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L.A. Times: Hospital's ban on abortion tied to deal with Catholic provider
Opinion: Hoag's underhanded abortion ban
When Hoag Hospital announced this spring it would no longer provide elective abortions, officials at the esteemed Orange County medical center said the decision was made because of low demand.
But records and interviews show the decision was closely tied to the hospital's new partnership with a Catholic healthcare provider.
Hoag Hospital officials told The Times this week they wanted the deal to go through and knew elective abortions were a sensitive issue for St. Joseph Health System, which has a statement of common values that prohibits them.
Richard Afable, a top executive at St. Joseph Health who runs the joint health network, said that his organization made it clear to Hoag that the abortion ban was sacrosanct and required of ourselves and anyone we would work with.
So on May 1, Hoag Hospital stopped providing elective abortions and promised to refer patients elsewhere.
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Physicians said they raised concerns last fall about the effect of Hoag Hospital partnering with a Catholic institution but said they were told that hospital care policies wouldnt change.
They flat-out said its not going to affect you at all, said Beverly Sansone, an ob/gyn who treats patients at the hospital. She and seven other Hoag-affiliated doctors recently penned a public letter saying they were shocked and dismayed about the ban and that forcing women to go elsewhere for care is bad medicine.
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The board then determined that the continuation of elective abortions at Hoag was not the optimal solution to maintain the highest-quality family planning services to women in our community, he said. Hoag officials said they are confident women have other, high-quality options, including Planned Parenthood and UC Irvine.
Hoag decided, however, to continue other care not typically found in Catholic hospitals, including sterilization and fertility treatments. The hospital has also pledged to continue providing emergency contraception following rape or sexual assault and managing pregnancy complications.
Opinion: Hoag's underhanded abortion ban
Open letter from eight Hoag physicians:What's worse, doctors at Newport Beach-based Hoag say the administration lied to them about the partnership deal. They were assured from the outset there would be no changes in the services they provide to their female patients. But public documents suggest that the abortion ban was planned by Hoag and St. Joseph as long ago as last fall.
Even worse: The entire arrangement was blessed by Atty. Gen. Kamala D. Harris, who has the legal authority to rule on any change like an abortion ban as a condition of her approving a major transaction involving California nonprofit medical institutions. She was aware that the merger partners were planning to end abortion services at Hoag. Unconscionably, she waved it through.
One more thing: The terms of her approval could allow Hoag to eliminate other reproductive services frowned on by Catholic healthcare doctrine when the state's oversight of the deal expires, 10 years from now.
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Despite that pledge, the news alarmed Hoag's OB/GYN staff. During the fall, they asked administrators how their ability to provide reproductive services to patients would be affected by partnering with a Catholic hospital group. "We were told this wouldn't affect care at Hoag in any way," says Jeffrey Illeck, a Hoag OB/GYN. The doctors specifically inquired about abortion services. "We were repeatedly assured that there would be no change in these services at Hoag," according to an open letter signed by Illeck and seven of his colleagues and published in the Orange County Daily Pilot.
But things did change at Hoag. In March, the administration informed doctors out of the blue that "elective abortions" would be banned at Hoag as of May 1. "We were blindsided," Illeck told me.
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What especially infuriates the doctors is the transparently false claim by Hoag's leadership that the abortion decision had nothing to do with pressure from St. Joseph.
In a statement published in May, Hoag Chief Executive Robert Braithwaite and Hoag Board Chairman Gary McKitterick contended that only about 100 elective abortions have been performed at Hoag in each of the last two years. They implied that Hoag's doctors couldn't meet the "requirement for clinical excellence" for abortions because they don't provide the full array of necessary counseling and support services for patients.
The doctors dispute the figure of 100 abortions per year as too low, and take as an affront the suggestion that they aren't at the top of their game because of its rarity. (Harris' office is investigating the claim of bogus statistics.)
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Unlike women living in areas where abortion rights are under full-scale assault and where there may be a lone abortion clinic for hundreds of miles around, women in Orange County obviously don't lack for options for reproductive healthcare. But that doesn't mean Hoag's action is not "significant."
The Hoag and St. Joseph affiliation aims to serve fully one-third of Orange County's 3 million residents. Hoag has the highest market share in obstetrics of any hospital in its area, at 26%. The seven partnering hospitals are linchpins of charity and community care in the county. That's a significant chunk of healthcare capacity closed to women seeking a legal medical procedure.
The second point that we wish to refute is that patients undergoing elective abortion at Hoag do not receive, as they put it in their commentary, the "full complement of services" required, including "a comprehensive range of education and support, such as pre- and post- procedure support services, counseling and a full array of reproductive family planning services." Apparently Mr. Braithwaite and Mr. McKitterick are not familiar with what obstetrician/gynecologists do outside of the confines of the hospital. These women are our patients, and we care for them before they are admitted to a hospital and after they are discharged. We are experts in providing the "full array of reproductive family planning services" to which they refer as lacking at Hoag.
While Mr. Braithwaite and Mr. McKitterick like to tell us all how the Hoag-St. Joseph affiliation will improve the efficiency of and fill gaps in health care in Orange County, the banning of elective abortions at Hoag does just the opposite. Instead of being cared for by her own doctor during an emotionally traumatizing period, Hoag will step into the patient-doctor relationship and require that the patient go elsewhere for care, creating unnecessary delay and potentially added cost and worry for the patient. This is not only inhumane and inefficient it is bad medicine.
Finally, we are concerned about one more point made by Mr. Braithwaite and Mr. McKitterick. The California attorney general requires Hoag to continue providing all other women's health services for at least 10 years. What will happen after 10 years? They state, "[T]he Hoag board will maintain decision-making authority of clinical services". We are not reassured.