Pittsburgh Catholic Column: Jan. 4, 2008
What makes a health care facility Catholic?
by Dr. Charles J. Dougherty
Mercy Hospital is now owned by UPMC. How can it be a Catholic hospital when it is owned by a non-Catholic entity?
The answer is that the Catholic character of a hospital is determined not by ownership, but by how it is operated. The critical criterion is operation in accordance with the Ethical and Religious Directives for Catholic Health Care Services issued by the U.S. Conference of Catholic Bishops. No other hospital in the UPMC system follows the directives. UPMC Mercy does, and that — with the recognition of the bishop — makes it a Catholic hospital.
The directives were first published by the American bishops in 1981 to provide guidance against the background of the growing clinical power of contemporary health care. They have been revised several times since to keep them abreast of changes in health care and its delivery.
The directives are based on the church’s teachings on the meaning of death and suffering and on centuries of reflection on the application of natural law to the specific circumstances of health care. They are grounded in the special care that Jesus Christ displayed for the sick and dying. This provides Catholic health care institutions, health care professionals, and lay people caring for others’ health care needs with a special standing in the church. They are doing, on behalf of all of us, the healing work of Christ.
The directives also embody Catholic social teaching. Catholic hospitals should be institutions that care for the least well-off in society — the poor and the marginalized. They should be places where mutual respect prevails and where employees are treated fairly. And Catholic hospitals must be responsible stewards of their resources.
Pastoral care should be a distinctive mark of a Catholic hospital. There should be easy and regular access to prayer and the sacraments.
Catholic hospitals must also respect the right of patients to make informed decisions, including the right to prepare an advanced directive or to have another make such decisions as a surrogate when the patient is impaired. Patients also have the right to decline further treatments and to accept death when such treatments have become extraordinary — that is, when they offer no reasonable hope of benefit without imposing excessive risks and burdens. Of course, all these rights of patients are limited by the right of the hospital itself to operate in accord with Catholic principles, that is, in accord with the directives.
At the heart of Catholic teaching on health care is respect for life. A Catholic hospital must not perform abortions or any medical procedure whose immediate effect is the termination of pregnancy. Embryonic stem-cell research cannot be pursued for the same reason. Direct sterilizations may not be performed nor may treatments for infertility unless they are in line with church teaching on marriage.
The directives underscore the special commitment of Catholic hospitals to the dying. Patients deserve candor about their conditions to allow for spiritual preparation for death. Catholic hospitals should and do cooperate with legitimate requests to remove or refrain from imposing extraordinary measures. They should also maximize pain control, even if such measures indirectly hasten death. But they may not cooperate with requests from the dying or their representatives for euthanasia or any form of assisted suicide.
Great changes are occurring in health care and its delivery. More innovative arrangements in ownership can be expected. But the defining feature of a Catholic hospital is adherence to the Ethical and Religious Directives for Catholic Health Care Services. This was true in the past at Mercy Hospital. It is true today and it will continue to be true at UPMC Mercy.