On Dec. 30, Governor Steve Beshear announced that he could not approve the proposed new hospital network involving Jewish Hospital & St. Mary’s HealthCare and University Medical Center. At that time, in response to a reporter’s question, the archdiocese announced that I had found no moral barrier to the proposed network since compliance with the Ethical and Religious Directives for Catholic Health Care Services was ensured as reviewed by the appropriate experts at the National Catholic Bioethics Center.
Subsequent to the governor’s decision, Catholic Health Initiatives (CHI) announced that it was proceeding with the merger of Jewish Hospital and St. Mary’s HealthCare in Louisville and Saint Joseph Health System, based in Lexington, Ky., to form KentuckyOne Health.
My purpose in this column is not to comment on the technical analysis underlying the development of the health care network or on the due diligence of those who have reviewed it. Rather it is to clarify my role as archbishop.
At times, the public rhetoric has produced inaccurate depictions of the bishop’s role and inadequate reflections on the role of faith in the public square.
Catholic Health Initiatives had requested the approval from my office as part of the Church review process that must be applied to any entity that includes Catholic organizations that will carry out a Catholic health care ministry. In response, I issued a nihil obstat. These Latin words mean that “nothing stands in the way” and reflect a judgment by a church authority that a publication or action does not contain errors in faith or moral teaching and practice.
The role of the bishop in the proposed network is clear. I do not own or govern CHI and am not involved in decisions about the best way to deliver health care. As archbishop, I defer to experts in the field to run and govern health care institutions. My involvement is in preserving a morally sound Catholic identity and in making sure that our health care institutions are faithful to the call of the Church to make health care accessible to as many as possible, especially the poor and vulnerable.
I carry out my responsibilities through the Ethical and Religious Directives for Catholic Health Care Services (ERDs). These were established by the United States Conference of Catholic Bishops (USCCB) in the early 1970s and then revised most recently in 2009, partly in light of the cooperative ventures between Catholic institutions and other health care providers. These directives are prepared for bishops to use and promulgate within their dioceses, and it is compliance with the ERDs that was my serious and careful focus during this review process.
Hospital networks can be complex and involve moral intricacies that must be carefully addressed. Thus, my focus is on ensuring that the proposed network, though involving institutions that are not specifically Catholic, will not allow any actions that will cause CHI to fall out of compliance with the ERDs. In addition, the nihil obstat encourages respect for the contributions that the ERDs bring to safeguarding the dignity of the human person.
The analysis necessary to issue the nihil obstat was carried out very carefully to ensure that the proposed network is providing services that are clearly within morally acceptable parameters. I am grateful to the ethicists at CHI and to the moral theologians and bioethicists at The National Catholic Bioethics Center, who provided this ethical analysis.
Ultimately, this approval recognizes that the members of the network hope to combine the faith-based and academic heritages of the partners and that the partners have stated their commitment to foster, nurture and celebrate one another’s traditions, missions and values, including adherence to the Church’s Ethical and Religious Directives for Catholic Health Care Services in the Catholic entities.
This nihil obstat acknowledges that CHI will provide all necessary oversight to ensure that there is compliance on the part of the Catholic entities with the Ethical and Religious Directives and that no actions taken by the non-Catholic parties to this agreement will cause CHI to fall out of compliance with the directives. CHI has also agreed to an annual review of compliance by my office.
In the debate that has taken place about the originally proposed hospital network, some have questioned the role of religion. Certainly the issues are complex, and citizens have the right to ask questions, just as people of faith have the right to propose a vision for the common good. The laws of our land, grounded in the Constitution and Bill of Rights, allow us as good citizens to advocate for the common good in a way that does not deprive our civic and public life of the richness of religious convictions that also find their foundation in natural law and that are accessible through reason.
For example, both reason and our faith tell us that the direct, deliberate taking of human life is wrong. Thus, those motivated by both religious convictions and reason seek to propose laws that protect all of life from conception to natural death. This exercise of religious freedom must be done with civility and respect, but without it, our understanding of freedom may become shallow and may only reflect the lowest common denominators in our culture.
KentuckyOne Health leaders have said they will continue to seek ways to work with the university and the governor to assist with the issues facing University Medical Center. In doing so, CHI has assured me of its commitment to ensure that our Catholic health care remains faithful to its mission, especially as reflected in the Ethical and Religious Directives.
This has been a difficult and arduous process for all involved, but I know that the “bottom line” for Catholic Health Initiatives is commitment to the healing ministry of Jesus Christ as all involved seek a truly healthy commonwealth and better access to quality health care for the poor and vulnerable. Please continue to keep in prayer all those who exercise this vital ministry of our Church.