Member Care and Transparency—Part 4

Developmental Musings on Blowing Whistles

Whistle blowing is a difficult and risky aspect of transparency.

It takes moral courage, skill, and support.

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Whistle blowing is a term from the sports world. A referee overseeing a game will blow a whistle when some type of wrong behavior (breaking the rules) is committed by a player or even by a coach. The game is temporarily stopped when the whistle blows. The infraction is pointed out clearly and “publically” to all the participants. There is usually a consequence—a penalty.

One example of a misbehavior meriting a referee’s whistle would be intentionally or accidentally kicking someone in a football match. Another example would be intentionally or accidentally pushing someone down during a basketball game. Still other examples would be the far more minor violations like being off sides in a football match or dribbling the basketball with both hands at the same time.

Referees can blow whistles without fear of reprisal because they have recognized and legitimate authority to do so. Their job is to enforce the rules and ensure fair play. Staff in organizations on the other hand, do not usually have the authority of a referee. Neither do staff usually have a set of rules (recognized organizational guidelines) regarding how to do whistle blowing and handle grievances. They can thus be reticent to query/challenge possible misbehaviors and if they do so they may be vulnerable to reprisals. The same applies, as well, to leaders in many organizations. Could such reprisals happen in faith-based organizations and others that espouse good relationships, justice, compassion, and high ethical values? Well, quite possibly!

Whistle blowing in organizational settings can include lots of things. It might mean an employee talking to a supervisor about someone’s inappropriate sexual comments or relentless teasing of others. It could be confronting a leadership team that is withholding information about environmental damage or undisclosed political contributions related to the organization’s activities. Or it could entail filing a formal complaint with the governing board or an external regulatory or police body about possible inappropriate allocation of funds. Whistle blowing serves as a protective function. It is a call for transparency and accountability.

Moral Courage and Moral Cowardice, with Lots In-Between

Let’s imagine that there were some major international frauds in the faith-based sector. Many people were devastated by them. What would people in the sector do who heard about the frauds? Would they inquire more about the frauds and confront the frauds in spite of possible negative consequences? What if there was very little response in terms of transparency and accountability by people who had been involved or affected? Is it OK then to just let things be and to move on? What if the situation malignantly spread to also involve various overlapping issues including discrediting, wrongful dismissals, cover ups, and other injustices? How involved would people likely become in order to do something about it? What would you do? Or what would you want if you were one of the victims?

Note that there have in fact been numerous financial scandals that have affected the faith based sector. This year, 2009, for example, marks the 20th anniversary of the start of the New Era scandal in the USA. As you will see in the staggering information linked below, fraudsters in the more recent news like Bernie Madoff certainly have had their predecessors in people like New Era’s John Bennett who embezzled some 135 Million US dollars from over 1000 donors in the Christian charities and organizations.

Thank goodness for the courage, determination, and research of whistle blowing people like Harry Markopolis and Albert Meyer. Markopolis was a financial analyst who “chased” Madoff for some nine years and Meyer was an accounting teacher who insisted that Bennett’s scheme was fraudulent. In spite of being ignored or opposed by others (especially people/institutions benefiting from these “amazing and benevolent” profit-making investments), their ethical commitment to confront wrongdoing and to protect others continued to impel them to take a stand.

http://en.wikipedia.org/wiki/Bernard_Madoff

http://en.wikipedia.org/wiki/Foundation_for_New_Era_Philanthropy

Fortunately in major situations like this the details usually go public in due course. The concerted voices from the citizen sector, often with support from people of influence, usually win the day. Government investigators/agencies begin to investigate then prosecute and the international media carry the story. The wheels of justice turn slowly yet the state ultimately does not wield the sword in vain upon those who practice evil (Romans 13: 4).

What could we learn from such situations in the faith-based sector? First we probably have to acknowledge that we may not in fact have learned very much from previous history. We continue to be vulnerable to unscrupulous people who we “trust” and of whom we find it difficult to believe that they could intentionally dupe others and cover up. So we would have to be transparent about the reality that these things do in fact happen, even as the New Testament, business sector, governments, and history warn us over and over again. (See the weblog post from 6 November 2008 for example on New Testament warnings. Go to this internal link and then scroll down to the date: http://coremembercare.blogspot.com/search?updated-max=2009-02-18T21%3A06%3A00Z&max-results=25).

Second we would need to acknowledge our limitations, mistakes, and fears in addition to what we have done well. How have we responded and why? Have we acted with moral courage or have we acted with moral cowardice, or something in-between? In other words we would have to be willing to openly review the specific fraud situations and how they have been handled. We would have to minimize rationalizations and making excuses for not confronting those who are guilty or getting more involved to protect vulnerable people. This individual and group commitment to soul-searching, including doing external independent reviews and internal “morbidity and mortality” consultations, would be one of the best safeguards for preventing similar injustices in the future in which people and organizations get exploited and damaged.

For some related thoughts on fostering organizational health and for dealing with serious deviance and dysfunction, see the article and links at the Reality DOSE web site (link is below). This material goes along well with the recent research by Transparency International et al on Preventing Corruption in Humanitarian Assistance. See the link below for the research report, especially the two-page "Executive Summary". By and large the mission and humanitarian sector, for all our admirable and exemplary qualities, can be vulnerable, naïve, and lack the basic training and recognized protocols to report and deal with serious misconduct.
http://MCAresources.googlepages.com/realitydose

http://transparency.org/publications/publications/other/humanitarian_assistance_report_2008

God is Pro-Transparency

The main actor in situations where there is serious injustice and a paucity of transparency/accountability would seem to be God Himself. He truly hears the cries of the afflicted. He really hears the whistles blowing loud and clear. He Himself will be transparent about the truth even if people are not. Psalm 37 is very instructive here. The promises in this Psalm on the part of God are encouraging and substantial. Here are some excerpts that can be of much help to anyone who is struggling with life’s injustices.

“Do not fret because of evil doers…
they will wither quickly like the grass.

Trust in the Lord and do good…commit your way to the Lord.

He will bring forth your righteousness as the light
and your judgment as the noonday.

For the Lord loves justice and does not forsake His godly ones.

He delivers them from the wicked and saves them,
because they take refuge in Him.”

Transparency—The Book

Consider carefully this next set of quotes from Bennis et al in Transparency: How Leaders Create a Culture of Candor (2006). I think that this is a timely book for all of us in member care and mission/aid. Remember too that it is not just about the “them” out there somewhere or the “bad” people in our midst. It relates to all of us.

“But legislation alone [the Sarbanes-Oxley Act in the USA] cannot make organizations open and healthy. Only the character and will of those who run them and participate in them can do that….If a culture of collusion exists instead of a culture of candor, participants will find ways around the rules, new or old, however stringent.” (p. 8)

“Although whistleblowers are often exiled from their organizations for their unwanted candor, Glazer's study revealed that they almost always found the courage to speak out in their deep commitment to the core values of the organization. Even when labeled traitors by their colleagues, such tellers of unsettling truths often feel passionate loyalty to the organization and act because they feel the secret activity violates its mission and ethical core.” (10)

“But sometimes employees find the actions of their bosses so unconscionable that they feel they have no choice but to resign and go public. Typically, this is the last resort of those who have voiced disagreement internally and exhausted all channels of appeal but feel they were not given a serious hearing. On rare occasions, a respected and powerful organizational insider will proffer such a principled resignation but, typically, those who quit over matters of principle are powerless people who have been pushed to the extreme of quitting by the disrespect shown to them by superiors. ….In general people have to be angry as hell before they quit and go public. And because anger is such an unattractive, unsettling, and even frightening trait, angry people seldom have much influence, and they are easily dismissed by those in power as out of control, or ‘in turmoil.’ ” (p. 78)

“If dissidents aren’t called crazy, they are portrayed as disloyal—and treason after all, is a capital offense. The charge of disloyalty is as easy for leaders to bring against followers as it is difficult for the accused to counter and disprove. Moreover, as loyalty is typically an admirable trait, it is also a convenient blind for cowardly followers to hide behind.” (p. 79)

For more information on whistle blowing see the helpful suggested policy/white paper on the web site of the Evangelical Council for Finacial Accountability (ECFA):

http://www.ecfa.org/TopicDisplay.aspx?PageName=TopicPolicy_SuspectedMisconduct

For some additional perspectives on fraud in Christian circles, see the June 2009 article "Popping the Fraud Bubble" and related links in the magazine Christianity Today.
http://www.christianitytoday.com/ct/2009/june/4.14.html?start=1#related

Reflection and Discussion

1. Recall a time when you blew a whistle. What was it like and what happened?

2. What protocols exist in your organization for grievances and whistle blowing? How adequate are these protocols?

3. List three thoughts from Bennis et al that make the most sense to you. How can you apply these in your setting?

4. Respond to this statement and give an example: Often times there is not a need for more light to shine. Rather the need is to act upon the light that is already clearly shining.

Member Care and Transparency—Part 3

Developmental Musings on Parenting Truth

Parenting truth?

By this I mean that parents instruct and influence their children
about how to tell the truth.

It's about how kid's and all of us develop and internalize
the virtue of being honest.

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I remember when I was about 15 years old. I was practicing backing the new car out of our garage in California. The car was actually a dealer car from my father’s Buick-Opel franchise. It was pretty fun having a dad who owned a car dealership. The possibility of driving lots of new cars was really exciting to me! The photo above was taken about a year later than this actual story, in June 1972, at the car dealership. This is my family. I was the fourth oldest and the third youngest.

OK. Back to backing out of the garage. I was doing this for the first time, all by myself, with my mother’s permission, fairly confident that I could do it. I was pretty much in awe to be able to drive, even if it were only for a few feet! I had begun to tackle the first stages of this developmental milestone—becoming more independent by learning how to transport myself hither and yon with the help of an internal combustion engine.

Apparently at age 15 I did not know how to back out of garages very well, as I was soon to learn. The front side of our shiny Buick station wagon hit the brick wall of the garage. This unexpected event resulted in a conspicuous dent in the car, a chunk of brick chipping off the garage wall, and a near state of panic on my part. What was I to do?

The standard tapes started to play in my mind. If I told my mom she would be angry and I would get into trouble. It would also show her and the rest of my family that I was not mature and skilled enough to drive yet. But above all, it would remind me of a spectre in my past. It was a fiasco from six years previously when I managed to crash a new family station wagon into a tree at the bottom of the hill on our street. Don’t ask. Fortunately no one was injured. But I really felt stupid, and ashamed, and scared. Anyway, back to age 15 and to the same painful feelings that were stirring deep within. What was I to do?

Well, I ended up taking the higher ethical road. I told my mom about what had happened. But only after I had taken the lower ethical road first: I clumsily glued the brick chunk back to the wall and let my mom take the car out for a drive for a day or two in hopes that she would think that the car got dented by some other vehicle (by some unscrupulous person that would not tell her of his/her driving error) while it was parked in some parking lot.

Two days later, my mom did in fact notice the dent. Somehow she just seemed to know intuitively that the dent was not due to some other vehicle or person. It was due to me. Parents seem to not only have extra eyes on the backs of their heads but special eyes that can peer into the soul. And so my mom simply asked me if I was responsible for the dent. And frankly, I am so glad she asked me because I was just swarming in guilt about how I had tried to cover up. It was such a relief to be gently confronted and to tell her the whole story and even how I tried to glue the brick back to the wall in order to disguise the scene of the crime.

I remember my mothers calm, corrective attitude. I remember her not minimizing my mistake nor the far greater mistake (sin) of covering up my mistake. I appreciate how my mother dealt with the situation and how she dealt with me. She was parenting the truth.

Trans-Transparency:
Non-Selective Honesty with Self, Others, and God

Transparency begins by peering into our own souls. Such self-scrutinizing, especially for those with member care responsibility, is to be built into our lifestyle. It is self-honesty. It is reinforced by relationships with confidants to whom we give permission to peer into our lives. And we learn it from our parents and the significant adults in our lives as we grow up, and as they model honesty to us.

Transparency also involves God in a big way. God desires that we acknowledge reality—truth—in our core being (Psalm 51:6). We entreat God to help us be transparent—to search us and know our hearts (Psalm 139:26). The search for transparency, truth, self-honesty is especially important given the fact that our own hearts, like those of all humans, are deceitful and even desperately sick (Jeremiah 17:9 ).

One other thing I have learned over the years. We usually think we are far more transparent and accountable than we actually are. A corollary to this is we believe we are acting with far more integrity and honesty than we actually may be. Still another corollary is that sometimes we are only transparent and honest when we have to be and/or after a wrong behaviour or mistake is discovered. This is why we need the light of God and others in our lives. So we must trust ourselves but at the same time not entirely so.

Transparency—The Book

Consider this next set of quotes from Bennis et al in Transparency: How Leaders Create a Culture of Candor (2006). As I shared in the previous entry, if there were a book I would recommend right now to colleagues in member care and mission/aid it would be this one. Especially the first chapter. Read and discuss and apply it! Remember, it is not just about “them.” It is about all of us.

