LGBTQ Patients at Center of Dispute Between Catholic Health System, University of California

A University of California (UC) task force has been formed to determine how to move forward with the institution’s partnership with the Dignity Health system after the organization’s reached an impasse over Dignity Health’s religious policies on limiting reproductive healthcare, LGBTQ healthcare, and end of life care.

The expansion of the partnership between UC San Francisco (UCSF) and Dignity, a Catholic hospital system, was previously called off because of the impasse. However, according to The Aggie, the UC system formed the Working Group on Comprehensive Access (WGCA) to determine how to best affiliate with healthcare systems such as Dignity. The task force is meant to create policy recommendations to help ensure the values of the UC system do not conflict with affiliate systems.

However, the WGCA, formed in August 2019, has not been able to reach a consensus so  instead it presented two options for moving forward. Option 1 would “allow affiliations to continue with healthcare systems that might deny people care on the basis of the hospital sponsor’s religious doctrine, while the second option would discourage the continued affiliation.

Back in April of 2019, a petition opposing UCSF’s proposed expanded affiliation with Dignity Health gained over 1,500 signatures from UCSF’s doctors and hospital staff. The petition stated that the expanded partnership would hurt “the UCSF value of providing equitable care to all of our patients, irrespective of sexual orientation or gender identity.” The petition notes that Dignity’s policies would inhibit doctors to provide their patients with the best health care options available, because of the limitations set by the hospital’s religious doctrine.

Dignity Health and other Catholic hospital systems follow the Ethical and Religious Directives (ERDs) set by the U.S. Conference of Catholic Bishops (USCCB), not by medical professionals. Dignity Health operates by the ERDs at 17 out of 31 of their hospitals. The Aggie explains:

“The ERDs do not allow the prescription of any FDA-approved methods for preventing pregnancy including sterilization, elective abortion; assistive reproductive technology such as in-vitro fertilization (IVF) or the use of a surrogate for pregnancy; gender-affirming care such as hormone replacement therapy or surgery or physician-assisted aid in dying.”

As always with restrictive policies such as these, the most affected parties are women, transgender people, and same-gender couples seeking in vitro fertilization. In 2019, Evan Minton, a transgender man, sued Dignity Health when the hospital canceled his hysterectomy after learning of his gender identity. Minton’s legal team, which includes representation from the ACLU, said that hospitals should not be able to “pick and choose” the care they offer to patients. An appeals court ruled last year that Minton’s case could proceed. The ACLU Foundations of California and the National Health Law Program have an ongoing campaign, “All Care Everywhere,” to challenge the mistreatment vulnerable patients, like transgender people, receive at Catholic hospitals. 

Vanessa Jacoby is a member of the WGCA and a doctor specializing in obstetrics and gynecology. She believes the ERDs are clearly discriminatory to women and transgender people. She said of the affiliation:

“When I’m considering a healthcare decision, if one of the harms is discrimination against any group, but in this case discrimination against women and against LGBT people and against transgender patients […] that, to me, overwhelms any potential benefit. I don’t believe UC should violate our anti-discrimination policies, no matter what the potential benefits are.”

The Working Group on Comprehensive Access’ inability to find a way forward for a partnership between the University of California and Dignity Health is but one example of the conflict between religious providers and secular healthcare. Catholic health systems control one in six hospital beds, and are often the only location for treatment in some rural areas. But patients should not have to risk being treated by people who adhere to guidelines from the bishops that, in too many cases, ignore reality. Every patient should be treated according to actual science and medical best practices, an approach the Catholic intellectual tradition which is so focused on reason complementing faith can readily support.

—Melissa Feito, New Ways Ministry, June 17, 2020