PlainViews

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