Ethical and Religious Directives that Govern Catholic Hospitals

The following Ethical and Religious Directives* and comments** were provided to the Franciscan Sisters of Perpetual Adoration and administrators at Franciscan Healthcare:

45. Abortion (that is, the directly intended termination of pregnancy before viability or  the directly intended destruction of a viable fetus) is never permitted. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo. Catholic health care institutions are not to provide abortion services, even based upon the principle of material cooperation. In this context, Catholic health care institutions need to be concerned about the danger of scandal in any association with abortion providers.

50. Prenatal diagnosis is permitted when the procedure does not threaten the life or physical integrity of the unborn child or the mother…and when the parents, or at least the mother, give free and informed consent. Prenatal diagnosis is not permitted when undertaken with the intention of aborting an unborn child with a serious defect.

69. If a Catholic health care organization is considering entering into an arrangement with another organization that may be involved in activities judged morally wrong by the Church, participation in such activities must be limited to what is in accord with the moral principles governing cooperation.

70. Catholic health care organizations are not permitted to engage in immediate material cooperation in actions that are intrinsically immoral, such as abortion, euthanasia, assisted suicide, and direct sterilization.

From what I can tell, material cooperation consists in assisting in an evil act without approving of the act.  Material cooperation with abortion is not permitted, because the evil, the taking of innocent life, is grave.  Ascension Hospital’s site explains that immediate material cooperation occurs when the organization provides for, contributes to or participates in specific circumstances that are essential to, or are an essential condition for, the principal agent to carry out a specific objectionable action.

In this case, Franciscan Healthcare is providing circumstances that provide for abortions to eventually be performed.  This actually rises to the level of formal cooperation in immoral actions, which is a higher level of involvement than material cooperation.  In formal cooperation, you intend and assist the evil act, although someone else performs the act.  For example, as moral ethicists such as Germaine Grisez explain, a doctor who provides abortion referrals is formally cooperating with abortion.  Formal cooperation is never permissible.  As the Catechism of the Catholic Church states, “Formal cooperation in an abortion constitutes a grave offense. The Church attaches the canonical penalty of excommunication to this crime against human life.” (CCC 2272).

In fact, an even greater level of cooperation takes place at Franciscan Healthcare.  Instead of referring out to an abortionist, you actually bring the abortionist in to meet with your patients.  The abortionist then takes patients to another hospital to perform abortions.  This is an extremely high level of cooperation, and, for a Catholic hospital, it is scandalous.

71. The possibility of scandal must be considered when applying the principles governing cooperation.  Cooperation, which in all other respects is morally licit, may need to be refused because of the scandal that might be caused.

27. Free and informed consent requires that the person or the person’s surrogate receive all reasonable information about the essential nature of the proposed treatment and its benefits; its risks, side-effects, consequences, and cost; and any reasonable and morally legitimate alternatives, including no treatment at all.

Taking innocent life is not “treatment.”

Before Dr. Rose performs abortions, we hope that he is informing patients about all of the harmful effects of abortion, both physical and mental.  We also hope that he is speaking about reasonable alternatives, such as adoption.

Pregnant women should be given an opportunity to give free and informed consent to having an abortionist provide care to them and to their babies.  It is shocking that this information is concealed from pregnant women.

28. Each person or the person’s surrogate should have access to medical and moral information and counseling so as to be able to form his or her conscience.

To fulfill this requirement, you should educate your doctors and medical staff in the ethical teachings of the Catholic Church and their application to medical-ethical issues.


*To read the entire Ethical and Religious Directives for Catholic Health Care Services please visit:

**Comments are provided by Leif and/or Karen Arvidson