January 24, 2010
By Jerry Kopel
People who have health insurance through Kaiser had better be made aware
of what is contained in a 16 page directive drafted by and guiding
Catholic Bishops across the nation regarding treatment of hospital
patients. The major words are "Catholic moral principles" which form the
basis of the document and in effect have to be coped with by the patient
who anticipates disagreement with that standard.
Exempla Lutheran, Exempla Good Samaritan, Exempla Healthcare, Exempla
Saint Joseph, and Exempla System Services all lost health leadership
that had been in place through the transfer of powers to the
Kansas-based Sisters of Charity of Leavenworth. The transfer was debated
before the Denver City Club in December and every luncheon participant
was provided with a copy of the Bishops' directive.
Kaiser patients are usually treated at medical facilities involved in
this recent transfer of ownership and management. (Swedish Medical
Center in Englewood is also used by Kaiser and is not under Exempla.)
The issue of religion is discussed by itself, providing the director of
pastoral care should be a Catholic unless an exemption is approved by
the diocesan bishop. Thus a Protestant or Jew, regardless of whether
they accept the Bishops' directive cannot be appointed regardless of the
talent brought to the position without an approval by the bishop. In
early January, Exempla board chairman William Murray announced the
dismissal of five officers from positions of authority in the hospital
system and replacements.
I expected a strong sectarian defense of an anti-abortion position as
stated in the Wall Street Journal that "the U.S. Conference of
Catholic Bishops is one of the most powerful anti-abortion groups." The
Bishops' directive requires obedience to a process and choices available
to the now more-seriously sectarian hospital system.
Major speaker at the City Club noon lunch was attorney Frances Koncilja
who blamed State Attorney General John Suthers for not stopping the
hospital take over.
Unless the hospital receives money raised by taxation or public
borrowing, it is not covered under CRS 24-34-401, Colorado's
anti-discrimination statute. The Bishop directive however provides for
no discrimination against employees on race, sex, age, national origin,
or disability, or rights to bargain collectively. The statement on
employment did not include "religion."
Sisters of Charity did not pay the former hospital authority for the
value of the property. Hopefully they will use such funds to follow the
biblical mandate to care for the poor. There seems to be a high priority
for care for the poor, the uninsured and the underinsured in the opening
pages of the directive.
The terms "the protection of life from conception until death" is a
major directive. There are exceptions, such as in denial of
sterilization for either men or women unless a serious pathology cannot
otherwise be overcome. On the other hand, denial of contraceptives in
any form before or after conception is clear.
Beyond normal conception you will find conception occurring other than
by copulation between the married couples as the "wrong way" to go.
Fertilization involving a donor other than the spouse , or homologous
artificial fertilization for extra-corporeal conception, or surrogate
motherhood get a definite "no", but does not in any way that would hurt
the baby being born. If fact, if the unborn child has a serious defect,
fetal diagnosis is not permitted if the intent of the parent would be
Most of the ways when non-normal copulation occurs, the Bishops'
directive might provide a gateway if there is a real possibility of the
death of the mother.
Religion is there at the last moment if a newly born infant is in danger
of dying or already miscarried. The infant should, so direct the
bishops, be baptized. Anyone can validly baptize, and the baptism record
will be sent to the parish where the institution is located.
For the elderly ready to die: The directive allows food and drink to the
dying contrary to decisions made as advance direction under Colorado
statutes when the sustaining process is not sought and would be rejected
even if such rejection is contrary to Catholic moral teaching.
The choice between a request by a patient
contrary to the moral teaching of the Church is to be judged by the
teaching authority of the Church even if contrary to the medical
procedure sought by the patient.
How will the Catholic Church direction be applied to patients insured by
Medicare or Medicaid? Here is wriggle room. One consideration is
patients' burden of excessive expense for the family or the community.
Suicide and euthanasia are forbidden. The
patient can be provided remedies for pain but will be provided reminders
of and understanding of the redemptive suffering of Christ.
The directive has some wriggle room, but not
enough for me.
If I somehow find myself taken to the nearest
hospital which turns about to be under the Sisters, this column is to be
used as my demand to be sent to Rose Hospital.
A strict sectarian Catholic should have the right to observe religious
standards, but other patients should have the right to be transferred to
other medical facilities or have someone from their own religion
available at the end of life.
(Jerry Kopel served 22 years in the Colorado House.)