Ethics and Policy – Not as Abstract or Inaccessible as You Might Think (or Fear)

 By Jennifer Moore Ballentine, MA

October 9, 2023

The Coalition for Compassionate Care recently sent a survey to our members asking for input on a broad range of subjects – among them, preferred topics for our education efforts. I was not surprised to see Advance Care Planning, Cultural Aspects of Palliative Care, and Diversity, Equity, and Inclusion (DEI) in the top three slots, respectively – these are core issues in all we do, and we will continue to focus on them. I was a little surprised – and delighted – to see State and Federal Policy and Ethical and Legal Aspects of Palliative Care crowding next in line! Whoop de doo (as my great uncle used to say), we’ve got treats in store for you!

Our Annual Summit this year will host two half-day preconference sessions on April 2: one on Ethics and one on Policy! And we planned these even before we got the survey results back! 

Why, you might ask? Ethics and Policy are both topics that can get a bit of a bad rap. Ethics seems a little too cozy with compliance on the one hand or philosophy on the other, neither of which is winning any popularity awards in today’s culture. Policy is either where good ideas go to die or the kind of activity no mother ever raised her child to get involved in. The shenanigans going on in Washington and, sometimes let’s face it, Sacramento, aren’t exactly burnishing the glow of either one. 

Here's my take: 

Far from being some abstract set of theories or complicated rules, Ethics is the foundation of everything we do – at the bedside and in the boardroom. While all clinicians get some amount of formal Ethics education in their pre-professional courses, it can quickly recede into the background. A bedrock theme of the training we will do in April is that everyone (sociopaths aside) has an innate “icky meter” – a mostly subconscious gauge of whether a given action is “right” or “wrong.” When something isn’t going “right,” our icky meters create discomfort – just like your nerves register pain when you bang your knee. If that discomfort isn’t dealt with – if the issues aren’t surfaced, discussed, and resolved – moral distress and ultimately moral injury can occur, which are major factors in the burnout and stress our workforce is currently experiencing. This Ethics preconference session will equip you to bring your icky meter into conscious application, give you a vocabulary with which to articulate what your icky meter is telling you, and a set of realistic actions you can take to begin to resolve issues you now recognize. Intended for beginners and old hands, this training will be – we promise – highly interactive, fun, and very rewarding.

Policy, as defined by Merriam Webster, is “a course or principle of action adopted or proposed by a government, party, business, or individual.” In this case, we’re talking about the government version, and we’re talking about “Policy” with a capital “P,” not “policy” as in the kind keeping company with “procedures” in your organization’s manuals. When Policies are formed and adopted by governments, they become the proverbial boulder thrown into the lake creating massive ripples; they have huge influence – over allocations of financial, human, and other resources and over programs and initiatives that affect huge swaths of activity and focus and real lives. Some become or influence laws, some manifest in regulations, some in funding, some in intangible “clout.” But they aren’t the work of gods on Mount Olympus nor of magicians behind a black curtain. They are the work of dedicated, vocal, and hard-working people genuinely trying to do good in the world. And here’s the big headline: You, too, can affect how Policy is made and what influence it has. Our Policy preconference will bring you into the “rooms where it happens,” provide insight into what kinds of Policy is being made that will affect serious illness care in California and invite you to make your views and experience known. 

We hope you’ll join us for one or both preconference sessions; and keep your eyes open for more education in Ethics and Policy in the coming new year.