The directives also clarify the role of a bishop in overseeing collaborations of Catholic and non-Catholic institutions.
Joe Zalot, a staff ethicist with the National Catholic Bioethics Center, told CNA that these directives are necessary because health care collaborations are increasingly common, and can create complex situations when determining who has authority over these entities.
"Basically what's happened is that many of the Catholic hospitals, historically they were founded and run by religious orders, particularly women's religious orders, and as those orders are literally and figuratively dying out, there were not enough sisters to administer them," Zalot said.
As a result, some Catholic health care institutions are now overseen by what are called juridic persons in canon law, which are legal entities recognized by the Vatican. Because these juridic persons exist within a diocese, or in some cases multiple dioceses, the local bishop or bishops share responsibility in ensuring the Catholic identity of these entities, Zalot said.
"What these directives are doing is recognizing that fact and trying to define the role of the bishop in terms of Catholic health care entities in his diocese. Essentially the bishop has oversight of what happens in his diocese," Zalot said.
"What the bishops are saying is not new. What they're doing is clarifying the role of the bishop in terms of Catholic entities in (their) dioceses," he added.
Zalot said that for the most part, these directives usually do not pose problems for Catholic institutions that seek collaboration with non-Catholic ones.
"What (the bishops) are concerned with is ensuring the identity of the Catholic institution remains, even within these mergers. And actually it does happen, we see it, there's hospitals that have been merged into or bought by a secular institution. But one of the elements of the contract or the purchase agreement is that these institutions remain Catholic," he said.
"And as far as I know, most secular institutions don't have a problem with that," he added. The directives just help to ensure that "what is happening in a Catholic healthcare institution actually is Catholic, and you're providing care consistent with the teachings of the Church."
While discussing the revision of the directives at the general assembly in Fort Lauderdale, Archbishop William Lori of Baltimore noted that three of the five Catholic hospitals in Baltimore are already in collaborative arrangements, and that the new revision "doesn't answer every question, but it does offer helpful guidance."
Cardinal Donald Wuerl of Washington said the revision "walks a very clear path through many complex issues," preserving the theological principle of the autonomy of individual dioceses in pastoral ministry. It "makes clear there should be collaboration between dioceses, without taking away the autonomy of the individual bishop."
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The USCCB voted to approve the revised Ethical and Religious Directives June 14, by a vote of 183 to 2, with 2 abstentions.