Pastoral Guidelines for the
CATHOLIC HOSPITAL AND
CATHOLIC HEALTH CARE PERSONNEL
AD HOC COMMITTEE ON
PRO-LIFE ACTIVITIES, NCCB
April 11, 1973
The decision of the U.S. Supreme Court on January 22, 1973, in regard to the
abortion laws of
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 opinion. The Supreme Court held that the right of privacy encompasses a
woman's 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 opinion, during the first three months, once
the woman has decided to abort and the physician has been consulted, anyone may
perform the abortion procedure. Thus according to the Court, in such a case the
physician is primarily and basically responsible, 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 God and any human law we are held to follow
God's law." Catholics then, may not obey laws that require them to act in
violation 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 safeguards respecting
the moral responsibilities of Catholic hospitals and health care personnel,
there is reason for a specific application 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 restrictions imposed by moral convictions on policies and
behavior. Sterilization is treated separately, and a special section is added on
1. 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 sacramental
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 frequently during their stay in the hospital. (Cf. Immensae Caritatis,
Sacred Congregation of the Sacraments, January 29, 1973.)
3. Catholic hospitals should show a willingness 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 facilities.
4. Catholic hospitals must give public notice of their commitment to the
sanctity of life and their refusal to provide abortion or sterilization
5. The Catholic hospital has a responsibility 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 integrity 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 sacramental 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 conscientious refusal to participate in such actions. When efforts are
made to compel participation in these procedures, health care personnel should
protest this violation of conscience to their superiors and to the
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 colleagues or patients who
do not agree with or will not accept their conscientious convictions. 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 prohibited, 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 responsibility for the abortion
procedure rests with the doctor who advises and/or assists the woman to have an
4. All who willingly and deliberately assist in abortion procedures, share
the sinfulness of the abortive act. This is particularly true of the attending
surgeon and the health care personnel who administer abortifacient drugs or
other abortion procedures.
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 abortion would not ordinarily extend to
preparing patients for the procedure or providing 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.
1. Sterlization, though it does not destroy 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
sterilization procedures should not perform or assist in such procedures. They
should declare their unwillingness to participate in a letter to the
3. Nurses may be called upon to prepare 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 regard to delivery of the child, and emphasize the positive aspect of
giving birth. At the same time, the nurse should refrain from agreeing with the
decision to terminate the reproductive function by means of sterilization.
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 cooperates 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 assistants, nor can it be extended to legislators. It does not apply in
any way to sterilization procedures.
Human life exists in a person, who must be respected and cared for, and at
times, reconciled to God 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 responsibilities they will face in an increasingly 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 perhaps 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 attempted 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 chaplains 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
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
of NCCB and of individual Bishops. They do not replace diocesan policies,
but are supplementary to them.)