Pellegrino center newsletter applies teachings of its namesake to ethical issues

By LISA EISENHAUER

When the Edmund D. Pellegrino Center for Clinical Bioethics at Georgetown University Medical Center in Washington started its ethics newsletter in July 2020, the nation was in the thick of the COVID-19 pandemic and roiled by racial unrest over the police killing of George Floyd.

Dr. Allen H. Roberts II, editor-in-chief of the newsletter called The Pellegrino Report: Bioethics in Practice, said the launch at a time when health care equity and racial justice were at the top of the national conversation was coincidental. The newsletter had been in the conceptual stages for months.

Nevertheless, the newsletter jumped right into the conversation, with a first report titled “Pandemic and Pandemonium: Navigating Multiple Levels of Upheaval.” The piece was by Dr. Myles Sheehan, a Jesuit priest. He holds the David Lauler chair of Catholic health care ethics and is a professor of medicine at Georgetown University School of Medicine. Fr. Sheehan directs the Pellegrino Center.

In the article, Fr. Sheehan exhorted practitioners to show the same compassion and regard to people imperiled by structural racism as they have for those stricken with COVID.

“Lives were saved, and those who died from this illness were treated with respect and reverence for their dignity and value as human beings,” Fr. Sheehan wrote. “Our response to the events that have followed the murder of George Floyd, and others, needs to be as focused on the value and dignity of those whose lives are most threatened by systemic racism, structural vio-

Refugee assistance

From page 1 his homeland was to marry a woman who he hopes will someday be able to join him in Anchorage, now that he has stability and legal residency.

Abdalla says his prospects were forever changed for the better by Catholic Social Services and its partnership with Providence Alaska Medical Center, part of Providence Alaska. “New country, everything new, but that’s long ago and we know how to do things right now and we are good,” says Abdalla.

Model partnership

In the fiscal year that ended in October 2021, the Refugee Assistance & Immigration Services program aided 460 refugees. The refugees get a warm reception upon arrival in Alaska: case management, and assistance with housing, education and employment services, applying for citizenship and family reunification. They can stay in the program for up to five years.

Brigit Reynolds, the program’s refugee education and employment manager, says that while the number of enrollees goes up and down, it is currently on the upswing with 194 people newly enrolled from October 2022 through January. Many of the newest arrivals that Catholic Social Services is helping are fleeing the war in Ukraine or the Taliban takeover of Afghanistan.

Providence has been a partner in the Refugee Assistance & Immigration Services program for more than 12 years. The collaboration was suspended briefly early in the pandemic. The partnership has given dozens of refugees an opportunity for entrylevel job training and led to long-term

lence and inequality.”

Protecting the vulnerable

In the 2½ years since its founding, the monthly newsletter has continued to provide reflections and guidance on ethical issues from a Catholic perspective. The newsletter was specifically developed as a resource for practitioners at MedStar Georgetown University Hospital, Georgetown’s academic health system partner.

The hospital’s clinical ethics committee collaborated in the newsletter’s creation.

About 1,400 medical staff members and more than 500 resident physicians get each edition by email and a link to it is shared in weekly communications from hospital leadership. The newsletter also is available online for anyone with an interest in Catholic health care ethics to read.

Roberts noted that while other groups and health care facilities have created newsletters that delve into ethics — among them is Health Care Ethics USA, a quarterly produced by CHA in partnership with Saint Louis University — The Pellegrino Report is unique in that it specifically applies the teachings of the Pellegrino center’s founder and namesake to practical matters.

Pellegrino was a physician, philosopher and ethicist. Considered to be one of the founders of modern bioethics, he published more than 600 articles and wrote or co-wrote more than 23 books on medical science, philosophy and ethics. He was the founding editor of the Journal of Medicine and Philosophy. He died in 2013.

In Roberts’ view, Pellegrino took a logical and scientific approach to framing medical ethics. “He has set the medical principles in the light of Catholic thinking and all of his writing is for the protection and the safety of individual patients,” Roberts said. “More importantly, or as importantly perhaps, is protecting the vulnerable among us to ensure the sacredness of every human life.”

In short, Roberts said, Pellegrino believed that ethical medical care should be focused on providing “the right and good healing action and decision for every patient in every clinical encounter.”

Religious directives explained

In addition to emphasizing the teachings of Pellegrino, Roberts said the newsletter’s content aligns with and illuminates the Ethical and Religious Directives for Catholic Health Care Services established by the United States Conference of Catholic Bishops. Roberts called the directives “beautiful, practical testimony” to the Catholic faith.

