Ethical Challenges for Catholic health and aged care in a COVID-19 world

On Tuesday 28 April 2020, Rev Dr Joe Parkinson gave a videoconference presentation to AMPJP members on: Ethical Challenges for Catholic health and aged care in a COVID-19 world

This is the first videoconference of a formation nature that the AMPJP has organised. We were pleased to have 31 people from across eight of our member MPJPs.

The AMPJP Executive Officer’s summary of Rev Dr Parkinson’s presentation:

COVID-19 started as a health crisis, become an economic crisis and later a social (and moral) crisis.

The nature of our ministries means that COVID-19 challenges our ministries in ways that are sometimes similar and at other times different.

At the level of governance and stewardship level, the overall challenge of this period is

“What will the COVID-19 crisis challenge us to do differently into the future?”

Three questions arise from this COVID-19 situation – the answers to which contain insights from our Catholic ethical tradition:

1. Who are we really? When ministries have to provide services when resources are scarce there is a temptation to prioritise one patient over another. This temptation assumes that in a competition for scarce resources there will be winner and losers. This perspective comes from an over emphasis on the rights of individuals (see: Belmont Report 1978 USA – four pillars: autonomy, beneficence, non-maleficence, and justice). The USA tradition often asserts the moral absolute of the autonomy of the individual. This sets up a competitive view of rights. The Catholic tradition has a wider view that says that the common good and individual good must flourish together (not one at the expense of the other). We all belong together. Humans are subjects not objects (don’t instrumentalise – measure person against their usefulness). The Catholic perspective is of relational autonomy which says we (all of creation) are relational in character and we are inter-related. One consequence of this for health and aged care is the need to be aware of unconscious bias that might exclude some people. Education needs to help young people to appreciate (1) the validity of the ‘other’ and (2) a sense of our interconnectedness. Schools often do this by engaging young people in social outreach/service learning – where they reflect on the importance of the service they give.
2. How do we decide when there is no 1 obvious right answer? This is what Catholic ethics calls the true moral dilemma /the perplexed case (no obvious good thing to do, only least-worse, or cause the least harm). The process we use to make the decision should be clear, transparent and exemplary. Our decision-making process should include: (1) respect for the dignity of people (e.g., we don’t compare/measure the “worth” of individuals) and (2) we may want to do a lot of good but we may only be able to do a narrow band of good. Don’t waste energy worrying about what we can’t do – focus on what we can do. This is important to ensure we have energy to deal with the moral distress of the current situation. In the school context, young people can be helped in the formation in their conscience/moral code. For all in governance, it is vital to be realistic about the good we can do and to be committed to doing it.
3. How do we look after each other at this time? In health and aged care there is a heightened fear of making clinical errors. Clinical errors can happen when people are under stress. Three Catholic social justice principles can help guide how we care for those who are affected. Participation – we should engage all to share their views. Staff should have opportunities to have conversations about their concerns, fears, hopes and issues. Subsidiarity – issues should be addressed by the most appropriate person/body. It follows that the organisation must then follow through with support for those who have this responsibility.  Solidarity – means we reassure everyone that they will be supported even if errors happen. This doesn’t mean we lower our standards but that we have justice and compassion for care givers. Everyday is R.U.OK day – all have permission and responsibility to constantly support each other.

Catholic Health Australia has published a paper by Rev Dr Parkinson titled: “Contributions from the Catholic ethical tradition in time of pandemic” You can find this paper here.