PlainViews

Re: Chaplains: Are Hospitals Our Houses of Worship and Its Staff Our Congregants?, David Plunner (PlainViews, 4/2/08, Vol. 5, No. 5)

It is true that how we define our role is important in our relations with the professional staff of the hospital. On the other hand is it not equally true that the parishioner (hospital staff) chooses his own pastor, whether a chaplain or a local pastor, irregardless of how the chaplain defines his role.

I can also recall while on active duty asking another officer (I was only chaplain on the ship) to be my pastor and he was very helpful, reminding me of my unrealistic expectations of my commanding officer.

Rev. John R. Thomas
Retired Chaplain
Madison, WI

David Plummer asks: "Who sees the hospital as their house of worship? Why?" As a follow-up comes that great classic clinical pastoral education question: "Whose needs are being met?"

I am not a chaplain, although I have supervised chaplains in a spiritual care program and as a pastoral counselor, I consider chaplaincy a sister-discipline.

Plummer’s comments suggest that holding the pastoral role for the institution one serves rather than just its patients smacks of proselytizing and the imposition of one’s spiritual authority. I don’t believe that’s the case in my experience.

Chaplains carry their spiritual authority and an archetypal role wherever they go. The same is true of all ministers. One of the reasons I (finally) was ordained, despite my devotion theologically to the principle of the priesthood of all believers, was that it became apparent to me that the professional minister receives the unconscious projections of God or divine power from people – all kinds of people. It’s being the screen for those projections that allows us to work with the faith experience in a deep and profound way with patients, staff, colleagues – all whom may have their own pastor or pastors outside the institution in which we cross paths. The same dynamic is present for doctors, nurses, police officers and others. In assuming these roles, we have attached ourselves to a strong current of cultural power and influence, far beyond our own personal resources. The flow of this power is both seen and unseen. This is why it’s so important to weigh ethical issues carefully, and balance personal freedom against the responsibility to carry this professional role lightly and yet gracefully.

I do believe the chaplain is not only chaplain to patients, but to the institution. Chaplains are often called to engage the entire system on questions of ethics, to advocate for patients and their families and to interpret matters of faith to a constituency far beyond the patient’s room. I have seen chaplains spared criticism, given free coffee, and all sorts of special privileges because of unstated and assumed beliefs about what and who they represent to staff in the institutions they work. Chaplains cannot create an atmosphere devoid of this special influence and power within these institutions, and thus they exercise personal freedoms only within their professional role there.

Rev. Elizabeth (Betsy) Ritzman
AltCare Health Center
Oak Park, IL

I appreciated David Plummer's provocative questions about how we view fellow employees in our institutions...as "parishioners" or not. (I was also glad to hear of other discussion about the ER chaplain character beyond the comments of Nancy Berlinger and myself in a previous PlainViews).

While I do not view the hospital in which I work as a house of worship, staff and I often acknowledge that we are witnesses to sacred events about which they want to talk, albeit not usually in religious language.

I do not see hospital staff as congregants but - as part of our Spiritual Care Department mission - very much potential recipients of pastoral support. I go beyond waiting for staff invitation to pastoral dialogue, often initiating it when I've observed a staff member having a particularly challenging day, or when we've been involved together in an intense event. I judge whose needs are being met by the responsiveness, or lack of, from the staff member..and base my next steps accordingly. Requests from staff for periodic support groups - with our chaplains' involvement - tell me that our pastoral approach seems to be received well.

Thanks for the dialogue.

Julie Allen Berger, B.C.C.
Anchor Chaplain, Oncology Services
Barnes-Jewish Hospital
St. Louis, MO

My job description requires me to provide spiritual care to patients, their families and staff. Therefore I consider the hospital to be my parish and the staff come under my pastoral care, if they choose to seek it out.

I have had staff that I have previously had no relationship with approach me for pastoral care – the point being that any staff member can contact the chaplain at any time. They do not have to have had a previous relationship with them.

With regard to the comment about what other healthcare professionals would regard workplace colleagues as a part of their charge, calling, or responsibility – Chaplaincy like all forms of ministry is a vocation. I have difficulties with the idea of ministry being a profession in the sense of non religious professionals. Yes I am a professional in the sense of education, training, and competency, but I am called by God to serve his people in the institution in which I serve.

With regard to the chaplain in the ER Programme ( I have not seen it yet as we are some months behind the US with TV programmes, my real issue would be that chaplain enters into a sexual relationship outside of marriage. Many churches take the stand, “If single, celibate, if married, faithful”

Rev Ray Bloomfield QSM JP
Rotorua
New Zealand

I was involved in the conversation on the listserve that David Plummer referenced. It's possible that my point was not understood or was not stated clearly. Anyone who carries the title "Chaplain," whether ordained or not, is a designated "spiritual leader" in the organization that has conferred that title. The person carrying the title may be a CPE student who will have the title just for three months. That person is still a "spiritual leader" in that place and for that period of time. The title and role carry a certain set of behavioral expectations that likely do not attach to one with a title like "nurse," "doctor," "medical student," etc. A person who functions as a chaplain in an emergency department who begins to date a resident physician in that emergency department is "flirting" (irony intended) with the boundaries of those expectations. If the publicly observable behavior by the chaplain and the doctor in the emergency department leads the unit clerk to ask (mostly rhetorically) the physician: "Are you banging the chaplain?" then the boundaries have definitely been crossed. This has nothing to do with how I (or any other) chaplain views the nature of our relationship with the folks who work at our institutions. It does have to do with the role of "spiritual leader."

Jon Altman, Chaplain
Southern Care Hospice
Jackson, MS

The hospital where I have worked 16 years is not my house of worship. I worship in the congregation of my choice and do not have to put on a service of worship for patients and staff on the weekends. However, my position description states that I am to offer spiritual care to all who come to me for it, including staff. I sometimes counsel them individually a time or 2. If more is needed I refer them to our excellent EAP. So I choose not to form “best friends” with any of our staff as I may have occasion to be a “listener” for them. I believe strongly it’s the same with those who are pastors of congregations. One’s intimate associates should not be those for whom one is pastor. It’s the pastor’s and/or chaplain’s responsibility to set the boundaries in a relationship. I think calling the hospital one’s house of worship is different than maintaining pastoral boundaries with the hospital staff. This is not to say that we don’t enjoy each other’s company both on and off site. But none are my close friends, by my choice.

