Hospital Chaplaincy Research Articles

Medical Risk, Patient Hope, and Hospital Chaplaincy: Cautionary Tales

Medical Risk, Patient Hope, and Hospital Chaplaincy: Cautionary Tales

Shining a Light in COVID-19 Darkness

Introduction: The World Health Organization officially declared COVID-19 a global pandemic in March 2020, resulting in travel restrictions, closure of non-essential shops and services, and the discontinuation of elective healthcare. The escalation of the pandemic impacted on hospital healthcare professionals, who experienced the deaths of colleagues and unprecedented changes in their working conditions. One area that received media attention in the United Kingdom during the pandemic was the role of hospital chaplaincy and spiritual care teams.Methods: An exploratory study advertised via social media, the press and professional bodies resulted in 86 healthcare professionals and 63 chaplains, who had worked clinically in the United Kingdom during the pandemic, completing an open, free text electronic survey. Seven chaplains participated in a follow-up telephone interview, with all the data collected in 2022.Results: The survey demographic data were analysed using descriptive statistics. Free text responses and interviews were subject to thematic analysis. A focus on the support of health professionals was widely reported by all respondents. Two overarching themes were identified: (1) organizational initiatives, with subthemes of structural and virtual support; (2) proactive intervention – “going to the frontline”, with subthemes of emotional and spiritual support, moral support and practical input.Discussion/Conclusion: The overarching finding was that hospital chaplains worked alongside healthcare staff on the clinical frontline. Staff described this as invaluable in its immediacy of support and provision of a valued presence. The chaplain’s role changed to becoming more focused on staff support, which appears to be ongoing, thus impacting on the future role and training for hospital chaplaincy teams.

Working on the Clinical Frontline During the COVID-19 Pandemic

Hospital chaplaincy teams played a vital role during the COVID-19 pandemic, but the full depth of their experiences and personal impacts is not fully known. This UK study was advertised using social media platforms, local press outlets and chaplaincy professional bodies. An electronic survey was completed by 63 hospital chaplains, with the opportunity for all respondents to participate in follow-up interviews. This option was taken up by seven chaplains and explored the personal impacts, experiences and reflections of working during the pandemic. Their views of the impact of initiatives, practices and organizational changes were explored. Themes included: (1) challenges and personal impact, including reflections on the enormity of the situation, personal fears and sacrifices, and clinical challenges; (2) practical solutions, including personal strategies and the support of colleagues; and (3) organizational issues and suggestions. This article concludes with recommendations for organizations and further research.

The Triple Beholdenness of Polish Hospital Chaplains: How to Avoid Confusion?

Abstract Polish hospital chaplaincy, because of the unique political and sociological context in which it finds itself, presents a sort of triple beholdenness. It carries particular loyalties to the state, to Catholic doctrine, and above all, it is called to be faithful to the unique suffering person. In this article, I argue that the biggest challenge for Polish chaplaincy resides within the domain of loyalty to the patient, where the profound and immediate need for robust formation of individual Christian conscience through catechesis is needed. Although hospital chaplaincy’s involvement in catechesis and instructing the faithful might not be clearly evident for the reader, nevertheless I prove my point by bringing a story from my practice as a chaplain in one of Poland’s hospitals.

Will AI ever become spiritual? A Hospital Chaplaincy perspective

ABSTRACT With humanity’s ever-increasing reliance on, and closer integration with Artificial Intelligence (AI), the questions of AI’s agency as both potential spiritual-being and spiritual care-giver are pressing. This paper reviews these from an acute Hospital Chaplaincy perspective, utilising that sector’s broad definitions of spirituality, and case studies. The structure is provided by two broad questions: ‘Does AI need chaplaincy?’ and ‘Could AI provide chaplaincy?’ Focusing on Boden’s (2018) definition of AI as being humans and computers in symbiosis, this article argues that Chaplaincy may be deeply necessary for the human components of AI, especially with the lax ethical landscape around AI development and usage. Further, recognising that AI already provides quasi-Chaplaincy through apps, this article raises concerns around whether it can provide the same level of care as a human Chaplain, especially around questions of embodiment, free-will, veracity, professionalism, charity, and humanity. Although this paper has a specific focus on Hospital Chaplaincy and its arguments sit within those parameters (which the author recognises is more person-centred and limited than broader parish-based pastoral care), there are important implications for all in public ministry, whatever their setting.

