Francis X. Rocca of Religion News Service reports that the Vatican will write new guidelines for Catholic health care institutions in response to recent ideological clashes with the Catholic Health Association, notedly over the excommunication of a sister who approved an abortion to save the life of a woman and later the removal of Catholic standing for the hospital where she was treated.

Kevin Clarke at America Magazine (the national Catholic weekly) writes (rather rosily) that a series of communications and conference calls in January confirms that CHA and the USCCB are in agreement that the local bishop is the buck on ethical decisions at Catholic hospitals, but we suspect the clashes between the two organizations won’t so quickly be resolved.

The Vatican’s stance on many issues — particularly abortion, emergency contraception for rape victims, artificial nutrition and hydration at the end of life, artificial fertilization, and tubal ligations — often rub directly against federal and state laws that protect patient autonomy.  While all 624 U.S. Catholic hospitals are protected in their stance by a webwork of conscience clauses, medical practitioners and patients at Catholic institutions aren’t always as Catholic as the USCCB would like.

The friction between the two organizations isn’t necessarily one of poor language, as Monsignor Jean-Marie Musivi, undersecretary of the council, states.  Rather, medical practitioners and bishops tend to approach modern technology and the needs of patients from different positions.  The choices patients face, in the gap between faith and care choices, often fall into two categories: Health or Hell.

Even if the two organizations do come to a clear understanding of what can and can’t be provided to patients under Catholic guidelines, the greater challenge of resolving the injustice of the provision of denomination health care to an increasingly diverse community  — in 45 areas of the U.S., exclusively — is an issue for the courts, patients, state legislatures, and federal law.

Determining when life begins and ends may be the sole realm of a local bishop for consenting Catholics but those definitions will continually be challenged by patients who are relegated to the use of Catholic hospitals but don’t ascribe to the USCCB’s interpretations.