Chaplain Jane Mather continues her
discussion of HIPAA and Advocacy
HIPAA
and Advocacy: the Sequel
Our last article concerning HIPAA highlighted the potential for empowering
patients by allowing them choice with regard to clergy visits. In order for
HIPAA to enjoy the positive fruits of that intention, however, it is important
that the spirit in which those protections were conceived be part of HIPAA’s
interpretation and implementation as well. This deserves some careful consideration.
Hospitalized patients in today’s
healthcare environment are admitted
sicker and stay for fewer days
than ever before. In order to provide
today’s hospital patients with
a healing environment, it is important
that healthcare practices converge
to support patients’ needs for
medical, emotional, and spiritual
support. Since these sometimes
conflict, it is a task fraught
with challenges.
HIPAA’s regulations were an attempt
to create parity between the patient
and the healthcare facility, since
the balance of power has traditionally
favored the institution over the
individual. Whenever institutional
power is used to avoid or circumvent
practices that benefit patients’
right to dignity and autonomy,
it risks doing so at the expense
of critical mental, spiritual,
and emotional energies patients
need for healing.
In terms of local clergy access
to patients, the intention of HIPAA
was to offer patients a clearly
stated opportunity on admittance
to ‘opt out’ of the list shown
to clergy, thus protecting the
patient’s right to disclose/not
disclose their hospitalization.
When the institutional interpretation
of “opting out” involves any form
of indirect assent (i.e., burying
the question of inclusion in a
wordy “patients’ rights” document);
piggy-backing the patient’s willingness
to identify his/her religious preference
with the question “Would you like
to see a Chaplain;” or the patient
is forced to “opt in” (to declare
his/her desire to be on the clergy
list rather than simply be given
the opportunity to opt out), then
the intent of HIPAA has been violated,
even if the institution believes
it is meeting the letter of the
law.
The relational imbalance of power
between the patient and the institution
becomes particularly skewed if
the institution chooses to pursue
a purely legalistic interpretation
of any regulation, HIPAA included,
rather than thoughtfully applying
common sense. Complicated rules,
intended to protect patient’s rights,
are rendered impotent if the spirit
of the rules are not followed.
HIPAA is a complex set of rules,
subject to varying interpretations,
and fraught with legal and financial
consequences for nearly all healthcare
institutions. The ability of the
HIPAA Regulations to protect patients’
rights is dependent on all parties
pursuing the spirit of these regulations.
To date, the rights of patients
continue to be highly vulnerable.
Chaplain Jane Mather, a member
of the PlainViews Advisory Board,
is director of pastoral care at Winthrop-University
Hospital, a HealthCare Chaplaincy
partner institution. Seeking a more
diverse ministry, Chaplain Mather
came to New York from Spokane, Washington,
where she last served as manager
of pastoral services for Empire Health
Services, a two-hospital, 475-bed
system serving two trauma centers.
A Roman Catholic lay person, Chaplain
Mather is a member of several professional
organizations including the National
Association of Catholic Chaplains
and the Association of Clinical Pastoral
Education.
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Education & Research |
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The Rev. Denise Haines
on Mobilizing Students
for Change
From
Anger to Action:
Mobilizing Students
for Change
Sitting on the bus
to Washington DC, Linda
was furious. She and
I shared a seat on
the coach that left
promptly at 6am from
the B’nai Jeshurun
parking lot. Traveling
south with hundreds
of other buses, we
headed for the March
for Women’s Lives on
April 25th. Her high
school daughter had
promised to come with
us and then had elected
to sleep-in that morning.
Linda’s anger and dismay
was not so much about
the broken promise
as it was about her
daughter’s not sharing
her urgency and her
belief that this was
worth getting out of
bed for. It was time
to stand up and be
counted and she was
not there.
Working for justice,
however one defines
it (and we don’t all
agree), nearly always
means arousing from
lethargy, looking beyond
the familiar and comfortable,
eschewing hand-wringing
and helplessness, and
feeling not empathy,
but the “fire in the
belly” that impels
to action and keeps
us awake and aware.
One year, the exit
interviews from the
multiple CPE units
that we run simultaneously,
showed a pattern of
students being disgusted
and angry about the
filthy public restrooms
in their hospitals,
some serving poor neighborhoods
and some world-class
by reputation but financially
troubled. Just as an
unkempt and smelly
body is a signal of
personal distress,
so too these public
restrooms were early
warning signs—the dead
canaries in the coal
mines. Within two years,
these hospitals were
in the newspapers often
as they hemorrhaged
money and patient dissatisfaction
increased.
