the ERD’s

Medical and ethical policies in Catholic hospitals and medical systems are governed by the Religious and Ethical Directives for Catholic Health Care, promulgated by the U.S. Conference of Catholic Bishops.

The Directives forbid:

  • contraception
  • vasectomies
  • tubal ligation
  • medical treatments derived from embryonic stem cells
  • in-vitro fertilization
  • abortion under any circumstances, even in the case of an “extrauterine” (ectopic) pregnancy

The Directives require:

  • all hospital employees to follow the directives as a condition of employment
  • physicians to ignore end-of-life directives if they conflict with Catholic doctrine (in the case of a patient in a persistent, vegetative coma, similar to Terri Schiavo, tube feeding is required)

Following are key excerpts from the Directives themselves:

Directive 5.

Catholic health care services must adopt these Directives as policy, require adherence to them within the institution as a condition for medical privileges and employment, and provide appropriate instruction regarding the Directives for administration, medical and nursing staff, and other personnel.

Directive 9.

Employees of a Catholic health care institution must respect and uphold the religious mission of the institution and adhere to these Directives…

Text preceding Directive 23.

The Church’s moral teaching on health care nurtures a truly interpersonal professional-patient relationship.  This professional-patient relationship is never separated, then, from the Catholic identity of the health care institution.

Directive 24.

In compliance with federal law, a Catholic health care institution will make available to patients information about their rights, under the laws of their state, to make an advance directive for their medical treatment.  The institution, however, will not honor an advance directive that is contrary to Catholic teaching…

Directive 28.

Each person or the person’s surrogate should have access to medical and moral information and counseling so as to be able to form his or her conscience.  The free and informed health care decision of the person or the person’s surrogate is to be followed so long as it does not contradict Catholic principles.

Directive 36.

Compassionate and understanding care should be given to a person who is the victim of sexual assault….it is not permissible however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum.

Text prior to Directive 38

The Church cannot approve contraceptive interventions that “either in anticipation of the marital act, or in its accomplishment or in the development of its natural consequences, have the purpose, whether as an end or a means, to render procreation impossible…

Reproductive technologies that substitute for the marriage act are not consistent with human dignity.

Directive 42.

…participation in contracts or arrangements for surrogate motherhood is not permitted.

Directive 45.

Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted.  Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which in this moral context, includes the interval between conception and implantation of the embryo….

Directive 48.

In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion.

Directive 52.

Catholic health institutions may not promote or condone contraceptive practices but should provide, for married couples and the medical staff who counsel them, instruction both about the Church’s teaching on responsible parenthood and in methods of natural family planning.

Directive 53.

Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution…

Directive 58.

…there is an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally.  This obligation extends to patients in chronic and presumably irreversible conditions (e.g., the “persistent vegetative state”) who can reasonably be expected to live indefinitely if given such care.

Directive 60.

Catholic health care institutions may never condone or participate in euthanasia or assisted suicide in any way.  Dying patients who request euthanasia should receive loving care, psychological support, and appropriate remedies for pain and other symptoms so that they can live with dignity until the time of natural death.

Directive 67.

Any partnership that will affect the mission or religious and ethical identify of Catholic health care institutional services must respect church teaching and discipline….the diocesan bishop’s approval is required for partnerships sponsored by institutions subject to his governing authority…

Directive 70. 

Catholic health care organizations are not permitted to engage in immediate material cooperation in actions that are intrinsically immoral, such as abortion, euthanasia, assisted suicide, and direct sterilization.

Directive 71. 

The possibility of scandal must be considered when applying the principles governing cooperation (with other institutions).  The diocesan bishop has final responsibility for assessing and addressing issues of scandal, considering not only the circumstances in his local diocese but also the regional and national implications of his decision.

Directive 72. 

The Catholic partner in an arrangement has the responsibility periodically to assess whether the binding agreement is being observed and implemented in a way that is consistent with Catholic teaching.





2 thoughts on “the ERD’s

  1. Joy Mauser

    Where in the Seattle and surrounding areas of Kitsap, King, and Pierce counties is there a secular hospital where secular rules are followed and patients are not subject to Catholic ERDs? My husband and I are in are 80″s, have made out living wills and health care directives according to Compassion and Choices documents and hope we can find a hospital or some other care facility where our choices will be honored when the need arises.
    Any information you can supply will be greatly appreciated.
    Thank you,
    Joy Mauser

    1. catholicwatcher

      I would recommend Virginia Mason or the University of Washington system of hospitals at this time. Both have made clear in policies posted to the Washington State Department of Health website that they support a patient’s right to informed consent and access to Death with Dignity.


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