A Catholic Advance Directive: Protecting Dignity and Guiding Care

A Catholic advance directive helps others protect your life, honor your dignity, and apply faith-guided moral principles if you cannot make medical decisions yourself.

An advance directive is a written statement about future health care decisions. It may name a health care agent, provide instructions, or do both. Its purpose is not to predict every possible medical situation. Its purpose is to give trustworthy people a clear framework when you cannot speak for yourself.

For Catholics, that framework begins with the dignity of the human person. Human life is a gift from God and deserves protection from conception until natural death. Direct euthanasia and assisted suicide are morally unacceptable. At the same time, Catholic teaching does not require us to pursue every possible intervention regardless of its effect on the patient.

Ordinary and proportionate care

The Church teaches that we ordinarily have a duty to use treatments that offer a reasonable hope of benefit without imposing excessive burden or expense. These are often described as ordinary or proportionate means.

Treatments that are futile or excessively burdensome in relation to their expected benefit may be refused. Choosing not to begin or to discontinue a disproportionate treatment is not the same as intending death. The underlying illness is allowed to take its course while the person continues to receive appropriate care.

This distinction depends on the actual clinical situation. A treatment may be proportionate for one patient and disproportionate for another. That is why a trusted agent, good medical information, and sound moral guidance are so important.

Food, water, comfort, and spiritual care

The Church generally regards medically assisted nutrition and hydration as ordinary care when they can nourish the patient and are not excessively burdensome. In some situations, however, the body can no longer assimilate them, they do not achieve their purpose, or they create serious complications. Decisions must consider the patient’s condition and the moral principles involved rather than rely on a broad instruction to “do everything” or “do nothing.”

Pain relief and palliative care are morally appropriate. Medication may be used to relieve serious pain even when a foreseen but unintended side effect could be a shortening of life, provided death is not intended or used as the means. Ordinary nursing care, warmth, hygiene, companionship, and respect should never be abandoned.

Catholic planning should also name spiritual needs. Request the Anointing of the Sick when appropriate, the Eucharist when possible, prayer, and contact with a priest or pastoral minister. Serious illness is not only a medical event.

Why a Catholic form helps

Some standard advance directive forms use broad phrases that can be misunderstood or applied in ways that conflict with Catholic teaching. A Catholic Medical Advance Directive can express the desire to protect life, reject euthanasia and assisted suicide, receive proportionate care, avoid excessively burdensome treatment, and obtain spiritual support.

No form can replace a well-chosen agent. The USCCB notes that a checklist cannot capture every medical circumstance or substitute for a conversation about faith-guided principles.

Complete the plan while you are well

Advance care planning is not only for older adults. Maryland’s Advance Directive Program encourages every adult age 18 and older to name someone who can speak for them. A serious accident can happen at any age.

After signing the directive according to applicable law, give copies to your health care agent, physician, and anyone else who may need it. Tell family where it is stored and how to contact your parish.

A simple next step

Complete the Catholic Medical Advance Directive and the Completing Your Catholic Advance Directive Guide at DontLeaveAMess.org. Then schedule a conversation with your proposed health care agent about the principles behind your choices.

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1.   USCCB: Ethical and Religious Directives for Catholic Health Care Services, Seventh Edition

2.   USCCB: Catholic Considerations for Our Earthly Passing

3.   Catechism of the Catholic Church: Respect for Human Life