Mary E N Hanke, MDiv, CT
Chaplain
Stevens Hospital
Edmonds, WA

As a chaplain, I consider my patients, mostly hospice patients, to be my “flock” if you will, especially if they desire that relationship and have no other spiritual support.

As a support staff chaplain, I am friends with colleagues, but only broach a pastoral stance if they initiate the conversation and ask for guidance/support. At first, I attempted to be the chaplain 24/7, but found I was absolutely too drained. I realized that is precisely why I did not go into pulpit ministry and relaxed in knowing that God would have there the one who needed to be with that patient/family at that particular time.

Rev. Frankie B. May
Chaplain, Trinity Hospital/Hospice
Augusta, GA

Re: Health care and the rights of children, Jeanne M. Tessier (PlainViews, 4/2/08, Vol. 5, No. 5)

As a chaplain who worked for over twenty years primarily on the pediatric unit in one of the world’s premier cancer centers, I am sympathetic to Chaplain Tessier’s plea to give children a voice in their own care, especially at the end of life. Certainly, children must have a say in their own care, especially when that care is life preserving or palliative as opposed to life saving. There clearly are still too many places in our country where children’s voices are not routinely heard in these contexts.

However, given all of that, Chaplain Tessier far overstates her case and, in the process, does a significant disservice to several generations of care givers who have worked very hard, often at great sacrifice, to achieve many of the goals that Chaplain Tessier implies are not even underway.

First, she does not seem to appreciate the difference between consent which, generally by law, is not a right that minors have, and assent which is a right now written fairly routinely into experimental protocols that enroll children and incorporated generally into many pediatric practices.

Dr. Bluebond-Langner wrote her seminal work a full thirty years ago. While her vignettes are still highly instructive and should be required reading for anyone in pediatric chaplaincy, much has changed in the interim. In the unit I worked on, it would never be the case that a child would be given an experimental treatment such as a third bone marrow transplant without their assent. And this unit is far from unique. We have come a long way from when I trained in the early 1970s when parents were often not even allowed to stay over night on pediatric units.

Chaplain Tessier is simply wrong in stating that the effort to have children’s voices heard in health care is only beginning. Yes, much left to be done. However, there are scores of dedicated nurses, doctors, social workers, child life specialists, and even a few chaplains who have made sure that, on the pediatric units where they work, the voice of the child is certainly heard and respected. Their work needs to be honored.

Rev. George Handzo
Vice President, Pastoral Care Leadership & Practice
The HealthCare Chaplaincy
New York, NY

Re: Reaching Beyond Our Walls, Carolynne Fairweather (PlainViews, 3/19/08, Vol. 5, No. 4 )

Thank you to Chaplain Carolynne sharing her story, "Reaching Beyond Our Own Walls." Wow, another reminder of what can happen when one listens to the Spirit guiding.

Rev. Louise Shepard,MATh,, MS Ed, CT
Pediatric Chaplain
SUNY, Upstate Medical University
Syracuse, NY

Re: Judaism and (Our Struggle with) Dependence, Daniel Coleman (PlainViews, 3/19/08, Vol. 5, No. 4 )

I very much enjoyed Rabbi Coleman’s article on Judaism and our struggle with Dependence. It gave me several good points to think about and to incorporate in my care giving with others. I appreciated the richness and depth of his thoughts, questions, and pondering and how he connected them so intricately with his faith tradition. It is an article that I will reflect on as I muster additional tools for my chaplaincy belt. Thank you for sharing your gifts Rabbi Coleman.

George A. Teachey, M.Div.
New York

My colleague Rabbi Daniel Coleman's magnificently crafted article on "the freedom to just be" hits the most defining issue in medical ethics on which I am presently writing a book--the "Jerusalem" approach to health care versus the "Athens" aapproach to health care. According to the ancient Greeks, you had to be a "do-er" in order to deserve life. Biblical thought considers every human life sacred and infinitely worthwhile simply be virtue of being created in G-d's image. It is "Jerusalem" that gives us the right to simply be. "Athens" says "Be a do-er or die!" We can only hope that Jerusalem triumphs.

Rabbi Louis J. Feldman, Ph.D.
Retired Chaplain
Board Member
Scholl Institute of Bioethics
Los Angeles, CA

An up-date from the Ukraine about their Palliative Care movement

Dear Colleagues:

Let me inform you about our further steps in direction of development of palliative care in our country.

The Association takes active part in a project began on January in 2008 for initiatives of All-Ukrainian Council for patients rights and safety. The project is entitled «Experience exchange between Ukraine and France for the humanizing of medical and social services to the citizens of Ukraine». In the frameworks of the project, development of changes to the Ukrainian legislation which regulates rights of patients, mutual relations of the state and church in the field of providing medical services, development of palliative care (care for incurable patients) is planned. A project is supported by Embassy of France in Ukraine and by Protestant Federation of France. Also, to the realization of the project Ministry of health, Ukrainian orthodoxy church and All-Ukrainian Association of palliative care are actively attracted.

A working visit of Ukrainian delegation to Georgia took place on January 23-29, 2008. Seven representatives of state, public and church organizations visited Tbilisi and Batumі (Republic of Adjara) for discussing the possibility of collaboration in the field of new legislation, concerning access to opioids, future collaboration in the field of palliative care providing and safe public health development. A question concerning pain management is one of the most essential, as it is known that no less than 20-25 % patients which have the incurable diseases suffer from pain. However the Ukrainian legislation, unfortunately, remains bad both for citizens and medical workers.

During meeting in Georgian parliament, in which the First Lady of Georgia Sandra Rulofs, numerous deputies and representatives of Georgia government took part, it was agreed about the collaboration and mutual assistance in this sphere.

The Round table "Development of palliative care in Ukraine: availability of pain management and оpioids turnover" took place with the support of Ministry of Health on February 15, 2008. The participants were: Minister of health protection V. Knyazevich, first Minister’s deputy M. Prodanchuk, representatives of Ministry of Labour and social policy, Ministry of internal affairs, public and religious associations representatives. As a result of round table it was decided to acknowledge importance and actuality of the Interdisciplinary Task Force (working group) on the improvement of legislation on medical and social care, created in accordance to Order of MoH #201 issued on 06.07.2006. The Interdisciplinary Task Force has 3 Co-Heads which present MoH, Міnistry of Labour and All-Ukrainian Council for patients rights and safety.

