1/18/2006 Vol. 2, No. 24

Professional Practice

Patricia J. Baldwin, OT, on a meaningful process for therapy

Spirituality and Pediatric Rehabilitation Professionals

As an occupational therapist working with children with disabilities and their families, my role, on the surface, is to address the practical and functional barriers that exist due to disability; however, the nature of working together with a child and family around disability issues quickly reveals a deeper spiritual element. The experience of disability can powerfully impact upon the child or parent’s sense of both the meaning of life and the meaning in life. As well, an individual’s spirituality and spiritual beliefs can influence their perceptions and attitudes toward living with disability. Concerns about ‘meaningfulness’in relationship to disability often become a part of the therapist’s interaction with the child and family.

Hill & Pargament [1] observe that the human experience is understood and interpreted from within a set of beliefs –beliefs about self, others and creation. Spiritual beliefs may be theistic, metaphysical or humanistic in nature. They are a unique and dynamic aspect of the individual that may be formally or informally articulated. In their study of spirituality, religion and pediatric medicine, Barnes, Plotnikoff, Fox and Pendleton note “in every clinical encounter, a child’s and family’s spirituality and religious life will interact with that of the clinician.”[2] Gaining an understanding of a child and family’s spiritual needs [3] and beliefs may provide insight into their choices, their behaviours, and the strengths and resources from which they draw support as they engage in therapy. The success of therapy is linked with the use of approaches that are tailored to the child and family beliefs and understanding of their needs. {4] Related to the development of a meaningful process for therapy, this is distinctly different from the work of spiritual care providers who address an individual’s spirituality and spiritual beliefs as an outcome.

To gain a greater understanding of spirituality in relationship to therapy services, therapists can benefit from the knowledge and expertise of spiritual care providers. Working with children with disabilities and their families in a truly holistic fashion requires that pediatric rehabilitation professionals [5]

- become aware of personal values and spiritual beliefs
- gain knowledge of a broad diversity of religious/spiritual beliefs and practices
- develop skills that support the child and family in articulating their personal values and beliefs related to therapy needs
- work collaboratively with the child and family to develop therapeutic goals and treatment that are customized and meaningful
- engage in dialogue and research that will enhance and develop the collaborative work between spiritual care providers and rehabilitation professionals
- be knowledgeable about hospital and community-based spiritual care supports and make referrals to spiritual care supports of the child and family’s choice
- advocate for inclusive participation of children with disabilities and families in their faith communities

[1] Hill, P.C. and Pargament, K.I. “Advances in the Conceptualization and Measurement of Religion and Spirituality: Implications for Physical and Mental Health Research”, American Psychologist, January 2003, Vol 58:1, pp 64-74.
[2] Barnes, L. Plotnikoff, G., Fox, K., Pendleton, S. “Religious Traditions, Spiritualities and Pediatrics: Intersecting Worlds of Healing”, Pediatrics 2000, p. 901.
[3] Bartel, M., “What is Spiritual? What is Spiritual Suffering?”, Journal of Pastoral Care & Counseling, Fall, 2004, Vol. 58, No. 3, pp. 187-201 –refers to universal spiritual needs for love, faith, hope, virtue and beauty along a spectra.
[4] King, G., Zwaigenbaum, L., King, S., Baxter, D., Rosenbaum, P. A Qualitative Investigation of Changes in the Belief Systems of Families of Children with Autism or Down Syndrome, in publication.
[5] These suggestions have been variously documented as professional training and development needs of rehabilitation professionals by authors such as J. Swinton, M.Egan & M.D.Delaat, L.Barnes et al, P.S. Richards and A.E.Bergin, L. Treolar, and D.J.Morrison-Orton.

Do you have thoughts about professional practice you’d like to share with your colleagues? Send an e-mail info@PlainViews.org.

Advocacy

Rabbi Dr. David J. Zucker on being everyone’s chaplain

OUR UNIQUE ROLES AS CHAPLAINS/PASTORAL CAREGIVERS

Exodus 28 focuses on the special clothing worn by the high priest, and concentrates on those who do the day-to-day work of representing the people before God in terms of approaching the sanctuary. In those descriptions, there are special messages for chaplains/pastoral caregivers.

