EthicsWalk addresses
spiritual care as an ethical enterprise.
It explores why relationships between
spiritual care providers and those
they serve need protection, and
examines what that protection entails. PlainViews invites
our readers to share their responses
to each EthicsWalk column,
which will be published in the
following issue.
If you’d like to respond to EthicsWalk,
please send a comment of no more
than 100 words. You can use the
e-form below (click on "hearing
from you," link) or submit
your commentary to the editors
in the body of an e-mail (or
as a Microsoft Word attachment)
sent to Info@PlainViews.org.
Please put the phrase “EthicsWalk”
in your subject line.
We look forward to hearing
from you.
Facilitated Conciliation
Recently, I facilitated a discussion of a contentious mental retardation (MR) issue for which there is no clear law in the particular state. Two clergy-ethicists, two MR program directors and six lawyers participated. The lawyers worked for MR agencies whose policies reflected both ends of the opinion spectrum.
The course of the discussion astounded the non-lawyers and delighted the lawyers who appreciated an opportunity to engage as concerned MR experts rather than advocates. The facilitation plan is outlined below with hope it can be adapted to other health care situations.
1. The lawyers and I met first to establish commonalities [differences were clear]. I asked each: “Why do you work in MR?” Each spoke of family members or friends affected by MR. Personal commitment embodied in professional dedication was their commonality.
2. They were asked to phrase contentious topics as questions. They then identified the common denominator of each as public guardians’ use of coercion to implement their preferences for medication, residency, association with friends or relatives, and sexual expression of patient-wards.[1]
3. A second meeting was scheduled, to include members of the respective ethics advisory panels, and delve into the differences articulated.
4. I chose, “Does the Public Guardian’s Office have authority to use physical coercion, when other reasonable means have failed, to force a ward to comply with the guardian’s residential recommendations?” as the focus question.
5. The second meeting opened with my summarizing the commonalities and concerns and outlining the process to follow. No one knew in advance the focus question or process:
• I asked the Public Advocate (PA) and Public Guardian (PG) each to take five minutes to articulate the other’s view on the focus question.
• I summarized what I’d heard and invited the actual PA and PG to correct or add to my interpretation but make no commentary. (There were very few additions and both were impressed and heartened by the precision of the other’s presentation.[2])
• The agency attorneys were invited to offer any perspective particular to their agency if not already articulated. The purpose was to get all views on the table without advocacy or comment.
• I then listed what I heard as points for discussion, asked for consensus and, after a few modifications, opened the discussion to everyone present.
What was scheduled as a two-hour meeting went three – they skipped lunch to have an extra hour because so many ideas were fermenting. A palpable sprit d’ corps permeated the room. No “position” prevailed, but consensus was reached to cooperate to clarify the law by bringing a test case. The loosing side would appeal – forcing the state supreme court to rectify the ambiguity. Additionally, everyone pledged to combine resources to lobby the legislature to change the evidentiary standard of proof in competency and guardianship cases.[3]
Establishing personal connectedness, being challenged to articulate “the other” perspective and structuring discussion free of positional posturing and advocacy often permits creative responses to the commonalities imbedded in our differences.
Footnotes:
[[1] The common law concept of parens patriae grounds the view of those accepting physical coercion when other reasonable measures have failed. Those opposing it in any instance cite First Amendment rights and Supreme Court cases implying a penumbra of privacy regarding where and with whom one chooses to live. Each legal foundation is legitimate. The former emphasizes patient and community safety; the latter, patient autonomy.
[2] In couple’s therapy, a common technique is for each person to state his or her view and then have the other person summarize what they’ve heard. In facilitating professional differences, I find it more useful to have each party articulate what they would say if in the other’s position and then I play back the comments. This format forces each to move out of his or her own advocacy stance and into the others’. My summarizing what’s been said permits the critique to be directed at me rather than the “other person.” I re-shape whatever is said into positive statements to maximize cooperative dialogue.
[3] Like many states, the one here uses the lowest standard, “preponderance” rather than the higher “clear and convincing” which everyone agreed would strengthen patient opportunity to maintain appropriate autonomy.
Anne Underwood has an undergraduate
degree in religious studies, a
master’s degree in rural sociology
and a mid-life law degree obtained
after working over a decade as
a college administrator. She has
mediated for the Maine family courts
since 1983. Currently she serves
as an advisor to the ethics commissions
of ACPE, APC, the CCAR (Central
Conference of American Rabbis),
and NAJC, and consults with a variety
of Protestant faith communities
on issues of power, fair process,
and congregational conflict management.
Her articles on mediation and restorative
justice have appeared in the ACPE
News, The APC News and on the ACPE
web site. Articles on clergy accountability
and judicatory processes are published
by the Alban Institute and The
Journal on Religion and Abuse.
A
chapter, “Clergy Sexual Misconduct:
A Justice Issue,” appears in Body
and Soul: Rethinking Sexuality
as Justice-Love
, Marvin Ellison
and Sylvia Thorson-Smith, editors,
The Pilgrim Press, 2003.
.gif){kind=spacer}
.gif){kind=spacer}
.gif){kind=spacer}
