Bishop Thomas Olmsted

I have written before about the holy war that flared up last year between Bishop Thomas Olmsted of Phoenix and St. Joseph’s Hospital and Medical Center. (See the stories here and here.)

The trouble brewed over an emergency procedure the hospital staff performed. It terminated a pregnancy, but saved the life of the mother. Instead of the reaction you might expect—sorrow for the loss paired with praise for the medical team—we were witness to the bishop’s recriminations and ultimate statement that a Catholic sister who had participated in the decision to save the mother’s life was essentially excommunicated.

The firestorm that grew up nationwide surprised many. And perhaps most surprising was the support that the hospital received. Now stripped of its “Catholic” status (but keeping its oh-so-Catholic name), the facility continues to serve a community it has served for generations.

Today, New York Times columnist Nicholas D. Kristof examines the debate anew. In “Tussling Over Jesus,” he dissects the jarring intersection of world views that played out in Phoenix. Most interesting, he points out that the clash is nationwide, and growing in frequency:

“Make no mistake: This clash of values is a bellwether of a profound disagreement that is playing out at many Catholic hospitals around the country. These hospitals are part of the backbone of American health care, amounting to 15 percent of hospital beds.”

“Already in Bend, Ore., last year, a bishop ended the church’s official relationship with St. Charles Medical Center for making tubal ligation sterilizations available to women who requested them. And two Catholic hospitals in Texas halted tubal ligations at the insistence of the local bishop in Tyler.”

Nicholas D. Kristof

When I wrote about this in December, I pondered on a simple and pragmatic question: What care would I receive if I were admitted to a Catholic hospital? Given that I had always indicated on my insurance data that St. Joe’s was my hospital of choice, should I reassess? Would they give me not the best care possible, but just the best Catholic care possible?

“You see, when it comes to doctoring around with the human body, I may be like a lot of people: I prefer the scientifical over the pontifical. Health care decisions are supposed to be about a lot of things, but they are not supposed to be about who wears the bigger hat.”

Kristof read my mind. His column today includes these startling sentences:

“The National Women’s Law Center has just issued a report quoting doctors at Catholic-affiliated hospitals as saying that sometimes they are forced by church doctrine to provide substandard care to women with miscarriages or ectopic pregnancies in ways that can leave the women infertile or even endanger their lives. More clashes are likely as the church hierarchy grows more conservative, and as hospitals and laity grow more impatient with bishops who seem increasingly out of touch.”

As the “health care debate” rages around the country, it is striking that we have a health care debate of our own right here in town. This debate goes back centuries, but its resolution may say a lot about modern-day America.

Bishop Thomas Olmsted

At today’s 10:00 a.m. press conference, the Catholic Diocese of Phoenix stripped St. Joseph’s Hospital and Medical Center of its “Catholic” status. The result stemmed from a controversy between Bishop Thomas Olmsted and the hospital over a procedure that the bishop has called an abortion.

We wrote earlier about the situation here.

The full story is here.

Bishop Thomas Olmsted

This month, the Catholic bishop in Arizona has given people a lot to think about. And that may not be a good thing.

A controversy began brewing December 15, when the Arizona Republic reported that the Phoenix diocese’s bishop, Thomas J. Olmsted, had mailed a letter to the hospital administrators. He told Catholic Healthcare West—parent company of St. Joseph’s Hospital and Medical Center—that its “Catholic status” was hanging in the balance. To ensure that status continued, the hospital must accede to the bishop’s demands.

The conflict began over a medical procedure. At least, the people who run the hospital’s operations thought it was a medical procedure. But it turns out that it was a spiritual procedure.

The Republic described the November 2009 genesis of that debate:

“A pregnant woman at the hospital suffered from pulmonary hypertension, a condition that limits the ability of the heart and lungs to function and is made worse, possibly fatal, by pregnancy. After consulting with Sister Margaret McBride, a member of the hospital’s ethics committee, doctors terminated the pregnancy.”

