Jerry Kopel

KOPEL: HOSPITAL MERGER DICTATES END-OF-LIFE CARE

Don’t let the Sisters determine my fate

People who have health insurance through Kaiser should know what is contained in “Ethical and Religious Directives for Catholic Health Care Services, Fourth Edition,” a 16-page directive drafted by — and designed to guide — Catholic bishops across the nation regarding treatment of hospital patients. The directive covers the “Catholic moral principles” that patients will have to deal with, whether or not they agree with that standard.

Exempla Lutheran, Exempla Good Samaritan, Exempla Healthcare, Exempla Saint Joseph and Exempla System Services all lost leadership through the transfer of powers to the Kansas-based Sisters of Charity of Leavenworth, Kan. 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 usually are treated at medical facilities involved in this recent transfer of ownership and management. (Swedish Medical Center, in Englewood, which also is used by Kaiser, is not under Exempla.)

Religion is discussed in the directive, which says the director of pastoral care in each facility should be a Catholic unless an exemption is approved by the diocesan bishop. Thus, Protestants, Jews or Muslims — regardless of whether they accept the bishops’ directive, cannot be appointed without specific approval by the bishop.

In early January, new Exempla Board Chairman William Murray announced the dismissal of five officers from positions of authority in the hospital system and announced their replacements.

I expected a strong sectarian defense of an anti-abortion position, and we got one. The Wall Street Journal has said 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 limits choices available within the now seriously sectarian hospital system.

The major speaker at the City Club event was attorney Frances Koncilja, who blamed state Attorney General John Suthers for failing to stop the hospital takeover.

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 bishops’ directive bans discrimination against employees based on race, sex, age, national origin, disability or rights to bargain collectively — but not religion.

Sisters of Charity did not pay the former hospital authority for the property. Hopefully, they will use some of their savings 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 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.

Conception occurring other than by copulation between a married man and woman is the “wrong way,” says the directive. Fertilization involving a donor other than the spouse, homologous artificial fertilization for extra-corporeal conception and surrogate motherhood get a definite “no.” Nothing is allowed that would hurt a baby that has been conceived. In fact, if the unborn child has a serious defect, fetal diagnosis is not permitted if the outcome might result in an
abortion.

Only if there’s a real possibility that the mother would die if the pregnancy were taken to term would an abortion be permitted under the bishops’
directive.

Religion is there at the last moment if a newborn infant is in danger of dying or has 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:

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. The directive has wriggle room, but not enough for me. The directive instructs that food and drink be given to the dying even if that is contrary to decisions made as advance direction under Colorado statutes and 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 Catholic 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, there’s 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 also will be provided reminders of and an understanding of the redemptive suffering of Christ.

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.