Seattle Children's Hospital's Version of Accountability Fails to Prioritize Healing of Odessa Brown Families

by Adana Protonentis and Jasmine M. Pulido

In the weeks since Dr. Ben Danielson's resignation from the Odessa Brown Children's Clinic (OBCC) was made public, there has been an outpouring of shock, grief, anger, and loss from the community he served. Running consistently through these messages have been calls for accountability. But what does that mean?

"True accountability is not only apologizing, understanding the impact your actions have caused on yourself and others, making amends or reparations to the harmed parties; but most importantly, true accountability is changing your behavior so that the harm, violence, abuse does not happen again." — Mia Mingus

In the United States, accountability is often transactional. Our criminal legal system is an example: Someone commits a criminalized act, they are assigned a punishment (jail or prison time, restitution, community service), they complete the punishment, and the case is closed. There are collateral consequences that continue to punish the "offender" for years afterward, and those who were harmed rarely find closure. The wound cannot heal. In this version of accountability, the community is not centered. There is a transaction between a system and an individual. The individual is punished, but no one is made whole.

We have seen a similar process play out in organizations: A company is accused of racism, they make a symbolic gesture (usually terminating someone), issue a vague statement about their commitment to equity and inclusion, and then lay low until the news cycle moves on. It's a pattern we've seen again and again. These examples beg the question: Is this enough? Do these steps lead to behavioral change and transformation? Can this business-as-usual approach create the conditions for trust to grow again? Does this version of accountability facilitate healing?

Community members have continued to ask for an acknowledgment for the harm done to Dr. Danielson, OBCC and Seattle Children's Hospital (SCH) staff of color, and OBCC families through a public apology that explicitly acknowledges SCH's role in institutional racism and a commitment to do better. "Step one is basic acknowledgement of what happened versus giving a more generic response," Korean American OBCC parent of two, Jimmy Kim said.

South Seattle families consistently vocalized their desire for transparency and honesty, a follow-up with concrete steps, in moving forward with SCH. Srilata Remala, one of the trustees on the SCH Foundation Board, made a clear distinction of what families have communicated to her as a board member. "The intention is not to bring down the system," Remala said. "But we also need to ask ourselves, in order to move forward, that Children's acknowledge the harm that has been caused to the community."

In a city where racism has been declared a public health crisis, in a medical institution that houses doctors who take seriously the Hippocratic Oath to "first, do no harm," these steps are critical for healing this community and the children it promises to serve. Beyond that, South Seattle families also expressed an extensive investment into supporting the mental health and well-being of leaders, physicians, and nurses of color still providing care at OBCC, as well as hiring more providers of color. "I just think there needs to be real substantive money and recruitment of physicians of color, particularly Black physicians, to bolster the existing Odessa Brown clinic but also in establishing the new one [being built] in the South [King County]," African American South Seattle parent, Jason Davison said.

While a Family Advisory Council for SCH does exist, it does not specifically center the needs of the predominantly Black and Brown communities OBCC serves. The council is tasked with advising SCH more generally and providing feedback on "proposed policy, program, and organizational changes." The council's mandate does not include an explicit focus on social equity or anti-racism. OBCC families have called for more opportunities to be seen and heard by SCH leadership and, more specifically, for Black and Brown people's voices to be centered in these conversations.

The South Seattle community repeatedly requested to be an integral part of future decisions and actions that will impact their children. A town hall held by OBCC leadership on Jan. 16, supposedly for OBCC families grieving Dr. Danielson's departure, focused more on the clinic's founding and history, with minimal reference to his departure. Few questions about Dr. Danielson's charges were answered.

The community's calls for accountability align with the principles of transformative justice (TJ). What we now call transformative justice is rooted in approaches to conflict management that communities of Color have practiced for centuries. Following the rise of restorative justice as an effort to improve our criminal legal system, our current iteration of TJ arose out of queer, trans, and disabled Black, Indigenous, People of Color (BIPOC) communities who, through practice and collective process, expanded restorative justice to a framework for navigating and addressing issues of harm without involvement of police or prisons. In Beyond Survival, authors Dixon and Piepenza-Samarasinha tell us TJ seeks to disrupt and dismantle the upstream systems, structures, and norms that created the circumstances for the harm to occur. TJ explicitly challenges and addresses inequities, injustices, oppression, and domination. It calls upon everyone to voluntarily engage in a critical dialogue and the need for everyone to transform.

Transformative justice seeks to break cycles of harm. It is a liberatory approach to justice — seeking not to punish but to transform the systems that allowed the harm and violence to occur. TJ is about changing circumstances. It is collaborative, not proscriptive. It requires coming together, sharing power, and working to create the conditions for community members to feel safe. It is not a hierarchical process. It is a tool for liberation.

