SACH
Scottish Journal of Healthcare Chaplaincy
Vol 12 No 1 June 2009
Editorial
Since the last edition of this Journal, Margo MacDonald MSP introduced her proposal for an ‘End of Life Choices (Scotland) Bill’. This proposal has been through its initial consultation phase and responses have been, as one would expect, mixed. Even a cursory perusal of internet sites shows a range of opinion on the subject with most faith based opinions being highly critical of the recommendations (see, for example, the Christian Medical Fellowship site at www.cmf.org.uk linked with www.carenotkilling.org.uk).
A specific and united response from Scottish Chaplaincy is harder to gauge. There are many reasons for this, among them the fact that there may not be unity of opinion among Scottish Chaplains on this subject.
Many Chaplains who are on their Health Boards’ clinical ethics committee have chosen that as their vehicle of response. Others may have responded directly and as an individual in the consultation process and others through their own faith or belief group.
What is abundantly clear is that this is a topic of central importance to spiritual care in general and to healthcare chaplaincy in particular. End of life care, the finding of meaning and purpose in life, the resolving of ‘unfinished business’ and dying a good death are part and parcel of a healthcare chaplain’s work.
Lindsay Carey offers us, in this edition of SJHC, the findings of a fascinating piece of qualitative and quantitative research, involving over 300 Australian healthcare chaplains, concerning their involvement in patient and staff issues with regard to euthanasia. One of his main findings is that those who are trained and experienced in the delivery of spiritual care should be included when considering euthanasia issues and decisions.
Chaplains are involved in such matters whenever there is a consultation period like the one recently held in terms of Margo MacDonald’s proposed bill. However, it is unlikely that Chaplains’ opinions will be specifically sought out beyond a consultation of the general public. Carey’s article stresses the important role Chaplains can have in addressing these vitally important discussions.
Again, since the last edition of SJHC, the National Secular Society grabbed headlines by suggesting that millions of pounds could be saved in the NHS if the provision of Chaplaincy was paid for by the Churches. While I am sure that the saving of money for the NHS is not uppermost in the thinking of the NSS in coming to this conclusion, its arguments raise questions about cost-effectiveness and evidence base for Chaplaincy. Increasingly, Chaplaincy is going to be asked to justify its existence in these terms. These are issues that the profession must acknowledge, especially in times of growing financial stringency.
Many Chaplains have already responded to the NSS through local and national media. In particular, Derek Johnston, Lead Chaplain in Belfast, has written a very helpful reflection from a Northern Ireland perspective in response to the NSS recommendations. Much of his argument and evidence finds application in any Chaplaincy setting across the UK.
As well as these two highly topical issues, this edition of the SJHC offers articles examining the experience of audit within chaplaincy departments in NHS Tayside and in Plymouth Hospitals NHS Trust. The former is an audit of the Chaplaincy Service using the self-assessment tool that is part of the professional standards document published in 2007. The latter is a review of how the Chaplaincy space in an acute hospital was used in a 24 hour period.
As already noted, in a world where Chaplaincy is increasingly going to be asked what kind of service it is providing and what benefits this service offers wider healthcare, such audits may become increasingly common.
Finally, there is a piece which asks us to reflect upon the nature of human suffering, to rehabilitate the experience of this suffering and to see the positive role of chaplaincy in offering a genuinely alternative worldview to the dominant one offered by our culture, which is that suffering is a ‘cosmic mistake’. Sally Nelson’s excellent and thought-provoking article comes as a timely reminder of the vital and distinctive role of chaplaincy within healthcare.
Chaplains are better equipped than many other healthcare staff to offer help and insight in the search for meaning and purpose and in the context of human suffering.
So this edition of the journal offers a highly contemporary view of Chaplaincy and covers current issues as diverse as the flu pandemic (Orere Source), euthanasia (Carey et al), and the distinctive contribution of Chaplaincy (Nelson) within a service that is increasingly asking us to account for ourselves (Levison et al, Baxendale) in a world where strident voices question the funding of the service we provide (Johnston).
But let us know what you think! The Editorial Board often comments on the lack of letters to the Journal. As these highly topical issues all impinge upon our daily practice it would be helpful to know the thoughts of the readership.
On an entirely different note, regular readers may have noticed a slight change in the cover. Moving with the times, we now have a camera ready digitalized image version of the SACH logo which will greatly facilitate the printing of each cover, and which will allow for the on-line sharing of the cover of each edition and, indeed, the on-line sharing of the SACH logo.
Health Care Chaplaincy and Euthanasia in Australia
Lindsay B. Carey, Jeffrey Cohen and Bruce Rumbold
Abstract:This article presents the findings of quantitative and qualitative research involving over 300 Australian health care chaplains concerning their involvement in patient and staff issues with regard to euthanasia. Approximately one quarter of chaplains (26.3%) indicated having been involved in patient / family euthanasia issues and one fifth of chaplains were involved in staff euthanasia issues. Forty-three (n = 43) chaplains consented to in-depth interviews about the nature of their involvement in euthanasia issues. It is noted that the important knowledge and tacit experience of those trained and practicing in pastoral care should be included when considering euthanasia issues and decisions.
