Column: UCSF drops affiliation with Catholic hospitals, victory for reproductive rights
UC San Francisco announced on Tuesday that it was abandoning plans for expanded affiliation with Dignity Health, a Catholic hospital chain that imposes blatantly discriminatory restrictions on abortions, transgender care and other services.
The decision was announced in a letter to the UCSF community and “concerned citizens” signed by Sam Hawgood, the chancellor of USCF, and Mark Laret, CEO of UCSF Health, who had lobbied for the plan in presentations to UC regents.
In a separate declaration, the administration said it would not present any proposals regarding Dignity Health before the regents at the upcoming meetings in June and July. He said the affiliate plan was “still under discussion and had not been finalized” until the decision was made to abandon it. The UCSF said earlier agreements with Dignity Bay Area Hospitals, which dealt with clinical programs on a limited scale, will continue.
We have heard a growing chorus of concerns from multiple stakeholders … in light of the passing of very tough anti-abortion legislation in many states.
Vanessa Jacoby, Faculty of Obstetrics UCSF
In an emailed statement, Dignity Health said, “We have heard and understand the concerns raised by UCSF professors and others regarding the proposed partnership between Dignity Health and UCSF Health, and agree that we cannot move forward with the partnership as originally planned. “
The decision reflects concerns that had been raised among UCSF medical professionals and women’s health and LGBTQ advocates about the proposed affiliation. The deal would have strengthened UCSF’s relationship with the four Dignity Bay area hospitals: Dominican Hospital in Santa Cruz, Sequoia Hospital in Redwood City, and St. Francis Memorial and St. Mary’s Medical Center in San Francisco.
As we will report, these concerns stemmed from Dignity’s adherence to the dictates of the Catholic Church regarding women’s reproductive health and transgender services, among others. St. Mary’s and Dominican are designated as Catholic hospitals subject to the Ethical and religious guidelines for Catholic Health Care Service, known as DRE.
Sequoia and St. Francis are designated as non-Catholic hospitals within Dignity Health. They are subject to the least restrictive of the church “Declaration of common values”, which prohibits “direct abortions”, physician-assisted suicide and fertility treatments such as in vitro fertilization – the only way, as the petition states, that gay and lesbian couples can conceive a biological child – but authorize certain other services prohibited by the DRE.
The proposed affiliation with the Catholic health system has threatened to put UCSF on the wrong side of the movement for women’s reproductive health and transgender rights, especially as these rights are under attack across the country.
“We have heard a growing chorus of concern from several stakeholders over the past few weeks,” Vanessa Jacoby, OB-GYN associate professor at UCSF and a major opponent of the proposal, “particularly at the in light of the passage of very tough anti-abortion laws in many states and the removal of transgender anti-discrimination protections by the [Trump] administration.”
“What might have been theoretical in people’s minds has become a reality in terms of encroachments on women’s reproductive health and protections for transgender people,” Jacoby told me.
What remains uncertain from statements from UCSF and Dignity is whether potential partners will try to reshape their plan and present it to the regents in a new form. “We will work to find a new way forward,” UCSF said. Dignity’s statement, which characterized Tuesday’s action as ending the proposal “as originally planned”, added that “in the future we will explore ways to work together.”
UCSF administrators had insisted that faculty members would not face any constraints in treating patients at Dignity Hospitals. “We were not contemplating a merger or any arrangement in which Dignity Health would have played a role in the UCSF facilities,” UCSF said on Tuesday.
But doubts about the affiliation applied to UCSF activities in facilities managed by Dignity, and not by UCSF. As Tuesday’s statement acknowledged, the specific terms of the proposed arrangement were never finalized and no details were ever made public. As a result, it is impossible to assess how the ability of physicians to counsel and treat their patients without interference would have been preserved.
In any event, UCSF officials have acknowledged that patients requiring services prohibited by Catholic rules may need to be transferred out of dignified hospitals to receive them. UCSF staff may even have to resort to subterfuge to provide certain services to patients, they acknowledged. Any non-medical interference with doctors’ judgments, critics of the plan said, would increase the health risks for UCSF patients.
However, more than 1,500 faculty members, alumni, students and others have signed a petition urging the administration to abandon the plan. Several faculty members raised questions about the arrangement at the Regents’ Health Services Committee in April and December and at a board of regents meeting in early May.
The proposed affiliation highlighted the problems associated with the growing influence exerted on health care in the United States by Catholic hospitals, which today represent one in six hospital beds. In some communities – including some in California – alternatives to Catholic hospitals are geographically inaccessible. This can make legal medical procedures such as abortions and sterilizations beyond the reach of many patients.
Critics of the plan have argued that membership, regardless of its terms, places the university in the unacceptable position of accepting a discriminatory model in its practice of medicine. The arrangement would improve the church’s ability to enact its non-medical restrictions on care, Jacoby warned.
No interaction between UCSF and Dignity Health would ever influence Catholic institutions to relax their restrictions, Jacoby said. “They never compromise their values,” she said. “They are not allowed to change. They will never provide contraceptives. They will never do an abortion to our standard of care. “