It was decided it is necessary to extend composition of the Task Force and to invite representatives of other ministries and stakeholders and continue the advocacy, informational, raise awareness compain on palliative care.

The Minister V. Knyasevych marked priority of palliative care development in Ukraine. So there is “political will” for development of palliative care in our country.

We will be very grateful for your suggestions concerning palliative help development in Ukraine.

Please send them to alexander@tb.org.ua or dzvony@yahoo.com,

Mr. Alexander Wolf
Palliative care program director
(All-Ukrainian Council for patients rights and safety, All-Ukrainian Association of palliative care)

Re: Health Care Chaplaincy in Scotland, Derek Brown (PlainViews, 3/5/08, Vol. 5, No. 3)

I am delighted with your decision to feature different countries. I recently went to Uganda, Africa as part of a Health Mission trip. I was looking for materials to help me better understand the culture and customs I would be entering. One of your articles was written by a man from Nigeria and I found it a helpful glimpse into some African health care.

More efforts, like the one I was on, will happen and you can help prepare us to go forward and not offend.

Kathleen Brown, MAPS, NACC
Regional Chaplain
Luther Midelfort-Oakridge and Chippewa Valley
Mayo Health System

Re: Judaism and (Our Struggle With) Dependence, Daniel Coleman (PlainViews, 3/5/08, Vol. 5, No. 3)

As a student chaplain with 5 units of CPE and an MDiv. in progress, I beg all of you PLEASE stop using the nomenclature "nursing home". Look into the eyes of the person you've said them to and see the injury those words have caused. The senior care industry is working to use the words that describe the level of care offered, i.e. independent living (IL), assisted living facility (ALF) or skilled nursing facility (SNF). It DOES make a difference which words are used and surely chaplains should support words that heal rather than injure.

Donna Zuroweste,
CPE Resident, VAMC-STL
St. Louis, NMO

Re: Doing Theology When Nothing Else Will Do, Kathleen Ennis-Durstine (PlainViews, 2/6/08, Vol. 5, No. 1 )

I want to express my thanks to Rev. Kathleen Ennis-Durstine for her recent reflection. For me, as a former Peds Chaplain, it was a powerful reminder that we as chaplains stand in the presence of theologians all of the time, if we would but listen.

I appreciated her confession to the statements that she has used with families over the years. While my words were different, the meaning was the same – “OK now I know you have wants – but we can’t always have our wants.” The statement Chaplain Durstine wrote: “Their belief carried an imprimatur: God expects them to do everything humanly possible to save their child’s life. Then and only then could God act in miraculous ways. Anything less than everything would bar God’s intervention.”, really slammed into me and gave me a new appreciation of families that want to do everything even when doing everything goes against all medical knowledge, experience, and skill.
Kathleen, thank you for your thoughtful sharing.

D. James Stapleford, D. Min.
Director, Spiritual Care and Clinical Pastoral Education
LifePath Hospice and Palliative Care
Temple Terrace, FL

Re: Feburary 6, 2008 Issue of PlainViews

While PlainViews has an excellent track record in presenting timely and interesting articles, doing a good mix of theoretical and practical, the 2/6/08 issue was particularly good.

The article by Rev. Ennis-Durstine on theology was the BEST I have read in many, many issues. She was right on target. Excellent work.

Part of our challenge is to be with those whose theology is so very different from ours, and while she framed it in her work as a pediatric chaplain, it is so true for many of us:

Years ago I thought that theology was an intellectual, philosophic endeavor. I thought that with good exegesis and excellent argument we could identify, explain, and defend all of the relevant aspects of God and of God's relationship with humanity.

Today, with years of work as a pediatric chaplain, I know powerfully that theology is anything but academic. Theology is about meeting God face to face in the lives and experiences of child patients and their families.
. . . (and)

Theology is what we do when there is nothing else we can do.

The article by Dr. Diane Bridges was a good reminder to all of us - chaplains, nurses, social workers, doctors, etc. that we are a TEAM and if we think TEAM, we do better for the patient (resident/client) and we do better for ourselves. It is wonderfully mutually beneficial .....

I have made copies for my shop . . .

Doc Martin's article on choosing belief over non-belief, likewise was stimulating. If I read it correctly, he argued seeing God with us, even in despair, does not say that God caused the despair, but that God can be with us even there . . . even there.

Once again, well done.

Rabbi Dr. David J. Zucker
Shalom Park
Aurora, CO

Re: Research on Music and its Effect on Healing Inquiry

This is an inquiry about anyone doing or interested in doing research regarding the role of music and its effect on healing. I am particularly interested in how music may facilitate the faith resources of a patient and an understanding of the sacred. I am working with a psychology professor at Fort Lewis College in Durango, CO who is interested in helping develop a study. Connecting with a wider group in this would be helpful. Please let me know if there is anyone who I might be in touch with on this topic of research.

Art Meyer, D. Min., BCC
Manager, Pastoral Care Department
San Juan Regional Medical Center
Farmington, NM

Re: Documenting Out Care: Chaplaincy Charting, Brent Peery (PlainViews, 1/16/08, Vol. 4, No. 24)

I commend Brent Peery on both his article and tenacity in working this project on through. I appreciate the update. I have been working through a similar journey and appreciate the ground he's plowed as well as the journey he's shared.

Charles Barley
Manager of the Pastoral Care Department
Glenwood Regional Medical Center
West Monroe, LA

Re: Seeking Self-Satisfaction, David Zucker (PlainViews, 1/16/08, Vol. 4, No. 24)

Good question: When is enough, enough? Jesus in his Parable of the Sower referred to the "deceitfulness of wealth" that acts as a thorn that prevents the seed of God's Truth from taking solid root and growing fruitfully in our lives. Certainly in our North American culture, we are probably least equipped to understand when enough is enough because we have been conditioned to always want more. There are even some in our culture that "preach" that losing your drive for more is paramount to "sin" to use Judeo-Christian language. Our culture insists that the insatiability of want is one of the drives that make a truly successful person.