"A universal problem is that when staff speak to their leader, the very nature of the message tends to change. The message is likely to be spun, softened, of colored in ways calculated in ways to make it more acceptable to the person in power. In order to continue to receive reliable information, those in power must be aware that whatever they hear from their direct reports has probably been heavily edited….And so wise leaders find ways to get information raw." (p. 28)

"The best way for leaders to start information flowing freely in their organizations is to set a good example. They must accept, even welcome, unsettling information. If leaders regularly demonstrate that they want to hear more than incessant happy talk, and praise those with the courage to articulate unpleasant truths, then the norm will begin to shift toward transparency. Transparency is one evidence of an organization's moral health." (p. 42)

"Perhaps the only thing riskier than telling the boss he is wrong is to have to admit one's own mistakes. Speaking truth to power is a particularly threatening exercise when it entails owning up to serious error. Indeed, fear of punishment by tyrannical leaders causes many managers to become risk averse." (pp. 58-59)

"…it is advisable for people in organizations to “practice having unpleasant conversations.” (p. 74)

Reflection and Discussion

1. Think of a time when you made a mistake and tried to cover it up? What did you feel inside, what did you do, and what did others do?

2. Is there something currently that you need to be transparent about?

3. How much transparency is appropriate and with whom are we transparent?

4. Find a few ways that the above quotes from Bennis et al apply to your life and work setting.

Member Care and Transparency—Part 2

Developmental Musings on Being Honest

After university I joined a mission organization as a volunteer.

I was 21 years old. This was nearly one-third of a century ago!

I worked in Mexico on a project to distribute Scripture for free.

 We also did practical work to help folks in the local communities.

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Arriba Mexico!

The project was birthed in 1977 following a disastrous hurricane that struck the area around La Paz on the southern tip of the Baja California peninsula. Many volunteers from many countries arrived soon after to help hurricane victims who had lost their homes.

Shortly afterwards and stimulated by the experiences in La Paz, small teams of volunteers from different American and Mexican communities began to work together on what was called Bibles for Mexico. Collectively the many sort-teams teams went village to village, city to city, systematically giving free Bibles and seeing how they could help in practical ways. The goal was to give a free Bible to every home in Mexico, not just in Baja California (one of the 31 states of Mexico).

I joined this project a few months after the La Paz hurricane, in late 1977. We made it a point to mingle and work with the local community. We did things like clothing distribution, played sports with the kids, performed street theatre, and attended/did services at the churches.

Ensenada, Baja California Norte, Mexico--August 1978

It took eight years to cover the entire nine hundred mile span of the Baja California peninsula with free Bibles. The scale of the outreaches ranged from working in the large cities of Tijuana and Mexicali in the north to the many small villages scattered throughout the state.  We actually ended up giving out just the New Testament and in a version that was acceptable to both Roman Catholics and Protestants in Mexico (Dios Llega al Hombre--Good News for Modern Man). It took many teams and many years. But we did it. Together.

One of the amazing things for me in retrospect was that I was able to participate in this extensive project esentially as a volunteer working part-time while I was attending graduate school full-time. I was living and studying in Southern California and was two hours by car from the Baja border. So access to Mexico was pretty easy. Much of the work seemd to be on a learn-by doing basis in consultation with others, especially Mexicans. And there were lots of prayer and encouragement too to support our efforts. I ended up helping to organize and/or being responsible for some 40 outreaches. I could sure tell stories—but some other time!

These were some of my first sustained cross-cultural experiences. I learned so much about the many different types of people in Mexico and my own cultural influences. My Spanish improved of course, and I saw first- hand how God could use all of our strengths and limitations to help others, if we would trust Him and commit to work together. The many lessons, memories, and special people are embedded in my soul. This time was foundational for my future work and responsibilities in member care. These early developmental years in cross-cultural ministry were just so, so special!

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Hurray for Honesty!

One of the main items that impacted me in my early 20s in Mexico was a statement written on the small sticker that you see at the top of this weblog entry. Don’t gloss over these powerful words. We put this sticker on the front page of many of the Bibles that we were giving out. Thousands and thousands of them. It is both a declaration and a warning. As you can probably tell, it means:

“Only the dishonest fear the truth.”

This somber sticker reminds me of our topic of transparency. I still ask myself, in what ways might I be afraid of the truth? The truth about my weaknesses or ways that I have been wrong and need to make amends. We all need to do this. "Who can say, 'I have cleansed my heart, I am pure from my sin.' " (Proverbs 20:9).

Courage to Act Responsibly

Currently there is major concern about the need for greater transparency and accountability in the business world and in Christian ministry. This concern is very welcome. It is well past the time to upgrade our ways in the faith-based sector in these crucial areas.

We may all want to take the lower ethical road and avoid transparency and accountability. We usually do so out of fear of negative consequences, self-interest,  and other reasons which can be rationalized and presented as being reasonable or virtuous. It is such a sad day when this happens in the faith-based sector. It just creates more wounds for the already wounded Body of Christ.

So  I wonder: who among us will act with honesty even if there are negative consequences? Who has the courage to take the higher ethical road of not covering up? "He who conceals a transgresson will not prosper but he who confesses and forsakes them will find compassion." (Proverbs 28:13)

Or what do we actually do when we are aware that there is strong evidence of major organizational misconduct, dysfunction, deviance, and things like covering up serious fiscal impropriety? Perhaps we simply look the other way in hopes that someone else will deal with it. Or we say to ourselves that we must be mistaken or should mind our own business because our leaders and our organizations would never act this way or permit such things to happen. Well, think again. But just don't ratinalize away reality or our responsibilities.

We need courage to take responsibility, to confront, to call for honesty (transparency and accountability) . We must not allow ourselves to be intimidated by the common responses of discrediting, distracting, minimizing, skapegoating, silencing, or harassing.

Acting with honesty and asking for honesty are risky. But when is work in the mission/aid world not risky? The areas of greatest need are often the areas of greatest risk. Sometimes this significant risk lies is within our own organizations, communities, and sectors. Risk is not just out there somewhere in the dangerous, unstable "field" locations  laden with conflicts and calamities.

We say we are willing to lose our life for Christ. This is a noble aspiration. Time will tell. But in the meantime are we willing to risk losing our reputations and our careers for His sake?

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Transparency—The Book

Consider this next set of quotes from Bennis et al in Transparency: How Leaders Create a Culture of Candor (2006). Ah—if there were a book I would recommend right now to colleagues in member care and mission/aid it would be this one. Especially the first chapter. May I suggest that you read it and discuss it again and again. Apply it deeply and widely. It is not just about “them.” It is about all of us.

"But at any time an organization makes a seriously wrong decision, its leaders should call for an intensive postmortem. Such learning opportunities are too often overlooked. The tendency is simply to call on the public relations department to spin the mater, to make another inadequately thought-out decision, and perhaps to scapegoat, even fire, a few staff members. Because most companies cover up their mistakes instead of learning from them, systemic flaws in information flow tend to remain to do their damage another day." (pp. 22-23)

"Pride in belonging to a high-performing or a high-status group and the cozy sense of belonging to a tight-knit organizational “family” can be genuine sources of professional satisfaction. The paradox is that there is a dark side to belonging—the almost reflexive temptation to spin information in ways that protect the group’s shared pride, to make the group look better than it really is, or even simply to preserve the group. All these make it easier for group members to suppress information or distort it." (pp. 35-36)

"So the first rule of management is that organizations get the behavior they reward – not the behavior they describe in their posted values statements. Because denial, self-deception, and hypocrisy are such common features of organizational life, it is often useful for companies to bring in outside "anthropologists," independent observers skilled in identifying potentially toxic behaviors and the hidden values that drive them." (88-89)

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Reflection and Discussion

1. What are some of your own developmental musings about lessons and principles you learned during your initial cross-cultural experiences?

2. Why is it so hard to act honestly and to admit when we make mistakes?

3. In light of the Bennis quotes above, why is it difficult for organizations to confront their own errors and to ingrain honesty into their organizational ethos?

4. Give at least one positive example of a leader, friend, or organization that gets it right consistently—he/she/they admits a mistake, acts with integrity, and accepts the negative consequences.

Member Care and Transparency—Part 1

Developmental Musings on Playing Fair

What things do you remember when you were five years old?

Anything about being honest and fair?

I wonder what Josephine above would say.
She looks to be about five but she is actually 45 years old.

She was and still is Michele's doll.
She's a member of our family.
Josephine over the years has watched us all learn to play fair.

*****

I vividly recall a lesson in transparency that occurred when I was five. The lesson began with my eyeing the money-laden offering basket coming my way during a church service.

*

I was sitting next to my father. He had just given me a quarter (25 US cents) for the offering. But as I held that quarter in my hand, and as the basket steadily progressed towards the pew where all six members of my family sat, a brilliant idea occurred to me. What if I substituted the six pennies (one cent coins) that were in my pocket and kept the quarter instead? It seemed like a good deal and a win-win situation. The church and God and I all would benefit.

*

There was a problem though. I was not too adept at things like this. Another problem was that my nearly omniscient dad saw me, I realized after the fact, as I carefully, I mean slyly, put in my pennies. After the basket passed he turned to me and whispered: “Give me the quarter”, which I did. Then he said “You just lost your pennies.” My heart sank and my gaze did too.

*

I will never forget how suddenly my clever, spontaneous plan had fallen to pieces and the shame I felt in having been discovered by someone who I looked up to. It was a hard but necessary learning experience. My understanding of justice and my understanding of self-deception really made progress that Sunday morning. I am very grateful to my father for his wise intervention.

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Transparency is Virtuous
Transparency refers to appropriately disclosing what is really going on in our work and lives, for better or for worse. Of course it would be helpful to discuss what "apppropriately disclosing" means. But for now let me just say that it means far more than simply abiding by minimal legal or minimal ethical standards. It means sharing accurate and full information with people to whom we are accountable. It means verifying, in terms of my story above, that we have given our quarters as expected and not our pennies. It also means saying that we gave pennies when we should have given quarters.

Transparency reflects our character and who we are. It is a core part of being honest and provides important evidence that we are trustworthy. Transparency and honesty are developmental virtues. We learn them over time and throughout our entire lives. Higher levels of transparency are motivated not simply to avoid negative consequences but rather to live in accordance with internalized ethical values.

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Transparency—The Book
Let’s look at a few short quotes from Bennis et al’s 2008 book Transparency: How Leaders Create a Culture of Candor. It's axiomatic: healthy people create healthy families—and healthy organizations. And unhealthy people create unhealthy families/organizations.

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"Danish playwright Henrik Ibsen coined the term "vital lies" for the operative fictions that cover a more disturbing truth in troubled families. A vital lie masks a truth that is too threatening, dangerous, or painful to be spoken aloud. The vital lie preserves the surface harmony of the family but at great cost. Problems that are not acknowledged rarely get better on their own." (34)

*
"The emotion that seals people's lips about vital lies is the unconscious fear that if we look at and speak about these dangerous secrets, we will either destroy the family or be expelled from it. The anxiety of living with these secrets is often allayed by ignoring them." (35)
*
"Just as in families, organizational secrets distort relationships. Those sharing the secret tend to form a tightly knit bond while distancing themselves from outsiders, thus cutting themselves off from those who might expose them as well as those who might influence them in positive ways." (p. 37)

*

"Transparency is one evidence of an organization’s moral health." (p. 42)

*

Reflection and Discussion

1. Recall an experience in your life when you were confronted for your lack of transparency. What did you feel and what did you learn?

*

2. Is there someone right now with whom you would like to be transparent? How could you do this?

*

3. Think of a couple applications—positive and negative—of the quotes from Bennis et al to an organization with which you are familiar. How does transparency affect the organization?
*
4. Let's suppose you have a favorite doll or stuffed animal that watched your actions over the course of your life so far. Sort of like Josephine in the picture above. This benevolent, forthright, and faithful companion could summarize the extent to which you play fairly, honestly, and transparently. What would the doll/stuffed animal say about you, in one to five sentences?

Member Care and the Hippocratic Oath, Part 10—Summary

Hippocrates as Historical Precedent:

Roots and Responsibilities

La saeta lanza

fasta un cierto fito,

y la letra alcanza

desde Burgos a Egipto.

Sem Tob, 14th century, Spain

***

Translation:

Darts hit their mark when carefully thrown

Writings go far when skilfully sown.

***

This is our 10th and final discussion of the Hippocratic Oath. As the above moral proverb indicates (and many thanks to you Sem Tob for your universally-wise rhymes!), the truth in skilfully written words, such as those in the Hippocratic Oath, span across continents, generations, centuries, and health disciplines. The ethical core for health practitioners in the Oath, arguably, is unprecedented as a historical foundation of good practice.

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Just one case in point among many is the current version of the American Psychology’s Ethical Principles for Psychologists and Code of Conduct (2002). This code like its “cousin codes” in related health sciences, is replete what can only be called by this point in our discussions, "hippocratisms.” Smile. Meander through the Introduction and the Preamble, and then on to the General Principles and then Ethical Standards sections and you will quickly bump into such familiar concepts/commitments as doing no harm, responsibility, competence, confidentiality, and yes, even not having sex with clients etc. Check it out at: http://www.apa.org/ethics/code2002.html  The Hippocratic foundation is there (along with other items such as justice, integrity, and rights along with more specific, contemporary standards involving things like psychological testing, court testimony, etc.).

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Final Application

We want to summarize the 10 core principles that we have covered over the past three plus months. These principles are commitments that are explicitly embedded in the Hippocratic Oath (HO). We want to remember our roots and our responsibilties. These core priciples could be likened to being the 10 commandments for healthcare practitioners. But let’s just call it the “10 HO Commitments”. We also list the first draft of the newly condensed version (10 items now) of the “15 Commitments for Member Care Workers” (from the 2006 article “Five Stones for Member Care: Upgrading Ethical Practice.”

