MANCHESTER, N.H. (ChurchMilitant.com) - For the third time in a little over two decades, the Catholic health care system in the state of New Hampshire is facing the prospect of being outsourced to a secular corporation deeply embedded in the Culture of Death.
On Sept. 30, 2019, a combination agreement was signed between Granite One Health, the corporate parent of Catholic Medical Center (and its various affiliates) in Manchester, and Dartmouth-Hitchcock Health, a private, non-sectarian hospital chain, whose flagship facility is the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.
Dartmouth-Hitchcock is the largest health care provider in New Hampshire. It is also the state's biggest non-governmental employer, and a major perpetrator of abortions. On Dec. 30, the parties submitted a "joint notice of change of control" to the director of charitable trusts of the New Hampshire Department of Justice. Now all that remains for the acquisition to go forward is regulatory approval by the Federal Trade Commission and by the Charitable Trusts Unit, a division of the New Hampshire attorney general's office.
Two previous attempts by non-Catholic entities to merge with or absorb Catholic medical institutions in New Hampshire (in 1999 and in 2010) ended in failure. The outcome of the current effort may well be determined by the unreserved and very public support it enjoys from the diocese of Manchester. In September, the Most Rev. Peter A. Libasci, bishop of Manchester, issued a nihil obstat approving the combination agreement.
The provision of medical care to those in need, especially to the indigent, has been integral to the charitable apostolate of the Church from time immemorial. The health care ministry became particularly urgent in 19th-century America because the Catholic population was largely composed of poor, urban immigrants and because most private hospitals were Protestant, which oftentimes translated to the exclusion of Catholic chaplains.
The origins of Catholic health care in New Hampshire hearkens back to the 1890s. The Sisters of Mercy, under the leadership of Mother Mary Gonzaga R.S.M. (Sarah Anne O'Brien of Cork), established Sacred Heart Hospital in Manchester in 1892. The Sisters had previously helped found and staff the state's first Catholic orphanages and parochial schools. Monsignor Peter Hevey, pastor of Saint Mary's Church in Manchester, collaborated with the Sisters of Charity of Saint Hyacinthe to open Notre Dame Hospital in 1894. The two hospitals merged in 1974 to form Catholic Medical Center, a full-service, 330-bed, acute-care hospital, which is located on the site of Notre Dame.
The first attempt to merge Catholic Medical Center with a non-Catholic hospital foundered in 1999 because, according to a spokeswoman for the prospective partner, Elliot Hospital (whose governing board included representatives of Manchester's mainline Protestant churches), "The inability to reconcile the ethical and religious directives of the United States Conference of Catholic Bishops with non-Catholic health care services resulted in the end of that relationship. The charitable missions of both organizations were deemed to be incompatible."
In 2010, a proposal to bring Catholic Medical Center under the control of Dartmouth-Hitchcock failed when New Hampshire attorney general Michael A. Delaney, on the advice of the Charitable Trusts Unit, disallowed it under the so-called neutral principles of charitable trusts law, stating it would diminish the fiduciary obligations of the Catholic Medical Center board and inhibit the ability of CMC to carry out its foundational charitable mission.
Dartmouth-Hitchcock Health, which is seeking to assume control of Catholic Medical Center in the summer of 2020, holds positions and engages in practices that are antithetical to Catholic moral teachings about the sanctity and dignity — from conception to natural death — of innocent human life. Moreover, it repudiates the Church's teachings on the impermissibility of contraception, on the immutability of gender and on the inviolability of a properly formed conscience.
Dartmouth-Hitchcock performs both elective and so-called therapeutic abortions, along with abortions sought because the child in the womb may suffer from a potential birth defect. These abortions may be either surgical or chemical, the latter now being described as "medical" abortions. It also performs prenatal genetic testing, which is intended to detect fetal abnormalities (like Down syndrome) so as to facilitate the decision to procure an abortion. Five percent of all pregnancies at Dartmouth-Hitchcock end in abortion.
Dartmouth-Hitchcock carries out in-vitro fertilizations, which invariably result in multiple embryonic abortions. The hospital system dispenses abortifacient hormonal contraceptives and performs procedures to emplace barrier contraceptive devices (which are also abortifacients) in women. Among the contraceptive options is so-called emergency contraception, which is, once again, an abortifacient. Additionally, it performs both surgical and non-surgical sterilizations. Recently, it has begun surgical referrals and hormonal therapy for "gender reassignment."
Physician-assisted suicide remains, for now, illegal in New Hampshire. In 2013, however, neighboring Vermont passed the Patient Choice at End of Life Law, Act 39, authorizing what is characterized as "medical aid in dying." The principal advocacy group for this horrific practice, Patient Choices Vermont, has confirmed that Dartmouth-Hitchcock Medical Center doctors licensed in Vermont can now prescribe under Act 39. In Oct. 2019, Dartmouth-Hitchcock Medical Center sponsored a conference offering academic credit on assisted suicide for physicians, nurses and medical students.
