Health progress (Saint Louis, Mo.)
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Views on Catholic health care administration vary. It is a "necessary evil" or a true proclamation of Jesus' healing ministry? Scripture confirms that administration is a ministry. Administrators participate in the Church's healing mission as they participate in the Catholic health care organization's ministry to the sick. ⋯ Ministry with the sponsoring religious institute. Acting on behalf of the sponsor, administrators must make certain that they act with compassion and love and that their decisions are consistent with the institute's mission and philosophy. By excelling in the ministry of hospitality, the administrator can witness to the Gospel and further the healing ministry in the Church.
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Medical technology has created dilemmas for those who make decisions regarding whether to prolong life in the face of severe, irreversible illness. Two questions usually arise: who should decide, and what standards should the decision makers use? These questions can be particularly difficult for members of religious institutes. The basic legal standard for such decisions is the patient's autonomy or self-determination; the patient's wishes are paramount. ⋯ In the case of a religious who becomes incompetent and has no family members, the physician probably will accept a member of the institute as a surrogate. If the incompetent religious has family, they and the institute should discuss who should be responsible for communicating with medical personnel. In California, a competent member of an institute should designate a surrogate in advance to avoid any confusion or conflict later.
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The idea of involvement in social justice issues transcends the traditional responsibilities of most institutional ethics committees (IECs). Yet precedents for such an advocacy role exist in several areas: the development of regulations that protect handicapped newborns from discriminatory decisions of nontreatment and the institutional committees that review research protocols or formulate "do not resuscitate" policies. The need for IECs to take up social justice issues is based in the concepts of autonomy--the capacity for freedom of choice--and relationality--the capacity to known and to love. ⋯ If a health care institution is to address such questions as affirmative action policies in financing and purchasing, the just pricing of medical care, the ethics of treatment decisions, and the right to medical care, it needs a forum in which to deliberate, collaborate, and discern responsible corporate moral action. For example, an ethics committee can: Call for correction of problems of sexism, racism, and classism in health care institutions; Address government regulations in a way that enables a better understanding of professional commitments; and Lead facilities to discover ways to network with others to meet the needs of the populations they serve. Above all, IECs can help health care professionals find a new "hermeneutic" for interpreting the health care mission to allow them greater power to respond to the dignity and the needs of human persons.