From Swedish Fish to Jesus Fish

Will Swedish Hospital's Takeover by Catholics Result in More Restrictive End-of-Life and Anti-Abortion Policies for Seattle Patients?

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James Yamasaki

Surrounded by family in his Bellingham home, 88-year-old Norman Shapiro died a slow, agonizing death. "He was suffering tremendously, and we were all traumatized by watching helplessly," wrote his widow, Audrey Roll-Shapiro, following her husband's death from esophageal cancer in 2010. The staff at Whatcom Hospice, owned by the Catholic health system PeaceHealth, was attentive, Roll-Shapiro allowed, but she said they failed to inform the family of their legal rights under 2008's voter-approved Washington Death with Dignity Act, which allows physicians to prescribe lethal doses of self-­administered drugs to terminal patients.

"Not once did any Whatcom Hospice staff mention that Norman had other options, such as palliative sedation or aid in dying," wrote Roll-Shapiro in an October 2010 guest post on the blog of Compassion & Choices of Washington, a group that helped get the Death with Dignity Act passed. (PeaceHealth responded at the time that it was exercising its own rights under the opt-out provision of the Death with Dignity Act.) Roll-­Shapiro only learned about her husband's rights the day after he died.

It's a scenario that could soon become more common in Seattle.

On October 5, Swedish Health Services announced a proposed alliance with Catholic-affiliated Providence Health & Services, which refuses to advise patients on their death with dignity options. This new alliance would be overseen by an independent board appointed by both hospital groups, but Providence, being the larger partner, would appoint more members. The alliance would affect Swedish's five hospitals, more than 70 primary-care and specialty clinics, three ambulatory-care centers, and home-care division, totaling 11,000 employees, the largest nonprofit health-care provider in the greater Seattle area. If approved by federal regulators, it would be the third such merger between Catholic and non-religious health systems in Washington State since 2010.

Economic pressures are forcing a wave of hospital mergers nationwide, and wherever Catholic-affiliated health systems expand, access to aid in dying, abortion, sterilization, and other legal services declines. An example here in Washington: The policy at Southwest Medical Center in Vancouver used to allow discussion of death with dignity before the hospital adopted PeaceHealth's restrictive policies, following their merger in 2010. Now staff are prohibited from discussing death with dignity options. It's a trend that's enabling Catholic organizations to establish through the marketplace the very same conservative end-of-life and reproductive-health policies they could not advance through the courts or at the polls.

According to the United States Conference of Catholic Bishops, 573 Catholic hospitals served 84.7 million patients in 2005, and that number is growing. MergerWatch, a patients' rights organization, has tracked more than 140 merger and affiliation agreements between religious and non-religious hospitals since 1997. The group says that 70 percent of religious-affiliated hospitals in the country are Catholic.

Catholic health systems—hospitals, hospices, clinics, and home-care providers—deliver valuable services to communities, services that will be increasingly in demand as the state continues hacking away at its social safety net (the Basic Health program will once again be on the chopping block during the legislature's upcoming special session, which begins November 28 in Olympia). But medical services from Catholic-affiliated health providers come with one very long string attached: a requirement that they follow the Conference of Catholic Bishops' "Ethical and Religious Directives for Catholic Health Care Services." These directives include prohibitions against abortion, birth control, fertility treatments, aid in dying, and even the honoring of end-of-life advance directives deemed "contrary to Catholic moral teaching."

According to a recently published Q&A, Swedish claims that after the merger it "will not be subject to the Ethical and Religious Directives that apply to Catholic health-care facilities." With the exception of its decision to shift elective abortions to a new Planned Parenthood clinic slated for its First Hill campus, the hospital insists none of its reproductive-­health policies will change. Like all Washington hospitals, Swedish has never allowed what it calls "physician-assisted suicide" on its premises, but says it will place no additional restrictions on the freedom of physicians to advise their patients about the options available: "There will be no change to current practices," the Q&A states.

