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The latest in a long list of affiliations in Washington between secular hospitals and religious health-care systems is a shocker: UW Medicine and PeaceHealth announced Monday they had signed up to create a “strategic affiliation,” with details to be spelled out by the end of September.

UW Medicine, which receives taxpayer support, includes the University of Washington and Harborview medical centers, Northwest Hospital & Medical Center, Valley Medical Center, UW Neighborhood Clinics, UW Physicians, UW School of Medicine and Airlift Northwest.

PeaceHealth, a not-for-profit system based in Clark County and founded by the Sisters of St. Joseph of Peace, operates nine hospitals and physician groups in Alaska, Washington and Oregon, and a Medicaid health plan (Columbia United Providers).

The two organizations said they will remain legally separate and independent, but critics of such affiliations noted that after Swedish Medical Center used such language in an affiliation with Providence Health & Services last year, it stopped doing elective abortions and closed its hospice service.

The U.S. Catholic Bishops’ Ethical and Religious Directives for Catholic Health Care Services restrict such services as abortion, birth control, sterilization and patients’ rights regarding end-of-life treatment.

Other so-called affiliations have turned out to be wholesale purchases of hospitals by Catholic systems.

“We are troubled and concerned because we have yet to see the final details,” said Sarah Dunne, legal director for the ACLU of Washington. “What we don’t know is whether this is a Trojan horse. … They’re saying they’re independent organizations, but we’ve seen this before, and lo and behold, once they’re connected, one takes over the other.”

In a joint statement, the UW and PeaceHealth said the two organizations shared common values, including being mission-driven, not-for-profit organizations with a focus on evidence-based medicine, community health improvement and cost-effective care.

Johnese Spisso, UW Medicine chief health system officer, said the affiliation will allow coordination of care and services with a respected health-care organization “that shares our passion for serving everyone in the community regardless of their ability to pay.”

Peter Adler, chief strategy officer for PeaceHealth, said the affiliation will allow his organization to better provide a full continuum from primary care to the most complex specialized services, such as high-risk obstetrics and neurosciences.

But the assurances did not mollify critics, who have mobilized in the past year after MergerWatch, a New York-based patients rights advocacy group, singled out Washington as having the most secular-religious affiliations under way.

“This is terrible news for anybody who cares about the separation of church and state and not having the Catholic bishops interfere with health care,” said Monica Harrington, an outspoken critic of religious control of health care since PeaceHealth affiliated with the public hospital district on San Juan Island, where she is a part-time resident.

“What we have seen is they always underplay the nature of the affiliation,” she said. “Affiliations have a way of morphing into partnerships.”

She noted that PeaceHealth has said it is essentially a church, and in a public meeting last year, one of its leaders said it would not disobey the (local) archbishop. “So for the University of Washington to enter into a partnership with a church should send chills up everybody’s spine. We hope the governor and the attorney general put a stop to this.”

Attorney General Bob Ferguson has been asked to rule whether a tax-supported hospital, no matter its affiliation, is obligated to provide or refer patients for legal reproductive and family-planning services.

In other states, such secular-religious affiliations have provoked strong objections. In 2011, a plan in Kentucky by Catholic Health Initiatives to merge with a publicly funded university hospital and two others was rejected by the governor, and renegotiated in a form that allowed the University of Louisville Hospital to remain independent of religious directives.

The U.S. Bishops’ directives also say that any partnership that affects the mission “or religious and ethical identity” of Catholic health care “must respect church teaching and discipline,” and that local bishops and church authorities should be involved to work out details of the arrangements.

Dunne, of the ACLU, said she is worried that such an arrangement might affect training of medical students.

“We’re troubled by the notion that PeaceHealth, because it is currently guided and directed by the Catholic Ethical and Religious Directives, would be training the next generation of health-care providers, because they have restrictions on medical care.”

Carol M. Ostrom: or 206-464-2249. On Twitter @costrom