ETHICS MADE REAL

GORDON SELF

In 1979 I befriended a young refugee family. They were one of thousands of "boat people" who fled their country after the Vietnam War. They were grateful for not only surviving the perilous journey on the sea but being able to settle in Canada where they have since flourished.

Despite initial language barriers we managed to communicate, and I have since learned much about their ethnic culture and customs. They remain my cherished adopted Vietnamese family.

I have also been blessed to befriend and work with other good people of diverse religious and ethnic backgrounds. Reflecting on my formation in Catholic health care ethics, I believe such exposure has graced me with the sensitivity to help navigate the cultural subtleties and nuances in clinical decision making.

Another close friend, a Muslim physician, and I have co-presented on the need for cultural humility in health care – humility in asking respectful questions of others to deepen understanding of their needs, wishes and values. It is when we make assumptions about people's needs that we risk misunderstanding and ethical conflict.

One issue the new 2012 Health Ethics Guide wisely sought to address was the increasing cultural and religious diversity of the people we serve and work with.

VALUES STATEMENT

Article 25, Respect for Varying Cultures and Traditions, echoes what is reflected in Covenant Health's own values statement. That is, our commitment to serve people "of all faiths, cultures and circumstances."

I am so proud of this statement. When I worked at another Catholic hospital in Canada, I was proud the local Jewish community claimed the hospital as its own. Muslim patients also felt equally at home.

In Edmonton, the Grey Nuns' Community Hospital is celebrating its 25-year history this spring. One of the hospital's most memorable moments was the day the Mill Woods community rallied in the streets to save the hospital. This is significant given the incredibly diverse ethnic and religious makeup of the community.

Our facilities in Bonnyville, Banff and Lethbridge also proudly serve richly diverse populations. Like my Vietnamese family, there is a deep pride when another cultural and ethnic community adopts you as its own.

CATHOLIC DEFINITION

In presenting the new Health Ethics Guide, there have been a number of questions regarding Catholic identity, that is, what makes a hospital and our ethics service, Catholic?

Our lived experience reminds us that we do not just serve or work with Catholics, let alone Christians. Time and again we see Jesus reaching out to touch the vulnerable – peoples whose religious identity (woman at the well), political affiliation (Roman centurion), social role (tax collector), or circumstances (the "good thief" on the cross, the leper, the prostitute, to name a few) may shock our moral sensibilities.

When asked who is our neighbour, Jesus answers with the parable of the Good Samaritan, serving to frame the introduction to the new Health Ethics Guide. Jesus constantly meets people where they are at, demonstrating an openness to engage in deeper conversation to facilitate both physical healing as well as restoration to community, even if it is not "my" community.

These are challenging words, because when it comes to Catholic identity we know there will be vulnerable people in our care who may not stand up to the moral standards of others. Proverbial modern day "lepers and tax collectors" will present who nevertheless need healing.

Does that mean anything goes? Article 25 calls us to respect those in our care insofar we are not "compelled to provide any service that is inconsistent with (the organization's) Catholic identity and mission statement or that fails to meet standards for quality care."

So while we would not perform an abortion in our facility, neither will we turn away someone with complications having had such procedure done elsewhere. Some might see that as cooperation with evil. I would say failing to stop the bleeding or infection is abandonment.

Ethically, morally and even legally we cannot abandon people. It is inconsistent with who we say we are.

PUBLIC SUPPORT

So when media ask why bother to have a Catholic health care system in Alberta, I say why not ask the very people who rallied to keep it. People who may not be Catholic or Christian or living morally upright lives as perceived by others, but nevertheless have personally experienced what is core to Catholic identity and our moral tradition – reverence for their intrinsic dignity regardless of culture or circumstances.

Such outpouring of support happens because of profound respect for diversity, not in spite of it.

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