Since then, our CPE
faculty has been trained
to supervise “change
projects.” A change
project teaches students
to mobilize their anger
and disgust for good
purpose. In short,
they research the problem,
discern who has the
power to make change
(this is not always
obvious), and decide
if and how they or
others might take action
on their findings.
The problem of dirty
restrooms is small
but significant. In
a time when competition
for patients is fierce,
these poor public facilities
send a message: unclean,
uncaring, unconcerned,
understaffed, and unfit.
Taking on such a project,
and similar others
such as poor signage,
rude telephone answering,
etc., promotes advocacy
for visitors and for
the institutions we
serve as well.
Just as marching at
the capitol is a small
step toward a very
large and difficult
goal, so too a change
project is a tiny way
to address a huge institution’s
big problems. The million
women who took that
small step were noticed.
So too are CPE students
and chaplains who make
a concerted effort
to promote change.
It all adds up.
The Rev. Denise
Haines is the director
of education and community
outreach for The HealthCare
Chaplaincy. She is an
Episcopal priest in the
Diocese of Newark, and
a clinical pastoral supervisor
certified by ACPE since
1979. She represents
the Eastern Region on
the national ACPE Ethics
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Spiritual
Development |
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.gif) Janet Bristow on the healing ministry
of hand-knit shawls
Mantles
of Love
Seven years ago, Vicky Galo and I began knitting shawls of comfort for people
we knew. We had just graduated from the Women’s Leadership Institute at
The Hartford Seminary in Hartford, Connecticut. This certificate program
explores women’s spirituality, leadership, and feminist perspective in
religion and society. The shawls seemed to be the perfect metaphor for
what we had experienced and symbolic of the comforting, mothering, unconditionally
loving God that we had come to know. They were also the answer to the challenge
of finding a way to reach out to the people in our lives with our own gifts
and talents, go forward with what we had learned, and pass on a blessing.
We had no idea that our little ministry would go any further!
As the shawls were
passed person-to-person,
hand-to-hand, and heart-to-heart,
a grassroots movement
began. Others saw that
this was something
they could do. In times
of sorrow, little can
be said or done that
adequately expresses
one’s concern and desire
to help. No words can
make it all better.
But with the giving
of a shawl, few words
are necessary. Placing
a beautiful, warm wrap
around someone’s shoulders
in a hug of empathy
and support is transcendent.
For the receiver,
G-d’s presence is felt, as she or he realizes that they are not alone but
enfolded in the prayers and good intentions of another.
The process of making a shawl becomes a spiritual practice centered in prayer,
as prayer, for prayer. Throughout the work are sprinkled the meditations
and good intentions of the knitter for the recipient. When the shawl is passed
onto the receiver, it’s a grace-filled moment for the giver, as well, because
a part of herself goes with the shawl.
We like to stress
that the shawls are
given in good times
as well as difficult
ones. Many have been
gifts to brides and
new mothers, the newly
ordained and those
who are graduating.
They have been given
as birthday, wedding,
anniversary, rites
of passage, christenings,
and Christmas presents.
Women, children, and
men are being wrapped
in loving care.
Vicky and I travel
to various churches
to present our workshop.
We encourage groups
to make it an ecumenical
event by inviting others
in their community.
This is a great way
for people from different
faith traditions to
gather together and
connect across the
barriers of various
religious beliefs.
When I reflect on
how and why this ministry
has grown so fast and
been embraced by so
many, I can only conclude
that
G-d’s Spirit is the guiding force. Vicky and I just happened to be open to
the inspiration. It’s simple; the concept is based in love; the method is
ancient; the principle is basic with no strings attached. Knitted into this
ministry is a joy that weaves its way around, over, under, and through the
gamut of human experience from the giver to receiver and back again. It spreads
like ripples on the water, touching and expanding, going where it will, embracing
everyone, like shawls have been doing for centuries.
Janet Bristow works
in special education.
She is a graduate of
the Women's Leadership
Institute at The Hartford
Seminary, the program
that inspired her and
Vicky to start the Shawl
Ministry. Janet is a
workshop facilitator
of women's and youth
programs. She is a member
of St. Patrick/St. Anthony
Church in Hartford, CT.
where she coordinates
the Prayer Shawl Ministry
and sits on the Women
of Hope Committee and
the Health Cabinet. Janet
is married to Matthew
and has two daughters,
Beth and Amanda. www.shawlministry.com
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5/5/2004
Vol. 1, No. 7