May the blessing of contentment be yours,

Larry Hirst, chaplain
Bethesda Hospital and Place
Steinbach, Manitoba, CANADA

Re: PlainViews

Just wanted to let you know that receiving and reading articles from PlainViews is helpful for this retired chaplain. When I take the time to read an article or two, I feel that the vocation in which I participated was very worthwhile. That is very comforting to me. Thanks for your excellent leadership with this publication.

Sincerely,
Dick Fehnel
Ret. APC Chaplain
Lancaster, PA

Re: BioEthicsWalk – No Harm Done?

As a hospice chaplain, I resist reducing prayer to the terms 'therapeutic' and 'effective'. People don't pray nor welcome prayer being convinced of the 'scientific evidence' for its therapeutic 'efficacy.' Regarding respect for autonomy, the dying fear less 'undermined autonomy,' than unmanaged pain, or that pleas for assistance getting to the toilet will go unheeded. An ethic of 'respect for autonomy'--that 'empty signifier' per Stanley Hauerwas--is not, in my experience of those dying, the "first among well established ethical principals which differentiate health care institutions." Care giving and receiving per se 'de-absolutizes' autonomy.

Jeffrey F. Krauss, D. Min.
Home care chaplain
Vitas Innovative Hospice of Northern Virginia
Vienna, VA

Re: Daily Conversations – A Reflection on Spiritual Care, Jerry Griffin (PlainViews, 12/19/07, Vol. 4, No. 22)

Thank you Rev. Jerry for taking the time to write and share this profound experience of talking with Mr. Sammy God and his dear friend Mr. "Peabody".

Diane Bridges. D.Min.
Director, Spiritual & Religious Care
Trillium Health Centre
100 Queensway West Mississauga, On

Re: "Where you go, I will go..." Sullivan and Zollfrank (PlainViews, 12/19/07, Vol. 4, No. 22)

Thank you for "Where you go, I will go...". The story of Ruth spending months in the hospital with kidney failure and hoping for recovery has me recalling an incident from years ago where the antithesis of this was experienced.

Charlotte was a Catholic Sister in a large hospital that had pioneered in kidney transplants. When Charlotte was told that she had kidney disease and needed at least dialysis and perhaps a transplant, she
let it be known that she would have none of it! Charlotte was a co-chaplain and it was with trepidation that I visited her a week or so later as she lay dying, untreated, not attached to any medical inventions. What could I say to her? I was somewhat shocked by her decision; she was not beyond criticism by the medical staff either.

I think I just said, "Hi, Charlotte". I remember she seemed calm, I felt storms rising. She died that week. In the years since then I remember Charlotte when I hear of the millions of children dying for lack of a one dollar antibiotic; when I think of the billions of resources wasted on violence and war; even when I hear of almost miraculous successes of high tech medicine.

I remember few patients from those years long ago. Charlotte I remember for her choice.

John P. Stangle,
NACC BCC Chaplain Advanced Emeritus

Continuing the discussion about Organ Donation and when someone is considered "Brain Dead" (TalkBack 12/5/07)

It is good to protect the most vulnerable and defenseless patients. As Noel Tiano has done in Nevada, and as I have done in Texas, Chaplains can help by taking aggressive part in the legislative process. As has been evidenced, some would pursue a religious driven agenda to the extent of obstructing a VOLUNTARY registration of individual medical health care wishes. Failing this, zealots seek change in state law to declassify Artificial Nutrition and Hydration (ANH) from being defined as a life-sustaining treatment (LST) in the terminally ill. Such an attempt failed in the most recent Texas legislative session. These actions are evidence, not of concern for the individual right of self-determination exercised by establishing wishes and desires, but for a forced ideology sacrificing autonomy and justice. What I hear is, “If we cannot keep your voluntarily documented wishes from being freely accessed, we will change the state law so it is considered common standard medical care to force medicine (lunch) into your stomach as you die; it is just the right thing to do.”

Melvin Ray
Director of Spiritual Services
Hunt Memorial Hospital District at Presbyterian Hospital
Greenville, Texas

Re: E Pluribus Utrum, BioethicsWalk (PlainViews, 12/5/07, Vol. 4, No. 21)

There’s no one definition of CHAPLAIN that every organization, association, society or institute agrees upon. A general definition might include terms like: pastoral care giving, spiritual care giving, being a presence, accompanying, listening to their voices, hearing the silence, etc. None of which distinguish chaplains as health professionals: not in the mental health field (doesn’t that belong to the psychiatrist?) nor in the psychological health field (isn’t that the purview of psychologists/social workers?).

What actually then is our job? I believe a person’s spiritual, religious, and even mystical well being falls into our domain. When people find peace and comfort – when their faith, convictions and religious views are strengthened and validated, this may ultimately encourage improved physical, emotional and even psychological health.

If we are successful - spiritually uplifting them and calming their spirit, we affect their total being. That is the role I believe we are to fulfill, and the ultimate definition of CHAPLAIN.

If it is made clear to every person, that their file can be scrutinized by any chaplain that happens to be on duty at any given time, that anything written in their chart - all personal or private medical info can be read - AND the person is okay with that…fine.

But, should we know their business? Being a blank slate diminishes prejudging, allows listening without modification, and joining them were they are

Laurie Dinnerstein-Kurs
County Chaplain
Mercer County, New Jersey

A note of appreciation and encouragement

To my professional Colleagues, I want to say a word of appreciation to the Managing Editor of PlainViews, Martha Jacobs. Through her tireless efforts, she has given those of us in the field a venue through which we can share our struggles, moments of joy, and discoveries. One of the things that I like about PlainViews is that those who contribute share what is on their hearts and is meaningful in their professional lives. I look forward to reading all of the submissions each time that I receive PlainViews. In addition, I want to thank those of you who have submitted articles. I have found that your warmth comes through your words and offers me a chance to reflect on events in my ministry that reflect those same type of experiences. This has been good for me to know that, while at times I feel isolated, I am but one in a host of witnesses. I also want to encourage those who read this newsletter to contribute a part of yourself. Sharing of the spirit is the sweetest communion and is the life spirit of our calling.

James Stapleford, D. Min., MBA
Director of Spiritual Care and Education
Phoebe Putney Memorial Hospital
Albany, GA

Re: "Chain of Care," Francine K. Zabkar (PlainViews, 12/5/07, Vol. 4, No. 21)

The "Blessing of the Hands" is surely a beautiful ritual that can have great meaning for a caregiver. But, as professional spiritual caregivers, it is important that we be sensitive to the theological assumptions behind what we are doing. This is especially true if we are presenting a ritual as being one where "all faith traditions are welcome", as Francine Zabkar says of the "Blessing of the Hands" service.

