Making integrity work
Catholic Health Assn. promotes ethical decision-making

By Michele Martin
Staff Writer

Corporate scandals. The clerical sexual abuse crisis. The dilemmas posed by stem-cell research, genetic manipulation and other emerging biotechnologies. The squeezing of funds for Medicaid and other public health programs.

Catholic hospitals and other health care organizations face these issues and the ethical questions they raise every day.

More than 1,100 leaders in Catholic health care gathered in Chicago June 6-9 at the Catholic Health Association’s 89th national assembly to discuss ethical integrity in decision-making.

“We are going to speak about ethics in many of our sessions during the coming days,” said Auxiliary Bishop Edwin M. Conway of Chicago, who celebrated the opening liturgy.

“What drives us to be people of ethical behavior? The very fact that we are made in God’s image and likeness,” he said, adding that this creates a responsibility to others, because each person is made in God’s image and likeness.

“So in a business transaction, if we are buying or selling equipment for a hospital, or if we are in a surgery room at a surgery table, or sitting in a room caring for someone ... wherever that line may pass through our life, of caring for people and interrelating to them in health care (settings), the love of God, the created image of God, permeates us in our relationships,” said Bishop Conway, the archdiocese’s vicar general.

Speakers included Sherron Watkins, the Enron whistleblower; Jesuit Father William Byron, interim president of Loyola University in New Orleans; and health care policy specialist Rick Carlson, an attorney and president of the Health Strategies Group. Topics ranged from the spiritual to the academic.

The way they all come together, said Father Michael Place, is that health care institutions must make sure they are structured to encourage ethical behavior in all areas. Place is the association’s president and chief executive officer.

“The issue is the issue behind the ethics issue,” said Place, a priest of the Archdiocese of Chicago. “We need to make sure we have both systems and processes in place to support reflection on those critical issues. They are all so complex that you cannot presume that they can be solved easily. It’s not enough to have an ethicist or a theologian on staff and say you are doing ethics.”

Indeed, Place said, “ethics” is not a thing that a person or organization does; it is its way of being.

“Our mission compels us to act in a manner which is integral to our identity,” Place said. “Ethics is about how we meet our mission, with what virtue do we live our mission as we provide health care.”

That mission is expressed in the reason Catholics became involved in health care in the first place, and the way in which Catholic institutions continue to provide care, Place said.

“One organization can be distinguished from another organization that does the same thing by its motive, its motivation and its purpose,” Place said. “We use the provision of health care—quality, safe health care—as a vehicle to express our motivation of being followers of the Lord Jesus, whose mission was to bring healing. Our mission is to enhance the reign of God and provide for the advancement of the common good. That makes different the way in which you do it, the environment in which you do it and the way in which you prioritize what you do.

“For publicly traded health care companies, the service of providing health care is a means to an end of making a profit. Our service is a means to an end of being a people of service.”

Byron, who spoke about the source of ethics, cited 10 old-fashioned principles, from integrity to social responsibility, that lead to ethical behavior.

His last principle was love, which, he said, is “an internalized conviction that prompts a willingness to sacrifice one’s time, convenience and a share of one’s material goods for others.”

Byron, who drew strong parallels between the corporate scandals at Enron and Arthur Andersen and the clerical sexual abuse scandal when he spoke June 7, told assembly members that they must take responsibility for evaluating how well their organizations put ethical principles in action.

“It is important for you to articulate your own opinion on these matters and to assess how widely shared, in your own organization, are the understandings you have of these classic principles,” he said. “Remember, a culture is a set of shared meanings and values.”

Watkins, who offered the opening address June 6, also stressed the role of individuals in keeping organizations on an ethically straight path.

Watkins worked for Enron for eight years and tried to bring questionable practices to the attention of the board. She identified some of the cultural characteristics of organizations that can lead to ethical lapses, such as those that led to Enron’s downfall in 2001.

While American businesses often value innovation above all other qualities, an excessive and narrow focus on that quality can lead companies to go from being “creative, to aggressive, to fraudulent.” She said in this environment, the pressure to cheat and the opportunity to do so eventually allows rationalization of unethical behavior.

Watkins said Enron’s obsession with creativity, coupled with a refusal to acknowledge the signs of questionable activities, made the company a “virtual breeding ground for unethical behavior.”

She called on all employees to address suspicious behavior by asking themselves about the “three Ms”: that is, would you discuss this business practice with a favorite manager, with the media, or even with your own mother?

Watkins also called on CEOs to consider reducing executive compensation levels, which she said engenders an atmosphere of greed in today’s business world.

Later in the meeting, Mercy Sister Patricia Talone, CHA vice president for mission services, moderated an “ethics lab” general session in which participants voted by electronic key pads on how clinic personnel should handle the cases of patients who “just do not want to help themselves” by making regular visits to the doctor and taking their prescribed medications.

Initially, 51 percent said the clinic was responsible to care for patients regardless of the patient’s behavior. But after a three-member panel weighed in and another vote was taken, only 36 percent came to that conclusion.

“We did not know how it would turn out,” Talone said. “But we are convinced that ethical discourse, listening attentively to one another, can help change the way each of us looks at a situation, and ultimately can help shape and guide decisions that are made.”