CHW Statement of Common Values
Preamble
Catholic Healthcare West (CHW) is a health system structured to foster collaborative efforts among the religious congregations that are its sponsors, namely the Sisters of Mercy, Auburn, and Burlingame, Regional Communities; the Sisters of St. Dominic of Adrian, Michigan; the Sisters of Charity of the Incarnate Word of Houston, Texas, the Dominican Sisters of San Rafael, the Dominican Sisters of St. Catherine of Siena of Kenosha, Wisconsin, the Franciscan Sisters of the Sacred Heart of Frankfort, Illinois and the Sisters of St Francis of Penance and Christian Charity of Redwood City, California. The sponsors collaborate with their lay partners in a spirit of ecumenism to direct the mission inherent in the corporate ministry of CHW.
Throughout its many years of health care ministry, CHW and its sponsors have recognized the importance of partnerships. We believe the social fabric must be woven in partnership with all that have a call to serve the community and we champion collaboration among those partners. Our ability to carry out our mission of healing rests largely on the formation of linkages with others -- health care providers, community organizations, physician organizations, government agencies, employers, health plans, and individuals. By forming partnerships, we can respond to the community's need in a manner that is holistic and comprehensive, rather than fragmented or duplicative.
CHW's respect for values including the dignity of persons, care for the poor, the common good and responsible stewardship are essential in our ministry of healing. We invite our partners to understand and participate in realizing our values, many of which we believe we hold in common with our partners.
Social Responsibility of Health Care Providers
Health care is a ministry that serves the needs of individuals and communities -- it is a social good and a community service. The ministry of health care promotes healthy individuals and a healthy community that advances the social, economic and environmental well being of its Community. Most importantly, access to health care is a fundamental right of all persons.
CHW champions the dignity and well-being of all persons without regard to age, gender, sexual orientation, culture, race, ethnicity, economic, immigration or employment status. As a community, we have a moral responsibility to care for the poor and powerless, those of low socioeconomic status, individuals who have had catastrophic illnesses and those needing chronic care services.
Special concern is shown for the poor, helping them through direct service and acting as an advocate to change structures that keep them in poverty. We also have a special responsibility to those individuals at the beginning of life's journey as well as those who have shared so much of their wisdom throughout their years -- children and elderly.
As an employer, CHW treats its employees respectfully and justly, fostering a meaningful and humanizing work environment. Such an environment involves giving people a voice in matters affecting their work; respecting and promoting people's personal and professional growth; and providing a just wage. We try to promote trust, fairness, and mutual communication in all aspects of employment.
Through our health care ministry, we seek to contribute to the common good, which is realized when economic, political and social conditions protect and promote the fundamental rights of all persons and enable them to reach their common goals. Health care resources belong to the community and as providers we are stewards of those resources with the responsibility to use them in a way that advances the health care status of the community. In addition, CHW acknowledges its responsibility as a steward of the earth and recognizes that these resources are limited. CHW is committed to an equitable and ecologically sound use of the earth's resources.
Pastoral and Spiritual Responsibility of Health Care Providers
It is our goal that health care be provided in a holistic way, respecting all dimensions of a person. At a time of extraordinary technological advancement developed to cure disease -- one that focuses on the physical dimension of person -- we need to emphasize and embrace the psychological, social and spiritual dimensions of persons.
Care should not be limited to the treatment of disease. We express our compassion and spirituality by easing the pain and suffering of our patients. Spiritual care is integral to health care and should support the religious and spiritual needs of all those it serves. Care encompasses the full range of spiritual services, including a listening presence as well as help in dealing with powerlessness, pain and alienation. Close collaboration with spiritual leaders, caring ministries and communities of faith is essential.
The Professional-Patient Relationship
We respect the privacy of the physician-patient relationship. A person in need of health care and the professional health care provider who accepts that person as a patient enter into a relationship that requires, among other things, mutual respect, trust, honesty and appropriate confidentiality. The resulting free exchange of information must avoid manipulation, intimidation, condescension or judgment. Such a relationship enables the patient to disclose personal information needed for effective care and permits the health care provider to use his or her professional competence most effectively to maintain or restore the patient's health. Neither the health care professional nor the patient acts independently of the other -- both participate in the healing process.
Health care is patient-centered. Patients have the right to make medical treatment decisions (including accepting or rejecting treatment), which includes free and informed consent, access to medical and other information regarding their care, the right to make an advance directive and to name a surrogate decisionmaker. Medical treatment decisions may generate ethical dilemmas for health care providers, patients and their families or surrogate decision-makers. An ethics committee or some alternative form of ethical consultation will be available to assist by advising on particular ethical situations, by offering educational opportunities and by reviewing and recommending policies.
Issues in Care for the Dying
The practice of medicine is a delicate weaving of art and science, and of ethics and philosophy. Now that medical technology offers so many more ways of keeping us alive, dying can be a prolonged process. Death is not the ultimate defeat; rather it is a natural part of the living and aging process. Health care must be a community of respect, love and support to patients and their families as they face the reality of death. One of the primary purposes of medicine in caring for the dying is the relief of pain and the suffering caused by it. Effective pain management in all its forms is critical in the appropriate care of the dying.
There is no obligation for the patient to begin or continue life-sustaining treatment if, from the patient's perspective, it is an excessive burden or offers no reasonable hope of benefit. The patient, in these circumstances, may decide to forgo medical treatment to allow the natural process of dying. An individual's decision to refrain from aggressive or curative treatment will be respected even when such a decision may result in the person's death. In addition, pain management of the highest quality is critical in allowing a person to die comfortably and with dignity. Medicines capable of alleviating or suppressing pain may be given to a person even if this therapy may indirectly shorten the person's life, so long as the intent is not to hasten death.
Procedures That Are Not Performed
We are committed to human dignity and the sanctity of life from the moment of conception until death. Therefore, the following procedures will not be performed at our affiliated facilities:
1) Direct abortion is not performed. Indirect abortion is performed in certain medically indicated cases. An indirect abortion is a termination of pregnancy that is not directly intended and in which the sole purpose is the cure of a proportionately serious pathological condition of the mother, when the treatment cannot be safely postponed until the fetus is viable.
2) Assisted suicide, physician aid-in-dying or euthanasia is not performed. These are to be distinguished from allowing the natural process of dying to occur by withholding or withdrawing treatment because the treatment is too burdensome or does not provide proportionate benefit. Assisted suicide, physician-aid-in-dying or euthanasia also should be distinguished from appropriate decisions regarding pain management that have been addressed in this document.
3) Artificial reproductive procedures, including donor insemination and In Vitro Fertilization, are not performed.
Resolution of Unforeseen Issues
In any affiliation between partners of differing histories and cultures, there may be situations in which the appropriate application of values we hold in common has not been anticipated. In such situations, we agree that a collaborative dialogue is necessary to come to an adequate resolution. In these situations, we will engage in a structured decision-making process (called the A Process for Ethical Decision Making, attached) by gathering all the stakeholders and reflecting deliberately on the values at stake in the decision.
Revised March 2002
