Strengthening the role of ethics in turbulent times.

Ethics may not be the first thing that comes to mind when thinking about “strengthening the ministry in turbulent times,” or perhaps even the second or third thing. But it is critical. It is critical because beneath the many factors that make up “turbulent times” are the identity and integrity of Catholic health care. Above all, through turbulent times, Catholic health care must remain true to itself — true to who it is and claims to be, and true in what it does and should do. Identity and integrity are the ultimate goals of whatever strengthening occurs. If the ministry loses either, it probably should not exist, at least as “Catholic” health care. Ethics is critical to promoting and supporting the identity and integrity of Catholic health care as a whole, and of individual Catholic health care organizations. “Catholic health care ethics ... is central not only to helping shape the culture of an organization, its identity, but is also central to guiding the organization’s decision-making and behavior, its integrity. Ethics should assist the organization to be what it claims to be in regard to identity, character and culture, and to discern what it ought to do (and not do) in light of who it claims to be. It should help Catholic identity to permeate the entire organization and to be integrated throughout the organization.”1 Ethics in Catholic health care, then, has a dual focus (as it does generally) — identity and integrity, character and behavior, who Catholic health care is and should be, and what Catholic health care does and should do. The first has much to do with formation, and the second with discernment, decisionmaking and action. One of ethics’ primary roles, in collaboration with mission, is to help nourish, sustain, promote and even challenge the culture of the organization and to engage in the ongoing formation of leaders and staff into the desired culture. Ethics is central to these efforts because ethics deals with the very substance of culture — values, beliefs, practices and policies. Especially in turbulent times, the issue of culture is paramount. Will the culture of the organization and the ministry be one informed by the values and beliefs of the Gospel and of the sponsors, or will the culture instead predominantly reflect the values, beliefs, practices and dynamics of the marketplace and of the broader American culture? In challenging times, there may be a tendency to address immediate threats, to “put out fires,” to the neglect of fundamentals. But in the long run, this will exact a high price. Dealing with the challenges as well as continued efforts to strengthen identity must go hand-in-hand. Helping to create a culture reflective of the organization’s identity is not the sole formative contribution of ethics. It should also seek to form communities of moral discourse, places where ethical issues are acknowledged and taken seriously, where conversations can take place about ethical concerns and issues, and where ethical discernment can take place. “[E]thics practice provides a means for creating communities of concern and meaning. Although ethics in Catholic health care certainly helps with complex clinical and business decisions, it is also, and importantly, about cultivating an environment in which meaningful conversation about values can occur, and