meet the needs of their communities, well, sterilization is a need of their community, and it's a pretty big need. Not only does Catholic teaching say, well this is a little more negotiable-- it's evil, but it's a little more negotiable-- it's also a lot less negotiable from the other side. It's something they really need to do for their communities."

Bayley said a fundamental fact to remember is that these Unihealth hospitals "are not Catholic hospitals. They are full affiliate partners," she said, "but unlike a St. Vincent's or a St. Francis, they do not carry a Catholic identity. They share all of our other values; they share a commitment to the same core values that rest of CHW has. They do their fair share, and, in fact, they do more than their fair share for the poor, in a lot of cases. That is not something that is negotiable... We're looking for partners that are interested in doing the kinds of things we do-- whether they do them for the same reason, is a different question. These Unihealth hospitals have set about doing what they do, which is very similar to what other hospitals in Catholic Healthcare West do, for a different reason. We've said, whatever your reason, come with us."

The hospitals acquired by Catholic Healthcare West are: California Hospital Medical Center, Los Angeles; Glendale Memorial Hospital and Health Center, Glendale; La Palma Intercommunity Hospital, La Palma; Long Beach Community Medical Center, Long Beach; Martin Luther Hospital, Anaheim; Northridge Hospital Medical Center (Roscoe Boulevard campus, Northridge); Northridge Hospital Medical Center (Sherman Way campus, Van Nuys); and San Gabriel Valley Medical Center in San Gabriel. *

In a future issue, the Mission will explore the ethical questions surrounding sterilization and abortion in Catholic owned healthcare facilities.

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