My dear brothers and sisters in Christ,

Now that the State of Illinois has legalized physician assisted suicide, is it ethical for Catholics to request medical assistance to hasten their death? How about the voluntary cessation of eating and drinking? Must nutrition and hydration be given to a terminally ill patient? Does the Catholic Church have any moral objection to in vitro fertilization or surrogate parenting? Can Catholic hospitals have collaborative agreements with non-Catholic entities? Are abortions or sex-reassignment interventions ever permissible in a Catholic medical facility?

These are just some of the bioethical questions that are addressed in a document published by the United States Conference of Catholic Bishops (USCCB) called the Ethical and Religious Directives for Health Care Services (ERDs). Tracing its roots to a set of norms on medical ethics issued for Catholic hospitals in the United States in 1921, the ERDs have been updated and reissued in revised editions over the past century to reflect new developments in medical technology and changes in the field of health care services. For example, the previous edition of the ERDs, the sixth edition, was published in 2018 with a major revision to part six on “Collaborative Arrangements with Other Health Care Organizations and Providers,” which was prompted by the growing trend of mergers and acquisitions of health care systems.

None of the previous editions addressed the issue of transgenderism or sex-reassignment surgery. The most recent edition of the ERDs now takes these recent societal developments into consideration. In revising the text, the USCCB’s Committee on Doctrine consulted extensively with numerous parties, including physicians, psychologists, moral theologians, medical ethicists, and stakeholders in Catholic health care, especially with the National Catholic Bioethics Center, the Catholic Health Association, the Alliance of Catholic Health Care, and the Catholic Medical Association.

The Ethical and Religious Directives for Health Care Services, Seventh Edition was approved by the USCCB at its November 2025 Plenary Assembly. It was then the responsibility of each diocesan bishop to adopt and promulgate the seventh edition of the ERDs as particular law for that diocese. I issued a decree to that effect on Dec. 12, 2025, stating that the “provisions of the Seventh Edition of the Ethical and Religious Directives for Catholic Health Care Services shall become effective and binding within the Diocese of Springfield in Illinois on Jan. 1, 2026.” The full text of the seventh edition of the ERDs with my decree is posted on our diocesan website at https://dio.org/policy-and-procedures/.

As stated in the Preamble, “The Ethical and Religious Directives are concerned primarily with institutionally based Catholic health care services. They address the sponsors, trustees, administrators, chaplains, physicians, health care personnel, and patients or residents of these institutions and services. Since they express the Church’s moral teaching, these Directives also will be helpful to Catholic professionals engaged in health care services in other settings.”

The Directives begin with a general introduction that presents a theological basis for the Catholic health care ministry. Each of the six parts that follow is divided into two sections. The first section serves as an introduction and provides the context in which concrete issues can be discussed from the perspective of the Catholic faith. The second section is in prescriptive form; the directives promote and protect the truths of the Catholic faith as those truths are brought to bear on concrete issues in health care.

The six parts of the ERDs are as follows:

1. The Social Responsibility of Catholic Health Care Services
2. The Pastoral and Spiritual Responsibility of Catholic Health Care
3. The Professional–Patient Relationship
4. Issues in Care for the Beginning of Life
5. Issues in Care for the Seriously Ill and Dying
6. Collaborative Arrangements with Other Health Care Organizations and Providers

According to Joseph Meaney, Ph.D., Past President and Senior Ethicist for the National Catholic Bioethics Center, “This seventh edition of the ERDs constitutes the most extensive revision since 1994 with changes to four of the six component parts of the document. … The seventh edition explicitly prohibits Catholic health care professionals and institutions from referring patients for interventions that violate the moral law.” He notes that this “revision of the ERDs was initiated in 2023 principally to provide clear guidance on medical interventions related to gender identity. The revised Directive 28 now proscribes ‘interventions, whether surgical, hormonal, or genetic, that aim not to restore but rather to alter the fundamental order of the body in its form or function.’ This includes procedures and treatments intended to transform a person’s distinctive sexual traits to resemble those of the opposite sex or to nullify the body’s sexual characteristics. … Voluntary Stopping Eating and Drinking (VSED) is included and defined as a form of suicide that should not be facilitated by Catholic health care institutions, and Catholic health care professionals are exhorted to make every effort to dissuade patients from VSED. The full range of ethical multidisciplinary palliative care was endorsed for the first time in this latest edition of the ERDs. Directive 45 was edited to clarify the definition of abortion and is now even more comprehensive than in past editions.”

Directive 59 says clearly and compassionately, “Catholic health care institutions may never condone or participate in euthanasia or assisted suicide in any way. Dying patients who request euthanasia should instead be given loving care, psychological and spiritual support, and appropriate remedies for pain and other symptoms so that they can live with dignity until the time of natural death.”

Dr. Timothy Millea, M.D., Chairman of the Health Care Policy Committee of the Catholic Medical Association, said, “Because the CMA is committed to providing Christ-centered care to all persons we encounter, regardless of their race, religion, politics, sexual orientation, or any other factor, this new edition of the ERDs will serve as additional support and encouragement in our efforts. Every patient we see is a child of God that deserves respect and compassion from those of us who care for them and these directs serve as a guide to fulfill our mission to imitate Jesus Christ in the practice of medicine.”

Catholic health care is a great gift to society for which we should all be grateful.

May God give us this grace. Amen.