Whether a health care professional or a patient accessing health care services, navigating appropriate treatment options and interventions within an ethical framework can sometimes be difficult if the principles are not laid out in an easily understood manner.
In New Zealand, the difficulties in navigating treatment options are particularly problematic because most health care is administered through secular providers who may not necessarily adhere to the same ethical principles that the Catholic Church teaches.
Unfortunately, practices such as induced abortion, contraception, IVF, euthanasia and assisted suicide are all regarded as “health care.”
Despite the secular nature of New Zealand’s healthcare system, many Catholic and Christian health practitioners work within it, and an even greater number of people of faith access these services every day. Many people desire to make decisions about their health care and provide health care to patients that reflect authentic moral principles.
Ethical and Religious Directives for Catholic Health Care Services
Enter the Ethical and Religious Directives for Catholic Health Care Services (ERDs). Published by the United States Conference of Catholic Bishops (USCCB), this comprehensive document is based firmly on the moral principles taught by the Catholic Church.
In the preamble, the purpose of the ERDs is made known: “[F]irst, to reaffirm the ethical standards of behaviour in health care that flow from the Church’s teaching about the dignity of the human person; second, to provide authoritative guidance on certain moral issues that face Catholic health care today.”
Because the scope of healthcare is ever-expanding and innovations are often introduced, the ERDs are not a static document. Currently, the USCCB is working on an update that will include greater guidance on ethical dilemmas surrounding people who are experiencing gender dysphoria and who may be tempted to seek or be offered “gender-affirming care.”
Although the first audience for the Ethical and Religious Directives is those who run, work and use Catholic healthcare institutions, they are of use outside of these settings. “Since they express the Church’s moral teaching,” the preamble explains, “these Directives also will be helpful to Catholic professionals engaged in health care services in other settings.”
“The moral teachings that we profess here flow principally from the natural law, understood in the light of the revelation Christ has entrusted to his Church. From this source the Church has derived its understanding of the nature of the human person, of human acts, and of the goals that shape human activity.”
Topics covered in the Ethical and Religious Directives for Health Care Services
Divided into six parts, the Ethical and Religious Directives provide moral principles and clear Directives for each of the following areas in the provision of health care:
- The Social Responsibility of Catholic Health Care Services
- The Pastoral and Spiritual Responsibility of Catholic Health Care
- The Professional-Patient Relationship
- Issues in Care for the Beginning of Life
- Issues in Care for the Seriously Ill and Dying
- Collaborative Arrangements with Other Health Care Organizations and Providers
The Ethical and Religious Directives for Catholic Health Care Services are a must-read for all those involved in providing health care, whether on the front lines or in support or administrative roles. The Directives are also helpful for patients and their families who wish to ensure that they and their loved ones are cared for in a way that reflects their beliefs and dignity as a human person.
Selected Ethical Directives
#02
Catholic health care should be marked by a spirit of mutual respect among caregivers that disposes them to deal with those it serves and their families with the compassion of Christ, sensitive to their vulnerability at a time of special need.
#15
Responsive to a patient’s desires and condition, all involved in pastoral care should facilitate the availability of priests to provide the sacrament of Anointing of the Sick, recognizing that through this sacrament Christ provides grace and support to those who are seriously ill or weakened by advanced age. Normally, the sacrament is celebrated when the sick person is fully conscious. It may be conferred upon the sick who have lost consciousness or the use of reason, if there is reason to believe that they would have asked for the sacrament while in control of their faculties.
#16
All Catholics who are capable of receiving Communion should receive Viaticum when they are in danger of death, while still in full possession of their faculties.
#23
The inherent dignity of the human person must be respected and protected regardless of the nature of the person’s health problem or social status. The respect for human dignity extends to all persons who are served by Catholic health care.
#27
Free and informed consent requires that the person or the person’s surrogate receive all reasonable information about the essential nature of the proposed treatment and its benefits; its risks, side-effects, consequences, and cost; and any reasonable and morally legitimate alternatives, including no treatment at all.
#32
While every person is obliged to use ordinary means to preserve his or her health, no person should be obliged to submit to a health care procedure that the person has judged, with a free and informed conscience, not to provide a reasonable hope of benefit without imposing excessive risks and burdens on the patient or excessive expense to family or community.
#38
When the marital act of sexual intercourse is not able to attain its procreative purpose, assistance that does not separate the unitive and procreative ends of the act, an does not substitute for the marital act itself, may be used to help married couples conceive.
#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 its moral context, includes the interval between conception and implantation of the embryo. Catholic health care institutions are not to provide abortion services, even based upon the principle of material cooperation. In this context, Catholic health care institutions need to be concerned about the danger of scandal in any association with abortion providers.
#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.
#56
A person has a moral obligation to use ordinary or proportionate means of preserving his or her life. Proportionate means are those that in the judgment of the patient offer a reasonable hope of benefit and do not entail an excessive burden or impose excessive expense on the family or the community.
#57
A person may forgo extraordinary or disproportionate means of preserving life. Disproportionate means are those that in the patient’s judgment do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community.
#58
In principle, 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. Medically assisted nutrition and hydration become morally optional when they cannot reasonably be expected to prolong life or when they would be “excessively burdensome for the patient or [would] cause significant physical discomfort, for example resulting from complications in the use of the means employed.” For instance, as a patient draws close to inevitable death from an underlying progressive and fatal condition, certain measures to provide nutrition and hydration may become excessively burdensome and therefore not obligatory in light of their very limited ability to prolong life or provide comfort.
#59
Euthanasia is an action or omission that of itself or by intention causes death in order to alleviate suffering. 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 and spiritual support, and appropriate remedies for pain and other symptoms so that they can live with dignity until the time of natural death.
#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.
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- To women who have had an abortion
In his encyclical letter Evangelium Vitae, Saint John Paul II advocates for a culture of life and love, challenging society’s distorted views on freedom and autonomy. He extends compassion to women who have had abortions, acknowledging their pain and offering hope and forgiveness through repentance and reconciliation. He urges them to become advocates for life.