Tuesday, February 21, 2012

"Appeal to Conscience Clauses in the Face of Divergent Practices among Catholic Hospitals"

Your Excellencies:

I have had the opportunity to read Dr. Sandra Hapenney's Appeal to Conscience Clauses in the Face of Divergent Practices among Catholic Hospitals," which is the dissertation referenced in the recent Philadelphia Inquirer article. As you know, that dissertation maintains that 7 of 8 New Jersey Catholic hospitals are performing direct sterilizations, and that St. Peter's in New Brunswick stands alone in NOT providing that morally excluded service (Kudos go to Ron Rak, President & CEO of Saint Peter's, who was one of the presentors at a 2/11/12 health care conference at St. Charles Borromeo Seminary. It certainly comes as no surprise that St. Peter's is home to the Gianna Center, which absolutely forgoes contraceptives and employs the pioneering NaPro Technology.).

As per the Philadelphia Inquirer article, "Bishop David M. O'Connell of the Trenton Diocese said in an e-mail that he had talked to hospital administrators and had 'been assured that procedures at Lourdes Medical Center of Burlington County were in compliance.'" On pages 1 & 2 of its code of ethics, it is indeed stated that:


  • "OLLHCS, Inc. has adopted a Code of Ethics as an expression of its identity as a Catholic Healthcare Organization and on behalf of the people it serves. A general framework for this code can be found in the Ethical and Religious Directives for Catholic Health Care Services, the codes of ethics of the various professional groups working within OLLHCS, Inc.,
    applicable state and federal laws, as well as other documents."
It is Dr. Hapenney's contention that "all hospitals assert that they are abiding by the ERD" (Ethical and Religious Directives for Catholic Health Care Services, 5th edition). Yet, her dissertation points out troubling interpretations of those directives. It is noteworthy that Our Lady of Lourdes' web site lists 28 physicians who specialize in Obstetrics and Gynecology:


  1. Michael M. Frattarola

  2. Katheryn Kaldor

  3. James D. Lavis

  4. Joseph Ombalsky

  5. Paul L. Schell

  6. Keith Williams

  7. David S. Hulbert

  8. Chike William Obianwu

  9. O'Flynn Leisa

  10. Michael H. Minoff

  11. Carl Christie

  12. Misa Belazi

  13. Nancy Hendrix

  14. Camille E. Semple-Daly

  15. Diana L. Scott

  16. Joseph Riggs

  17. Eytan R. Barnea

  18. Martin Hyman

  19. Sherrilynn H. Parrish

  20. Gregory Margolin

  21. Michael Horn

  22. Michael T. Snyder

  23. Derek Q. Chapman

  24. C. Linda Hopkins

  25. George H. Davis

  26. Francine M. Siegel

  27. Michael Zalkin

  28. Kenneth H. Chen
Your Excellencies, I am a native New Yorker and am prone to be suspicious. Cross checking the above list with a listing of NFP-only OBGYNs, I find NONE of the OBGYNs from Our Lady of Lourdes on the NFP-only listing (I would be delighted to learn that either the listing or myself is in error.). That being the case, it is challenging to believe that these OBGYNs are truly embracing the ERDs, when they are at Our Lady of Lourdes.

Dr. Hapenney also cautions us that "It is worth evaluating the practices of those health care systems included in the study which also operate in states outside the study area." Our Lady of Lourdes Medical Center falls under the Lourdes Health System, which in turn falls under Catholic Health East of Newtown Square in the Archdiocese of Philadelphia. In the Archdiocese, 5 hospitals are associate with Catholic Health East:
1) Mercy Fitzgerald (part of the Mercy Health System)
2) Mercy Philadelphia (part of the Mercy Health System)
3) Mercy Suburban (part of the Mercy Health System)
4) Nazareth (part of the Mercy Health System)
5) St. Mary Medical Center (part of Catholic Health East )
Historically, I believe that Catholic Health East has provided excellent reasons to be suspicious of their embrace of the ERDs:


  • "[A] Church-instigated challenge to medical ethics has arisen as a result of a grass roots protest...against the well-regarded St. Mary's Medical Center of Langhorne. In this case, Dr. Stephen Smith of St. Mary's performed an ultrasound on an expecting mother and confirmed that the fetus had polycystic kidney disease, a fatal condition in infants. Smith recommended an abortion....a private citizen named Joseph Trevington demanded a formal review of St. Mary's by the local archdiocese....a diocese spokesman stated that changes in the hospital policies are to be expected" (Huffington Post, 2/10/10). Two years later, Dr. Stephen Smith continues to be listed on the web site of Mercy Health Systems.

  • Dr. Smith is a partner of Dr. Frank Craparo, a popular practitioner of and published expert on euphemistically termed "reduction" (i.e., abortion). Until very recent, Craparo was also listed on the web site of Mercy Health Systems.
In advocating for ethics audits, Dr. Hapenney is in excellent company. In a July 2008 interview, Dr. John Haas of the National Catholic Bioethics Center spoke of direct sterilizations occuring in Catholic hospitals and also spoke of such ethics audits.


  • "you have a lot of non-Catholic physicians in Catholic hospitals. They are required to abide by the Ethical and Religious Directives, but they might not even know what they are or be familiar with them....Another difficulty is a lack of sound understanding of Catholic moral teaching....Ethicists are giving bishops bad advice, and some ethicists are unbelievably ill-formed themselves....[A] bishop who has a health care system told the CEO of the system to bring in the Bioethics Center for a complete ethics audit of the entire system. Hospitals already have medical audits and financial audits, and they should have ethics audits, too" (Our Sunday Visitor, July 2008).

Dr. Hapenney notes that



  • "A point of comparison would be...the mechanism implemented to protect minors from abuse. A best practices model would provide for the mandatory reporting of violations of the ERD to an independent review board with failure to report incidents leading to penalties or dismissal. Also, it would require the ethics committee of a hospital to be required to report all violations that come to their attention to an independent review board. The decisions of the ethics committee would also be mandatorily reviewed by an independent board. Another requirement would be that the hospital be required to report their patient diagnostic and procedure codes to an independent review board and ecclesial authorities on a periodic basis." Well said, indeed!

Your Excellencies, I have written to both of you, to applaud your statements on the draconian HHS mandates. Yet as per Dr. Hapenney, we are in danger of having conscience protections lost by practices at Catholic hospitals:




  • "Without oversight mechanisms in place, the lack of uniformity of practice among Catholic hospitals may pose a judicial risk to the hospitals if a legal challenge is made against a hospital to force the provision of sterilization procedures....Also at risk would be those individual health professionals who conscientiously object to involvement with procedures prohibited by the ERD when the Catholic hospital in which they practice allows those procedures."
As you know, I also believe that the inclusion of advertisers in parish bulletins from providers of prohibited services (e.g., abortifacients and contraceptives) undercuts Church teaching about the sanctity of human life and marriage/family.

Respectfully,

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