Interview with Emmanuel Hirsch, ORPEA Group’s Director of Medical Ethics, who explains his mission and talks about ethics in our daily actions

You joined ORPEA Group at the start of the year as Director of Medical Ethics; can you give us an initial assessment?

Emmanuel Hirsch: As soon as I met ORPEA’s Group’s professionals in the field, along with those we care for in our facilities and their families, I understood its concern for an ethical thought process and subsequent commitment. However, circumstances must lead us to be humble in this respect, and to make sure we uphold this culture of consideration, benevolence and solidarity with people who are very often vulnerable as a result of illness, disability or old age. Assuming our responsibilities means being competent, available and ready to listen in a sensitive human environment where the key values of democratic life are engaged. In this capacity, we are expected to be up to the task and worthy of the trust placed in us. Regarding everyday practices that respect human beings and the common good, we must demonstrate the values for which we are individually and collectively responsible. As for my initial assessment, I am convinced that the ethical focus in ORPEA’s renewal effort is recognised as an essential component of the Group’s identity, and that together, we must demonstrate an exemplary commitment for the benefit of those who seek our care.

“We must make sure we uphold this culture of consideration, benevolence and solidarity with people who are very often vulnerable as a result of illness, disability or old age.”

In your view, how are ethics defined in the scope of ORPEA’s missions?

E.H.: I mentioned the principles of our ethical approach: it must be developed through dialogue, encounters, and sharing of experience and expertise initiated as close to the ground as possible. For some months now, we have gathered people’s views, suggestions, expectations and even urgent requirements. To be sure, those who live in our facilities or who receive support in their homes seek to benefit from the most appropriate form of care and support, but in an environment respectful of who they are, their choices, their private sphere and their acknowledged place in society. The same goes for their close ones; they too seek hospitality, consideration and attentiveness. The professionals themselves feel the need for benevolence towards them, and for a fair assessment of the issues and difficulties faced when carrying out complex missions in a context of extreme vulnerability. As for society at large, it must understand that political choices and new forms of solidarity are required to avoid excluding people from the social field simply because they are incompatible with an ideal that rejects anyone who do not seem to conform to the current model.

In our facilities, we support those affected by mental illness, the after-effects of traumatic experiences, progressive and terminal illnesses, and loss of autonomy or of cognitive abilities that make them more dependent that others. Accordingly, our ethics are expressed with a duty of non-abandonment and being open to others in circumstances that may be very challenging. Our missions must inherently prompt us to think about ethics, to better understand the meaning and purpose of our actions and to implement a practical form of ethics, and ethics focused on commitment. This is not about giving orders; it is about sharing knowledge of reality to foster fair and appropriate actions focused on what the person cares about.

“Our ethics are expressed with an obligation of non-abandonment and of being open to others in what are often very difficult circumstances. Our missions must inherently prompt us to think about ethics, to better understand the meaning and purpose of our actions and to implement a practical form of ethics, and ethics focused on commitment.”

What exactly is the mission of the Medical Department’s Ethical Policy Council? 

E.H.: We will discuss the actual structuring of the ethical system to be deployed within ORPEA another time. However, I can tell you a little more about the Group’s Ethical Policy Council, which is central to its national and international openness. It is not an ethics committee or an ethics forum, rather a consultation body that combines diverse skills and expertise to guide the group’s ethical approach. For the sake of transparency, its governance and the way it operates will be presented on the website. In fact, it forms the basis of the ethical network that we are setting up to ensure democracy in healthcare and in medical and social services. The members of the council (whether internal or external to the Group) responded to a request that was widely disseminated. Following personalised meetings, we agreed on their interest in contributing to our approach in a spirit of pluralism and openness to society. As of February 2023, we will undertake in-depth work on three themes, one of which is particularly topical as it concerns the French citizens’ convention on the end of life. We will also publish a document comprising some fifty contributions: “Ethics with you and for you”.

“This is not about philosophising from afar, but embodying and upholding – in the field – the values of dignity, respect, benevolence and justice at the heart of living together.”

In the coming weeks, we will set about gradually deploying our ethics approach, in line with the drive for transformation engaged by everyone within the Group. Our goal is to advance – from our rightful place – ORPEA’s vocation and missions, i.e. those for which our professionals will be responsible in relation to the people they welcome and support in their lives. They and their close ones are entitled to demand that we conduct ourselves in an exemplary manner.

As you can see, ORPEA’s ethical culture must draw on the diversity and strength of everyone’s commitment. This is not about philosophising from afar, but embodying and upholding – in the field – the values of dignity, respect, benevolence and justice at the heart of living together. The next time, I will talk to you about the body that will be set up in the regions, namely the ethical monitoring and vigilance unit. We must pro-actively monitor, anticipate and dialogue in order to provide the insights and, where necessary, measures required for this ethical alliance, which I like to think of as a safety rope that links us all together at the heart of care and support, for the benefit of the common good.

Many thanks Emmanuel Hirsch!