Mennonite Health Journal

Moral Dilemmas and Healthcare Ethics: The Future of ACHE

Paul D. Leichty

from Mennonite Health Journal, Vol. 15, No. 2, April 2013

“Moral Dilemmas in Healthcare” This is the theme for this year’s Annual Gathering of Mennonite Healthcare Fellowship (MHF), coming up June 21-23 at Goshen College.  As the MHF Board and a special Planning Committee have worked with this theme, we have realized that there are many aspects to the theme and many directions that we could go in our explorations.  Obviously, we won’t be able to cover everything in one weekend.  So one of the questions that will linger is how we can look at some overarching issues and use those as a springboard for exploring other issues.

On the national scene, there has been considerable controversy over the Patient Protection and Affordable Care Act (PPACA) passed by the U.S. Congress and signed into law by President Obama on March 23, 2010. Just prior to last year’s MHF Gathering at Laurelville, Pennsylvania, the U.S. Supreme Court upheld most of the provisions of that law and this was a major topic of conversation for the weekend event at Laurelville.  Now, many people have their sights set on January 1, 2014, when most of the remaining major provisions of the law go into effect. While some see this date representing a small but significant victory, others are focused on new dilemmas they foresee.

It is important to realize again that there are moral dilemmas, as well as legal, social, and economic dilemmas, that pushed the law into existence in the first place. Mennonite leaders, including leaders from the predecessor organizations of MHF recognized this for some time.  As Mennonites have become increasingly involved in healthcare services and the healthcare system, it seemed important to create avenues for discussion and discernment on many increasingly complex healthcare issues.

One of the responses around the turn of the millennium was the creation of the Anabaptist Center for Healthcare Ethics (ACHE) in 2001.  ACHE was formed as an association of Mennonite organizations and agencies and incorporated in 2003. Mennonite Medical Association (MMA) and Mennonite Nurses Association (MNA), the predecessor organizations of what is now Mennonite Healthcare Fellowship, were among the members of this association.

Under the leadership of Joseph Kotva, ACHE was largely responsible for developing resources, including a booklet called “Healing Healthcare,” that propelled a wider discussion in Mennonite Church USA congregations about the issues in the U.S. healthcare system.  During the 2005-07 biennium, Glen E. Miller gave leadership to the Mennonite Church USA healthcare access initiative that encouraged these discussions.

Unfortunately, a sustainable funding model for ACHE was never achieved.  Staffing and the active work of ACHE ceased on May 31, 2007.  From that time until the end of 2012, the corporate structure and some remaining funds were administered by one of the association partners, Mennonite Health Services Alliance.  During that period of time major changes were taking place in most of the association partners.  In addition to the merger of MMA and MNA to become MHF and the restructuring of MHS into MHS Alliance (now soon to become an agency of Mennonite Church USA), Mennonite Mutual Aid became Everence and AMBS changed from “Associated” to Anabaptist Mennonite Biblical Seminary.  Only Mennonite Chaplains Association kept the same name and structure.

In 2012, MHS Alliance and Everence initiated a discussion concerning what to do about the corporate structure of ACHE. They asked MHF to participate in that discussion.  At a meeting in September 2012, it seemed clear to those present that healthcare ethics touches the mission of a number of Mennonite organizations, agencies, and institutions. The question was whether the corporate shell of ACHE should be kept alive and what direction the discussion of healthcare ethics should take in the Mennonite Church.

The other leaders at that meeting challenged MHF to think about whether healthcare ethics is “central” to the organizational vision/mission or just an “interest” of MHF.  In response, the MHF Board affirmed that it is central to the MHF mission. It was part of the founding vision laid out by the Implementation Team that put together MHF and it is specifically mentioned on the MHF brochure.  It remains a high interest among our Board and our membership and a point of attraction to new members as well.  Finally, a prime illustration of its centrality is the theme for this year’s Annual Gathering, “Moral Dilemmas in Healthcare.”

While the MHF Board realized the centrality of healthcare ethics in MHF’s work, they did not see their way clear to develop new programming while still in the start-up phase and having only two half-time staff persons.  They suggested, instead, that the discussion of healthcare ethics be incorporated into existing forums.  These would include churchwide conventions, Mennonite Health Assembly (MHA), and MHF’s Annual Gatherings and Regional Meetings.  MHF agreed to give some limited leadership to coordination and consultation on this mutual agenda.

MHF also agreed to a plan to manage the financial assets of ACHE, using them to further the healthcare ethics agenda of the Mennonite Church as opportunities arise.  This plan was approved by the association partners of ACHE and the transfer of assets was carried out in early 2013.

What this means for the immediate future is the following:

• The ACHE Fund will be administered similarly to two mission funds which were inherited from Mennonite Medical Association (MMA). Both the Mobilization for Mission Fund and the Steven Roth Fund were set up for specific mission-related purposes and the assets of those funds are tracked separately from the operating budget of MHF.  When MHF members send in their yearly dues, they are given the opportunity to make additional contributions to MHF operations as well as to these funds.  MHF keeps members informed about the assets in those funds and how they are being used.  Designated contributions can be received from non-MHF-members as well. The MHF Board also follows MMA precedent and charges a yearly amount for administrative purposes that gets transferred from the fund to the MHF operating budget.  This is now how the ACHE Fund will also be administered.
• ACHE funds will be available to any of the association partners for projects that involve healthcare ethics.  The first such project is the MHF Annual Gathering in June.  ACHE will help subsidize the expense for speakers and a larger meeting space so that the discussion of moral and ethical issues in healthcare can be broadened in the Mennonite Church and related groups.
• MHF members and other interested persons will be given the opportunity to give feedback to the MHF Board as to what they envision as the future of ACHE.  This will happen first at the Annual Gathering in Goshen and the Mennonite Church USA Convention in Phoenix in early July.  Additional means for seeking counsel may also be developed.  In addition, MHF members can speak with their contributions as to how much they are willing to contribute to replenish and sustain the ACHE fund.  It is hoped that this method of operation could help determine over time whether this is, or leads to, a viable long term model and thus help answer the question of what to do with the ACHE corporate structure.

ACHE is simply a structure used to address a perceived need for a larger Mennonite Church discussion on healthcare ethics.  It fulfilled a crucial purpose in the first decade of the new century.  It seems clear that the “moral dilemmas” and other issues of Christian ethics related to healthcare have not gone away.  Yet, the question remains on what the best means is to continue to discuss and come to discernment on those issues.  Readers of Mennonite Health Journal are welcome to give their counsel at any time.  Address your feedback to the MHF Office.

About the author

Paul D. Leichty, M.Div. was the first Executive Director of Mennonite Healthcare Fellowship (MHF), serving from Sept. 2011 through May 2020.  Paul has served as a pastor, church musician, computer support person, disabilities advocate, and administrator/organizer of a number of church-related ministries. In addition to responsibilities at MHF, Paul is Executive Director of Congregational Accessibility Network and was formerly Director of User Services at Mennonite.net.  He is a member of Agape Fellowship of the Mennonite Church in Williamsport, Pennsylvania where he lives with his wife, Twila Charles Leichty.