EthicsWalk addresses spiritual care as an ethical enterprise. It explores why relationships between spiritual care providers and those they serve need protection, and examines what that protection entails. PlainViews invites our readers to share their responses to each EthicsWalk column, which will be published in the following issue.

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Bounded Intimacy

Codes of Ethics and work place policies are external guides to professional conduct. What are the internal guides? How does one discern them? How are one’s abilities and vulnerabilities used to assist those in one’s care?

Power between giver and receiver is always imbalanced during professional care. Fiduciary (trust) duty requires the giver focus the relationship to benefit the receiver. Ethics codes and policies are deontological. Deontological requirements must be balanced with the teleological realities of individual care receivers. Professional judgment and personal discernment can never be replaced by rules. But the anarchy of personal desire is not an acceptable alternative.

That said, is there a concept to guide how one shares the self that enriches one’s professional persona? Literature in social work, psychology and ministry suggests “boundaries” [1] may.

Websters Dictionary defines a boundary as “something that sets a limit.” Ethicist Rev. Marie Fortune says, “Boundaries are a means to attend to our relative power and vulnerability in any relationship without doing harm.” Boundaries promote the ethical values of beneficence, non-maleficence, autonomy and respect for persons.

Aspects of chaplaincy relationships implicating boundaries are:
1. Intimacy: emotional, spiritual, sexual;
2. Friendship: is mutuality in relationship ever possible between professional care provider and receiver given the latter’s heightened vulnerability?
3. Finances: should a care-giver ever borrow/loan money from a client/patient?, be trustee for patient’s funds? Accept gifts or money?
4. Information: gathering more than is needed? Disclosing inappropriately?
5. Confidentiality: failing to know what must be shared? Failing to warn patient of requirements to share? Chattering on the elevator? Sharing with one’s domestic partner?
6. Promises: of more than can be delivered by the care giver’s own skill or role, the program; the institution within which the relationship occurs.

Are boundaries boarders which separate a spiritual care giver, from those served? Or, are boundaries points of contact at which people meet, but which allow the provider safely to maintain enough separation to focus on the other’s best interests rather than on the provider’s own needs or the other’s inappropriate requests?

Observing boundaries need not remove warmth. Miriam Greenspan of the Stone Center says, “Boundaries do not mean ‘detached neutrality,’ boundaries need to be about passionate, but trustworthy engagement.” Enmeshment/friendship at one end of the spectrum or “power-over” professional hierarchy do not define the full range of appropriate relationships.

Some ethicists [2] invite recognizing moments in the middle range – which occur more frequently and safely as the professional’s skills and experience increase. Boundaries may be navigated for the other’s benefit and in consultation with a supervisor or mentor. Professional care relationships should not coexist with personal ones. However, once the professional relationship terminates and time passes, friendship may occur when initiated by the care receiver [ except for psychotherapist-client relationships which remain forever professional].

Boundaries insure space for the unique intimacy of a pastoral relationship in which neither person has to worry, wonder or fantasize, “where are these special encounters going to lead?” The answer is assured: on a sacred, companied journey with the Holy One.

Anne Underwood has an undergraduate degree in religious studies, a master’s degree in rural sociology and a mid-life law degree obtained after working over a decade as a college administrator. She has mediated for the Maine family courts since 1983. Currently she serves as an advisor to the ethics commissions of ACPE, APC, the CCAR (Central Conference of American Rabbis), and NAJC, and consults with a variety of Protestant faith communities on issues of power, fair process, and congregational conflict management. Her articles on mediation and restorative justice have appeared in the ACPE News, The APC News and on the ACPE web site. Articles on clergy accountability and judicatory processes are published by the Alban Institute and The Journal on Religion and Abuse. A chapter, “Clergy Sexual Misconduct: A Justice Issue,” appears in Body and Soul: Rethinking Sexuality as Justice-Love, Marvin Ellison and Sylvia Thorson-Smith, editors, The Pilgrim Press, 2003.