Dartmouth-Hitchcock Health not only performs abortions but trains medical students and practitioners in abortion procedures — and its medical personnel engage in public advocacy for abortion. In May 2019, President and CEO Joanne Conroy admitted that learning to perform abortions was part of the hospital system's "ob-gyn kind of curriculum." The Dartmouth-Hitchcock Medical Center is listed as one of 90 hospitals in the United States and Canada that participate in the Kenneth J. Ryan Residency Training Program in abortion and family planning.
In a shocking display of callousness, Dr. Judy Tyson of Dartmouth-Hitchcock was quoted infamously as saying that abortion was so simple that she could "teach standard abortion procedures to a chimpanzee in less than an hour."
The hospital's intimate and longstanding relationship with the abortion business is reflected in the link on its website to the National Abortion Federation, the trade association of the abortion industry founded by Frances Kissling, who later went on to become the head of the anti-Catholic front group Catholics for a Free Choice.
On Jan. 29, 2020, Dr. Ellen Joyce of Dartmouth-Hitchcock was part of a panel of four speakers, organized by Planned Parenthood, who testified in a New Hampshire House Judiciary Committee hearing against born-alive, fetal-heartbeat and parental-consent legislation. Medical students from Dartmouth-Hitchcock made up much of the audience at the hearing and at the subsequent Planned Parenthood press conference.
Four years earlier, in 2015, Dr. Barry Smith, the former chairman of obstetrics and gynecology at the Dartmouth Hitchcock Medical Center, defended the taxpayer funding of Planned Parenthood in an op-ed piece for the New Hampshire Business Review. The ob-gyn curriculum at Dartmouth-Hitchcock actually includes a one-month training rotation in family planning at Planned Parenthood of Northern New England.
Compounding this close association with the abortion culture is the pervasive institutional hostility of Dartmouth-Hitchcock to the conscientious objections made by some members of its medical staff to life-ending procedures.
Hospital policy requires that "residents who do not provide abortions themselves are still expected to counsel patients, make appropriate referrals and manage post-abortal complications." In April 2019, Susan Smith, a registered nurse and a Catholic who worked at Dartmouth-Hitchcock Medical Center for 11 years, was terminated after complaining about the removal of a feeding tube from a patient. This suggests that Dartmouth-Hitchcock rejects the Catholic understanding that nutrition and hydration do not represent an extraordinary means to prolong life.
Although Bp. Libasci has described the transaction between Catholic Medical Center and Dartmouth-Hitchcock Health as a "combination," it is, in fact, an acquisition: A larger organization is absorbing a smaller one. Under the notice of change of control, while Catholic Medical Center and CMC Health System will retain their own governing boards, Dartmouth-Hitchcock Health will be the "coordinating entity of the combined system and will hold certain reserved powers" over the Catholic institutions.
These reserved powers over Catholic Medical Center and CMC Health System will include the adoption and approval of capital and operating budgets and of any supplementary or deficiency spending; auditing, the acquisition of debt and the disposition of assets; strategic planning and partnerships; the addition or elimination of any health care program; and the adoption or revision of academic policies and research programs.
The system board will also have the right to veto the election of trustees to the subsidiary boards, to approve any change in the bylaws of the subsidiaries and finally, the right to appoint up to one-third of the members of the CMC and CMCHS boards. The system board of the combination will have 15 members, only six of whom will come from CMC (the remaining nine being delegates of Dartmouth-Hitchcock). This arrangement will prevail for a six-year transition period. After that, the system board will be self-perpetuating, without regard to constituent representation.
Effectively, following the combination, Dartmouth-Hitchcock will have immediate control of all major decision-making in Catholic Medical Center and will be in a position to closely monitor and surveil day-to-day administration. The provision for the continued existence of largely powerless CMC and CMCHS boards appears to be nothing more than a fig leaf to barely conceal the takeover of Catholic Medical Center by Dartmouth-Hitchcock Health. The purpose of this contrivance is to circumvent the 2010 objection of the New Hampshire attorney general's office to the loss of the foundational charitable mission of Catholic Medical Center and its institutional predecessors.
In 2020, instead of a formal, overt, de jure annexation of Catholic Medical Center by Dartmouth-Hitchcock, there will be a de facto, slightly-less-overt colonization of CMC, whose status will quickly descend from that of a protectorate to a fully subordinate province of the Dartmouth-Hitchcock imperium.
Finally, as New Hampshire Right to Life has pointed out, two small, secular hospitals affiliated with Catholic Medical Center through the Granite One umbrella will now fall under the direct control of Dartmouth-Hitchcock. Currently, these medical facilities (Monadnock Community Hospital and Huggins Hospital) do not perform abortions. Unconstrained (or perhaps instructed) by the new regime, they will likely become a new conquest for the Culture of Death.