But Robb Miller, the executive director of Compassion & Choices, met with representatives from Swedish on Friday, October 28, and came away concerned about the future of Swedish's hospice program, which is relatively small and unprofitable compared to the one run by Providence. The whole point of the hospital alliance is to save money through economies of scale, so it only makes business sense for Swedish to eventually close its hospice and roll it into Providence's, even though Providence's "draconian" policies concerning death with dignity "are the worst in the state," according to Miller.

Swedish currently places no restrictions on what caregivers can talk about, "including all options available to patients under the Death with Dignity Act," whereas Providence prohibits staff from even referring patients to third parties, let alone counseling them on their legal options, according to Miller. Which could mean more deaths like Norman Shapiro's—slow and agonizing, not only for patients, but for loved ones who sit by and watch, helpless and uninformed.

Whatever the outcome, Seattle-area patients will still enjoy many more options than those in much of the rest of Washington, where most hospice services are Catholic-affiliated. But even out there the mergers continue. PeaceHealth, a near-monopoly provider in Bellingham, recently secured similar dominance in Vancouver through its merger with Southwest Washington Health System, and is in the process of acquiring United General Hospital in Sedro-Woolley.

"Death with dignity may be legal," laments Miller, "but for many Washingtonians, it's not an option." recommended


Comments (14) RSS

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Healthy women can have abortions in any clinic in town. We have good coverage for that.

Women who need medical care are the ones that will suffer - even as simple as a woman with slightly higher blood pressure or asthma. The addition of a clinic by Planned Parenthood doesn't help with that - they refuse help women that have any degree of medical issue either.

Will women even be told of their options? Or will the be denied service and information.

This is a huge blow for women.
Posted by show the sham on November 2, 2011 at 10:15 AM · Report this
Evergreen Hospice is nondenominational and has experience supporting patients who choose Death with Dignity. Their service area includes all of King County, with some extension into outlying areas.
Posted by lforrest on November 2, 2011 at 6:15 PM · Report this
I'll die BEFORE succumbing to PeaceHealth.
Posted by auntie grizelda on November 3, 2011 at 12:58 AM · Report this
How is this a huge blow for women? I wasn't aware the Swedish Hospital was currently a supplier of abortions. This whole article is fearmongering nonsense. Nothing is going to change at Swedish Hospital. I worked for Catholic Healthcare West in California, where there were no Death with Dignity laws, and every care was taken to keep the patient as comfortable as possible and not to prolong life in terminal cases.

And btw, Catholics don't do the Jesus Fish thing. That's the Protestants.
Posted by spider88 on November 4, 2011 at 4:15 PM · Report this
spider88, in the simplest terms, you don't know shit.

Swedish did do some abortions, quietly, for high-risk women who cannot be safely seen at outside clinics. That will end. Many Catholic hospitals also have a moral clause for physicians contracted with them, forbidding them from participating in abortion even when at another facility. Will Swedish still provide emergency contraception to rape survivors in their busy ER? How about tubal ligations? How about complex ART procedures that may result in embryo destruction?

There is a death with dignity law in Washington, voter-approved. This isn't a theocracy. The religion of a health care provider does not trump the right of people to receive appropriate and legal care. You want to pull the moral card? Do some other kind of work. I hear podiatrists have very little night call.
Posted by sage-femme on November 4, 2011 at 4:24 PM · Report this
Sage-Femme You are the one who doesn't know shit. You're being anti-Catholic and not doing you're homework. Catholic hospitals everywhere provide emergency surgery for ectopic pregnancy. What's your proof that Swedish *currently* treats rape survivors in the ER? Harborview is around the corner, ffs. Catholic Hospitals have ended pregnancies that saved the mother's life, without regard for the bishops threatening (or actually) ex-communicating them. Meanwhile, secular hospitals let miscarrying women bleed out in the ER because no on there wants to do a D&C, or wasn't trained to.

Swedish (which is a Lutheran organisation, something oddly not mentioned here) CURRENTLY DOES NOT PROVIDE DEATH WITH DIGNITY. CURRENTLY.

