Last reviewed October 2026 by LSS Law.
Can a Catholic hospital in New Jersey refuse to follow my advance directive?
QUICK ANSWER: Not exactly. New Jersey law lets a hospital decline, on conscience grounds, to personally carry out certain instructions, but it can’t simply ignore your directive and do nothing.
- A hospital or health care professional can decline to participate in specific actions, most often withdrawing life-sustaining treatment, based on sincerely held conscience.
- If they decline, New Jersey law requires them to take reasonable steps to transfer you, promptly and respectfully, to a willing provider or institution.
- Ignoring or overriding your directive outright, rather than transferring your care, carries real legal consequences, including fines and, in some circumstances, criminal penalties.
The Myth: “They Can Just Say No”
Somewhere along the way, a lot of people pick up the idea that a religiously affiliated hospital can set an advance directive aside if it conflicts with the institution’s beliefs, full stop, end of conversation. It’s an understandable thing to worry about, especially if you or a parent’s directive includes instructions about withdrawing life-sustaining treatment.
It’s also not quite how New Jersey law actually works. The real rule is more specific, and more protective of you, than “they can just say no.”
What New Jersey Law Actually Allows
New Jersey’s Advance Directives for Health Care Act does give health care professionals and institutions a real right of conscience. A hospital, physician, or other health care professional can decline to participate in withholding or withdrawing life-sustaining treatment, in accordance with sincerely held personal or professional convictions.1
That’s a genuine legal right, and it’s exactly the piece of the law that fuels the myth. But it’s only half of what the statute actually says.
The Debunk: Declining Isn’t the Same as Ignoring
Here’s the part that usually gets left out. When a health care institution declines to carry out a directive on conscience grounds, New Jersey law requires it to take all reasonable steps to arrange a timely, respectful transfer of your care to another provider or institution willing to honor your wishes.2 The institution has to make sure you’re not abandoned or treated disrespectfully in the process, and it has to promptly transfer your medical records, including a copy of your advance directive, to wherever your care is going next.3
In plain terms: the hospital can say “we personally won’t do this,” but it can’t say “and neither will anyone else, because we’re not helping you get there.” Declining and abandoning are two very different things under New Jersey law, even though they can feel similar in the moment if nobody explains the difference.
The Law Has Real Teeth Behind It
This isn’t just a polite suggestion written into the statute. New Jersey law backs the transfer requirement with actual consequences. A health care institution that intentionally fails to comply can be fined up to $1,000 for each offense, with each violation counted separately.4 Separately, willfully concealing, disregarding, or overriding someone’s advance directive without their consent is a crime of the fourth degree.5
That combination, a specific conscience right paired with a mandatory, enforceable transfer duty, is the actual legal picture. “Override” isn’t really the right word for what’s allowed. “Decline and transfer” is closer to it.
Why This Catches So Many Families by Surprise
Nationally, roughly one in six hospital beds is in a Catholic-affiliated facility, according to data tracked by the healthcare watchdog group MergerWatch. That means a meaningful share of patients and families are already receiving care somewhere that could raise this exact question, often without realizing it until a specific decision is actually on the table.
That’s not a reason for alarm. It’s a reason to know the actual rule ahead of time, rather than learning it for the first time in a moment when a decision can’t wait.
A Few Questions Families Ask Us Often
Does this mean a Catholic hospital will always transfer my care if there’s a conflict? It means they’re legally required to take reasonable steps toward a timely, respectful transfer. The specifics of how quickly that happens can still vary by situation, which is exactly why it helps to know your directive’s terms and discuss them with an institution before a crisis, not during one.
Can I ask my hospital in advance what their policy is? Yes, and it’s a reasonable thing to do. Asking directly and giving the hospital a copy of your advance directive in advance gives everyone more time to sort out any conflict calmly, rather than in an emergency.
Does this conscience right apply to every part of an advance directive, or just life-sustaining treatment? The specific right discussed here concerns withholding or withdrawing life-sustaining treatment. Other parts of your directive, like naming a health care representative, aren’t the kind of decision this conscience provision is built around.
Key Takeaways
- New Jersey law gives health care institutions a real right to decline, on conscience grounds, to personally withdraw life-sustaining treatment.
- That same law requires them to arrange a timely, respectful transfer to a willing provider if they decline, not to stop responding.
- Intentional noncompliance carries real penalties, including institutional fines and, in some cases, criminal charges.
- About one in six U.S. hospital beds is in a Catholic-affiliated facility, so this question is more common than most families expect.
What to Do With This Before It Becomes Urgent
The best time to sort this out is well before it matters, not in the middle of a hospital stay. Knowing your hospital’s affiliation, sharing your advance directive with them directly, and understanding exactly what New Jersey law requires of them gives your family a much clearer picture than guessing under pressure later.
We help New Jersey families ensure their advance directive actually says what they need it to, and that they understand exactly how it will be handled wherever they receive care. If that would help, you can reach us at www.lsslawoffices.com/contact.
