Fictional case draws out real examples of equity issues in decision-making

July 1, 2022

By LISA EISENHAUER

INDIANAPOLIS — A fictional take on whether a health system should join a national sustainability initiative elicited many real examples at the 2022 Catholic Health Assembly of the complicated challenges Catholic health systems face as they work to address climate change.

The discussion among participants in the session, titled "Discernment Today — The Equity Lens in Decision Making," revolved around a scripted case study. In the case study, a sustainability leader wanted to convince a group made up of executives, sponsor board members, an ethicist and a mission leader from a Catholic hospital to join her cause.


Karthik Raja, right, senior vice president for analytics and chief data science officer at Ascension, participates in a table dicussion during a pre-Assembly session on using an equity lens in discernment. At left is Marcos Pesquera, system vice president of community benefit, health equity, diversity and inclusion at CHRISTUS Health.
Jerry Naunheim Jr./© CHA

One question raised during the fictional chat was what factors besides return on investment health care leaders should weigh in taking environmentally minded action, particularly from an ethical perspective.

Ali Santore, executive vice president, chief advocacy and social responsibility officer for Providence St. Joseph Health, shared an experience she had after telling information systems employees about how the system is working to reach its goal of being carbon negative — or offsetting more carbon than it creates — by 2030. One of the points she made to the employees was that transitioning data centers to the remote servers known as the cloud helped Providence in reaching this commitment.

Santore later got an email from an information systems worker who said he had felt burned out until he found out that his efforts were supporting sustainability goals. "He had no idea that the work that he was doing was contributing to this common good and this living example of our mission in action," she said, "and so he shared that he made the decision not to leave the organization because he felt so grounded and inspired by this work."


Ali Santore, executive vice president, chief advocacy and social responsibility officer for Providence St. Joseph Health, listens to comments during a Catholic Health Assembly session on using an equity lens in decision making.
Jerry Naunheim Jr./© CHA

Participants in the session cited proper stewardship of resources, compassion, fairness and short- versus long-term gains as being among the many competing factors in sustainability discussions.

Marcos Pesquera, system vice president of community benefit, health equity, diversity and inclusion at CHRISTUS Health, joined Santore on the panel that facilitated the session. He said his system starts from a position of humility when it comes to sustainability.

"We have taken a posture of we have a lot to learn with this, so who is at the table is really important," he said. "We are bringing our community organizations to talk about this because we do have a lot to learn. Environmental stewardship is complex and it touches many areas. You could move one lever here and impact stakeholders in a negative or a positive way. All points need to be considered."

Panelist Fr. Michael Rozier, SJ, an assistant professor of health management and policy in Saint Louis University's College for Public Health and Social Justice, is president of SSM Health's ministerial public juridic person, SSM Health Ministries. Fr. Rozier had a suggestion for those who engage in discernments with multiple concerns and stakeholders at play.

"If we all enter into the conversation presuming the best of the other people around the table, I think that assists us in these complicated discernments where we are ultimately going to have to make a decision of which good or goods are going to be triumphant," Fr. Rozier said.

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