A brief history. A summary of the development of the Ethical and Religious Directives for Catholic Health Care Services.

Fr. O'Rourke is professor of bioethics, Stritch School of Medicine, Loyola I 'mra-sity Chicago; Fr. Kopfen steiner is associate professor, 'Lheo/ojjy Department, Lordham University, Bronx, NT; and Dr. Hatnel is senior director. Ethics, CHA. C atholics engaged in health care t h r o u g h o u t the centur ies have always sought to minister in the spirit of Christ and in accord with the reaching of the church as they carried on their ministry of healing. In the 16th century, theologians began to treat issues arising in the practice of medicine more frequently. Thus, such questions as how to determine that death had occurred and which medical methods to prolong life were mandatory and which methods were optional were discussed. Professionals engaged in Catholic health care applied treatment norms agreed upon by theologians as well as general norms for compassionate health care. No formal set of directives was issued for any country in the centuries immediately following, but a com mon teaching in the Catholic Church concerned the ethical practice of medicine and patient care. In the United States and Canada, the ministry of Catholic health care grew and flourished during the late 19th and early 20th centur ies . Hospitals and long-term care facilities multiplied, usually under the sponsorship of religious communities, but always under the jurisdiction of the diocesan bishop.