22 Modern Healthcare | August 12, 2019
markets, including Chicago and Denver.
These advocacy groups previously challenged the
merger of CHI and Dignity Health, which included 15 his-
torically non-Catholic hospitals. But that deal ultimately
was approved by the California attorney general and was
completed last year, forming CommonSpirit Health.
The secular forces are intensifying their efforts as part
of a broader political fight against measures by the Trump
administration and Republican-led states to restrict ac-
cess to abortion and contraception and let healthcare
workers refuse to provide certain services on religious or
moral grounds.
They cite research showing that most Catholic facilities
do not explicitly inform patients about care restrictions at
Catholic hospitals and that many patients aren’t aware of
them. In addition, physicians, particularly OB-GYNs, often
struggle to arrange workarounds to get patients care they
need, such as fudging a medical condition to justify insert-
ing an IUD.
OB-GYNs practicing in Catholic hospitals say they
have to seek permission from religious authorities to end
pregnancies in cases of miscarriage or premature rup-
ture of membranes, or to perform tubal ligations as part
of cesarean deliveries. Such decisions may vary sharply
depending on the Catholic ethics official who is on duty
at the time, and policies can change when a new bishop
or archbishop is appointed.
“You really don’t know what you can or can’t do,” said
Dr. Eliza Buyers, a Denver OB-GYN who practiced for
eight years at a Catholic hospital in that city. “There are
things we were doing, then we couldn’t do them, like do-ing a tubal at the time of a C-section. That felt very restric-
tive and wrong.”
That uncertainty is illustrated by Oliver Knight’s case.
He said he was prepped to undergo a hysterectomy in
August 2017 at St. Joseph Hospital in Eureka, Calif., as
part of his treatment for gender dysphoria. But his OB-
GYN surgeon came in minutes before the scheduled
start of the procedure and told him the hospital wouldn’t
allow it because Knight is transgender.
Knight said he went into a panic attack and was given
a sedative, then was immediately discharged. He has
sued St. Joseph for violation of his civil rights and inflic-
tion of emotional distress.
“Everything was cleared and I had no idea there was
any issue with me being transgender,” Knight said. “We
shouldn’t be refused care just because of who we are.”
In its response to Knight’s lawsuit, St. Joseph said it
has a constitutional right to refuse to perform proce-
dures barred by Catholic religious doctrine.
Advocacy groups say UCSF’s recent retreat from its ex-
panded partnership with Dignity due to concerns about
religious rules has given their side new momentum in
the fight.
“Particularly in light of what’s happening with attacks
on reproductive healthcare and LGBTQ folks, people
are saying we have to protect bias-free medicine,” said
Phyllida Burlingame, reproductive justice and gender
equity director for the American Civil Liberties Union of
Northern California. “There is much more understand-
ing about the risk posed by hospitals making decisions
based on religion rather than health needs.”“Our Catholicity has
strengthened over the last seven
years to the point where I believe
we are the most conservative Catholic
hospital in New England.”Dr. Joseph Pepe
CEO
GraniteOne Health and Catholic Medical Center