The Catholic bishops of New York issued an updated pastoral guide, “Now and at the Hour of Our Death”, on April 20 to assist the faithful in navigating end-of-life decisions in light of the state’s recent legalisation of assisted suicide, which is scheduled to take effect in August 2026.
Published by the New York State Catholic Conference, the eight-page pamphlet explains core Catholic moral principles on preserving life, distinguishes between ordinary and extraordinary medical treatments, and offers practical advice on advance care planning while firmly rejecting assisted suicide and euthanasia as gravely immoral.
The guide comes shortly after Governor Kathy Hochul signed the Medical Aid in Dying Act in February 2026, making New York the latest jurisdiction to permit terminally ill adults with a prognosis of six months or less to request physician-prescribed medication to end their lives. The bishops’ document responds directly to this development, warning that assisted suicide – described as “the voluntary termination of one’s own life using physician-prescribed chemicals or drugs” – constitutes active euthanasia and remains “objectively immoral” regardless of claims of compassion.
“Medical advances bring with them new and complex questions with regard to medical treatments and moral decision-making,” the introduction states. The pamphlet aims to provide clear explanations of Church teaching and to outline lawful options for advance directives available in New York, encouraging Catholics to appoint a healthcare proxy who understands and will honour their faith-based values.
Central to the document is the traditional Catholic distinction between “ordinary” means of care, which are morally obligatory, and “extraordinary” means, which are morally optional. Ordinary care includes basic interventions such as food and water, including via feeding tubes when necessary, which must be provided as they offer reasonable hope of benefit without imposing excessive burdens. Withholding ordinary care with the intention of causing death is identified as passive euthanasia and “always gravely contrary to God’s will”.
The bishops stress that Catholics are not required to prolong the dying process through every possible medical intervention. Extraordinary or disproportionate treatments – for example, aggressive therapies with low success rates and severe burdens – may be refused after prudent discernment of benefits versus burdens for the individual patient. However, decisions must never be motivated by a judgment that a life lacks value or by a desire to hasten death.
The guide explicitly states: “It is never permissible to remove a feeding tube, or any other form of life-sustaining treatment, based on a belief that the patient’s life no longer holds value or with the intention to terminate the patient’s life.” Exceptions may exist in extreme cases, such as when death is imminent or when artificial nutrition causes serious complications, but even then hydration and nutrition should be provided to the extent possible.
The bishops emphasise that end-of-life choices are fundamentally moral and spiritual, not merely pragmatic. They urge the use of the virtue of prudence and recommend consulting a priest, chaplain or ethicist grounded in Church teaching. Prayer remains essential, and decisions should involve collaboration between the patient or surrogate, family, medical providers and spiritual advisers.
For practical planning, the pamphlet highlights the New York healthcare proxy form as the most appropriate tool, allowing individuals to designate a trusted decision-maker and provide guidance aligned with Catholic principles. The New York State Catholic Conference has made the guide available in English and Spanish for download.
Dennis Poust, executive director of the New York State Catholic Conference, noted that the original edition of the booklet has served Catholics for more than 15 years. “Our hope is that many thousands more Catholics in the years to come will find ‘Now and at the Hour of Our Death’ to be a useful guide in what is by nature a very stressful time,” he said. “We urge Catholics to read the booklet and familiarise themselves with Catholic teaching on these issues and the options available in New York now, before they or their loved ones are facing a health crisis.”
The document supplements the Church’s consistent defence of the sanctity of human life from conception to natural death, offering faithful Catholics in New York a clear framework for upholding that teaching amid shifting legal and cultural pressures. The full guide is available on the New York State Catholic Conference website.
