Boeing recently announced that its employees will be able to choose from two Partnership Plan Accountable Care Organizations: UW Medicine or Providence/Swedish.
Because UW is a public institution, no religious restrictions are imposed on physicians or patients. With UW Medicine, Boeing employees and their families will have access to the full spectrum of reproductive health care and end of life treatments at preferred rates. They’ll also be able to participate in clinical trials and benefit from treatments that rely on embryonic stem cells.
Because Providence/Swedish is a Catholic health care ministry, employees who choose the Providence/Swedish option will be subject to care that is limited by Catholic doctrine as laid out in the Ethical and Religious Directives for Catholic Health Care. Providence very clearly says that “As a Catholic health care organization, we require adherence to all Ethical and Religious Directives as a condition of medical privileges and employment.” These ERDs forbid contraception, “direct” abortion in all circumstances, research that relies on embryonic stem cells, and participation with WA’s Death with Dignity Law.
Swedish, which is a wholly-owned subsidiary of Providence, says it has less restrictive policies, but still follows Catholic doctrine in some circumstances, especially related to pregnancy and end-of-life care. Before its takeover by Providence, e.g., Swedish allowed physicians and patients to make all decisions about whether a pregnancy could be terminated without religious oversight. Now decisions relating to pregnancy termination are subject to review by a Providence ethics committee, and pregnancy terminations are allowed only in cases deemed an “emergency.”
This means that a woman who wants or needs a pregnancy termination must satisfy the “emergency” standard or go outside the Providence/Swedish ACO for care. If a pregnant woman learns, for example, that her pregnancy has a serious fetal abnormality such as Trisomy 13, a chromosonal condition associated with severe physical and intellectual disabilities, she cannot get a pregnancy termination within Swedish because the diagnosis, while serious and tragic, does not meet the “emergency” standard.
Similarly, because Swedish has no hospice or nursing facilities and Providence forbids physicians from participating with Death with Dignity, patients who want to be able to exercise their rights under WA’s Death with Dignity Law will need to be extra careful, especially because of the Providence requirement that “privileges” require adherence to the ERDs. Given all of this, it’s worth considering how many people within Washington State are likely to feel comfortable with health care that is restricted according to the Ethical and Religious Directives.
According to Pew research, about 16% of Washington residents are “affiliated” with the Catholic Church. Pew doesn’t break down beliefs within a specific religion on a state-by-state basis, but nationally, about 19% of Catholics say that “There is only ONE true way to interpret the teachings of my religion.” This would indicate that about 19% of the 16% of WA residents who are Catholic likely support the Ethical and Religious Directives for Catholic Health Care in their entirety. This translates to about 3% of the residents of the State of Washington. Given that 98% of Catholic women who have ever had sex have used birth control to prevent pregnancy, the 3% figure seems in the ballpark.
For now, it’s highly doubtful that many of the 97% of Washington residents (including Boeing employees) who don’t adhere to conservative Catholic teachings even know that the care they receive through Providence is severely restricted. But, given the stakes, it’s important that they start learning and paying attention soon so they can make health care decisions that reflect their own values and priorities.