Ethical and religious directives for catholic health care

Ethical and Religious Directives for
Catholic Health Care Services
Sixth Edition
UNITED STATES CONFERENCE OF CATHOLIC BISHOPS
2
Ethical and Religious Directives for Catholic Health Care
Services, Sixth Edition
This sixth edition of the Ethical and Religious Directives for
Catholic Health Care Services was
developed by the Committee on Doctrine of the United States
Conference of Catholic Bishops (USCCB)

and approved by the USCCB at its June 2018 Plenary Assembly.
This edition of the Directives replaces
all previous editions, is recommended for implementation by the
diocesan bishop, and is authorized for
publication by the undersigned.
Msgr. J. Brian Bransfield, STD
General Secretary, USCCB
Excerpts from The Documents of Vatican II, ed. Walter M.
Abbott, SJ, copyright © 1966 by America
Press are used with permission. All rights reserved.
Scripture texts used in this work are taken from the New
American Bible, copyright © 1991, 1986, and
1970 by the Confraternity of Christian Doctrine, Washington,
DC, 20017 and are used by permission of
the copyright owner. All rights reserved.
Digital Edition, June 2018
Copyright © 2009, 2018, United States Conference of Catholic

Bishops, Washington, DC. All rights
reserved. No part of this work may be reproduced or transmitted
in any form or by any means, electronic
or mechanical, including photocopying, recording, or by any
information storage and retrieval system,
without permission in writing from the copyright holder.
3
Contents
4 Preamble
6 General Introduction
8 PART ONE
The Social Responsibility of
Catholic Health Care
Services
10 PART TWO

The Pastoral and Spiritual
Responsibility of Catholic
Health Care
13 PART THREE
The Professional-Patient Relationship
16 PART FOUR
Issues in Care for the Beginning of Life
20 PART FIVE
Issues in Care for the Seriously Ill
and Dying
23 PART SIX
Collaborative Arrangements with
Other Health Care Organizations and Providers
27 Conclusion
4

Preamble
Health care in the United States is marked by extraordinary
change. Not only is there
continuing change in clinical practice due to technological
advances, but the health care system
in the United States is being challenged by both institutional
and social factors as well. At the
same time, there are a number of developments within the
Catholic Church affecting the
ecclesial mission of health care. Among these are significant
changes in religious orders and
congregations, the increased involvement of lay men and
women, a heightened awareness of
the Church’s social role in the world, and developments in
moral theology since the Second
Vatican Council. A contemporary understanding of the Catholic
health care ministry must take
into account the new challenges presented by transitions both in
the Church and in American
society.
Throughout the centuries, with the aid of other sciences, a body
of moral principles has

emerged that expresses the Church’s teaching on medical and
moral matters and has proven to
be pertinent and applicable to the ever-changing circumstances
of health care and its delivery. In
response to today’s challenges, these same moral principles of
Catholic teaching provide the
rationale and direction for this revision of the Ethical and
Religious Directives for Catholic
Health Care Services.
These Directives presuppose our statement Health and Health
Care published in 1981.1
There we presented the theological principles that guide the
Church’s vision of health care,
called for all Catholics to share in the healing mission of the
Church, expressed our full
commitment to the health care ministry, and offered
encouragement to all those who are
involved in it. Now, with American health care facing even
more dramatic changes, we
reaffirm the Church’s commitment to health care ministry and
the distinctive Catholic identity
of the Church’s institutional health care services.2 The purpose
of these Ethical and Religious

Directives then is twofold: first, to reaffirm the ethical
standards of behavior in health care that
flow from the Church’s teaching about the dignity of the human
person; second, to provide
authoritative guidance on certain moral issues that face Catholic
health care today.
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 moral teachings that we
profess here flow principally from the natural law, understood
in the light of the revelation
Christ has entrusted to his Church. From this source the Church
has derived its understanding
of the nature of the human person, of human acts, and of the
goals that shape human activity.
The Directives have been refined through an extensive process
of consultation with bishops,

theologians, sponsors, administrators, physicians, and other
health care providers. While providing
standards and guidance, the Directives do not cover in detail all
of the complex issues that confront
Catholic health care today. Moreover, the Directives will be
reviewed periodically by the United
States Conference of Catholic Bishops (formerly the National
Conference of Catholic Bishops), in
the light of authoritative church teaching, in order to address
new insights from theological and
5
medical research or new requirements of public policy.
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 is in expository form; it 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.
6
General Introduction
The Church has always sought to embody our Savior’s concern
for the sick. The gospel
accounts of Jesus’ ministry draw special attention to his acts of
healing: he cleansed a man
with leprosy (Mt 8:1-4; Mk 1:40-42); he gave sight to two
people who were blind (Mt 20:29-
34; Mk 10:46-52); he enabled one who was mute to speak (Lk
11:14); he cured a woman who
was hemorrhaging (Mt 9:20-22; Mk 5:25-34); and he brought a
young girl back to life (Mt
9:18, 23-25; Mk 5:35-42). Indeed, the Gospels are replete with

examples of how the Lord
cured every kind of ailment and disease (Mt 9:35). In the
account of Matthew, Jesus’ mission
fulfilled the prophecy of Isaiah: “He took away our infirmities
and bore our diseases” (Mt
8:17; cf. Is 53:4).
Jesus’ healing mission went further than caring only for
physical affliction. He touched
people at the deepest level of their existence; he sought their
physical, mental, and spiritual
healing (Jn 6:35, 11:25-27). He “came so that they might have
life and have it more
abundantly” (Jn 10:10).
The mystery of Christ casts light on every facet of Catholic
health care: to see Christian
love as the animating principle of health care; to see healing
and compassion as a continuation
of Christ’s mission; to see suffering as a participation in the
redemptive power of Christ’s
passion, death, and resurrection; and to see death, transformed
by the resurrection, as an
opportunity for a final act of communion with Christ.
For the Christian, our encounter with suffering and death can

take on a positive and
distinctive meaning through the redemptive power of Jesus’
suffering and death. As St. Paul
says, we are “always carrying about in the body the dying of
Jesus, so that the life of Jesus
may also be manifested in our body” (2 Cor 4:10). This truth
does not lessen the pain and fear,
but gives confidence and grace for bearing suffering rather than
being overwhelmed by it.
Catholic health care ministry bears witness to the truth that, for
those who are in Christ,
suffering and death are the birth pangs of the new creation.
“God himself will always be with
them [as their God]. He will wipe every tear from their eyes,
and there shall be no more death
or mourning, wailing or pain, [for] the old order has passed
away” (Rev 21:3-4).
In faithful imitation of Jesus Christ, the Church has served the
sick, suffering, and dying in
various ways throughout history. The zealous service of
individuals and communities has
provided shelter for the traveler; infirmaries for the sick; and
homes for children, adults, and
the elderly.3 In the United States, the many religious

communities as well as dioceses that
sponsor and staff this country’s Catholic health care institutions
and services have established
an effective Catholic presence in health care. Modeling their
efforts on the gospel parable of
the Good Samaritan, these communities of women and men have
exemplified authentic
neighborliness to those in need (Lk 10:25-37). The Church
seeks to ensure that the service
offered in the past will be continued into the future.
While many religious communities continue their commitment
to the health care ministry,
lay Catholics increasingly have stepped forward to collaborate
in this ministry. Inspired by the
example of Christ and mandated by the Second Vatican Council,
lay faithful are invited to a
broader and more intense field of ministries than in the past.4
By virtue of their Baptism, lay
7

faithful are called to participate actively in the Church’s life
and mission.5 Their participation
and leadership in the health care ministry, through new forms of
sponsorship and governance
of institutional Catholic health care, are essential for the Church
to continue her ministry of
healing and compassion. They are joined in the Church’s health
care mission by many men
and women who are not Catholic.
Catholic health care expresses the healing ministry of Christ in
a specific way within the
local church. Here the diocesan bishop exercises responsibilities
that are rooted in his office as
pastor, teacher, and priest. As the center of unity in the diocese
and coordinator of ministries
in the local church, the diocesan bishop fosters the mission of
Catholic health care in a way
that promotes collaboration among health care leaders,
providers, medical professionals,
theologians, and other specialists. As pastor, the diocesan
bishop is in a unique position to
encourage the faithful to greater responsibility in the healing
ministry of the Church. As

