Ethics Discernment Framework

What leaders are saying...


Wright Lassiter III

Chief Executive Officer, CommonSpirit Health

“We apply a certain rigor to each and every decision we make – big or small – to ensure operational effectiveness and consistency with our mission and values. The Ethics Discernment Framework helps us work through these clinical, organizational and social ethics dilemmas in a thoughtful way.”

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CommonSpirit Health at Home

"I am very impressed at how methodical and respectful this process is pertaining to all those impacted by decisions made.  Proud to be with an organization which employs a comprehensive strategy like this.  This is certainly living our mission."

Doug Lawson

Doug Lawson, PhD

CEO, Texas Division

"We recently chose to discern a potentially controversial decision. During the discernment process a couple of things were very clear, the passions were high and quite diverse. The process helped the group recognize each other in a way that gave direction and understanding to the ongoing dialogue of needs and fears."

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CommonSpirit Health at Home

"This provided me with exposure to viewpoints and considerations I had not previously reflected on even though I am very close to the impact of this decision"

Michael Ahrendt

Michael Ahrendt

SVP, Infusion Services, CHI Health at Home

“You’ve got us thinking about things that we weren’t thinking about before, and that makes this worthwhile.”

Rachelle B

Rachelle Barina

SVP, Chief Mission Officer, Hospital Sisters Health System

“The Ethics Discernment Framework ensures that we listen to each other, explore differing viewpoints, and thoroughly consider relevant factors. It helps us make decisions more fully aligned with our values and sometimes in the long run even save time that otherwise would be spent on clean-up or discussion about how and why a decision was made.”

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The CommonSpirit Ethics Discernment Framework is a standard deliberative process and spiritual exercise for leaders, Executive Teams, and Boards to use when making decisions.

  • First, ask “Who is God calling us to be?”
  • Then, answer “What are we going to do?”



Wisdom of a community

Moral vision


One step of a journey


Who do we want to be?

Decision making


Choice, alternatives

Intellect and intuition

Episodic or one-time event


What are we going to do?


Using the Ethics Discernment Framework intentionally and consistently allows us to:

  • Help leaders make decisions that flow from our Mission and Values
  • Identify and adequately address logical and logistical pitfalls of organizational decisions to promote Excellence
  • Live out Integrity by keeping our Mission and Values at the center of who we are as CommonSpirit Health
  • Identify, analyze, and resolve biases and obstacles to successful decisions
  • Avoid hasty decisions: fast = mental shortcuts = omissions and oversights
  • Create a space to engage in meaningful deliberation grounded in Compassion
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Use the Discernment Framework in the way that best fits the situation.
As a Team

  • Use the Process as a team, department, or working group
  • Identify someone to lead the discernment
  • Especially suited for Routine Decisions (see WHEN)

With a Facilitator

  • Request a trained facilitator to lead the discernment and serve as an impartial guide
  • Facilitators identify unspoken assumptions and ask the difficult questions to prompt self-reflection
  • Expected for Key Decisions (see WHEN)

Adapt a Pre-existing Process

  • To increase agility, work with the Theology and Ethics Department to integrate elements of the Ethics Discernment Framework into your team or department’s typical decision making process
  • Examples include finance, strategy at the national office


Use subsidiarity to to identify the right participants for successful discernment.

  • Subsidiarity - an ethical principle that states decisions should be made at the lowest appropriate level, as close to the issue as possible.
  • Invite stakeholders based on role and perspective, some to be present and some to provide input and viewpoints, to foster Collaboration
  • Inclusion calls us to identify participants who are diverse in background, experience, profession, and level of the organization
  • Include enough participants to represent relevant viewpoints but not so many that it restricts agility
  • Pay specific attention to how each option will impact those who are vulnerable
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Examples of when to use this framework include:
Routine decisions

  • Difference of opinion - team members or subject matter experts disagree about the best way forward
  • Policies - how does our Mission call us to go beyond the industry standard?
  • RFPs - identify values relevant to choose between top candidates
  • Unease - a decision or proposed solution might cause discomfort or misgivings
  • Uncertainty - choosing between multiple options, all of which are good

Key decisions

  • Collaborative arrangements - acquisitions, divestitures, growth, joint ventures, mergers, partnerships, etc.
  • Communications - internal or external communication strategies or marketing campaigns
  • Finance - budgets, capital allocation, or investment strategies
  • Human resources - benefits changes, compensation policies, outsourcing, difficult terminations, or RIFs or restructurings over 1,000 employees or 10% of staff
  • Operations - addition, expansion, or decrease of key services, closing or opening a facility or service line, one time capital expenditures over $10million
  • Population health – creation of shared savings plans, clinically integrated networks, or changing member benefits
  • Strategic plans – development and implementation
  • Any decision or action of critical significance for the ministry or organization