Verse 6 ff. depicts the ephod and suggests that this garment has two shoulder straps. On each strap is one lapis lazuli (or onyx) stone, each one bears half the names of the tribes of Israel.

In our context, it is instructive that within this society it is the designated religious figure –if you will, the chaplain/pastoral caregiver –who carries the burden of the community on his/her shoulders. In her or his work, the chaplain/pastoral caregiver always tries to keep the broad picture, the total community, in mind. We are everyone’s chaplain/pastoral caregiver; we deal with all of the people, irrespective of their particular tribe (the Christian tribe, the Jewish tribe, the Buddhist tribe, the Muslim tribe, the Secular tribe, the No Religion Listed tribe, etc.)

Then, a few verses on, Exodus 28:15 ff. describes the breastplate, with its twelve individual stones, each containing the name of but one tribe. Aaron wears the breastplate over his heart when he enters the sanctuary and encounters God (v. 29). In like manner, as chaplains/pastoral caregivers, while we represent –and need to be open to –the community as a whole, when we are in a personal encounter with a specific person, like those individual stones, we focus on that individual. We are with them in their individuality. We encounter them on a one-to-one basis.

In the best possible way, we apply a both/and methodology to our sacred work and not the narrower view of an either/or approach. We are there for the community when that is appropriate, and we focus on each person in her/his need when that is required of us.

Sacred Source of blessing, encourage us in our daily activities to find the ongoing strength to shoulder the burden of community, and inspire within us the compassion to value each individual whom we encounter, so that we will honor Your name and Your special place in our world. Amen.

Do you have thoughts about advocacy you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.

Education & Research

Rabbi Gene Kwalwasser on the commonality of religious practices

When a Devout Catholic Prays with a Modern Orthodox Rabbi

It is mid-morning as I enter the “surgical waiting area”of Beth Israel Medical Center in New York City. I am there to visit with patients who are scheduled for surgery or family members awaiting the surgical results of their loved ones.

As my eye scans the area, I notice a middle-aged gentleman sitting in the corner of the room looking somewhat forlorn. After introducing myself and asking permission to join him, we begin a conversation. I will refer to him only as NC to protect his privacy. NC’s wife (who I will call OC), was having both abdominal and back surgery.

As we talked, NC shared his deep belief in Jesus and the divine one, as well as his feeling that the “Good Lord”sent me to be with him at this difficult time. He was anxious, nervous, and worried about the surgical procedure.

I was not quite sure how to proceed. I felt in my gut that if I prayed on behalf of OC, NC would want me to include Jesus in my devotions. As a Modern Orthodox rabbi, my faith tradition differs greatly from that of NC, and I would not be able to justify praying in such a fashion. In other situations with non-Jews, I would explain to the patient that I believe that prayer is universal, and that my words reflect our common belief in one God.

I told NC that, as a rabbi, I was not familiar with his prayer service and that it might be better if he offered the prayer. I would be more than happy to hold his hand during the recitation of his words and at its conclusion I would respond Amen which means “let it be the will of God.”

NC stood up and grabbed my hand. In turn, I stood up facing him. With tears in his eyes, he offered heart wrenching words of prayer that were emotionally very moving. As I suspected, he included Jesus in his prayer, and as he concluded, I kept my promise and answered Amen. NC gave me a bear hug, cried on my shoulder and kept thanking me in between his sobs for just being there with him. He asked if I would visit again, once his wife was in a regular hospital room. I told him that I would make every effort to see both of them later that week.

How does such an experience work for me? This was a powerful moment in my CPE experience. Ever human being has a right to worship G-d in a way that is meaningful to him. While I do not share NC’s faith tradition, I do not feel that it is appropriate for me, as a chaplain, to enter into intellectual or philosophical religious dialogue with the people I serve. When a person is in the throes of facing difficult times, I learned, my job is to just be there and help him walk through his pain.

For me, this entire experience made me feel good about the commonality of religious practice and ritual that bind people of differing faith traditions together. This could also possibly be one of the meanings of the Hebrew idiomatic phrase Tikun Olam, helping fix even a small piece of the brokenness in the world.

Do you have thoughts about education & research you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.

