Medical Clearance Checklists Priests Should Use Before Major Exorcisms

Introduction — Why medical clearance matters

Before any major exorcism (more formal or prolonged deliverance session), clergy should treat the situation as a guarded clinical encounter, not purely a ritual performance. That means a structured pre-ritual medical and psychiatric screening, clear documentation, informed consent, and a coordinated plan with clinicians when appropriate. This approach reduces risk to the person involved, protects witnesses and ministers, and honors both pastoral and clinical responsibilities.

Core pre‑exorcism medical clearance checklist

Use this checklist as a working template. It is not a substitute for clinical assessment by a licensed clinician; rather, it helps priests gather facts and make safe, consistent decisions about referrals and precautions.

• Identify and document: legal name, DOB, emergency contact, primary care clinician and current treating mental‑health provider (if any).
• Presenting complaint and timeline: onset, pattern, triggers, prior episodes, prior treatments and any prior exorcism/deliverance attempts.
• Vital signs & baseline status: note pulse, blood pressure, respiratory rate, temperature and mental status (awake/alert/oriented).
• Medications and allergies: prescription, over‑the‑counter, herbal supplements, recent changes, and anticoagulant or sedative use that could affect safety.
• Substance use and recent intoxication/withdrawal risk: alcohol, benzodiazepines, stimulants, hallucinogens — recent intoxication or withdrawal can cause severe medical instability and mimic ‘possession’ presentations.
• Seizure and neurologic history: prior seizures, head injury, syncope, or neurologic disease; if present, avoid unmonitored physical restraint and arrange medical oversight.
• Psychiatric history and current risk: prior psychosis, suicide attempts, self‑harm, or severe mood disorders — urgent psychiatric evaluation is indicated for active suicidal ideation or severe psychosis.
• Pregnancy and special conditions: pregnancy, advanced age, severe cardiac, respiratory, hepatic or renal disease increase procedural risk and change disposition.
• Informed consent and capacity: document that the person (or legal guardian) understands the proposed rite, potential risks and alternatives, and has capacity to consent; if capacity is impaired, seek legal/medical advice before proceeding.
• Media and confidentiality: obtain explicit permission if any recording is proposed; ordinarily refuse media and publicizing the rite.

These items reflect standard pre‑procedure screening practices and should prompt referral to medical or mental‑health services when gaps or red flags are present.

When to pause and refer: medical & psychiatric red flags

Pause the ritual and obtain immediate medical or psychiatric help if any of the following apply: active suicidal ideation or self‑harm, unresponsive or dangerously agitated behavior, signs of intoxication or withdrawal (especially heavy alcohol or sedative withdrawal), uncontrolled bleeding, difficulty breathing, seizure lasting longer than usual, or any signs of cardiovascular instability.

For matters specifically involving suspected seizures or prolonged convulsions, follow recognized first‑aid and emergency criteria: call emergency services if a seizure lasts longer than five minutes, if seizures occur back‑to‑back without recovery, the person does not regain consciousness, or they have difficulty breathing or were injured during the event.

Collaboration, documentation and safety planning

Best practice is interdisciplinary: clergy should consult or have protocols with local primary‑care, emergency, neurology and mental‑health teams so clinicians can evaluate and clear a person for ritual work when necessary. Formal guidelines for clinicians working with people who report possession emphasize this collaborative boundary: clinicians diagnose medical/psychiatric conditions and clergy address spiritual needs; neither should act alone when serious medical or psychiatric concerns exist.

Document all steps taken: the checklist findings, names and contact details of consulted clinicians, signed informed consent (or reason consent could not be obtained), who was present during the ritual, and the emergency plan (nearest ER, ambulance phone number, assigned responder). Keep records according to diocesan policy and applicable privacy laws.

Practical risk‑mitigation & sample pre‑ritual protocol

Suggested practical measures for a major exorcism (adapt these to diocesan policy and local law):

1. Require a completed pre‑exorcism medical checklist and, if red flags are present, a recent clinician note or direct clinician clearance.
2. Limit the number of attendees; have at least two sober, trained assistants to keep the environment safe and to observe for medical distress.
3. Designate an on‑site person with a charged phone and a plan to call emergency services; identify the nearest emergency department in advance.
4. Do not use physical restraint except to prevent imminent harm and only in ways consistent with medical advice and local law; avoid vigorous force that could cause injury.
5. Have basic first‑aid supplies and oxygen if available; if sedation or medical interventions could be needed, ensure clinicians manage those interventions (do not self‑administer medications outside clinical supervision).
6. After any session with concerning behavior, arrange timely medical and psychiatric follow‑up and document the outcome.

These measures apply the same safety mindset used for other non‑medical but high‑risk activities (for example, organized rituals where restraint, exertion or altered consciousness is anticipated) and echo clinical preprocedure recommendations about baseline vitals, consent and emergency readiness.