Secular-sacred union between Washington state hospitals

Suffice it to say that your GetReligionistas frequently receive emails that sound something like this:

In the Sunday, April 28, 2013 Seattle Times there is an interesting story on the potential impact of Catholic hospitals taking over public hospitals. … Overall the article is interesting and informative; however, as a former reporter I found it perplexing how the author … slips into what is essentially an advocacy role in the story.

Paragraph four reads: “But over the years, these citizens have paid hard-earned tax money to keep United General Hospital open, and they don’t want religious doctrine espoused by someone else — surely not someone in Rome or even Seattle — to govern their reproductive and end-of-life choices.”

That strikes me as editorializing. …

Actually, this is a close call for me. The key is an editing rule that I try to teach my journalism students every semester.

Consider this journalism question: Must reporters include an attribution phrase with each and every sentence, or even paragraph, that they write? This is an especially tricky issue when reporters offer paraphrased quotes built on multiple interviews, as opposed to direct quotes from one specific individual or document.

I teach students this rule: Never let readers go more than one paragraph without knowing the source of the information. Stated another way: It’s OK to have a paragraph without an attribution clause if its information is clearly connected to information in a previous paragraph that is clearly attributed to a source or a group of sources.

In this case, the story opened by discussing debates in a Washington town called Sedro-Woolley about changes linked to the merger of their small, struggling secular hospital with a multistate Catholic health-care system. In that context, readers are told:

Critics say they’re not anti-Catholic or anti-religion. And they don’t underestimate the hardship and hard work of the dedicated nuns who brought health care to remote logging and mining towns in Washington before it was even a state.

But over the years, these citizens have paid hard-earned tax money to keep United General Hospital open, and they don’t want religious doctrine espoused by someone else — surely not someone in Rome or even Seattle — to govern their reproductive and end-of-life choices.

“When a hierarchy of a religious entity is in charge of the ethics of a hospital, then they are in control — not the members of a community,” says Mary Kay Barbieri, 69, co-chairwoman of People for Healthcare Freedom, which is fighting the proposal.

Well now. For me, what we have here is a questionable attempt to chop one strong summary paragraph — note the connecting “but” in the third sentence — into two punchy paragraphs, perhaps to quicken the pace for readers.

However, in doing this, editors created a strongly opinionated second paragraph that is not clearly linked to that earlier attribution phrase, “Critics say they are not …”

Would our GetReligion reader have reacted negatively if the editors had been more old school and added a few more words to the offending neo-opinion paragraph? What if the story had said: “But over the years, these critics have paid hard-earned tax money to keep United General Hospital open, and they insist that they don’t want religious doctrine espoused by someone else — surely not someone in Rome or even Seattle — to govern their reproductive and end-of-life choices.”

Better? What does the story lose through that tiny addition?

It’s likely that our reader would not have had a negative reaction to that, or if the two paragraphs had been combined with that crucial “but” clause in the middle.

Picky? You bet. But this is an important and loaded topic. There are, to state the obvious, crucial church-state issues involved and the setting is oh, so provocative. As the story later notes:

It may have been inevitable that Catholic doctrine and public values would clash in Washington. In no other state have voters directly insisted on having both the right to legal abortion and to a doctor’s assistance in hastening death at the end of life — not to mention same-sex marriage, which the church also opposes.

Catholic religious communities in Washington, on the other hand, have a long history here of building hospitals, often in underserved areas, and caring for the poor. The three major systems — Renton-based Providence Health & Services, Tacoma-based Franciscan Health System and Vancouver-based PeaceHealth — together employ more than 48,000 people in the state.

“Health care in this country was initiated under the guidance of Catholic religious communities,” says Sister Kathleen Pruitt, until recently vice president for ethics at PeaceHealth. “Health care is part of our DNA.”

But what happens when you have a Catholic institution that continues to directly receive some local tax dollars? The church-state issues are much clearer when a private hospital is totally private, or secular hospitals are able to stay open in an increasingly competitive medical marketplace. But, as the story shows, these mergers are taking place.

The American Civil Liberties Union shows up as a source, as it should. But for me, as a willing reader of stories about church-state conflicts, I wanted to know more about the legal issues on the church side of the issue, the arguments for the church institution to practice its own unique approach to health care (even while receiving SOME public money). What have courts said about that? What if the only other choice is no local hospital at all?

In the end, what we have here is basically a solid story about a complex issue, only with a few editing flaws. Right?

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  • dalea

    One under-explored part of this issue is just what is the religious status of the hospital corporation in terms of its relationship to the Roman Catholic Church. Having worked for one of the named entitities, I can say that it is a not for profit corporation which received many, but not all, of the medical care assets of a religious order. The setup was such that the order had very little say in the running of the hospitals which was taken up by an entirely secular administrative staff. The hospitals were described, at least in internal literature, as being ‘in the Catholic tradition’. The order acknowleged the religious roots of the hospitals but did not plant it firmly in the church. What this means legally and doctrinally, I don’t know. But it did allow the NFP to assume the assets of a taxpayer built hospital and take over the administration of it while still receiving local tax money. This is an enormously complicated area which requires highly specialized business knowlege.

    And how does this apply when the Catholic agency does not buy the hospital but simply provides management services, which does happen. Or when the sugery is a department owned by the surgeons who lease facilities from the Catholic hospital. The article uses an overly simplified view of how hospitals operate.

