Ethics advocate challenges doctors, nurses to 'see the face of Christ' in patients following annual Rose Mass at Sacred Heart

DETROIT — Following Communion during the annual Archdiocese of Detroit Rose Mass for health care workers on Sunday, March 31, at Sacred Heart Major Seminary, doctors, nurses and medical practitioners were invited to swear the Oath of Hippocrates.

The oath is a promise before God and their fellow health care workers that they will “follow that method of treatment which, according to my ability and judgment, I consider for the benefit of my patient and abstain from whatever is harmful or mischievous.”

But in an era when more than 33,000 Americans died last year as a result of an opioid overdose — more than 140 people a day — and when Michigan has one of the highest opioid-related death rates in the country, “abstaining from whatever is harmful” can be a challenge for a doctor who knows his or her patient is in pain, but also knows the risk of addiction and overdose is all too real.

With the well-publicized opioid-overdose epidemic in the background, Cherie Sammis, director of ethics integration at Ascension Michigan Health System, delivered a lecture to Catholic health care professionals at the seminary following Mass.

“People are dying, and are we, in health care, the cause?” Sammis asked the room full of doctors, nurses, chaplains and hospital administrators. “Or are we doing something about the cause?”

In the 1980s and '90s, pharmaceutical companies pressured physicians to prescribe opioids to treat pain, but that led to an increase in dependency on painkillers, Sammis said, which in turn led to an epidemic of opioid-related deaths in the 2000s and 2010s that have swept across all areas of the country, traversing gender, age, race and social class lines.

“We say, ‘This patient is a drug seeker,’ but what does a drug seeker look like?” Sammis asked. “The unifying factor is, they all need help. Everything we do in Catholic health care is rooted in the Gospel, rooted in compassion. Our response to the opioid crisis must be rooted in compassion.”

Sammis described a mission-driven health care response to the opioid crisis as one in which doctors and nurses at Catholic health systems weigh the potential for addiction and drug abuse with the very real pain of victims, whose stories are often overlooked or viewed with suspicion by those who see them as potential “drug seekers,” particularly patients of racial minorities or in the lower end of the socio-economic spectrum.

“The inherent dignity of people must be protected regardless of addiction, illness, class or income,” Sammis said. “We have to think about functional recovery when prescribing to patients. Doctors have to analyze the risks and benefits with prescription painkillers. We need to look at our own biases, and not demand exceptions for ourselves.”

Patients who have been to the emergency room multiple times or who constantly seek prescription painkillers are seen as “frequent flyer patients” or “pill seekers,” and all too rarely are seen as people in need of help, Sammis said.

“The patients who come back to us, over and over again, are coming back to us because God brings them back to us,” Sammis said. “When thinking about prescription opioids, we have to think about when patients are misleading the physician, but also we need to hear their stories, why they are seeking these painkillers and where they need help.

“Going into Catholic health care, we address many aspects of pain: the physical, the physiological and the spiritual,” Sammis continued. “But sometimes in Catholic health care, we overlook the spiritual care. That is what we mean when we talk about balance in the opioid epidemic, and ‘opioid phobia,’ where we have grown so skeptical of our patients’ stories that we no longer see the pain they are in.”

Sammis said recent national and regional attention to the opioid crisis led to a 10 percent drop in opioid-related deaths last year. She also noted recent acts by the Michigan Legislature to monitor and track how many prescription painkillers doctors are prescribing and pharmacists are fulfilling, along with increased access of Naloxone, a drug overdose medication, have been positive steps.

But it doesn’t get to the core problem of patients being in pain and seeking medication as their only solution.

“Being in health care for almost 40 years now, I think we are beginning to see the pendulum swing,” Sammis told Detroit Catholic in an interview after her lecture. “I won’t say (it's swung) too far or the wrong way (when it comes to not prescribing painkillers to patients in need), but particularly in Catholic health care, we’re getting much, much better at having conversations to address the problem.”

Recent action in Michigan and in the Archdiocese of Detroit, where parishes have hosted pill takeback days to get rid of unused medication or legislation to limit how many opioids can be filled at a time are positive steps, Sammis said.

“I think they are all helpful, but the problem is multi-pronged, so it is going to take a multi-pronged approach,” Sammis said. “We have to come together — health systems, parishes, governments. That is the whole embodiment of holistic care and holistic outreach.”  

Sammis said she believes it will take a generation or more before society sees a significant improvement in handling opioids. 

“It is going to be baby steps. But if we don’t do it right now, and don’t keep doing it, we won’t get to that generation that will solve this problem,” Sammis said.

The first step, she said, is taking just a little bit more time to educate, to learn and to empathize with people seeking to be healed, body and soul.

“We need to think back on our mission and the human dignity of the other person, which is rooted in the love and ministry of Jesus as a healer,” Sammis said. “When we commit to serving all people, paying special attention to health care of the vulnerable with love and mercy, we will see the face of Christ in everyone who comes through our doors, seeking healing.”