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PASTORAL

GUIDELINES

for the

CATHOLIC HOSPITAL

and

CATHOLIC HEALTH CARE

PERSONNEL

AD HOC COMMITTEE ON

PRO-LIFE ACTIVITIES

NATIONAL CONFERENCE OF

CATHOLIC BISHOPS

April 11, 1973



PASTORAL GUIDELINES

for the

CATHOLIC HOSPITAL

and

CATHOLIC HEALTH CARE
PERSONNEL

AD HOC COMMITTEE ON
PRO-LIFE ACTIVITIES, NCCB

April 11
,
1973

T
he decision of the U.S. Supreme Court

on January 22
, 1973, in regard to the

abortion laws of Texas and Georgia radically

changed the legal and political discussion of

the past decade. For practical purposes, the

Court has given its approval to abortion on

request, and the sweeping opinion of the

Court has left many states In legal disarray

regarding abortion.

Legally, the question of responsibility has

been made ambiguous by the Court's opin-

ion. The Supreme Court held that the right

of privacy encompasses a woman' decision

to obtain an abortion. The Court also stated

that the abortion decision is "primarily a

medical decision and basic responsibility for

it must rest with the physician." In its opin-

ion, during the first three months, once the

woman has decided to abort and the physi-

cian has been consulted, anyone may per-

form the abortion procedure. Thus ac-

cording to the Court, in such a case the

physician Is primarily and basically respon-

sible, though he may have the least to do

with the abortion itself.

In terms of moral teaching, the American

Bishops have declared that the "opinion of

the Court Is wrong and is entirely contrary

to the fundamental principles of morality. . .

.

Whenever a conflict arises between the law

of Cod and any human law we are held to



follow Cod's law." Catholics then, may not

obey laws that require them to act in viola-

tion of their conscience.

Catholic hospitals cannot comply with

laws requiring them to provide abortion

services, and Catholic physicians, nurses and

health care workers who work in facilities

that provide abortions and sterilizations may

not take part in such procedures in good

conscience. Thus, in light of the legal safe-

guards respecting the moral responsibilities

of Catholic hospitals and health care per-

sonnel, there is reason for a specific appli-

cation of moral principles.

In this analysis, the application of the

moral principles on conscientious objection

to abortion is approached in terms of the

responsibilities of Catholic hospitals and

health care personnel to give witness to their

faith and moral convictions, and the restric-

tions imposed by moral convictions on poli-

cies and behavior. Sterilization is treated

separately, and a special section is added on

excommunication.

I. Principles of Responsibility for Catholic

Hospitals

1. Catholic hospitals must witness to

the sanctity of life, the integrity of the

human person and the value of human

life at every stage of its existence.

2. Catholic hospitals should commit

themselves to a special effort in providing

compassion and care for pregnant women

and their unborn children. This would

include providing a full range of pre-natal,

obstetric and post-natal services. It would

also Involve spiritual assistance and sacra-

mental administration. In this regard, the

designation of sisters or nurses as special

ministers of the Eucharist in keeping with

the latest norms of the Holy See might

be especially helpful In making it possible

for women to receive the Eucharist fre-
quently during their stay In the hospital.

(Cf. Immensae Caritatis. Sacred Congre-

gation of the Sacraments, January 29,

1973.)



3. Catholic hospitals should show a will-

ingness to extend privileges to physicians

and health care workers who share this

commitment to serving life, particularly in

situations where such health care workers

find that their opposition to abortion or

sterilization procedures places them at a

disadvantage In other hospitals or facili-

ties.

4. Catholic hospitals must give public

notice of their commitment to the sanctity

of life and their refusal to provide abor-

tion or sterilization services.

5. The Catholic hospital has a responsi-

bility to clearly enunciate its policies for

all physicians holding privileges and for

all health care personnel employed by the

hospital.

II. Responsibilities of Physicians, Nurses and

Health Care Workers

1. Physicians, nurses and health care

workers should give public witness to

their belief In the sanctity of life, the in-

tegrity of every person and the value of

human life at every stage of Its existence

by their compassion and care for their

patients.

2. Physicians, nurses and health care

workers should provide encouragement

and support for women and their children.

They should be especially attentive to the

tensions created for women by society's

depreciation of the value of life. When

advisable, they should seek the assistance

of the chaplain in making available the

Church's spiritual assistance and sacra-

mental administration.

3. Physicians, nurses and health care

workers who work in hospitals that provide

abortion or sterilization services should

notify the hospital in writing of their con-

scientious refusal to participate In such

actions. When efforts are made to compel

participation in these procedures, health

care personnel should protest this viola-

latlon of conscience to their superiors and

to the administrator.



4. In their professional associations and

contacts, Catholic physicians, nurses and

health care workers should candidly and

charitably explain their convictions to

their colleagues when called upon to do

so. Charity also requires that they refrain

from judging the motives of their col-

leagues or patients who do not agree with

or will not accept their conscientious con-

victions. Catholics must expect that their

faith and moral convictions on the sanctity

of life may result in their being misjudged,

treated unfairly or alienated. Such is the

price of Christian witness in today's world.

