Nurse-ethicist-professor identifies most of all as a healer

July 1, 2020


Johnny Cox has had many jobs during his lifetime: nurse, ethicist, professor, hospice director, mission leader, health system sponsor. But the role he most identifies with is healer.

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"I always sensed a calling to be a healer, primarily from the example of my mother, who was a nurse," said Cox. The retired vice president, theology and ethics, for St. Joseph Health system in Orange, California, continues to serve as chief ethics adviser for the Alliance of Catholic Health Care in Sacramento.

Cox, 76, is the 2020 winner of CHA's Lifetime Achievement Award. Due to the coronavirus pandemic, and the resulting need for CHA to host a virtual Catholic Health Assembly this year, Cox and other 2020 CHA award winners will accept their awards in person at the 2021 Catholic Health Assembly in Indianapolis.

Growing up in California, Cox saw his mother and the entire family caring for his younger brother, Brian, who suffered a grand mal seizure at age 3 and experienced a lifetime of epilepsy seizure disorder, leaving him severely developmentally disabled.

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Along with sponsor colleagues from Providence Ministries, Johnny Cox, center, joins with sponsors of St. Joseph Health Ministry as both groups sign the covenant establishing Providence St. Joseph Health.

"He lived at home with us until it was impossible," with three other children born into the family after him, Cox said. "My family's life revolved around caring for him. My mother's compassionate nursing and the family's commitment to Brian were imprint events on my life."

Brian, who died at the age of 55, lived in institutions and group homes after he could no longer be cared for at home.

Groundbreaker, mentor
Cox's professional life has been a series of firsts. He was hired by Gonzaga University in Spokane, Washington, in 1972 as the first person to teach ethics as a theological discipline. After hearing about the concept of hospice, he helped establish and then directed Hospice of Spokane, one of the first dozen hospices in the United States. Sacred Heart Medical Center in Spokane (now Providence Sacred Heart Medical Center & Children's Hospital) hired him as the first ethicist employed full time in a community hospital in North America, and he later was appointed as the first vice president of mission for Providence Services. (Providence Services joined with Providence Health System to form Providence Health & Services. St. Joseph Health merged with Providence Health & Services in 2016 to form Providence St. Joseph Health.)

Johnny and Barb Cox both had vocations in the Catholic health ministry. The couple worked together for a time in mission leadership at St. Joseph Health in Orange, California.

Barbara Savage is president of Providence Ministries, one of the two public juridic persons of Providence St. Joseph Health. She served with Cox on the original sponsor board of that public juridic person. She first met Cox when she was his student at Gonzaga in the early 1970s and helped him found the Hospice of Spokane. She said one of his greatest gifts is the encouragement and support he gives to colleagues that helps them recognize and grow their own leadership skills.

"I was a bedside nurse in ICU and I would have never imagined myself being an integral part of forming a hospice," Savage said. "I didn't see myself in a leadership role, but he prodded me and others to develop into those leadership roles, tapping on whatever our skills were."

Love and devotion
But above all else, Cox is "very, very much a family man," Savage said. "His family has always been his heart and his focus."

Cox and his wife, Barb, have four grown children — Brian, Sarah, Mike and Dan — and 10 grandchildren. The couple had worked together in mission leadership at St. Joseph Health in Orange, and also worked for competing health systems.

"For Barb and me, our state of life was marriage and family, but our vocation was in the healing ministry," he said. "We were much better together than we were apart."

Both now retired, they divide their time between Phoenix and Spokane after Johnny Cox vowed to "never shovel snow again."

Cox chafes at the notion of health care as simply a career, noting that the word "career" has the same root as "careen" or a car "heading in your own direction." "But a vocation is never an individual calling; it's always a calling into a community," he said.

Faith-based community of care
He sees one of the greatest threats to Catholic health care in an erosion of its understanding as a service and the view that it is just another "commodity in a marketplace." The main challenge for Catholic health care ethicists today and in the future is "to strengthen and fulfill the commitments" of the first three directives of the Ethical and Religious Directives for Catholic Health Care Services, he added.

Those directives state that Catholic health care must be a community "animated by the Gospel of Jesus Christ and guided by the moral tradition of the church," must be delivered "with the compassion of Christ" and must distinguish itself by service and advocacy to the most vulnerable in society.

With the commodification of health care and the secularization of society, Catholic ethicists and health care leaders "will be challenged with deepening the foundations of their work in our faith tradition and making it explicit in their work," Cox said.

"Many good, committed people are attracted to us because they see a values-driven organization committed to the common good," he said. "But in addition to being values-driven, Catholic health care must be a faith-based community of persons serving with the compassion of Christ the most vulnerable in our society. The unseen erosion of Catholic health care would be satisfaction with a values-driven organization and not a faith-based community infused with God's love and Jesus' healing ministry."

Lifelong teacher and learner
William J. "Bill" Cox, president and chief executive of the Alliance of Catholic Health Care, which represents 16% of all California hospitals, said Johnny Cox (no relation) "has helped me enormously in understanding Catholic moral tradition and how it is to be applied to Catholic health care." He also helped the California bishops navigate complex ethical issues in health care for many years by consulting and editing a bioethics brief distributed to the bishops.

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Professor Cox and son Brian in the young professor's office at Gonzaga University in Spokane, Washington.

Johnny Cox also taught for many years in the Ministry Leadership Center formation program based in Sacramento, a consortium of several Catholic health systems that educated some 1,000 chief executives and senior executives, Bill Cox said. The formation program no longer exists because each health system has incorporated it into in-house training programs, he added.

Sr. Katherine "Kit" Gray, CSJ, met Johnny Cox in the early 2000s when she was general superior of the Sisters of St. Joseph of Orange and he was vice president, theology and ethics, at St. Joseph Health.

"I learned from him different ways of thinking, styles of presentation, ways of engaging people in the ethical conversations that health care entails," she said. "As a nurse, he brought wonderful clinical experience to these very important conversations: what are the ethical principles and how do we apply them in real life?"

Sr. Gray also described Cox as a "lifelong learner" and said he is "always looking for the next thing to think about."

Asked about that description, Cox said his current focus is "learning about Sabbath — God's rest — by experiencing it."

Because his work with the Alliance of Catholic Health Care "is not very time-consuming," he said, "I have the time and the opportunity to gaze without interruption on the faces of the people I love, my family and friends. And I feel gratitude and delight for the beauty and goodness I find in them."



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