Spiritual Development

The Rev. Dr. William Zeckhausen on a valuable lesson for a young minister

The Widow's Might

Thirty-five years ago, fresh out of seminary, I was learning the trade, so to speak, at a venerable old church in Boston. As Assistant Minister on a staff with a Senior Minister and an Associate Minister, both at least 30 years older than me, I was routinely assigned tasks considered to be beneath them.

One morning I was told that an elderly widow, unknown to the clerical or administrative staff at the church, had taken her life. She made one request: that her funeral be conducted by a minister on the staff of the historic Old South Church. It was scheduled that afternoon. I was asked to follow up on the widow’s request.

I received no further information about this woman. She had no relatives; no other names were provided through whom I might learn more about her. I had no idea who or how many people planned to attend the service. I was given only a time and a place for the ceremony and a couple of hours to prepare the service.

When I arrived, no one was present except the funeral director. He handed me an envelope with a check from the woman’s estate as payment for my services.

The funeral director was the only other person who would be attending the service. Apparently he hadn’t known the widow either. I supposed that he probably attended several funerals of strangers every week and had no particular investment in this one. My first impulse was to return the envelope and depart. This woman obviously meant nothing to him, nor did I.

I felt uneasy delivering the service only to him. I also felt sad that this lonely woman, with no known relatives or friends, had taken her life, leaving behind just one request –and no one knew why.

I had to deal with my feelings. I decided to imagine that this woman was present during the service, and that I would fulfill her one wish. With that thought, I proceeded to deliver the service –not for the funeral director, but for her. Imagining that she was there, I didn’t feel so foolish reading the words I had prepared. Imagining her presence provided some meaning to me as I spoke to an indifferent audience of one.

Now I realize that in my awkwardness and insecurity, I assumed the funeral director to be indifferent, but really I had no idea what was going on in his mind as he fulfilled his part in a routine obligation. If I had it to do over again, I would have shared my feelings about the awkwardness of the situation. I would say that I appreciated his presence during my readings; I would tell him what I had in mind while presenting the service. Perhaps that would have added meaning to our time together. At least I might have connected with him in a more humane way, which probably would have been of value for both of us.

I departed feeling grateful that a way to address this “event”had come to mind. Rather than giving in to my first impulse to refuse the envelope and leave, I accepted the check. To return it would have felt like a rejection of the woman.

Every now and then this memory returns to me –the poignancy of that situation, and the mystery of who that woman was, and what her experience may have been at the end of her life.

Do you have thoughts about spiritual development you’d like to share with your colleagues? Send an e-mail of any length to info@PlainViews.org.

EthicsWalk

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.

If you’d like to respond to EthicsWalk, please send a comment of no more than 100 words. You can use the e-form below (click on "hearing from you," link) or submit your commentary to the editors in the body of an e-mail (or as a Microsoft Word attachment) sent to Info@PlainViews.org. Please put the phrase “EthicsWalk” in your subject line.

We look forward to hearing from you.

Responses to Anne Underwood's column

Thanks for the informative article. I look forward to the continuation. In note 12 you write, "For example, unlike compulsory secularization of public schools in France, the U.S. Court has upheld the rights of Muslim women to cover their heads and Jewish men to wear the yarmulke in government work and education forums." While I am not a lawyer, I don't believe that this statement is accurate as it applies to educational settings. (The Supreme Court case with a yarmulke involved a military officer, not a public school.) At least as of the mid-1990s, I know that Pennsylvania law (from the late 19th century) forbade public school teachers from wearing religious garb. An Orthodox Jewish teacher was threatened with dismissal for wearing a yarmulke. The organized Jewish community was divided over the free-exercise issue versus the risks of allowing more explicit (usually Christian) symbols in a public classroom and after behind the scenes discussions, there was not unity for seeking repeal of the law (originally an anti-Catholic law). As far as I know, this law still stands and there has not been any state or federal decision overruling it. My sense is that there are legal reasons why more restrictions can survive on public schools (age of the students, compulsory attendance) that might not apply in an adult workplace, for example.