5. An aborted fetus showing signs of

life, at any stage of pregnancy, is entitled

to Baptism.

III. Restrictions that Follow from Moral

Convictions

1. No Catholic hospital may provide

abortion services, nor may any Catholic

hospital make its facilities or personnel

available for abortions.

2. A Catholic hospital should make it

clear to all staff and health care workers

that abortions and sterilizations are pro-

hibited, and that agreement to this policy

is a condition for privileges.

3. Abortion, the deliberate expulsion of

the fetus from the womb of its mother to
terminate the pregnancy, is a serious and

immoral action. Catholics who perform

or obtain abortions, or persuade others to

do so, commit a serious sin. Among those

who assist the woman, primary responsi-

bility for the abortion procedure rests with

the doctor who advises and/or assists the

woman to have an abortion.

4. All who willingly and deliberately

assist in abortion procedures share the

sinfulness of the abortive act. This is par-

ticularly true of the attending surgeon and

the health care personnel who administer

abortifacient drugs or other abortion pro-

cedures.

5. Nurses and health care personnel

may not assist in abortion procedures.



Particular questions of conscience should

be taken up with a confessor.

6. Cooperation in the sinful act of abor-

tion would not ordinarily extend to pre-

paring patients for the procedure or pro-

viding after-care. However, because in

many instances abortion is promoted as

an alternate method of birth control and

thus a denial of the value of the child, the

cooperation of the Catholic health care

worker may be interpreted as agreement

that the unborn child is of subordinate

value and has no right to life. Christian

witness may well require Catholic nurses

to avoid even those actions that—although
not necessarily evil—may be interpreted
as a compromise of Christian values.

Sterilization

1. Sterilization, though it does not de-

stroy the life of the unborn child as does

abortion, may not be used as a means of

contraception.

2. Doctors, nurses and health care

workers in hospitals that permit steriliza-

tion procedures should not perform or

assist in such procedures. They should

declare their unwillingness to participate

In a letter to the administrator.

3. Nurses may be called upon to pre-

pare a patient or provide after-care when

the sterilization is attendant on delivery

of a baby. The nurse's role is complicated

and difficult. She should provide support

and encouragement to the mother in re-

gard to delivery of the child, and empha-

size the positive aspect of giving birth.

At the same time, the nurse should refrain

from agreeing with the decision to termi-

nate the reproductive function by means

of sterilization.

Excommunication

1. Because abortion Is a serious evil,

both for those who take part In it and for

society, the Church has sought to dissuade

people from utilizing it by placing it in a

special moral category. Under Church



law, those who perform or obtain an

abortion or deliberately persuade others

to do so, place themselves in a state of

excommunication. Ordinarily this involves

the woman who obtains an abortion, the

doctor who performs the abortion, the

person who persuades a woman to have

an abortion, and any person who co-

operates to the extent that the abortion

would not otherwise take place without

his or her cooperation.

2. Excommunication is a special penalty,

and conditions under which It applies

must be strictly interpreted. Generally it

does not apply to nurses and other as-

sistants, nor can it be extended to legis-

lators. It does not apply in any way to

sterilization procedures.

Conclusion

Human life exists in a person, who must

be respected and cared for, and at times,

reconciled to Cod and the community.

Catholic hospitals and health care workers

have distinguished themselves in the past

in the provision of competent medical care

motivated by respect for the person and

Christian charity. Along with the added re-

sponsibilities they will face in an increas-

ingly permissive abortion atmosphere there

are also opportunities for Christian witness,

for competent care based on charity, for

encouraging women and health care workers

who refuse to take part In abortions, and

for reconciling and showing mercy to those

who have failed. Now, more than in the

past. Catholic health care workers, and per-

haps especially those In hospitals not under

Catholic auspices, will be ministers of God's

word and mediators of His grace. They

deserve the support and assistance of the

entire Church.

Finally, though these guidelines have at-

tempted to cover a wide range of problems,

there are many cases that do not fall within

the specified categories. In these cases, the

standard principles of moral theology need

to be applied. Parish priests, hospital chap-

lains and sisters involved In the ministry to



the sick should be available to explain and

apply the principles and to encourage and

support doctors, nurses and health care

workers.

AD HOC COMMITTEE ON PRO-LIFE
ACTIVITIES, NCCB

John Cardinal Cody, Chairman

Bishop George W. Ahr

Bishop Juan A. Arzube

Bishop Walter W. Curtis

Bishop Francis Dunn

Bishop Timothy Harrington

Bishop Andrew McDonald

Bishop Harold R. Perry

Secretary: Msgr. James T. McHugh,

Family Life Division, United States

Catholic Conference

Consultant: Sister Virginia Schwager,

Division of Health Affairs, United

States Catholic Conference

April 11, 1973

(These guidelines are intended to correlate

with the pastoral statements ot NCCB and

of individual Bishops. They do not replace

diocesan policies, but are supplementary to

them.)

1973

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