(http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx).

*

Well, if this does not have your head spinning yet, then this may well do the trick: The 10 Commitments in the Hippocratic Oath will then be referenced to the 10 MCW Commitments (in parentheses)--although note there is definitely not a one-to-one correspondence. Here we go!

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10 HO Commitments (for health care workers)

1. Foundational Principle: Accountability to a Higher Power

2. High Standards: Agapeoath for Trans-Practitioners

3. Professional Obligations to Respect, Relate, and Reproduce

4. Hippocratic Heart: Dong Good and Doing No Harm

5. Respecting Human Life: Conception through Completion

6. Growing in Character and Competence

7. Prudence: No Sex with Clients

8. Confidentiality as a Lifestyle

9. Consequences of Good vs Poor Practice

10. Historical Precedents: Roots and Responsibilities

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10 MCW Commitments (for member care workers)

1. Ongoing training, personal growth, and self-care. (HO6)

2. Ongoing accountability for my personal/work life, including consulting/supervision. (HO1)

3. Recognizing my strengths/limits and representing my skills/ background accurately. (HO6)

4. Understanding/respecting felt needs, culture, and diversity of those with whom I work. (H03)

5. Working with other colleagues, and making referrals when needed. (HO3)

6. Preventing problems and offering supportive/restorative and at times pro bono services.(HO5)

7. Having high standards in my services and embracing specific ethical guidelines. (HO2)

8. Not imposing my disciplinary/regulatory norms on other MCWs. (H03)

9. Abiding by any legal requirements for offering member care where I reside/practice. (HO9)

10. Growing in my relationship to Christ, the Good Practitioner. (HO1)

*

Reflection and Discussion

We hope these 10 entries since June have stimulated your thinking about new, old, and creative ways to understand member care. Take some time to identify/review three meaningful concepts for you in particular.

*

I especially enjoyed the challenge of trying to relate the moral proverbs of Sem Tob and the indigenous artwork of Diego Rivera with member care thinking and the Hippocratic Oath. Perhaps you would like to have a go at some integrative member care work that includes the arts, sciences, and history etc. too.

*

It has personally been a lot of work and I was not always sure where we would end up. Perhaps the same is true for you. Are you OK for example with the summary in the 10 HO Commitments?
*
I am tempted to close with yet another gem from the Jewish rabbi Sem Tob in 14th century Spain/ However  I want to finish now with something from an anonymous Christian monk in 8th century Ireland. This excerpt from the poem Pangur Ban (White Cat) aptly describes what this integrative journey into "Member Care and the Hippocratic Oath" has been like for me. Like the monk in this poem, I have been hunting at length for the right words to convey my thoughts and I have been keenly aware of how small my wisdom really is. Maybe you have a proverb or short poem that reflects your experience too.

*

I and Pangur Ban my cat

‘Tis a like task we are at

Hunting mice is his delight

Hunting words I sit all night.

*

Against the wall he sets his eye

Full and fierce and sharp and sly

Against the wall of knowledge I

All my little wisdom try.

Member Care and the Hippocratic Oath, Part 9

Should Member Care Practitioners Be Disciplined?

An impeached and disgraced President Nixon,

leaving the White House and US Presidency

some 35 years ago--August 9, 1974.

***

Tórnase sin tardar

la mar mansa muy brava;

el mundo hoy despreciar

al que ayer honraba.

Por ende el grande estado

al hombre que ha saber,

face venir cuitado

y tristezas haber.

Sem Tob, 14th century, Spain

***
Translation:

Just as placid seas quickly turn fierce in a storm

so honor today can become tomorrow’s scorn.

Therefore remember our exalted state

can suddenly turn to sadness by fate.

***
If I keep this oath faithfully,

may I enjoy my life and practice my art,

respected by all men and in all times;

but if I swerve from it or violate it,

may the reverse be my lot.

Hippocratic Oath

***

According to the final part of the Oath, practitioners freely invoke/embrace the consequences of good practice vs poor practice. One’s keeping of this Oath will result in three outcomes:

*

1. Enjoying life vs not enjoying life

2. Practicing health care vs not being able or allowed to practice health care

3. Being respected by people always vs never being respected by people.

*

It is not clear however in the Oath who or what is relegating the consequences for the quality of one’s practice. A god? Fate? Some type of Hellenistic karma? Or is it just the acknowledgement that one does not deserve good things from life if one deviates from properly caring for his/her clients/patients, with the word properly being defined by the general parameters of the Oath? Whatever the case, this is serious business and obviously one should never take such a life-impacting oath lightly.

*

Applications

So should there be consequences for member care practitioners who fail to practice ethically and competently? Yes, of course. This is especially true if they consistently practice unethically and incompetently in ways that hurt others.

*

But what should the consequences be, especially in a field like international member care that is largely unregulated? Should poor practitioners who make serious errors or who are consistently negligent be disciplined or otherwise removed from practice? Probably. But the modus for such action is hazy at best. Perhaps receiving informal or even formal correctives from one’s peers or organizational affiliations are the most we can hope for.
*
In the Hippocratic Oath, there are no specific external referents to regulatory bodies such as a licensing board, a professional ethics committee, or civil law. For many member care practitioners, the same is true: there is no regulatory body to monitor member care practice and to receive any client complaints. This of course is not the case for professional caregivers in member care who are legally certified in a special field and part of a professional association.

*

On the More Positive Side:

Good self-care and good social support are the core safeguards to help one continue to practice well and to avoid impairment in judgement, inferior services, and even burnout. In addition having different interests outside of one’s work, an ability to maintain perspective in difficult times, having fun, and being self-aware are also important qualities to promote well being and foster good practice. Know your limits, know your strengths, and know your relevant ethics codes!

*

Bennett et al in Assessing and Managing Risk in Psychological Practice (2006) remind psychologists [and for our purposes member care practitioners] that good practice is “hard work.” We are encouraged to “Strive for excellence but not perfection” and to know that:

**"You will make mistakes.

**You cannot help everyone.

**You will not know everything.

**You cannot go it alone.

**It is helpful to have a proper mix of confidence and humility.” (p.5)

*
Reflection and Discussion

We are entrusted to help foster the well-being of individuals, couples, children, families, teams, organizations etc. Again, it's serious business for sure! This serious and final part of the Hippocratic Oath reminds me of an admonition in Deuteronomy 28: 1-2, 15, attributed by many to Moses.

*

“Now it shall be, if you diligently obey the LORD your God, being careful to do all His commandments which I command you today, the LORD your God will set you high above all the nations of the earth. And all these blessings will come upon you and overtake you if you obey the LORD your God…But it shall come about, if you do not obey the LORD your God, to observe to do all His commandments and His statutes with which I charge you today, that all these curses will come upon you and overtake you…”

*

Comment on this final declaration of the Hippocratic Oath in light of this portion of Jewish-Christian Scripture (which may have preceded Hippocrates by up to 10 centuries!) and in light of these assertions:

1. There are pros and cons for member care practitioners who say that they are accountable to a Higher Being--God.

*

2. Regardless of one’s profession in life, acting ethically will have certain consequences and acting unethically with have certain consequences.

*

3. Learning and growth do not occur without making mistakes regardless of one’s level of experience.

*

4. “Keep this oath faithfully” (Hippocrates) and “Diligently obey the Lord” (Moses). Both can be easily harmonized and can be done simultaneously.

*

5. Discipline can be misapplied and good practitioners can be seriously hurt by people who are misinformed, overly spiritual, who have political agendas, and in some cases by those who have serious problems themselves. On the other end of the "discipline continuum" are poor practitioners who can essentially do whatever they want with impunity. Both extremes involve serious errors in discipline/accountability with the end result being that people get hurt. The Hippocratic heart (as described in Part 4 of this series) of "doing good and doing no harm" can thus sadly be broken.

Member Care and the Hippocratic Oath, Part 8

Confidentiality as a Lifestyle

Diego Rivera, Women combing each others’ hair, 1957

***
Si fuese el fablar

de plata figurado,

debe ser el callar

de oro afinado.

Sem Tob, 14th century, Spain

***

Translation:

If speech is silver

then silence is gold.

***

All that may come to my knowledge

in the exercise of my profession

or in daily commerce with men,

which ought not to be spread abroad,

I will keep secret and will never reveal.

Hippocratic Oath

***

Keeping confidences is not just a member care practice or a professional standard (e.g., confidentiality is a serious part of “the exercise of my profession” Hippocratic Oath). It is also part of our lifestyle and commitment to integrity in our relationships (e.g., confidentiality is also explicitly included in our “daily commerce with men” Hippocratic Oath).
*

Have you ever wondered when it is OK to share information with another person? Can you tell one friend what another friend told you privately? What if there was no explicit stipulation that you need to keep this information to yourself? Or what if your friend "would not mind" if you told someone else--or so you think/rationalise? Is it just a matter of your discretion to determine, in the terms of the Hippocratic oath “what ought not to be spread abroad?”

*
Likewise when is it OK for us to share private information with a “consultant” in order to get “input”. Who and what constitutes a person being a “consultant” anyway? When might such consultancy be or lapse into more of a thin veneer for a juicy round of gossip or for effecting some unidisclosed manipulative end?

*
The list of questions and situations involving private communications and disclosures is seemingly endless, both in our private lives as well as in our member care work. The adage “when in doubt, don’t” is not a bad place to begin. The counter to all of this however is not to create some culture of secrecy where simply sharing news with each other is somehow hindered or viewed with suspicion.

*
The following material can help give us all some more clarity as member care practitioners. It is from the 2009 article, “Ethics and Human Rights in Member Care: Developing Guidelines for Good Practice” by Kelly O’Donnell

*

When is information considered “confidential”?

The basic consensus among professional codes of ethics is that any information shared during the course of professional services is considered to be "privileged" information. This means that only the "client" (the person asking for help/receiving services) can determine when and how this information can be shared by the helper/member care worker. There are a few important exceptions however when there is a danger to self/others (see below).

*
Confidentiality is a core part of the helping relationship, and a foundation for trust and good practice. It is not just a matter of member care workers (MCWs) simply being “discrete”—which can be interpreted in many different ways—and relying on one’s own “good” judgment concerning disclosures. Rather the MCW abides by a strict standard that honours the client’s rights.

*
Here are three confidentiality examples to consider. The third one was added to this blog entry. It is a a short prosaic piece (indicting almost all of us I'm afraid) on the common practice of ‘indulging in idle talk and rumours about others, especially the private affairs of others, often while feigning noble motives for such improprietous disclosures.’

*
Example One: Member Care Associates

Confidentiality (from Service Agreement)

We want you to know that what you share with us is confidential. The only exception, in compliance with most laws (e.g., American and European), is when: a) you or someone's life may be in danger (e.g., child/elder abuse, suicidal/homicidal threat, gravely disabled); or b) explicit written permission by you has been given to waive confidentiality.
*
Other types of personal struggles can significantly interfere with one's work role and/or credibility of one/s organization (e.g., abusive leadership, addictions, major depression, moral failure, serious marital conflict.) In such cases we usually encourage you to inform a leader whom you trust within your organization(s). We see such struggles as being larger than the helping relationship, and thus usually best handled with the involvement and support of others.
*
Note for group or debriefing services: The material shared by others during the group/debriefing sessions will be kept strictly confidential by the participants.

*
Example Two: American Association for Marriage and Family Therapy (AAMFT)

Confidentiality (Code of Ethics, July 2001)

www.aamft.org/resources/lrm_plan/Ethics/ethicscode2001.asp

Marriage and family counselors/therapists often work with more than one person in a family. It is important to guard each client’s confidence but it can be challenging at times. The AAMFT has developed six points relating to confidentiality. The main ideas in each point are listed below. Be sure to see the full code at the

AAMFT site listed above.

*
1. Discuss the nature of confidentiality to clients and any others involved in the case

2. Do not disclose information without written authorization or when required by the law.

3. Confidentiality is protected when using examples for teaching, writing, research ,etc.

4. Clarity about how to safeguard and destroy records of clients

5. Clarity about how to deal with client records when closing a practice, moving, or dying

6. When/how to disclose information if one consults with colleagues about a case

*
Example Three: The Snake That Poisons Everybody

Author Unknown (1980s)

It topples governments, wrecks marriages, ruins careers, busts reputations, causes heartaches, nightmares, indigestion, spawns suspicion, generates grief, dispatches innocent people to cry in their pillows.

Even it's name hisses.

It's called gossip.

Office gossip. Shop gossip. Party gossip.

It makes headlines and headaches.

Before you repeat a story, ask yourself:

Is it true? Is if fair? Is it necessary?

If not, shut up!

*
Reflection and Discussion

1. In what ways are the above “standards” relevant to member care workers who provide more "informal" services, or who do not have a "professional" certification, or who are not therapists, or who come from different countries?

*
2. How thorough and how specific should such standards be, for different settings in which different types of member care are provided, including counselling, team meetings, or internet communications?

*
3. Confidentiality sometimes leads to misunderstandings. For example, it can be seen as being secretive and withholding important information from an organization about its staff. How can this be minimized?

