Commentary: Hoag has agreed to far-reaching dogma

Many people have wondered what kind of health care still will be available at Hoag after its recent affiliation with the Catholic organization St. Joseph Health System.

The questions focus on women’s reproductive services and on end-of-life decisions, because it is commonly known that the Catholic religion has great concern and concomitantly rigid directives about them.

This is not the first such affiliation for a Catholic health system, so some insight into Hoag’s future might be found by examining other affiliations of non-Catholic hospitals with Catholic hospitals. There shouldn’t be much variation, if any, among the affiliations, since all Catholic hospitals have to obey the comprehensive directives of the “Ethical and Religious Directives for Catholic Health Care Services” prescribed by the U.S. Conference of Catholic Bishops.

Dignity Health is an affiliation similar to Covenant Health Network, the one Hoag is in. Dignity, like Covenant, is a secular nonprofit. Covenant now operates Hoag’s two non-Catholic hospitals and SJHS’s four Catholic hospitals.

Dignity Health used to be called Catholic Healthcare West. CHW was a large Catholic healthcare system that had some non-Catholic hospitals as members. CHW got in trouble with the overseeing bishops because it had given non-Catholic hospitals freedom to ignore certain Catholic moral and social teachings.

The solution had two parts: (1) Get the Catholic church out of such close involvement with non-Catholic hospitals by substituting a secular organization – Dignity Health – to operate the system; yet (2) keep the non-Catholic hospitals in line with Catholic morals and teachings by requiring them to agree to honor a so-called Statement of Common Values. While Dignity’s Statement has the appearance of an anodyne document mostly full of warm fuzzies, it actually contains some ERDs critical to the Bishops, but couched in innocuous words.

It achieved the desired result: As of Jan. 24, 2012, Catholic leaders in San Francisco could say that their hospitals would not be scandalized by closely cooperating with non-Catholics, and non-Catholic hospitals could tell their donors that they had not turned Catholic.

Ten months later, here in Orange County, SJHS composed a similar Statement of Common Values, dated Dec. 12, 2012, that Hoag has apparently agreed to in its effort to gain greater clout for the expected competition in 21st century healthcare.

It contains the crucial sentence: “We believe that respecting the dignity of persons requires wonder and reverence at every moment of life — from natural conception to natural death.”

This seemingly innocuous sentence must be interpreted in light of the special meanings the ERDs give to the words. When this is done, it turns out that agreeing to the statement means Hoag is agreeing to some far-reaching Catholic dogma that is contrary to traditional Hoag practice:

• Hoag agrees that a life begins at “the moment of conception,” as opposed to at “quickening” or any other time.

• Hoag agrees that “natural conception” means no assisted conception, such as homologous artificial fertilization, as with in vitro fertilization, even when “using the gametes of the two spouses joined in marriage.”

• Hoag agrees that “natural death” prohibits so-called direct abortions (“the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus,” even for a life-threatening ectopic (extrauterine) pregnancy such as tubal pregnancy.

• Hoag agrees that “natural conception” also means that “direct” contraceptive practices shall not be promoted or condoned. This includes both male and female sterilization as well as condoms, diaphragms, IUDs, “the pill” and the “morning-after pill.”

• Hoag agrees that, regarding judgments made by “competent” adult patients at the end of life, “use or withdrawal of life-sustaining procedures should always be respected and normally complied with, unless it is contrary to Catholic moral teaching.”

Dignity’s Statement of Common Values has a similarly crucial – and elliptical – statement: “For Dignity Health, respecting the dignity of persons requires reverence at every stage of life’s journey from conception to natural death.”

But it also contains chillingly direct statements: “Therefore, direct abortion is not performed.” Further, “Reproductive technologies in which conception occurs outside a woman’s body will not be part of Dignity Health’s services. This includes in vitro fertilization.”

All in all, Hoag’s affiliation with SJHS is reminiscent of the wooden horse that the Greeks gifted to the city of Troy: attractive exterior, but dangerous interior.

TOM EGAN lives in Costa Mesa.