Qualifications and Competencies for Ethicists in Catholic Health Care

Download a PDF of the Ethicist Competencies

May 2018

Preamble

As health care ethics has become more professionalized, patients, clinical colleagues and senior leaders in Catholic health care expect professional expertise and accountability from ethicists. This expectation is based upon appropriate qualifications, competencies, and character traits that allow ethicists to function with integrity.

To this end, the Catholic Health Association has developed these qualifications and competencies. We offer them to leaders in Catholic health care to assist in recruitment, hiring, professional development and management of ethicists throughout their ministries.

These guidelines were developed over two years by CHA's Theology and Ethics Committee and involved consultation with ethicists across Catholic health care. They are intended to supplement other resources such as CHA's Striving for Excellence in Ethics document and the quarterly publication HealthCare Ethics USA.

Ethics is both a secular and a faith-based discipline. Because we serve and work with diverse members of our communities and engage in dialogue with other-than-Catholic counterparts, Catholic health care ethicists should also be conversant with trends and approaches in secular health care ethics, such as those described in such documents as the American Society for Bioethics and Humanities (ASBH) Core Competencies for Health Care Ethics Consultation (2nd edition, 2011). The competencies we outline in this document are consistent with those of the ASBH, but include additional aspects specific to Catholic methodology and principles.

Education and Experience

Required at facility or regional level, where the onsite ethics professional handles more routine issues and may have other roles (e.g., Director of Mission Integration): Master's degree in one or more of the following:

• Health care ethics/bioethics, and courses in Catholic theology,
• Theology/theological ethics with a concentration in health care ethics/bioethics,
• Philosophical ethics with a concentration in health care ethics/bioethics, and courses in Catholic theology.

Required at system level and preferred at facility or regional level, where the ethicist not only provides consultation on more complex issues, but also does research and policy development for an entire system: Ph.D., Doctor of Bioethics or equivalent in one or more of the following:

• Catholic theology/moral theology with an expertise in health care ethics/bioethics,
• Health care ethics with a master's degree in theology,
• Philosophical ethics with an expertise in health care ethics/bioethics and a master's degree in theology,
• Related field with master's level work in health care ethics/bioethics and in theology, MD, or JD with master's level work in health care ethics/bioethics and in theology, particularly Catholic moral theology.

Ethicists in Catholic health must be able to articulate and apply the Catholic moral tradition, including Catholic social teaching. Additionally, ethicists need to have clinical experience in health care, preferably in a Catholic setting; experience with ethics committees and clinicians; and with ethics consultations.

Completion of one to two years of a post-graduate health care ethics fellowship is preferred. We recognize however that not many of these fellowships exist at this time, and therefore, criteria and standards need to be developed further.

Knowledge, Skills and Abilities

All ethicists in Catholic health care must demonstrate:

• Knowledge of and ability to apply the Catholic moral tradition, including Catholic social teaching;
• Knowledge of Catholic health care ethics, including the Ethical and Religious Directives; up-to-date knowledge in bioethics, clinical ethics, organizational ethics, ethics of biomedical research on human subjects, and ethics in medical innovation; current understanding of the mission and charism of the communities that comprise the system or organization; and ability to appropriately communicate and apply the Church's teaching and moral principles to medical, social, and management issues;
• Familiarity with ethics committees (types, composition, and functioning) and the processes of ethics consultation in clinical, organizational, and research setting;
• An understanding of the professional scope and boundaries of ethics and ability to work with other members of the clinical team;
• Ability to teach, present, and write clearly and effectively; knowledge of and ability to employ adult learning models;
• Ability to engage in research and scholarship;
• Ability to develop educational programs on the local level;
• Ability to communicate effectively with diverse groups (e.g., clinicians, patients and families, administrators, employees, and the media) and the ability to use a variety of media, including computers and standard computer programs;
• Critical thinking and creative problem solving; expertise in moral reasoning and engagement of others in a discernment process; capacity for systems thinking;
• Ease at facilitating meetings and groups, employing appropriate techniques regarding conflict engagement, building consensus.

In addition, system ethicists must demonstrate:

• General knowledge of Scripture and Catholic systematic theology, in particular theological methodology, theological anthropology, ecclesiology, Christology and sacraments; and a general understanding of philosophy, especially moral philosophy, metaphysics and epistemology;
• Familiarity with and understanding of the larger world of health care, including health care systems and institutions; canon law as it affects health care and health care systems and sponsorship; health care law, especially the seminal cases; health care administration, including health finance, health policy, and the processes of ethics consultation;
• Ability to contribute to the discipline of health care ethics through research, scholarship, publication, and presentation in professional societies and conferences;
• Ability to develop educational and formational programs and resources for Catholic health care systems and the wider church;
• Ability to create and implement structures (e.g., procedures, policies, educational curricula and opportunities, reporting tools, quality metrics, discernment processes, etc.) within the system and throughout the various business and organizational units including acute care, long-term care, physician practices, contracting, etc., that enable others to identify and address ethical matters and promote collective ethical discernment and a virtuous community;
• Ability to contribute to the discipline of health care ethics through research, publication, professional conferences and creation of other resources for health care entities and the wider church;
• Ability to serve as a trusted collaborator in formation and mission integration at multiple levels.

Character Development and Spiritual Formation

Competent ethicists must reflect ethical integrity and personal virtue in their own lives. The ethicist in Catholic health care displays:

• Self-confidence exhibited in respect, empathy, and compassion toward others; ability to listen well and to engage multiple points of view; ability to collaborate, motivate and inspire others;
• Commitment to the Catholic health care ministry, to health care in general, to the mission and values of the organization, and to the profession;
• Dedication to the Church and the Church's teaching, while furthering theological and ethical inquiry;
• Ability to be objective with an awareness of one's biases;
• Ability to set appropriate boundaries and maintain confidentiality;
• Critical personal qualities, such as honesty, integrity, humility, prudence, courage, tolerance for ambiguity, open-mindedness, balanced judgment and demeanor, initiative, accountability, and good stewardship of human, financial, and environmental resources;
• Commitment to deepening their own spiritual awareness and active participation in their faith tradition. Ethicists at all levels of the organization and professional development should avail themselves of formation programming offered in their ministries or through other appropriate entities. Formation is a complement to the competencies (skills and knowledge) above and help to ground the individual's professional practices as an ethicist in a personal calling and build the character traits described above.

These guidelines were developed by the Theology and Ethics Committee of the Catholic Health Association, chaired by Joseph Cardone, Ph.D., between 2016 and 2018 and approved by them in March 2018. Further revisions in May 2018 subject to committee review and approval by committee members .