*
4. Can you think of additional ways to put into personal practice the third example above, on “gossip”?

*
5. How might the above standards apply to protecting information in written and digital form?

Member Care and the Hippocratic Oath, Part 7

Member Care Never Includes Sex

Diego Rivera, Dance of Tehuantapec, 1928

Como el pez en el río,
vicioso y riendo,
non piensa el sandío
la red quel’ van teniendo.

Sem Tob, 14th cnetury, Spain

Translation:

Imprudent people like careless fish get
trapped in their folly and caught in a net.

*****
In every house where I come
I will enter only for the good of my patients,
keeping myself far from all intentional ill-doing and all seduction
and especially from the pleasures of love with women or with men,
be they free or slaves.
Hippocratic Oath
*****

As member care providers and those with member care responsibility, we are committed to the good of those with whom we work. We do good and do no harm. We enter into many types of houses so to speak (the term used in the Hippocrates Oath) during the course of our work. Houses can be literal as well as represent peoples’ lives, organizations, countries, and cultures. We are trusted guests. No matter how helpful or beautiful or fun or anything one might wish to frame such an experience:

There is no ethical context
for having member care sex.

*
So chill out. Take a cold shower. Stay accountable to colleagues. Because having sexual relationships with people who receive our services–-regardless of our world views or spiritual leanings--is a no go. Just don’t do it. And don’t even think about it. But do think about and stay in touch with your own sexuality.
*
The same goes for romance, as you will note in the examples below of professional principles, codes, and laws. Remember there are millions of other foxes in the lea and fish in sea besides that "irresistible" person you are trying to “help.”
*
Sexual Purity in Missions (p. 249-250)
Dr. Ken Williams in Doing Member Care Well, 2002
[Note: This article is also available in Chinese, Arabic, Spanish, Portuguese, and Korean. The article also includes two helpful self-assessment tools. The English and Chinese versions are available in Section Five (Special Issues) at http://www.chinamembercare.com/]
*
Being sexual and sane these days is no easy thing …We need to be just as concerned about understanding the normal and healthy aspects of human sexuality as we are about its potential dangers and downside. What a powerful and lovely gift we have from the Creator!
*
Professional Therapy Never Includes Sex, 2004, (p. 5)
California Department of Consumer Affairs
http://www.psychboard.ca.gov/formspubs/proftherapy.pdf
*
Professional psychotherapy never includes sex. It also never includes verbal sexual advances or any other kind of sexual contact or behavior. Sexual contact of any kind between a therapist and a patient is unethical and illegal in the state of California. Additionally, with regard to former patients, sexual contact within two years after termination of therapy is also illegal and unethical.
*
Sexual contact between a therapist and a patient can also be harmful to the patient. Harm may arise from the therapist’s exploitation of the patient to fulfill his or her own needs or desires, and from the therapist’s loss of the objectivity necessary for effective therapy. All therapists are trained and educated to know that this kind of behavior is inappropriate and can result in the revocation of their professional license.
*
Therapists are trusted and respected, and it is common for patients to admire and feel attracted to them. However, a therapist who accepts or encourages these normal feelings in a sexual way — or tells a patient that sexual involvement is part of therapy — is using the trusting therapy relationship to take advantage of the patient. And once sexual involvement begins, therapy for the patient ends. The original issues that brought the patient to therapy are postponed, neglected, and sometimes lost.

*
Many people who endure this kind of abusive behavior from therapists suffer harmful, long-lasting emotional and psychological effects. Family life and friendships are often disrupted, or sometimes ruined.
*
Ethical Principles of Psychologists and Code of Conduct, 2002
American Psychological Association
http://www.apa.org/ethics/code2002.html
*
Principle A: Beneficence and Nonmaleficence. Psychologists strive to benefit those with whom they work and take care to do no harm…Because psychologists' scientific and professional judgments and actions may affect the lives of others, they are alert to and guard against personal, financial, social, organizational, or political factors that might lead to misuse of their influence. Psychologists strive to be aware of the possible effect of their own physical and mental health on their ability to help those with whom they work.
*
3.02 Sexual Harassment. Psychologists do not engage in sexual harassment. Sexual harassment is sexual solicitation, physical advances, or verbal or nonverbal conduct that is sexual in nature, that occurs in connection with the psychologist's activities or roles as a psychologist, and that either (1) is unwelcome, is offensive, or creates a hostile workplace or educational environment, and the psychologist knows or is told this or (2) is sufficiently severe or intense to be abusive to a reasonable person in the context. Sexual harassment can consist of a single intense or severe act or of multiple persistent or pervasive acts.
*

10.05 Sexual Intimacies With Current Therapy Clients/Patients. Psychologists do not engage in sexual intimacies with current therapy clients/patients.
*

10.06 Sexual Intimacies With Relatives or Significant Others of Current Therapy Clients/Patients. Psychologists do not engage in sexual intimacies with individuals they know to be close relatives, guardians, or significant others of current clients/patients. Psychologists do not terminate therapy to circumvent this standard.
*

10.07 Therapy With Former Sexual Partners. Psychologists do not accept as therapy clients/patients persons with whom they have engaged in sexual intimacies.

*
10.08 Sexual Intimacies With Former Therapy Clients/Patients.

(a) Psychologists do not engage in sexual intimacies with former clients/patients for at least two years after cessation or termination of therapy.

*

(b) Psychologists do not engage in sexual intimacies with former clients/patients even after a two-year interval except in the most unusual circumstances. Psychologists who engage in such activity after the two years following cessation or termination of therapy and of having no sexual contact with the former client/patient bear the burden of demonstrating that there has been no exploitation, in light of all relevant factors, including (1) the amount of time that has passed since therapy terminated; (2) the nature, duration, and intensity of the therapy; (3) the circumstances of termination; (4) the client's/patient's personal history; (5) the client's/patient's current mental status; (6) the likelihood of adverse impact on the client/patient; and (7) any statements or actions made by the therapist during the course of therapy suggesting or inviting the possibility of a posttermination sexual or romantic relationship with the client/patient. (See also Standard 3.05, Multiple Relationships.)
*
Reflection and Discussion
1. To what extent do the above principles and codes (from the USA) apply to member caregivers with various backgrounds and in other countries? Can the above standards and caveats be written (or are they alredy written) in such a way as to be universal?
*

2. What are some of the safeguards you and those in your setting have to avoid sexual intimicies with the people you are trying to help?
*

3. What is the best way to handle a situation in which you are infatuated with a person (client, student, colleague, neighbour) and having a sexual or romantic relationship is likely although clearly not appropriate (due to marriage, the nature of your member care relationship, values, etc.).
*

4. Condoms are currently handed out freely all over the globe. So will the  day ever come when it will be seen as OK or even "ethical" to give condoms to clients when they walk into our member care offices--and lives? Just in case something happens between helper and helpee?
*

5. How should we respond to member caregivers who have sexual intimicies with those that they are trying to help?

*

Note: This entry did not get into the topic of "intentional ill-doing" as stated in this part of the Hippocratic Oath. What would such "ill-doing" involve? Probably the exploitation of others for one's own selfish ends (e.g., overcharging, spreading gossip about a person, deceiving someone concerning credentials and qualifications, not admitting errors etc.).

Member Care and the Hippocratic Oath, Part 6

Character and Competence

La Era (garden), Diego Rivera, 1904
*****
El sabio, con corona,
como leon semeja;
la verdad es leona
la mentira es gulpeja.
Sem Tob, 14th century, Spain

Translation :
Wise people are like lions:
Crowned in truth they hold their ground.
But lying foxes run around.
*****
But I will preserve the purity of my life and my arts.
I will not cut for stone,

even for patients in whom the disease is manifest;
I will leave this operation to be performed by practitioners,

specialists in this art.

Hippoctratic Oath
*****

For member care practitioners, and all of us with member care responsibility, character and competence are inseparable in our lives. Said another way, we want to extol and develop both virtue and skill. And we want to help others–-fellow practitioners, organizations, clients, etc—to do the same.
*
The notion of character, broadly speaking, is embodied in the Hippocratic commitment to “preserve the purity of my life and arts”. It necessitates practicing ethically and living ethically.
*
The notion of competence—or more specifically working within one’s sphere of competency—is seen in the commitment to “not cut for stone”. Apparently this refers to the surgical removal of things like gall stones or kidney stones. Such practices at that time in 4th century Greece were not part of the purview of medical practitioners.
*
It bears mentioning that during our work in member care we are often stretched both:

**ethically (not everything in our work of course is black and white—and we cannot always know the consequences of our interventions) and

**experientially (not everything we do fits neatly into our training backgrounds—and we cannot always know what the “best practice” will be).
*
I appreciate the simile of the lion cited above from Rabbi Sem Tob’s heptasyllabic quartet (that sounds serious—well, what I mean is that it is a short poem written in a certain manner :-) Tob's creative gem states that our crowning wisdom is demonstrated through our courage and clarity in speaking/acting truthfully (holding our ground with the truth, not being distracted from our course, and being open to input when the truth is not clear).

*

By “truth” I mean the conformity of mind to reality, as the Scholastics would say (e.g., Thomas Aquinas et al). Of course we could then ask what is mind and what is reality! But I will leave that for others to deal with who are far more learned than I am.

*

What I am really getting at here via the blend of Sem Tob's morality poem, Hippocrates' oath, and Rivera's painting, is that we are committed in the member care field to work knowledgeably and ethically within our "gardens"--that is, our spheres of influence. Knowledge and ethics are all part of the character/competency core.
*
Here are three related items--resources--that you will hopefully find helpful. (from Kelly O’Donnell)
*
1. Some Suggested Ethical Guidelines for the Delivery of Mental Health Services in Mission Settings, Helping Missionaries Grow, (1988) p. 469
**MHPs [mental health practitioners in missions] are dedicated to high standards of competence in the interest of the individuals and mission agencies which they serve. They recognize the limits of their training, experience, and skills, and endeavor to develop and maintain professional competencies. MHPs keep abreast with current professional information and scientific research related to their work in mission settings.
-----
2. Upgrading Member Care: Five Stones for Ethical Practice (2009)
**MCWs are committed to provide the best services possible in the best interests of the people whom they serve…. Character, competence, and compassion are necessary to practice member care well.
*

**[Character] refers to moral virtue, emotional stability, and overall maturity. Basically, the qualifications for leaders in Timothy and Titus reflect the types of character traits needed for MCWs. Those in member care ministry have positions of trust and responsibility, and work with people who are often in a vulnerable place. Therefore they need to model godly characteristics as they minister responsibly—to protect/provide for those who receive their services…

*

**[Competence] refers to having the necessary skills to help well (via life experience and training). I have found that competence is not necessarily based on degrees or certification, although the systematic training that is required to get these “validations” is a very important consideration. Others without such institutional validation are also capable of doing member care well (usually via more supportive than specialized care), and indeed in many places they are the primary service providers (e.g., peers, team leaders). Note that MCWs, like others in the health care fields, can be “stretched” at times to work in ways that may go beyond their skill level. And many services can be in ambiguous, complex, and difficult settings, with the outcomes (positive or negative) not easy to predict. Caution and consultation with others are needed in such cases…
*

**[Compassion] refers to our core motivation for member care work. It is the love of Christ that compels us. We value people for their inherent worth, and just for their “important” work.
-----
3. Member Care Involvement Grid—Strengths and Preferences (2003, adapted)
This grid helps us to identify the “fit” and practice parameters for ourselves and colleagues. This grid is a continuum. It could also be used as part of a simple/informal team building exercise as a way to get to know other MCWs and understand their strengths and preferences. Note that there are many other items that cold be included on this grid. What would you include?

*
Administration focus/involvement-----People focus/involvement
Working by oneself mostly-----Working as part of a group mostly
Mostly provide member care-----Mostly develop member care
Working groups that Talk/think-----Work groups that “Task”/do
Services as needed/requested-----Systematic/planned services
Local geographic focus-----International geographic focus
One main ministry focus-----Multiple ministry focus
One specialty-----Many specialities
One organization focus------Interagency focus
Connection in a sector-----Connection in many sectors
Additional
*****

Reflection and Discussion (apologies for the “leading questions”!)
1. Should the member care field be regulated to better ensure the quality of services and qualifications of service providers? If so, how?
*
2. How do we measure competence in member care practitioners?
What could be some specific behavioural criteria to consider (so not just academic degrees, titles, job descriptions, time living in another culture etc.)?
*
3. How could the member care sector build program evaluation/outcome studies/research into the member care field in order to empirically measure the effectiveness of the various types of services/interventions that we provide? Is it appropriate—ethical--to continue providing and developing services without assessing their effectiveness?

*

4. How relevant is the notion of developing evidence-based, expert-consensus guidelines for member care practice? What are the criteria for "evidence"--"expert"--"consensus"?!