Rabbi Robert Tabak, PhD
Staff chaplain
Hospital of the University of Pennsylvania

I am neither a scientific or a religious expert. I have an undergraduate degree in biology, a B.S. in nursing, and just graduated with an MDiv from Andover-Newton Theological School. I have worked as a naturalist, a community nurse, and a science teacher. I realize that people both consider evolution to be a fact and/or a theory. I tend to the former. I see nothing that is more mysterious, more magnificent than the story of life beginning as proteins emerging from the ocean and developing into Homo sapiens. The evolutionary story ties us firmly to the web of life. This understanding can lead to mindful behavior and sensitivity to all life. Thomas Berry, a Catholic priest, and Brian Swimme, physicist, have written "The "Universe Story." This book is a religious presentation of the story of evolution. James Berry, director of The Center for Reflection on the Second Law, has written, "But if it is not the perfect replacement for the old story, it will certainly do until a better one comes along. The need for it cannot be overstated. We have to rescue the Earth and we must start with a right story. This book (The Universe Story) will provide us with the energy and the will to launch into the Ecological Age. . . The new story which emerges here is the essential thing. It opens up a world of awe and joy and wonder in what lies before us." [1]

This quote does not mention the importance of the two creation stories in Genesis. These stories are important in peoples' religious lives. They provide inspiration. They do not, however, tell the scientific explanation that is so important in teaching humanity its place on this planet and how our arrogance can has been destroying our home.

[1] from website, http://trumpeter.athabascau.ca/contentv10.2/berry.html

Eleanor (ellie) Manire-Gatti
4th Unit Chaplain Intern
Amherst, Massachusetts

Theology, Science, and The First Amendment
Intelligent Design, Darwin, And Religious Freedom
Part 1: Constitutional Issues

Spiritual care providers witness events both rationally inexplicable and awesomely concrete. This may equip them to mediate the confused furor over the December 20 decision in Kitzmiller v. Dover Area School District prohibiting teaching Intelligent Design (ID) in public school science classes.[1]

Kitzmiller does not question the existence of God or the theological validity of ID. Kitzmiller does not prohibit discussing God or ID in public schools, nor does it denigrate family values and the importance of passing onto children a family’s religious beliefs. Kitzmiller does not hold that Darwin’s theory of evolution is perfect nor does it “controvert that ID should continue to be studied, debated, and discussed.”[2]

Kitzmiller does hold, based on six weeks of testimony by scientists for both Plaintiffs and Defendants, that ID is not a science and “that ID cannot uncouple itself from its creationist, and thus religious, antecedents”and concludes “that it is unconstitutional to teach ID as an alternative to evolution in a public school science classroom.”[3]

Understanding the constitutional underpinnings of Kitzmiller is requisite to discussing the heartfelt positions held by religious people on all sides of this controversy.

The First Amendment guarantees freedom of religious belief according to personal conscience without interference or influence by governmental entities.[4] Such entities cannot include or exclude anyone based on religious belief.[5] The nation’s founders, themselves people of faith, did not seek to remove God from public discourse but to “preclude government from conveying or attempting to convey a message that religion or a particular religious belief is favored or preferred.”[6]

The most challenging forum for balancing First Amendment establishment concerns and free exercise rights[7] is public schools. Students are captive audiences vulnerable to the authority of teachers’words.

Two tests for constitutional permissibility are applied when a policy which could implicate religion is proposed for a governmental entity. In the “endorsement”test, a hypothetical reasonable observer[8] looks at the evidence “to ascertain whether the policy ‘in fact conveys a message of endorsement or disapproval’of religion, irrespective of what the government might have intended by it.”[9]

The Lemon test asks of such policy: (1) does it reflect a clearly secular legislative purpose; (2) have a primary effect that neither advances nor inhibits religion; (3) avoid excessive entanglements with religion.[10]

Establishment and endorsement tests promote justice and hospitality –virtues in the three Biblical religions. As the Supreme Court observed:

School sponsorship of a religious message is impermissible because it sends the ancillary message to members of the audience who are nonadherents ‘that they are outsiders, not full members of the political community, and an accompanying message to adherents that they are insiders, favored members of the political community.[11]

Families and faith communities have the absolute right to include or exclude anyone from their gatherings for any reason. Individuals and faith communities have the absolute right themselves to be included, and feel included in any government entity without prejudice because of religious belief (or disbelief).[12] This does not permit, however, the governmental entity to provide a forum for expression of particular religious convictions.

