Preference is given to arrangements between Catholic organizations
By BETSY TAYLOR
The United States bishops have provided additional detail outlining how Catholic and non-Catholic organizations should work together to build health care collaborations.
Members of the United States Conference of Catholic Bishops voted June 14 to revise the Ethical and Religious Directives for Catholic Health Care Services. The nearly unanimous approval of the revisions came after several years of discussion and consultation with stakeholders, including ethicists from CHA and Catholic health systems.
The revisions are to Part Six of the ERDs. That section governs the collaborations and partnerships with health care organizations and providers — arrangements that have become increasingly common and complex in recent years. The introduction to Part Six now highlights "the unique and vitally important opportunities" opened through collaboration.
The revisions add five new directives that establish:
- If a health care system extends across multiple dioceses, it remains the responsibility of the bishop in each diocese where the system has affiliated institutions to locally approve a prospective collaboration, or to grant "nihil obstat" — which is to say that the bishop has no objection to it based on doctrinal or moral grounds. The diocesan bishop where the system's headquarters is located is charged with initiating a collaboration with the other bishops in affected dioceses. The bishops should make every effort to reach a consensus.
- Collaborations under the control of a Catholic institution "whether by acquisition, governance or management" must be operated in full accordance with the church's moral teaching, including the ERDs.
- It is not permissible to establish another entity to oversee, manage or perform immoral procedures. The act of establishment includes drawing up civil bylaws, policies or procedures, setting up finances for or legally incorporating such an entity.
- Representatives of Catholic health care organizations who sit on governing boards of non-Catholic organizations that do not follow the ERDs should voice opposition to immoral procedures and not consent to decisions "proximately connected" with such procedures. "Great care must be exercised to avoid scandal…," according to the ERDs. In this context, scandal is using power in a manner that leads others to do wrong.
- If it is discovered that a "Catholic health care institution" might be cooperating with immoral procedures, the bishop who is the local ordinary should be informed immediately. The institution's leaders should resolve the situation as soon as reasonably possible.
Fr. Bouchard
Hibner
Fr. Charles Bouchard, OP, CHA's senior director of theology and ethics, and Nathaniel Hibner, CHA's director of ethics, published an initial analysis of the revisions to Part Six of the ERDs in the summer 2018 issue of Health Care Ethics USA. It is available at chausa.org/HCEUSA.
The CHA ethicists wrote that the revisions do not contain new teaching and are in "clear continuity with previous editions of the ERDs and with the Catholic moral tradition."
"Most of this is clarification and it reflects current practice," Fr. Bouchard said in an interview. He said the bishops recognized the opportunities collaboration presents for the common good and that quality health care requires collaboration.
Fr. Kopfensteiner
He said that leaders of Catholic health systems work to build strong relationships with local ordinaries. Trust built through ongoing dialogue between health care executives and local bishops helps ensure that business collaborations are framed in a manner consistent with church teachings.
Hibner said CHA appreciates the bishops' work to clarify practices related to collaborations between Catholic and other-than-Catholic organizations and the opportunity the bishops provided for direct dialogue with many in the Catholic health care ministry.
Fr. Tom Kopfensteiner, executive vice president of mission for Englewood, Colo.-based Catholic Health Initiatives, worked on the previous edition of the ERDs. He said the 2018 revisions reflect the "Principles for Collaboration" issued by the Vatican's Congregation for the Doctrine of the Faith in 2014. Those principles were intended to guide the formation of Catholic organizations with other-than-Catholic institutions.
Fr. Kopfensteiner said the June revisions highlight that Catholic institutions can "partner with other-than-Catholic partners as a vehicle for Catholic interests."