ST. LOUIS — How can ethicists accompany caregivers who are experiencing trauma? How can the ministry understand the Catholic Church’s moral tradition as expressed by Pope Francis? How do caregivers use artificial intelligence to augment rather than replace the best of what humans offer to one another?
Those questions were discussed when about 60 theologians, ethicists and others in the Catholic health ministry gathered April 8-10 in St. Louis for the Theology and Ethics Colloquium organized by CHA. They heard updates from CHA leaders and others and explored how to tend to their own spiritual and vocational well-being in the face of today’s changing health care landscape.
“I don’t think there’s ever been a time that’s quite as chaotic as right now,” said Patricia Cassidy in her presentation on the future landscape of health care in the United States. “And I have always told myself and my colleagues, it is in times of chaos where we have the most opportunity.”
Cassidy is vice president of strategy and consulting services at Cardiothoracic and Vascular Surgical Associates and an adjunct instructor in the Neiswanger Institute for Bioethics at Loyola University Chicago. She noted the staffing changes and financial instability that health systems have faced since the COVID-19 pandemic and the shift of focus from inpatient to outpatient care. Technology, she said, “is one of our greatest gifts and maybe one of our biggest curses.”
She added that while the financial performance of health systems has improved, it’s not enough to fuel the growth and capital investment those systems desire.
She acknowledged the ethical implications of federal mandates, particularly when it comes to women’s health, transgender care, and the safety of immigrants. “Doctors are afraid to treat certain things. Patients are afraid to seek care for certain things. That’s not good,” she said.
When it comes to Medicare and Medicaid reform, she said that to benefit patients, simple tweaks could be made without wiping out the system. For example, she cited a story from an emergency room doctor who told her about an unhoused man with diabetes who came in for bad wounds to his feet. This happened a few times until a worker went across the street to a store and bought the man a $50 pair of boots.
“We ought to be able to figure out a way to do this better than have this guy hospitalized four times,” which likely cost thousands of dollars, she pointed out. “I don’t know the answer to that, but when we talk about reform and rebuilding systems, I feel like that’s where we need some grassroots starting points for some of this work.”
Pope Francis as moral influence
Conor Kelly, an associate professor in the department of theology at Marquette University, discussed Catholic moral theology under the influence of Pope Francis. Kelly cited published works from dozens of researchers on the topic, with key themes of concern for the poor and marginalized, tolerance of ambiguity and making room for openness and debate, attention to structural dynamics, and how freedom is complicated and subject to many forces.
He pointed out that Pope Francis has met with migrants, set up showers and a laundromat for the unhoused near the Vatican, and met with indigenous leaders in Canada. “He has this one-on-one dimension of encounter that you see in this direct outreach to people who would otherwise be excluded,” Kelly said.
Pope Francis, he added, has developed an “engagement for insight” that’s “not just a token … it’s actually a listening that says, ‘How am I changed from this process?’”
Kelly invited the group to think of “large-scale structural challenges,” such as the priest sexual abuse crisis, and about collective responsibility going forward. “We can all begin to work together to do something productive,” he said. “There’s also ... a call in all these reflections to a multifaceted response to complex problem.”
He also urged participants to listen to the voices that are not otherwise being heard.
Exploring ethics and AIRyan Orlowski, associate vice president of artificial intelligence and data science for Ascension, spoke about how artificial intelligence and big data are changing health care delivery. “AI cannot be just a tool for innovation, but a steward of our values, a partner in healing and a pathway towards more just and equitable care,” he said.
He acknowledged the pressures facing health care, including an aging population and the workforce crisis. “AI isn’t a luxury,” Orlowski said. “It’s becoming a necessity to sustain compassionate, effective care. But how we adopt it matters.”
He explained that Ascension has formed a multidisciplinary AI and ethics committee. The committee considers how to balance innovation with ethical considerations, such as ensuring patient privacy, figuring out the worth of investment and handling data privacy and security concerns.
“It’s a fast-moving space, and we’re adapting to it as well,” he said. “But the real goal of this is to automate documentation, reduce burnout, and free time for presence and compassion for all our associates. We want to augment humans, not replace them. This goes back to the Catholic social teaching of good work, and how AI can support people if adopted responsibly.”
Dr. Heather Schmidt, SSM Health’s medical director of employee well-being, and Dr. Ann Cappellari, SSM Health’s chief medical information officer, spoke on using AI to protect the well-being of caregivers. They spoke about tools they are using to measure caregiver burnout and help care providers work more efficiently, such as an ambient listening app that records and summarizes doctor and patient conversations.
“As we’re thinking about these tools, we need to make sure that we’re keeping that ethical design also at top of mind, those trauma-informed principles at top of mind,” said Schmidt. “Are we causing harm?”
They noted that SSM Health also has a multidisciplinary AI and ethics committee to evaluate the use of such tools. In Cappellari’s own words, the system’s approach is simple: “Let humans do human things; let computers do computer things,” with “smart and continuous oversight by those humans.”
Responding to trauma
Stephanie Edwards, a social worker and the executive director of the Boston Theological Interreligious Consortium, emphasized the need to recognize the reality of trauma in the workplace and to respond appropriately. Theology and community can play a role in healing beyond responding to it as a medical diagnosis, she said.
She asked participants to think about the definition of trauma and reflect on whether they have the tools to respond to it as individuals, as community, as a workplace and as a church.
She urged caregivers to nurture balance and a healthy environment in their work, and to consider how theology affects their approach to trauma.
Edwards said many in the room are lucky to have the support of mission-aligned institutions. “Somewhere in between internalizing an ethic of martyrdom and ignoring ongoing crises,” she said, “lies the balance that we must find to sustain our work.”