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NATHANIEL BLANTON HIBNER, PhD

For nearly three years, the health care ministry and our country have faced a crisis unseen by many generations. Throughout the COVID-19 pandemic, we have had to navigate new and complex ethical dilemmas, such as scarce resource allocation and public health mandates. To do so, our health care organizations relied upon prudential leaders who saw the path ahead clearly while balancing the many demands placed on our colleagues. In doing so, these leaders exhibited the virtue ethicists refer to as prudential wisdom, playing a role in enabling the Holy Spirit to guide the ministry's work.

ACTION THROUGH PRUDENCE
St. Thomas Aquinas wrote extensively about the virtues and how they affect our decision-making in his Summa Theologica. Furthering the work of Aristotle, St. Augustine and others, Aquinas expanded on the many different virtues, providing us with a schematic of their functions. For the virtue of prudence, Aquinas named it a wisdom.¹ For Aquinas, wisdom is the process of ordering and judging. It prioritizes competing ends and judges the action that will most likely result in the desired outcome. It is a virtue of practical intellect rather than merely speculative.

When looking at the innovation and adaptability displayed by health care leaders — especially during the early stages of the pandemic — how does this virtue apply? A person strong in prudence applies right reason to any given matter. Aquinas quotes St. Isidore of Seville, stating, "A prudent man is one who sees as it were from afar, for his sight is keen, and he foresees the event of uncertainties."² They go beyond simply examining and reflecting, leaning also toward action and application. They can direct our means toward our sincerest intentions. In fact, Aquinas argues that for any moral virtue to meet its intended end, prudence must be there to guide it. Therefore, prudence has been called the Auriga virtutum, or the charioteer of the virtues.

THE PATH TO PRUDENCE
Aquinas breaks down the process of prudence into three main elements: counsel, judgment and command.³ Counsel involves inquiry and deliberation, the collecting of data. Judgment includes decision-making and choice. Finally, command, the element that is unique to prudence, moves toward the application of the decision. This process might seem familiar to anyone who has gone through a formal discernment model. If we look at CHA's model for discernment,⁴ we will find that its five steps follow the outline Aquinas writes regarding prudence. The prudential wisdom infused into the process of discernment enables the Catholic health care ministry to put our mission into action. In many ways, it is through this virtue that we live out the healing ministry of Jesus by acting rightly toward our patients, communities and associates. The ministry's commitment to health equity by prioritizing services that help shape healthier communities is just one of the many ways that we live out this virtue through our work.

When decisions are made that lack prudence, they often follow a path toward a lesser good. In these cases, some influence other than God directs the decision-makers. Aquinas would call this "false prudence." The person deceives themselves into thinking that the goal they desire is the same as that of the Holy Spirit, when, in fact, it comes instead from avarice and vice. The process of discernment should include steps to self-reflect on one's intentions and goals so that true prudence may lead the way.

Like any virtue, prudence must be learned and practiced. Aquinas argues that prudence is not naturally gifted to people, though some might be more receptive to learning it. The way to do so is to reflect deeply upon experiences, asking oneself whether the action taken resulted in the desired outcome. Through this reflective practice, a person begins to develop a better understanding of the application of virtuous actions and their consequences. They also learn just as much from their mistakes as they do from their successes.

CONCLUSION
For those who lead the ministry's work, I invite you to take time and learn more about this virtue — whether through reading what Aquinas has written, or through developing a mentoring relationship with someone who exhibits prudential wisdom. Many systems have opportunities to join mentoring programs. If your system lacks a formal mentoring program, you can also ask someone whose decision-making you admire to walk you through the steps of how they reach their decisions. Or, someone more experienced may be willing to talk with you about what factors they considered if they encountered a similar situation. In addition to CHA's discernment model and facilitator guide, another helpful resource is Stephen J. Pope's book The Ethics of Aquinas.⁵

As our health care ministry continues to face challenges, we look upon our leaders to act in light of prudence. May our work continue to be blessed by those who see clearly and act confidently.

NATHANIEL BLANTON HIBNER, PhD, is senior director, ethics, for the Catholic Health Association, St. Louis.

NOTES

1. Thomas Aquinas, Summa Theologica, Second Part of the Second Part, question 47, article 2.
2. Aquinas, Summa Theologica, Second Part of the Second Part, question 47, article 1.
3. Aquinas, Summa Theologica, Second Part of the Second Part, question 47, articles 8-9.
4. Cooperating With the Spirit: CHA Discernment Model and Facilitator's Guide (St. Louis: Catholic Health Association), https://www.chausa.org/store/products/product?id=4653.
5. Stephen J. Pope, ed., The Ethics of Aquinas (Washington, DC, Georgetown University Press, 2002).