teacher, the diocesan bishop ensures the moral and religious
identity of the health care
ministry in whatever setting it is carried out in the diocese. As
priest, the diocesan bishop
oversees the sacramental care of the sick. These responsibilities
will require that Catholic
health care providers and the diocesan bishop engage in ongoing
communication on ethical
and pastoral matters that require his attention.
In a time of new medical discoveries, rapid technological
developments, and social change,
what is new can either be an opportunity for genuine
advancement in human culture, or it can
lead to policies and actions that are contrary to the true dignity
and vocation of the human
person. In consultation with medical professionals, church
leaders review these developments,
judge them according to the principles of right reason and the
ultimate standard of revealed
truth, and offer authoritative teaching and guidance about the
moral and pastoral
responsibilities entailed by the Christian faith.6 While the
Church cannot furnish a ready
answer to every moral dilemma, there are many questions about

which she provides
normative guidance and direction. In the absence of a
determination by the magisterium, but
never contrary to church teaching, the guidance of approved
authors can offer appropriate
guidance for ethical decision making.
Created in God’s image and likeness, the human family shares
in the dominion that Christ
manifested in his healing ministry. This sharing involves a
stewardship over all material
creation (Gn 1:26) that should neither abuse nor squander
nature’s resources. Through science
the human race comes to understand God’s wonderful work; and
through technology it must
conserve, protect, and perfect nature in harmony with God’s
purposes. Health care
professionals pursue a special vocation to share in carrying
forth God’s life-giving and
healing work.
The dialogue between medical science and Christian faith has
for its primary purpose the
common good of all human persons. It presupposes that science
and faith do not contradict

each other. Both are grounded in respect for truth and freedom.
As new knowledge and new
technologies expand, each person must form a correct
conscience based on the moral norms
for proper health care.
8
PART ONE
The Social Responsibility of Catholic Health Care Services
Introduction
Their embrace of Christ’s healing mission has led
institutionally based Catholic health care
services in the United States to become an integral part of the
nation’s health care system.
Today, this complex health care system confronts a range of
economic, technological, social,
and moral challenges. The response of Catholic health care
institutions and services to these
challenges is guided by normative principles that inform the

Church’s healing ministry.
First, Catholic health care ministry is rooted in a commitment to
promote and defend
human dignity; this is the foundation of its concern to respect
the sacredness of every human
life from the moment of conception until death. The first right
of the human person, the right
to life, entails a right to the means for the proper development
of life, such as adequate
health care.7
Second, the biblical mandate to care for the poor requires us to
express this in concrete
action at all levels of Catholic health care. This mandate
prompts us to work to ensure that our
country’s health care delivery system provides adequate health
care for the poor. In Catholic
institutions, particular attention should be given to the health
care needs of the poor, the
uninsured, and the underinsured.8 Third, Catholic health care
ministry seeks to contribute to
the common good. The common good is realized when
economic, political, and social
conditions ensure protection for the fundamental rights of all
individuals and enable all to

fulfill their common purpose and reach their common goals.9
Fourth, Catholic health care ministry exercises responsible
stewardship of available health
care resources. A just health care system will be concerned both
with promoting equity of
care—to assure that the right of each person to basic health care
is respected—and with
promoting the good health of all in the communi ty. The
responsible stewardship of health care
resources can be accomplished best in dialogue with people
from all levels of society, in
accordance with the principle of subsidiarity and with respect
for the moral principles that
guide institutions and persons.
Fifth, within a pluralistic society, Catholic health care services
will encounter requests for
medical procedures contrary to the moral teachings of the
Church. Catholic health care does
not offend the rights of individual conscience by refusing to
provide or permit medical
procedures that are judged morally wrong by the teaching
authority of the Church.

Directives
1. A Catholic institutional health care service is a community
that provides health care to
those in need of it. This service must be animated by the Gospel
of Jesus Christ and
guided by the moral tradition of the Church.
2. Catholic health care should be marked by a spirit of mutual
respect among caregivers that
disposes them to deal with those it serves and their families
with the compassion of Christ,
sensitive to their vulnerability at a time of special need.
9
3. In accord with its mission, Catholic health care should
distinguish itself by service to and
advocacy for those people whose social condition puts them at
the margins of our society
and makes them particularly vulnerable to discrimination: the
poor; the uninsured and the
underinsured; children and the unborn; single parents; the

elderly; those with incurable
diseases and chemical dependencies; racial minorities;
immigrants and refugees. In
particular, the person with mental or physical disabilities,
regardless of the cause or
severity, must be treated as a unique person of incomparable
worth, with the same right to
life and to adequate health care as all other persons.
4. A Catholic health care institution, especially a teaching
hospital, will promote medical
research consistent with its mission of providing health care and
with concern for the
responsible stewardship of health care resources. Such medical
research must adhere to
Catholic moral principles.
5. Catholic health care services must adopt these Directives as
policy, require adherence to
them within the institution as a condition for medical privileges
and employment, and
provide appropriate instruction regarding the Directives for
administration, medical and
nursing staff, and other personnel.
6. A Catholic health care organization should be a responsible

steward of the health care
resources available to it. Collaboration with other health care
providers, in ways that do
not compromise Catholic social and moral teaching, can be an
effective means of such
stewardship.10
7. A Catholic health care institution must treat its employees
respectfully and justly. This
responsibility includes: equal employment opportunities for
anyone qualified for the task,
irrespective of a person’s race, sex, age, national origin, or
disability; a workplace that
promotes employee participation; a work environment that
ensures employee safety and
well-being; just compensation and benefits; and recognition of
the rights of employees to
organize and bargain collectively without prejudice to the
common good.
8. Catholic health care institutions have a unique relationship to
both the Church and the
wider community they serve. Because of the ecclesial nature of
this relationship, the
relevant requirements of canon law will be observed with regard
to the foundation of a

new Catholic health care institution; the substantial revision of
the mission of an
institution; and the sale, sponsorship transfer, or closure of an
existing institution.
9. Employees of a Catholic health care institution must respect
and uphold the religious
mission of the institution and adhere to these Directives. They
should maintain
professional standards and promote the institution’s
commitment to human dignity and the
common good.
10
PART TWO
The Pastoral and Spiritual Responsibility of
Catholic Health Care
Introduction
The dignity of human life flows from creation in the image of

God (Gn 1:26), from
redemption by Jesus Christ (Eph 1:10; 1 Tm 2:4-6), and from
our common destiny to share a
life with God beyond all corruption (1 Cor 15:42-57). Catholic
health care has the
responsibility to treat those in need in a way that respects the
human dignity and eternal
destiny of all. The words of Christ have provided inspiration for
Catholic health care: “I was
ill and you cared for me” (Mt 25:36). The care provided assists
those in need to experience
their own dignity and value, especially when these are obscured
by the burdens of illness or
the anxiety of imminent death.
Since a Catholic health care institution is a community of
healing and compassion, the care
offered is not limited to the treatment of a disease or bodily
ailment but embraces the physical,
psychological, social, and spiritual dimensions of the human
person. The medical expertise
offered through Catholic health care is combined with other
forms of care to promote health
and relieve human suffering. For this reason, Catholic health
care extends to the spiritual

nature of the person. “Without health of the spirit, high
technology focused strictly on the
body offers limited hope for healing the whole person.” 11
Directed to spiritual needs that are
often appreciated more deeply during times of illness, pastoral
care is an integral part of
Catholic health care. Pastoral care encompasses the full range
of spiritual services, including a
listening presence; help in dealing with powerlessness, pain,
and alienation; and assistance in
recognizing and responding to God’s will with greater joy and
peace. It should be
acknowledged, of course, that technological advances in
medicine have reduced the length of
hospital stays dramatically. It follows, therefore, that the
pastoral care of patients, especially
administration of the sacraments, will be provided more often
than not at the parish level, both
before and after one’s hospitalization. For this reason, it is
essential that there be very cordial
and cooperative relationships between the personnel of pastoral
care departments and the local
clergy and ministers of care.