Reconfiguring the health-promoting hospital: the role of chaplaincy in England.

This paper seeks to explore how hospitals can be reconfigured to adopt more 'health-promoting' approaches and values. Specifically, the paper focuses on the role of hospital chaplaincy and argues that spiritual care should be considered alongside other health domains. Using semi-structured interviews, the aim of the paper is to explore the experiences of patients who accepted (n = 10) and declined (n = 10) hospital chaplaincy services. Data were analysed drawing on principles of interpretative phenomenological analysis (IPA). The findings suggested that participants who accessed chaplaincy services reported using the chaplains for pastoral, religious and spiritual care which contributed positively to their sense of well-being. This included religious rituals and supportive conversations. The majority of these participants had existing links with a faith institution. Participants who declined chaplaincy services reported having personal religious or spiritual beliefs. Other reasons cited, included: that the offer was made close to discharge; they had different support mechanisms; they were unaware of what the chaplaincy service offered. Participants identified a number of skills and attributes they associated with chaplains. They perceived them as being religious but available to all, somebody to talk to who was perceived as impartial with a shared knowledge and understanding. The paper concludes by highlighting the important role of chaplaincy as part of a holistic health-promoting hospital. This has implications not only for the design, delivery and promotion of chaplaincy services but also for health promotion more broadly to consider spiritual needs.

ENFERMAGEM E CUIDADO PALIATIVO ONCOLÓGICO EM UMA INSTITUIÇÃO DE REFERÊNCIA (2005 - 2006)

ABSTRACT Objective: to analyze the strategies undertaken by nurses at Hospital do Câncer IV to act in accordance with the World Health Organization guidelines. Method: a historical and qualitative study carried out at Hospital do Câncer IV, a reference and exclusive Palliative Care unit belonging to the National Cancer Institute. Data collection included written documents and six oral statements and was carried out from August 2020 to August 2022. The study findings were organized and analyzed in accordance with the historical method, which included triangulation of the written and oral sources and the context in which they were produced. Results: based on the references of St. Christopher's Hospice and with the support of the Unit's Humanization Group, the strategies undertaken by the nurses and evidenced in this research were as follows: expansion of the Hospital Chaplaincy Project and the Silence Room; investments in graduate courses; professional training and technical-scientific update courses, both at the unit and at other institutions; participation in events as organizers, speakers and listeners; and performance in the Nursing Residency Program. Conclusion: nurses undertook effective strategies in the Oncology Nursing field through the consolidation and dissemination of specialized knowledge in Oncology Nursing in Brazil.

Hospital chaplains facing the pandemic. A qualitative study

The article explores hospital chaplains perspective on the impact of the coronavirus pandemic on the provision of spiritual care in Poland. Semi-structured interviews with sixteen hospital chaplains providing spiritual care in hospitals during the COVID-19 pandemic were performed. Six main themes emerged during the interviews: chaplains’ experience of the pandemic, chaplaincy during the outbreak, patients’ needs, health professionals needs, social stigma and discriminatory behaviours against chaplains, and the importance of spiritual care during the crisis. Results indicate that although the COVID-19 crisis has limited the possibilities of providing spiritual care in hospitals and has changed its nature, it has positively impacted the visibility of hospital chaplaincy. It also underpins the contribution of hospital chaplains to modern healthcare practice and suggests that chaplains role as key healthcare workers should be further recognized and their integration into the healthcare system is required.

