I was trained to argue about ethics in a seminar room.
I spent my career arguing about it in intensive care units.
Ethics becomes serious when someone has to act. A family sitting with a neonatologist
at two in the morning is not weighing a thought experiment — they are deciding
something that cannot be taken back, usually without the words for what they are being
asked. The question that has held me for most of my life is what a moral tradition is
worth when it is put under that kind of pressure.
I came to it before I had read anything useful about it — in the United States Navy,
aboard Enterprise, on the January morning twenty-eight men died on her flight deck.
I served a further tour aboard Constellation, took an honorable discharge, and went
to Seattle University on the GI Bill.
The books took a long time after that. My doctorate at the University of Notre Dame was in
theological ethics, with a dissertation on how Catholic moral thought absorbed the discovery
that its own norms had a history — that natural law had been argued into existence over
centuries rather than handed down complete. There was an interval of three years in the middle
of it when I worked in Alaska, on the docks at Kodiak and on shrimp, cod and bottomfish
boats for the New England Fish Company. Then I went back and finished.
What made the abstraction concrete again was the clinic. I trained as a clinical ethics fellow
under John C. Fletcher, Chief Bioethicist at the National Institutes of Health, and began
taking consultations at the bedside. What I learned there is that hospitals do not mainly need
better arguments. They need structures — a service a nurse can call at three in the morning,
a committee with real terms of reference, a policy that anticipated this case before it arrived,
and clinicians who have been taught to reason about it rather than defer. So that is what I built:
an eighteen-member consultation service at the University of Nebraska Medical Center, a twenty-four-hour
ethics service across the five Mater hospitals in Brisbane, an ethics advisory council reporting to a
hospital governing board, and courses that put more than six hundred clinicians through a formal
grounding in clinical ethics. I also helped write the patient-rights and organisational-ethics section
of the accreditation standards American hospitals are measured against.
After the Mater I went out on my own, consulting to hospital ethics committees across Queensland
and running workshops throughout the state.
The communications work came out of all of it rather than alongside it. Directing the outreach
program at the University of Virginia’s Center for Biomedical Ethics, building course sequences
and publications across the Mater hospitals, convening a national bioethics conference under my own
auspices — that is production work, and the skills accumulated. Video, editing and web publishing
are what the same job looks like now.
The question I started with has taken me somewhere I did not expect. I work now in support of
First Nations human rights and truth-telling in Australia. I built and maintain the website for
Truth-Telling, the monthly gathering at
Mitchelton Library in Brisbane where First Nations speakers share their histories, and I photograph
and film the speakers. I manage participation for the
Yarning Circle Series at
St John’s Cathedral, hosted by Uncle Bill Lemson. Earlier, the Yes23 referendum campaign.
It is communications, research and video: making sure that what Elders want said is recorded
properly and reaches the people it is meant to reach. I am not the author of it, and that is the
point of it. But it is the same question it always was — who decides, on what grounds, and
how a community holds itself to an answer.