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EthicsWalk
 

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.


Attorney Ethics: Not an Oxymoron

Patient Autonomy v. Family Comfort: The Provider’s Dilemma (PlainViews, 12/6/06, vol. 3, no. 21) portrayed a family divided over withdrawal of life support in a medically futile situation. The accident victim’s wife disagreed with the health care proxy’s decision for withdrawal. Advance directives clearly demonstrated withdrawal would be the patient’s wishes. The family’s minister and the hospital chaplain said “beneficence” dictated giving the wife more time to accept the situation. She hired an attorney who challenged the validity of the proxy and threatened suit if withdrawal occurred before determination.

The column elicited this response from Chaplain Gordon Putnam: “I am confused about the duty of the wife’s attorney. With an advance directive that seems so clear, isn’t there an ethical responsibility for the attorney to explain the law to the wife rather than threaten a lawsuit?”

Both chaplain and attorney had ethical responsibilities to counsel the wife. The chaplain’s duty flowed from the principles of autonomy and beneficence. Those principles attached to the patient whose wishes the chaplain needed steadfastly to articulate to the wife.[1]

The attorney’s duty was to the goals of the client-wife. Client autonomy is foundational to the attorney-client relationship. The attorney’s obligation is to advocate what the client believes to be the client’s best interests. Ethically, the attorney had to advocate for slowing the withdrawal process in spite of patient directives. Threatening a suit bought time for the wife’s grieving process.

Attorneys can educate and counsel clients, indeed plead and prod, but once a case is accepted, attorneys are ethically bound to advocate for their client’s wishes. Attorneys cannot knowingly permit clients to break laws or commit perjury. But attorneys must advocate for the interpretation of law or facts that best meet a client’s interests.

Most attorneys take seriously their role as “counselors at law.” They maneuver through clients’ emotional and psychological attachments recognizing those that can be compromised and adapting to those that cannot. They attempt to inform, educate and guide clients to reasonable decisions. The American Bar Association Model Rules[2] state: “In representing a client, a lawyer shall exercise independent professional judgment and render candid advice. In rendering advice, a lawyer may refer not only to law but to other considerations such as moral, economic, social and political factors, that may be relevant to the client's situation.”[3]

However, the client, not the attorney, ultimately determines the goals and chooses the course of action to achieve those goals. An attorney is the client’s alter ego, not the client’s super ego. Quoting again from the Model Rules: “a lawyer shall abide by a client's decisions concerning the objectives of representation and…shall consult with the client as to the means by which they are to be pursued. ... A lawyer shall abide by a client's decision whether to settle a matter. …(b) A lawyer's representation of a client, including representation by appointment, does not constitute an endorsement of the client's political, economic, social or moral views or activities.”[4]

Health care providers must provide competent medical services for patients in their care regardless of judgments about the patient’s values or life choices. Attorneys must represent the positions of their clients regardless of the attorney’s own feelings about those positions. A surgeon cannot walk out in the middle of an operation unless an equally competent surgeon is present to take over. An attorney cannot withdraw from representation in a case unless another attorney has entered an appearance on the client’s behalf.

The United States judicial system for all its flaws works because people can obtain legal representation regardless of their psychological quirks, emotional entanglements, political proclivities, or alleged crimes and misdemeanors. Judges and juries render findings and decisions, not attorneys. Ethically, attorneys can render only their professional advice and vigorous advocacy and must do both without publicly criticizing their clients.

Next month’s column will suggest ways in which people can work effectively with attorneys – their own and another’s – to prevent or to resolve conflict.

 

Footnotes:

[1] Arguably, the chaplain breached ethical responsibility to the patient by supporting the wife’s contrary position. The chaplain should have welcomed the intervention of the attorney as an ethically proper means of advocacy for the wife.

[2] The American Bar Association Model Rules of Professional Conduct are the basis for each state’s ethical conduct code for members of its bar.

[3] The American Bar Association Model Rules of Professional Conduct, Counselor Rule 2.1, Advisor

[4] The American Bar Association Model Rules of Professional Conduct, Client-Lawyer Relationship, Rule 1.2, Scope of Representation And Allocation of Authority Between Client and Lawyer.


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.

 

 

1/17/2007 Vol. 3, No. 24 - Anne Underwood, MS, JD: Facilitated Conciliation
1/3/2007 Vol. 3, No. 23 - Anne Underwood, MS, JD: Facilitated Conciliation
12/6/2006 Vol. 3, No. 21 - Anne Underwood, MS, JD: patient autonomy v. family comfort—the provider's
dilemma
11/15/2006 Vol. 3, No. 20 - Anne Underwood, MS, JD: questions about surrogate health care decision
makers
11/1/2006 Vol. 3, No. 19 - Anne Underwood, MS, JD: surrogate health care decision makers
10/4/2006 Vol. 3, No. 17 - Anne Underwood, MS, JD: Social Security Numbers –be responsible –use
discretely
9/20/2006 Vol. 3, No. 16 - Anne Underwood, MS, JD: The Good Samaritan: Parable to Practice
9/6/2006 Vol. 3, No. 15 - Anne Underwood, MS, JD: The Good Samaritan: Parable to Practice
5/17/2006 Vol. 3, No. 8 - Response to: re-focusing on the patient
5/3/2006 Vol. 3, No. 7 - Anne Underwood, MS, JD: re-focusing on the patient: response to
CaseConference #7

4/19/2006 Vol. 3, No. 6 - Response to: end-of-life discernment: personal, not political
4/5/2006 Vol. 3, No. 5 - Anne Underwood, MS, JD: end-of-life discernment: personal, not political
3/15/2006 Vol. 3, No. 4 - Anne Underwood, MS, JD: Response to: Immigration reform: politics and the
human spirit
3/1/2006 Vol. 3, No. 3 - Anne Underwood, MS, JD: Immigration reform: politics and the human spirit
2/15/2006 Vol. 3, No. 2 - Anne Underwood, MS, JD: Response to Theology, Science, and The First
Amendment - Part 2: contextualizing the conflict
2/1/2006 Vol. 3, No. 1 - Anne Underwood, MS, JD: Theology, Science, and The First Amendment - Part 2:
contextualizing the conflict

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2/7/2007 Vol. 4, No. 1
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Professional Practice
A passion for teaching others - remembering Joan Hemenway
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Advocacy
Rev. Dr. Martha R. Jacobs: claiming what we do
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Education & Research
Paulette Heinlein: accepting oneself where one is
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Spiritual Development
Judith Buswell: glimpsing the soul of another
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EthicsWalk
Anne Underwood, MS, JD: Attorney Ethics: not an oxymoron
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CaseConference
Case #16 resolution
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Reviews
Sarah Masters reviews: Christian Meditation: Entering the Mind of Christ

Chaplain Joan Paddock Maxwell reviews:
The Rebirth of the Clinic: An Introduction to Spirituality in Health Care
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