THEOLOGICAL ASPECTS OF THE BRAZILIAN STRICTO SENSU ACADEMIC PRODUCTION ON HOSPITAL CHAPLAINCY

This article presents a descriptive approach whose objective is to explain theological models present in academic publications (theses and dissertations). It is not intended to be a systematic analysis or even a hermeneutic-exegetical study, but rather a narrative approach to the theologies present in the consulted material. This is a narrative review of the literature, and the steps for elaboration and organization derived from other studies. It was operationalized according to the following steps: identification of the theme, bibliographic survey, selection of texts, annotations, preliminary structuring and logical structuring of the study. We sought to provide an understanding of current knowledge on the theme “hospital chaplaincy”, highlighting possible gaps and suggesting an agenda of investigations to be undertaken. The TQO strategy (theme, qualifier, object) was used to formulate the research question, which is indicated for narrative reviews, resulting in the issue: which theological models are present in theses and dissertations available in the Brazilian context? The searches were online in the theses and dissertations database of the Coordination for the Improvement of Higher Education Personnel (Capes), carried out in 2020, using the descriptor “chapel*/hospital chaplaincy”, without restrictions on the year of publication or any other. The titles of interest related to the theme were included, in order to answer the proposed question. Data were organized in tables, with qualitative and quantitative summaries. Thirteen productions were retrieved. Among the main results, it is highlighted that approaches of anthropological and praxiological origin prevailed, associated with theological models/concepts such as “imago Dei”, “poimenics” and “theodicy”.

Mental illness, personhood, and transcendence: Spiritual and religious assistance in Catholic psychiatric contexts.

In recent decades, there have been many calls for the inclusion of spirituality and religion (S/R) in therapeutic contexts. In some contexts, this has been an institutionalized form of spiritual and religious assistance (SRA). This article examines the concepts and practices involved in SRA services at three psychiatric institutions in Portugal, a country with strong Catholic roots but increasing efforts at secularity and recognition of religious diversity. The case of a user who contacted the SRA service allows us to better grasp this new practice in action. Although some SRA practices have similarities with mindfulness, a systematic comparison allows us to explore the links between SRA and the global dynamics related to S/R in mental health and the particularities of Catholic spirituality. In the contexts observed, the transition from the Catholic hospital chaplaincy system to the SRA model is developing through the integration of features of the Catholic spiritual tradition with concepts and practices drawn from the psychology of religious experience. The accompaniment of the 'whole person' emerges as the central concept of this form of SRA. Spirituality gains significance as an integrative approach to the subjectivity fragmented by the illness and the fragmentation of care across multiple clinical specialties. Furthermore, the prioritization of the spiritual needs expressed by users suggests that SRA combines well with the individualistic rationales and the technification of care in the field of mental health.

Hospital-based spiritual care: what matters to patients?

Demographic changes in Australia have led to an increase in both religious diversity and the number of people who do not nominate a faith affiliation at hospital admission. Models of chaplaincy have shifted from clerical and largely male to an increasingly skilled and diverse spiritual care workforce appointed directly by health services. This study uses survey and in-depth interview methods at an inner-city Australian hospital to examine patient preferences for hospital chaplaincy provided by faith communities, and the importance of faith affiliation compared to other spiritual care provider characteristics. Survey results indicate that of 110 respondents, a high proportion (74%) prefer spiritual care to be provided by a person of the same faith. However, when considered relative to other characteristics, faith affiliation was not as important as kindness, listening skills and a non-judgmental attitude. Our findings have implications for workforce planning and educating. Further research in different settings and with different populations will make the findings more generalizable.

Hospital Chaplaincy during the Covid-19 Pandemic

The text deals with the experience of Czech hospital chaplains in 2020. Specifically, it concerns the period during the spring and autumn waves of the pandemic caused by the spread of the SARS-CoV-2 virus which leads to a viral disease known as covid-19. The article builds on data obtained through an online questionnaire and subsequent ten interviews with hospital chaplains. The results of the research are presented in four thematic blocks: chaplain and institutions, chaplain and staff, chaplain and patient, and the chaplain himself. Based on a qualitative analysis of the data, we conclude that the pandemic affected the self-concept of many chaplains. It mainly depended on their effectiveness, that is, the possibility of applying their skills, in the hospital during the pandemic. In many cases, the pandemic crisis has accelerated the development of relations with the institution and staff, for better or worse. The position of the chaplain in the hospital before the outbreak of the pandemic proved to be crucial. The work with patients themselves did not usually undergo a fundamental change; the chaplains often functioned here as a substitute for forbidden visits. At the end of the article, we present some practical recommendations resulting from our data.

