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From the Director's Desk... |
| [Woodstock Report, March 1999, No. 57] |
| This issue of the Woodstock Report features highlights of presentations at a recent Woodstock Forum. It
focused on Woodstock's recent publication, Ethical Issues in Managed Health Care
Organizations (Georgetown University Press, 1999). The presenters were three of the
54 health care professionals who subscribed to this statement after two years of study and
four major conferences. They were physicians, nurses, and other clinicians, executives and
medical directors of health care organizations, corporate purchasers of health care plans,
directors or presidents of national associations, and academic experts in ethics and
economics -- from all over the country. As you can imagine, consensus wasn't reached
easily! The process started with the invitation to share personal experiences of ethical dilemmas, many of them replete with conflict, misunderstanding, and resentment. As stories were told, it was clear how divergent the perspectives were, between, for instance, the physicians and the health care managers. Physicians were concerned principally with patient care; administrators were concerned with paying the bills! Both had a good and necessary point, but it was tempting for each to regard the other as simply self-interested or shortsighted. A subsequent analysis of managed care as a social structure, however, made it abundantly clear that these conflicts ran deeper than perspective or personality. They are grounded in the system itself, which, we discovered, is a strange new amalgam of elements from private medical practice, old-style insurance coverage, and public health. This key insight helped us understand much better why we experience certain ethical dilemmas and it opened up for us a way of addressing them. Explanation, illustration, and commendation of this "way" of making ethically sound decisions is, as you'll see here, the principal contribution of this consensus statement. One note of caution. The "way" doesn't work automatically. For the "way" to work, the decision maker has to be a person of intelligence and integrity. It presumes that the decider is well informed of and sympathetic to the concerns and claims of all the stakeholders, and not captive to tunnel-vision or self-interest. This is Aristotle's view: it takes a virtuous person to make a virtuous decision. But the good news is that by using the "way" well we become more virtuous people! Another highlight of this Report is a wonderful presentation by Father Joseph A. Panuska, S.J., delivered at a dinner to celebrate Woodstock's 25th birthday! He was one of the two "founding fathers" of Woodstock as a theological reflection center way back in 1974. He was the provincial of the Maryland Province of Jesuits and Father Eamon Taylor was provincial of the New York Province. His remarks recall the originating vision and challenge us with future hopes. Finally, the "Activities of the Fellows" column will give you some idea how that vision and challenge are currently playing out! Prayers for a joyful Easter season, James L. Connor, S.J. |