Texas Catholic hospitals did not follow Catholic ethics, report claims


Huntington, Jul 3, 2008 - At least 9,684 sterilizations and even some abortions may have been performed at Catholic hospitals in Texas between 2000 and 2003, a whistleblower report based on state records alleges. While Catholic ethical directives are supposed to govern Catholic healthcare systems, the report claims that "all six US Catholic hospital systems operating in Texas do not follow these directives."

The July 13 issue of Our Sunday Visitor examines the anonymous group's report, based upon data from the Texas government, which requires most major hospitals to file information from inpatient records. The group reportedly includes a self-described biostatistician who says she worked with four other people, including a computer scientist and a medical ethicist. The biostatistician says the group chose to remain anonymous because of "concern over job loss or retaliation."

According to Our Sunday Visitor, the researchers said they were motivated by a desire to increase transparency and accountability in Catholic hospitals, to inform the public about practices in Catholic health systems, and to encourage accountability for the Religious sisters who own and run the systems. The researchers believe the unethical practices could be taking place nationwide.

The data used in the report covers procedures performed between 2000 and 2003 at the Texas facilities of Ascension Health System, CHRISTUS Health System, Franciscan Services Corporation, Sisters of Mercy Health System, Trinity Mother Frances Health System and St. Joseph Health System of Orange, California. The researcher said her group had to purchase the state data at a cost of $4,600 per year, with more recent data being prohibitively expensive.

The report says that, according to state data, 9,684 instances of allegedly unequivocal "sterilization for contraceptive purposes" were performed in the 2000-2003 time period. The state data also indicates 39 abortions were performed at Catholic hospitals during the same period, but such statistics may record morally licit procedures such as the removal of a stillborn baby or emergency services for an abortion performed elsewhere, according to Our Sunday Visitor.

The researcher told Our Sunday Visitor that the abortion coding used in the state data is complex and must be studied on a case-by-case basis.

Joining together with the Catholic Health Association, the six Catholic health systems examined in the report issued a statement saying they are committed to "serving in fidelity" the Ethical and Religious Directives for Catholic Health Care Services (ERDs), which are the national standards for Catholic medical ethics. The healthcare providers also said some of the report's data could be open to interpretation "and cannot be taken to infer immoral practices."

The statement further argued that the numbers may not "reflect current practices," saying some data codes indicate licit "indirect" sterilizations or could be due to joint operating agreements, no longer in effect, that allowed non-hospital staff to perform sterilizations on-site.

"The Catholic health ministries in Texas are engaged in investigating and interpreting the meaning of the data in the report and are in direct conversations with their bishops," the statement said, according to Our Sunday Visitor.

Professors of biostatistics consulted by Our Sunday Visitor said a surface review of the report's methodology looked reasonable.

Obstetrician/gynecologist Dr. Lorna Cvetkovich at the Tepeyac Family Center in Fairfax, Virginia, told the magazine that many Catholic hospitals now have non-Catholic boards and administrators who see Catholic directives as impediments to financial solvency.

"They rationalize that if they don't offer the full smorgasbord of contraception, abortion, sterilization, and Assisted Reproductive Technologies, patients will go elsewhere for those services, as well as for delivery of their babies, and thus they will lose the small financial margin which allows them to care for the underserved," Dr. Cvetkovich said.

She added that the problem is compounded by "the great confusion over Catholic teaching on contraception and sterilization over the past 40 years."

Catholic hospitals also face ethical dilemmas in hospital mergers and state legislation, some of which could require contraceptives to be distributed and sterilizations or even abortions to be performed.