“Olmsted condemned the surgery as an abortion, which is prohibited by church doctrine, and at the time said the decision effectively meant the excommunication of McBride, a St. Joseph’s vice president.”

The bishop is no shrinking violet—first he issued a sort-of excommunication, and then a demand letter. His correspondence to the hospital pulled no punches in setting out his terms:

In order to retain his support, he said, Catholic Healthcare West must:

  • Acknowledge he was right and the hospital was wrong in its interpretation of a church health-care directive regarding so-called indirect abortions.
  • Submit itself to a diocesan review and certification ‘to ensure full compliance’ with Catholic moral teachings. Olmsted wrote that the certification would be similar to other accreditations that hospitals seek.
  • Agree to give its medical staff ongoing training on the Ethical and Religious Directives, a document from the national bishops council that explains Catholic moral teachings for health-care providers.

“‘Failure to fulfill these requirements will lead me to decree the suspension of my endorsement of St. Joseph’s Hospital, forcing me to notify the Catholic faithful that St. Joseph’s Hospital no longer qualifies as a ‘Catholic’ hospital,” the bishop wrote.

He was right and they were wrong. What could be clearer than that?

There may be legal remedies each party may pursue, but it appears the bishop is within his rights in the hierarchy to require his demands be enforced.

The conflict has spurred a national debate. We also learned that the bishop extended the deadline by which Catholic Healthcare West must reply (from December 17 to December 21).

And then at about 6:00 p.m. Monday, word came out that the diocese would be holding a press conference Tuesday morning at 10:00 a.m.

Of course, the press conference is almost immaterial, because in this canonical dustup, the bishop has already won. He has communicated what he sought: The hospital is under his control, through and through.

And that’s why many people may rethink their health care choices.

In my own case, I have always indicated on all my insurance information that St. Joe’s is my choice in the event of an emergency. It’s close to my house, it’s been around forever. And it has—had—a good name.

But I am reassessing that choice.

You see, when it comes to doctoring around with the human body, I may be like a lot of people: I prefer the scientifical over the pontifical. Health care decisions are supposed to be about a lot of things, but they are not supposed to be about who wears the bigger hat.

So as I said, the bishop has already won. No matter what response the hospital makes—and you know they do not want to anger this bishop—many people may now be sufficiently wary about how medical decisions are made in that institution. If they are cautious about their health, and not privy to hospital–church backroom negotiations, they may move their body-business elsewhere, if they have the opportunity. I know I will.

Even if the hospital takes a strong public stand, there is no doubt that the administrators were shaken by the bishop’s power play. So how will that affect patient care? For us average patients, will your doctor–priest at St. Joe’s provide full disclosure of every option they could provide—if you were at a medical hospital—but that they are not—because you are at a religious hospital?

The diocese may say that this was a single procedure, hardly a blip on the mass of procedures the hospital performs every day.

But it was a procedure that saved a woman’s life, which the bishop has deemed an “abortion.” Now there are suggestions that tubal ligation, no matter the reason performed, will be prohibited. So it’s not one thing, but potentially many.

Perhaps the diocese has a problem with any procedure that comes into close proximity of reproductive organs.

Well, Bishop Olmsted, to quote a fellow traveler: Don’t touch my junk.

One biographical note that counts as full disclosure:

In the 1940s, my wife’s grandfather was driven up to St. Joe’s with a serious injury. I’m sure he was confident that the Sisters of Mercy would take good care of him. But after taking one look at the Japanese American man, the sister on duty did her duty—and turned him away. So I suppose being a discriminating provider is not such a new thing. But at least that nun’s judgmental nature, which also trumped best medical practices, was right up front. This month’s process has been more behind the scenes.

We’ll see what edict is handed down this morning. In the meantime, I may change my insurance forms to indicate Good Samaritan Hospital as my first health care choice.