Priests, deacons, religious, and laity exercise diverse but
complementary roles in this
pastoral care. Since many areas of pastoral care call upon the
creative response of these
pastoral caregivers to the particular needs of patients or
residents, the following directives
address only a limited number of specific pastoral activities.
Directives
10. A Catholic health care organization should provide pastoral
care to minister to the
religious and spiritual needs of all those it serves. Pastoral care
personnel—clergy,
religious, and lay alike—should have appropriate professional
preparation, including an
understanding of these Directives.
11
11. Pastoral care personnel should work in close collaboration
with local parishes and

community clergy. Appropriate pastoral services and/or
referrals should be available to all
in keeping with their religious beliefs or affiliation.
12. For Catholic patients or residents, provision for the
sacraments is an especially important
part of Catholic health care ministry. Every effort should be
made to have priests assigned
to hospitals and health care institutions to celebrate the
Eucharist and provide the
sacraments to patients and staff.
13. Particular care should be taken to provide and to publicize
opportunities for patients or
residents to receive the sacrament of Penance.
14. Properly prepared lay Catholics can be appointed to serve as
extraordinary ministers of
Holy Communion, in accordance with canon law and the
policies of the local diocese.
They should assist pastoral care personnel—clergy, religious,
and laity—by providing
supportive visits, advising patients regarding the availability of
priests for the sacrament
of Penance, and distributing Holy Communion to the faithful
who request it.

15. Responsive to a patient’s desires and condition, all involved
in pastoral care should
facilitate the availability of priests to provide the sacrament of
Anointing of the Sick,
recognizing that through this sacrament Christ provides grace
and support to those who
are seriously ill or weakened by advanced age. Normally, the
sacrament is celebrated
when the sick person is fully conscious. It may be conferred
upon the sick who have lost
consciousness or the use of reason, if there is reason to believe
that they would have asked
for the sacrament while in control of their faculties.
16. All Catholics who are capable of receiving Communion
should receive Viaticum when
they are in danger of death, while still in full possession of their
faculties.12
17. Except in cases of emergency (i.e., danger of death), any
request for Baptism made by
adults or for infants should be referred to the chaplain of the
institution. Newly born infants
in danger of death, including those miscarried, should be
baptized if this is possible.13 In
case of emergency, if a priest or a deacon is not available,

anyone can validly baptize.14 In
the case of emergency Baptism, the chaplain or the director of
pastoral care is to be
notified.
18. When a Catholic who has been baptized but not yet
confirmed is in danger of death, any
priest may confirm the person.15
19. A record of the conferral of Baptism or Confirmation should
be sent to the parish in which
the institution is located and posted in its baptism/confirmation
registers.
20. Catholic discipline generally reserves the reception of the
sacraments to Catholics. In
accord with canon 844, §3, Catholic ministers may administer
the sacraments of Eucharist,
Penance, and Anointing of the Sick to members of the oriental
churches that do not have
12

full communion with the Catholic Church, or of other churches
that in the judgment of the
Holy See are in the same condition as the oriental churches, if
such persons ask for the
sacraments on their own and are properly disposed.
With regard to other Christians not in full communion with the
Catholic Church, when
the danger of death or other grave necessity is present, the four
conditions of canon 844,
§4, also must be present, namely, they cannot approach a
minister of their own
community; they ask for the sacraments on their own; they
manifest Catholic faith in these
sacraments; and they are properly disposed. The diocesan
bishop has the responsibility to
oversee this pastoral practice.
21. The appointment of priests and deacons to the pastoral care
staff of a Catholic institution
must have the explicit approval or confirmation of the local
bishop in collaboration with
the administration of the institution. The appointment of the
director of the pastoral care
staff should be made in consultation with the diocesan bishop.

22. For the sake of appropriate ecumenical and interfaith
relations, a diocesan policy should
be developed with regard to the appointment of non-Catholic
members to the pastoral care
staff of a Catholic health care institution. The director of
pastoral care at a Catholic
institution should be a Catholic; any exception to this norm
should be approved by the
diocesan bishop.
13
PART THREE
The Professional-Patient Relationship
Introduction
A person in need of health care and the professional health care
provider who accepts that
person as a patient enter into a relationship that requires, among
other things, mutual respect,

trust, honesty, and appropriate confidentiality. The resulting
free exchange of information
must avoid manipulation, intimidation, or condescension. Such
a relationship enables the
patient to disclose personal information needed for effective
care and permits the health care
provider to use his or her professional competence most
effectively to maintain or restore the
patient’s health. Neither the health care professional nor the
patient acts independently of the
other; both participate in the healing process.
Today, a patient often receives health care from a team of
providers, especially in the
setting of the modern acute-care hospital. But the resulting
multiplication of relationships does
not alter the personal character of the interaction between health
care providers and the
patient. The relationship of the person seeking health care and
the professionals providing that
care is an important part of the foundation on which diagnosis
and care are provided.
Diagnosis and care, therefore, entail a series of decisions with
ethical as well as medical
dimensions. The health care professional has the knowledge and

experience to pursue the
goals of healing, the maintenance of health, and the
compassionate care of the dying, taking
into account the patient’s convictions and spiritual needs, and
the moral responsibilities of all
concerned. The person in need of health care depends on the
skill of the health care provider to
1
Douglass, Frederick, 1817?-1895. The heroic slave
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The heroic slave
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The heroic slave
Autographs for freedom
Frederick Douglass Editor Julia Griffiths p. 174-239
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-174-
THE HEROIC SLAVE.
PART I.
Oh! child of grief, why weepest thou?

Why droops thy sad and mournful brow?
Why is thy look so like despair ?
What deep, sad sorrow lingers there?
The State of Virginia is famous in American annals for the
multitudinous array of her
statesmen and heroes. She has been dignified by some the
mother of statesmen. History has not
http://etext.virginia.edu/conditions.html
3
been sparing in recording their names, or in blazoning their
deeds. Her high position in this
respect, has given her an enviable distinction among her sister
States. With Virginia for his birth-
place, even a man of ordinary parts, on account of the general
partiality for her sons, easily rises
to eminent stations. Men, not great enough to attract special
attention in their native States, have,
like a certain distinguished citizen in the State of New York,
sighed and repined that they were
not born in Virginia. Yet not all the great ones of the Old

-175-
Dominion have, by the fact of their birth-place, escaped
undeserved obscurity. By some strange
neglect, one of the truest, manliest, and bravest of her children,
-- one who, in after years, will, I
think, command the pen of genius to set his merits forth, holds
now no higher place in the
records of that grand old Commonwealth than is held by a horse
or an ox. Let those account for it
who can, but there stands the fact, that a man who loved liberty
as well as did Patrick Henry, --
who deserved it as much as Thomas Jefferson, -- and who
fought for it with a valor as high, an
arm as strong, and against odds as great, as he who led all the
armies of the American colonies
through the great war for freedom and independence, lives now
only in the chattel records of his
native State.
Glimpses of this great character are all that can now be
presented. He is brought to view only
by a few transient incidents, and these afford but partial
satisfaction. Like a guiding star on a

stormy night, he is seen through the parted clouds and the
howling tempests; or, like the gray
peak of a menacing rock on a perilous coast, he is seen by the
quivering flash of angry lightning,
and he again disappears covered with mystery.
Curiously, earnestly, anxiously we peer into the dark, and
wish even for the blinding flash, or
the light of northern skies to reveal him. But alas! he is still
enveloped in darkness, and we return
from the pursuit like a wearied and disheartened mother, (after a
tedious and unsuccessful search
for a lost
-176-
child,) who returns weighed down with disappointment and
sorrow. Speaking of marks, traces,
possibles, and probabilities, we come before our readers.
In the spring of 1835, on a Sabbath morning, within hearing
of the solemn peals of the church
bells at a distant village, a Northern traveller through the State
of Virginia drew up his horse to
drink at a sparkling brook, near the edge of a dark pine forest.

