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SPEAKOUT: Finding compromise in hospital sale

Dr. Lawrence Rust

Published December 3, 2007 at 12:08 p.m.

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The impasse that the Exempla Lutheran Medical Center staff and the Sisters of Charity find themselves locked in (regarding the sale of the hospital to a Catholic health-care organization) has a solution that need not necessarily involve the heavy hand of the Colorado attorney general.

If both sides of this dispute can salvage their most important principles by finding a compromise, can an agreement be worked out?

Physically carving out a piece of the hospital for certain procedures as suggested in the Rocky Mountain News article of Nov. 29 ("Coalition fighting sale of two hospitals") is both practically unworkable and insufficient to settle the end-of-life disputes (and other various ethical disagreements) that will exist all over the hospital.

I believe the solution lies at a more fundamental level.

The medical staff at Lutheran needs assurance that they will be free to practice on a daily basis without interference.

As Catholics, the Sisters of Charity need to know that the organization that they own faithfully represents their core values. These two principles can both be honored by focusing on institutional processes, not architectural manipulation.

The Catholic voice should be represented within the organizational structure of a Catholic hospital. There should be a representative of the church (ideally a priest or nun trained in bioethics and institutional ethics) on the governing board, ethics committee and the medical staff executive committee. That voice should play a prominent and constant role in the decisions that emanate from those bodies.

The presence of the Catholic influence at this level would create an atmosphere that pays careful attention to ethics and moral teaching. Most important, the presence of that Catholic voice should create a "trickle down" effect for the hospital that conveys the message of meaning found in human suffering. This is the real value of the Catholic hospital.

Just as important, however, is preserving the integrity of the doctor-patient relationship.

The Lutheran medical staff must be free from unwarranted institutional intrusion into their day-to-day practice. They need to know that patient autonomy and privacy of their relationship with their patients is guaranteed. By dealing with controversial issues prospectively and in a committee approach, the physicians will be able to have a voice in all disputes and be assured of the collaborative nature of any policy.

When a physician disagrees with a policy, the disagreement would be handled openly by peers. The Catholic voice would be joined with other professional voices in committees and the resulting decisions would be forged from reason and discussion.

If a decision disagreed with the Catholic approach (such as allowing tubal ligations) both sides would have had the opportunity to fully present their side but the consensus approach would prevail.

This solution to the current impasse has the advantage of respecting both sides while creating a policy that is workable. It can deal with issues as they arise through collaboration. Importantly, it assures the tradition of Catholic-centered health care can continue to exist even when it grows into a large and complex institution.

Without this model we are left with the rigid polarities that pit people of goodwill against each other and, ultimately, the people of Denver's western suburbs would suffer. Maybe with this procedural approach, Christians can find common ground.

Dr. Lawrence Rust is a retired trauma surgeon who practiced at St. Anthony Central and Lutheran Medical Center. He also has a master's degree in bioethics from Loyola University Chicago and currently works with the University of Colorado Health Sciences Center.

Comments

  • December 3, 2007

    3:45 p.m.

    Suggest removal

    RNBSN writes:

    Thank you for introducing some reason into what seemed to have started as a militant attack on Catholic healthcare.

  • December 3, 2007

    5:02 p.m.

    Suggest removal

    yaakovwatkins writes:

    This proposal may make Dr. Rust feel good, but in the case of a tubal ligation, I suspect that the woman would hit menopause before there was consensus. As a society we have been debating that particular procedure for at least 70 years. The only way that there would be consensus is if someone stacks the deck by predetermining who gets a vote.