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Good News From Kentucky!

2011 closed with good news out of Kentucky. On Friday Governor Steve Beshear refused to approve a Louisville hospital merger that threatened patient choice. Compassion & Choices, MergerWatch, the National Women’s Law Center and other national advocacy organizations joined local activists to raise constitutional and public policy questions regarding potential threats to end-of-life and reproductive care. In announcing his decision, Gov. Beshear noted “significant legal and policy concerns.”

Religious doctrine limits patient choice in over 600 of our nation’s hospitals, nursing homes and HMOs. When a Catholic healthcare institution merges with a non-sectarian one, the Ethical and Religious Directives for Healthcare (ERDs) invariably control care provided by the merged entity. Compassion & Choices is committed to joining patient rights advocates to oppose the imposition of religious restrictions wherever the threat arises.

This proposal ceded control of Louisville’s only public hospital to a Catholic healthcare company (St. Joseph Health System), and placed healthcare decisions in the hands of the local bishop and the United States Conference of Catholic Bishops. We applaud Governor Beshear for exercising good stewardship and ensuring that University Hospital (UNL) serves the public interest and needs for future generations of Kentucky citizens. “If this merger were allowed to happen,” Beshear said, “UNL and the public would have only indirect and minority influence over the new statewide network’s affairs and its use of public assets.”

Despite assurances from architects of the merger, loss of public influence in healthcare could have disastrous consequences for the people who depend on publicly funded healthcare. The people could never again rely on their public institution to place the highest priority on community needs. The ERDs that govern Catholic healthcare enforce Catholic doctrine. Staff and administrators must balance that doctrine, when possible, with community needs. Some options remain forbidden, no matter how great or pressing the need may be. This balance can leave the community with uncertain and unpredictable service.

A doctor at St. Joseph Hospital – a defender of St. Joseph’s Catholic identity – wrote of the confusing and contradictory statements made by hospital officials:

An Oct. 24 (Louisville) Courier-Journal article noted that on June 14, U of L Dean Halperin, “made a promise that we’ll respect the ERDs of the Catholic Church,” and on June 30, University Hospital CEO James Taylor stated, “we’ve also made the commitment that by joining the network with (SJHS) … we will adhere to the ERDs.”

Now that a merger might be imminent, a different stance has surfaced. The merger partners state in an Oct. 19 Metro Board of Health (BOH) release that University Hospital “will not become a Catholic hospital and will not be required to follow the ERDs.”

The Courier-Journal calls this “legal mumbo-jumbo.” Nonetheless, University Hospital spokesman David McArthur would not concede that it was a position change, but “an evolution of our explanation.”

Without governing authority, UNL and the citizens it serves could be forever tossed like a kite upon the changing winds of “evolving explanations” and changes in Church policy. In recent decades, the Vatican has become more conservative and U.S. bishops have required stricter obedience from Catholic healthcare institutions. No one can predict how Catholic doctrine or enforcement may change in the future, and once a public institution is lost, its accountability to the public welfare is lost forever.

So we welcome the new year with a celebration of effective community advocacy and a toast to elected officials who act in the public interest. Kentucky Reps. Mary Lou Marzian and Tom Burch helped inform the governor of advocates’ concerns and urged him to stand up for all Kentucky residents and their right to comprehensive healthcare. We remain watchful. Announcing his decision, the governor said “… I have determined that this proposed transaction is not in the best interest of the commonwealth …” The emphasis was his. Compassion & Choices will resist any proposal – in Kentucky or elsewhere – that fails to safeguard patient rights to a full range of end-of-life healthcare choices

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BarbaraCoombsLee

BarbaraCoombsLee

Barbara Coombs Lee is President of Compassion & Choices, a non-profit organization dedicated to expanding and protecting the rights of the terminally ill. She practiced as a nurse and physician assistant for 25 years before beginning a career in law and health
policy.

Since then she has devoted her professional life to individual choice and empowerment in health care. As a private attorney, as counsel to the Oregon State Senate, as a managed care executive and finally as Chief Petitioner for Oregon’s Death with Dignity Act, she has championed initiatives that enable individuals to consider a full range of choices and be full participants in their health care decisions.

Ms. Lee took her undergraduate education at Vassar College and Cornell University and obtained advanced degrees in law and medicine from the University of Washington and Lewis & Clark College. She holds an adjunct position at the University of Washington School of Public Health and Preventative Medicine and is a member of the Oregon State Bar.

She has been interviewed by NBC News, CNN Crossfire, 60 Minutes, McNeil Lehrer News Hour, NPR, The Today Show, and Bill Moyers’ “On Death and Dying” among others. She has also testified before the US Congress on end-of-life issues.

She has been recognized with a national health Policy Fellowship, Boeringer Ingeheim Foundation, an American Jurisprudence Award for outstanding performance in the study of medical law and a National Health Lawyers Association scholarship for outstanding student achievement.

Ms. Coombs Lee has been a presenter at programs sponsored by American Bar Association, Older Women’s League, American Pain Society, Oregon State Bar, Americans for Better Care of The Dying, American Associations for the Advancement of Science, End of Life Concerns, and the American Pain Society. She spoke at the World Federation Right to Die conference in Zurich, Boston and Brussels.
Her audiences have included the Oregon Gerontological Association: the California Nurse Assembly & Education Conference. Her debate “Doctor Assisted Suicide: Compassionate Alternative or Murder” with James Bopp, Jr., was produced by “Justice Talking” a project of the University of Pennsylvania’s Annenberg Public Policy Center
for Public Radio.

Since Gonzales v. Oregon, the lawsuit defending the Oregon assisted-dying law, Ms. Coombs Lee has been interviewed by many of the nation’s newspapers. She has been quoted in the New York Times, The Washington Post, The Chicago Tribune, and on NPR’s All Things Considered. Recently, The Harvey M. Meyerhoff Lectures on Ethics at the End of Life hosted her presentation “Local Medical Practice and the Federal Threat” at Johns Hopkins University.