Catholic Healthcare Comes To My Hospital: a “win-win-win-win” for Holy Redeemer Health System

Residents of southeastern Pennsylvania are dreading an arranged marriage.

Funny thing about that merger between Abington Memorial Hospital (where I have been a patient) and Holy Redeemer Health System.

The only people who are calling it a “merger” are the ones who had nothing to do with the decision. So far, these two hospitals outside of Philadelphia, PA (one a local Catholic health system, one a secular community hospital) are more tight-lipped about their new relationship than any recently divorced Hollywood starlet who takes up with a rock singer.

In an official statement dated June 6th, 2012, Abington Health announced plans to form “a new regional health system” with Holy Redeemer, saying, “Abington and Holy Redeemer are committed to providing information to the community as it becomes available.”

So they say.

“There are so many rumors because the hospitals have not been forthcoming. They’re not talking to the public,” says Rita Poley, an artist and curator living in Elkins Park who created a fast-growing Facebook page, “Stop the Abington Hospital Merger”, to oppose what the hospitals call the “new regional system”. The extent of the silence on the proposed “new organization”, which would bring Catholic health directives to a major secular facility, has shocked Abington staff, who did not find out about their board’s decision to pursue the partnership with Holy Redeemer until the news broke in the press.

The local public – especially the large Jewish community in the area – has a livid reaction to what everyone has termed “the merger”, despite the fact that the word “merger” doesn’t appear in any of the hospital releases I’ve received. Rather, in written statements, the hospitals refer to the move as a partnership, a “plan”, a “vision” and a “continuum of services”.

Why are we all so gol-darned upset?

This is big news here, but I realize that more far-flung readers may not know what I’m talking about. This short article from The New York Times, published last February, is a good introduction to the issue of Catholic-secular hospital mergers in the US.

Catholic hospitals, which serve a significant portion of the American public, operate by special guidelines that put religious principles ahead of medical ones.

The most controversial of these rules involve pregnancy (and pregnancy’s prelude) and the end of life. Directives from the US Conference of Catholic Bishops (USCCB) website govern the use of contraceptives, fertility treatments, abortion, and end-of-life choices.

Catholic hospitals prohibit the use of contraceptives or even counseling about contraceptives, aside from “natural family planning” between husbands and wives.

They prohibit abortion in almost every imaginable case, including the earliest stages of conception in the case of rape, life-threatening pregnancies that take hold outside the womb, and cases where the fetus will not survive on its own or be born with fatal defects.

They prohibit sterilization procedures for people who do not want to have children.

They prohibit many forms of fertility treatments, including those that would use a donor egg or sperm because this is undignified and “contrary to the covenant of marriage and the unity of the spouses.”

The Catholic edict of life’s sacredness, from conception to last breath, also means that Catholic institutions “will not honor” an advance healthcare directive (for example, what measures a person wants or does not want performed to prolong life) that they judge contrary to Catholic teaching.

“Any partnership that will affect the mission or religious and ethical identity of the Catholic health care institutional services must respect church teaching and discipline,” the directives say.

That last one is the problem here.

In considering the partnership, Abington, a nationally-renowned high-tech trauma center, agrees that they will stop providing abortions once the partnership is finalized next spring.

Statements from both hospitals attempt to minimize the abortion issue. They point out that according to Pennsylvania records, in the twelve months leading up to last March, in the five-county area of southeastern PA served by the hospital, Abington performed only 48 abortions out of 17,575.

Come on, admit it. Aren’t we all just making a mountain out of a molehill here? Women will obviously be able to find a clinic once Abington complies with Catholic directives.

That’s misleading, Abington physician Dr. Philip Rosenfeld told me in an interview this week. Dr. Rosenfeld is an ear, nose and throat specialist who has been practicing at Abington for 40 years, not counting his Abington internship and surgical residency.

He is disappointed that hospital statements would downplay the abortion issue in this way. He says that describing the statistically tiny number of abortions performed at Abington misses the point.

But why would an ear, nose, and throat doctor care? Unless a pregnant lady needs her tonsils out or something, what does Dr. Rosenfeld have to do with rules in the obstetrics department?

“It’s not just abortions,” he says. “It’s what should rule the hospital. Should it be ruled by someone’s religious convictions? The only thing that should guide your medical decision is what is best for this patient.”

Dr. Rosenfeld tells me that among Abington doctors and staff, opposition to the Catholic partnership is strident and unanimous.  From OB-GYNs to ophthalmologists, Abington doctors are as aghast at the prohibition of abortions as they would be if the Holy Redeemer directives stipulated that appendectomies were to be discontinued as immoral. That’s because, according to Dr. Rosenfeld, this edict touches more than the OB-GYN department: it affects the core philosophy of healthcare itself.

Abington is a secular hospital with a full range of healthcare services, Dr. Rosenfeld explains. “That’s the way we’ve always been, that’s the way we should be. Our orientation should be the patient, not anybody’s religion.”

Many outlets have already covered the fact that Abington is not your average abortion clinic. The number of abortions it performs may be statistically small, but they’re performed at the hospital for a reason. Many of them are emergency life-saving procedures, where women face death unless the pregnancy is terminated.

“Most of these abortions are not about family planning,” Poley adds. “Many of them are medical emergencies. If you’re going to take women out of the hospital, out of the care of their doctors, and say, ‘go to a clinic’, what kind of medical care is that? It’s outrageous.”

(This worthwhile blog post by a local doctor explains many possible implications for women’s care, should Abington comply with Holy Redeemer’s directive).

To drive the point home, Dr. Rosenfeld illustrates with a case two years ago involving a pregnant Holy Redeemer patient.

“She needed an emergency abortion. It was life-threatening. What do you think they did? They sent her to Abington. They wouldn’t do it there, even though they risked her life to transport her.”