While his weary and thirsty steed
drew in the grateful water, the rider caught the sound of a
human voice, apparently engaged in
earnest conversation.
4
Following the direction of the sound, he descried, among the
tall pines, the man whose voice
had arrested his attention. "To whom can he be speaking?"
thought the traveller. "He seems to be
alone." The circumstance interested him much, and he became
intensely curious to know what
thoughts and feelings, or, it might be, high aspirations, guided
those rich and mellow accents.
Tieing his horse at a short distance from the brook, he stealthily
drew near the solitary speaker;
and, concealing himself by the side of a huge fallen tree, he
distinctly heard the following
soliloquy: --
"What, then, is life to me? it is aimless and worthless, and
worse than worthless. Those birds,
perched on yon swinging boughs, in friendly conclave, sounding

forth their merry notes in
seeming worship of the rising sun, though liable
-177-
to the sportsman's fowling-piece, are still my superiors. They
live free, though they may die
slaves. They fly where they list by day, and retire in freedom at
night. But what is freedom to
me, or I to it? I am a slave, -- born a slave, an abject slave, --
even before I made part of this
breathing world, the scourge was platted for my back; the
fetters were forged for my limbs. How
mean a thing am I. That accursed and crawling snake, that
miserable reptile, that has just glided
into its slimy home, is freer and better off than I. He escaped
my blow, and is safe. But here am I,
a man, -- yes, a man! -- with thoughts and wishes, with powers
and faculties as far as angel's
flight above that hated reptile, -- yet he is my superior, and
scorns to own me as his master, or to
stop to take my blows. When he saw my uplifted arm, he darted
beyond my reach, and turned to

give me battle. I dare not do as much as that. I neither run nor
fight, but do meanly stand,
answering each heavy blow of a cruel master with doleful wails
and piteous cries. I am galled
with irons; but even these are more tolerable than the
consciousness, the galling consciousness of
cowardice and indecision. Can it be that I dare not run away?
Perish the thought, I dare do any
thing which may be done by another. When that young man
struggled with the waves for life,
and others stood back appalled in helpless horror, did I not
plunge in, forgetful of life, to save
his? The raging bull from whom all others fled, pale with
-178-
fright, did I not keep at bay with a single pitchfork? Could a
coward do that? No, -- no, -- I
wrong myself, -- I am no coward. Liberty I will have, or die in
the attempt to gain it. This
working that others may in idleness! This cringing submission
to insolence and curses! This
living under the constant dread and apprehension of being sold
and transferred, like a mere brute,

is toomuch for me. I will stand it no longer. What others have
done, I will do. These trusty legs,
or these sinewy arms shall place me among the free. Tom
escaped; so can I. The North Star will
not be less kind to me than to him. I will follow it. I will at
least make the trial. I have nothing to
5
lose. If I am caught, I shall only be a slave. If I am shot, I shall
only lose a life which is a burden
and a curse. If I get clear, (as something tells me I shall,)
liberty, the inalienable birth-right of
every man, precious and priceless, will be mine. My resolution
is fixed. I shall be free."
At these words the traveller raised his head cautiously and
noiselessly, and caught, from his
hiding-place, a full view of the unsuspecting speaker. Madison
(for that was the name of our
hero) was standing erect, a smile of satisfaction rippled upon
his expressive countenance, like
that which plays upon the face of one who has but just solved a
difficult problem, or vanquished

a malignant foe; for at that moment he was free, at least in
spirit. The future gleamed brightly
before him, and his fetters lay broken at his feet. His air was
triumphant.
-179-
Madison was of manly form. Tall, symmetrical, round, and
strong. In his movements he
seemed to combine, with the strength of the lion, a lion's
elasticity. His torn sleeves disclosed
arms like polished iron. His face was "black, but comely." His
eye, lit with emotion, kept guard
under a brow as dark and as glossy as the raven's wing. His
whole appearance betokened
Herculean strength: yet there was nothing savage or forbidding
in his aspect. A child might play
in his arms, or dance on his shoulders. A giant's strength, but
not a giant's heart was in him. His
broad mouth and nose spoke only of good nature and kindness.
But his voice, that unfailing
index of the soul, though full and melodious, had that in it
which could terrify as well as charm.
He was just the man you would choose when hardships were to
be endured, or danger to be

encountered, -- intelligent and brave. He had the head to
conceive, and the hand to execute. In a
word, he was one to be sought as a friend, but to be dreaded as
an enemy.
As our traveller gazed upon him, he almost trembled at the
thought of his dangerous intrusion.
Still he could not quit the place. He had long desired to sound
the mysterious depths of the
thoughts and feelings of a slave. He was not, therefore, disposed
to allow so providential an
opportunity to pass unimproved. He resolved to hear more; so
he listened again for those mellow
and mournful accents which, he says, made such an
-180-
impression upon him as can never be erased. He did not have to
wait long. There came another
gush from the same full fountain; now bitter, and now sweet.
Scathing denunciations of the
cruelty and injustice of slavery; heart-touching narrations of his
own personal suffering,
intermingled with prayers to the God of the oppressed for help

and deliverance, were followed
by presentations of the dangers and difficulties of escape, and
formed the burden of his eloquent
utterances; but his high resolution clung to him, -- for he ended
each speech by an emphatic
declaration of his purpose to be free. It seemed that the very
repetition of this, imparted a glow to
6
his countenance. The hope of freedom seemed to sweeten, for a
season, the bitter cup of slavery,
and to make it, for a time, tolerable; for when in the very
whirlwind of anguish, -- when his
heart's cord seemed screwed up to snapping tension, hope
sprung up and soothed his troubled
spirit. Fitfully he would exclaim, "How can I leave her? Poor
thing! what can she do when I am
gone? Oh! oh! 'tis impossible that I can leave poor Susan!"
A brief pause intervened. Our traveller raised his head, and
saw again the sorrow-smitten slave.
His eye was fixed upon the ground. The strong man staggered
under a heavy load. Recovering

himself, he argued thus aloud: "All is uncertain here. To-
morrow's sun may not rise before I am
sold, and separated from her I love. What, then, could I do for
her? I should be in more hopeless
-181-
slavery, and she no nearer to liberty, -- whereas if I were free, -
- my arms my own, -- I might
devise the means to rescue her."
This said, Madison cast around a searching glance, as if the
thought of being overheard had
flashed across his mind. He said no more, but, with measured
steps, walked away, and was lost
to the eye of our traveller amidst the wildering woods.
Long after Madison had left the ground, Mr. Listwell (our
traveller) remained in motionless
silence, meditating on the extraordinary revelations to which he
had listened. He seemed
fastened to the spot, and stood half hoping, half fearing the
return of the sable preacher to his
solitary temple. The speech of Madison rung through the
chambers of his soul, and vibrated

through his entire frame. "Here is indeed a man," thought he,
"of rare endowments, -- a child of
God, -- guilty of no crime but the color of his skin, hiding away
from the face of humanity, and
pouring out his thoughts and feelings, his hopes and resolutions
to the lonely woods; to him
those distant church bells have no grateful music. He shuns the
church, the altar, and the great
congregation of christian worshippers, and wanders away to the
gloomy forest, to utter in the
vacant air complaints and griefs, which the religion of his times
and his country can neither
console nor relieve. Goaded almost to madness by the sense of
the injustice done him, he resorts
hither to give
-182-
vent to his pent up feelings, and to debate with himself the
feasibility of plans, plans of his own
invention, for his own deliverance. From this hour I am an
abolitionist. I have seen enough and
heard enough, and I shall go to my home in Ohio resolved to
atone for my past indifference to

this ill-starred race, by making such exertions as I shall be able
to do, for the speedy
emancipation of every slave in the land.
7
PART II.
"The gaudy, blabbling and remorseful day
Is crept into the bosom of the sea;
And now loud-howlig wolves arouse the jades
That drag the tragic melancholy night;
Who with their drowsy, slow, and flagging wings
Clip dead men's graves, and from their misty jaws
Breathe foul contagions, darkness in the air."
Shakspeare.
Five years after the foregoing singular occurence, in the
winter of 1840, Mr. and Mrs. Listwell

sat together by the fireside of their own happy home in the State
of Ohio. The children were all
gone to bed. A single lamp burnt brightly on the centre-table.
All was still and comfortable
within; but the night was cold and dark; a heavy wind sighed
-183-
and moaned sorrowfully around the house and barn,
occasionally bringing against the clattering
windows a stray leaf from the large oak trees that embowered
their dwelling. It was a night for
strange noises and for strange fancies. A whole wilderness of
thought might pass through one's
mind during such an evening. The smouldering embers,
partaking of the spirit of the restless
night, became fruitful of varied and fantastic pictures, and
revived man bygone scenes and old
impressions. The happy pair seemed to sit in silent fascination,
gazing on the fire. Suddenly this
reverie was interrupted by a heavy growl. Ordinarily such an
occurrence would have scarcely
provoked a single word, or excited the least apprehension. But
there are certain seasons when the

