People before problems

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St Vincent’s Hospital, Lismore, is celebrating its centenary this year. PHOTO: Courtesy of St Vincent’s Hospital, Lismore

Modern Catholic hospitals are ideal places to nurture people in a holistic way, says bioethicist

Hospitality is the DNA of healthcare, and hospitals should rediscover its importance to enrich patients’ experiences as hospitals become larger and more bureaucratic, Australian Catholic University bioethicist Dr Xavier Symons has said in his 2022 Plunkett Lecture on Bioethics.

Hospitals take their name and purpose from the Latin for stranger or guest, hospes, and the classical practice of hospitium towards strangers: offering lodging, food, medical assistance and other assistance.

Yet hospitals are today experienced as “strange and uninviting places”, Dr Symons said.

The sophisticated bureaucracy and technology needed to operate modern hospitals “has brought with it the spectre of depersonalisation in hospital care”.

“The very idea of the doctor-patient relationship is to some extent in jeopardy. Acute care is provided by complex teams of specialists each bringing their own unique medical expertise to the medical ‘problem’ that the patient is experiencing.

“It’s hard for an emergency physician to ‘welcome a patient’, even to smile, when their ED is bed-blocked and they’re fourteen hours into a ten hour shift.”

“This multidisciplinary, multispeciality approach to care facilitates comprehensive treatment, but it runs the risk of leaving the patient asking – who specifically is responsible for my care?

“Who is the person to whom I should voice my concerns and in whom I should seek assurance?”

Dr Symons emphasised that his remarks were not intended as criticisms of healthcare workers, who have been at the forefront of the COVID-19 pandemic of recent years, but as encouragement to continue the good work they already perform.

He also acknowledged the sheer scale of the task facing medical professionals every day.

“It’s hard for an emergency physician to ‘welcome a patient’, even to smile, when their ED is bed-blocked and they’re fourteen hours into a ten hour shift.

“One might see hospitality as a nice idea that in the present context is simply unrealistic.”

Dr Symons encouraged medical professionals to remember the “strangeness of human existence” and the Christian teaching that we are wayfarers: “the world is not the final destination for the human person.”

Dr Xavier Symons, Australian Catholic University bioethicist. Photo: ACU
Dr Xavier Symons, Australian Catholic University bioethicist. Photo: ACU

Hospitality means making oneself “available” to the other person, and to treat them with respect rather than as an object presenting a particular pathology.

He suggested that patients could benefit from accompaniment by pastoral care staff as they proceed through complex treatments, often involving many different staff.

Several initiatives at St Vincent’s Hospital in Darlinghurst were also commended during the lecture, such as Tierney House, a facility that provides temporary accommodation and support for people who are homeless and require medical care.

The Plunkett Lecture is an initiative of the Plunkett Centre for Bioethics at the Australian Catholic University, headed by Dr Bernadette Tobin. It is normally delivered at St Vincent’s Hospital, but due to COVID-19 protocols was this year held online.

Speaking with The Catholic Weekly after the lecture, Dr Symons said he thought COVID-19 has “radically changed the way in which hospitals are functioning”.

While the quarantining of patients to control infection in the hospital context was important, he said there could be “reasonable disagreement about how strict things should be”, such as visiting policies and vaccine mandates for staff.

A focus on hospitality might help “shift the scales” away from a strong insistence on isolating patients for extended periods, or preventing patients from seeing family members.

“It is a bit of a worry that people are so concerned about controlling the spread of disease these days, and so little concerned about the moral challenge that society faces.”

“Hospitality is not an optional extra, and that should be a starting point for these discussions,” Dr Symons said.

“It’s an essential part of the healing process, and we need to provide hospitality if we want patients to best manage the existential challenges of illness.”

Catholic hospitals are uniquely placed to rediscover the ethos of hospitality, he added, because in addition to the material conditions of patients they also emphasised the importance of a holistic, integrated approach to healthcare that also included moral and spiritual concerns.

“It is a bit of a worry that people are so concerned about controlling the spread of disease these days, and so little concerned about the moral challenge that society faces,” Dr Symons said.

“I think that’s a bit of a double standard, and we need to reflect on just how much value we place on health, and how much we place on moral character and the improvement of society.

“If health has something to do with the spiritual wellbeing of society in general, there is a sense in which Catholic hospitals play an important role because they are conduits of spiritual goods for a society that’s otherwise estranged from religion.”