After Roman Catholic leaders issued strong criticism about its trampling of religious freedom, the American Medical Association approved a watered-down measure supporting continued community access to a full range of reproductive services following hospital consolidations.
The AMA's amended resolution stopped short of saying Catholic hospitals should have to perform all reproductive health procedures, including vasectomies and tubal ligations, which are prohibited by the church.
The AMA instead upheld its policy that physicians and hospitals not be forced to perform services that violate their moral principles.
The resolution does not specially mention abortion.
The AMA House of Delegates passed the amendment at its meeting last week in Chicago by a 247-184 vote.
The availability of reproductive services has gained national attention as more Catholic hospitals merge with secular facilities, which can result in the curtailment of some of these services.
The measure the AMA adopted was dramatically different from the one first introduced by the California AMA delegation.
Opponents to that resolution, including Cardinal Francis George, archbishop of Chicago, said the California proposal was aimed at trying to force Catholic hospitals to provide reproductive services not allowed by the church.
The original resolution said any hospital providing perinatal services and receiving taxpayer money, such as Medicare and Medicaid, should have to provide a full range of reproductive services.
The St. Louis-based Catholic Health Association applauded the AMA's final action.
"We consider it a major victory for religious freedom in the United States," said the Rev. Michael Place, president and chief executive officer of the CHA, which represents more than 2,000 Catholic healthcare providers and religious sponsors.
Place and Michael Collins, M.D., chairman-elect of the CHA, left the association's annual meeting in San Francisco last week to fly to the AMA meeting in Chicago. Collins testified before the AMA but Place didn't.
After hearing testimony from Collins and other opponents, an AMA committee recommended revamping the California proposal.
The amended resolution includes support from the AMA for laws requiring that health plans that cover reproductive services provide access to those services.
The delegates also voted to oppose gag clauses that prevent doctors from discussing with their patients all reproductive healthcare options.
Michael Cohen, M.D., an alternate delegate from California, was responsible for the amendment that calls for continued community access to services after hospital mergers.
Cohen told the story of two hospitals near Gilroy, Calif., one owned by San Francisco-based Catholic Healthcare West and another by Nashville-based HCA-The Healthcare Co.
Cohen said CHW bought the HCA facility, closed its other hospital and eliminated reproductive services at what was the only hospital left in a 35-mile radius.
It was this action, he said, that prompted the California Medical Association to draft its resolution to the AMA.
AMA trustee John Nelson, M.D., said the amended resolution would encourage the AMA to keep better tabs on local situations involving access to services issues, such as in the case of Santa Clara County, Calif.
The AMA, he said, would look around the country to see if there are access problems and encourage that solutions be worked out at the local level.
But Nelson stressed: "We don't support any law that takes away freedom."
With Kristen Hallam