Editorial: Reproductive services: the Hoag Hospital compact

When Hoag Hospital, which has facilities in Irvine and Newport Beach, announced it was establishing a partnership with St. Joseph Health System, community groups say they were promised that the hospital would continue to provide the same services it always had. But soon after — and not all that surprisingly, given that St. Joseph is Catholic-run — Hoag declared that it would stop providing elective abortions.

The decision drew an angry protest from some doctors and women's groups, who felt they had been lied to. On top of that, Hoag explained it was giving up the procedure because of low demand, although it subsequently turned out that ending elective abortions was a condition of the partnership from the start. And when the hospital announced it was dropping the procedure, officials said they would instead give women information about alternative providers in the area. Critics soon began to complain that that wasn't happening, either.

California Atty. Gen. Kamala Harris, whose office had approved the partnership, undertook an investigation. Although her office did not ultimately weigh in on whether Hoag had broken its promises, it did something that may prove even more important: It drew up a stringent agreement that holds the hospital to specific guidelines governing reproductive services. For example, Hoag had already agreed to continue to perform sterilizations and fertility treatments. The new agreement extends that for 20 years instead of the 10 promised under the original agreement. The hospital also had agreed to continue to perform nonelective abortions necessary to treat medical conditions, including miscarriages. The new agreement specifies the types of pregnancy complications that might require an abortion.

Additionally, the agreement requires Hoag to post a link on its website to information about providers of elective abortions; it must also maintain a referral service for patients about abortion services in Orange County. And physicians with private practice offices in Hoag facilities are exempt from the ban on elective abortions.

The Hoag controversy comes at a time when more hospitals are merging with Catholic hospitals that ban various types of reproductive healthcare. According to the American Civil Liberties Union, the number of Catholic-sponsored or -affiliated hospitals increased by 16% between 2001 and 2011 around the country even as the overall number declined. This can leave women with few places to turn for reproductive services.

The agreement with Hoag will help. Indeed, it would be good if all hospitals affiliating with religious institutions were to spell out similarly specific steps to assure that women are not left stranded without access to legal, safe reproductive care.

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