Stop being a knee-jerk anti-Catholic. Again, the Jesus Fish isn't even a Catholic symbol.
Posted by spider88 on November 5, 2011 at 1:22 PM · Report this
KittenKoder 7
Glad I don't go to Swedish, but then again .... I should contact some of their doctors.
Posted by KittenKoder on November 5, 2011 at 4:29 PM · Report this
Comcast is the subject of a class action lawsuit in King County superior court Court: King Co Superior Ct
Case Number: 11-2-34714-1
they are making employees work off the clock. why give franchise to company engaged in illegal activity?
Posted by xfaility on November 5, 2011 at 10:05 PM · Report this
Comcast is the subject of a class action lawsuit in King County superior court Court: King Co Superior Ct
Case Number: 11-2-34714-1
they are making employees work off the clock. why give franchise to company engaged in illegal activity?
Posted by xfaility on November 5, 2011 at 10:06 PM · Report this
Spider is right. One thing the article mentions in passing, but is a crux issue, is that Catholic hospitals, which are generally located in urban areas, provide health care to millions of people (many of them poor) every year, and are a critical part of the overall health care system. Yes, they don't perform abortions, but neither do many other hospitals and health care clinics around the country. Catholic hospitals do not exist to perpetuate dogma--they exist to treat people regardless of religion, and often regardless of people's ability to pay. By the way, my mom died in a Catholic hospital (after having a major stroke), and they completely respected our wish (and hers) to not prolong her life once it was clear she had no hope of recovery.

This is a non-story, and just another attempt by The Stranger to bash religion for the sake of doing so.
Posted by Irish on November 7, 2011 at 9:22 AM · Report this
Don't let catholics control anything. They bring denial, abuse, ignorance and exploitation to every institution they touch. They simply cannot be trusted with the lives of little boys or old ladies.
Posted by Lilly Munster on November 7, 2011 at 4:58 PM · Report this
Or adulthood. My friend was having what I thought was a panic attack. We were about nineteen. I took him to the emergency room at the nearest hospital in our small town, which happened to be a Catholic facility. The woman at the admission desk asked him if he had taken drugs, and he said not that day but that he had smoked pot about a week before that, and that he smoked it several times a week on average. They tsk tsk'd him, left him sitting in the ER for-fucking-ever, and he ended up having a seizure on the floor while waiting. At which point they still didn't take him back to see a doctor, but one did bring him water and a pillow and, when asked what was holding up his care, responded condescendingly with, "Well I guess maybe you shouldn't take illegal drugs, heh." I was aghast. Fuck Catholic hospitals and their harmful judgmental bullshit. Had we been wiser then, I would have told him to sue.

Swedish is publicly throwing support behind a new Planned Parenthood in Seattle. The Times has written several times this month about it, but I am not in favor of Catholic anything when it comes to reproductive health care.
Posted by boo to the kid-fuckers on November 8, 2011 at 8:16 AM · Report this
Folks, you might want to read my original Crosscut story about the Catholic impact of the Swedish-Providence affiliation, which has more background on what's happened in other places after such mergers (including kicking out hospitals that violate Catholic policies). I broke the story. Contrary to what one poster said, Swedish doctors and hospice staff do participate in helping patients with their Death with Dignity options, even though Swedish, like other hospitals, does not allow patients to take the lethal medication on premises. There are also questions about what other Catholic policies Swedish may adopt down the line on reproductive and end-of-life care, such as mandatory tube feeding. These are serious issues for all patients at Swedish and other hospitals around the country that are merging with Catholic systems.…
Posted by HarrisMeyer on November 8, 2011 at 10:26 AM · Report this
Rev.Smith 14
@4 BAD TITLE - agreed! thanks for calling out the jesus fish thing: shame on goldy/his editor for the terribly inaccurate association between catholics and protestants (not to mention the maligned now-canadian candy!!) - hell, from this title, one could think IKEA is being taken over by Casey Treat.
not to mention the flattened-oval symbol has a much older history, as that of the (yonic)symbol, when rotated 90 degrees from the protestants' bumpersticker use; for vagina.
i.e. Protestants = Fishmongers!!

Makes this image rather freudian, though: File:Codex_Bruchsal_1_01v_cropped.jpg">…

Posted by Rev.Smith on December 9, 2011 at 2:54 AM · Report this

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