Lost in suburban hospital merger Reproductive health: More than abortion at stake in proposed GBMC-St. Joseph alliance.

March 12, 1998

AS THE HEALTH care landscape changes, increasing numbers of hospitals are seeking mergers and alliances to weather the economic storms that are shrinking revenues and profits. The results can produce uncomfortable partnerships, particularly in cases where church-related institutions demand that their partners adhere to religious guidelines.

A case in point is the proposed merger of Greater Baltimore Medical Center (GBMC), which prides itself on its reproductive health services, especially its Women's Resource Center, and St. Joseph Medical Center, a Catholic institution also in Towson. Depending on its final terms, the merger could mean a major setback in access to reproductive health services for women in the Baltimore region.

A hospital's religious affiliation can be a powerful statement about the institution's values -- an advertisement that it cares as much about its respect for the dignity of each patient as for the bottom line. But in some areas, particularly reproductive health, religious affiliation can also impose limitations on the kinds of care a patient can receive.

Abortion is usually the most publicized loss, as it would be at GBMC. The hospital's board insists it is trying to maintain GBMC's ability to offer other reproductive health services, but that will not be clear until any final agreement is made public. There is reason to be wary.

In many communities across the country, hospital mergers and health maintenance organization agreements have left people without access to contraceptives, tubal ligation, vasectomy and treatments for infertility. Rules governing Catholic health care facilities can also affect end-of-life care; in some cases, Catholic hospitals reserve the right not to honor living wills or other advance directives if they feel it conflicts with their moral code.

Even if GBMC crafted a merger that ended abortions but preserved all its other reproductive services, that would represent a huge loss in access. Currently, GBMC is the only community-based hospital in the Baltimore area that will perform an elective abortion.

GBMC has a strong heritage of providing services to women; one of the institutions that merged to form GBMC in 1965 was a women's hospital. Today, its board seems poised to abandon that heritage for an alliance that may make sense financially, but raises questions about GBMC's commitment to reproductive health care for women.

A merger between GBMC and St. Joseph would clearly shrink access to abortion in the Baltimore area. Without definitive and binding assurances regarding contraceptive and fertility services, it would also raise troubling questions about GBMC's willingness to continue its tradition of excellent service in those critical areas of health care.

Pub Date: 3/12/98

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