The first story broke on October 13 on WXYZ Detroit.

An OB-GYN, Dr. Michael Arthur Roth, is suspected of performing abortions in his and/or other peoples’ homes. Now under investigation by the Michigan Attorney General, he hadn’t been charged with any crime as of this writing.

The reporter who broke the story, Jim Kiertzner, was justifiably surprised by what he was uncovering. But the Michigan pro-life movement was not. They have been following Roth for years, as reported in Life News on October 15; the story also reported that Roth “works” at St. John/Providence Park Hospital, part of Ascension Health, the country’s largest non-profit health-care system (and the world’s largest Catholic one).

Is this something Catholics in Detroit should be alarmed about?

Misunderstandings can cause confusion and antagonism—what the Catholic Church calls “giving scandal.” So first, the basic principle: Catholic hospitals are supposed to be guided by the Ethical and Religious Directives for Catholic Health Care Services (ERD’s), issued by the United States Conference of Catholic Bishops. ERDs clearly prohibit medical procedures that are judged to be morally wrong by the teaching authority of the Church.

At this point, I do not know what Roth’s status was or is with regard to St. John/Providence Park Hospital. “Work” is an imprecise term. Roth has long had a private practice as an OB-GYN. His name had been listed on the hospital website (and was quickly removed after the story broke).

Michigan Catholics have complained before about Roth and three other abortionists having admitting privileges at St. John/Providence. “Having privileges” does not mean that a doctor is employed by a hospital, however; it means that a doctor is allowed to admit patients there.

Significantly, the ERDs say nothing about admitting privileges. If a patient needs emergency care as a result of a botched abortion, is it not in the best interest of the patient that the abortionist have admitting privileges at a nearby hospital?

Indeed, hasn’t legislation requiring admitting privileges for abortionists been a pro-life initiative in many states over the last several years?

Of course, privileges can be revoked; they cannot be revoked, however, simply because a doctor performs abortions.

Since 1973, federal law has required that hospitals receiving federal funds (read: all hospitals) not deny employment or privileges to medical personnel because they are willing OR unwilling to provide abortions or sterilizations. Known as the Church Amendment, the law was enacted shortly after Roe v. Wade to protect the conscience rights of pro-life doctors.

Bottom line for Catholics: Don’t start the letter-writing campaign to the bishop yet.

While we await clarification on the Roth situation, it is true that around the country there are Catholic hospitals that appear to allow procedures clearly in violation of the ERDs.

Does this mean the local bishops are asleep at the wheel?

Well, perhaps sometimes, yes. Often, a legal sleight of hand is thus revealed.

The Catholic Health Association (CHA)—that monopoly trade association of Catholic hospitals whose president, Sister Carol Keehan, gave Obamacare a final boost over the congressional goal line—provides legal guidance to most Catholic hospitals.

When a Catholic hospital acquires a non-Catholic one, if the acquired hospital follows the ERDs, certain medical procedures will no longer be available to the population previously served by the non-Catholic hospital.

For this reason, federal regulators may not allow the merger to go forward. This, by the way, is not the fruit of Obamacare, but a longstanding policy of federal regulation of hospital services.

CHA encourages hospitals to propose this compromise to federal regulators: Merge the hospitals, but create a separate legal entity that owns the “women’s health center.” Co-locate it inside the physical plant of the Catholic hospital. But give it a separate legal existence. Result: Patients walk down the hall and never notice the “Suzy Q Women’s Health Center” sign. They think they’re still in the Catholic (or Baptist, or Lutheran) hospital, but in fact, they are not.

If the women’s health center is a separate legal entity, then the board of directors of the Catholic hospital can tell the bishop: “No abortions in our hospital.” A true statement because the abortions are not being done in their hospital; they are being done by the hospital’s tenant, the Suzy Q Center.

Unless the bishop is exceptionally well-versed in health-care law and policy, he won’t even be looking for the mental reservation on the part of the hospital’s board. Suzy Q may have been a generous benefactor. Or Suzy Q may be a separate legal entity. It takes expertise to figure out which.

When Philadelphia Archbishop Charles Chaput was in charge of the Denver archdiocese several years ago, he got wise to this sleight of hand and put his foot down. Not on my watch, he said: In this diocese, we’re following the ERDs in spirit and in letter. He prevailed, but the upshot, after a legislative battle, was that the State of Colorado now essentially prohibits Catholic hospitals from acquiring non-Catholic ones.

In a business environment in which not to expand is to die, this means that Catholic hospitals faithful to the ERDs may not exist in Colorado fifty years from now. The ACLU and ACOG want to eliminate the ERDs because they don’t meet the current “standard of care.”

In the face of this growing anti-Catholicism, as Catholic hospitals are attacked for following the ERDs, the Catholic faithful may find comfort in Blessed Teresa of Calcutta’s reminder that “we are not called to be successful, we are called to be faithful.”

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Connie Marshner is a commentator and researcher on life and family issues in the Washington, D.C., area.