Next month’s column enumerates findings specific to Kitzmiller. The following month suggests discussion points by analogy with other religious doctrines which defy but coexist with secular and scientific theories.

I welcome any comments you might want to submit in response to these articles.

[1] Tammy Kitzmiller, et al. v. Dover Area School District, et al., U.S. District Court for the Middle District of Pennsylvania, Case No. 04cv2688, Judge John E. Jones III, December 20, 2005.
[2] Id. 137
[3] Id.
[4] Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; Amendment I, U.S. Constitution (1791). The Fourteenth Amendment applies the Constitution to the States and hence to public schools which are arms of state government.
[5] Belief is absolutely protected; practice is not in all circumstances.
[6] County of Allegheny v. ACLU, 492 U.S. 573 (1989)
[7] One of the first such cases anticipates Kitzmiller: the 1925 challenge to teaching evolution in public schools, the so called Scopes “monkey trail.”
[8] Someone who knows the history of the disputed policy/action, the history of the community and the broader social and historical context in which the policy/action arose.
[9] Lynch v. Donnelly, 465 U.S. 668, 690 (1984) quoted in Kitzmiller at 17. The endorsement test has been applied in cases addressing school prayer, vouchers, religious student clubs meeting on school property, government aid to parochial schools, university funding of religious newspapers, etc.
[10] Lemon v. Kurtzman, 403 U.S. 602 (1971), court struck down R.I. plan to use state funds to pay parochial-school teachers only teaching secular subjects and meeting state license requirements.
[11] Id., 688 quoted in Kitzmiller at 11.
[12] For example, unlike compulsory secularization of public schools in France, the U.S. Court has upheld the rights of Muslim women to cover their heads and Jewish men to wear the yarmulke in government work and education forums.

CaseConference

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.

Case Conference # 4 (see below for responses)

A child was involved in a highly visible accident where the media was immediately present and knew (from firsthand observation at the scene) what many of the members of the family looked like. Upon arrival at the hospital, the chaplain –a vital part of the trauma code team –accompanied the family to an area typically "safe" from outsiders including media and followed protocol by asking whether the family wanted to be seen by or conduct an interview with the media. The family's answer was an unequivocal "No! Not now," which was conveyed to the press corps spokesperson.

Because the media had been on the scene and followed the emergency vehicles to the hospital, dozens of reporters, camera crews and gawkers lined the perimeter of the hospital grounds –keeping the mandated 50' distance and waiting eagerly for word of the child's condition or an opportunity to "interview" the family. However, one ambitious young newswoman who was familiar with the hospital broke protocol by removing her press badge. She (and her un-badged cameraman) made their way to the family area, asking for the family by name.

The chaplain, who was sitting with the waiting, anxious family, noticed this well-dressed woman approaching and had the presence of mind to gracefully intercept and eventually divert the intruding media miscreant! The chaplain, having escorted the woman and cameraman away from the family unobtrusively, called security and turned over the offenders and returned to the family.

A short time later the chaplain learned that the intruding media team had been warned, asked to leave the building and released on their own without serious consequence. Seeing the news crew walking up the street away from the hospital, the chaplain made chase, running after and catching up to the departing crew in the middle of the street. Then and there the chaplain proceeded to mete a form of verbal justice that actually reduced the reporter to tears. Her lack of integrity, ethics and sensitivity were harshly-but-accurately noted, as well as her assault on the privacy of the distraught family and her shameful disrespect for the rules of engagement traditionally followed by media at the hospital. Motives and actions were publicly impugned.

The chaplain felt justified in this response because of the reprehensible nature of the media team's behavior and, in the mind of the chaplain, the insufficient consequences imposed by the hospital for said behavior. (In fact ,the chaplain noted that rather than being censured for their actions, the media crew would have probably received a heroes' welcome back at the station –especially had they successfully breached the family's circle!)

