Spirituality and Ethics: Wings and Roots of Catholic Health Leadership CHAC National Conference May 10, 2012 Jon Gilchrist Clinical Ethics Leader Gordon Self Vice President, Mission, Ethics and Spirituality Objectives To describe the relationship between spirituality and ethics, and importance for Catholic health care leaders To locate a theological model for deeper level conversation within John 4: 1-30 To present 2 case studies that illustrate the interplay between spirituality and ethics To explore opportunities to integrate spirituality and ethics in Catholic health care leadership formation To be known is to be loved
Intentional Awareness What we value depends on what we pay attention to and how we pay attention to it. We make choices in the world that we notice, and what we notice is shaped by the metaphors and habits of the heart that we bring to experience. These resources for attentiveness may be derived from spirituality or from morality and ethics. William C. Spohn, "Spirituality and Ethics: Exploring the Connections", Theological Studies 58 (1997) 109-123 Paying attention to our experience Ethical principles and doctrinal teachings are in themselves insufficient to provide direction/meaning in all cases not at the expense of story Clinical and organizational issues complex, nuanced, diverse, requiring a prudential judgment Personal encounter consistent with New Evangelization? Need to locate ourselves within our inner experience, too Spirituality Sense of connectedness, hunger for meaning/purpose and ultimate value, relationship with the transcendent The spiritual life as deeper level conversation - with self, others and God In contract, religiosity as a shared way of expressing one s spirituality through formal rituals, traditions, beliefs Different wells sunk in the same underground stream - put out into the deep water
Ethics The discipline that examines who we ought to be and what we out to do in light of who we say we are. Like religion, ethics involves different principles, norms and philosophical approaches But more than simply application of principles, especially in face of the complex, and complicated And, more than simply solving the case. Rather deepening capacity for ethical reflection Spirituality and Ethics Then the woman left her water-jar and went back to the city Ethics without spirituality is rootless; spirituality without ethics is disembodied Richard Gula, Spirituality and Ethics in Healthcare, Health Progress, 81, no 4 (July -August, 2000), 17-19 The role of spiritual/pastoral care Our ethics teams well resourced by Spiritual Care Not always an ethics issue per se, but a pastoral one Both disciplines involve listening for deeper meaning/value Religious/cultural beliefs shape understanding of what we need to pay attention to- sometimes the key issue
The encounter at the well Risking the deeper level conversation Willing to engage another in honest dialogue - not hide behind principles/authority Prepared to critically examine one s tightly held views and behaviour Accept responsibility to advocate staying engaged in the tension The Three Ways Purgative Way Exposing assumption, bias, resistance Illuminative Way Yielding new insights, learning, shifting attitudes/perspectives Unitive Way Long after the particular ethical issue has been resolved there is a lasting mark left on the person/organization. Deeper level conversion taking on spiritual dimensions
Case #1 Where is my doctor? asks the labouring patient as she is brought into the case room for delivery of her baby. I need my own doctor. A man can t touch me. The head of her baby is crowning; there is no time to wait. It is not the optimum place to begin to exploring the reasons for her request. The obstetrician on call is male. Case #2 Sad to say, in our context harm reduction means reducing not only the harm caused by the diseases of addiction, but all the harm caused by the social assault on drug addicts. Gabor Maté, In the Realm of Hungry Ghosts: Close Encounters with Addiction. Toronto: Knopf, 2008, 314. No Males Policy 3 conversations 1st layer conversation: Determining actual need behind the patient s/family s request Discrimination? Entitlement? Respect for diversity? 2nd layer conversation: Physicians and administrators as co-fiduciaries How do we bridge this gap for the benefit of vulnerable patients? 3rd layer conversation: Issues of diversity and reverence for all peoples How does this work inform our understanding of Catholic identify?
Harm reduction 3 conversations 1st layer conversation: Determining who we are called to serve and therapeutic options If abstinence is difficult/unattainable, how do we minimize harm? 2nd layer conversation: Relationship with community/church and issues of cooperation Is harm reduction an act of complicity or the lesser of two evils? 3rd layer conversation: Practical expressions of compassion and justice Who is my neighbour? Implications for leadership Ethics and spirituality is more than purview of the select few - beware of deference We will be challenged by the tough issues - need to equip our leaders with the skill to think deeply as well as broadly Capacity to reflect - beyond principles and doctrines Case studies and principles of adult education in leadership programs Summary Spirituality and ethics are related wings and roots Increasingly complex health care environment requires leaders to engage the deeper level questions The story of the encounter at the well is about transformation To what is Catholic health care called to transformation?
and to be loved is to be known