Ethical-religious-directives-catholic-health-service-sixth-edition

Introduction

A person in need of health care and the professional health care provider who accepts that person as a patient enter into a relationship characterized by mutual respect, trust, honesty, and appropriate confidentiality. This relationship is founded on the expectation that both parties will engage in a free exchange of information that is devoid of manipulation, intimidation, or condescension. Such a dynamic is essential for the patient to disclose personal information necessary for effective care, while allowing the health care provider to utilize their professional competencies to effectively maintain or restore the patient’s health.<br>Neither the health care professional nor the patient acts independently; both parties are integral to the healing process. In contemporary health care, particularly within modern acute-care hospital settings, a patient often interacts with a multidisciplinary team of health care providers. Despite the complexity of these relationships, the personal character of the interaction between health care providers and patients remains of utmost importance.<br> The relationship between a person seeking health care and the professionals providing that care forms a crucial foundation upon which accurate diagnosis and effective care are built. Therefore, both diagnosis and care entail a series of decisions encompassing ethical considerations alongside medical judgments. The health care professional possesses the requisite knowledge and experience to pursue various goals, such as healing, maintaining health, and delivering compassionate care, particularly towards the dying, while also respecting the patient’s personal convictions and spiritual aspirations, as well as the moral responsibilities shared among all parties involved. In turn, the patient is responsible for utilizing their physical and mental resources in alignment with their moral and spiritual goals to the best of their ability.<br> When utilizing institutional Catholic health care, both the health care professional and the patient acknowledge a commitment to the Church’s understanding of and witness to human dignity. The moral teachings of the Church concerning health care foster a genuinely interpersonal professional-patient relationship. Thus, this professional-patient relationship is always interconnected with the Catholic identity of the health care institution. The faith that undergirds Catholic health care provides guidance for medical decision-making that fully respects human dignity and the integral relationship with the healthcare provider.

Directives

23. Respect for Human Dignity

The inherent dignity of every human being must be respected and protected, regardless of the nature of an individual’s health challenge or their socio-economic status. This respect extends across all persons served by Catholic health care.<br>

24. Advance Directives

In compliance with federal law, Catholic health care institutions are obligated to provide patients with information about their rights to establish advance directives for their medical treatment according to their state laws. However, the institution will not uphold any advance directive that is contrary to Catholic teaching. Should a conflict arise, a detailed explanation should be presented as to why the directive cannot be honored.<br>

25. Surrogacy in Health Care Decisions

Individuals are permitted to designate a representative—often termed a surrogate—to make health care decisions in the event that they lose the ability to make such decisions themselves. It is essential that this surrogate’s choices are in fidelity to Catholic moral principles and reflect the person's intentions and values. If the person’s intentions are uncertain, decisions should be aligned with the individual's best interests. In scenarios where no advance directive has been executed, those closest to the patient—typically family members and significant others—should partake in the decision-making process for the incapacitated individual.<br>

26. Free and Informed Consent

The concept of free and informed consent is foundational in medical treatments and procedures, requiring consent from the patient or the surrogate unless an emergency situation arises where consent cannot be procured and it is evident that the patient would not refuse consent.<br>

27. Comprehensive Information for Consent

Obtaining free and informed consent necessitates that the patient or their surrogate receive extensive and reasonable information concerning the essential nature of the proposed treatment, including its benefits, risks including side effects and potential consequences, costs, and any reasonable and morally sound alternatives, which may include opting for no treatment at all.<br>

28. Access to Information and Counseling

Every individual or their surrogate must have access to the necessary medical and moral information and counseling to adequately form their conscience. This means that the healthcare decision made, either by the patient or their surrogate, should be honored provided it does not conflict with Catholic principles.<br>

29. Right to Bodily and Functional Integrity

Individuals served by Catholic health care possess both the right and the duty to safeguard their bodily and functional integrity. Situations may arise where sacrificing a person's functional integrity is morally justifiable, specifically when no other ethically permissible means exist to preserve one’s health or life.<br>

30. Organ Transplantation

The transplantation of organs from living donors is deemed morally acceptable as long as such a donation does not compromise or severely impair any crucial bodily function, and if the anticipated benefit to the recipient is proportionate to the detriment experienced by the donor. Combined with this, the autonomy of the potential donor must be upheld, with no economic incentives being granted to the donor for their contribution.<br>

31. Medical and Genetic Experimentation

Individuals must not be subjected to medical or genetic experimentation, including therapeutic ones, without their explicit and informed consent. In cases of nontherapeutic experimentation, surrogates can only provide consent if the risks posed to the individual's well-being are minimal. It’s vital that any experimentation, especially nontherapeutic, is conducted with heightened caution, as the person’s level of vulnerability and incompetency increases.<br>

32. Obligation to Use Ordinary Means

While individuals are required to engage in ordinary means to preserve their health, it is not permissible to coerce any person into undergoing a health care procedure they have discerned, in accordance with their free and informed conscience, does not present a reasonable expectation of benefit without imposing excessive risks, burdens, or costs.<br>

33. Holistic Consideration in Treatment Decisions

It is essential that therapeutic interventions consider the overall well-being of the individual. Procedures that may likely result in harm or undesired side effects can only be justified when the anticipated benefits to the patient are proportionate.<br>

34. Respect for Privacy and Confidentiality

Healthcare providers are mandated to honor each individual's right to privacy and confidentiality concerning any information related to their diagnosis, treatment, and overall care.<br>

35. Reporting Abuse

Health care professionals should be trained to identify signs of abuse and violence and are obligated to report occurrences of abuse to the appropriate authorities in accordance with local statutes.<br>

36. Care for Victims of Sexual Assault

Compassionate and supportive care must be provided to individuals who are survivors of sexual assault. Healthcare providers are expected to collaborate with law enforcement and offer the necessary psychological and spiritual support, alongside accurate medical information. Should evidence exist suggesting that conception from the sexual assault has not occurred, a female who has been assaulted may be treated with medications that prevent ovulation, sperm capacitation, or fertilization. However, it remains impermissible to initiate or recommend any treatment aimed at the removal, destruction, or interference with the implantation of a fertilized ovum.<br>

37. Ethics Committees

An ethics committee, or an alternative form of ethical consultation, should be present to provide guidance on specific ethical dilemmas, offer educational opportunities, and assess and recommend policies. Appropriate standards for medical ethical consultation within a given diocese must be followed, respecting the pastoral responsibility of the diocesan bishop while also ensuring that ethics committee members are well-acquainted with Catholic medical ethics and these Directives.