Dr John M

cardiac electrophysiologist, cyclist, learner

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When religion intersects healthcare reform

January 1, 2012 By Dr John

The gusty winds of healthcare reform have recently swept through my city, Louisville KY. Similar to what is happening across the US, hospitals in Louisville seek consolidation. Strength be in numbers and in control of patients.

The problem with merging University of Louisville Hospital (public), Jewish Hospital and St Mary’s and Elizabeth Hospital (both private) was that ultimate control of the merged system would have rested in the Denver-based Catholic Health Initiative.

Of course, you can probably guess the issue:

In regards to women’s reproductive health, Catholic doctrine severely impacts medical-decision making. It’s not just banning abortion; common therapies like prescribing oral contraceptives and tubal ligation would be prohibited. An especially scary scenario here involves the management of ectopic pregnancy, where abortion of the (ultimately inviable) fetus is required to save the life of the mother. Technically, Catholic doctrine prohibits the only acceptable therapy.

Merger proponents argued that the benefits of the merger–financially propping up University Hospital, which serves the indigent and provides medical education–would ultimately serve the community as a whole. Proponents cite arrangements for reproductive services at a nearby hospital. Basically, they argue that the benefits of the merger outweigh the costs. One proponent recently told me in the doctors’ lounge that University Hospital did only 27 tubal ligations last year. “Can’t we somehow work around this small number, for the greater good.”

So…

Is the greater good worth giving religious doctrine veto power in the medical care of women?

The debate in town was both intense and wide-reaching, even making mention in the WSJ. After a legal opinion rendered the merger a public matter, as University Hospital was deemed a public institution, the decision went to the Governor. He stewed. And waited. He sought opinions. The anticipation mounted.

Then the decision: No to the merger.

Thank goodness.

Even though I see and understand the greater good, and I think Catholics do a lot of good, the price was simply too high. Spirituality is one thing; I believe in the spirit of human goodness. Spirituality entwines itself with the human heart.

But I also believe in the religious freedoms set out by our founding fathers. America has this idea right.

The more I learn about our framers, the more impressed I am with their ‘enlightenment.’

JMM

(Full Disclosure: I was raised Catholic. I like a lot about Catholicism.)

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Filed Under: Doctoring, Health Care Reform Tagged With: Louisville Merger, Merger, Religion

John Mandrola, MD

Welcome, Enjoy, Interact. john-mandrola I am a cardiac electrophysiologist practicing in Louisville KY. I am also a husband to a palliative care doctor, a father, a bike racer, and a regular columnist at theHeart.org | Medscape

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