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
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Confidentiality v. Duty of Care
Scene
1: Sandy, age 8, is admitted
for surgery. Over a puzzle
Sandy says: “Chaplain, please tell God I’m sorry for how I treat my father… I am bad. I don’t mean to be and I don’t know what I do, but he says I make him so hot he can’t help himself. Then he does things that hurt my private spots. Sometimes I cry. Afterwards he feels bad too. He cries and then buys me a present. I’m afraid God hates me for liking presents so much that I make my father hurt me to get them. Will you tell God I’m sorry? Please don’t
tell anyone but God.”
Scene 2: You find Sandy’s father, Fred, in the surgery waiting room. You sit down. He tells you he’s “ alone in his worry.” Sandy’s mother is incarcerated. Two older siblings are emancipated and Fred doesn’t allow Sandy to see them: “bad influences – don’t respect my authority or the Lord’s.” Fred leans close and says, “Chaplain, maybe you can help. Sandy and I do things that’s probably not right. Mind you, Sandy likes it and I always get Sandy something special afterwards, but the Bible says what we do should only happen with my wife.” You ask for more specifics and then affirm that the behavior is prohibited by scripture -- and state law, and is harmful to Sandy. Fred cries and says “pray with me to stop but don’t
tell no one else. I can do
this on my own with the Lord
and you.”
Is this an ethical dilemma? Strictly speaking, yes. The duty of confidentially conflicts with the duty of care (here, protecting a vulnerable child). Clergy confidentiality, many believe, encourages people who otherwise would not, to confess their sins to God in the presence of clergy who will offer spiritual guidance to foster healing and reconciliation. Rules of testimonial evidence, statutory and case law in the United States recognize and honor clergy confidentiality. Indeed, for some, this is a cornerstone of the religious freedom enshrined in the U.S. Constitution.
The duty of confidentiality is challenged by laws mandating reports of suspected child abuse. Arguably, a duty of care ethic requires clergy to examine the primacy of confidentiality in circumstances involving God’s most vulnerable persons, children (and in some instances, incapacitated adults).
What would you do here?
Note:
1. Both communications came in your role as chaplain.
2. No third parties were present either time.
3. Each communicator asks for secrecy.
4. Each requests intercessory prayer and assumes prayer and your involvement are “enough.”
5. In your state, clergy are permissive but not mandated reporters of child abuse; and, clergy privilege permits exclusion of testimony for information obtained during the course of “spiritual counseling or confession.” [No state’s privilege rule
specifically addresses child abuse reporting – privileges apply only to court related testimony.]
6. The hospital requires all personnel to report suspected child abuse to the state.
7. Would your denominational polity influence your decision?
You’re invited to share your discernment with Plainviews for dialogue with other readers and with me.
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.
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