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The Magazine of The Evangelical Lutheran Church in America

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Ethical triaging

What requires our most urgent response?

A pastor challenged me to think about how the ELCA might engage in "ethical triaging." The phrase is both intriguing and bewildering. He described an experience many of us have faced personally or with a family member. Arriving at an emergency room, we check in with a triage nurse and describe the symptoms or accident for which we need attention. Following registration, we usually are asked to take a seat and wait.

We are not called to see the physician in the order we arrived. This can be comforting or frustrating. We become impatient as well as curious, wondering, "What makes another's needs more urgent?" Sometimes their pain or bleeding makes it obvious. More often it is not clear. Yet as we reflect, we realize the staff is making thoughtful decisions and we, too, will receive care.

The pastor described the overwhelming needs and questions facing our world and this church. "We cannot respond to all of them at the same time," he contended. "Yet sometimes it seems we lack a way to determine which require our most immediate response. As a church we need to learn how to engage in ethical triaging."

How do we as individuals, congregations and a church decide what requires immediate response? Human suffering in Sudan? The ravages of wars in Iraq and the Middle East? People who are dying each day from hunger and related diseases or from polluted air and water? Or perhaps the more hidden conflicts in our families and the struggles of our spiritual lives?

Certainly this already is taking place throughout this church as we — as individuals and as congregations — make decisions about causes to which we will contribute our time and money. We participate in ethical triage when we as the ELCA develop and adopt social statements and set priorities. Yet I wonder if we are as intentional as the pastor's request suggests.

Ethical triage involves prayer and the study of Scripture. It calls us to assess our gifts, insights and resources. It leads us to ask with whom we might join in our response. Ethical triage implies a willingness to make difficult decisions, recognizing that we cannot respond to everything. We need to trust that sometimes others will act and let some pressing issue wait for our response.

When I asked, the pastor said he thinks growing poverty and the HIV/AIDS pandemic most urgently require our response. He makes a persuasive contribution to our shared task of ethical triage.


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