slightest sound sends a jar through all the subtle chambers of
the mind; and such a season was
this. The happy pair started up, as if some sudden danger had
come upon them. The growl was
from their trusty watch-dog.
"What can it mean? certainly no one can be out on such a
night as this," said Mrs. Listwell.
"The wind has deceived the dog, my dear; he has mistaken the
noise of falling branches,
brought down by the wind, for that of the footsteps of persons
coming to the house. I have
several times to-night thought that I heard the sound of
footsteps. I am sure, however, that it was
8
but the wind. Friends would not be likely to come out at such an
hour, or such a night; and
thieves are
-184-

too lazy and self-indulgent to expose themselves to this biting
frost; but should there be any one
about, our brave old Monte, who is on the lookout, will not be
slow in sounding the alarm."
Saying this they quietly left the window, whither they had
gone to learn the cause of the
menacing growl, and re-seated themselves by the fire, as if
reluctant to leave the slowly expiring
embers, although the hour was late. A few minutes only
intervened after resuming their seats,
when again their sober meditations were disturbed. Their
faithful dog now growled and barked
furiously, as if assailed by an advancing foe. Simultaneously the
good couple arose, and stood in
mute expectation. The contest without seemed fierce and
violent. It was, however, soon over, --
the barking ceased, for, with true canine instinct, Monte quickly
discovered that a friend, not an
enemy of the family, was coming to the house, and instead of
rushing to repel the supposed
intruder, he was now at the door, whimpering and dancing for
the admission of himself and his
newly made friend.
Mr. Listwell knew by this movement that all was well; he

advanced and opened the door, and
saw by the light that streamed out into the darkness, a tall man
advancing slowly towards the
house, with a stick in one hand, and a small bundle in the other.
"It is a traveller," thought he,
"who has missed his way, and is coming to inquire the road. I
am glad we did not go to
-185-
bed earlier, -- I have felt all the evening as if somebody would
be here to-night."
The man had now halted a short distance from the door, and
looked prepared alike for flight or
battle. "Come in, sir, don't be alarmed, you have probably lost
your way."
Slightly hesitating, the traveller walked in; not, however,
without regarding his host with a
scrutinizing glance. "No, sir," said he "I have come to ask you a
greater favor."
Instantly Mr. Listwell exclaimed, (as the recollection of the
Virginia forest scene flashed upon
him,) "Oh, sir, I know not your name, but I have seen your face,
and heard your voice before. I

am glad to see you. I know all. You are flying for your liberty, -
- be seated, -- be seated, -- banish
all fear. You are safe under my roof."
9
This recognition, so unexpected, rather disconcerted and
disquieted the noble fugitive. The
timidity and suspicion of persons escaping from slavery are
easily awakened, and often what is
intended to dispel the one, and to allay the other, has precisely
the opposite effect. It was so in
this case. Quickly observing the unhappy impression made by
his words and action, Mr. Listwell
assumed a more quiet and inquiring aspect, and finally
succeeded in removing the apprehensions
which his very natural and generous salutation had aroused.
Thus assured, the stranger said, "Sir, you have rightly
guessed, I am, indeed, a fugitive from
-186-

slavery. My name is Madison, -- Madison Washington my
mother used to call me. I am on my
way to Canada, where I learn that persons of my color are
protected in all the rights of men; and
my object in calling upon you was, to beg the privilege of
resting my weary limbs for the night in
your barn. It was my purpose to have continued my journey till
morning; but the piercing cold,
and the frowning darkness compelled me to seek shelter; and,
seeing a light through the lattice of
your window, I was encouraged to come here to beg the
privilege named. You will do me a great
favor by affording me shelter for the night."
"A resting-place, indeed, sir, you shall have; not, however, in
my barn, but in the best room of
my house. Consider yourself, if you please, under the roof of a
friend; for such I am to you, and
to all your deeply injured race."
While this introductory conversation was going on, the kind
lady had revived the fire, and was
diligently preparing supper; for she, not less than her husband,
felt for the sorrows of the
oppressed and hunted ones of earth, and was always glad of an
opportunity to do them a service.

A bountiful repast was quickly prepared, and the hungry and
toil-worn bondman was cordially
invited to partake thereof. Gratefully he acknowledged the favor
of his benevolent benefactress;
but appeared scarcely to understand what such hospitality could
mean. It was the first time in his
life that he had
-187-
met so humane and friendly a greeting at the hands of persons
whose color was unlike his own;
yet it was impossible for him to doubt the charitableness of his
new friends, or the genuineness
of the welcome so freely given; and he therefore, with many
thanks, took his seat at the table
with Mr. and Mrs. Listwell, who, desirous to make him feel at
home, took a cup of tea
themselves, while urging upon Madison the best that the house
could afford.
10

Supper over, all doubts and apprehensions banished, the three
drew around the blazing fire, and
a conversation commenced which lasted till long after midnight.
"Now," said Madison to Mr. Listwell, "I was a little surprised
and alarmed when I came in, by
what you said; do tell me, sir, why you thought you had seen my
face before, and by what you
knew me to be a fugitive from slavery; for I am sure that I never
was before in this
neighborhood, and I certainly sought to conceal what I supposed
to be the manner of a fugitive
slave."
Mr. Listwell at once frankly disclosed the secret; describing
the place where he first saw him;
rehearsing the language which he (Madison) had used; referring
to the effect which his manner
and speech had made upon him; declaring the resolution he
there formed to be an abolitionist;
telling how often he had spoken of the circumstance, and the
deep concern he had ever since felt
to know what had become of him; and whether he had carried
-188-

out the purpose to make his escape, as in the woods he declared
he would do.
"Ever since that morning," said Mr. Listwell, "you have
seldom been absent from my mind,
and though now I did not dare to hope that I should ever see you
again, I have often wished that
such might be my fortune; for, from that hour, your face seemed
to be daguerreotyped on my
memory."
Madison looked quite astonished, and felt amazed at the
narration to which he had listened.
After recovering himself he said, "I well remember that
morning, and the bitter anguish that
wrung my heart; I will state the occasion of it. I had, on the
previous Saturday, suffered a cruel
lashing; had been tied tip to the limb of a tree, with my feet
chained together, and a heavy iron
bar placed between my ankles. Thus suspended, I received on
my naked back forty stripes, and
was kept in this distressing position three or four hours, and
was then let down, only to have my
torture increased; for my bleeding back, gashed by the cow -

skin, was washed by the overseer
with old brine, partly to augment my suffering, and partly, as he
said, to prevent inflammation.
My crime was that I had stayed longer at the mill, the day
previous, than it was thought I ought
to have done, which, I assured my master and the overseer, was
no fault of mine; but no excuses
were allowed. 'Hold your tongue, you impudent rascal,' met my
every explanation. Slave-holders
are so imperious when their passions are excited, as to
-189-
construe every word of the slave into insolence. I could do
nothing but submit to the agonizing
11
infliction. Smarting still from the wounds, as well as from the
consciousness of being whipt for
no cause, I took advantage of the absence of my master, who
had gone to church, to spend the
time in the woods, and brood over my wretched lot. Oh, sir, I

remember it well, and can never
forget it."
"But this was five years ago; where have you been since?"
"I will try to tell you," said Madison. "Just four weeks after
that Sabbath morning, I gathered
up the few rags of clothing I had, and started, as I supposed, for
the North and for freedom. I
must not stop to describe my feelings on taking this step. It
seemed like taking a leap into the
dark. The thought of leaving my poor wife and two little
children caused me indescribable
anguish; but consoling myself with the reflection that once free,
I could, possibly, devise ways
and means to gain their freedom also, I nerved myself up to
make the attempt. I started, but ill-
luck attended me; for after being out a whole week, strange to
say, I still found myself on my
master's grounds; the third night after being out, a season of
clouds and rain set in, wholly
preventing me from seeing the North Star, which I had trusted
as my guide, not dreaming that
clouds might intervene between us.
"This circumstance was fatal to my project, for