Valuable experience

The experience is valuable even for the trainees who move on afterward, Reynolds says. Going through the onboarding process at a large employer prepares them for what to expect elsewhere and having the Providence name on a resume can open other doors.

Laarni Competente Power is community partnerships coordinator for Providence Alaska, which is part of Providence St. Joseph Health. She says Providence Alaska Medical Center places its trainees in environmental services, laundry or food and nutrition services. The workers can jump right into positions in those departments because the duties are easy to learn, the jobs don’t require certifications and the departments usually are in need of staff.

Power says the training typically lasts three to six months. Catholic Social Services staffers accompany the trainees during their orientation and on their first day on the job. The nonprofit also provides interpreters as needed.

The number of refugees in training at the medical center varies. In late February, the hospital had one trainee with two others about to start. Three former trainees transitioned to permanent jobs in the second half of last year.

Fr. Sheehan has written several pieces for the newsletter that explain or reflect on the directives. For the January 2023 edition, he focused on the section about social responsibility. He wrote that the section encourages Catholic health care providers “to reflect on the fact that we work in a system where there are health care disparities, where a person’s ZIP code may tell you if they will live a longer or shorter life, and where the legacy of racism and discrimination can still spread its poison, even if we do not notice it.”

Along with Roberts and Fr. Sheehan, Marti Patchell, administrative consultant to the Pellegrino center, and Maria Maisto, academic and program specialist at the center, round out the newsletter’s editorial board. They meet twice a month to discuss topics for the publication. Roberts extends invitations for article submissions to people at the center, the university and the hospital based on those topics.

Recent newsletter topics have included the connection between ethics and hope, the dilemmas created by the absence of a medical surrogate and caring for premature infants.

Inspiring the next generation leisenhauer@chausa.org and don’t know anybody,” she says.

Roberts’ medical career has included 20 years in the U.S. Navy Medical Corps and serving as White House physician under President George H.W. Bush before becoming a professor at Georgetown University Medical Center and a physician executive at MedStar Georgetown University Hospital. He says he never expected his resume to include “editor-in-chief,” but is pleased to be a part of a worthy endeavor. “We want to keep Pellegrino and his work alive in the imaginations of the next generation,” he said.

Resettlement for some of the refugees from warmer climes is probably a bit more challenging in Alaska than it might be in the lower 48 states, Power acknowledges. One recent trainee left the state for a more temperate one. Long, dark, frigid and snowy winters can be too taxing for some people, she says.

Crystal “Nikki” Brayboy, manager of the environmental services department at Providence Alaska Medical Center, has watched refugees thrive after being trained in her department. Many of the workers have stayed on long term and others have shifted to other areas of the hospital, including supply chain and sterile processing.

Some refugees who started as housekeepers or janitors have learned the skills or earned the certifications needed to move into positions such as nursing assistant and patient care technician. “We’ve had people come in and flourish and we share the wealth with Providence,” Brayboy says.

Two-way learning

employment for many of them.

Reynolds says that while Catholic Social Services has several employer partners throughout Alaska, the partnership with Providence Alaska Medical Center is a model one. The hospital pays the workers at the same scale it does other entry-level employees, something not all the employers do. It also hires many of the workers and offers them continued training and advancement opportunities.

“It just provides a really good opportunity for growth and for a good paying job right out of the gate,” Reynolds notes. “That is not always super common and available.”

Power says the refugees take jobs that have grown increasingly challenging to fill. The hospital’s human resources department counts on them and managers want to see them succeed, she says.

Sharing the wealth

Providence’s participation in the refugee assistance program delivers on its commitment to serve the poor and vulnerable, Power says. “I can’t think of anything greater than helping someone who has been displaced from their home through no choice of their own and had to relocate to a community that’s completely foreign to them in which they have language barriers

In addition to being grateful for their jobs, the refugees on her staff are eager to bond with their co-workers and overcome cultural barriers in their new lives, Brayboy says. The co-workers generally reciprocate, she says, helping the refugees with language skills and inviting the newcomers into their homes and on outings.

“I kind of have to give a lot of credit to my caregivers,” she says. “They’re the ones who help me a lot with bridging the gaps.” leisenhauer@chausa.org

In addition to Ukraine and Afghanistan, Brayboy’s trainees’ countries of origin have included Sudan, Iraq, Somalia and Bhutan. She calls her staff “a big melting pot.” They foster in each other an appreciation for the diversity of cultures, traditions and challenges around the world. “To me it’s all a big learning and compassion-filled adventure,” Brayboy says.