Attorney General Rosenblum: Do Not Waive Catholic Hospitals' Merger Review

Catholic Ethical & Religious Directives Restrict Reproductive, End-of-Life Care

January 14, 2016 - The ACLU of Oregon and 12 other public interest organizations sent Oregon Attorney General Ellen Rosenblum a letter urging her to reject a request for a waiver from the standard process for reviewing merger transactions by the nation’s 6th largest nonprofit hospital system, Providence Health & Services, and St. Joseph Health.

“This proposed transaction involves eight hospitals across Oregon, and a total of almost 50 hospitals across six states [Alaska, California, Montana, Oregon, Texas, Washington],” the groups said in the letter sent to AG’s office on Jan. 8. “Even absent the transfer of assets, significant changes in health care delivery are likely to occur…it behooves the Attorney General to undertake the full review process to ensure that this transaction preserves existing health care services and benefits the public interest.”

St. Joseph and Providence are both Catholic health systems. Catholic hospitals must typically follow the Ethical and Religious Directives (ERDs) promulgated by the United States Conference of Catholic Bishops. The ERDs many forbid reproductive health services, including all birth control methods, sterilization, miscarriage management, abortion, the least invasive treatments for ectopic pregnancies, and some infertility treatments. The ERDs provide no exceptions for risks to a patient’s health or even life.“Every patient who enters a hospital, clinic, doctor’s office, or any other medical setting expects that she or he will receive treatment information and services that meet the standard of care,” the letter notes. “Yet, the restrictions the ERDs place on Catholic hospitals are severe limitations that violate basic evidence-based standards of care – accepted medical practice and as adopted by the major professional medical associations.”

In addition, the ERDs limit medical end-of-life decision making of patients by restricting options for advanced directives, surrogate decision-making, and withdrawal of life-sustaining procedures in Catholic healthcare settings. Providence and St. Joseph operate hospitals in four states - California, Montana, Oregon, and Washington - that authorize medical aid in dying as an end-of-life care option for terminally ill adults.

When Harrison Medical Center in Bremerton, WA affiliated in 2013 with the Franciscan [Catholic] Health System, doctors at Harrison were forbidden from performing “elective” abortions or writing prescriptions for aid-in-dying medication to terminally ill adults who request it. 

“Or. Rev. Stat. 65.807(1) requires that the Attorney General conduct a public hearing on the proposed transaction,” the letter concludes. “The purpose of the public meeting is to receive input and comments from the immediate community to be directly affected. This critical step in the review process should not be waived.”

The California Attorney General’s office rejected a similar waiver request.

The following groups signed the letter:

ACLU of Oregon
Asian Pacific American Network of Oregon
Catholics for Choice
Compassion & Choices
Lambda Legal Defense and Education Fund
Legal Voice
MergerWatch
NARAL Pro Choice Oregon
National Health Law Program
Northwest Health Law Advocates
Physicians for Reproductive Health
Pride Foundation
Western States Center