Rita Poley was shocked by the Abington/Holy Redeemer news, and the way it was allowed to blindside the public and hospital staffers alike.

Rita Poley

“My daughter said, you know what you need, Mom? You need a Facebook page.”

With the help of a friend, Poley launched her Stop The Abington Hospital Merger page on July 3rd, and begin circulating a petition to halt the partnership.

About a week later, it had 25,000 views and 800 “likes”. The next day, unique visitors to the page was up to 36,000, and it topped 55,000 by the end of the week.  The petition garnered over 4,000 signatures in one week. As of July 14th, it had well over 5,000. Poley notes that support is coming in across religious lines.

While she was glad to speak up, Poley was unprepared for the deluge of community and local and national media attention that followed her decision to spearhead the opposition. “I’m like this little artist person,” she laughs of trying to balance all the publicity with her busy job as curator and director of the Temple Judea Museum.

The child of parents who owned a Jewish bakery in Philadelphia, Poley insists that she’s “not a regular activist,” but she’s no stranger to motivating for a good cause.

“My first activism was when I was nine years old. I wrote to City Hall to ask them to put a traffic light on a busy corner,” she remembers.

Poley is moved to protect the principle of community healthcare unbiased by religious dogma. But the deafening silence from the decision-makers disturbs her just as much.

The lack of public hearings, and a refusal by board officials to give interviews, worries her and countless other community members who want to know what’s happening.

In current statements, the hospitals say that despite traditional Catholic directives, Abington will continue to provide contraceptive services, tubal ligations and vasectomies, operate its well-known fertility clinic, and honor patients’ end-of-life directives and Do Not Resuscitate orders.

“Patients receiving care at Abington will have access to all reproductive health services except abortion,” reads a July 12th statement. “Abington Health’s philosophy and practices regarding end-of-life care will remain unchanged.”

“What does this mean?” Poley asks. Given the refusal of hospital officials so far to discuss anything further with the public, “what’s going to happen next month, in six months, or a year?” The demonstrated reality of secular/religious hospital mergers and Catholic directives across the US healthcare system, combined with the suspicious silence from the entities involved in this local tempest, make community members extremely nervous about what might be coming, and whether it might happen behind doors firmly shut to staff, the press and the community the hospital serves.

“There was not a word said,” Dr. Rosenfeld explains of the new partnership. “Everyone on the board had to sign a confidentiality agreement until the decision was released. And among the other people who had no idea was the chairman of the [Abington] OB-GYN department. He had no idea that this was coming until it came. He was blindsided by a cannon, basically. Nobody knew.”

To him, this is almost as sinister as the prospect of religious teachings, instead of medical expertise and respect for individual patients, guiding Abington doctors’ care.

“You can’t get through to the administration now with your opinion,” he says. “They’re not interested, they’re not responding. And that’s why [the press] can’t get through either. They don’t want to hear from you; they don’t want to hear from anybody.”

He urges community members to continue an onslaught of letters, phone-calls and e-mails to the Abington board. “Unless enough of the board members’ minds can be changed in the near future, this will go through to the great harm of the hospital and the community,” he says emphatically.

As a journalist, I wanted to balance my perspective. I don’t want press releases whose real purpose is to keep me at arm’s length, rather than inform me.

Someone close to the negotiations at Holy Redeemer spoke with me on the promise of strict confidentiality. This source described the partnership as a beneficial meeting between Abington’s “high-tech” and Holy Redeemer’s “high-touch” philosophies. While Abington is known for cutting-edge trauma treatment, Holy Redeemer is one of the largest and best-regarded hospice and long-term care providers in the region.

So I tried to get an interview.

I e-mailed Barbara L’Amoreaux, a spokesperson for Holy Redeemer. When she didn’t respond to my query, I called the next day.

I asked if she could connect me with anyone there for an official statement. She said she was just about to send me an updated release. I asked if anyone would give an interview, to balance comments from the opposition.

She said they were not giving any interviews, but that she would keep me in mind if that changed.

She also chuckled audibly.

The statement she sent confirmed that in partnering with Holy Redeemer, Abington would not perform abortions come spring of 2013. But the statement also reads that Abington will continue to provide “all necessary measures to preserve the health of the mother, including those that may result in terminating a pregnancy”.

I e-mailed again to ask for clarification on this point, but she didn’t reply.

Instead of denying interviews, Holy Redeemer might do well to revisit the USCCB directives.

“The possibility of scandal must be considered when applying the principles governing cooperation,” USCCB writes of secular/Catholic mergers. “Scandal can sometimes be avoided by an appropriate explanation of what is in fact being done at the health care facility under Catholic auspices.”

Before we ask that Abington and Holy Redeemer shut their partnership negotiations, we should ask that they open their mouths outside the boardroom.

“I can only conjecture on why they’re keeping quiet,” Dr. Rosenfeld says. “But for them, it’s a huge plus.” According to him, Abington is a profitable hospital, while Holy Redeemer is not: “this is Abington becoming their savior. Not only do they get saved economically, but they get their religious dogma as part of the entire institution. For them, it’s a win-win-win-win and why would they comment?”

“They know what they’re doing,” one of my neighbors said bitterly at the local train station this week.

As I interviewed Poley at a coffee shop a few blocks from each of our homes, the woman sitting at the next table, unnoticed at the time by Poley, slid a piece of paper onto our table before leaving the shop.

“As long as they don’t satisfy this community outrage, this will continue to fester,” Poley promises. “This will become more and more of a community effort.”

What’s your opinion? Do you go to a Catholic hospital? Why or why not? What has your experience been?

Update: on July 18th, among increasing community outcry, a statement was released calling off the partnership between the two hospitals.