Americans United has monitored hospital mergers for a number of years now, pointing out that when Catholic hospitals join with non-Catholic institutions, Catholic doctrine is imposed, and certain services are lost.

What’s going on in Louisville, Ky., is especially alarming. A University of Louisville-affiliated hospital that serves a mostly low-income population is planning a merger with a Catholic health-care system. An array of services may be lost, hitting a population that can ill afford to see them go.

As Inside Higher Ed reports, under the proposal, the University of Louisville Hospital would combine with two other systems under the umbrella of Catholic Health Initiatives, a firm based in Denver.

If the merger goes through, the university hospital will be required to abide by a list of directives promulgated by the church hierarchy and may stop providing numerous services, including therapeutic abortion, sterilization procedures, distribution of “morning after” pills for rape victims and other procedures. In addition, patients’ end-of-life decisions may be ignored if they conflict with Catholic dogma.

The good news is that residents of Louisville are fighting back. More than 400 people have signed a petition protesting the merger.

Political leaders have also questioned the deal. In an opinion column that ran in the Louisville Courier-Journal, Kentucky Reps. Tom Burch and Mary Lou Marzian wrote, “Both men and women will be dismayed to see their advance medical directives are not respected in a Catholic hospital. Women should never have to question their doctor’s allegiance, and providers should not have to worry that they will be dismissed for giving comprehensive care.”

(Burch, himself a Catholic, co-chairs the legislature’s Joint Committee on Health and Welfare, which will hold a hearing on the merger later this month. He told the Courier-Journal that University Hospital “belongs to the citizens,” not the Catholic Church. “As a conscientious Catholic,” he said, “I have an obligation to my constituents and to the people of Kentucky [to see that] that they do not fall under dictates that they do not believe in.”)

Others have noted that the Catholic directives are so broad and dogmatic that in some cases they can actually jeopardize women’s lives.

“The Catholic directives that are proposed for use at University Hospital involve not just tubal ligation and end-of-life choices, but emergency medical treatment to women who develop life-threatening conditions during pregnancy,” wrote Beverly Glascock, a former nurse at the hospital who is now an attorney. “Unfortunately, there are a number of conditions that can arise during pregnancy that require an abortion to save the mother’s life, including preeclampsia and eclampsia, ectopic pregnancy, sepsis, miscarriage and more.”

But the church is digging in. Louisville Archbishop Joseph E. Kurtz told a community group, “If something calls itself a Catholic ministry, it is the responsibility of the bishop to ensure as best we can that that indeed is an accurate title.” He later wrote a column vowing to make certain that all hospitals in the merger follow the directives.

At the same, university officials are adamant that a full range of services will be offered – even if it means taking them to a separate building.

“I have understood the point of view articulated by Archbishop Kurtz from the start of the merger conversation,” Dr. Edward Halperin, dean of the university’s School of Medicine, told the Courier-Journal. “This is a hospital merger, not a merger of this public university, its School of Medicine, or its faculty. We will serve the citizens from whom our support derives. We are the people’s university.”

Halperin added, “Elective abortion, medically indicated abortion if the mother’s health is in danger, and tubal ligation will continue to be available from my faculty. We have made a promise. We will keep it.”

Those are strong words, and I applaud them. But the people of Louisville need more than words right now. They need to understand that their medical care is at risk and mobilize to save it. Only then will Dr. Halperin be able to honor his promise.