For those who value church-state separation and responsible health care, there is a growing issue with partnerships between public institutions and religiously affiliated hospitals. 

Consider the situation at the University of Texas, which plans to open a medical school but train its students at a Catholic-run teaching hospital.

The Austin American-Statesman reported last week that a closed-door negotiation is now underway to form a partnership between the public university, the Catholic-owned Seton Healthcare Family and Central Health, which is the Travis County hospital district.

The newspaper said local health and university officials don’t see any problem with this arrangement, asserting that women will receive the same treatment options that they have now. But what does that mean, exactly?

Since 1995, Seton has run Brackenridge Hospital, Texas’ oldest public hospital, the American-Statesman said. Meghan Smith of Catholics for Choice told the newspaper that this arrangement has forced the hospital to “jump through hoops” to honor Catholic doctrine while continuing to offer some reproductive and end-of-life services.

This previous merger led to the creation of a “hospital within a hospital,” where procedures such as voluntary sterilizations took place on one floor only under the direction of a public entity. But that practice stopped this year, the American-Statesman said, while other services, such as abortions, are only available through Planned Parenthood.

It doesn’t sound like Seton is backing off of its Catholic doctrinal restrictions on healthcare services now, and that could be a big problem when future doctors come to train at the hospital.

Americans United Staff Attorney Ian Smith told the Austin newspaper that medical students will face all sorts of constitutional conflicts.

“You have the University of Texas sending public school students to a hospital where … they have to tell their students they are bound by Catholic religious doctrine,” he said.

That’s very bad news for healthcare as a whole and the rights of both patients and doctors.

Unfortunately the situation in Texas is not the only one in recent years that would create a constitutionally problematic public-private hospital merger. A similar situation arose in Louisville, Ky., in which a Catholic hospital system was set to gain control of a public hospital until Americans United and others spoke up.

When public entities merge with religious ones, there are always problems. Who is in charge? Who gets the final say? And what do you do when one side (or both) can’t work out a conflict through compromise?

Since these questions are always difficult to answer, public and religiously affiliated hospitals should not merge. History shows that the religious groups often get the upper hand in these mergers, thereby forcing patients and doctors to be bound by religious restrictions they do not subscribe to.

When that happens, the church wins while everyone else loses.