-190-
in losing my star, I lost my way; so when I supposed I was far
towards the North, and had almost
gained my freedom, I discovered myself at the very point from
which I had started. It was a
severe trial, for I arrived at home in great destitution; my feet
were sore, and in travelling in the
dark, I had dashed my foot against a stump, and started a nai l,
and lamed myself. I was wet and
cold; one week had exhausted all my stores; and when I landed
on my master's plantation, with
all my work to do over again, -- hungry, tired, lame, and
bewildered, -- I almost cursed the day
that I was born. In this extremity I approached the quarters. I
did so stealthily, although in my
desperation I hardly cared whether I was discovered or not.
Peeping through the rents of the
quarters, I saw my fellow-slaves seated by a warm fire, merrily
passing away the time, as though
their hearts knew no sorrow. Although I envied their seeming
contentment, all wretched as I was,

I despised the cowardly acquiescence in their own degradation
which it implied, and felt a kind
of pride and glory in my own desperate lot. I dared not enter the
quarters, -- for where there is
seeming contentment with slavery, there is certain treachery to
freedom. I proceeded towards the
great house, in the hope of catching a glimpse of my poor wife,
whom I knew might be trusted
with my secrets even on the scaffold. Just as I reached the fence
which divided the field from the
garden, I saw a woman in the yard, who in the darkness I took
to
-191-
12
be my wife; but a nearer approach told me it was not she. I was
about to speak; had I done so, I
would not have been here this night; for an alarm would have
been sounded, and the hunters
been put on my track. Here were hunger, cold, thirst,
disappointment, and chagrin, confronted

only by the dim hope of liberty. I tremble to think of that
dreadful hour. To face the deadly
cannon's mouth in warm blood unterrified, is, I think, a small
achievement, compared with a
conflict like this with gaunt starvation. The gnawings of hunger
conquers by degrees, till all that
a man has he would give in exchange for a single crust of bread.
Thank God, I was not quite
reduced to this extremity.
"Happily for me, before the fatal moment of utter despair, my
good wife made her appearance
in the yard. It was she; I knew her step. All was well now. I
was, however, afraid to speak lest I
should frighten her. Yet speak I did; and, to my great joy, my
voice was known. Our meeting can
be more easily imagined than described. For a time hunger,
thirst, weariness, and lameness were
forgotten. But it was soon necessary for her to return to the
house. She being a house-servant, her
absence from the kitchen, if discovered, might have excited
suspicion. Our parting was like
tearing the flesh from my bones; yet it was the part of wisdom
for her to go. She left me with the

purpose of meeting me at midnight in the very forest where you
last saw me. She knew the place
well,
-192-
as one of my melancholy resorts, and could easily find it,
though the night was dark.
"I hastened away, therefore, and concealed myself, to await
the arrival of my good angel. As I
lay there among the leaves, I was strongly tempted to return
again to the house of my master and
give myself up; but remembering my solemn pledge on that
memorable Sunday morning, I was
able to linger out the two long hours between ten and midnight.
I may well call them long hours.
I have endured much hardship; I have encountered many perils;
but the anxiety of those two
hours, was the bitterest I ever experienced. True to her word,
my wife came laden with
provisions, and we sat down on the side of a log, at that dark
and lonesome hour of the night. I
cannot say we talked; our feelings were too great for that; yet
we came to an understanding that I

should make the woods my home, for if I gave myself up, I
should be whipped and sold away;
and if I started for the North, I should leave a wife doubly dear
to me. We mutually determined,
therefore, that I should remain in the vicinity. …
END OF LIFE
CONSENT
ADVANCE DIRECTIVES
POWER OF ATTORNEY
DO NOT RESUSCITATE
POLST
MOLST
CONSENT
• FREE AND INFORMED (ERD 28, 27, 26, 59)
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. The free and
informed health care decision of the person or

the person’s surrogate is to be followed so long
as it does not contradict Catholic principles.
CONSENT
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.
CONSENT
26. The free and informed consent of the
person or the person’s surrogate is required
for medical treatments and procedures,
except in an emergency situation when
consent cannot be obtained and there is no
indication that the patient would refuse
consent to the treatment.
CONSENT

• FREE AND INFORMED (ERD 28, 27, 26,
59)
59. The free and informed judgment made
by a competent adult patient concerning
the use or withdrawal of life-sustaining
procedures should always be respected
and normally complied with, unless it is
contrary to Catholic moral teaching.
CONSENT
• PROXY (ERD 25, 24)
25. Each person may identify in advance a representative
to make health care decisions as his or her surrogate in
the event that the person loses the capacity to make
health care decisions. Decisions by the designated
surrogate should be faithful to Catholic moral principles
and to the person’s intentions and values, or if the
person’s intentions are unknown, to the person’s best
interests. In the event that an advance directive is not
executed, those who are in a position to know best the
patient’s wishes—usually family members and loved
ones—should participate in the treatment decisions for
the person who has lost the capacity to make health care
decisions.
CONSENT
• PROXY (ERD 25, 24)

24. In compliance with federal law, a Catholic health
care institution will make available to patients
information about their rights, under the laws of
their state, to make an advance directive for their
medical treatment. The institution, however, will not
honor an advance directive that is contrary to
Catholic teaching. If the advance directive conflicts
with Catholic teaching, an explanation should be
provided as to why the directive cannot be honored.
PROXY CONSENT (LEGAL):
Process by which people with the legal right to consent to
medical treatment for
themselves or for a minor or a ward delegate that right to
another person.
3 fundamental constraints:
1. Person making the delegation must have the right to consent.
2. Person must be legally and medically competent to delegate
the right to consent.
3. Right to consent must be delegated to a legally and medically
competent adult.
ADVANCE DIRECTIVES
• Written instructions
• Regarding medical care preferences

• When unable to make one’s own health care decisions
• Guide for one’s family and doctors
• Can help reduce confusion or disagreement
• Generally legally binding
Advance directives include:
• Living will
• Medical or health care power of attorney (POA)
• Do not resuscitate (DNR) order
LIVING WILL
Florida Conference of Catholic Bishops (https://flaccb.org/)
CATHOLIC DECLARATION ON LIFE AND DEATH, BOTH:
• ADVANCE DIRECTIVE
• HEALTH SURROGATE DESIGNATION
https://www.flacathconf.org/declaration-on-life-and-death
https://flaccb.org/
https://www.flacathconf.org/declaration-on-life-and-death

POWER OF ATTORNEY (POA)
Medical or health care power of attorney (POA). The medical
POA is a
legal document that designates an individual — referred to as
your
health care agent or proxy — to make medical decisions for you
in the
event that you're unable to do so.
• DURABLE POA: EVEN WHEN PERSON IS MENTALLY
INCAPACITATED
• RECORD IT IN THE COUNTY COURT
Do not resuscitate (DNR) order
Request to not have cardiopulmonary resuscitation
(CPR) if your heart stops or if you stop breathing.
Advance directives do not have to include a DNR order,
and you don't have to have an advance directive to have
a DNR order.
Your doctor can put a DNR order in your medical chart.
PHYSICIAN ORDERS for LIFE-SUSTAINING TREATMENTS
(POLST)
MEDICAL ORDERS for LIFE-SUSTAINING TREATMENTS
(MOLST)

END OF LIFE��CONSENT��ADVANCE
DIRECTIVES��POWER OF ATTORNEY��DO NOT
RESUSCITATE��POLST��MOLSTSlide Number 2Slide
Number 3Slide Number 4Slide Number 5Slide Number 6Slide
Number 11Slide Number 12Slide Number 13Slide Number 14
DURABLE POWER OF ATTORNEY
State of Florida
County of ____________________________
KNOW ALL MEN BY THESE PRESENTS, that
I,__________________________________, of
____________________,
(name) (county)
Florida, as authorized by Florida law, do hereby
appoint,______________________________________________
_________
(name)
To manage and conduct my affairs. This power of attorney
shall be non-delegable except as otherwise provided in Florida
Statutes,
and shall be valid and effective from date hereof until such time
as I shall die or revoke the power. This durable power of
attorney is
not affected by subsequent incapacity of the principal except as
provided in Florida Statutes.

