Lisa C. Ikemoto

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Mention of this topic-the potential elimination of health services resulting from a merger or affiliation between Catholic and non-Catholic hospitals-rarely triggers discussions about "community health." It does trigger comments about abortion' and First Amendment Free Exercise and Establishment concerns.2 Some have characterized the issues arising out of these alliances as "women's reproductive health" issues,' but few have described the issues in terms of community health. Perhaps the phrase, "women's reproductive health," suggests why. Women's health is often understood to be reproductive health, or as the narrower issue, abortion. Unfortunately, it seems to go without saying, that women's reproductive health is generally understood to be different and separate from "health." So under patriarchal logic, it stands to reason that we fail to discuss the elimination of services-many of which are known as women's reproductive health services-as a community health problem.

It is also interesting that abortion so clearly shapes the discussion of this topic. That probably reflects the level of political controversy surrounding the legality of abortion and the Catholic Church's role in the controversy, as well as the conflation of women's health with abortion. In fact, a merger or affiliation between Catholic and non- Catholic hospitals may result in the elimination of certain end-of-life choices, counseling for persons who are Human Immune Deficiency ("HIV") positive about the use of condoms to prevent HIV transmission, clinical trials for women, vasectomies, tubal ligations, contraceptive advice and distribution, the morning-after pill for rape victims, many types of assisted procreation technologies, as well as abortion. For some, the potential impact of a Catholic/non-Catholic hospital alliance on health care choices of men transforms the issue into one of community health as opposed to women's health. Yet, why should it take direct impact on men (or the middle class, or whites, or American citizens) to gain recognition of a problem as one affecting community?