I, personally, would have been deeply uncomfortable with participating in any ceremony where someone recites the words "I bless and anoint your hands." First of all, anointing is a practice that, while having a long history in the Christian faith tradition, has not been a part of the Jewish tradition since the destruction of the Second Temple in 70 C.E. Secondly, the idea that another human being has the power to bring blessing to me (or my hands) implies a theological assumption that some kind of authority has been passed from God on to the person offering that blessing. This, too, is inconsistent with the Jewish tradition, which roots its practice around blessings on the Priestly Blessing from Numbers 6:24-26. There, the priests ask that God may bless the people: "May HaShem bless you, and may He keep you."

The form of the Priestly Blessing expresses a theological assumption that the true source of all blessing is God. It is interesting to note that the original form of the Blessing of the Hands -- written by feminist liturgist and psychotherapist Diann Neu -- seems to share this assumption. As she pointed out to me in an email exchange I had with her last year, the original prayer opens with "Blessed be the work of your hands, O Holy One."

In Peace,

Rabbi Alan Abrams
Supervisory Fellow
Reading Hospital and Medical Center
Reading, PA

Re: Democracy is Not a Spectator Sport, Noel Tiano (PlainViews, 12/5/07, Vol. 4, No. 21)

I wanted to thank author, Noel Tiano, Th.D., for the excellent article "Democracy Is Not A Spectator Sport." Not only was the article informative about how to work with state legislative processes, but it also was a good reminder of what any of us chaplains can do to get involved. I couldn't help but forward it on to all 50 of the State Advocacy Chairs of the Association of Professional Chaplains.

Chaplain Dick Cathell, Ph.D., BCC
Chair, Commission on Advocacy
Association of Professional Chaplains
St. Joseph Hospital
Bellingham, Washington

Noel Tiano's faith in the political process involving Nevada's AB 158 may be restored but not mine. The amendments desired by life advocacy groups were totally reasonable:

1) Besides the standard advance directive that varous states have, there are advance directives prepared by varous religious groups that are totally valid. I prefer to use one of several Jewish advance directives because, quite frankly, I do not trust the secular process. There is also the National Right to Life "Will to Live" that was worded to comply with Nevada Law. The validity of these alternative documents must be given full official recognition.

2) Artificial feeding and hydration is not "life-sustaining medical treatment"--it is somebody's lunch!

3) Automatic civil and criminal legal immunity from "good faith" errors terrifies me. We are dealing with life and death.

4) There should have been consultation with disability advocacy groups such as "Not Dead Yet" and from renowned anti-euthanasia experts such a Wesley J. Smith.

The only thing that Nevada's AB 158 accomplished was to further imperil the most vulnerable and defenseless patients.

Rabbi Louis J. Feldman, Ph.D.
Scholl Institute for Bioethics

A response from the author, Noel Tiano:

Rabbi Louis Feldman and I may disagree on some of the major issues re Nevada's advance directives, but I think we both agree on the importance of respecting the wishes of the dying person. AB158 merely creates a repository (aka electronic filing cabinet) of such wishes. While this is only one measure and it certainly has its limitations in terms of logistics, access to computer, internet, etc., yet it is one big step towards more consumer education, health care planning, and communication between patient and provider. Moreover, this bill is strictly voluntary. To me, what is absolutely vital is that such caring conversations need to take place during family gatherings, at the kitchen table, in offices, faith communities and certainly among friends. Additionally, I would encourage all of us to document our wishes clearly either through a letter, video, RTL/Catholic/ Jewish/ Protestant/Jehovah's witness/religious advance directive, or testament, and the state-specific directives.

Response to BioethicsWalk

Dear Nancy, Your first words described a beautiful memory, and I knew you were from Union before I read the credits! Christopher Morse began each lecture as a professor and ended it as a preacher. I love the form of the utrum paper, and value the insights I receive. Writing the paper as an exercise in negotiation or understanding truly teaches me to explore the reasoning and the passions of those on the other side of the argument - or the table. Being a Unitarian Universalist at Union offered many opportunities to explore all sides of many questions, and with some trepidation I wrote an utrum paper for Christopher Morse on the trinity. I was a bit nervous when Dr. Morse read the title, but with a big smile he said, "Oh, good, Unitarian Universalists write the best papers on the trinity!" Thank you for reminding me how valuable it is to use the form of the utrum to stand in someone else's shoes.

Jill Bowden
Director of Pastoral Care
Winthrop University Hospital
Mineola, NY

Continuing the discussion about Organ Donation and when someone is considered "Brain Dead" (TalkBack 12/5/07)

The Uniform Determination of Death Act as adopted by most states reads: “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory function, or irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.” The definitive word is functions, the meaningful accomplishment of the purpose of the brain. The definitive diagnostic now is the Apnea Test. Repetition of the apnea test is optional. More importantly, confirmatory tests are optional, not mandatory. Electroencephalography (EEG) is only one of the common optional tests. To say it takes more than a flat EEG to declare a patient dead is not true, as a flat EEG is not required. It is also misleading to say destruction of the brainstem must be verified; it is the cessation of the function, not the form, which defines death. Lack of consistency in practice and understanding in this area should be addressed by universal policy. I recommend reading "The Clinical Response to Brain Death: A Policy Proposal," in JONA’S Healthcare Law, Ethics, and Regulation, Volume 8, Number 2/April-June 2006.

I celebrate medical technology which improves and saves lives. I applaud the common requirement of Joint Commission for hospitals to implement policies and procedures which support Donation After Cardiac Death (DCD), thereby allowing for donation by those who are irreversibly injured but not “brain dead”. However, I feel DCD would be unnecessary if we supported, by legislation, Presumed Consent for organ donation or, at the lest, First Person Consent – protecting individual autonomy to document consent (prior to deadly conditions) which cannot be overruled by family or religious leaders.

