Catholic ethics and church law must be at the center of a merger of two major Catholic health care systems that, if approved, will create the largest non-profit health system in the country, an archdiocesan official says.

Denver-based Catholic Health Initiatives and San Francisco-based Dignity Health announced the proposed merger Dec. 7.

They aim to create a new Catholic healthcare system, set to be based in Chicago. The combined health system will be run by the CEOs of both companies. It will include 139 hospitals, employ 159,000 people, and have a combined revenue of $28.4 billion.

The merger requires regulatory approval—and also scrutiny that it does not violate Catholic ethical and canonical norms.

Denver Archbishop Samuel J. Aquila and Archbishop Salvatore Cordileone of San Francisco are among those responsible for analyzing the moral and ethical considerations of the proposed merger for the health systems based in their respective cities, David Uebbing, chancellor for the Archdiocese of Denver, told CNA.

The leaders of both health care systems said the proposed merger would be better for health care.

Catholic Healthcare West, later renamed Dignity Health, came under scrutiny following a 2009 incident at St. Joseph’s Hospital and Medical Center in Phoenix, which is part of the health system. The hospital’s ethics board decided that a direct abortion could be performed on a woman who was suffering severe medical complications, in violation of Catholic teaching that direct abortion is inherently evil.

In December 2010 Bishop Thomas J. Olmsted of Phoenix revoked the Catholic status of the hospital after an investigation found both the hospital and its parent company involved in a pattern of behavior that violated Catholic health care ethics, including creating and managing a government program that offers birth control, sterilization procedures and abortion.

In January 2012 the health network’s CEO, Dean, said concerns about the system’s Catholic affiliation hindered potential agreements with other hospitals.

The expansion of Catholic hospitals operating according to Catholic teaching has drawn opposition from critics, including the American Civil Liberties Union and the MergerWatch project. Those groups co-authored a 2013 report that claimed the growth of Catholic hospitals was a “miscarriage of medicine.”

The report said the ACLU’s advocacy in the area was backed by various funders including the Arcus Foundation, which is a major funder of an influence campaign to restrict religious freedoms in areas that run counter to the foundation’s vision of LGBT advocacy and reproductive health.

Full story at Catholic News Agency.