Chaplains respond to an issue of great importance

Responses to the Spirituality/Medicine Interface Program

Editor’s note: Normally, responses to articles are included in TalkBack. However, the responses to Dr. Hamdy’s article, “Spirituality and Medicine” that appeared in the last issue of PlainViews (Education & Research, June 21, Vol 3, No. 10) raises an issue of great importance to the chaplaincy profession. PlainViews encourages chaplains to write and participate in raising the level of professionalism, awareness and understanding with other disciplines that interact with chaplains. Therefore, the decision was made to include these comments in place of an article, including Dr. Hamdy’s response to the two chaplains who responded so forcefully and passionately to his article.

I appreciate that the Southern Medical Association has taken the initiative to hold a conference addressing issues of spirituality and medicine as described by Dr. Ronald Hamdy in the June 21 issue of PlainViews. Dr. Hamdy notes that "Patients often value interactions with community-based clergy and hospital chaplains saying their visits bring hope and ease difficulties." He also goes on to identify that the scope and objectives of the Spirituality/Medicine Interface program are to "promote among physicians, chaplains, counselors, students, ministerial staff affiliated with hospitals, social workers, nurses, and other health care professionals - an appreciation of the importance that spirituality and religion may have in their patients' lives."

However, upon closer look at the information on the website promoting the conference, the Spirituality/Medicine Interface Program faculty does not include a board certified professional chaplain. I wonder how the program intends to "encourage dialogue on this topic" when spiritual care professionals are not included as faculty members. This would be akin to another professional organization offering a conference on medical interventions without including a physician's expertise. As one who works with numerous healthcare agencies and disciplines in articulating the contributions of board certified professional chaplains and knows the importance of first learning my audience before attempting collaboration or providing input, I find this offering disappointing.

One additional note: if Dr. Hamdy and the Southern Medical Association were truly engaged in understanding the role of spirituality, beliefs, and values in medicine, they would be sensitive to the choice of language that is being used in this Program. The use of words such as "clergy" and "ministerial staff" indicate a Christian bias, and are not inclusive of the wide range of religious and cultural beliefs. In the same way, the linking of "spirituality/religiousness or religiosity" shows a misunderstanding of the
significant differences between the two. A board certified chaplain, if included in the planning process, would have identified these issues before the information was finalized. One only has to look at professional literature and programs of healthcare organizations, including the AMA and JCAHO, to see that professional chaplains have contributed greatly and are sought out for their expertise.

The Southern Medical Association has shown good intent to begin to engage in dialogue on this critical topic. This could have been a wonderful opportunity to engage in dialogue on ways to contribute to better patient care by attending to spiritual, religious, and cultural beliefs, values, and needs. I am saddened that board certified professional chaplains, who are the trained and nationally certified experts in spirituality and pastoral care, have not been invited to share their expertise.

Rev. Sue Wintz, M.Div., BCC
Chair, Commission on Quality in Pastoral Services
Association of Professional Chaplains
St. Joseph's Hospital and Medical Center
Phoenix, AZ

What an interesting juxtaposition of articles. On the one hand, we have an excellent article by Rozann Shackleton advocating for the need for professional chaplains to pick up the pen and enter the world of publication. Without our valuable input into the critic issues of the intersection and application of spirituality and healthcare, the field is left wide open to other professionals, such as physicians, nurses, social workers, etc., who are neither intentionally trained nor directly work in the area of spiritual care in a healthcare setting.

Then, on the other hand, we have an article, or better, advertisement by Ronald C. Hamdy, MD, for a workshop coming up in September at Emory on the intersection of spirituality and medicine sponsored by the Templeton Foundation. How exciting, we think to ourselves as all giddy we follow the links to the web page. But, low and behold, as most things on this level of sponsorship, we find all MDs, a couple of PhDs and one ThM--but no board certified chaplains!!! According to the bios for the faculty, I did not see one who directly provides spiritual care in a healthcare setting. I did read quickly, however, as my giddiness drained over the let down of once again finding that the medical-scientific community has their own agenda when addressing the issue of spirituality, which appears to be getting all the research money and then putting on showcase workshops for one another.

It sounded so good and forward thinking, Dr. Hamdy, when I first began to read. But it is the same old suffocating blanket of medicine's hegemony attempting to spread itself over an area of which few medically trained physicians and academically trained PhDs have working knowledge. This is evidenced by the "teaser" case on the web page that attempts to lure us with interest to the workshop. Baa, humbug! If you want to understand the intersection of medicine and spirituality, then engage some professionally trained and board certified chaplains as dialogue and presentation partners. Otherwise, don't pretend to offer something that is related to our work as chaplains.

Respectfully,
Mark LaRocca-Pitts, Ph.D, BCC
Staff Chaplain
Athens Regional Medical Center
Athens, GA

Dr. Hamdy's response:

The over-riding goal of the conference, as stated in the Mission/Vision (page 2 of the brochure) is to "promote, among physicians and health care professionals, an appreciation of the importance that spirituality and religion may have in their patients' lives..." As such we felt it appropriate to have among the faculty physicians with expertise in this area. I hope you will agree that the credentials of Drs. Koenig, Peteet, and Curlin are outstanding and that they are very well suited to address these issues. Rather than having "professional chaplains" discuss what they may have to offer, it was felt to be of greater impact if these comments were made by the consumer, i.e., the physician who has witnessed, utilized, worked with, and come to appreciate the value of the "professional chaplain." This also would give an opportunity for the chaplains to interact with clinicians and appreciate their perceptions.

The contents of this program have been developed with significant input from "board certified chaplains". Furthermore, of the 6 faculty, 3 are MDs, 2 are theologians and one is engaged in public health. This conference is part of a large initiative launched by the Southern Medical Journal and Southern Medical Association to examine the Spirituality/Medicine Interface. An advisory board, with representation from "board certified professional chaplains," has been formed to advise on all components of the program. Indeed, at the inaugural session of the program last November, one of the three lectures was given by a professional chaplain.

The April issue of the SMJ Spirituality/Medicine Interface is entirely dedicated to chaplain education and their role in health care. Its main aim is to familiarize clinicians with the background, education, knowledge, experience and potential of chaplains who we strongly believe should be an integral part of the health care team. Alas, as we all well know this is very often not the case.

Frankly, I am disappointed. We are trying to bridge the gap between spirituality and medicine; we are trying to highlight the importance of spirituality in health and the important role chaplains have to play. I would have expected chaplains to seize the opportunity and actively get involved in the dialogue we are trying to initiate. Instead, I note with regret that you are more concerned about the choice of terms and of faculty. The interactive format of the conference with plenty of time for discussion should offer chaplains who attend the conference ample opportunities to establish their claims and correct any misconception.

The gap between spirituality and medicine cannot be bridged unless we are prepared to blunt our sensitivities, repress our prejudices and engage in a dialogue with a positive attitude. I hope that the conference in Atlanta will provide such a forum and I sincerely hope that you will attend and especially participate in this conference to clearly state your views and engage in a constructive dialogue. As this is a dialogue, no one has the "final word," nor do we wish this conference to be limited by such temporal concerns.

I look forward to meeting you in Atlanta next September.

Ronald C. Hamdy, MD, FRCP, FACP
Editor-in-Chief, Southern Medical Journal
Professor of Medicine
Cecile Cox Quillen Chair of Geriatric Medicine
Director, Osteoporosis Center
East Tennessee State University
Johnson City, TN

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