Anne Underwood, M.S., J.D. introduces EthicsWalk, a new PlainViews column

EthicsWalk: An Introduction

Beginning in its next issue, PlainViews will feature a monthly column called “EthicsWalk.” EthicsWalk will address spiritual care as an ethical enterprise. It will explore why relationships between spiritual care providers and those they serve need protection, and will examine what that protection entails. Let me make it clear in this introduction that protection does not require sterilization or a sealing off of our common humanity. It does, however, require close attentiveness to the needs and perceptions of those who are served, which is the crux of ethical behavior in the professions. PlainViews will invite readers to share their responses to each EthicsWalk column, which will be published in the following issue.

In the last issue of PlainViews, Gerald Ash mentioned four of the ten moral principles of medical ethics: Autonomy, Beneficence, Nonmaleficence and Justice. The other principles that apply to professional ethics are: respect, confidentiality, honesty, fidelity, utility and burden/benefit. They reflect the Theological Virtues: faith, hope, love; and the Greek Cardinal Virtues: prudence, justice, temperance, and courage. These principles and virtues inform, but don’t dictate, ethical actions.

For professional care providers, the first ethical question is always “What should I do?” in relation to another’s rights and/ or well-being. What is the “moral,” or normatively human, course of action? “Moral” is not based on what Mother, the Scouts, or a professional Code of Ethics says, but on ethical principles and one’s maturing ethical narrative.

Ethics is a process of making decisions about what course of action is moral in a given situation. Dilemmas arise when there is more than one normatively human response for the situation and the responses conflict. For example: “Should I have a sexual relationship with the patient in 302?” is an ethical question. It is NEVER an ethical dilemma!

Whereas: “Should I inform the patient in Room 302’s partner, who seeks my spiritual counsel, that the patient is HIV positive and does not intend anyone to know?” is an ethical dilemma. The decision implicates the justice duty to warn versus patient autonomy and confidentiality. [It may also have legal consequences.]

EthicsWalk will invite you to enter into a process of recognizing problematic situations and making responses informed by ethical values rather than fixed rules; to honor professional codes of ethics but not to memorize them! Rather, I invite you to discern the principles and virtues that underlie those codes to inform your work.

Catholic moral theologian Richard Gula notes: “’Shoulds’ and ‘have-tos’ belong to someone else. The ‘wants’ of conscience (what my truest self would want to do) belong to us. Whereas the ‘shoulds’ and ‘have-tos’ of the superego look to authority, the ‘wants’ of conscience look to our personalized and internalized values, or acquired virtues.”[1]

Next month: The Genealogy of Sexual Harassment Policies

[1] “Conscience,” Richard Gula, in Hoose, Bernard. Christian Ethics: An Introduction, The Liturgical Press, 1998. p.111.

Do you have thoughts about advocacy you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.