Irreconcilable Differences?

Reproductive health care could be the sticking point during consolidation talks between religious and secular hospitals

In light of the Berger Commission’s recommendations for restructuring New York state’s hospital system, several reproductive-rights advocacy groups are wondering whether the proposed consolidation of four religiously affiliated hospitals with their nonsectarian counterparts will result in a step backward for women’s health care.

“It is of the utmost importance to the reproductive justice and reproductive freedom of all the females in this country to keep the two trains on different tracks,” said Barbara Morrissey, president of the Albany-area chapter of the National Organization of Woman, of the need to maintain a separation between institutions with religious affiliations and those without.

The Berger Commission’s recommendations will affect the communities of Elmira, Kingston, Niagara Falls and Schenectady, where the commission identified Ellis and St. Clare’s hospitals for unification. The plan to combine Ellis and St. Clare’s comes as a double slap in the face to women’s health care, some say, because the Berger Commission issued the recommendation simultaneously with a proposal to close Bellevue Women’s Hospital in Niskayuna, one of only two exclusively women’s facilities in the nation.

JoAnn Smith, president of Family Planning Advocates of New York State, said that while she recognizes the need for hospital mergers, consolidations must occur under circumstances that will preserve progressive reproductive policy. She suggested it is possible for a religious and nonsectarian hospital to merge under terms that protect women’s health care, but said she is concerned that such conditions may not play out in the four cases outlined by the Berger Commission.

In its recommendation for the merger of the two hospitals in Kingston, the commission report suggests that the two should form a single governing structure and move reproductive services to a “proximate” location. The report further suggests that this model could become a prototype for other mergers between religious and secular facilities.

Had the consolidation recommendation stopped at calling for a unified governing body, Smith said she happily would have accepted the terms, but calling for moving women’s services to a “proximate” location crossed the line of reasonableness.

“Reproductive health care is part of a woman’s health, and for a nonsectarian hospital to agree to separate it, to move it away, to somehow indicate that it isn’t part of a regular hospital system, is just unacceptable,” Smith said. “It’s unacceptable to assume that a woman’s reproductive life can be shuttled to a different part of the equation. It’s not 1640. Women need to be treated with respect.”

The differences between how Catholic and nonsectarian hospitals practice women’s reproductive health care go beyond the most obvious difference in abortion policy. Catholic hospitals follow rules outlined in the Ethical and Religious Directives for Catholic Health Care Services. The directives include rules limiting abortions, tubal ligation surgery, certain sexual-health counseling such as prescribing birth control, and more.

Smith wondered whether moving women’s health care to a “proximate” location would mean all reproductive services would be required to occur within that premises. In other words, for example, would a doctor be able to provide counseling about a woman’s changing birth-control needs when she’s undergoing chemotherapy, or would a doctor be able to perform a tubal ligation for a woman who requested the surgery occur during her cesarean section?

According to David Sandman, executive director for the Berger Commission, there’s no need for fears such as those expressed by Smith because consolidation need only involve the unification of each hospital’s governing structure. Each hospital would maintain its own campus and identity. “To the average patient on the street, there are still two distinct hospital campuses and they have a choice of where to go,” he said.

Sandman said he’s familiar with the arguments reproductive-rights organizations raise against the consolidations, but he disagreed with their claims that the Berger Commission showed a disregard for women’s health care in its report.

“When you look at the specific merger that was recommended of Kingston and Benedictine, the recommendation shows extraordinary sensitivity and respect for the issue of women’s access to reproductive services, which is an absolute condition of bringing together Kingston and Benedictine hospitals,” Sandman said. “The fact that we made absolutely explicit provisions and protections for those services speaks for itself.”

Ceil Mack, a spokeswoman for St. Clare’s Hospital, said the hospital is not currently answering questions regarding the merger, and therefore declined to comment about whether consolidation in Schenectady would use the Kingston model. She did provide a statement issued jointly Dec. 5 by the chairmen of St. Clare’s and Ellis hospitals, which announced that they have accepted the recommendation of the Berger Commission.

Dennis Poust, director of communications for New York State Catholic Conference, said he could not comment because the mergers are currently considered individual diocese issues and the Catholic Conference has yet to choose a unified position.

Ken Goldfarb, director of communications for the Diocese of Albany, in which Schenectady County is included, said discussions about the unification are occurring internally within St. Clare’s and Ellis hospitals and that the diocese is waiting to see what develops before commenting.

Smith also is anxious to see what terms St. Clare’s and Ellis hospitals develop for their consolidation, but she maintained that her worry about the future of women’s health care is compounded by the Berger Commission’s an nouncement that Bellevue Women’s Hospital must close.

“The reason [Bellevue] has been important in our conversation is because it’s like, ‘You’re closing the only women’s hospital at the same time you’re putting restrictions on women’s health care?’ What’s the pattern here? It doesn’t look good,” Smith said. “So we’ve been trying to be supportive of Bellevue because we think that they’ve given a really nice community service. We will do whatever we can in this crisis to help them stay afloat, but our main concern is that women’s health care doesn’t disappear from the community.”

Despite the commission’s recommendation, Anne Saile, CEO of Bellevue Women’s Hospital, has vowed that “Bellevue is here to stay.” Supporters have rallied to keep the hospital from shutting down by submitting comments to area politicians, holding vigils outside the state Capitol and the hospital, and so forth.

“I’m steadfast against the closing of Bellevue,” Morrissey said. “I feel that the Berger Commission report was simply based upon only looking at a financial perspective as opposed to looking at the uniqueness of this one institution, which is extremely, extremely important to the woman who have had children there, to women’s health in general, and to all the babies who will be born there.”

—Nicole Klaas

nklaas@metroland.net

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