Respectfully,
Melvin Ray
Director of Spiritual Services
Hunt Memorial Hospital District at Presbyterian Hospital
Greenville, Texas

Re: The Development of an Authentic Self, Jenny Lannom (PlainViews, 11/7/07, Vol. 4, No. 19)

The weekend before I read the Rev. Jenny Lannom’s article, I had attended a retreat with my church for covenant group leaders at an Anglican convent in upstate New York. (Covenant groups are a lay people equivalent of the cohort groups for clergy that Rev. Lannom discussed.) Her article serendipitously echoed the overarching themes of the weekend, especially the idea that learning to be our authentic selves without shame is a potentially terrifying but incredibly worthwhile journey that close friendships can help us travel.

Our goal in our covenant groups is to open ourselves before God and other people, just as Christ opened himself in his life and through his death. In doing so, we allow our authentic, God-made selves to show through in both our strengths and our weaknesses, our joys and our fears, our light and our darkness. The space between us becomes holy as we let go of our desire for control, accept our humanness, and let ourselves be vulnerable. In this mutual vulnerability, we meet grace head on. We see a face of God.

Alison VanBuskirk
VISTA Member, Communications
New York Disaster Interfaith Services
New York, NY

Re: Tear Soup Review, David Zucker (PlainViews, 11/7/07, Vol. 4, No. 19)

Just as an addition to the review... I also find this book very helpful. There is also a Tear Soup DVD which allows the listeners in a group to view the beautiful illustrations while the book is being read to them.

Peace, Rev. Louise Tallman-Shepard
Pediatric Chaplain
SUNY, Upstate Medical University
University Hospital
Syracuse, NY

Re: Response from reader about The Organ Donation Process (TalkBack, 11/7/07)

I would ask Rabbi Feldman to provide proof of the “heinous incidents” to which he refers – murders in order to retrieve organs. In the absence of substantiation his statements are merely reckless allegations. It would seem the Scholl Institute of Bioethics advocates the position which would deny death by neurological criteria. The end-of-life is difficult enough without those who would stretch the definition of life to the point where no person is safe in a hospital or nursing home. The wise person will document Advance Care Planning so as not to have directions sacrificed on the alter of another opinion. This is especially true for those in New York and New Jersey, where death may be legally defined, not by physicians and science, but by religious dogma.

Melvin Ray, Board Certified Chaplain
Director of Spiritual Services
Hunt Memorial Hospital District
Presbyterian Hospital
Greenville, Texas

Rabbi Friedman's response:

A July edition of the Los Angeles Times had a three-page article about a San Francisco transplant surgeon who is facing criminal charges for "excessively prescribing drugs to a 25-year-old disabled man last year in order to hasten his death and harvest his organs sooner." This was also reported in the Daily News on July 31, 2007. This is just one incident! Melvin Ray makes the libelous assumption that the Scholl Institute of Bioethics "advocates the position which would deny death by neurological criteria". This is not true. However, it takes a lot more than a flat EEG to declare a patient dead. There has to be extremely detailed and documented verfification of brainstem destruction. I have written extensively on this subject that requires more dialogue than these abbreviated "talkbacks".

Rabbi Louis J. Feldman, Ph.D.
Retired Chaplain
Board Member
Scholl Institute of Bioethics
Los Angeles, CA

Re: The Organ Donation Process as Spiritual Care, Oran Lee and Karrie Oertli (PlainViews, 10/17/07, Vol. 4, No. 18)

I wonder if I'm the only one who noticed a possible logical inconsistency in the article "The Organ Donation Process as Spiritual Care." The authors detailed how the chaplaincy service responded to a COO initiative to increase a hospital's donation rate. At the end of the article the authors state that "chaplains offer unbiased support for families in making donation decisions." Could not the desire to be seen by administration as helping increase the donation rate be in conflict with offering "unbiased support for families in making donation decisions"?

Jon Altman, Chaplain
Southern Care Hospice
Jackson, MS

I was delighted to read of Chaplains Lee and Oertli involvement with Organ Donation at their hospital. I too was active in the early days of the Breakthrough Collaborative, and helped make consent rates increase at my hospital. Now, as a Chaplain employed by an Organ Procurement Organization, I have been excited by the involvement of Spiritual Care in increasing organ and tissue consent rates across the country. Chaplains have become an important voice for stewardship, ethics, and compassionate care for donor families as well as policy development and implementation. And Chaplains can play a critical, clinical role in the areas of rapid referral, rounding, and clinical triggers. Chaplains are helping to save lives through organ and tissue donation, and should be proud of their record of achievement in this area.

I will be offering a workshop entitled "The Chaplain's Role in Organ and Tissue Donation" at the 2008 APC Conference in Pittsburgh. I hope many more Chaplains will attend and become advocates for this important ministry.

Rev. Donald B. Stouder, M.Div., PCS
Family Services Chaplain
Lifesharing Organ & Tissue Donation
San Diego, CA

In the discussion of what the chaplain’s role should be in the organ donation process the perennial question, of course, has to do with the perception that people might have of the chaplain who is a requestor. Does a grieving family perceive the chaplain as being truly “unbiased” when the chaplain actively advocates for the donation? We know that people bring to their encounter with a chaplain their preconceived notions about clergy roles, clergy authority and other clergy “stuff.” Is the chaplain requestor able to assure that the family member perceives no coercion when the chaplain is the one requesting donation? Increasing the donation rate to 89% is a tremendous testimony to the effectiveness and hard work of the team that was assembled. I would hope that chaplains would always be a part of such a team. On the other hand, I also wonder if chaplains might sometimes diminish the opportunity to be pastoral by being a requestor.

Stan Jones
Chaplain Coordinator
Methodist Hospital
Clarian Health Partners
Indianapolis, IN

It is with some uneasiness that I read several articles about organ donations. The key issue with cadaveric donors is to be sure that you are not harvesting an organ from a person who is still living. The definition of death becomes very important. There have been a number of heinous incidents in which a vulnerable patient was "helped along" in the dying process. There are also those who would really stretch the definition of death to the point where no person would be safe in a hospital or nursing home.

