If Sophia Bryson is near death and unable to talk, she has an advance directive to speak for her.
“If I’m in a vegetative state and there’s not really much that can be done for me, I just don’t want to be artificially kept alive by a feeding tube and hydration and all that,” she said. “When it’s time to go, then let me go.”
But Bryson, 72, of Tallmadge is concerned Summa Health System’s partnership with soon-to-be minority owner Catholic Health Partners could result in her wishes being ignored.
“I don’t want somebody else deciding for me,” she said.
Summa physician leaders for women’s health and end-of-life care recently addressed widespread questions about whether the health system’s policies will change after Catholic Health Partners gets a 30 percent ownership stake.
The agreement specifies that Summa won’t be required to adhere to the Ethical and Religious Directives (ERDs) for Catholic Health Care, the doctrine followed by all Catholic-sponsored hospitals.
Under the terms of a separate “Statement of Common Values” with the Cincinnati-based Catholic hospital system, Summa can’t perform “direct abortions” or withhold nutrition or hydration to hasten death.
Summa officials insist the partnership won’t result in any changes to medical services at the Akron-based health system.
“Our approach to care at the end of life or at the margins of life will not change in any way,” Dr. Steven Radwany, Summa’s medical director for hospice and palliative care services and chair of the ethics committee, said in a recent interview. “We will always keep patients’ wishes in the highest priority and emphasize comfort and dignity in those terrible situations.”
The Statement of Common Values indicates Summa won’t “deliberately hasten or cause death either by withholding treatments that are reasonably beneficial and not excessively burdensome or by depriving a patient of basic human care in the form of nourishment or hydration.”
Summa already follows this approach, Radwany said.
“We will not do things to hasten death,” he said.
Artificial nutrition and hydration aren’t used for all patients, particularly if these measures do not offer help, he said.
“Many times, artificial nutrition provides a much greater burden to people,” he said. “That’s a burden they don’t want or need. When it’s more harmful than helpful, we can’t do that.”
And, in fact, “the Catholic tradition is in complete alignment with the issue,” Catholic Health Partners President and Chief Executive Michael D. Connelly said.
Reproductive care
In the area of women’s health services, Kellie Copeland, executive director of NARAL Pro-Choice Ohio, said her organization is concerned whether Summa’s affiliation with Catholic Health Partners “will seriously impact the availability of abortion care.”
“We just really want to know how this merger is going to impact the availability of needed reproductive health care for the community,” she said. “Obviously, we have a concern if a hospital is not going to provide abortion care if there is an immediate health need for a woman or her health issues make it not appropriate for her to have a procedure at a stand-alone abortion clinic or she might need the type of medical interventions that might only be available at a hospital.
“When it comes to women’s health, we expect the hospitals in our communities to intervene when needed, regardless of whether it’s a reproductive issue or a heart attack.”
Summa hospitals will continue to terminate pregnancies in those rare cases in which a mother’s life is in jeopardy or some complex, lethal fetal anomalies are discovered, said Dr. Vivian E. von Gruenigen, medical director of women’s health services for Summa. In other circumstances, abortions are provided at independent clinics in the region.
“Through a series of conversations, the hospital leadership, administration and CHP all agree that we will not be changing the way we practice medicine for women,” she said.
Von Gruenigen estimates Summa provides fewer than 10 abortions per year when mothers’ lives are at risk from severe hypertension, an infection in the uterus or other serious health issues.
“The services that we provide are for those catastrophic, terrible situations that we are the safest place for the woman,” she said.
Summa will continue to have transfer agreements with area abortion clinics, which are required to have these arrangements in place if complications occur, von Gruenigen said.
Drug formulary unchanged
Summa also isn’t removing any prescription drugs — including the emergency contraceptive known as the “morning-after pill” — from its formulary as a result of the partnership, von Gruenigen said.
Under the terms of the agreement, CHP can’t ban Summa facilities from providing tubal ligations, vasectomies and prescriptions for contraceptive drugs and devices — all services in conflict with the Catholic church.
However, the definitive agreement states “no portion of the CHP investment will be used to support any procedures or activities of Summa operated facilities that conflict with the Catholic ERDs, nor will CHP provide management services or support for, or otherwise be connected to, or financially benefit from, such procedures.”
Cheryl Powell can be reached at 330-996-3902 or cpowell@thebeaconjournal.com. Follow Powell on Twitter at twitter.com/abjcherylpowell.