Ethical Decision Making in Healthcare
By Andrew Tripp, Director, Chelsea Jewish Personal Care, and Member of the CJF Ethics Committee
Healthcare is fraught with ethical decisions with difficult questions and harder answers. How do I figure out what I would like my own care to look like, the care I would like to receive for aging family, and what care do I want to see provided for our residents and clients? Families are often not of a single mind about the care for a beloved elder, and a patient or client’s wish for care may go against our own moral values. Recently, Massachusetts had a ballot initiative for PAD, and with the movement to decriminalize and allow for medical marijuana use, there are tough medical ethics issues all around us.
My PhD was an interdisciplinary work in social ethics and pastoral care, with significant emphasis on how communities behave based on their values. Our CJF mission speaks about our values as a community – we provide compassionate person-centered care and embody the Jewish tradition of Tikkun Olam (repairing the world) through our warm hospitality to people of diverse cultural, religious, and financial backgrounds. My education and experience in healthcare prepared me for my role on the Chelsea Jewish Lifecare Ethics Committee. As a committee, we meet each quarter to discuss pressing ethical issues, keeping in mind our communal commitment to the values that undergird our mission and vision.
The CJF Ethics Committee provides ethical consults to residents, clients, and their families; staff; and to outside agencies that want our input on care of our residents and clients. Ethics committee consults include a small subset of our ethics committee that can educate, advise, and advocate on ethical issues after hearing all sides of an issue. The process is confidential and the ethics committee looks for the values that cause people to make the decisions they make. One person’s decision to voluntarily stop eating and drinking may come from a value of human dignity, and is a choice based on ethical principles in the same way another person in the same scenario would choose to have tube feeding in the case of an inability to eat since nutrition may be a sacred form of care in his or her culture.
Often in ethical decision making the answers are not easily black and white with regard to the proper choice. In a situation of competing options of grey, a discernment process based on listening, values and moral beliefs, and thoughtful consideration, yields choices that let us all be proud of the work we do and the care we provide. Communally and institutionally, we cultivate practices that promote equitable and just conditions for our clients, residents, and staff.