Kentucky Hospital Merger Moves Forward Despite Church-State Questions

A controversial merger between a public university-affiliated hospital, a Jewish hospital and a Catholic hospital in Louisville, Ky., is moving forward despite concerns over church-state separation and the possible loss of certain medical services.

The Federal Trade Commission in August signed off on the proposed merger between the three institutions, saying it would not harm health-care competition in the region. The matter now goes to state officials for review.

The proposal has sparked concern because one of the hospitals involved, University of Louisville Hospital, serves a mostly low-income population. If the merger goes through, all three hospitals will be required to follow Catholic directives on health care, which may limit access to important services.

The merger calls for combining the university hospital with Jewish Hospital and St. Mary’s Healthcare under the umbrella of Catholic Health Initiatives, a firm based in Denver. If it goes through, the university hospital and the Jewish institution will be required to abide by a list of directives promulgated by the church hierarchy. Numerous services, including therapeutic abortion, sterilization procedures, distribution of “morning after” pills for rape victims and other procedures will likely be lost. In addition, patients’ end-of-life decisions may be ignored if they conflict with Catholic dogma.

The plan has aroused opposition in Louisville. More than 400 people have signed a petition protesting the merger.

Political leaders have also questioned the deal. In an opinion column that ran in the Louisville Courier-Journal, Kentucky Reps. Tom Burch and Mary Lou Marzian wrote, “Both men and women will be dismayed to see their advance medical directives are not respected in a Catholic hospital. Women should never have to question their doctor’s allegiance, and providers should not have to worry that they will be dismissed for giving comprehensive care.”

Burch, who is himself a Catholic, co-chairs the legislature’s Joint Committee on Health and Welfare. He told the Courier-Journal that University Hospital “belongs to the citizens,” not the Catholic Church.

“As a conscientious Catholic,” he said, “I have an obligation to my constituents and to the people of Kentucky [to see that] they do not fall under dictates that they do not believe in.”

Others have noted that the Catholic directives are so broad and dogmatic that in some cases they can actually jeopardize women’s lives.

“The Catholic directives that are proposed for use at University Hospital involve not just tubal ligation and end-of-life choices, but emergency medical treatment to women who develop life-threatening conditions during pregnancy,” wrote Beverly Glascock, a former nurse at the hospital who is now an attorney. “Unfortunately, there are a number of conditions that can arise during pregnancy that require an abortion to save the mother’s life, including preeclampsia and eclampsia, ectopic pregnancy, sepsis, miscarriage and more.”

But church authorities are digging in.

Louisville Archbishop Joseph E. Kurtz told a community group, “If something calls itself a Catholic ministry, it is the responsibility of the bishop to ensure as best we can that that indeed is an accurate title.” He later wrote a column vowing to make certain that all hospitals in the merger follow the directives.

At the same time, university officials are adamant that a full range of services will be offered – even if it means taking them to a separate building.

“I have understood the point of view articulated by Archbishop Kurtz from the start of the merger conversation,” Dr. Edward Halperin, dean of the university’s School of Medicine, told the Courier-Journal. “This is a hospital merger, not a merger of this public university, its School of Medicine, or its faculty. We will serve the citizens from whom our support derives. We are the people’s university.”

Halperin added, “Elective abortion, medically indicated abortion if the mother’s health is in danger, and tubal ligation will continue to be available from my faculty. We have made a promise. We will keep it.”

Because the university hospital sits on public land, state officials must approve the deal. Gov. Steve Beshear must sign off on it, and he has stated that he will not approve it unless University Hospital remains true to its “public mission.”