We post an ethical or situational concern that has arisen in a facility where one of our readers works. It has no identifiers included. It gives you only the facts of the case. Then, you can respond to that concern. This is an ongoing dialogue, with comments added as they come in. In the following issue, assuming it has been resolved, we give you the outcome from the facility where the incident took place. Please send any cases that you would like considered for inclusion to: info@plainviews.org

We hope that this new addition will help to inform not only those who are dealing with the issue, but will enable all of our readers to learn from the experiences and perhaps mistakes of others.

PLEASE NOTE: Due to unanticipated continuing responses to both the case and the resolution of the case, added responses can be viewed in the archives. Click HERE.

CaseConference #5 resolution:

The chaplain tried to intervene and bring some calm to the explosive situation. When that did not work, security was called to ensure that the family members did not start throwing punches (one family member had already tried to land a punch and missed). Two of the more angry family members were taken out for some "fresh air." The chaplain, while initially concerned over her own safety, was able to find a calmness within that helped the other family members to calm down. The chaplain facilitated the conversation with the rest of the family. Once the remaining family members had made a decision to sign a DNR and discussed it with the attending doctor, the chaplain went in search of the two family members who had been removed by security. At the request of the family, the chaplain had been asked to relay the information to the two and to invite them to come back if they were prepared to accept what the balance of the family had decided. Upon hearing of the decision of the family, one of the two that had raised his fists started to cry. The chaplain was then able to help him begin to deal with the impending loss of his father.

When the incident was reviewed with the chaplain's supervisor, the supervisor was concerned for the safety of the chaplain. The supervisor suggesting that in the future, the chaplain should step back and not get so directly involved for fear of harm coming to the chaplain. The chaplain disagreed with the supervisor, feeling that the actions taken were appropriate.

CaseConference #5:

A patient, who had small cell lung cancer and was in the hospital for chemotherapy, coded and was in the Intensive Care Unit. The family, divided on the extent of care that their loved one should receive, got into a fight in the ICU waiting room. The Chaplain, who had been with the patient and family prior to the code, was present when the argument started. The Chaplain was aware that the family had disagreed from the beginning on how aggressive the care should be for the patient.

What is the Chaplain’s role in this situation?

Given the chaplain's presence with the family what (if any) might be an appropriate intervention with this family?

Please check below for comments made about the last CaseConference.

Send your comments about CaseConference to info@PlainViews.org.