The Catholic bishops of Minnesota formally enacted a recent edition of the Church’s national health care guidelines that explicitly prohibit Catholic institutions from participating in voluntary starvation to hasten a patient’s death and from providing medical interventions in an attempt to alter a person’s sex.
The six bishops promulgated the Seventh Edition of the United States Conference of Catholic Bishops (USCCB) “Ethical and Religious Directives for Catholic Health Care Services” — known as ERDs — as binding law in their dioceses on Feb. 11, the World Day of the Sick and the Feast of Our Lady of Lourdes.
The updated directives were approved by the USCCB in November 2025, but the bishops’ formal action makes them binding in Minnesota’s six dioceses, meaning Catholic hospitals, clinics, and long-term-care facilities operating under diocesan authority must follow them.
In a joint statement released Feb. 11, the bishops said the ERDs “outline the moral principles that govern the provision of health care services in Catholic health care ministries” and are intended to “clearly articulat[e] the ethical and spiritual standards of care in this important work of the Church.”
What the ERDs govern
The ERDs serve as the ethical framework for Catholic health care nationwide. They address questions ranging from end-of-life care to reproductive medicine, human dignity, and institutional identity.
The Minnesota bishops said press release the purpose of the directives is to help Catholic health ministries operate “in accordance with the dignity of the human person, made in the image of God,” and to distinguish Catholic health care as “an irreplaceable witness to human solidarity.”
The bishops’ statement emphasized the role of the diocesan bishop in overseeing Catholic health care.
“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,” the press release stated. “As priest, the diocesan bishop oversees the sacramental care of the sick.”
Voluntary stopping of eating and drinking (VSED)
Among the most notable clarifications in the Seventh Edition is an explicit prohibition on voluntary stopping of eating and drinking, commonly referred to as VSED.
The bishops wrote that while Catholic teaching allows patients to refuse “extraordinary interventions” when the burdens outweigh the benefits, there remains “a presumption of providing (and receiving) nutrition and hydration as an ordinary means of care.”
The document distinguished VSED — defined as “starving oneself to hasten death, a practice being increasingly promoted today” — from refusing overly burdensome medical interventions such as a feeding tube or the natural loss of appetite that can accompany the dying process.
VSED, the ERDs state, “intentionally introduces a cause of death apart from the underlying illness” and therefore “constitutes a form of suicide in which health care providers are enlisted to facilitate.” Such an action, the bishops wrote, “would be contrary to the healing profession and deny the stewardship of life God entrusts to us.”
The directives say Catholic health care institutions and practitioners “should not encourage, condone, or cooperate with a patient’s decision to resort to VSED” and instead encourage hospice and palliative care as “proven alternatives in such situations.”
“The Church respects patients’ decisions about life-sustaining treatments when done so in accord with Catholic teaching,” the ERDs state.
Prohibition on gender ‘transition’ interventions
The Seventh Edition also reinforced a prohibition on what is often called “gender-affirming care” within Catholic health care, which is chemically and surgically altering healthy bodies to make them resemble the opposite sex or a non-binary presentation.
The bishops wrote that while providers must care for all patients, including those experiencing “gender incongruence or gender dysphoria,” such care must respect the “true nature and dignity of the human person.”
The ERDs prohibit Catholic providers from administering “medical interventions, whether surgical, hormonal, or genetic, that aim not to restore but rather to alter the fundamental order of the body in its form or function,” including procedures that “aim to transform sexual characteristics of a human body into those of the opposite sex or to nullify sexual characteristics.”
The statement directed readers to a 2023 doctrinal note issued by the USCCB’s Committee on Doctrine for further explanation of the teaching.
Implementation and next steps
The bishops encouraged Catholic health systems to establish training protocols and ethics committees and to consult with their diocesan bishop in difficult cases. They also urged civil authorities to respect the mission and conscience protections of Catholic health care institutions.
The statement was signed by Archbishop Bernard Hebda of St. Paul and Minneapolis, along with Bishops Andrew Cozzens of Crookston, Daniel Felton of Duluth, Robert Barron of Winona-Rochester, Chad Zielinski of New Ulm, and Patrick Neary of St. Cloud.
The Minnesota Catholic Conference and the Catholic Health Association’s Minnesota chapter plan to host a webinar on March 3 to answer questions about the new directives.
The bishops concluded their statement by describing health care workers and patients as “stewards of the gift of life,” urging both to respect “their mutual rights and responsibilities” as the Church seeks to continue the healing mission of Christ.