Catholic Healthcare West Becomes Dignity Health - What Does It Mean?

By: Most Reverend George H. Niederauer, Archbishop of San Francisco

In late January 2012 Catholic Healthcare West (CHW), a San Francisco-based health care system that operates 25 Catholic and 15 non-Catholic hospitals, announced that it had changed its governance structure and name, and would henceforth be known as Dignity Health. Several media headlines proclaimed that CHW undertook this action in order to “pare its ties with the Church” in a “quest to grow.” Some of these reports implied that Catholic bishops had approved such a result. These headlines and the stories that accompanied them have left many Catholics and the larger public with the mistaken impression that CHW’s Catholic hospitals had become secular health care facilities. This is not the case. I am writing to clarify the situation.

Some time ago, the bishops of the United States determined that Catholic hospital systems may not operate non-Catholic hospitals that do not follow all of the Church’s moral and doctrinal teachings. While CHW’s Catholic hospitals are expected to follow the Church’s moral teachings, it’s non-Catholic hospitals were brought into the system under a different protocol that required them to follow Church teaching on abortion, assisted suicide and several other procedures, but allowed them to perform direct sterilizations, which the Church does not permit. This arrangement was unsustainable because, among other important things, it was confusing for patients, their families, health care workers, Church leaders and others, as they couldn’t be certain whether a hospital bearing the name Catholic Healthcare West was Catholic or non-Catholic.

In February 2011, in my capacity as the Archbishop of the diocese in which CHW’s home office is located, I initiated discussions with representatives of the six orders of sisters that sponsored CHW to determine how this situation could be corrected. Earlier, in November 2009, the sisters and CHW’s board and management had begun their own examination of the problem and had formulated a proposed restructuring of CHW’s governance. Under this proposal, CHW would no longer be a sponsored ministry of the Catholic Church – that is, it would become a secular nonprofit health care system governed by a self-perpetuating board, and would change its name to reflect that reality.

The new system would operate both Catholic and non-Catholic hospitals, and the six orders of sisters would, within the new system, continue to sponsor and retain important controls over the Catholic hospitals. The Catholic hospitals would be required to follow all of the Church’s moral and social teachings; the non-Catholic hospitals would continue to follow their ethical protocol, which, as noted above, does not allow them to perform direct abortions and certain other procedures. The sisters would be able to veto any proposed changes to this protocol.

The sisters who sponsored CHW expressed their conviction that while this proposal would regrettably end their sponsorship of the overall system, it nevertheless would enable them to continue sponsoring their Catholic hospitals, and continue to exercise a vital Catholic evangelical influence on the new system’s mission and culture. At the sisters’ request, their proposal became an important focus of our nearly nine-month-long dialogue.

During this time, I engaged several Catholic moral theologians to analyze the sisters’ proposal in terms of its effect on the Catholic identity and ethical integrity of CHW’s Catholic hospitals, and consulted widely with both the bishops that have CHW facilities in their dioceses and the chairman of the United States Catholic Conference of Bishops’ Task Force on Health Care. I also retained a nationally respected health care consultant to examine the proposal against other possible structures.

Based on these analyses and consultations, late last fall, I determined that the proposed restructuring is consistent with Catholic moral and doctrinal teachings and that the sponsors and their Catholic hospitals are, therefore, free to participate in it. I need to emphasize that my finding that the restructuring is consistent with Church teaching does not imply that I, or any other bishop, believes it is necessarily the best possible arrangement for the sister sponsors and their Catholic hospitals, only that I found no moral reason to object to it.

Will the new arrangement work? Will the sister sponsors be able to sustain and strengthen the Catholic character of their twenty-five hospitals and exercise a profound evangelical influence on Dignity Health’s culture and its non-Catholic hospitals? Given the enormous challenges facing today’s Catholic hospitals, no one can answer that question with certainty; only time and careful observation will tell. The sisters, whose hospitals have been caring for the poor and sick in the western United States for over 150 years, are firmly committed both to achieving these ministerial goals and maintaining effective relations and regular communication with the bishops in each of the dioceses in which they sponsor hospitals. I have assured them of my lasting gratitude for their Christian service and my commitment to help them measure and evaluate their progress as they proceed on this arduous, uncertain journey. Most importantly, I have also assured them of my prayers. They and I, welcome yours.