The local hospital district Commissioners told citizens attending the Wednesday, August 28 commission meeting the state Attorney General's opinion, which stated hospital districts must comply with state laws and offer the full range of women's reproductive services, is only an opinion.
The board is asking their attorney for his interpretation, he negotiated the 50-year contract with PeaceHealth. The hospital district turns over the property tax collected for the district to PeaceHealth.
The healthcare organization is a healthcare mission of the Sisters of St. Joseph of Peace who answer directly to the Vatican.
PeaceHealth's website states it abides by the Bishop's ethical and religious directives. Those directives don't allow abortion even in the cases of rape or life-threatening ectopic pregnances; don't allow contraception; euthanasia; assisted suicide; direct sterilization; or treatments based on some types of stem cell research.
Commissioner Michael Edwards did not know PeaceHealth's website contained the statement that they abide by the Bishop's directives. Commission Chair Lenore Bayuk confirmed it was there.
Edwards stated at the Aug. 28, 2013 meeting that PeaceHealth was one of three entities that had received special exemptions from the Vatican. Sister Pruitt was not at the Aug. 28 meeting.
During a discussion during a board meeting last fall Sister Kathleen Pruitt made it clear, it's the bishop's policy on these issues that matters and they will not disobey the bishop.
Some of the directives, including one regarding advanced directives, are posted at the end of this article. It should be noted advanced directives and death with dignity were not addressed in the AG's opinion. The question presented to the AG concerned public funds and state law.
Four of the five commissioners said they hadn't made up their minds about whether changes were necessary.
Commission Chair Lenore Bayuk said, "I feel good about what we are providing."
Commissioner Michael Edwards several times told the assembled citizens this affects more than the local hospital and the board would be consulting the hospital association to see what other districts are going to do.
An audience member reminded the board that citizens were their constituency not PeaceHealth.
Some of the commissioners' confusion may be because the AG's opinion referred to two separate RCWs:
"It is clear under the statute, however, that public hospital districts may not administer or fund programs to provide "maternity care benefits, services, or information to women" without also making provision for the rights secured by RCW 9.02.100 and .160."
RCW 9.02.100 The state may not deny or interfere with a woman's right to choose to have an abortion prior to viability of the fetus, or to protect her life or health.
RCW 9.02.160. No person or private medical facility may be required by law or contract in any circumstances to participate in the performance of an abortion if such person or private medical facility objects to so doing. No person may be discriminated against in employment or professional privileges because of the person's participation or refusal to participate in the termination of a pregnancy.
The term "state" includes hospital districts. Reading the AG's opinion it is clear the hospital district must provide the reproductive services approved by voters - if any type of maternity care or information is provided. The other RCW gives private hospitals an out but not hospital districts . (emphasis added).
Commissioner George Foster believed people did not understand the services already provided and referred to having to deal with the "stupidity void" He also said after other media reports he received death threats and calls telling him: "I hope you burn in hell."
Commissioner Rosanna O' Donnell who had started off the meeting by stating she did not understand the document and would need someone to read it to her, said. "I don't want to form an opinion. I need to be told by an attorney."
Bayuk and other commissioners repeatedly emphasized at the August 28 meeting that contraception is provided at PeaceHealth Peace Island Medical Center. The commissioners also noted the assurances PIMC CEO Jim Barnhart has given about such things continuing to be offered.
The tendency on the board to make the issues personal - stating their opposition to death with dignity for example - was frustrating to many in the audience. The personal aspect included the Commissioners taking the questioning from the audience during the public comment period as personal attacks on them and a lack of appreciation for the work that went into the creation of PIMC.
Bayuk's husband John Stamey rebuked Dr. Geyman during what was supposed to be a dialogue between the audience and the board members. Stamey asked him what he had done to help when Inter Island Medical Center was fiscally not sustainable. When he said, "Do you mean killing?" in response to Geyman's concerns about providing Death with Dignity, a man in the audience interrupted and told the board he was not attending the meeting to listen to conversations between audience members.
Another man asked Bayuk to take control of the meeting.
San Juan Island and Seattle resident Monica Harrington, catholicwatch.org, who is a leading advocate for not having someone else's religion affecting another's medical care, said, "This is so not personal. I am concerned about a 50-year-agreement. The people on the board now won't be here 20 years from now. You need to be assertive to protect patients' rights.
Several times people attempted to lower the hostility in the room. By the end of the hour-long question period things had settled down somewhat.
Commissioner Keri Talbott said, "I want to honor the agreement with PeaceHealth and as a public servant I want to help. I want to give the community what they need and want. I want to do the right thing but I don't know what that is."
The meeting was adjourned with still the only actions the board committed to was speaking to their attorney and researching the actions of other districts.
Edwards said, "Have faith in us."
Some of the 72 Religious and Ethical Directives
Directive 5: Catholic health care services must adopt these Directives as policy, require adherence to them within the institution as a condition for medical privileges and employment, and provide appropriate instruction regarding the Directives for administration, medical and nursing staff, and other personnel.
Directive 24. In compliance with federal law, a Catholic health care institution will make available to patients information about their rights, under the laws of their state, to make an advance directive for their medical treatment. The institution, however, will not honor an advanced directive that is contrary to Catholic teaching. If the advance directive conflicts with Catholic teaching, an explanation should be provided as to why the directive cannot be honored.
Directive 36. Compassionate and understanding care should be given to a person who is the victim of sexual assault. Health care providers should cooperate with law enforcement officials and offer the person psychological and spiritual support as well as accurate medical information. A female who has been raped should be able to defend herself against a potential conception from the sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum.
Directive 39. Those techniques of assisted conception that respect the unitive and procreative meanings of sexual intercourse and do not involve the destruction of human embryos, or their deliberate generation in such numbers that it is clearly envisaged that all cannot implant and some are simply being used to maximize the chances of others implanting, may be used as therapies for infertility.
Directive 44. A Catholic health care institution should provide prenatal, obstetric, and postnatal services for mothers and their children in a manner consonant with its mission.
Directive 45. Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo. Catholic health care institutions are not to provide abortion services, even based upon the principle of material cooperation. In this context, Catholic health care institutions need to be concerned about the danger of scandal in any association with abortion providers
Directive 48. In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion. 31 (Footnote 31: Cf. directive 45.)
Directive 52. Catholic health institutions may not promote or condone contraceptive practices but should provide, for married couples and the medicalstaff who counsel them, instruction both about the Church’s teaching on responsible parenthood and in methods of natural family planning.
Directive 53. Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution. Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available. 34 (Footnote: 34. Cf. Congregation for the Doctrine of the Faith, "Responses on Uterine Isolation and Related Matters," July 31, 1993, Origins 24 (1994): 211-212)
After an earlier story appeared referring to Directive 48 the following comments were sent in by PeaceHealth:
While any individual is free to interpret the Ethical and Religious Directives of the Catholic Church, it is inaccurate to represent one's own interpretation as that of a health care organization. We acknowledge the ERD's can be confusing, but they are based on centuries of ethical thought and study, and not easily interpreted by laypeople.
The bottom line – in unvarnished language – is that there are zero issues when it comes to properly treating ectopic pregnancy in our facilities.
How are ectopic pregnancies handled at PeaceHealth hospitals?
Regarding ectopic pregnancy, PeaceHealth employs the same standard of care as any other hospital to remove the pathological tissue that threatens the life of the mother. Standard of care for ectopic pregnancies is to inject the drug methotrexate or to remove the pathological tissue which, unavoidably, results in the death of the embryo, while leaving the fallopian tube intact with the intention of preserving fertility.