The ERDs: Part One – The Social Mission of Catholic Health Care Services

The Ethical and Religious Directives for Catholic Health Care Services (ERDs) exist to guide administrators, providers, and patients regarding the Church’s principles for maintaining human dignity while providing ethical patient care. A brief history of the document itself is presented followed by a discussion of selected portions of Part One of the ERDs, which relate directly to the mission of Catholic healthcare and why this is important as the secular culture becomes increasingly hostile to religious beliefs.

A History of Development of Medical Missions and Catholic Evangelization in Sub-Saharan Africa From the Early Twentieth Century to the Present: Tracing Some Representative Founders and Orders in the Context of the Twentieth Century Church

Although the care of the sick has been a charism of Catholic community since the beginning, and hospitals as we know them have developed since the fourth century, religious orders began to develop hospitals as part of their mission work during the colonial expansion of the seventeenth century. These early efforts, however, were primarily a response to the needs of the colonists as well as recognition that the poor who were sick required care in these regions. It can be argued that medical missions developed during the twentieth century as a response to the outreach of Protestants as well as the exposure of physicians to the needs in mission territories, and that their advancement and success impacted the attitudes of the popes and bishops of the twentieth century. This article examines several individuals and organizations who have contributed to the development of medical missions in Africa in modern times and trace the approach of the Church toward medical missions by exploring missionary religious orders, especially women’s religious orders, and papal and council documents. It primarily considers the role of medical missions in areas that had only a limited Catholic presence prior to nineteenth and twentieth centuries, and where Catholic health care and the local Catholic Church essentially developed together, and considers ways in which the growth of medical missions and the thinking of the Church developed together.

Revising the ERDs for the 21st Century

Since their inception in 1948, The Ethical and Religious Directives for Catholic Health Care Services (ERDs) have guided Catholic health care ministries in the United States, aiding in the application of Catholic moral tradition to modern health care delivery. The ERDs have undergone two major revisions in that time, with about twenty years separating each revision. The first came in 1971 and the second came twenty-six years ago, in 1995. As such, a third major revision is due and will likely be undertaken soon.

Pandemic Visitation Restrictions at the End of Life

Dying today looks dramatically different than it did a century ago, largely due to wider treatment options and more specialized medical practices. Often missing from these advancements is the focus on factors relative to a patient’s total circumstances. Especially in light of the recent pandemic, it is incumbent upon Catholic health care providers to treat who whole person rather than simply focus on more utilitarian philosophies of care.

Template Policy for Catholic Health Care and Gender Identity

Gender ideology and medical interventions for so-called transitioning pose profound challenges for Catholic health care. Unfortunately, many institutions do not offer clear, specific policy guidance addressing these issues. This template policy is offered to Catholic health care institutions and systems to assist them in drafting such guidance. The template defines the mission of Catholic health care, summarizes Church teaching with regard to gender ideology, and identifies both licit and illicit clinical interventions for gender dysphoria. The template also offers guidance on practical issues, including name and pronoun use, sex-specific facilities, employee training programs, and health benefits. An appendix offers model language that institutions can incorporate into employment documents to maintain Catholic identity and mission.

Harm Reduction for Intravenous Substance Use

North America is facing an ongoing, persistent opioid epidemic, and Vancouver, British Columbia, continues to be one of its devastating epicenters, with record overdose deaths in 2020. Roman Catholic health care organizations in Vancouver are compelled to pioneer potential solutions to this public health crisis—in solidarity and employing necessary strategies to help the most vulnerable in the communities served. While controversial, harm reduction strategies for intravenous substance use keep people alive until they are able to receive the help that they need to recover. An evaluation of the degree of cooperation involved in some harm reduction strategies indicates that they can be considered morally permissible and compatible with core tenets of Catholic bioethics.

Beyond Stewardship: Reordering the Economic Imagination of Catholic Health Care

The principle of stewardship has come to play a significant role in the consciousness of Catholic health care. This is a recent development correlative with changes in the economic configurations of Catholic health care in the latter two decades of the twentieth century, as well as with the striking ascendance of the principle within US Catholic culture during the same period. Yet while the concept of stewardship seems to be an unobjectionable given central to Catholic practice, I argue that in its contemporary configuration, it embodies a deeply problematic set of theological assumptions drawn from a particular historical trajectory that is—from a Catholic perspective—quite troubling. This history is concurrent with an equally problematic deformation of the concept of charity. Taken together, these malformed concepts often shackle and misdirect the ability of those who work within Catholic health care to creatively discern transformative solutions and faithful modes of practice.