Member Care and the Hippocratic Oath, Part 5

Respecting Human Life—From Conception to Completion

Diego Rivera, Flower Day

No tengas por vil hombre
por pequeño que lo veas,
nin escribas tu nombre
en carta que non leas.
Sem Tob, 14th century, Spain

*

Translation:
Don’t look down on people because they may be small
Don’t sign a document unless you’ve read it all.
*
There are an estimated 42 million abortions each year worldwide.
Over 80% take place in the “developed” world.
http://www.abortionno.org/Resources/fastfacts.html

*****

Hippocrates Then and Hypocrisy Now?
I will not give a woman a pessary to cause an abortion.
But I will preserve the purity of my life and arts.
Hippocratic Oath, circa 400 BC

Didache Then and Deadkids Now?
There are two ways, one of life and one of death, but a great difference between the two ways…you shall not murder a child by abortion nor kill that which is born.
Didache—The Teaching of The Twelve, circa 100 AD

Conception Then and Concession Now?
I solemnly pledge myself to consecrate my life to the service of humanity…I will maintain the utmost respect for human life from the time of conception, even under threat, I will not use my medical knowledge contrary to the laws of humanity...
Declaration of Geneva, adopted by the General Assembly of the World Medical Association, Geneva, Switzerland, September 1948.

The current amended version of the Declaration of Geneva excludes “conception” and says:
"...I will maintain the utmost respect for human life..."

Humans Then and Non-Humans Now?
Quotes from Physicians for Life web site:
http://www.physiciansforlife.org/

*

American Medical Association. For 125 years, the American Medical Association took a firm anti-abortion position, declaring in 1859 that abortion is the "unwarranted destruction of human life." In 1871, the AMA denounced doctors who would perform abortions as "false to their professions, false to principle, false to honor, false to humanity, false to God." But, in 1989, the AMA called abortion a "fundamental right," to be decided "free of state interference" in the absence of compelling justification.
*

The United Nations. The United Nations Declaration on the Rights of the Child, adopted by the General Assembly in 1959, stated that a child "needs special safeguards and care, including appropriate legal protection, before as well as after birth." This is reaffirmed in the 1990 United Nations Convention on the Rights of the Child.
*
Planned Parenthood. In 1963, Planned Parenthood insisted that the organization's birth control campaign did not support abortion, stating: "An abortion kills the life of a baby after it has begun."
*
California Medical Association. The California Medical Association, in 1970, declared abortion to be "killing" and referred to "the scientific fact, which everyone really knows, that human life begins at conception and is continuous whether intra- or extra-uterine until death."

Reflection and Discussion
1. Physicians for Life says that “Until the 1970s, medical professionals, human rights groups, and birth control providers traditionally understood human life to begin at conception/fertilization.” If this is accurate, then what has changed and why?

2. Should unborn humans be considered to be an unreached people group (UPG)? If so to what extent is this understanding being incorporated into mainstream missiological thinking and practice?

3. What is the place of member care, broadly speaking, for prenatal humans? How could member care practitioners also help in the areas of human sexuality and reproductive health on behalf of postnatal humans?

4. The American Psychological Association has emphasised and supported research that looks at the mental health effects of abortion on mothers/parents. We are wondering if psychologists have explored the mental health effects of abortion on unborn humans--you know the luckless recipients of abortion. Any ideas for “research”? Who knows. Perhaps the dismembered and/or scorched mass of previable fetal parts could actually score quite well on a standardized Mental Health Exam. It might even be oriented for (non)person, place, and placenta, inspite of having a relatively low APGAR score.

My God and my fellow post-natal humans:

this is rubbish and it has to stop!

5. Here’s a short video expressing the beauty and humanness of prenatal life, accompanied by a song from the musician Joe Cocker (You Are So Beautiful).
http://www.youtube.com/watch?v=LdxWFr_UjqQ&feature=PlayList&p=D0E2770173A13165&index=5

**Note 1: To see the Rivera painting that we preferred to put here, go to this web site and click on the second grouping in the gallery (thumbnails) and then click on the last (eigth) painting):

http://www.diegorivera.com/gallery/index.php

**Note 2: It is important to confirm the sources, context, and accuracy of the above quotes for the web site of Physicians for Life. We have not yet been able to do so, but the quotes do fit with the predominant medical/ethical thinking of the times indicated.

**Note 3: This has been the most difficult (saddest and emotionally draining) weblog entry we have done to date.

Member Care and the Hippocratic Oath, Part 4

The "Hippocratic Heart":

Doing Good and Avoiding Harm

Diego Rivera, The Vendor of Lillies

Non hay tan buen tesoro
como el bien facer
nin tan precioso oro
nin tan dulce placer.
Sem Tob, 14th century, Spain

Translation:

Doing good is the greatest treasure,
Better than gold, better than pleasure.

*****
“I will prescribe regimens for the good of my patients
according to my ability and my judgment
and never do harm to anyone.”
Hippocrates, 4th century, Greece
*****

This portion of the Hippocratic Oath can be summarized in two words and also in two phrases: Benevolence—Do good and Nonmaleficence—Do no harm. So much of helpful and ethical health care practice is founded upon these timeless principles.
*
Applications for the "Hippocratic Heart"
1. Memorize. A suggestion: Do you know other languages besides English? If so, get an accurate translation of these two words and two phrases, especially in your heart language. Memorize them.
*
2. Competency. We practice within our level of competency (“ability and judgement”). We also acknowledge that we will be “stretched” at times in our practice, and may be called upon to help in ways that are not fully within our experiential, training, and certainly comfort zones. Is this OK? Consult with colleagues as much as possible in such situations. In addition and in general, get supervision as needed. Participate in peer supervision and group case consultations. These all help us in doing good (good practice) and avoiding ham (poor practice).
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3. Love. The foundational principles of benevolence and nonmaleficence are clearly reflected throughout the New Testament. They can be seen as core principles founded upon the bedrock of “love”. Here are some quotes.
*
**Let love be without hypocrisy. Abhor what is evil; cling to what is good.
Romans 12:9
*
*Love works no evil to a neighbour. Love therefore is the fulfillment of the law.
Romans 13:10
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**Let us not lose heart in doing good…let us do good to all people, especially those who are of the household of the faith.
Galatians 6:9,10
*
Reflection and Discussion
1. Primum non nocere--first, do no harm. Sometimes this principle is used without the accompanying principle of “doing good” What are your thoughts about the possible sufficiency of nonmaleficence?
*
2. Sometimes we are in situations when we are not sure of the best course of action or the best intervention/treatment. Nor are we able to foresee the consequences of our work. A classic example is if we help one person in a dysfunctional system, will that lead to positive change in the overall system as hoped or will it lead to greater problems for the healthier person and the system—e.g., the person may have to still reamain part of the dysfunctional system and may be dependent on the system as he/she tries to effect healthy change. Comment on such situations and give any examples in your life, practice, current international events, history.
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3. It is helpful to make organizational applications of the principles of Benevolence—Do good and Nonmaleficence—Do no harm. For example, what practices can organizations put into place to make sure that leaders, staff, the ethos, policies etc. do in fact reflect these core Hippocratic principles?

Member Care and the Hippocratic Oath, Part 3

Some Ideas for Responsible Practice:

Respect, Relate, Reproduce

*****

Diego Reivera, The Flower Carrier, 1935

*****

Non hay tan dulce cosa

como la fidelidad

nin miel tan sabrosa

como la buena amistad.

Tem Tob, 14th century, Spain

*

Translation:

Good, faithful friends are sweeter than anything.

*

“To consider dear to me, as my parents,

him who taught me this art;

To live in common with him and, if necessary,

to share my goods with him;

To look upon his children as my own brothers,

to teach them this art.”
*

This second section of the Oath, quoted above, might not seem too applicable for us in the member care field. The type of close teacher-student relationship described here is not exactly the same today as it was 2400 years ago in Greece. But let’s look into it more closely. I would like to suggest that we extract three broad principles from this section that are relevant for member care practitioners.
*

Applications
1. Respecting Senior Colleagues.
We show respect to (and “consider dear”) the senior practitioners in our field. For me, this applies to people whose proven character and proven contributions are sustained over time. It especially applies to those aged 70+ who were working in the pre-member care field in the 1970s and even 1960s. We show respect by listening carefully to their input and honouring them in our gatherings.
*
Personally I so enjoy learning more about our roots as a field and the efforts of those who trail blazed so long ago. Often these folks were not even aware that they were blazing anything but rather thought that they were just doing their job. These folks in their steadfastness and depth inspire me: Stringham, Lindquist, Foyle, Narramore the Grossmans and surely many more! As Tolkien says of Aragorn, a “senior (Ranger) practitioner” in the Lord of the Rings, “the old that is strong does not wither, deep roots are not reached by the frost.”
*
The Oath indicates that the teachers and the students have a close personal and working relationship. They may even “live in common”. I likewise want to encourage member care workers and senior practitioners to connect closely together for personal and professional learning. Would it ever be possible for practitioners and senior practitioners to “live in common” in some sense? Now that is quite an idea! Perhaps the closest thing that I am aware of is sharing a room together at a conference for a week, or working on a field-based project for a few weeks, or working on staff together as part of a course or school for a few months. And maybe there are additional types of relationships that we can creatively consider. Why not?
*
The Oath also mentions providing practical support for teachers/senior practitioners as needed. The labourer is worthy of her/his wages. Note that there is no clear requirement for remuneration in the Oath, and perhaps this is not mentioned so that senior practitioners would not be tempted to exploit underlings for money. Perhaps the default arrangement as much as possible was pro bono instruction. Paul the Apostle gets into this point in 2 Corinthians 11 regarding his status as a senior (apostolic) practitioner. He reminds the Corinthians (as he did the Thessalonians and other churches, e.g., I Thes. 2:9) that he served them freely and was not a financial burden to them even though he could have honourably and ethically asked them to help meet his needs. Bottom line: keep our financial relationships clear, and don’t exploit anyone who needs our services or whose services (such as training) that we ourselves need.
*
2. Relating Closely with Colleagues.
Our relationships with the family members of teachers/senior practitioners is the next broad principle. Apparently priority was to be given to children (sons) of the medical teachers. There seems to be a sense of duty to look after the teacher’s children as well as a strategic sense that the children will be in a good place to continue the medical profession, having watched and learned from their parent who is a physician.
*
How to apply this? Well, I like the idea of getting to know the families of senior colleagues and also the families of a few close colleagues. Many family members and others can benefit beyond the dyadic teacher-student relationship. And maybe we will be seeing second or even third biological generations of member care practitioners. Again I say, why not? But consider these caveats: let’s avoid any type of nepotism or favouritism in the member care community. And let’s not confuse professional roles and responsibilities with personal preferences and gain that produce conflicts of interest, not to mention envy and resentment.
*
3. Reproducing Knowledge/Skills.
We provide services but we also try to multiply our services reesponsibly. In fact, as member care practitioners we try to multiply ourselves—our competencies as well as our character. Training in many contexts can thus also involve "imparting our own lives" (I Thes. 2: 8). This is a special privlege and responsibility to be taken very seriously. It also requires accountability. “Let not many of you become teachers knowing that as such you shall receive a stricter judgement” (James 3:1).

*
One additional application is to mention that it is especially challenging to offer instruction well in light of the diversity of the member care world and mission/aid settings. One example among many: how to intervene in a “troubled” family/team setting in which the parent/team leader is seen as being rigid and authoritarian by some members and as exercising firm, caring authority by others? These types of sitautions certainly "stretch" our own experiential and practice boundaries. Good member care practice often requires going beyond the familiar (or with reference to the Oath, we go beyond the family of our senior teachers) in order to embrace the diverse. We have to cross sectors and disciplines, genders and generations, in addition to crossing cultures. Have a look at the material from the World Federation of Mental Health, prepared for World Mental Health Day 2007: Mental Health in a Changing World: The Impact of Culture and Diversity

http://wfmh.org/COVERS/2007WMHDAY.jpg
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Final Thought
An important part of our member care practice involves responsibly: a) respecting other practitioners, b) relating to other practitioners, and c) reproducing other practitioners. Can we really read all of these responsibilities into the second section of the Hippocratic Oath? Well, yes, in a general way. Without overstepping our interpretive bounds, we can build upon our Greek predecessors. We can use this part of the Oath as a further springboard to help us consider how we want to practice responsibly.
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Reflection and Discussion
1. Is there a senior colleague with whom you regularly relate? Do you have any special type of agreed-upon relationship?
*
2. Are there member care workers who look to you as being something like a senior colleague, and consult with you for help?
*
3. Who are your closest colleagues? How close are you to their family members?
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4. What are the pros and cons of member care workers who link personal and professional relationships together?
*
5. In what ways are you reproducing your knowledge and skills within your sphere of influence? What thoughts do you have about training (i.e. responsible multiplication) in light of the diversity of caregivers/settings?

Member Care and the Hippocratic Oath, Part 2

Should Member Care Practitioners Take an Oath Too?

*****

*****

Face rico los hombres

con su prometimiento;

después fállanse pobres

odres llenos de viento.

Sem Tob, 14th century, Spain

Translation:

You might get rich by false promises tried

But you'll end up poor and empty inside.

*****

Many medical practitioners, health care professionals, politicians, and others have historically taken “oaths”. These oaths have been solemn commitments by people with important responsibilities, who are recognized for having mastered a certain body of knowledge and skill sets, and thus able to competently and ethically practice a profession. How might taking such an oath be relevant for the very diverse and largely unregulated member care field?

*

Commitments and Agapeoath

The Hippocratic Oath begins with: “I swear…to keep according to my ability and my judgment, the following Oath and agreement.” See the previous entry to view the full Hippocratic Oath. I personally can imagine member care practitioners taking some type of an oath as part of their commitment to practice member care competently and ethically. Such an oath would lbe volunatary, likely brief, and include wording that would give it universal appeal and relevance for faith-based pratitioners from a variety of backgrounds.

