Tradition in transition. What it means to be a Catholic healthcare facility today

Until recently we rarely questioned whether Catholic healthcare facilities would remain Catholic. New types of business ventures, however, have changed this. More important, the traditional elements that identified a facility as Catholic no longer seem enough to sustain the ministry. What are the distinct qualities that identify a healthcare facility as Catholic? Three elements are crucial to successfully defining any identity: distinctiveness, relatedness, and richness. To determine the meaning of Catholic identity, we must look at these elements from the perspective of the changes occurring in the Catholic Church and in healthcare in the United States. In light of this we can identify distinctive features that characterize U.S. Catholic healthcare. These components include understanding healthcare as a ministry, being guided by Church teachings, collaborating with others, participating in care for the world community and the poor, giving holistic care, promoting self-determination, and respecting and protecting human life while accepting suffering and death. Only in their totality, however, can these components set forth a vision rooted in our past that speaks to the realities of the present and calls us forward to a future where greater justice will reign.

Helping people prepare. Catholic healthcare facilities can give patients advice on advance directives

Although state courts have tended recently to allow surrogates to make healthcare treatment decisions for incompetent patients, the Missouri Supreme Court went against the trend by denying Nancy Cruzan's family the right to withdraw her artificial nutrition and hydration. The U.S. Supreme Court upheld the Missouri decision. At the same time, however, the Court's opinions strongly implied that it would uphold other state courts' decisions affirming the right of surrogates to make treatment decisions for incompetent patients. In his majority opinion, moreover, Chief Justice William Rehnquist upheld a competent person's liberty interest in refusing medical treatment, including artificial nutrition and hydration. Catholic healthcare facilities should be prepared to provide information to the many patients and long-term care residents seeking advice on advance directives as a result of the Court's ruling. Because living wills are proving to be less effective than many at first thought they would be, providers can best help individuals by giving them information on preparing proxy documents.

Genetic counseling in Catholic hospitals. Facilities must provide guidance to keep pace with new knowledge and techniques

As advances in the knowledge of human genetics change the practice of medicine, Catholic healthcare facilities will, according to ethicists, be increasingly obliged to provide genetic counseling services to their patients. Facilities should ensure that counselors make genetic information available in a context in which no pressure, overt or subtle, is exerted to use that information in a way that may violate an individual's value system. Some hospitals may, for example, set up a separate genetic counseling department, which does not diagnose or treat genetic disorders but does facilitate access to these treatments when patients need them. Effective counseling requires accurate, current knowledge about tests and treatments, as well as about theological discussions and Church decisions on the subject. Counselors also need to be aware of some typical misconceptions people have about genetic disease. Catholic hospitals should also work with other Catholic organizations to influence legislation addressing human genetic issues, especially when such legislation addresses reproductive rights.