Who benefits from this takeover? Unlike the former Caritas Christi Healthcare System in the archdiocese of Boston, Catholic Medical Center in Manchester is not confronting a crisis of continuing deficits, mounting debt, an unfunded pension liability and the need for recapitalization. The official filings cite a menu of boilerplate reasons for the New Hampshire transaction, ranging from an aging population to the opioid crisis to the need to improve rural health care.
One possible clue is a reference to the out-migration of health care consumers to Boston's medical megalopolis. This would seem more likely to produce an unfavorable impact on the larger of the two components of the combine, that is, Dartmouth-Hitchcock. That is no reason, however, for the diocese of Manchester to contract out a functioning Catholic health care system. Nonetheless, there remains no clear, compelling, urgent and readily apparent justification for such a radical and long-reaching change in the status of Catholic medicine in New Hampshire.
This may be, of course, just empire-building by Dartmouth-Hitchcock Health, which has succeeded in inveigling CMC. Between 2016 and 2017, it tried (unsuccessfully) to absorb Elliot Hospital. There is an old principle in politics that if something is not evident from the standpoint of the public good, it may have a definite advantage from the standpoint of some private good. Whether that private good is individual or institutional, it is likely to be found on the Dartmouth-Hitchcock side.
The diocese of Manchester has, with solemn and confident assurance, stated that after the consummation of the agreement, the Catholic identity of CMC will remain intact and unimpaired, that the practice of medicine at CMC will conform to the Code of Canon Law and to the ethical and religious directives for Catholic health care services of the U.S. Conference of Catholic Bishops and that the bishop of Manchester will be the sole arbiter in interpreting the law and the directives and in resolving all disputes arising therefrom.
In this, the diocese has been seconded by the esteemed National Catholic Bioethics Center. There is nothing in the documentary record which would appear to contradict this assertion by the diocese. However, there sometimes can be a broad disparity between legislation and legislative intent on one hand, and the application and enforcement of law on the other. Given the de-Christianization of our culture, the polarization of politics in our country today and the divergence of moral principles between Christian and post-Christian America, the undertaking of any collaboration between a Catholic institution and a secular one is fraught with danger.
Certain elementary conditions would be requisite. These might include the absence of insurmountable moral barriers; good faith, goodwill and respect for Catholic values on the part of the non-Catholic participants; conviction and vigilance on the part of the Catholics; and the acquiescence, or at least the neutrality, of civil society. None of these conditions are present in the current controversy. Catholic and secular medicine cannot agree on the humanity of the unborn child, the definition of gender or the explicit prohibitions of the Hippocratic Oath.
The aggressive advocacy of abortion, the affiliation with Planned Parenthood and the disregard for the conscience rights of their own employees suggests that the leadership of Dartmouth-Hitchcock has nothing but contempt for Catholic values. When one of the physicians affiliated with Catholic Medical Center, Dr. Renee J. Novello, is a Planned Parenthood abortionist, one doubts the commitment of the leadership of Catholic Medical Center to preserve its Catholic identity and religious integrity. Catholic hospitals throughout the country are under attack. They are being denounced, monitored and, in some cases, sued by aggressive secularists, led by the American Civil Liberties Union.
In California, the state court of appeals ruled that a transgender patient can sue a Catholic hospital for refusing to perform a hysterectomy. The ACLU has begun a campaign to incite fear of the so-called threat that Catholic hospitals pose to "reproductive rights." In the Bay State, NARAL Pro-Choice Massachusetts monitors Catholic hospitals to determine if they are complying with the law that requires them to provide "emergency" contraception.
We live in a time and in a culture where, if they are to survive, the identity of Catholic institutions needs to be strengthened, not diluted. Instead of submerging them in the dominant secular culture, it may be prudent to keep them apart. Sadly, all of the official Catholic institutions and organizations in the diocese of Manchester are invested in this reckless policy of engagement. Only former state representatives Barbara Hagan and Kathleen Souza, Catholic medical ethicist Colleen McCormick, New Hampshire Right To Life and the Friends of Saint Benedict Center have warned of the folly of trusting the mandarins of the Culture of Death to protect institutions dedicated to the Author of Life.
Prior to the COVID-19 lockdown, the Charitable Trusts Unit of the New Hampshire attorney general's office planned to hold a series of regional public hearings on the proposed combination agreement between Catholic Medical Center and Dartmouth-Hitchcock Health, followed by a public comment period. The deadlines for those events have now been suspended. Once the state of emergency has been lifted, the process will resume. Ultimately, the attorney general of New Hampshire will issue his findings in a final report. Ironically, if Catholic health care is preserved in New Hampshire, the secular state, not the Catholic hierarchy, will be its savior.
C. J. Doyle is the director of communications for the Friends of Saint Benedict Center.