Did you know that each Catholic hospital is guided by directives of Catholic moral theology called the Ethical and Religious Directives (ERDs)? These directives offer guidance on a host of issues regarding the morality of certain medical procedures, such as end-of-life issues, nutrition, hydration, hospice care, fertility, etc.
The statue of St. Francis of Assisi outside the main entrance of Saint Francis Medical Center, Thursday, June 25, 2015 in Cape Girardeau. (Glenn Landberg)
Why am I going into all this? Well, I recently attended a workshop for bishops, Feb. 7-9, 2022, in Dallas, regarding the ERDs in the 21st century. It’s a reminder for me of the great work done in our Catholic hospitals and the challenges that they face in healthcare today. We are grateful for the Sisters of Mercy, the Daughters of St. Francis of Assisi, the Daughters of the Sacred Heart of Jesus and Mary, the Sisters of Charity, and the Visitation Nuns who established our hospitals and selflessly labored in health care here in southern Missouri. We are grateful for those who continue this work today.
The ERDs are nothing new. The first set of directives was produced over 100 years ago, was referred to as “A Surgical Code,” and included 14 directives. In 1948, the first document to bear the name “Ethical and Religious Directives” was issued and expanded to include 60 directives. In 1971, the ERDs were issued for the first time by the Catholic bishops with 43 directives. The year 1995 saw the biggest revision in 50 years, and the directives expanded to 70. Since then, there have been revisions of different sections and individual directives to now include 77. As medical knowledge expands, there will certainly be additional directives to cover situations that simply did not exist even a decade ago.
What are the principles expressed in the ERDs? First, respect for human life: covering such issues as abortion, euthanasia, and any direct killing during pregnancy. Second, respect for human fertility: sterilization, contraceptive acts, artificial reproduction. Third, informed consent and the rights of the patient. Fourth, care at the end of life: ordinary means for nutrition and hydration; preparation for death; and ethical sedation to deal with pain. Fifth, spiritual care: above all, the availability of the sacraments of baptism, Eucharist, penance, and anointing. Sixth, the recognition that the ERDs are provisional and will need updating as appropriate to address future medical advancements.
SOCIAL RESPONSIBILITY OF CATHOLIC HEALTHCARE
The current edition of the ERDs includes a preamble, along with the general introduction, followed by six different parts and a conclusion. The six parts outline the social responsibility of Catholic health care services; pastoral and spiritual responsibility of a Catholic hospital; the professional–patient relationship; issues in the care for the beginning of life; care for the seriously ill and dying; and collaborative arrangements with other healthcare organizations and providers. The last section dealing with collaboration is of utmost importance as more and more Catholic hospitals are in systems that may involve non-Catholic healthcare services.
We are blessed in southern Missouri to have a Catholic hospital in our three major cities: Cape Girardeau, Joplin, and Springfield. In addition, we have a Catholic hospital in Mountain View. At the same time, there are also highquality non-Catholic hospitals in southern Missouri. The reality is that in the Diocese of Springfield-Cape Girardeau, Catholics make up only 5 percent of the general population. Therefore, the majority of non-Catholics encounter Catholicism through Catholic health care. Additionally, the majority of those employed in our Catholic hospitals are not Catholic, and thus the importance of forming new hires— from doctors to cafeteria workers— in the mission and principles of Catholic health care.
The medical profession is constantly evolving with new and better ways to address certain health issues. Simultaneously, just because something is available does not necessarily mean it is right or moral. Thus, the need for ERDs. We pray for our nurses, doctors, and all those in the medical profession that have put their own lives on hold these past two years in order to serve mankind. May Christ, the Divine Physician, bless the work of their hands.