Ethical questions abound in this situation, but certainly most would be leveled at the conduct of the media team. However, our question revolves around the chaplain's response to the departing media team and how or whether it 'fits' the image of the chaplain –or should! As chaplains we are more often cast as 'peacemakers' than 'warriors', but occasionally we feel compelled to lash out at injustice, insensitivity and egregious wrongdoing. When feeling 'called to battle' we hope to be armed with passion, courage and opportunity and hope that our professional role includes room for such balance.

Was this such a time for the chaplain at this hospital under the circumstances set forth? If yes, why, and if no, why not?

Responses to CaseConference #4:

I think I would encourage the chaplain to do some inner reflection to see what “buttons”this case pushed in his/her soul. This case doesn’t bring to question the image of chaplains as being peacemakers as much as it brings to mind the humanity of this chaplain, and that sometimes all of us “lose our cool.”My question is this: what was the chaplain trying to accomplish by confronting and reprimanding the departing media? What good was it going to accomplish? What buttons were pushed? What could the chaplain have done differently?

Granted, it sounds like the media was being ghoulish. However, as we watch the scads of news each day, is this not the nature of the media? Not to excuse it, but, it seems that the media were in there doing their job as well. This reporter was probably going to be congratulated for breaking through, even if it was through unethical means of gaining entry. Is the chaplain going to be congratulated by the hospital for “going the extra mile”by publicly reprimanding reporter?

The main thing I observed is that this chaplain did, indeed, protect the family and fulfill their request to not have any contact with the media.

Rev. Amy Jo Jones, BM, MM, MDiv, BCC
Chaplain/Grief Support Center Coordinator
Big Sky Hospice
Billings, MT

Was this such a time? No. This scenario arises from a clash of ethical standards and as such some resolution needs to be achieved, however a highly emotional and public confrontation is a poor means to achieve the end. The risks far outweigh any possible benefits.

Unlike the parsons of colonial New England, chaplains are not charged with the responsibility of maintaining public morality. The news crew was operating within an ethical framework practiced in their profession. By taking personal affront at their behavior, the chaplain assumes a moral superiority that is inappropriate. This superior attitude may well have arisen out of the chaplain's close emotional identification with the family. Acting on an emotionally charged impulse, the chaplain may be trying to redirect the anger and fear evoked by the chaplain's grief response to the accident onto the 'miscreant' news crew. This projection puts the chaplain's professionalism at risk along with the hospital's credibility as a healthy public institution.

As an officer of the hospital organization, the chaplain's assault on the crew puts the hospital's relationship with the media in peril. One can almost picture the 6 O'clock news featuring this wild-eyed ranter spouting frothy moral indignations as a condemning finger slashes in the air. The footage would be irresistible, and the media will hardly be able to contain their eagerness to provoke it again. The next morning, the hospital's Director of Public Relations begins to polish the old resume as Human Resources begins adding notes from the Board to the chaplain's employment record, and security may not take the chaplain's judgments upon their actions with a light heart. The chaplain, in a fit of self-righteousness, has failed the hospital team.

By assailing the crew so forcefully, the chaplain also escalates the emotional violence already present in the exchange. The very experience the chaplain hated to see imposed on the family was inflicted upon the crew. The chaplain's actions fly right past justice and into vengeance.

That said, I do believe that additional action against the crew is appropriate. The chaplain could organize hospital leaders and plan a formal response that speaks to the violation without replicating it. As Gandhi and King demonstrated so elegantly, when battling injustice, we are far more likely to be successful if we gather our collective strength and move deliberately than to lash out impulsively.

Peace,
Keith Goheen
Chaplain
Beebe Medical Center
Lewes, DE. USA

The chaplain's chasing the media people up the street gave me pause. If the chaplain had, within the hospital, told the intruders in strong, clear language that their behavior was unethical and insensitive, i would see that as totally appropriate. To punish them later, outside of the hospital grounds, seems to be a reverse of the media breaking the boundary to get what they want-- the chaplain left the boundary of the hospital to express rage at injustice.

Chaplain Jonathan Scott
Day Kimball Hospital
Putnam, CT

I do not see this as a test of ethics or ethical behavior as much as I see it as a case of unprofessional behavior, mostly on the part of the chaplain. The media may not have acted too far out of bounds for their profession. However, the chaplain was way out of bounds professionally.

