Same-sex marriage advances– hospital secrecy recedes.
While I am sure it is coincidental, I find it ironic that on the same weekend the Supreme Court refused to take on the same-sex marriage issue in Washington– thus making such marriages legal in 11 additional states– the Kentucky Court of Appeals ruled that University Medical Center Inc. is indeed a public agency. I wondered what was happening to that lingering litigation. I will try to assemble and post the various briefs from the trial and appeals courts and try fill in the gaps. The opinion gives a useful overview of hospital history. Read it here.
The stories are linked.
From my perspective, the two stories are linked because of the intrusion of religious dogma into the administrative, research, and clinical operations at University of Louisville Hospital, and indeed at UfoL itself. One of the first things KentuckyOne Health did when they took over management of University Hospital was to take away longstanding benefits to employees in legal same-sex marriages and committed domestic partnerships— a rather cruel way to save a few dollars I thought. KentuckyOne and the University claim that the hospital itself is now a private institution, can follow their own rules, and is immune to the accountability demanded by Kentucky’s Open Records Act. Jefferson County Circuit Court, Kentucky’s Attorney General, and the Appeals Court all took a rather different view, albeit for different reasons, and returned our hospital to its public. KentuckyOne and its partners now have to decide whether to appeal the decision to the Kentucky Supreme Court. I suspect they will. Avoiding exposure of what lies behind the curtain has become reflex in University matters.
Marriage is bustin out all over.
What will KentuckyOne do when same sex marriage becomes legal in Kentucky– as it surely will soon be. Will it claim a corporate privilege to exercise its religious freedom to discriminate as it pleases? Indeed, looking at a national map, Catholic Health Initiatives (CHI), the owner of KentuckyOne Health, has hospitals in 7 states that already recognize same-sex marriages: Washington, Oregon, New Mexico, Minnesota, Iowa, Pennsylvania, and New Jersey. Following last week’s pass by the US Supreme Court, CHI now has hospitals in an additional 4 states including Indiana, Wisconsin, Kansas, and Colorado in which discrimination against same-sex marriage will shortly be legal. Colorado even houses CHI’s corporate offices! Can anyone out there tell us how CHI treats its gay and lesbian employees in the states listed above? Are there any states in which CHI currently recognizes the legal same-sex marriages and families of its employees? If so, why should it be any different here in Kentucky? If not, how is that practice being justified legally?
As it is now, there are two separate hospitals under the same roof in the University Hospital building. The one still managed by University Medical Center, Inc. continues to respect all of its employees in the same way it always has– including the provision of comprehensive reproductive healthcare benefits. The other hospital trivializes and ignores the marriages of some of its employees, dolling out as a kind of favor selected employee benefits for those willing or even eligible to characterize their spouses as dependents instead of true partners. It seems superfluous to add here that even those benefits exclude contemporary comprehensive reproductive healthcare. It is appropriate to here add that patients in the two hospitals are also treated differently.
Leaks substituting for fully informed consent.
Despite considerable pressure by KentuckyOne and UofL to discourage employees and faculty to talk to people like me or other reporters, enough have shared experiences to reinforce my opinion that subjugating academic medical practice to religious dogma would lead to inappropriate outcomes. UofL and KentuckyOne also have reason to be concerned. I am being told that birth control pills ordered by physicians for patients on the general medical floors are sometimes not being administered. On the other hand, at other times they are! No one should be happy about this! Not giving ordered medications should give UofL malpractice lawyers some concern, and giving contraceptives to its patients puts KentuckyOne in a state of religious “scandal.”
The American way of death– who decides?
I was concerned previously that end-of-life patients would have parts of their living wills ignored in that part of University Hospital that adheres to the Ethical and Religious Directives of the Catholic Church. I do not have enough evidence in hand to dispel completely my fear that termination of fluids and feeding for the dying would be continued against a patient’s or family’s wishes as it is in some if not all Catholic hospitals. My correspondents tell me that they have not seen a change in the way end-of-life care is being provided at University Hospital. I do not know if CHI or KentuckyOne would be comfortable admitting that such “natural” treatments were being withdrawn in their hospital. I hope they are willing to tell us all that they are.
I should not have to be writing about such things. It is no secret that I am unhappy with UofL for dragging us into this mess. Perhaps its motives will become more clear. If UMC, KentuckyOne, and UofL accept the judgements of the courts, the curtains will rise and we of the public will have the transparency and accountability to which we are entitled. I predict there will be much to be proud of, but we will likely also see things that may be embarrassing to the University. Better in the longer term to get things out in the open where they can be either admired or fixed!
As always, if I have made an error in fact, please help me fix it.
Peter Hasselbacher, MD
Emeritus Professor of Medicine, UofL
October 9, 2014
Court Documents for 2013-CA-000446:
Court Proceedings from University Medical Center Inc.’s appeal of lower court decision finding it to be a public institution, and not the private corporation it claims to be.
• UMC Brief of 7-15-2013. (pdf 1.4 MB)
• Amicus Brief from ACLU of 10-11-2013. (pdf 1.0 MB)
• Amicus Brief from Courier Journal et. al. -undated. (pdf 1.4 MB)
• UMC Reply to Amicus Brief of ACLU. 10-25-2013 (pdf 0.6 MB)