GBMC, St. Joseph should weigh needs of the public, too

March 15, 1998|By Sara Engram

A FEW YEARS ago, a coalition of family planning organizations in New York state received a telephone call from a perplexed 19-year-old woman. The outpatient center where she had been receiving contraceptive injections had just turned her away, informing her that after a merger they no longer offered the service.

The young woman, already a mother, explained that she was trying to finish school and that another pregnancy could prevent her from reaching that goal. But the clinic gave her no referrals.

That phone call to Family Planning Advocates of New York State helped prompt the coalition to set up a project to monitor the effects of hospital and health plan mergers around the country, with special attention to reproductive health-care services.

Financial pressures on hospitals have produced a rapid rise in mergers and partnerships. When these arrangements involve a religious institution that opposes abortion or other reproductive services, the result can be less access for the community.

A watchdog

MergerWatch, which the family planning group established as a monitor, has detected some disturbing trends, including numerous cases in which hospital partnerships or health maintenance organizations attached to religiously affiliated hospitals have restricted access to abortion, contraception or fertility services. But the project has also found a number of creative approaches to partnerships that preserve choices for patients.

In Poughkeepsie, N.Y., Vassar Brothers Hospital and St. Francis Hospital backed away from a proposed merger in response to community objections to the imposition of Catholic guidelines on health care at Vassar Brothers. Instead, they created a partnership that enables them to cooperate and save money without actually merging. Vassar Brothers continues to provide a full range of reproductive health care.

When sensitive issues are thoroughly aired before an arrangement becomes final, the prospective partners often find ways of accommodating the needs of the community, as well as the values of each institution.

That's why it's good to see public discussion of a proposed partnership between the Greater Baltimore Medical Center and St. Joseph Medical Center, a Roman Catholic hospital.

Both of these Towson institutions represent valued traditions in this community. But no one would turn to St. Joseph for an elective abortion, or expect to obtain contraceptives or fertility treatments from a Catholic hospital.

GBMC's tradition

GBMC, on the other hand, has long specialized in reproductive health care, offering contraceptive services, fertility treatments, genetic counseling and abortions. GBMC officials say that while a partnership with neighboring St. Joseph would mean that GBMC no longer would perform elective abortions, they would maintain all other reproductive health services.

"Without question, we would not move forward if it were to interfere with the other women's services," says Robert P. Kowal, GBMC's president. "We like to consider ourselves the women's hospital for the state."

In a town as rich with medical facilities as Baltimore, women will have other places to turn if GBMC no longer performs abortions. In fact, the number of abortions performed there has declined dramatically. In recent years, almost all late-term abortions have been referred to specialists at other hospitals.

There may be little reason to doubt that GBMC can continue its tradition of excellent care for women in all other areas. Even so, it seems somewhat ironic to bow to a moral guideline that prohibits elective abortion, while continuing to do a thriving business in genetic counseling and testing for women who want to ensure they are carrying a healthy fetus -- implying that in cases of serious abnormalities they would choose to have abortions.

In serving their communities, hospitals build relationships with people that can be intense and even emotional. New business arrangements can easily affect those relationships.

As GBMC and St. Joseph map out their partnership, public airing of these issues will help produce an arrangement that protects the public interest as well as the community's relationship with both of these valued institutions.

Sara Engram is deputy editorial page editor of The Sun.

Pub Date: 3/15/98

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