*

I would like to propose something called an agapeoath (agapeo + oath = agapeoath; pronounced uh-gah-PAY-oath). This term embodies the essence of sacrificial love (agapeo) and a serious promise (oath). It would be a solemn commitment to practice true love in a member care context as we endeavor to do good/do no harm to those who receive our services and as we pursue ongoing healthy relationships (aka "relational resiliency") with fellow workers.

*

This commitment is sustained in spite of work/life's difficulties "come hell or high water." It is tough love that perseveres and does not "sell" one's integrity, principles, or colleagues for thirty pieces of anything when the going gets tough. It is practical and observable not simply idealistic or ethereal. It is love which "swears to one's own hurt"-- that is, keeping your word even when it may cost you things like your reputation and finances (Psalm 15: 4).
*

Commitments and Trans-Practitioners

What also makes much sense to me is embracing a series of commitments to practice member care responsibly. These commitments would be founded upon agapeo per the previously mentioned foundational oath of agapeo--agapeoath. Is this moving in a direction that the diversity of member care practitioners could embrace? I think so, but it is something to be discussed broadly.
*

I would like to introduce another term: trans-practitioner. This term refers to member care workers who intentionally cross cultures, disciplines, sectors, organizations, genders, generations, and other "borders" for the sake of mutual learning and good practice. Trans-pracitioners seek and use core concepts which are relevant in many settings. One example is the set of “15 Commitments for Member Care Workers” that promotes high standards for character and competency and that aim to be applicable to the diversity of member care workers. These commitments are discussed earlier on this blog (see April 29, 2007) and in the article Ethics and Human Rights in Member Care (2009): http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx
*

Taking the High Road
The member care field is fairly loose. Not surprisingly, some unfortunate and clearly erroneous practices have occurred. We probably all know of cases where people receiving services have been negatively impacted; where there have been unresolved relationship struggles that have not been dealt with adequately and which have seriously injured people and disrupted mission/aid work; and where unchecked personal/systemic dysfunction have put wedges within different commiunities including the practitioner community.

*

We can change these problem areas. But to do so we must not be afraid to admit them, discuss them, work through them, learn from them, and put appropriate safeguards in place. Such actions will require courage--a courage that seeks mutual transparency, accountability and the welfare of all. It will require integrity: an integrity which is not just based on living harmoniously with one’s own internal norms but based on the fuller integrity which arises from living congruently with externally-referenced norms/high standards such as the 15 commitments mentioned above.

*

Maybe it is time to adjust our course as a field in a way that will help sustain us through the dark days and intense challenges in this world. Maybe it is time to take the higher road, a road demarcated by trans-practitioner commitments founded upon a solemn oath of agapeo.
*
Final Thoughts

Hippocrates was not just on the right road. He helped forge the right road. He took his professional responsibility seriously as well as that of his colleagues and his students. He made a serious, public commitment to practice competently and ethically. Member care workers would do well to do the same.
*

Reflection and Discussion
1. Should every member care practitioner have a clear set of commitments to which she/he is accountable? Consider this question in light of the above comments and in light of this quote: (context is exploring the relevance and lack of relevance of ethical codes for member care workers)

*
“Many types of professional ethical codes exist that can relate to the practice of member care. For some practitioners, these codes are essential and are a good “fit.” But one size does not fit all! For example, as a psychologist and as an international affiliate of the American Psychological Association (APA), I abide by the APA’s Ethical Principles of Psychologists and Code of Conduct (2002). But a skilled Nigerian pastor providing trauma training/care in Sudan may not find this code so helpful. Such ethical codes are primarily relevant for the disciplines and countries for which they were intended. Yet many MCWs enter the member care field via a combination of their life experiences and informal training, and are not part of a professional association with a written ethics code. Common sense and one’s moral convictions only go so far. Further, appealing to another country or discipline’s ethical code can result in a rather cumbersome mismatch between the person and the code.” Ethics and Human Rights in Member Care (2009), Kelly O’Donnell
*

2. How could a set of commitments help keep member care practitioners working together competently and with good relationships? Consider this question in light of the above comments and in light of this quote:

(context is a description of how the growing "darkness" has surrounded the woodland kingdom of the elves , and the consequences to relationships to peoples of good will in Middle Earth)
*

"Indeed in nothing is the power of the Dark Lord more clearly shown than in the estrangement that divides all those who still oppose him...We live now upon an island amid many perils, and our hands are more often upon on the bowstring than the harp." The Fellowship of the Ring (1954), J.R.R. Tolkien
*

3. Love is all you need, right? Consider this question in light of the above comments and in light of this quote:

(context is identifying some of the essential future directions for the member care field)
*

"Above all, the core of E2MC [that is, Ethne to Ethne Member Care—providing/developing member care for/from all people groups] involves the trans-ethnê, New Testament practice of fervently loving one another—like encouraging one another each day; bearing one another’s burdens; and forgiving one another from the heart. By this all people will know that we are His disciples (John 13:35). The Great Commission and the Great Commandment are inseparable. Our love is the final apologetic. It is the ultimate measure of the effectiveness of our member care.” God in the Global Office, 2009, Kelly O’Donnell

Member Care and the Hippocratic Oath, Part 1

Hippocrates and Higher Powers

Non hay lanza que pase 
todas las armaduras,

nin que tanto traspase

como las escrituras.
Sem Tob, 14th century, Spain

***
Translation:

No spear can pierce all armour in a fight

Nothing penetrates like words that we write.

***

This is the first of 10 brief discussions about the Hippocratic Oath and its relevance for member care. As the above 14th century proverb suggests, the written word--in this case the Hippocratic Oath--has adeptly penetrated practitioner hearts, human history, and the health sciences themselves.
*

I really enjoyed studying Greek mythology and life in ancient Greece as a boy. It was thrilling to read over and over again about the heroic feats of Achilles at Troy; the decade-long wanderings of courageous Odysseus; the harrowing foot race along the sea between peerless Atlanta and love-struck Hippomenes; the atoning descent into treacherous Hades by Heracles; satyrs, naiads, centaurs, tritons, and many other mostly delightful mythical creatures. So intentionally meandering now into the ancient Greek world has both a familiar and fascinating feel to it!

*

Hippocrates lived in the fourth century BC (circa 460-370 BC). He is considered to be the "father" of western medicine and is credited with helping to further develop and establish the practice of medicine in Greece at a time when Greek civilization was flourishing under Pericles.
*

The Hippocratic Oath (reproduced below, translation by the National Institute of Health in the USA) is attributed to Hippocrates and pertains to the ethical practice of medicine. What were the core principles to embrace which would guide specific medical interventions? The Oath summarizes these key principles. Physicians in his day and beyond swore this oath or some variation of it. The principles of "doing good and doing no harm" for example, are still widely accepted and a usefulwayto summarize the Oath itself.

*

The Oath is relevant in so many ways for member care practitioners and the member care field. The first application we propose is to look at the opening salvo and consider our work, as Hippocrates et al did, in light of Higher Powers and accountabilty.

*

A Foundational Application

By Jove, by the gods above, by Apollo, or by Whoever or Whatever, we humans are not alone in our health care activities. Hippocrates appealed to a Higher Power (gods) to whom all humans and physicians were ultimately accountable and in some sense dependent upon. The specific gods listed by Hippocrates were apparently linked to healing in Greek religion/mythology (Apollo, Asclepius, Hygieia, and Panacea).

*

Member care practice likewise starts with a Higher Power--God--who sees all, knows all, is the source of healing, and who holds us accountable for our personal and professsional actions. It is not ultimately good practice codes or professional standards to which we are accountable, but a Creator. We also note for reference that "Master Care"--care for and care by God the Master--is placed at the center (beginning) of the international/macro member care model (Doing Member Care Well, 2002, chapter one).

*

Further, we as member care practitioners facilitate healing because being made in the image of God, we emulate the Creator who heals. In the Judeo-Christian tradition, this is YHWH-Rapha, a special name for God which means the Lord that Heals. So perhaps we might see Hippocrates et al as getting their theology wrong, but they were certainly on the right track as they began with and appealed to Higher Powers as being the "first principle" to consider for their healing arts.

*

In short: Member care starts with God. Member caregivers are accountable to God. Simple.

*

Hippocratic Oath (other translations/versions are slightly longer but essentially the same)

I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement:

*

To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art.
*

I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.
*

I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.

*

But I will preserve the purity of my life and my arts.
*

I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.
*

In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.

*

All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.
*

If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.

*

Reflection and Discussion

Member care should not be ahistorical.

Comment on this assertion

*

Member care also has some roots outside of the Judeo-Christian tradition and which pre-date the New Testament.

Comment on this assertion.

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Member care, like any of the helping professions/healing arts, must philosophically and ethically start with a First Principle, a Higher Power.

Comment on this assertion.

Note: During these 10 discussions of the Hippocratic Oath we will introduce two additional items into the integrative mix: a special proverb and a special work of art. Our goal is to broaden our understanding of member care in some new and creative ways.These two items are:
a. a related proverb from Sem Tob, a relatively unknown 12th century Rabbi in the court of Peter I in Castilla, Spain.
b. a related piece of art from Diego Rivera, the widely-known 20th century Mexican artist who created large murals depicting various social themes as well as paintings depicting indigenous life in Mexico.

Member Care: Pearls and the Perils--Introductory Devotional

Named, Known and Called
Dr. Cynthia Eriksson, Fuller School of Psychology, USA

This encouraging devotional, given 19 February, 2009, set the stage for the three lectures that followed at Fuller’s Integration Symposium. Cynthia Eriksson shares her journey as a missionary with mental health training and as a psychologist in missions. Using the interaction of Jesus and Peter in John 21: 15-19, she encourages us to live in the freedom of who we are and the freedom of who we are called to be. Her healing words are especially addressed to those of us in leadership: like Peter our frailties are not so much obstacles as they are a means to experience God’s grace, relationship, and call to lead.

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We think you will hear some very helpful comments by Cynthia as she intertwines her own life experiences with those of Peter’s. Her devotional and the opening remarks to the Symposium are about 37 minutes, and available to download for free in audio and video formats at:

http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx

*****

*

Reflection and Discussion

1. Summarize Cynthia's main point in one sentence. How does it apply to your life practically?

*

2. List two charactersitics of Peter that are similar to your own characteristics. Are these areas we need to change or are they more like weaknesses that we need to live with?

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3. What are you thoughtts on Cynthia's assertion that Peter could still be called to lead in his broken state? How might this apply to your own leadership?

Member Care: Pearls and Perils, Lecture 3

Ethics and Human Rights in Member Care:

Developing Guidelines for Good Practice
*****

This third lecture at Fuller School of Psychology (February 2009) explored ethical principles for member care workers and sending groups as well as how human rights commitments are foundational for member care work. The goal was to move towards a trans-cultural/conceptual framework for ethics as a way to upgrade the work we do in member care and mission/aid. The emphasis on human rights is a new contribution to the development of the member care field. The lectures are available on line for free in written, audio, and video formats. We have included a few excerpts below from the third lecture to encourage you to download and watch the video.

http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx

Shining light on good practice. © 2008 MCA/KOD

Perspectives on Ethics
Member care is a broad field with a wide range of practitioners. As this field continues to grow, it is important to offer guidelines to further clarify and shape good practice. Any guidelines must carefully consider the fact of the field’s international diversity, and blend together the best interests of both service receivers and service providers. They also need to be applicable to member care workers (MCWs) with different types of training and experience. This is a challenging task to undertake, and it is one that must be done in consultation with many others and on an ongoing basis. Trying to differentiate between codes, guidelines, frameworks, and suggestions is just one important aspect of this challenging task.

*

Many types of professional ethical codes exist that can relate to the practice of member care. For some practitioners, these codes are essential and are a good “fit.” But one size does not fit all! For example, as a psychologist and as an international affiliate of the American Psychological Association (APA), I abide by the APA’s Ethical Principles of Psychologists and Code of Conduct (2002). But a skilled Nigerian pastor providing trauma training/care in Sudan may not find this code so helpful. Such ethical codes are primarily relevant for the disciplines and countries for which they were intended. Yet many MCWs enter the member care field via a combination of their life experiences and informal training, and are not part of a professional association with a written ethics code. Common sense and one’s moral convictions only go so far. Further, appealing to another country or discipline’s ethical code can result in a rather cumbersome mismatch between the person and the code.
*

Guidelines for Good Practice

Stone one reflects the need for a generic set of guidelines for all types MCWs. The specific example given offers 15 basic guidelines for MCWs in the form of commitments. It focuses on the personal characteristics, backgrounds, and relationships needed to practice member care ethically. The underlying commitment is for MCWs to provide the best services possible in the best interests of the people whom they serve. Like all the stones, stone one is intended to be referred to regularly, to be discussed with colleagues, and to be applied in light of the variations in our backgrounds. Further, it requires serious reflection and a serious consideration of the implications for one’s life and work—these are not just “suggestions” but commitments. The “look before you leap” warning in Proverbs 20:25 is instructive here: ‘It is a snare for a person to say rashly, ‘It is holy!’ and after the vows to make inquiry.”

