The Roman Catholic Church has authority over a significant number of American hospitals, and thus the prerogative and opportunity to be a champion of labor rights in healthcare. But it isn’t acting like it. In 2019, 1 in 7 U.S. hospital patients were cared for in a network of Catholic facilities that employ over 700,000 workers. Many of these workers are unrepresented by labor unions and have been without institutional support in their campaigns to gain union representation, impeded by the Church’s reluctance to seriously apply its own teaching and directives against the anti-labor campaigns coordinated by Catholic hospitals.
In the summer of 2009, the USCCB Committee on Domestic Justice and Human Development re-published a working set of guidelines for organized labor campaigns within Catholic healthcare facilities. The U.S. Bishops were not alone in the twelve year process to create the document. The signatories of Respecting the Just Rights of Workers: Guidance and Options for Catholic Health Care and Unions include the leadership of the AFL-CIO, SEIU, and AFSCME as well as the CEOs of the Catholic Health Association and Catholic Healthcare Partners. The document, arguing from a pro-labor basis in Catholic Social Teaching, provides a distinct framework for Catholic hospitals to address labor organizing campaigns.
While a strong anti-union culture can be expected of any H.R. department in any secular hospital, the USCCB agreement pledges that “management agrees not to use traditional anti-union tactics or outside firms that specialize in such tactics” and goes so far as to place restrictions on mandatory and one-on-one meetings, anti-union literature, meritless litigation and using political and community pressure as tools to hinder labor organizing campaigns. These are the primary tools of any anti-union campaign and if such restrictions were implemented, healthcare workers would have much easier time organizing themselves into unions.
Unfortunately, the guidelines have had little impact on the nature and outcomes of labor organizing campaigns at Catholic hospitals. St. John’s Healthcare in Santa Monica, for example, would spend years on a lawsuit to enforce a ban on pro-union nurses from wearing a simple ribbon stating “Respect & Dignity”. The NLRB documents violations at, among others, Mercy Health Partners in 2010, St. Mary-Corwin Medical Center in 2012, and St. Francis Hospital in 2013. Roman Catholics, including clergy, used Respecting the Just Rights of Workers to support workers organizing at Ascension Health hospitals in Michigan and still Ascension engaged in an expansive union-busting campaign. At Santa Rosa Memorial Hospital in San Francisco, a direct intervention by the Santa Rosa diocesan priests’ council proved useless beyond one monsignor noting that the union was “much more enthusiastic” about the bishops’ document than the management of the Catholic institution.
Respecting the Just Rights of Workers is not alone in providing a doctrinal argument in support of hospital labor unions. The USCCB’s Ethical and Religious Directives for Catholic Health Care Services includes the mandate that Catholic health care agencies have a responsibility for the “recognition of the rights of employees to organize and bargain collectively without prejudice”. Far more than guidelines, these directives are part of institutional policy in every Catholic hospital and have been used by bishops to strip hospitals of their status as Catholic institutions, as happened to St. Joseph’s Hospital & Medical Center after it sanctioned an abortion procedure in 2010. The implementation of the directives, in fact, seems to be entirely focused on reproductive health and the restriction of related services. In contrast, the obligations to protect the labor rights of hospital workers have been quietly and routinley neglected.
The USCCB’s inaction could be symptomatic of the obsessively anti-labor capitalism of American politics, but the tendency to support the cause of labor in Catholic Social Teaching is inescapable. Since the publication of Rerum novarum in 1891, the Church has had to reckon with Pope Leo XIII’s favorability toward both the formation of labor unions and the right to collective bargaining as a “general and lasting law”. The greater Church leadership, often from countries with stronger traditions of organized labor, often seem to have a more genuine dedication to labor’s cause.
Pope Francis, during a recent meeting of Italian trade unionists, argued that there “is no good society without a good union”. His predecessor, Benedict XVI, called for the promotion of labor organizations to be “honored today even more than in the past” directly in reaction to new limitations on “the freedom or the negotiating capacity of labor unions” in his final encyclical Caritas in veritate. It seems fairly evident that American Catholic hospitals have placed themselves in opposition to Church teaching on labor matters.
Beyond directives and encyclicals based in Church teaching, there are material reasons to stop anti-union campaigns in Catholic hospitals. Staffing ratios are a life and death issue in any medical facility and nursing unions are champions of safer staffing ratios that lead to better patient outcomes. Nursing unions are able to set maximum work hours to prevent the serious danger of mistakes due to fatigue and exhaustion. There are also great benefits for the families of hospital workers who are ensured living wages, better paternal leave, and equitable rotation for holidays. The healing ministry of Catholic healthcare is improved by hospitals that value their workers over the profiteering austerity regime of neoliberal capitalism.
The Catholic Church, especially in America, has a long history of trying to balance its criticisms of capitalism’s indignities with its institutional and material investments in maintaining social harmony. The troubles of Catholic healthcare workers expose a possible tension within Catholic social teaching itself. For the many workers who have been defeated in their organizing efforts, this tension can seem like a practical betrayal of the Church’s pro-labor commitments. If the Church continues to fail to uphold its obligation to labor, it accepts a powerlessness against America’s uniquely toxic healthcare industry. Labor deregulation, which is prevalent in the American healthcare system, has been identified by the Pope Emeritus in Caritas in veritate as a “grave danger for the rights of workers, for fundamental human rights and for the solidarity associated with the traditional forms of the social State.”
We can hope that the USCCB will continue to draw from the Church’s rich teaching on the rights of workers to advocate for new forms of solidarity and to lend institutional support for the collective bargaining power of Catholic healthcare workers. They can at least start by enforcing their own directives against anti-worker campaigns in Catholic hospitals.
Jefferson Hodge is a Roman Catholic and member of Democratic Socialists of America. He lives in East Tennessee with his wife and son.