I wonder if anyone who might have witnessed the chaplain's public display would choose thereafter to have the chaplain listen at bedside to their story of personal failure and brokenness. Perhaps we can best have compassion upon other's failures and brokenness when we are first aware and humbled by our own. In my thinking, it is essential that chaplains see themselves and be perceived as being in process; rather than completed and finished, so as to have indignation over the behavior of another.

Thankfully, there is a new day, and we may start anew!

Stan Dunk, M.Div.,BCC
Director of Pastoral Care
Fort Hamilton Hospital
Hamilton,Ohio

The irony of what the chaplain did to the news crew being exactly what the news crew was about to do to the family would probably be lost on them. The chaplain's anger is justified and wish to act upon it
laudable. However, doing to others what you do not wish done to you and yours is not ethical or humane. It would have been better had she written an editorial or asked the media for time and space to share her views.

Ruth Brooks
Psychiatric Chaplain
Yale-New Haven Hospital

While the chaplain did seem to act appropriately in shielding the family inside the hospital, pursuing the reporter and camera person and reducing the reporter to tears hardly seems appropriate.

The case was very slanted against the media. The case reflects the negative attitude prevalent in our society these days. Yes, unethical journalists exist just as unethical people exist in every field. The case included a side comment from the chaplain in paragraph 5 that clearly illustrates the writer and chaplains distain for “the media.”The first sentence of the last paragraph assuming most of the ethical questions would involve the media further illustrates this negative slant. Did the case writer talk with the journalist to get that side of the story before writing the case?

This case has given me the opportunity to reflect on ways to respond to the people who assume members of the press should be treated with disdain.

Dorie L. Griggs, M. Div.
Producer,
Faith And The City Forum: Interfaith Dialogue on Public Issues

My contribution represents my own opinion and does not reflect views or policies of the department or hospital for which I work.

The case writer asks, whether the situation "called (the chaplain) to battle". My response, in keeping with the martial metaphor, is to ask two questions. My first question is, "Whose army are you enlisting in? Yours? The hospital's? The professional chaplains'?"

The Common Code of Ethics for Spiritual Care Professionals (refer to the APC website) adjures spiritual care professionals to "clearly distinguish between statements made or actions taken as a private
individual and those made as a member or representative of one of the cognate organizations" (Standard 4.12). Personally, I conclude that chaplain is "freelancing" by not consulting with other hospital staff before confronting the news crew. The hospital's response was to turn away the news crew and let the issue rest. The chaplain's subsequent intervention runs counter to the hospital's action, which I
view as a blurring of the distinction between personal action, and action taken by the agencies we represent. Therefore, the chaplain's intervention is questionable from an ethical standpoint.

Secondly I ask, "Have you thought out your tactical approach?

How we "do battle" is fraught with ethical questions as well.

Alternatives exist should one feel the need to further pursue the news crew's breach of the area protecting the family. Journalists are also professionals and abide by a code of ethics. The RTNDA (Radio Television News Directors Association) code of ethics highlights values of public trust and professional integrity and discourages newsgathering techniques that compromise respect for "subjects of news". The RTNDA code of ethics also advances the notion of public accountability. Therefore, the chaplain as a concerned private citizen might approach the news organization to lodge a complaint. The chaplain as a professional (ethically bound to respect other professions per the Common Code of Ethics Standard 4) might advocate that the hospital contact the news director or station manager to point out the blatant ethical wrongdoing on the part of the news team.

The statement that the media crew would receive a "heroes' welcome" when they returned to the station may or may not be valid. I sense within this statement the fallacy "you've seen one, you've seen 'em all". Such a fallacy cuts both ways. The journalist in question might infer that all chaplains are confrontational and reduce journalists to tears as a regular part of our work (a possibility one of our CPE residents identified). Another fallacy of generalization might be that the chaplain was speaking for the hospital and therefore the hospital's practice is to confront "harshly-but accurately". The chaplain's actions might engender such fallacious reasoning in the public's perception and therefore be deemed as doing harm.

Broadly speaking, was harm avoided when the chaplain "gave chase to the news team" and "meted out verbal justice"? The family appeared sufficiently protected with the chaplain's deft managing of the situation at the time the news reporter tried to approach the family.