*

Stone two focuses on the crucial role of sending groups to responsibly support and manage their staff well, including their international staff, local/national staff, home office staff, and family members of their staff. It also considers the big picture of member care from recruitment through retirement and the commitment to nurture both organizational and staff health. The international model of member care in Doing Member Care Well (2002) refers to sending groups as the “sustainers” of member care. “They demonstrate [their] commitment by the way they invest themselves and their resources, including finances, into staff care. Sending groups aspire to have a comprehensive, culturally relevant, and sustainable approach to member care, including a commitment to organizational development.” (p. 18). Sending groups do well to offer quality services for staff and to expect quality services from staff.

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Foundations for Good Practice--Human Rights Principles

This fifth stone is based on doing what we “know” is morally right to do. It shines light on our inner sense of duty. I believe that it must especially take into account human rights in a way which hitherto has received minimal consideration in the member care field. This includes understanding and protecting the rights of mission/aid staff and the people with whom they work, as described for example in international human rights documents (discussed below).
*
However, the primary focus of this stone is not just mission/aid staff. It is rather on the ethical responsibility—ethical imperative—for personal and group duty (often sacrificial duty) on behalf of humanity. It is about the duty and choice to risk one’s own rights and well-being in order to extend member care, broadly speaking, to vulnerable populations. More specifically, it is a principled commitment to improve the quality of life and seek justice for those whose human rights, including religious liberties and freedom of conscience as well as physical safety and economic livelihood, are habitually threatened through neglect, disasters, poverty, discrimination, fear, and persecution.

*

Reflection and Discussion

Here is one of the five "Ethics Sensitizers" from the article.
*

When is it ethical to deploy workers into risky areas?
Workers who serve in cross-cultural settings are often subject to a variety of extreme stressors. Natural disasters, wars, sudden relocation, imprisonment, sickness, and protracted relationship conflicts are but a few of the examples. The general consensus seems to be that sending groups that deploy their people into potentially adverse situations have an ethical responsibility to do all they can to prepare and support them. This thinking is in line with Principle 7 from the People in Aid Code of Good Practice (2003) which states, "The security, good health and safety of our staff are a prime responsibility of our organization." There are so many locations where the social/political situation is very unstable, where there is the possibility of death or serious physical/emotional injury in the course of helping others, and/or more isolated places where there are few supportive member care resources available. The very places that are the neediest are also often the riskiest.
*
Applications
Risk can also be understood as being part of one’s job description, and continuous with the reality that there are always risks in life regardless of one’s location or job. But to what extent should mission/aid workers take risks? Does one help victims of car accidents without having protective barriers that can prevent the transmission of HIV through the victims’ blood? Does one obey an organizational requirement to evacuate from a war zone knowing that there may be far more dire consequences to the nationals/locals that remain without the protective presence of international peacekeepers and providers? How much information about risk does one need to know in advance of an assignment?

Member Care: Pearls and Perils, Lecture 2

Wise Doves and Innocent Serpents?
Promoting Health and Managing Dysfunction in Mission/Aid

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This second lecture at Fuller School of Psychology (February 2009) looked at suggestions for developing healthy organisations and for safeguarding workers in light of personal/systemic dysfunction. Human relationships and organizatinal life are vierwed as being very positive provided that good practices are understood and embraced. The lectures are available on line for free in written, audio, and video formats. We have included a few excerpts below from the second lecture to encourage you to download and watch the video.
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http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx

Snakes in suits, doves in snakes. © 2006 MCA/KOD

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Overview of Health and Dysfunction

Most of us have been part of both healthy and dysfunctional work settings. The healthy ones are personally rewarding and we feel we are contributing and growing, and challenged and respected. The dysfunctional ones on the other hand drain us, stealing our time, focus, effectiveness, and even our emotional and physical health. Much of my work in member care is devoted to helping organizations develop healthy practices. Conflict management in particular takes up a lot of time for me and many of us, especially for those in management roles. Research also supports what we all seem to know from painful experience: relational struggles in the mission/aid sectors stress us out (Gish, 1983, Carter, 1999, Fawcett, 2003). Conflicts, even if managed well, do not always lead to personal growth and closer relationships. This is especially the case when dysfunction is involved. Dysfunction disables our people and purposes, but most importantly from a Christian viewpoint, it dishonors God (Rms. 2: 21-24).

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The above assertions may sound good and “balanced” most of the time. But we must also be concerned about the other side of the distortions—downgrading clear dysfunction and referring to obvious deviance as merely being “differences”. This will become apparent usually if skilled, unbiased people will take the time to inquire. Otherwise people back away from what is seen as a complex confusing story with two or more sides, rather than there being a cohesive core of truth that is being distorted/overlooked. So surely we must not make a mountain out of a molehill; yet neither should we make a molehill out of a mountain! The tricky part is trying to discern who has the clear or clearest perception of what constitutes a mountain or a molehill. It is also tricky since most issues are not so black and white. As Proverbs reminds us (16:2, 18:17): All the ways of a person are right in one’s own eyes, but the Lord weighs the motives; and the first to plead one’s case seems just, until one’s neighbor comes and gives input.

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Relational Resiliency

When I teach on relationships within the mission/aid sector, I like to distinguish between functional trust and foundational trust. Functional trust is assumed, and needed so that we can work together. It believes a priori, within limits, in the good intentions and reliability of a colleague. It gives others the benefit of the doubt until proven otherwise, so that work-related tasks and mutual interests can be realized. Foundational trust however is much deeper and it is earned. It is developed over both time and over tough times together. Enduring and genuine friendships are based on such trust. Functional and foundational trust can overlap over time, with work-related confidence in a colleague flowing into a growing friendship. Yet it is a real mistake to think that being friendly colleagues in a work context (functional trust) is the same as being true friends (foundational trust) in life. The shift from functional to foundational trust is slow and easily hindered. As Christians, this shift leads to deeper levels of “fellowship” (koininia) as emphasized in New Testament writings (e.g., John’s epistles) and to greater levels of “oneness, unity, community” (yachad) as emphasized in the Old Testament (e.g., Psalms 133).

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"Trust shifts" from the functional to the foundational are healthy. They happen via consistent demonstrations over time that people are seriously and sacrificially committed to each other. This is especially evident during crises which force people to work together closely with mutual dependency. Further, there is the genuine willingness to put someone else's best interests over one's own, with no strings attached. There is the deep sense that people are doing their utmost to respect and understand each other. People communicate regularly, equitably, and empathically. Finally, trust shifts happen when people fulfill their promises. Where foundational trust flows, entrenched conflicts usually do not.

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Essential Resources: Good Governance and Good Management

Healthy people form healthy organizations, and vice versa. One of the greatest challenges of maintaining a healthy organization is to manage conflict and dysfunction well. I have learned the hard way (not simply from the literature!) that people in conflict do not always play fair and that often significant dysfunction (not just differences in opinion or personality) must be addressed. Probably like many of us, I default towards being a helper who stays neutral, preserves unity, increases mutual understanding, arrives at a “win-win” outcome, who helps people agree to disagree and believe the best in each other. This approach is usually sensible of course. However there are times when this approach is inadequate and ill-advised, and confrontation and discipline are required. This is tough love that necessitates verifiable contrition and verifiable change. Otherwise innocent people, now and in the future, get hurt. And justice is not done.

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3. Guidelines for Grievances and Whistle-blowing. Third, I suggest that organizations have clear guidelines for handling grievances and for "whistle-blowing" including non-retaliation commitments to those who confront serious problems in an organization. These guidelines are part of good management practices and are in addition to those for conflict resolution. With regards to grievances, mission/aid organizations should also consider the role of an “ombudsman”, a person who acts as a neutral intermediary to represent and help negotiate the interests of both staff and the organization. As for whistle-blowing, one helpful resource is the Policy on Suspected Misconduct, Dishonesty, Fraud, and Whistle-Blower Protection by the Evangelical Council for Financial Accountability in the USA (see Box 9,). This policy takes into account the legal protection offered by the 2002 Sarbanes Oxley Act in the USA for those who report possible or actual organizational misconduct. It also urges that a variety of safe reporting mechanisms be set up that are understood and used by staff, and includes sample policies for both large and small organizations to adapt for their purposes. Note too that similar legislation to protect whistleblowers was passed in the United Kingdom in 1998, as part of the Public Interest Disclosure Act (http://www.opsi.gov.uk/acts/acts1998/ukpga_19980023_en_1). See also the standards for raising concerns and retaliation at: www.business-ethics.org/newsdetail.asp?newsid=88. Mission/aid workers, whether they are employees, volunteers, or independent contractors, need to be aware of their rights/status under the law. Organizations are responsible to explain these laws to their members and to abide by them.

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Reflection and Discussion

Here are three of the ten "Health Promoters" that are included in the article.

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1. Healthy organizations have clear policies/procedures that are understood, recognized, and reviewed. Clear ethical values/commitments are also indicators of health. Yet even still there can be a mess when healthy practices are not followed and dysfunction exists. What do you think?

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2. What behaviors in your experience would you consider to be dysfunctional? Examples: manipulation, lying, stealing, ignoring, ridiculing, discrediting, withholding information, blaming/shaming, scapegoating, demoting, dismissing, etc. Note that organizational and personal health can be described in opposite terms of how dysfunction is described (e.g., honesty vs. lying, affirming vs. discrediting). How can focusing on healthy practices be more constructive than focusing on the negative?

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3. Have you had to confront “poisoned water”? If so, what were the outcomes? What helped? What did you learn? Have you ever felt like you and/or your colleagues were being harassed and “sifted like wheat” by a malignant force that seemed far greater than yourself (e.g., Luke 22:31)? If so, what did you learn?

Member Care: Pearls and Perils, Lecture 1

Staying Healthy in Difficult Places:

Member Care for Mission/Aid Workers

This first lecture at Fuller School of Psychology (February 2009) looked at historical milestones in member care, listening to our global voices, and future directions for this field. The lectures are available on line for free in written, audio, and video formats. We have included a few excerpts below from the first lecture to help encourage you to download and watch the video.

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http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx

A Somali woman at the gate of the UNHCR compound prior to
registration and admission to a refugee camp in Dadaab, Kenya, October 2008.
© Manoocher Deghati/IRIN. Used by permission. http://www.irinnews.org

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Historical Milestones

Opportunity, danger, duty, hell. Life can be as difficult as it can be wonderful. And helping those whose life is even more difficult than our own can be very difficult indeed! There is so much misery that requires the interventions of the faith-based, government, and civil society sectors (e.g., natural and human made disasters, poverty, HIV-AIDS, malaria/diarrheic disease, and internecine war, to name a few). For the mission/aid community, helping can often involve staying sane—and alive—in unstable, insane places. It is not that mission/aid work always deals with life-threatening experiences, of course. Rather it is just that helping to relieve the “maims and moans” of creation takes its toll. Mission/aid workers, like the people they are helping, have some special challenges and needs indeed.

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Over the last 20 years, a special ministry within the Christian mission/aid sector, really a movement, has developed around the world that is called member care. At the core of member care is a commitment to provide ongoing, supportive resources to further develop mission/aid personnel. Currently there are an estimated 458,000 full-time “foreign missionaries” and over 11.8 million national Christian workers from all denominations (Barrett, Johnson, and Crossing, 2008). These figures do not reflect the number of Christians involved in the overlapping area of humanitarian aid, nor do they reflect the unknown number of “tentmakers” or Christians who intentionally work in different countries while also sharing their faith. Sending organizations and churches, colleagues and friends, specialist providers, and also locals who are befriended are key sources of such care.

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The member care ministry and movement did not develop easily. It was often through crises, mistakes, and failure that we began to realize that Christian workers needed quality support in order to help them in their challenging tasks. One of the first books written to help with this need was written by Marjorie Collins in 1974, providing many ideas for how churches and friends could better support mission personnel (Who Cares About the Missionary?). Previously in 1970 Joseph Stringham, a psychiatrist and missionary working in South Asia published two landmark articles in Evangelical Missions Quarterly on the mental health of missionaries. Stringham identified a number of external and internal challenges including culture shock, being disillusioned with others, children, medical care, etc. (external) and resentment, sexual issues, marital struggles, dishonesty, guilt, spirituality, trauma/deprivation in earlier life, motivation etc. (internal).

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Listening to our Global Voices
Expendable Humanitarian Workers, Africa, Viola Mukasa. I’m a humanitarian worker living in a location in Africa that is in prime need of help/missions. I’ve experienced many types of stress as I have worked in various mission programs. The most sustained tension that I have experienced has been related to the urgency and the amount of work to be done in a potentially explosive social and political environment. The challenge here is not only to produce expected results quickly, under tense and sometimes risky circumstances. The challenge is also to deal with the constant worry about the security and health of those within my immediate world and where I, my family, and friends fall within that world.
(Excerpts from chapter 27 Doing Member Care Well 2002)

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Grave Consequences. India, Dr. Manoj. The recent deaths of many young missionaries in different parts of the country have been very shocking. More so, because the causes of the deaths are malaria, enteric fever and other common treatable and preventable causes. Today when medical science has advanced so much, it is sad that these young budding lives have been lost through what could have been ignorance, neglect, or delayed/improper treatment….As a health professional, I would recommend that every missionary sent to the field, especially to the remote areas, be given a proper training in basic health and be oriented to the health realities of their locations, in addition to other areas of preparation.

