Columns

ETHICS MADE REAL

GORDON SELF

There is a saying that one person's trash is another person's treasure. Or is it? I have run two garage sales, and helped my parents with another. On each occasion I was surprised that stuff we considered "junk" was deemed a virtual "find" by the willing buyer.

Many things we sold or practically gave away were still in good condition that our children had simply outgrown or that my parents could no longer keep as they downsized their home. Besides the minor profit we made, it was satisfying to know the items could benefit others and not just end up in the landfill.

Other potential items, however, could never morally be sold or given away. For example: an old crib that did not meet current safety standards; toxic solvents and paints that needed to be disposed of at a waste management recovery site; tools or equipment that we knew to be damaged despite their appearance.

Selling or giving away any of these items would have been morally reprehensible.

Another kind of garage sale on the world stage raises similar ethical questions. In recent years an industry has developed around donating surplus medical equipment to nations which are economically disadvantaged or in a state of emergency.

Sharing one's resources to help the sick and injured elsewhere is commendable, and in keeping with the Christian principle of solidarity. It is also good stewardship not to discard surplus medical equipment and supplies that meet current industry standards of quality and safety just because a new product line comes to market.

But what if those surplus wheelchairs we want to give away have a substandard brake system? Or, the donated pharmaceuticals are past their expiry date? And is it OK to raise a person's expectations by inserting a free prosthetic hip without appropriate rehabilitative care to ensure the best surgical outcome?

Further, what about donating high-end medical equipment without at the same time providing the education and training so people can use the equipment safely and maintain it? Arguably, these so called "junk for Jesus" gestures cause more harm than good.

TECHNICAL SUPPORT

Not only must such medical equipment and supplies be of good quality, but there must also be a sustainable plan in place for training and technical support. There must also be careful attention to the logistics of distributing those goods or they risk sitting idle in warehouses, never benefiting the people for whom they are intended.

In such a case, despite the well-meaning generosity of others, the recipient country is saddled with the added burden of sorting through or even discarding stockpiles of broken equipment.

To ensure responsible redistribution of medical supplies and equipment, the Catholic Health Association of the United States has promoted the sharing of leading practices for hospitals and health systems, including thoughtful ethical reflection on the subject. (See www.chausa.org/internationaloutreach/medical-surplus-recovery.)

Canada's publicly-funded health care places limits on similar international advocacy efforts, given that the resources entrusted by taxpayers are not ours to do with simply as we please. Nevertheless, there are still opportunities for Catholic health care systems like Covenant Health to contribute to informed discussion, and to look for ways to redistribute surplus supplies.

Our value of stewardship challenges us to look at ways of reducing waste, avoiding duplication and ensuring efficiency. Absolutely. But stewardship also calls us to create opportunities to share our research, innovative practices and intellectual capital in the same spirit of solidarity in which we would give away quality equipment and supplies.

Stewardship means looking for opportunities to invest in the right people, to create partnerships and to advance our mission. It means promoting an attitude and spirituality of abundance, not for the sake of self-aggrandizement, but to grow the ministry.

MONITOR HEALTH SYSTEM

It means evaluating a robust health system for its quality and safety, patient and resident satisfaction, accreditation, stable leadership and, ultimately, its vision.

We need to appreciate the selfless generosity in which our clinicians, researchers and administrative leaders contribute to the good of others, especially in seniors' health, palliative and end-of-life care, and addictions and mental health.

Such vision in Catholic health care is truly a treasure for Jesus, that we should all be so proud of, and willing to support publically and in our prayers.

(Gordon Self is vice president, mission, ethics and spirituality for Covenant Health and can be reached at mes@covenanthealth.ca.)