If St. Vincent Regional Medical Center goes through with a proposed partnership with CHRISTUS Health, the hospital would become the only acute-care Catholic hospital in the state.

St. Vincent was a Catholic hospital for 110 years, but in 1975 it became a private, not-for-profit hospital.

In November, St. Vincent and CHRISTUS, a Catholic health care organization based in Texas, announced their formal intention to explore a 50-50 partnership. They plan to make an announcement by February, officials have said.

If the partnership becomes a reality, St. Vincent will follow the Catholic Church's Ethical and Religious Directives for Catholic Health Care Services, according to Alex Valdez, president of the hospital.

The directives forbid Catholic hospitals from performing abortions and sterilizations, and from promoting or condoning contraceptives.

For some, the directives have brought up questions about whether the hospital's reproductive health services will remain the same.

Valdez and other officials, however, have said the hospital plans to keep offering all the reproductive health services it already does. Also, employee health-insurance policies would remain the same, including access to birth control.

Nonetheless, Heather Brewer, executive director of NARAL Pro-Choice New Mexico, said she will be watching what happens at St. Vincent carefully.

It is important that people in Santa Fe know that the potential merger between St. Vincent and CHRISTUS could limit their reproductive health care services, Brewer said, but it is too early to say how.

Valdez said St. Vincent does not perform elective abortions or most elective sterilizations on campus, but there are some procedures — such as tubal ligations during C-sections — that the hospital does perform and would like to continue to perform.

St. Vincent and CHRISTUS officials are in the process of determining how the hospital will continue to offer the services under the Catholic directives, Valdez said.

Valdez said he has named three doctors to a committee to examine the subject and make recommendations.

The doctors are only in the preliminary stages of looking at the subject, said St. Vincent spokesman Arturo Delgado.

Most contraceptive counseling and prescription writing at St. Vincent is done on an outpatient basis, Delgado said.

State law mandates that hospitals make emergency contraception available to rape victims, said Barbara Goldman, executive director of the Santa Fe Rape Crisis Center.

Delgado added that the emergency contraception St. Vincent offers rape victims is Plan B. Plan B works like other birth control pills by stopping the release of an egg from the ovary and preventing the fertilization of an egg, according to online information from the manufacturer, Duramed. Plan B is not RU-486, the abortion pill, according to the company.

Dr. Thomas Royer, president and chief executive officer of CHRISTUS Health, said it is his belief, based on conversations with Michael J. Sheehan, archbishop of Santa Fe, that St. Vincent will continue to offer all the reproductive health services it already does.

Sheehan was at an Advent retreat and could not be reached.

Monsignor Jerome Martinez y Alire, rector of the Cathedral Basilica of St. Francis of Assisi, said it is his understanding that the hospital will continue to offer all the services it does now.

As for how St. Vincent would operate as a Catholic hospital, Abby Lowe, a spokeswoman for CHRISTUS, said that by becoming a Catholic hospital, the church would not have any ownership over St. Vincent.

CHRISTUS would be able to appoint half of the hospital's board members, and one-third of them could be CHRISTUS employees, said Joe Lupica, president of Stroudwater Capital, and an adviser to St. Vincent board members during their search for a partner.

Valdez, the hospital's president, would become a CHRISTUS employee, and CHRISTUS would have to appoint him to the board, Lupica said.

As for how CHRISTUS officials would monitor the hospital's compliance on the Catholic directives, CHRISTUS has a board of directors that includes five sisters, and part of the board's responsibilities is to make sure the organization and its affiliates are following the directives, Lowe said.

In addition, CHRISTUS employs a senior vice president of mission, ethics and spiritual care as well as a system director of ethics to ensure compliance with the directives, Lowe said.

There are also CHRISTUS associates who have responsibilities at the local level, Lowe said.

The archbishop, because he is responsible for all the ministries in his diocese including health care, could intervene if there was an issue, Lowe said.

CHRISTUS and its affiliates "... are really self-governing agencies that adhere to the directives because we feel strongly about them and because they are such a rich part of our heritage," Lowe said.

In terms of what has happened at other hospitals that have entered similar agreements with CHRISTUS, information is limited.

The only other 50-50 partnership CHRISTUS has with a hospital is with Baptist St. Anthony in Amarillo, Texas, Royer said.

Mary Barlow, director of communications for BSA Healthcare in Amarillo, said the hospital was half Catholic when it started, so not much changed when it entered the partnership with CHRISTUS.

But the hospital does not necessarily follow Catholic health care directives exactly, Barlow said. For example, the hospital does perform tubal ligations, she said.

A large legal document spells out exactly which reproductive health procedures doctors can perform at the hospital and which they can't, Barlow said.

Lowe said the reproductive health directives haven't been an issue at hospitals CHRISTUS owns because patients have been able to go to other community facilities for those services.

St. Vincent, however, is the only community hospital in Santa Fe.

Lois Uttley, head of MergerWatch, a health care watchdog group based in New York City, said until 2005, the Catholic Church allowed sterilizations to continue at many hospitals that became Catholic.

But then the U.S. Conference of Catholic Bishops decided sterilization was on the same moral level as abortion, Uttley said, and the church discontinued most of those agreements.

Local bishops decide how to interpret the conference's rules, so some bishops might allow sterilizations to continue, Uttley said.

This is one example of how health care services can change in the future, Uttley said.

For example, a bishop in New York state recently allowed a hospital to continue to perform post-partum tubal ligations because they are a continuation of treatment the doctor has already undertaken, Uttley said.

"It remains to be seen if that would be widely adopted," Uttley said.

Many women decide to have a tubal ligation when they deliver a child because they believe their families are complete, Uttley said. And having a postpartum tubal ligation can make medical sense if a woman is already under anesthesia.

Other hospitals have come up with other solutions, Uttley said.

Some hospitals have built separate facilities in a stand-alone building or dedicated separate floors for women's reproductive health services, Uttley said.

But moving some services off campus can be problematic because it results in fragmented care, Uttley said.

In all cases, hospital administrators must have a commitment to continuing services, and Catholic officials must be responsive to people of other faiths who want access to a full range of reproductive health services, Uttley said.

As far as end-of-life decisions, Lowe said CHRISTUS does have specific policies, and that would be up to the St. Vincent board of directors.

The hospital will follow state law, and will also look to the Ethical and Religious Directives for Catholic Health Care Services for guidance, Lowe said.

That directive reads in part, "There should be a presumption in favor of providing nutrition and hydration to all patients, including patients who require medically assisted nutrition and hydration, as long as this is of sufficient benefit to outweigh the burdens involved to the patient.

"Catholic health care institutions may never condone or participate in euthanasia or assisted suicide in any way. Dying patients who request euthanasia should receive loving care, psychological and spiritual support, and appropriate remedies for pain and other symptoms so that they can live with dignity until the time of natural death."