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Originally published Friday, October 14, 2011 at 12:31 PM

Under pressure on abortion, Swedish backs new Planned Parenthood clinic

Swedish Medical Center, which plans to stop performing elective abortions because of a pending alliance with Catholic-run Providence Health & Services, will send patients to a new, full-service Planned Parenthood clinic near its main hospital, which Swedish will help fund.

Seattle Times health reporter

Swedish-Providence affiliation

THE ARRANGEMENT would include all of Swedish's facilities and Providence's operations in four counties in Western Washington.

Swedish Health Services: www.swedish.org

• Based in Seattle, a private not-for- profit organization founded in 1910.

• Scope: King, Snohomish and Kittitas counties

• Hospitals: five

• Clinics: more than 70

• Employees: more than 11,000

• Medical staff: 3,000 physicians

Providence Health & Services: www.providence.org

• Based in Renton, a Catholic, not-for-profit organization founded in 1856 by the Sisters of Providence.

• Scope: Overall, Alaska, California, Montana, Oregon and Washington. For the affiliation: King, Snohomish, Thurston and Lewis counties.

• Hospitals: 27 in the five-state area

• Clinics: 214 overall

• Employees: 53,000 overall

• Medical staff: 1,100 physicians in Western Washington

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quotes This is an act of institutional cowardice, right down to the mealy-mouthed news release. Read more

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Swedish Medical Center, beset by mounting opposition to its decision to stop performing elective abortions if a pending alliance with a Catholic health system is approved, will help underwrite a Planned Parenthood center in the Nordstrom Tower adjacent to the hospital.

Swedish's plan to refer patients to the center, which will provide a full range of reproductive-health services, including elective abortion, has been in the works for several months and was expected to be announced next week.

On Friday, as women's rights groups and others began vocal protests about its decision to end elective abortions, Swedish decided to move up its announcement.

"Swedish is deeply committed to ensuring women have access to comprehensive care," said Dr. Jane Ulhir, Swedish's medical director, in a statement. "We chose Planned Parenthood because they are the experts in the efficient delivery of reproductive health care."

Last week, when Swedish revealed its pending affiliation with the much larger Providence Health & Services, it said it would "remain a nonreligious organization." However, Swedish spokesman Ed Boyle later said the system would stop performing elective abortions "out of respect for the affiliation" if the arrangement were to be approved by regulators.

"Extremely pleased"

The news caused an outcry by women's reproductive-rights groups. "If the reason they're doing this is because of the agreement with Providence, then it is one religion forcing its beliefs on the health-care system," said Lauren Simonds, executive director of NARAL Pro-Choice Washington.

Swedish will refer women to the center, to be called the First Hill Health Center of Planned Parenthood of the Great Northwest and expected to open in early 2012. Swedish will continue to provide reproductive emergency services and birth-control services, including tubal ligations.

"I'm extremely pleased that this has the potential to work for everybody," said Chris Charbonneau, president and CEO of Planned Parenthood of the Great Northwest. "Our plan is to make sure that not a single woman can't get the services they need."

Charbonneau, in a statement, said Swedish should be commended for its leadership in maintaining the continuity of care for its patients.

In 2000, when Swedish took over the former Providence Hospital in Seattle, now named Swedish/Cherry Hill, it announced that it had stopped performing elective abortions. At that point, the hospital was doing fewer than 50 of the procedures annually at its First Hill and Ballard campuses, it said.

The 2000 agreement was sought by Providence, which was founded by the Sisters of Providence, as a condition of the arrangement. At the time, Richard Peterson, then CEO of Swedish, said he realized the decision would be of "major concern to the community."

Abortions continued

Publicly, Swedish said it was continuing to provide other reproductive services, including tubal ligations, contraception and the morning-after pill. Providence's stance at the time was to keep the procedures at arm's length, saying it would not benefit economically from any of those services.

But in fact, said Charbonneau, Swedish never stopped performing elective abortions — a fact not openly disclosed and which took some Providence officials by surprise in the recent negotiations. Swedish has been segregating the procedures financially, so that Providence had no financial stake in them, she said.

Swedish would not say how many elective abortions it currently performs, other than saying it is a "limited number" that does not include late-term abortions, said spokeswoman Melissa Tizon.

Both Tizon and Charbonneau said abortions are more often — and more appropriately — performed in a clinic than in a hospital.

"Swedish should never have been doing those things in a hospital, anyway," Charbonneau said. "We have really perfected the office procedure. When you take people into a hospital, you add a level of complications and danger," unnecessarily medicalizing the procedure and typically making it more expensive, she said.

The announcement did not allay concerns that the pending affiliation might curtail patients' end-of-life choices.

Adjustments may be made

Boyle said Swedish does not currently participate in "physician-assisted suicide, euthanasia or IVF (in-vitro fertilization) procedures that involve embryonic destruction — and that will not change." But, he added, "we will be going through our policies to review them and make any adjustments in connection with the affiliation."

Washington legalized physician aid in dying in 2008, allowing physicians to prescribe lethal medication that terminal patients can use to hasten death; the Death with Dignity law went into effect in early 2009.

Robb Miller, executive director of Compassion and Choices of Washington, a right-to-die organization, said he worried that Swedish hospice workers would be told not to discuss physician assistance in dying or to refer patients to his organization for information.

In addition, he said, other affiliations with Catholic health systems have had a "chilling effect" on doctors' willingness to assist patients with death with dignity. "The thought of Swedish coming under Providence's supervision is very concerning, very very concerning," Miller said.

When PeaceHealth, a Catholic health system, took over Southwest Medical Center in Vancouver, Wash., late last year, Miller said, several doctors stopped helping patients use the law.

In general, critics of hospital-system mergers worry that health-care delivery, which they believe should be provided on a secular basis, could be curtailed by Catholic religious beliefs as Catholic-run hospital chains affiliate with secular health systems.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com

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