Catholic-run hospitals not new
Rules not driving patients from existing facilities
By Myung Oak Kim, Rocky Mountain News (Contact)
Published December 3, 2007 at 12:30 a.m.
The pending Catholic takeover of two local hospitals isn't treading new ground.
The company that is poised to take control of Lutheran Medical Center in Wheat Ridge and Good Samaritan Medical Center in Lafayette has long owned St. Joseph Hospital in Denver.
Sisters of Charity of Leavenworth has operated St. Joseph since 1883 and also owns seven other hospitals in the west. At least eight other hospitals in Colorado are owned by Catholic organizations.
Doctors at St. Joseph and other Catholic-owned hospitals must follow ethical and religious directives that include not performing tubal ligations, vasectomies, abortions or birth control counseling. Doctors also are directed not to remove feeding tubes from a person in a vegetative state.
But those rules are bendable, and they haven't driven patients away from St. Joseph.
In fact, St. Joseph is, by far, the most popular hospital in the metro area for delivering babies.
Doctors delivered more than 5,100 babies at St. Joseph in 2006, according to figures provided by the state Department of Public Health and Environment.
Many doctors at Lutheran and Good Samaritan are fighting a proposed $611 million hospital sale because they say the religious directives will compromise care and drive doctors and patients away. They're urging state Attorney General John Suthers to block the sale. So is the board of Exempla, which operates St. Joseph, Lutheran and Good Samaritan.
According to state law, Suthers can intervene in the sale of a nonprofit to another nonprofit if he determines that it would cause a material change in services.
He has until Dec. 31 to decide. The sale is scheduled to close by late January.
Jeff Selberg, CEO of Exempla, which operates St. Joseph, Lutheran and Good Samaritan, said doctors at St. Joseph must respect the religious directives and follow them as closely as possible. When doctors encounter a situation that could violate the directives, they consult with an ethics board.
And if a prohibited procedure - such as a tubal ligation - is deemed necessary to protect the woman's health, it is performed, he said.
"The language is there that says we respect life and we will not accept anything that would encroach upon or impact the dignity of one's life," Selberg said. "At the same time, judgment must be used to determine what is best for the individual and what is in alignment with one's conscience."
"On first blush, you see these rules as very literal, very black and white," Selberg said. "But when you read the entirety, you find that there is latitude in terms of judgment.
"There's discretion as long as there's good faith that the directives are being carried out to the degree possible and the patient's welfare is always put first."
That kind of flexibility is shown, for instance, with end-of-life issues, Selberg said.
If a patient is in an irreversible coma or vegetative state, doctors counsel relatives. If relatives want feeding tubes or ventilators to be removed, the request goes to the ethics committee, Selberg said.
"I can't think of a case that we've had where we have denied or refused the request," he said. "It is something that is reviewed or evaluated, but it is not unreasonably withheld."
The controversy
The flash point in the pending sale of Lutheran and Good Samaritan hospitals to a Catholic organization is a set of rules known as ethical and religious directives. Doctors and staff at Catholic hospitals must follow about 70 rules, which include the prohibition of:
* Tubal ligations
* Vasectomies
* Abortions
* Birth control counseling
* Removal of feeding tubes from someone who is in a persistent vegetative state
Doctors who encounter a situation that could violate the directives consult with an ethics board. Prohibited procedures can be performed if deemed necessary to protect the patient's health.
Birth statistics Hospital Births in 2006 State rank
* St. Joseph 5,107 1
* Memorial (Colo. Springs) 4,532 2
* Rose 3,823 3
* Denver Health 3,518 4
* University of Colorado 3,144 5
* Sky Ridge 2,999 6
* Penrose St. Francis (Colo. Springs) 2,998 7
* Lutheran 2,910 8
* Poudre Valley (Fort Collins) 2,786 9
* Avista Adventist (Louisville) 2,714 10
* Good Samaritan (Lafayette) 1,944 15
* Presbyterian/St. Luke's 1,442 22
* St. Anthony Central 1,197 24
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