The property subject to this durable power of attorney shall
include all real and personal property owned by me, my
interest in al property held in joint tenancy, my interest in all
non-homestead property held in tenancy by the entirety, and all
property over which I hold power of appointment and shall also
include authority to sell, mortgage or convey my homestead
property.
Without limiting the broad powers intended to be conferred by
the preceding provisions, I expressly authorize my attorney
acting hereunder in a fiduciary capacity to do and execute all or
any of the following acts, deeds, and things for my benefit and
on
my behalf.
1. COLLECTION POWERS: To ask, demand, sue for, recover,
collect, receive all sums of money, bank deposits, chattels
and other real or personal property, tangible or intangible, of
whatsoever nature or description that may be due,
owing, payable or belonging to me, and to execute and deliver
receipts, releases, cancellations or discharges.
2. PAYMENT POWERS: To settle any account or reckoning
whatsoever wherein I now am or at any time hereafter shall
be in any way interested or concerned with any person
whomsoever, and to pay or receive the balance thereof as the
case may require.

3. SAFE DEPOSIT BOXES: To enter any safe deposit or other
place of safekeeping standing in my name with full authority
to remove any and all the contents thereof and to make
additions, substitutions and replacements, specifically
including any safe deposit box in my name jointly with my
spouse or any other person.
4. BANKING POWERS:
(a) To borrow any sum or sums of money on such terms and
with such security, whether real or personal property
belonging to me, as my attorney may think fit, and to execute
any and all notes, mortgages and other
instruments which my attorney may deem necessary or
desirable.
(b) To draw, accept, make, endorse or otherwise deal with any
checks, promissory notes, bills of exchange or
other commercial or mercantile instruments, specifically
including the right to make withdrawals from any
savings account or building or loan deposits.
(c) To redeem or cash in any/or all bonds issued by the United
States Government or any of its agencies, any
other bonds and any certificates of deposit or other similar
assets or securities belonging to me.
(d) To sell all or any bonds, shares of stock, warrants,

debentures, or other securities belonging to me, and to
execute all assignments and other instruments necessary or
proper for transferring the same to the purchaser
or purchasers thereof, and to give good receipts and discharges
for all monies payable in respect thereof.
(e) To invest the proceeds of any redemptions or sal es
aforesaid, and any other of my monies, in such, bonds,
shares of stock and other securities as my attorney shall think
fit, and from time to time to vary the said
investments or any of them.
*POA*
*POA* Page 1 of 3
5. MANAGEMENT POWERS: To vote at all meetings of
stockholders of any company or corporation, and otherwise to
act
as my attorney or proxy in respect of my shares of stock or
other securities or investments which now or hereafter shall
belong to me, and to appoint substitutes or proxies with respect
to any such shares of stock.
6. TAX POWERS: To sign and execute in my behalf any tax
return, state or federal relating to income, gift, ad valorem,
intangible or other taxes, state or federal, and to act for me in
any examinations, audits, hearings, conferences or

litigation relating to any such taxes, including authority to file
and prosecute refund claims, and to enter into an effect
any settlements.
7. TRUST POWERS:
(a) To execute a revocable or irrevocable trust which provides
that all income and principal shall be paid to me or
the guardian of my estate, or applied for my benefit in such
manner as I or my attorney hereunder shall
request or as the trustee shall determine, and that on my death
any remaining assets, including income, shall
pass according to my will or intestate succession if I have no
will.
(b) To make additions of funds and assets, real and personal, to
any trust established by me.
8. BUSINESS INTERESTS:
(a) To sell, rent, lease for any term, or exchange, any real estate
or interests therein, for such considerations and
upon such terms and conditions as my attorney may see fit;
specifically including the power and authority to
execute acknowledge and deliver deeds, mortgages, leases and
other instruments conveying or encumbering
title to property owned by me and my spouse jointly.

(b) To commence, prosecute, discontinue or defend all actions
or other legal proceedings touching my estate or
any part thereof, or touching any matter in which I or my estate
may be in any way concerned.
(c) The powers herein conferred upon my attorney shall extend
to and include all of my right, title and interest in
and to any real and personal property, tangible or intangible, in
which I may have an estate by the entirety,
joint tenancy, tenancy in common, as trustee or beneficiary of
any trust, or in any other manner.
9. PERSONAL INTERESTS:
(a) To make gifts, outright or in trust, in an amount not greater
than $10,000.00 per donee per year or the
amounts allowed without gift tax consequences under the
appropriate Internal Revenue code provisions
(including my attorney hereunder appointed).
(b) To arrange for my entrance to and care at any hospital,
nursing home, health center, convalescent home,
retirement home or similar institution.
(c) To renounce or disclaim any interest acquired by testate or
intestate succession or by inter vivos transfer.
10. HEALTH CARE POWERS:
(a) To authorize, arrange for, consent to, waive and terminate

any and all medical and surgical procedures on my
behalf ( including any election or election and agreement under
the Life-Prolonging Procedures Act of Florida
with request to providing, withholding or withdrawing life-
prolonging procedures should I fail to make a
declaration hereunder) and to pay or arrange compensation for
my care.
(b) To make health care decisions for me and to provide
informed consent if I am incapable of making health care
decisions or providing informed consent.
(i) To be the final authority to act for me and to make health
care decisions for me in matters
regarding my health care during any period in which I have the
incapacity to consent.
(ii) To expeditiously consult with appropriate health care
providers to provide informed consent in
my best interest and make health care decisions for me which
my said Surrogate believes I would
have made under the circumstances if I were capable of making
such decisions.
(iii) To give any consent in writing using the appropriate
consent form.
(iv) To have access to appropriate clinical records regarding me
and have authority to authorize the

release of information and clinical records to appropriate
persons to insure the continuity of my
health care.
*POA*
*POA* Page 2 of 3
(v) To apply for public benefits, where necessary, such as
Medicare and Medicaid, for me and have
access to information regarding my income and assets to the
extent required to make such
application if necessary.
(vi) To make all health care decisions on my behalf including
but not limited to those set forth in F.S.
Chapter 765.
11. GENERAL POWERS:
(a) In general to do all other acts, deeds, matters and things
whatsoever in or about my estate, property and
affairs, or to concur with persons jointly interested with me
therein in doing all acts, deeds, matters and things
herein particularly or generally described, as fully and
effectually to all intents and purposes as I could do

myself.
(b) This instrument is executed by me in the State of Florida but
it is my intention that the powers and authority
herein conferred upon my attorney as authorized by the laws of
Florida now or hereafter in force and effect
shall be exercisable in any other state or jurisdiction where I
may have any property or assets.
I hereby ratify and confirm, and promise at all times to ratify
and confirm all and whatsoever my duly authorized attorney
hereunder shall lawfully do or cause to be done by virtue of
these presents, including anything which shall be done
between the revocation of this instrument by my death or in any
other manner and notice of such revocation reaching my
attorney; and I hereby declare that as against me and all persons
claiming under me everything which my said attorney
shall do or cause to be done in pursuance hereof after such
revocation as aforesaid shall be valid and effectual in favor of
any persons claiming the benefit thereof who, before the doing
thereof, shall not have had notice of such revocation.
IN WITNESS WHEREOF, I have executed this Durable Power
of Attorney.

___________________________________
____________________________________________
Witness Signature Date
Signature Date
___________________________________
____________________________________________
Witness Signature Date
Print Name
State of Florida
County of ___________________________
Before me, the undersigned authority, duly authorized to take
acknowledgements and administer oaths, personally
appeared ________________________________, personally
known to me to be the person described above, who being by
me first duly sworn states that (His or Her) is the person who
executed the foregoing instrument for the reasons expressed
therein.
Dated this ___________day of ____________,____________.