Transformative justice cultivates the things that promote well-being and prevent violence, such as healing, resilience, safety, and accountability. According to TJ scholar, Anthony Nocella, II, "Transformative justice, while addressing oppression and the role groups, institutions, and agencies have in creating and maintaining oppression, does not view anyone as an enemy, but rather argues that everyone needs to be involved in a voluntary, safe, constructive, critical dialogue where people take accountability, responsibility and the initiative to heal." TJ is an invitation to approach conflict creatively to address inequities, injustices, oppression, and domination through accountability, responsibility, and, most importantly, healing for transformative change. In other words, it is the opposite of what we have seen from Seattle Children's Hospital.

What have we seen and heard from SCH? Colonizer-style accountability.

What we have seen from SCH is a powerful, wealthy institution dictating the terms of accountability. There was an initial statement declaring a commitment to diversity, equity, and inclusion and promising an investigation. Then there was the creation of a steering committee without a single patient family representative. Next, there was the resignation of Dr. Jim Hendricks, followed by the engagement of a high-profile law firm from out-of-state. SCH CEO Jeff Sperring sent a letter to the King County Board of Health (KCBH) where he takes responsibility for the harm caused but does not apologize nor address OBCC families directly in any way.

None of these steps center the community that is in pain. None of these steps create conditions for trust to grow. None of these steps demonstrate a commitment to relationship-building, reparation, or healing. These steps are transactional, not transformational.

What these actions and decisions communicate is that SCH puts its faith and trust in those with prestigious titles and a wealth of resources to determine the way forward, rather than simply listening to and believing the community that has been harmed. They engage outsiders to conduct and manage an investigation, rather than partner with any of the many qualified equity professionals in our area. They minimize direct engagement with those who are most impacted. This isn't leadership, and it isn't accountability. SCH is not demonstrating a willingness to be accountable to the BIPOC families that trust them with their children's health. "This is unfortunate, but not surprising," Korean American OBCC parent, Gina Kim reflected while thinking about what response she has seen from SCH so far.

At the KCBH meeting held on Jan. 21, Resolution 21-03 unanimously passed for a "prompt, independent review of allegations about institutional racism at Seattle Children's Hospital." King County Councilmember Jeanne Kohl-Welles added language to include immediately engaging the community's extensive input in the independent investigation. King County Councilmember Girmay Zahilay added a request to lift related non-disclosure agreements for the sake of transparency in said investigation. During the discussion, Kohl-Welles noted that, in meetings with the SCH administration, SCH leaders appeared reluctant and wanted their own assessment conducted. She stated it took an ample amount of community and stakeholder input for SCH to agree to include the community. Dr. Danielson reflected, "As someone who has — a lot more than I care to — not seen systems work well in my own personal life, I am not prone to having a lot of faith in official investigations."

While SCH hasn't yet moved past their attachment to transactional accountability, the exhaustive rallying of local council members, health officials, stakeholders, activists, OBCC families, and community voices continues to strongly demand SCH come to the table for a different, more transformative, approach.

On the same day as the KCBH meeting, SCH held a CEO Town Hall announcing an "Anti-Racism Organizational Change and Accelerated Equity, Diversity, and Inclusion Plan" which claims to build in accountability that prioritizes an inclusive work environment for workforce, patients, and families. Five days after the KCBH's resolution passed, SCH announced, starting Feb. 8, Andrew Lee, Psy.D., formerly the chief diversity and inclusion officer at WellStar Health System in Georgia, will join SCH as vice president and chief equity, diversity, and inclusion officer. Alicia Adiele, MSW, LICSW, will serve as the director of the Health Equity, Diversity, and Inclusion Team and as the director of the Center for Diversity and Health Equity. Workforce members are also being asked to participate in strategy and feedback sessions to provide input for the establishment of a Health Equity, Diversity, and Inclusion Council.

Lastly, SCH is now exploring the formation of an Odessa Brown Parent Advisory Board. A one-hour listening session was held Jan. 31, with a second expected in the coming weeks. Feedback from these listening sessions is expected to inform the content of a planned February town hall with SCH executive leadership. It is unknown what form the potential OBCC parent group will take or what power the group will have.

While most of these changes still don't center the Black and Brown families at OBCC, the passing of Resolution 21-03 states, "The King County Board of Health calls on Seattle Children's Hospital to engage the community in the investigation." How much weight that input will carry remains to be seen.

The most powerful thing about transformative justice is the emphasis on community sovereignty. South End families will continue to advocate for transparency, collaboration, and behavior change. At the same time, these same families are mobilizing support for each other, Dr. Danielson, and the staff and families in the Odessa Brown community. South End families are accountable to each other — accountable in a way that is generative, holistic, and relationship-centered. They can be, and are, the trusted advisors of their own care. The only step left is for Seattle Children's Hospital to open its doors to their wisdom.

Adana Protonentis is a consultant, advocate, scholar, and a mother. As an organizational development consultant, Adana helps organizations put their values into practice and develop strategies that promote cultures of care, belonging, and accountability. She identifies as a mixed race, Black, disabled woman, and her work is rooted in the belief that our stories have the power to heal and liberate. She lives in South King County with her two kids, husband, and two dogs.

Featured image is by Justice Beitzel; used here under a Creative Commons license.