(Missionary Upholders Trust, Care and Serve Bulletin, March 2004; excerpts p.3)

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Research on Mission Workers, Dorothy Gish, 1983 Sample of 547 field missionaries in several countries and with several organizations, Stressors (reported by 40%+ to be moderate to great):
· Confronting one another when necessary
· Crossing language and cultural boundaries
· Time and effort maintaining donor contact
· Amount of work
· Work priorities

(Journal of Psychology and Theology, reprinted in Helping Missionaries Grow (1988)

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Future Directions

The need for old/new treasures [directions and resources] must also take into account the significant shifts in demographics among the world’s 2.1 billion “affiliated Christians,” especially the growing majority of Christians in/from the Global South and the proportional decline in Christians in/from the global North (Johnson and Kim, 2006). These treasures must also support the efforts to resolutely and responsibly deal with the world’s greatest problems, including the need to eradicate poverty (e.g., the 910 million urban slum dwellers), provide universal education, promote gender equality, combat HIV/AIDS, foster environmental sustainability, etc. (United Nations Millennium Development Goals http://www.un.org/millenniumgoals). Here are 12 such treasures...

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Treasure 3. Relief/Aid Workers—Psychosocial support is increasingly being recognized as a necessary and ethical organizational resource for workers in Complex Humanitarian Emergencies (CHEs). This support includes briefing, stress management, debriefing, and practical help for relief workers as well as equipping them with trauma/healing skills to help survivors (e.g., see the account in Randy Miller’s interview with a World Vision relief worker, “Staying Sane and Healthy in an Insane Job” (1998) and the many accounts in Sharing the Front Lines and the Back Hills, edited by Yael Danieli, 2001). Many disaster scenarios provide opportunities to interact with and help UPGs, leading to ongoing joint programs in community development. It is especially important to consider the reality of “neglected emergencies”—the ones that get overlooked due their chronic, seemingly unsolvable problems and overall lower profile— including “fragile states affected by ongoing conflict, poverty, corruption, and weak infrastructure (Gray, 2008, Moeller, 2008). One timely resource is the radio program and materials created to help survivors and caregivers in both natural and human-made disasters (http://www.seasonsofcaring.org/). See also two publications in particular from the International Federation of the Red Cross and Red Crescent Societies: Managing Stress in the Field (2001) www.ifrc.org/publicat/catalog/autogen/4773.asp and Psychological Support: Best Practices (2001) www.ifrc.org/publicat/catalog/autogen/4516.asp.

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Treasure 6. Special Support for A4 Workers—There is an increasing number of Christian workers from the A4 Regions. A4 senders/workers desire to provide develop quality member care approaches that fit their own sending groups, personnel, and cultures. Their experience in member care is also relevant for those from other sending nations (e.g., see the article on the India organization, Missionary Upholder’s Trust (Ethne-Member Care Update 11/08; www.ethne.net/membercare/updates). Quality care is also emphasized in a special listing of “15 Commitments of Member Care Workers”, developed with consideration for diversity in MCW backgrounds (Upgrading Member Care, Evangelical Missions Quarterly, 07/06). The commitment to quality care for A4 workers is also clearly stated in these excerpts from the Declaration by the Philippine Missionary Care Congress of October 2005...

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Reflection and Discussion

1. List a couple items that strike you as being especially relevant for member care: in its history, current status, or future direction.

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Comment on any of the above paragraphs in light of the concluding paragraph in this lecture/article (below):

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Love. Above all, the core of E2MC [Ethne to Ethne Member Care--that is, the vission and strategy to promote member care by and for all people groups] involves the trans-ethnê, New Testament practice of fervently loving one another—like encouraging one another each day; bearing one another’s burdens; and forgiving one another from the heart. By this all people will know that we are His disciples (John 13:35). The Great Commission and the Great Commandment are inseparable. Our love is the final apologetic. It is the ultimate measure of the effectiveness of our member care.

Member Care: Pearls and Perils

Good news.

The materials from the member care lectures at Fuller School of Psychology in February 2009 are now available on-line for free.

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The overall topic was:

The Pearls and the Perils:

Practicing Psychology in Mission/Aid Settings.

http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx

These materials include the articles, audio, and video for the three lectures. Please share this info with your colleagues and networks. The three lectures:
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1. Staying Healthy in Difficult Places

Historical milestones in member care, listening to our global voices, and future directions for this field.

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2. Promoting Health and Managing Dysfunction

Suggestions for developing healthy organizations and safeguarding workers/senders in light of dysfunction.

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3. Developing Guidelines for Good Practice

Ethical principles and human rights commitments to upgrade the work in member care and mission/aid.

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Opening prayer for the Symposium,

by Dr. Winston Gooden, Dean of the School of Psychology:

“God we thank you for the call on our lives. We thank you for the many places to which we are sent. We thank you for the sensitivity of those who care for us on this journey that we take. And now tonight as we come to hear, to learn, to study, to be inspired, we pray that your Spirit will hover over us. That you would strengthen our speaker, that you would open our minds, that you would fill us with your rich wisdom so we might be prepared to do your work. We pray this in the name of Him who was sent by You to be our Savior. Amen.”

Member Character(s)—4 of 4

A Glimpse at the Character of Saint Micaiah

Honourary Feast Day 25 March
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Have you heard of this Old Testament prophet—and saint?

Probably not.
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That’s because that in spite of being publicly ridiculed, publicly accused of not having the Spirit, and publicly struck in the face for not prophesizing favourably to Ahab the king of Israel, he was thrown into prison and never heard of again in Biblical history (1 Kings 22 and 2 Chronicles 18). Ahab later died in battle, according to the word of Micaiah as opposed to the false assurances of hundreds of other “prophets.”

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Nathan and Nothing
Micaiah was a “Nathan” who risked like Nathan, obeyed God like Nathan by confronting a king, yet did not fare well like Nathan. He is a forgotten Nathan. He is like, Nothing. That is why we are remembering him, and all those like him, on this his honourary feast day, 25 March.
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Courage as Strangers and Pilgrims
“All of these died in faith, without having received the promises, but having seen and accepted these promises with pleasure from afar, they confessed that they were strangers and pilgrims on the earth” (Hebrews 11:13). May we too have the courage to follow in their footsteps, even in the face of risk--by speaking the truth in love to ourselves, to God, and to fellow humans. Such love is the measure of our member care, and of our member character.
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Reflection and Discussion
**Micaiah said, “As the Lord lives, what the Lord says that I will speak.” Give an example of when you had to speak and act with such determination.
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**Micaiah’s concluding words were, “Listen, all peoples.”
What were the people then (and what are we) supposed to listen to?

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Note that Micaiah is not the same as the author of the Book of Micah.

Member Character(s)--3 of 4

A Glimpse at the Character of...Me :-)
Birthday 21 March
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Well, this is fun. It's my birthday.
Here are some things that have shaped my life and character.
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1. At age one+, as I was exploring the world through my mouth, I somehow managed to get my brother's metal belt-buckle stuck in my throat. It would not dislodge, despite the best efforts of parents and nurses alike. My skin was turning blue due to the lack of oxygen. I am very grateful to still be alive.
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2. At age eight I considered forming a motorcycle gang, when I was old enough, called the "Heaven's Devils". We would ride the North American streets and highways, specifically giving chase to members of the Hell's Angels, and thus protect fellow-citizens. To this date I have never really riden a motorcycle, but I have ridden in a lot of Buick's and Opels, as my father owned a Buick-Opel franchise.
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3. At age 16, dressed from head to foot as a nun, in an all-white habit, and donning a gorilla mask, I went in disguise to a Halloween party at an all-girls high school. I was the only guy there, and I was accompanied into the party by a friend who attended the school. It was fun to try to do something a bit different.
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4. At age 19, I had to chose a major/course of study in university. The two areas that interested me were marine science and psychology. I chose the latter, thinking that I could do more good for humans than for fish. I was also acutely aware that the end of the age could come at any time, and hence wanted to make the most of my life. This belief persists to this day.
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5. At age 23, I finished a masters degree programme in clinical-community psychology. The community psychology emphasis (e.g. human strengths, various types of practitioners, resource development, creating new structures) has especially shaped my member care involvement internationally. My first choice had been to attend a doctoral programme in clinical psychology and theology, yet in retrospect, the delay in doing this doctorate was providential.
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6. At age 27, I met a naiad-like being named Jane. Until this time, I was pretty convinced that I would be spending much of my life in Latin America, married to a California surfer lady. Really. Things change, of course. Just like Jane's name, which actually precedes her second name, Michele.

7. Finally, at age 52, shortly before my latest birthday, I had a few prescient-ish dreams in which I was talking to some colleagues around a table. You know this type of dream--sort of darkish and not being fully in control, but imbued with some existential/visceral sense of significance. I woke up missing colleagues and wanting to connect with mutual transparency and accountability. I liked these dreams. I like relational resiliency.
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Reflection and Discussion
List a couple experiences that have helped to shape your character, life, and work.

Member Character(s)--2 of 4

A Glimpse at the Character of Joseph

Feast Day March 19

What to say about Joseph? We know so little.

Can we chip off the "stained-glass" to see who he really was?

Joseph chose to stay committed to Mary and her son, pre and post natal, in some very difficult circumstances. Pregnancy out of wedlock was something that led to being socially ostracised. Maybe even stoned. Not nice. This was followed by fleeing for their lives to Egypt as political-religious refugees. Part of the ongoing historical wave of vulnerable assylum-seekers. Scarey. Anything else? Who knows. Like Patricius (see 17 March entry) his resolve/guidance were bolstered by two timely, divine dreams/visions. He must have been very brave too.

Reflection and Discussion

*What comes to your mind when you think of the character of Joseph--e.g., commitment, bravery, obedience, courage, etc.?

*How is virtuous character developed, in light of Joseph's life?

Member Character(s)--1 of 4

A Glimpse at the Character of Patrick

Feast Day 17 March

We remember and we celebrate

the life of this remarkable yet ordinary man,

Patricius, aka Patrick.

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'We beseech thee holy youth, come and walk among us again'. This was the message from an Irish person in a dream that Patricius had, circa age 40. Previously Patricius had spent several of his teenage years as a slave in Ireland.

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Patrick's impact on 5th century Ireland was multiplied far beyond the Irish shores, via his colleagues and their progeny, his example, and his autobiography, The Confessions of St. Patrick. His opening sentence in The Confessions reflects both his humility and his perseverance:

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"Ego Patricius, peccator, rusticissimus..."

I am Patrick,

a sinner, most unlearned,

the least of all the faithful,

and utterly despised by many.

Personally, I ignore most of the pious legends about him, along with the various socio-political versions that obfuscate who he really was. I rather connect with his character, his passion for God, and his commitment to humans. We salute you Patricius, with or without a pint of stout in our hands, and we salute all those courageous enough to follow your example.

*Refelction and Discussion

*The life work (apostolate) of Patricius began in his 40s. It took awhile for him to "find" his flow, niche, and anointing. Any applications to your life, to mission/aid workers, and/or to the life of member care practitioners?

*Patricius was a slave at one point, in his youth. This took awhile too (about six years of his life, until he escaped with guidance from a dream/vision)! Any applications for you and/or others? Try relating this experience to John 21--'when you are older, someone else will gird you and lead you to places where you may not want to go...'

*What character qualities do you see in Patricius via his opening declaration in The Confessions? What can we learn from this brief glimpse of who he was?

Growing as Good Practitioners--3. Developing Guidelines for Good Practice

Lecture Three

The Pearls and the Perils:

Developing Guidelines for Good Practice

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Stay tuned for more information on the free lecture articles and videos that will be on-line.

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Here is a summary of the third lecture.
Developing Guidelines for Good Practice

“I believe in discretion, not confidentiality.” “I’m too busy to follow-up that difficult matter—give me a break!” “This mistake must not discredit us by coming into public view.” Member care is a broad field with a wide range of practitioners and perspectives on what is ethically permissible. As this field continues to grow, it is important to offer guidelines to further clarify and shape good practice. In this presentation we will explore several ethical principles and human rights commitments to upgrade the quality of the supportive care that we offer mission/aid staff. We consider five types of guidelines: member care worker commitments, sending group principles, ethical rationalizations, specific ethics codes, and human rights principles. Ethical care is a mentality, a practice, and a commitment, based on moral law.

Growing as Good Practitioners--2. Promoting Health and Managing Dysfunction

Lecture Two
The Pearls and the Perils:
Promoting Health and Managing Dysfunction
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Stay tuned for more information on the free lecture articles and videos that will be on-line.
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Here is a summary of the second lecture.

Promoting Health and Managing Dysfunction

“Yesterday he prayed for me, today he preyed on me.” This presentation explores two important and overlooked areas for health in mission/aid. They are the role of human dysfunction (problems from significant weakness/wrongness, e.g., leadership abuse, psychological disorders, moral failure, harassment) and the role of discipline (correction to restore people/organizations which violate others e.g., independent reviews, counseling, recovery programs, remedial training, and dismissals). Further developing our capacity in these two areas is fundamental for safeguarding workers/senders and maintaining effective operations. We will look at five essential resources for personal/organizational health: conflict resolution guidelines, discipline/restoration procedures, organizational assessments, human resource departments, and whistle-blowing protection. We will also reflect on ways to upgrade friendships/trust among colleagues as we review perspectives from Sirach, Francis of Assisi, Machiavelli, and Orwell.