_____________________________________________________
__
NOTARY PUBLIC
My Commission
Expires:__________________________________
*POA*
*POA* 11/2010 Page 3 of 3

CATHOLIC DECLARATION ON LIFE AND DEATH
ADVANCE DIRECTIVE
(HEALTH SURROGATE DESIGNATION/LIVING WILL) OF
_____________________________________________________

____
(Name)
Introduction
I am executing this Catholic Declaration on Life and Death
while I am of sound mind. It is intended to
designate a surrogate and provide guidance in making medical
decisions in the event I am
incapacitated or unable to express my own wishes.
Statement of Faith
I believe that I have been created for eternal life in union with
God. The truth that my life is a
precious gift from God has profound implications for the
question of stewardship over my life. I have
a duty to preserve my life and to use it for God’s glory, but the
duty to preserve my life is not
absolute, for I may reject life-prolonging procedures that are
insufficiently beneficial or excessively
burdensome. Suicide and euthanasia are never morally
acceptable options.1 If I should become
irreversibly and terminally ill, I request to be fully informed of
my condition so that I can prepare
myself spiritually for death and witness to my belief in Christ’s
redemption.
Designation of Health Care Surrogate
In the event that I become incapacitated, I designate as my
surrogate for health care decisions (if no
surrogate is to be appointed, please write “none” in place of
“name” below):

Name:_______________________________________________
__________________
Address:_____________________________________________
__________________
Phones (H, W,
C):__________________________________________________
______
If my surrogate is unwilling or unable to perform his or her
duties or cannot be contacted, I wish to
designate as my alternate surrogate (if no alternate surrogate is
to be appointed, please write “none”
in place of “name” below):
Name:_______________________________________________
__________________

Address:_____________________________________________
__________________
Phones (H, W,
C):__________________________________________________
______
This directive will permit my surrogate to make health care
decisions, and to provide, withhold, or
withdraw consent on my behalf; to apply for public benefits to
defray the cost of health care; to
receive my personal health care information; and to authorize
my admission to or transfer from a
health care facility. My surrogate is further appointed as my
“Personal Representative.”2 This
directive is not being made as a condition of treatment or
admission to a health care facility. This
document must be signed and witnessed on the other side to be
valid.
1
Cf United States Conference of Catholic Bishops, Ethical &
Religious Directives for Catholic Health Care Services
(USCCB: Washington,
DC 2009), Part Five.
2
As defined by 45 CFR 164.502(g), for purposes of compliance
with Federal HIPAA Laws and Regulations (the Health
Insurance Portability

and Accountability Act of 1996).
Living Will
The following gives guidance for carrying out my wishes at the
end of life. If at any time I am incapacitated and I
have a terminal condition or I have an end-stage condition, and
if my attending or treating physician and another
consulting physician have determined that there is no
reasonable medical probability of my recovery from such
condition(s), my health care surrogate (designated above, if
any) will be authorized to make decisions for me in
accordance with my wishes expressed in this Declaration. If my
surrogate cannot be contacted (or I have not
named a surrogate), then I request and direct that each of the
following be considered in making a decision for
me.

That:
1. I be provided care and comfort, and that my pain be relieved.
2. No inappropriate, excessively burdensome nor
disproportionate means be used to prolong my life. This
can include medical or surgical procedures.
3. There should be a presumption in favor of providing nutrition
and hydration to me, including medically
assisted nutrition and hydration, unless:
re
excessively burdensome and do not
offer sufficient benefit or would cause me significant physical
discomfort; or
4. Nothing be done with the intention of causing my death.
5. Spiritual care be provided, including sacraments whenever
possible.
Additional Instructions
_____________________________________________________
__________________________________
_____________________________________________________
__________________________________

Signatures Required
It is my intention that my surrogate, family and physicians
honor this declaration as the expression of my
treatment wishes. I understand the full import of this
declaration, and I am emotionally and mentally competent
to make this declaration.
__________________________________________
_______________________________________
DECLARANT Date
Last 4 Social Security Number: ____________
__________________________________________
_______________________________________
Witness Signature Witness Signature
__________________________________________
_______________________________________
Printed/Typed Name Printed/Typed Name
The Health Care Surrogate cannot serve as a witness; at least
one witness must not be a spouse or blood
relative of the person signing.
December 7, 2015

Copies of this form are available from the Florida Catholic
Conference, 201 West Park Avenue, Tallahassee, FL 32301-
7760
www.flaccb.org
http://www.flaccb.org/
State of Florida
DO NOT RESUSCITATE ORDER
(please use ink)
Patient’s Full Legal Name:
________________________________________________Date:
____________________
(Print or Type Name)
PATIENT’S STATEMENT
Based upon informed consent, I, the undersigned, hereby direct
that CPR be withheld or withdrawn.
(If not signed by patient, check applicable box):
q Surrogate q Proxy (both as defined in Chapter 765, F.S.)
q Court appointed guardian q Durable power of attorney
(pursuant to Chapter 709, F.S.)

_____________________________________________________
___________________________________________
(Applicable Signature) (Print or Type Name)
PHYSICIAN’S STATEMENT
I, the undersigned, a physician licensed pursuant to Chapter 458
or 459, F.S., am the physician of the
patient named above. I hereby direct the withholding or
withdrawing of cardiopulmonary resuscitation
(artificial ventilation, cardiac compression, endotracheal
intubation and defibrillation) from the patient
in the event of the patient’s cardiac or respiratory arrest.
_____________________________________________________
___________________________________________
(Signature of Physician) (Date) Telephone
Number (Emergency)
_____________________________________________________
___________________________________________
(Print or Type Name) (Physician’s Medical License Number)
DH Form 1896, Revised December 2002
PHYSICIAN’S STATEMENT
I, the undersigned, a physician licensed pursuant to Chapter 458
or 459, F.S., am the physician of the patient named above.
I hereby direct the withholding or withdrawing of
cardiopulmonary
resuscitation (artificial ventilation, cardiac compression,
endotracheal intubation and defibrillation) from the patient in
the
event of the patient's cardiac or respiratory arrest.

_____________________________________________________
___
(Signature of Physician) (Date) Telephone Number
(Emergency)
_____________________________________________________
___
(Print or Type Name) (Physician’s Medical License Number)
DH Form 1896,Revised December 2002
State of Florida
DO NOT RESUSCITATE ORDER
_____________________________________________________
___________
Patient’s Full Legal Name (Print or Type)
(Date)
PATIENT’S STATEMENT
Based upon informed consent, I , the unders i g n e d ,h e r e by
direct that CPR
be withheld or withdrawn. (If not signed by patient, check
applicable box):
q Surrogate
q Proxy (both as defined in Chapter 765, F.S.)
q Court appointed guardian
q Durable power of attorney (pursuant to Chapter 709, F.S.)
_____________________________________________________
___________
(Applicable Signature) (Print or Type Name)
vickerykd
Text Box

Important!
In order to be legally valid this form MUST be printed on
yellow paper prior to being completed. EMS and medical
personnel are only required to honor the form if it is printed on
yellow paper.
This box will not show up when the form is printed.
END OF LIFE
CONSENT
ADVANCE DIRECTIVES
POWER OF ATTORNEY
DO NOT RESUSCITATE
POLST
MOLST
CONSENT
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. The free and
informed health care decision of the person or

END OF LIFE��CONSENT��ADVANCE
DIRECTIVES��POWER OF ATTORNEY��DO NOT
RESUSCITATE��POLST��MOLSTSlide Number 2Slide
Number 11Slide Number 12Slide Number 13Slide Number 14
*****Please watch these videos and answer questions. Also see
the other attachments. Answers must come from attachments
and videos.***********
https://www.youtube.com/watch?v=WdGqUeIJVes
https://www.youtube.com/watch?v=GWpHn2_a-eU&t=295s
1. Uniform Determination of Death Act (UDDA):
· How this law was created
· Legal definition of death, describe
2. Define dying within context of faith, basic principle about
human life
3. Bioethical Analysis of Pain Management - Pain Relief
4. What is the difference between Pain and suffering? Explain
5. Diagnosis / Prognosis: define both.
6. Ordinary / Extraordinary means of life support. Explain the
bioethical analysis.
7. Killing or allowing to die? Define both and explain which
one is ethically correct and why?
8. Catholic declaration on life and death; give a summary of this
document: https://ecatholic-
sites.s3.amazonaws.com/17766/documents/2018/11/CDLD.pdf (
Links to an external site.)
9. What is free and informed consent from the Catholic
perspective?
10. Define Proxi, Surrogate
11. Explain:
· Advance Directives
· Living Will
· PoA / Durable PoA

· DNR
12. Read and summarize ERD paragraphs #: 24, 25, 26, 27, 28,
55, 59, 61, 62.

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