Ethical reflection means getting messy

Gordon Self


June 23, 2014

I was invited by a leading Catholic health care journal to write a theological reflection on the influence of Pope Francis in our ministry. Where does one begin?

In the brief time since the Holy Father's election, the reach of his pastoral message has been enormous. Countless images and interview quotes have ignited the moral imagination of what it means to be Church, and how we are called to deeper expressions of service to the poor.

When Francis states in his apostolic exhortation Evangelii Gaudium (The Joy of the Gospel, 24) that we must "stand at the crossroads and welcome the outcast," even "taking on the smell of the sheep" while helping shoulder another's burdens, the ethical implications are clear.

We must be prepared to get involved in people's lives, no matter their need, background or life circumstance. Life is messy, and if we are called to be present in the most vulnerable moment of a person's life, we must be prepared to get involved in the messy stuff, too.

The "Francis effect" has indeed been huge. Readers likely have their favourite Pope Francis story that has touched them in a personal, perhaps even transformative way. One of my favourites is his exhortation to participants at last year's World Youth Day in Rio de Janeiro.

"I want a mess," may not sound like a very positive message coming from a pope. But from an ethical perspective, I see it as an invitation to get out of our comfort zones to be present in facing the real issues of people's lives.

Recall those privileged conversations when a person trusted you with their story. You may not have known what to say or do, especially if it involved some messy decision, but you were nevertheless called to be Christ's presence.

For example, I will never forget the time a man came to my hospital office the night before being sent to jail to begin his sentence and what he shared, perhaps as a first step towards redemption.

Nor will I forget the time many years ago when a high school classmate stood by me when I nearly died as a result of a senseless misadventure. These crossroad encounters can help people find meaning and strength to go on.

We can all look back at our lives wishing we could have done more, or made different decisions, or taken back words we had said. But we are who we are today as a result of such humble experiences.


Looking honestly at the messiness of our own lives can deepen our capacity for compassion to be present to others in their own pain and suffering. For all that has been celebrated about Pope Francis, there remain questions whether he could have done more as provincial superior of the Jesuits in Argentina when, in 1976, two of his priests were abducted and tortured by the military junta.

One can imagine that this test of his leadership has made him who he is today.

I frequently use the image of an Emergency Department resuscitation room following a medical intervention to talk about Covenant Health's values. It's a messy scene, not one we typically portray on our annual report. But it is real.

Scattered on the floor is blood, soiled gauze, tubing, plastic caps and wrapping. One can imagine family being present during the actual resuscitation, contemplating what they saw and heard.

What compassionate support was offered them? How did the interdisciplinary staff collaborate, all working together and respectfully for one common goal? Who explained to the other patients that their wait may be even longer, given our ethical obligation to serve the sickest first?


Who ensured the room was cleaned up and restocked with all the necessary medical supplies as good stewards of our resources so we were ready for the next patient?

Pope Francis calls us to take on the smell of the sheep, which any farmer can tell you is not pleasant. We are called to get involved in the messy issues of life, to name issues for what they are without sanitizing the experience.

We are called to be merciful, to ourselves and others, standing at the crossroads with the decisions people make, sometimes under extremely difficult circumstances that rules and principles do not always sufficiently address.

(Gordon Self is vice president, mission, ethics and spirituality for Covenant Health and can be reached at