Did any good come from the chaplain's confrontation of the reporter? Did the reporter benefit? We don't know whether the reporter's tears flow from contrition for her ethical failings or out of chagrin for being chastised in front of colleagues. The reporter may have learned her lesson. Or she might have resolved to be cleverer to avoid capture and censure next time. Who knows?

Did the chaplain's actions serve to advance the journalist's or the station's ethical observances? We don't have the details to speculate. Was the general public served? Frankly, I doubt it.
Thank you for posting this stimulating case for our consideration.

Speaking only for myself,
Bart Coleman, M.Div
Staff Chaplain
Boise, Idaho

Please check below for comments made about the last CaseConference.

1/4/2006 Vol. 2, No. 23 - Case #3 Resolution
12/21/2005 Vol. 2, No. 22 - Case #3
12/7/2005 Vol. 2, No. 21 - Case #2 resolution
11/16/2005 Vol. 2, No. 20 - Case #2
10/19/2005 Vol. 2, No. 18 - CaseConference #1

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Reviews

Sarah Masters reviews the film:

Devil's Playground

The primary rite of passage celebrated in the Amish community is wrenching. Boys and girls raised in the insular Amish world are turned loose at the age of 16 to experience the secular world. This “English”world they call the Devil’s Playground. The rite of passage, referred to as Rumspringa, or “running around,”releases these teenagers from all Amish religious and cultural restrictions for periods that range from just a few months to several years.

Winner of numerous film festival awards, including Best Documentary Grand Prize at the AFI DV Festival, Devil’s Playground earned a slot at a recent Sundance Film Festival, and is the first film to really get inside the Amish community. The film’s release radically altered the secular world view of this American religious subculture, so deeply rooted in 18th century religious tradition. Devil’s Playground is highly instructive on many levels for chaplains working with individuals who are wrestling with their faith and commitment to a religious way of life.

Devil’s Playground follows four Amish teens with no curfews and restrictions on their whereabouts through Rumspringa as they attempt to decide whether to be baptized in the Amish church, a lifelong commitment, or to leave the community. They are keenly aware that if they choose the church and then change their minds, they will be shunned. “If you’ve joined the church and then leave, they will shun you,”one teenager says. “The shunning for them is their last way of showing you that they love you. They think that you’re breaking your promise to the Amish church. They’re afraid for your soul.”

It is striking that the large majority of these children choose to return to an Amish way of life.

Completed: 2001
Running Time: 77 Minutes
Director: Lucy Walker
Producer: Steven Cantor
Executive Producer: Julie Goldman

If you are interested in purchasing this film, you can do so at www.hartleyfoundation.org. Just click on “Masterworks”on the homepage for more information. The cost of the film series is $24.99 for a DVD.

Book Review

Joan Paddock Maxwell reviews:

Intensive Care: A Doctor's Journal

As an acute-care hospital chaplain I'm keenly aware that my ignorance of advanced medical techniques keeps me clearly allied with naive patients and their families and so is a good thing. Nonetheless, I decided it would be helpful if I learned a bit more about the specialized vocabulary and activities of intensive care units (ICUs), where I spend a good deal of my professional time. Happily, I stumbled upon a paperback by John F. Murray called Intensive Care: A Doctor's Journal (Berkeley: University of California Press, 2002) which offers an easy-to-absorb dose of ICU-specific medical terminology and medical concerns.

Set in an inner-city acute-care hospital in San Francisco, the book records Dr. Murray's real-life patient and staff interactions over a 30-day period while he served as the attending physician on the ICU. The book's main point seems to be to describe the intense and complex medical care given to indigent locals ravaged by alcohol, drug abuse, and HIV. In the process, I learned about such things as pressors, weaning, tracheotomies, and the pecking order among the staff. I was struck by Murray's distrust of surgeons and their –to him –eagerness to "cut" no matter how sick the patient. Written for the intelligent general public rather than for a medical audience, the book moves along quite well and has made me feel better able to follow case conferences by medical staff.

Intensive Care: A Doctor's Journal. John F. Murray. (Berkeley: University of California Press, 2002). 296 pp.

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