Pages 3-12
Rev. Dr. Lindsay B. Carey, M.App.Sc., Ph.D. is Lecturer and Research Fellow, at the Palliative Care Unit, School of Public Health, Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia. Email: lindsay.carey@latrobe.edu.au
Rabbi Dr. Jeffrey Cohen, D.Min., D.D., F.R.S.A. is Visiting Senior Research Fellow, School of Public Health & Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Rev. Dr. Bruce Rumbold is Acting Director of the Palliative Care Unit, School of Public Health, Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia.
Standards for NHS Scotland Chaplaincy Services
Self Assessment Tool: NHS Tayside
Chris Levison, Gillian Munro and Sandy Young
Abstract: In 2007 the first Standards for NHS Scotland Chaplaincy Services, with a related audit tool, were published. NHS Tayside Spiritual Care Forum formally adopted these to measure the development of the work of the department of Spiritual Care. The audit carried out was the first of its kind in Scotland therefore a process had to be developed. Consideration was given to who should be involved, what the aims would be and where and when the process would be carried out. Two assessors were appointed and following collation of evidence and information and consultation with wider representation submission was made. Representatives were invited from the department and other areas involved in the work to attend the submission meeting. The resulting report was presented by one of the assessors to NHS Tayside Spiritual Care Forum. Reflection on the process is offered.
Keywords: Standards, audit, process, assessors, report, reflection
Pages 13-17
Chris Levison has recently retired as Healthcare Chaplaincy Training and Development Officer/Spiritual Care Advisor and was based at the NHS Education Scotland offices in Glasgow.
Gillian Munro is the Head of NHS Tayside Department of Spiritual Care based in Dundee.
Sandy Young is the Lead Chaplain for NHS Lothian, based in Edinburgh.
Medical rites: ‘priestly’ power in modern healthcare
Sally Nelson
Abstract: Patients and their families are often concerned to find a material cause for suffering rather than to accept the mystery of its ontological necessity. In modern healthcare settings, in which medicine is rightly based upon the reductionist empirical scientific method, spirituality is therefore likely to be seen as a bolt-on extra to medical care rather than as a truly alternative worldview. In this article I argue that suffering needs to be rehabilitated as an experience rather than a cosmic mistake, and that chaplains are better equipped than medical staff to offer this insight into transcendent reality.
Key Words: suffering, ritual, healthcare, liminality, chaplaincy
Pages 18-23
Sally Nelson is a doctoral research student based in North Yorkshire. She was formerly Chaplain to the Prince of Wales Hospice in Pontefract and pastor to a church in Watford.
Chaplaincy in the NHS – A Response to the National Secular
Society from Northern Ireland
Derek Johnston
Abstract: This article represents a response to the recent report form the National Secular Society which criticises the money spent on Chaplaincy services in the NHS and which recommends that these services be paid for by churches and faith communities.
Key words: National Secular Society, Chaplaincy, Spiritual Care, Holistic, Funding
Pages 24-27
Derek Johnston is Lead Chaplain Belfast Health & Social Care Trust, Director of Training NI Healthcare Chaplains' Association, Convenor Methodist Church in Ireland Prison & Healthcare Chaplaincy Committee.
24 Hours in the Chaplaincy
Rodney Baxendale
Abstract: As a means of establishing hard data on the usage of Chaplaincy real-estate in a large Acute Hospital, a 24-hour observation was carried out by an anonymous observer, in the Chapel, administration and Prayer-Room areas. An uninterpreted record of events was produced, which is summarised, and which gives an adequate basis for organisational debate and change. The limitations of the survey are outlined, and the scope for future surveys identified.
Key Words: Survey, prayer, staff, patients, solitude, support
Pages 28-31
Rodney Baxendale is Head of Pastoral and Spiritual Care, Plymouth Hospitals NHS Trust and is based at Derriford Hospital, Plymouth.
Book Reviews
Pages 32-36
Children and Spirituality Searching For Meaning and Connectedness
Hyde, Brendan 2008
ISBN 978 1 84310 589 3
Jessica Kingsley Publishers London and Philadelphia
192 pages
Speaking of Dying: a practical guide to using counselling skills in palliative care
Heyse-Moore L 2009
ISBN
Jessica Kingsley Publishers London and Philadelphia
192 pages
Passionate Supervision
Edited by Robin Shohet 2008
ISBN 9781843105565
Jessica Kingsley Publishers London and Philadelphia
222 pages
The Spiritual Dimension of Childhood
Kate Adams, Brendan Hyde and Richard Woolley 2008
ISBN 9781843106029
Jessica Kingsley Publishers London and Philadelphia
160 pages
Silent Grief, Living in the Wake of Suicide
Christopher Lukas and Henry M Seiden 2007
ISBN 9781843108474
Jessica Kingsley Publishers London and Philadelphia, 2nd Edition,
220 pages
Ageing, Disability and Spirituality : addressing the Challenge of Disability in Later Life
Elizabeth MacKinlay (Ed) 2008
Jessica Kingsley Publications
ISBN 978 1 84310 584 8
271 pages
THE ORERE SOURCE
Abstracts from the Pastoral Care and other Healthcare Journals
Page 35-43
The Rev. W. Noel Brown is a recently retired hospital chaplain and former A.C.P.E. supervisor. He is the Convenor of the Research Committee of the Association of Professional Chaplains. He is also the Editor of The Orere Source, a bi-monthly publication of his abstracts from the pastoral care and healthcare literature. There are over 16,750 abstracts in the database. He can be contacted at: oreresource@rocketmail.com