As promised several days ago, I want to quickly add a bit more to the discussion about Caritas Christi and Catholic health care in general.
I recommended Dr. Leonard Nelson's new book,
Diagnosis Critical as a start. It's a very clear intro to the subject - the historical, ethical, canonical and legal context of the provision of

health care by the Catholic Church in the United States. For deeper background, he has some helpful introductory chapters on the shifting grounds of Catholic moral theology over the past few decades.
He looks at the development of ethical guidelines over the past century, and the origins of Catholic health care institutions which, it's important to know, in the case of hospitals at least, have never been totally disengaged from government, even before Medicaid and Medicare. Many Catholic hospitals were actually built by local communities, with the physical plant paid for by local governments, with Catholic religious orders invited to staff and run them.
This arrangement developed a federal element with the Hill-Burton act in 1946.The issue of the provision of procedures contrary to Catholic moral teaching broke open in the mid-60's with
Humane Vitae and the resistance to it by large numbers of ethicists. This internal resistance, combined with the external economic and government pressures have resulted in the current situation that some Catholic health systems find themself in.
I want to isolate two points from the book.
First, this: One of the arguments you hear - I've read it in relationship to the Caritas situation - quite often is that these arrangements in which Catholic institutions are in some way connected to the provision of morally objectionable procedures is justified by the larger social justice concern of providing health care for communities, especially health care for the poor. Basically: we have to do this to survive economically, and if we don't, what we provide will be lost.
This isn't a new argument. It was advanced forty years ago by ethicist Richard McCormick. Nelson quotes him as he criticized the bishops' 1971 Ethical and Religion Directives (ERDs) for Catholic health care institutions. McCormick's first argument was that many "Catholic hospitals" are no longer that anyway:
Increasingly they have become community hospitals, often with heavy non-Catholic staff and clienteles. They were frequently financed through public funds or by appeal to the whole community, and still often enough the only health facility reasonably available to a community. In this climate the concept of a 'Catholic hospital' becomes problematic. (that's McCormick, cited in Nelson)
Nelson continues to summarize:
McCormick argued it was morally permissable for a hospital to permit immoral procedures when it served 'the total good of its patients.' By way of example he suggested that a prohibition on postpartum sterilization would be unjustified if it would result in the closing of an obstetrics-gynecology department. He thus concluded that 'the revised code does not adequately deal with the phenomenon of cooperation.'
This should sound familiar. We're hearing a lot of it these days - and the argument plays on the other side as well, as, for example, abortion and contraceptive advocacy groups have fought against Catholic health care institutions buying up other systems, moves that would result in the end of sterilization and/or abortion services in a certain area.
So there's the bottom line: Catholic health care institutions have to survive, and in the present climate, the only way they can is to partner with other entitities, no matter what these other entitites provide or finance. Don't worry, it's said, these bad things will happen in different rooms, on different floors and we won't see the money.
Catholic hospitals must survive.
But...do they?
That's the question with which Nelson ends his book.