Rabbi Louis J. Feldman, Ph.D.
Retired Chaplain
Board Member
Scholl Institute of Bioethics
Los Angeles, CA

Re: Singing the Lord’s Song in a Strange Land, Gary Batchelor (PlainViews, 10/3/07, Vol. 4, No. 17)

I just wanted to say thanks to Gary Batchelor for his article in PlainViews--it was well written and provided a well-reasoned counter-point to Harding's article. There are many of us professional chaplains who went through large CPE programs and then on to a multi-staff chaplaincy department that fail to understand the needs and the reality of the one-person departments. It is always sobering to catch a glimpse of the daily burdens and blessings that chaplains experience in such a setting. In our broad statements of what chaplaincy is and should be, we often fail to take full account of the variety of our settings and that one shoe does not fit all. A "whine" from one perspective is a lamentation from another, which has a cathartic value, a theological point, and a socio-political agenda: just ask Jeremiah--a one-person prophetic department!

Well done!

Mark LaRocca-Pitts, PhD, BCC
Staff Chaplain
Athens Regional Medical Center
Athens, GA

Very well said. This reminded me of the days when I WAS a one person department, trying to be all things to all people at all hours. Everything Gary said can be applied to a multi-chaplain staff who often are trying to educate a constantly changing staff as to who we are and what we do. Thanks also for the reminder of our calling, which can often get lost in the shuffle of daily demands.

Blessings,
Larry M. Connelly, MDiv., BCC
Director of Spiritual Care Services
Piedmont Hospital
Atlanta, Ga

Re: My First Chaplain, Lyn Brakeman (PlainViews, 10/3/07, Vol. 4, No. 17)

I was deeply moved by Lyn Brakeman's article, both as a result of her courage in writing it, and as someone who has experienced a similar dark journey with a childhood experience. Her article reminds us that images of God are deeply effected, as was mine, by the loss of trust and safety that can accompany such events. It is not something we are inclined to search out in our pastoral care and it is rare that those experiences come to light in most of the brief encounters that chaplains often have with patients. It is even rarer when people take the time, the expense, and the journey to find their way into a new sense of self after such events. But having journeyed through it, I encourage those who have not, to begin the search. It certainly helps us to travel lighter.

Chaplain George Burn
Mount Nittany Medical Center
State College, PA

Thank you, Lyn, for sharing your ever-present God and all the relationships of your life that did not measure up but, indeed, formed you and your faith. I had a similar childhood and companionship with God, and I appreciated hearing you articulate yours.

Blessings,
Ruth Brooks
psychiatric chaplain
Yale New Haven Hospital
New Haven, CT

Re: "Chaplain, Take Me Away," Angelo Betancourt (PlainViews, 10/3/07, Vol. 4, No. 17)

Chaplain Angelo Betancourt is right when he speaks about the stress levels among hospital personnel. It is facing the reality of life, very special that is the case in long term care facilities, where Nurses are not only dealing with a shortage of personal. There other factors which do play a very big role. People in these places are doing the very best possible job. It makes it even harder when they deal with people who in no way have the capability to express themselves. And in these places there are a great number of people who do not know how to put their feelings and thoughts into words. For personnel that can be stressful. They do need a source where they can express their frustration. The most appropriate person may well be the hospital chaplain. It is not so much a matter of giving advice, but more a matter of finding a release valve, and a place to speak about their frustration. The Chaplain’s role is a matter of hearing what people are telling him/her. The key point in all means of counseling is hearing what people are telling you.

With my greetings and prayer,
John Flipsen
Volunteer pastoral worker
Edmonton, AB,Canada

Re: A Silent Retreat and a Missing Thumb, Charles Lopez, Jr. (PlainViews, 10/3/07, Vol. 4, No. 17)

I did read the article on silent retreats and how enlightening it can be. I also did twice a guided silent retreat at Queens House in Saskatoon, Sask., Canada. Both retreats were based upon the spirituality of John of the Cross. In the morning there was a talk about the named spirituality by Fr Ronald Rolheiser, OMI. After the talk it was dead silence. And it must be said this priest is very good in leading retreats. On this spirituality he has written a number of books, such as The Restless Heart, Holy Longing, Forgotten Among the Lilies. This last book is short articles which he has written over the number of years. And if I am well informed the priest writes in some 60 different papers all around the world: England, a number of papers in Canada, Ireland, Australia, the US, and so on . He also is a speaker for many conferences. At the present time he is the President of the Oblate School of Theology in San Antonio, TX. I hope that this information is useful to PlainViews readers.

With greetings and prayer,
John Flipsen
Volunteer pastoral worker
Edmonton, AB,Canada

A request for chaplains in Africa!

All chaplains engage in the practicing of chaplaincy in the continent of Africa should please send their names, addresses, e-mail address, and telephone numbers to us at Global chapliancy corps. e-mail- evangelicalpentecostalism@yahoo.com for co-ordination and further information.

Archbishop David Mike Jacobs
Lagos - Nigeria, West Africa

A Listserv for CPE Supervisors-in-Training

http://groups.yahoo.com/group/CPESITS/ is a forum for CPE Supervisors-in-Training to discuss all things related to the process of becoming a CPE Supervisor. This may include theory papers, committee meetings, theology, disappointments, celebrations, etc. It is limited to current SITs and those that have been out of an SIT program for up to two years, whether or not they were certified.

The Rev. David W. Fleenor
Moderator, CPE SIT Listserv

On wearing a chaplain's uniform

Allow me to submit that the wearing of a chaplain uniform definitely defines one’s role and respect among the health care team in the hospital or hospice caregiving system. In the opening of our new geropsych, rehab and medical detox units of our hospital I started out wearing a Chaplain’s Clinical jacket akin to the physician jacket. With it came immediate recognition for my role and the accompanying respect from all medical staff for my position.

With it was developed a “Spiritual Assessment” and a procedure for making Spiritual Care referrals that was “passed” by the administration for immediate approval and use. Of course, I had to submit a letter offering the rationale for chaplaincy services to permeate the entire health services delivery to facilitate this action.

I believe it was the work of the Holy Spirit that promoted this effort and now allows the staff, patients and family members to have immediate access to solid spiritual care delivery.

Respectfully,
J. Russell, M. Div.
Coastal Plains Hospital
Corpus Christi, TX

On being in competition with "professional" chaplains

Dear Editor of PlainViews: First of all I do thank you that as a volunteer chaplain that I prescribed to your web mail. This is a terrific source of information and sharing of views and experiences. I do work in along term care facility here in the City. My experience with those who are" professionals" have a tendency to do everything themselves. For quite some time I did visit a Gentleman we talked about a good number of issues, personal, worldview and others. But after every discussion we prayed or shared a scripture reading, and than prayed about the passage. Last week this gentleman passed away. Was I told about this, absolutely not. Reason - privacy of the person. If we drive privacy this far than all means of communication fails to do justice to the ministry. There is a tendency to drive privacy too far. I also could be a means that the "professional" uses this for his own job protection. I have a feeling that I am in constant competition with the" professional". As Christians we have to look at the model that Jesus left behind. And that is so far from any means of competition. The model he left for us is "Being of Service."

