24 Modern Healthcare | August 12, 2019
hospitals and corporate members from requiring Catho-
lic Medical Center to do anything not consistent with the
ERDs,” he said. “It’s structured in a way where our Catho-
licity will remain ad infinitum.”
For their part, the non-Catholic partners are striving to
show secular advocacy groups that the deals will preserve
access to women’s reproductive and other services prohib-
ited under Catholic rules.
“We permit contraception, sterilization, in vitro fertiliza-
tion, and we are LGBTQ-friendly,” said Jill Kinney, admin-
istrative director for communications at Adventist Health’s
Northern California region. “We remain with our policies,
they remain with theirs, and nothing would change.”
Dr. Joanne Conroy, Dart-
mouth-Hitchcock’s CEO, em-
phasized that patients in the new
system, particularly obstetrics
patients, will be fully informed
about what services they can re-
ceive in what facilities, and will
be given a choice in advance
of where they want to go. Dart-
mouth-Hitchcock physicians
and residents already practice at
the Catholic Medical Center and
know how to navigate the differ-
ent care rules, she added.
“They do a really good job of
identifying what patients’ views
and desires are ahead of time,”
Conroy said. “For those with a
real affinity for Catholic health-
care, they make sure they de-
liver their OB care at Catholic
Medical Center. For those who
want something not covered
there, we direct those patients to
other facilities.”
But neither Catholic nor sec-
ular advocates are convinced, though the Catholic bish-
ops in both locations have allowed the negotiations to go
forward.
“The system board would approve budgets, and that
puts Dartmouth-Hitchcock, an abortion provider, in con-
trol of the finances of Catholic Medical Center,” said Jason
Hennessey, president of New Hampshire Right to Life. “As
it stands now, we’re dead-set against this combination,
which is not aligned with Catholic doctrine.”
The ACLU’s Burlingame was just as skeptical, pointing to
the tough language in the Catholic ERDs on partnerships
with non-Catholic providers.
“When they say they’ll allow Adventist to provide the
same level of services as before, that seems in fundamental
conflict with the new ERDs,” she said. “It’s essential these
questions be asked and answered in a substantial way be-
fore the California attorney general moves forward with
approving this deal.”
St. Joseph’s Klockenga insisted that the Catholic side
wouldn’t control any of the joint operating company assets
on the Adventist side, leaving Adventist’s care policies un-
touched. “The management of the JOC will be JOC employ-
ees, not employees of any Catholic organization,” he said.
He noted that other organizations that want to affiliate
with the new St. Joseph-Adventist system could choose be-
tween joining the Catholic or Adventist side, as with Centu-
ra in Colorado. In addition, he said physicians in St. Joseph
facilities, while forbidden to provide certain services, are
free to refer patients to Adventist or other facilities where
they can get those services.
Burlingame noted, however, that the ERDs specifically
bar administrators or employees of Catholic institutions
from making referrals for “immoral procedures.”
Another limitation is that Ad-
ventist Health, like St. Joseph,
does not offer gender transition
surgery or participate in physician
aid in dying, according to Adven-
tist’s Kinney.
The Seventh-day Adventist
Church officially describes gen-
der dysphoria as “an expression of
the damaging effects of sin” and
“st rong ly c aut ions t ra nsgender
people against sex reassignment
surgery and against marriage,”
the ACLU noted in a recent letter
to the California attorney gener-
al’s office challenging the Adven-
tist-St. Joseph deal.
Adventist Health’s Kinney said
her system does not discriminate
based on sexuality or gender iden-
tity but that its hospitals are not
equipped to provider gender con-
firmation treatment.
Back in Grand Junction, Com-
munity Hospital’s Thomas point-
ed to a new development that he
believes confirms the wisdom of his organization’s choice
to keep the hospital secular.
Physicians at the town’s largest independent OB-GYN
group just applied for privileges at Community because
officials at nearby St. Mary’s Medical Center recently
said they will no longer permit tubal ligations as part of
C-sections for women who don’t wish to bear any more
children, Thomas said. St. Mary’s declined to confirm or
deny this.
“That’s certainly disappointing for patients who need to
deliver at St. Mary’s,” said Dr. Kara Danner, an OB-GYN
employed by Community who was informed by St. Mary’s
about the new enforcement of the Catholic rule against
sterilization. “It doesn’t seem like the right thing to do to
make women who have to have a C-section go through two
separate surgeries when it could be done together.”
Thomas said all the OB-GYN physicians in town now
have privileges at his hospital, which has boosted its fi-
nances. “The board is feeling pretty good about the deci-
sion to make sure there are options in town,” he said. l“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.”Phyllida Burlingame
Reproductive justice and gender
equity director, American Civil
Liberties Union of Northern California