UPDATE: Governor Inslee's office says that he "remains very concerned" about this issue and has asked his staff to look into "all available options—including a moratorium—that will help ensure all Washingtonians maintain access to all health care services, whether reproductive care [or]end of life services."

Ten women's and civil rights organizations, led by the ACLU of Washington, are calling on Governor Jay Inslee to enact an immediate six-month moratorium on all proposed or pending hospital merger decisions in Washington state. As I reported earlier this year, the proposed mergers involve Catholic healthcare institutions that could severely restrict patient access to lawful treatments like abortion and end-of-life care.

Noting that "serious state constitutional concerns" arise when public tax dollars are used to fund religious hospitals that restrict access to women's reproductive healthcare and death-with-dignity services, the three-page letter (.pdf) states, "As leader of our state, we ask you to act immediately to safeguard patients' access to all lawful and medically appropriate health care services by: (i) enacting a six-month moratorium on any decision by the Washington State Department of Health on proposed or pending applications related to hospital ownership, operations, or management; and (ii) utilizing this six-month period to conduct a community health needs assessment that would provide an objective evaluation of such mergers' impact on patients' ability to access medically appropriate health care services and provide policy guidance moving forward.

I've contacted Inslee's office for comment; I'll let Slog know when I get a response.

The letter notes that without such a moratorium, 45 percent of hospital beds could be controlled by religious institutions by year's end (that number is currently at 40 percent). By contrast, religious institutions only controlled 20 percent of hospital beds in April 2010.

To get a better sense of how ominous all these mergers are, it's helpful to take a look at the Ethical and Religious Directives that guide Catholic hospital care (and the ACLU's letter helpfully includes a few, .pdf). For example:

Directive 1: A Catholic institutional health care service is a community that provides health care to those in need of it. This service must be animated by the Gospel of Jesus Christ and guided by the moral tradition of the Church.

Directive 5: Catholic health care services must adopt these Directives as policy, require adherence to them within the institution as a condition for medical privileges and employment, and provide appropriate instruction regarding the Directives for administration, medical and nursing staff, and other personnel.

Directive 24: In compliance with federal law, a Catholic health care institution will make available to patients information about their rights, under the laws of their state, to make an advance directive for their medical treatment. The institution, however, will not honor an advance directive that is contrary to Catholic teaching. (If Directive 24 isn't explicit enough, Directive 28 says that your "free and informed health care decision" should be followed "so long as it does not contradict Catholic principles.")

And my personal favorite, Directive 36: A female who has been raped should be able to defend herself against a potential conception from the sexual assault. If, after appropriate testing, there is no evidence that contraception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum.

The list (.pdf) goes on and on and on. It's truly horrifying.