Ethical and Religious Directives

The following is a summary of the Ethical and Religious Directives for Catholic Health Care Services (ERDs) as prepared by Wheaton Franciscan Services, Inc. It is not an official summary from the National Conference of Catholic Bishops and does not substitute for careful reading of the ERDs.

Preamble and introduction

There are two aims of the Ethical and Religious Directives for Catholic Health Care Services:

1. Reaffirm the ethical standards that flow from the Church’s teaching about human dignity.

2. Provide authoritative guidance on some specific moral issues facing Catholic health care.

Part 1: The social responsibility of Catholic health care services

Catholic health care is guided by four normative principles: 1) commitment to promote human dignity, 2) care for the poor, 3) contributions to the common good, and 4) responsible stewardship of available resources.
Catholic health care is marked by respect among caregivers (e.g., physicians and nurses).
Catholic health care is distinguished by service and advocacy to the poor and vulnerable.
Catholic health care institutions treat employees respectfully and justly.
Employees respect and uphold the ERDs.

Part 2: The pastoral and spiritual responsibility of Catholic health care

Catholic health care extends to and embraces the spiritual nature of the person.
Pastoral/spiritual care staff minister to the religious and spiritual needs of all patients, residents and families.
Pastoral/spiritual care staff work collaboratively with community clergy.
Sacramental ministry is available to Catholic patients and residents.
Staff has appropriate professional preparation.

Part 3: The professional-patient relationship

Both the patient and the professional participate in the healing process. The professional-patient relationship is built upon the values of respect, trust, honesty and appropriate confidentiality.
Personal nature of care must not be lost even when a team of caregivers is involved in care.
The dignity of the person is respected regardless of health problem or social status.
Advance directives, consistent with moral teaching, are respected and honored.
Informed consent of persons is required and includes information about benefits, risks, side effects, consequences and cost of treatment alternatives.
Organ donation is encouraged.
Caregivers, especially physicians, understand and utilize the benefit/burden principle (ordinary/extraordinary means) in the analysis of treatment options for patients and residents.
An ethics mechanism (e.g., ethics committee) is available to assist with case consultation, education and policy review.

Part 4: Issues in care for the beginning of life

Catholic health care ministry honors the sanctity of life from conception until death.
Some specific forms of procreative assistance are permissible.
Surrogate parenting relationships are precluded.
Abortion and elective sterilization are not allowed.
Compassionate care is provided to those who have had an abortion.

Part 5: Issues in care for the dying

A Catholic health care institution will be a community of respect, love, and support to patients and residents and their families as they face the reality of death. The task of medicine is to care even when it cannot cure.
Catholic health care avoids the use of futile or burdensome technology that offers no reasonable benefit to patient or resident.
Medical staff must not withdraw technology with the intention of causing death.
Euthanasia (physician-assisted dying) is not permitted.
There is the presumption for nutrition and hydration if the benefit outweighs the burden to the patient or resident.
Patients and residents should be kept as free of pain as possible.
Pain suppressing or alleviating medicine that may indirectly shorten a person's life is permitted so long as the intent is not to hasten death.

Part 6: Forming new partnerships with health care organizations and providers

Time of extraordinary change in health care finds Catholic health care organizations and systems increasingly involved with other providers.

New relationships may offer opportunities to influence the healing profession.
New relationships may pose serious challenges to Catholic identity.
Systematic and objective moral analysis is necessary when considering new relationships. Reliable theological experts are to be consulted when considering arrangements with other organizations.
Partnerships that affect the mission or religious and ethical identity of the Catholic health care institution must respect Church teaching and discipline.
Decisions leading to serious consequences for the identity or reputation of Catholic health care services are made in consultation with local church leadership.
Implementation of arrangements with other organizations must be periodically reviewed to ensure alignment with Church teaching.

For more information, please contact Ed Harasim, Vice President of Ethics, 414-465-3062 or Edward.Harasim@wfhc.org.