Will Not Honor Conflicting Advanced Directives
On November 17, 2009, with little fanfare, the United States Conference of Catholic Bishops issued a directive for Catholic health care that could bring distress and grief to hundreds of thousands of American families each year. The directive is binding on all Catholic hospitals, hospices and nursing homes. It forbids removal of artificial food and hydration tubes from a patient in any Catholic health care setting, regardless of patients’ expressed wishes as contained in an Advance Directive or similar document.
This directive limits your healthcare choices.
Questions have arisen about how a church hierarchy can abrogate legal directives from patients and whether Catholic health care providers will be required to follow church directives, whether patients are Catholic or not.
Below please find excerpts from some relevant directives:
Ethical and Religious Directives for Catholic Health Care Services (Emphasis added)
5. Catholic health care services must adopt these Directives as policy, require adherence to them with 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.
8. …the relevant requirements of canon law will be observed with regard to…
68. …must respect church teaching…
24. … The institution, however, will not honor an advance directive that is contrary to Catholic teaching.
28. … 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.
59. … life-sustaining procedures should always be respected and normally complied with, unless it is contrary to Catholic moral teaching.
It appears that the Directives: (1) limit a patient from electing aggressive pain care, including terminal sedation-an accepted practice in medicine, ethics, and law; (2) result in the disregard of advance directives or decisions made by a health care proxy; and (3) result in the application of unwanted life support or the continuation of unwanted life support.