Statement by: Sr. Carol Keehan, DC, President and Chief Executive Officer Catholic Health Association of the United States 

The New York Times' recent article "As Catholic Hospitals Expand, So Do Limits on Some Procedures," implies that U.S. Catholic hospitals are deliberately hiding their Catholic identity from the public and pose a threat to women's health. The article also distorts Catholic teaching on end-of-life care and the care of pregnant women. 

The premise of the article seems to be that because Catholic hospitals don't perform certain procedures, women who receive care at Catholic hospitals are at risk. The article relies on a few select cases to unfairly generalize all of Catholic health care. What the article doesn't mention is that Catholic hospitals operating in the United States are accredited and held to the exact same standards as non-Catholic hospitals. As it turns out, Catholic hospitals are actually among the highest performing hospitals in the U.S.

The Centers for Medicare and Medicaid publicly reports how hospitals perform on various quality measures using a five-point scale referred to as star ratings. In 2017, a comparison of star ratings shows that 47.3% of Catholic hospitals earned 4 or 5 stars (the highest ratings). In comparison, 29.6% of investor owned hospitals, 44.3% of not-for-profit hospitals that are not Catholic, and 34.1% of publicly operated hospitals earned 4 or 5 stars. 

The article makes the argument that Catholic hospitals should disclose what procedures we don't perform. The fact is, the vast majority of U.S. hospitals – Catholic and non-Catholic alike – do not, and simply cannot, provide every medical service currently available. After reviewing non-Catholic hospital webpages in several U.S. cities, the Catholic Health Association of the United States did not find one that included a list of procedures not offered. Hospitals, like other service organizations, list the services they do perform. The article seems to ignore the fact that the delivery of health care centers around the physician-patient relationship. A patient needing a medical procedure consults with his or her physician, who then schedules the procedure with a hospital or outpatient facility. While a patient may look at a hospital website to learn what services are offered, they can't schedule a surgery and show up at a hospital without having their physician involved. Catholic health care respects the clinician-patient relationship, and every caregiver who works in a Catholic facility is aware that there are certain procedures we do not perform such as abortions, euthanasia, and elective procedures that violate our deeply held moral convictions. This is not a new development.

The article states that, "many Catholic health care institutions also discourage clinicians from providing referrals for abortions or having conversations with patients about medical aid in dying for people who are terminally ill." While the first part of this statement about abortion referrals is correct, the second part about dying and terminally ill patients is simply not true. The facts are that Catholic health care strongly supports palliative and hospice care, actively encourages the use of advance directives, and has long championed end-of-life care that offers dignity and comfort for patients with terminal conditions. 

The article also incorrectly states "if a fetus is no longer viable after a woman's water breaks early in her pregnancy, most Catholic hospitals will not perform an abortion until after a fetal heartbeat is no longer detected, or the pregnant woman's life is in imminent danger." The reality is that Catholic hospitals allow treatments and procedures to treat a life-threatening condition of the mother, even if it is foreseen that such action will indirectly result in the death of the child. These painful situations for parents are handled every day in Catholic hospitals with competence and compassion. The exception is an elective abortion, which is rarely performed in a hospital. More than 95% of all elective abortions in the U.S. are performed in freestanding clinics.

A final point for clarification is where the article states that Catholic bishops in June started ordering Catholic hospitals to provide care consistent with Church teachings. Since the founding of U.S. Catholic hospitals in the 19th Century, the sanctity of human life has been at the core our mission. What the bishops did this summer was simply update a document that has been in existence since 1948. The revisions provide greater precision and clarity of what was stated in the preceding version last updated in 2014. It's important to note that the bishops also affirmed that partnerships between Catholic and non-Catholic institutions support the common good through models of responsible stewardship of limited resources that provide the poor and vulnerable with more equitable access to care. 

A point from the article that we do agree with and feel is important to highlight is that in some communities there is only a Catholic hospital. Hopefully readers will ask why that is. The simple answer is that Catholic health care – as it has done for the past two centuries – goes where there is a need. We choose to care for the most vulnerable among us and choose to locate and stay in communities challenged by poverty and lack of resources. While there are a few medical procedures we don't perform based on our beliefs, we offer a wide range of life-saving procedures that Americans have relied on and trusted us to deliver since the founding of our country.

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