  • Deacon John M. Bresnahan

    Part of the problem that should be covered– or at least mentioned– in the story is how many Catholics feel that institutions they created and built up to give witness to the faith and provide needed medical services to the community are being punished for doing a good job and made to look like “The Enemy” under the First Amendment.

  • The change from “citizens” to “critics” was a great improvement.

    Overall, I agree with the Deacon. It seems unbalanced. Surely there is another side, one that would welcome the merger, one that might even oppose the will of the majority regarding the controversial issues. After all, a Catholic health system would not “want secular doctrine espoused by someone else — surely not someone in Rome or even Seattle — to govern their reproductive and end-of-life policies.” After all, “when a hierarchy of a secular entity is in charge of the ethics of a hospital, then they are in control.”

    Another aspect that could have received more attention is how much of a secular hospital’s business in reproductive and end-of-life products and services the Catholic place will not offer. Would the critics prefer the hospital go under altogether so NO health services – especially the vital, life-saving services – would be available locally? Where would their “hard-earned tax money” be then? Is it soooo bad that they have to find another outlet for those other services? Does every health facility HAVE to offer those services?

  • Jimbino

    Strange that commenters here assume that, if a Catholic-run hospital went under, the local citizens would have to do without health care. That is your classic “false dichotomy.” It’s like saying that if Meals on Wheels stopped delivering gummint-subsidized meals to seniors, those seniors would starve to death.

    No, we have loads of entrepeneurs waiting in the wings to provide goods and services to the Amerikan people. One reason they can’t is that they can’t compete with gummint-subsidized or gummint-run entities on a level playing field. You can be sure that, if gummint education were put to rest, not only would alternatives spring up, but our kids might finally get an education.

    • Thomas A. Szyszkiewicz

      Not sure which comments you’re reading, Jimbinio, but I see nothing related to your complaint, which has absolutely nothing to do with journalism, by the way, and that’s what this site is about.

    • It is a secular hospital that is floundering. To prevent it’s demise, it is considering merging with a Catholic health system. In theory there are other options, such as merger or acquisition by non-Catholic entities – but those seem only to be hypothetical options for this hospital. The complete demise of that hospital seems like a looming alternative, but even that would not mean the eradication of all local health services so long as there are local physicians and other hospitals not too far away.

      So what you say is true. The notion that the demise of a Catholic health system means the end of healthcare altogether is false. (It will mean, however, a big change in the character and priorities of the remaining health infrastructure.) Yet that false dichotomy has not bee advanced, and it is somewhat odd that you raise it.

      In the press and in rhetoric, the false dichotomy is more apparent coming from those who say people who oppose Social Security want to push Grandma off a cliff, or those who oppose abortion want women to be chained to the maternity ward, or those who oppose Obamacare want poor people to be sick and die, or those who oppose euthanasia want sick people to suffer needlessly, or those health professionals who do not want to offer contraceptive products and services want to force their beliefs on everyone else…. I personally have never seen in the press the false dichotomy that you note, but the others are pretty darn common.

  • Thomas A. Szyszkiewicz

    What I don’t understand is why it took the writer 15 paragraphs before finally stating which hospital was the target of the takeover and another paragraph before stating which Catholic health system is proposing the takeover. I always thought the “who, what, where, when” questions were supposed to be answered in the opening paragraphs.

  • dalea

    The article links to a website, MergerWatch, which monitors the subject with a religion out of healthcare viewpoint. They do provide a page with a summary of the areas where religion clashes with treatment:

    There are some interesting conflicts, particularly in end of life directives. Are these directives binding on hospitals and on medical professionals? Can a medical professional refuse to remove a feeding tube when the advance directive orders doing so? Is the religious nature of a facility a defense in this case? This would be very interesting reporting, and probably is a developing area of practice. Would a physician who refuses to remove a feeding tube due to the hospital’s religious guidelines be protected from malpractice suits and licensing discipline?

  • Darrell Turner

    I especially like tmatt’s emphasis on the need for attribution. This seems to be a problem with many of the stories the GetReligionistas critique. Are many journalism schools no longer teaching this, and are many editors no longer demanding this?
    I tutor college writing at a campus of Ivy Tech Community College, and I routinely stress this for any and all student research papers. It’s not good enough to say a piece of information came from John Smith in the Magazine of Ideas. Who is John Smith? What are his qualifications to speak or write on the subject? What is the Magazine of Ideas? Is it a neutral research journal, or is it an advocacy periodical?

  • Greg Cook

    As the person who brought this story to Get Religion’s attention, I want to say thank you to tmatt and the commenters for the excellent analysis and discussion. I care about journalism, and I care about religion. When I covered religion for a small daily in 1999 and 2000 I truly enjoyed finding stories to cover that showed the intersection of faith, politics, and culture in a rural corner of NY. I reiterate what I wrote orginally: this is an important story, and by and large the Seattle Times did well in covering it. For readers outside WA, I’ll say that the other side of the coin is that by and large the public and the media are at best indifferent and at worse hostile to any and all religious communities here. One would think the equivalent of the Taliban were on the verge of taking over any time someone from any faith community dares utter an opinion on a matter of public policy. So all the more do we need a solid press to do its job of reporting in a relatively dispassionate manner.