Ethical and Religious Directives - Part Six

The last major section of the Ethical and Religious Directives [ERDs], Part 6, has the official title, "Forming New Partnerships with Healthcare Organizations and Providers." Dealing with change as it does, an unofficial title might be, "Tough Choices; Conflicting Feelings."

The issue is that in recent years Catholic health care providers have, in ever-increasing ways, become involved with other health care organizations and providers. And that development in our ministry has presented us with some new opportunities, but also some dangers—including risk of scandal, weakened identity and even threatened existence for some parties. In other words, we’re talking serious change.

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Ah, change! Is there any one of us who doesn’t know the conflicting feelings that change sparks? We can, of course, trumpet change as well as anyone: "Change? Great! It’s a part of life. If you don’t change, you die!"

But then the concrete realities can set in. For a staff person those realities might include: "You mean I might be going to a different building to work? We might be doing our procedures in new ways? We may be mixed in with a lot of new people from that other facility? Sharon might no longer be our boss?"

For an executive a reality might be: "I need to do what’s best for the organization in this transition, and yet I might not be chosen for the new team. Do I have the integrity to keep giving my best?"

 

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The kind of change that new partnerships and mergers effect, however, involves even broader worries and conflicts: Will this new arrangement seriously alter our character in three to five years? Will this development strengthen or dissipate our commitment to respect and social justice, compassion and care for the poor? Are we partnering with people who see health care as a ministry or just a business? Will we look back on this decision some day as a new beginning or the beginning of the end?

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Sometimes, of course, organizations, just like people, don’t have the luxury of working out black and white solutions. Survival can force a consideration of options we’d just as soon not face; e.g.,

•  A father has to consider a factory job where drugs and theft are commonplace in order to feed his family.

•  A single mother has to consider putting her children into day care for long hours in order to hold a job and go to school.

•  A Catholic facility, survival at stake, may have to explore partnering with an organization whose culture and values are worrisome or one that engages in some questionable ethical practice.

In such circumstances, what are people to do?

For a Catholic health care organization, this is where the ERDs provide helpful direction. Overall they articulate two principles:

(1) Just as a parent must do in facing a potentially dangerous choice, the facility or system needs to do a "systematic and objective moral analysis" of the situation. Such an analysis would include an assessment of:

• The actual culture and lived values of the other party;

• The nature and seriousness of any activity deemed ethically questionable;

• The risk of scandal;

• Whether an arrangement could be so structured that the Catholic partner is distanced from and uninvolved in a "formal or immediately material way" with any practice deemed unethical;

• The overall risk of getting involved, as well as that of not getting involved.

(2) Just as a parent, hopefully, wouldn’t face a difficult decision without information and wise counsel, so the facility or system should not make such a decision alone. Ideally three parties should discern together, listening, sharing and strategizing collaboratively for the well-being of the ministry. Those parties include the local bishop as the center of unity and coordinator of ministries in the diocese, the leadership of the Catholic facility or system, and people on the national scene in Catholic health care (e.g. associated with CHA), who have experience and expertise in such matters.

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As stated above, in order to be viable in the future, Catholic health care providers have been and will continue exploring new relationships with other health care organizations and providers. Some, upon review, may prove feasible; others will not. Fortunately, the ERDs provide us with wise counsel for such times and situations when we’re assured of "Tough Choices and Conflicting Feelings."