Thank you
John Flipsen

Re: Health Care through a Theological Lens, Keith Goheen (PlainViews, 8/15/07, Vol. 4, No. 14)

In this article, Chaplain Goheen raises an issue about Healthcare in the United States--who does or does not receive good care and who pays for it. Any of us working in the healthcare field these days are forced to grapple with these issues. I know I do. It concerned me that in reference to Michael Moore's movie "Sicko" and the health systems in Canada, France and Cuba, that there seemed to a pretty one-sided "whole cloth" presentation of the issues. There are genuine critiques of these other systems, not the least by those who receive care in them, that deserve honest attention just as their merrits do. Also, Michael Moore is not generally known for the objectivity with which he looks at issues. If I believe I am being propogandized, it tends to turn me off. If our country's system is going to change, it is going to change, I believe, through an honest, full-bore debate of all the issues and values involved. If we are going to move in a more socialist direction, which is the health system change being advocated, we need to be honest about the costs and liabilities involved as well as well as the benefits.

Don Moore
Staff Chaplain
University of Virginia Health Systems
Charlottesville, Virginia

I like how Keith framed our healthcare system in terms of theology, especially around the issue of the individual (salvation/cure) versus the collective/communal (salvation/cure). This divide can be traced
through much of our western religious heritage and it makes sense that the most individually based soteriology as expressed in American religious ethos would also give expression to the most individually
based healthcare system. Keith has provided me a new framework to reflect on these issues. Thanks.

Chaplain Mark LaRocca-Pitts
Staff Chaplain
Athens Regional Medical Center
Athens, GA

Re: Confiding Trust, Stephen Harding (PlainViews, 8/1/07, Vol. 4, No. 13)

I thought that Rev. Harding’s poem "Confiding Trust" was lovely. Maybe lovely is not the right word. Meaningful is more appropriate. Most of my chaplaincy is palliative care and bereavement. I am often at the bedside witnessing a family's grief or helping the Child Life Specialist making hand prints as a memorial.

"…the unnatural moving of your child's hand. . . "

Sometimes another author's words help express one's feelings. Thank you for sharing this experience as it has helped to frame my own.

Rabbi Mollie Cantor
Pediatric Chaplain
Mount Sinai Medical Center
New York, NY

Seeking others who work in Trauma

Is there anyone out there who works exclusively in Trauma Units? My responsibility is for the ER, Burn Unit and Trauma ICUs. I'd love to network with anyone else who does this kind of ministry, as its circumstances seem rather unique.

Feel free to contact me at work at (914) 493-7125 or dsprb@optonline.net

Doug Phillips
Westchester Medical Center
Valhalla, NY

Your Pastoral Counseling Skills Are Needed to Assist and Support Returning TROOPS AND THEIR FAMILIES

Give an Hour is a nonprofit organization (formed by psychologist, Barbara Romberg, PH.D), whose mission is to develop a national network of volunteers capable of responding to both acute and chronic conditions that arise within our society. They are initially focusing on the U.S. troops and families who are being affected by the current military conflicts in Afghanistan and Iraq. Large numbers of veterans are returning home from Iraq finding that they must cope with a wide range of psychological difficulties.

A national network of mental health professionals has been created who are giving an hour of their time each week to provide free mental health services to military personnel and their families.

Over the past 20 months, Give an Hour has developed important relationships with many Veterans' Service Organizations including the Coalition to Salute America's Heroes, the American Legion Auxiliary, TAPS (Tragedy Assistance Program for Survivors), the National Gulf War Resource Center and Vets 4 Vets. As a result of these relationships, mental health professionals will have opportunities to work with volunteers from these organizations to co-lead support groups and participate in community events. This is an opportunity for AAPC members to join a program that will provide critical services to these deserving men, women and families.

Thus far, over 425 professionals from the mental health community have registered to participate in this critical effort. Professionals are being asked to provide the type of services they currently provide in their offices. While no additional training is required, a variety of training opportunities are offered to those individuals who might be interested. In addition, participants will have the opportunity to interact with each other, to share information about their experience and to seek feedback and additional resources.

Give an Hour has asked providers to participate in its network for at least one year in order to provide continuity of care for these deserving families. Providers have the opportunity to change their status on the network from "available" to "full" while working with an individual or family. This prevents providers from receiving requests from individuals if their time is filled.

As a nonprofit organization, Give an Hour carries liability insurance that covers its volunteer providers. Providers should, however, also maintain their individual malpractice insurance while participating
in their network.

If you are a certified member of AAPC or a licensed mental health professional, please visit the Web site at http://www.giveanhour.org/cms/index.php to learn more about this organization. To sign up, on the web site, to be part national network click on "please do so", which is in the parapraph entiteld "Join Us." Volunteers are also welcome who want to join in developing and implementing this project.

The need is great.

Thank you.

Doug Ronsheim
AAPC Executive Director

Re: A Neonatal Service of Love and Remembrance, Sharon A. Frank (PlainViews, 7/18/07, Vol. 4, No. 12)

I just want to thank Chaplain Sharon Frank for her willingness to share the memorial service she created for the NICU patient/family. What awesome resources we could compile if everyone was willing to share their creative efforts (and we could stop trying to reinvent the wheel)!

Karen Gorski
Pastoral Care Coordinator/Chaplain
Henry Ford Wyandotte Hospital
Wyandotte, MI

I read the neonatal service submitted by Chaplain Sharon Frank ("A Neonatal Service of Love and Remembrance) with appreciation, especially because it was not Christocentric and therefore is widely useful. I would like to let the readers of PlainViews know about the web site sponsored by Kolot:The Center for Jewish Women's and Gender Studies - www.ritualwell.org. You need only register to use the site, to share your ritual or to browse thousands of Jewish rituals. I think this resource should be very helpful for chaplains.

Rabbi Dr. Susan Zengerle (Cowchock)
Wyncote, PA