BALTIMORE (CNS) -- During their fall general assembly in Baltimore, the U.S. bishops Nov. 11 voted overwhelmingly in favor of revising a section of the "Ethical and Religious Directives for Catholic Health Care Services" that deals with Catholic and non-Catholic health care partnerships.

The U.S. Conference of Catholic Bishops' Committee on Doctrine will draft a revision of Part 6 of the directives called: "Forming New Partnerships with Health Care Organizations and Providers" for the bishops' approval at a later meeting.

The revised draft will include principles offered by the Vatican Congregation for the Doctrine of the Faith to the bishops' doctrine committee this February.

The bishops previously revised the directive's final section, Part 6, in 2001.

The directives, first approved in 1971 and revised multiple times over the years, are essentially a national code to help Catholic health care facilities address a wide range of ethical questions. The document examines abortion, euthanasia, care for the poor, medical research, treatment of rape victims, surrogate motherhood, in vitro fertilization, prenatal testing, nutrition and hydration for the terminally ill, and organ donation.

In 2013, a "dubium," or formal question, was submitted to the doctrinal congregation by New York Cardinal Timothy M. Dolan, then president of the USCCB, concerning Catholic and non-Catholic health care partnerships.

The congregation's response, given in February of this year, was not a formal "responsum," or reply. It included 17 principles, which, according to an accompanying letter from Cardinal Gerhard Muller, prefect of the congregation "are meant to assist the bishops of the United States in considering their teaching and governing responsibilities in the development and reorganization of Catholic health care organizations or systems."

The principles acknowledge the need for such collaborations. They also say partnerships are not inherently wrong but are complex and often need to be viewed on a case by case basis.

An introduction to these principles stresses that Catholic healthcare institutions "must do everything they can to ensure that the church's involvement does not give scandal, whether to fellow Catholics and Christians, or to other persons of good will who look to the church, however obliquely, for moral guidance."

The bishops who spoke about the proposed revision of the directives during the Nov. 11 question-and-answer session prior to the vote said they supported it because they know about the complications in such partnerships and would appreciate more guidance in this area.

In the vote, 213 bishops voted in favor of the revision, two voted against it and one bishop abstained -- giving the action 99 percent approval.

Bishop William F. Murphy of Rockville Centre, New York, pointed out that with the last revision of the section 12 years ago, "we recognized (at the time) what we have is as far as we can go."

But a lot has changed in health care in 12 years, he said, particularly with mergers, boards, buying physicians' practices and health insurance.

"There are a number of issues that make it important to do the best we can to illuminate Catholic principles," he said, adding that as a bishop with health care facilities in his diocese, more guidance about this "will be helpful."

Phoenix Bishop Thomas J. Olmsted similarly was in favor of a revision but said it would help to have more specific direction about implementing any revised directives and suggested that the National Catholic Bioethics Center in Philadelphia might be able assist with this.

Archbishop John C. Nienstedt of St. Paul and Minneapolis, chairman of the doctrine committee, stressed that there has been a concern among bishops that current "principles of cooperation were not envisioned" by the current directives.

He said once a revision is drafted and approved, the doctrine committee could provide workshops for bishops to help them understand and implement the changes.