“Dog” is “God” Spelled Backward

This brief report describes the unique and innovative work of a hospital chaplaincy “Good Samaritan” staff welfare dog named “Poppy Jingles.” As the importance of stress prevention and burnout among National Health Service staff (UK) has been highlighted in current policy, the initiative of animal-assisted therapy is both timely and significant. The relevance of inter-species well-being is detailed in this article, describing what can be considered as Poppy’s “nonhuman charisma.” This includes eliciting specific aspects of well-being which can be thought to correspond to eudaimonic states of human flourishing.

Black and Buddhist: What Buddhism Can Teach Us About Race, Resilience, Transformation, and Freedom ed. by Pamela Ayo Yetunde and Cheryl Giles, and: Buddhist-Christian Dialogue, U.S. Law, and Womanist Theology for Transgender Spiritual Care by Pamela Ayo Yetunde

Reviewed by: Black and Buddhist: What Buddhism Can Teach Us About Race, Resilience, Transformation, and Freedom ed. by Pamela Ayo Yetunde and Cheryl Giles, and: Buddhist-Christian Dialogue, U.S. Law, and Womanist Theology for Transgender Spiritual Care by Pamela Ayo Yetunde Carolyn Jones Medine BLACK AND BUDDHIST: WHAT BUDDHISM CAN TEACH US ABOUT RACE, RESILIENCE, TRANSFORMATION, AND FREEDOM. Edited by Pamela Ayo Yetunde and Cheryl Giles. Boulder, CO: Shambhala Press, 2020. xxxii and 189 pp. BUDDHIST-CHRISTIAN DIALOGUE, U.S. LAW, AND WOMANIST THEOLOGY FOR TRANSGENDER SPIRITUAL CARE. By Pamela Ayo Yetunde. New York: Palgrave Macmillan, 2020. ix and 144 pp. Pamela Ayo Yetunde and Cheryl Giles offer a variety of Black Buddhist voices in their co-edited volume, Black and Buddhist: What Buddhism Can Teach Us About Race, Resilience, Transformation, and Freedom. Yetunde extends this work in her single author volume, Buddhist-Christian Dialogue, U.S. Law, and Womanist Theology for Transgender Spiritual Care. In this review essay, I, first, will give brief information about the two authors and turn to each work, looking at key themes and insights they offer us about African American Buddhist practice, in general, and about pastoral care and chaplaincy. Finally, I would like to suggest the importance of these two works. the work of two lives Pamela Ayo Yetunde has emerged as an innovative voice in Black Buddhist Studies. Dr. Yetunde is a Buddhist chaplain, having trained at the Sati Center for Buddhist Studies, and pastoral counselor who has been active in hospice work, having founded the Zen Caregiving Project; she also co-founded the Center of the Heart and the Audre: Spiritual Care for Women with Cancer. She is a professor at United Theological Seminary of the Twin Cities and a faculty member at the Upaya Institute and Zen Center and a Community Dharma Leader in the Insight Meditation tradition. [End Page 327] She has written for Buddhadharma, Lion's Roar, and Tricycle: The Buddhist Review. In addition, she has a law degree and has written a book about women and finance. With other practitioners, she founded the Buddhist Justice Reporter: The George Floyd Trials (www.buddhistjustice.com). Yetunde brings all this to her intersectional work on Black Buddhists and on Buddhism and pastoral care, and her work is trailblazing, opening up conversations around race, gender, and religion in the books under review and in her 2018 work, Object Relations, Buddhism, and Relationality in Womanist Practical Theology, which includes interviews of African American lesbian Buddhist practitioners in the Theravada Insight Meditation tradition. Dr. Cheryl A. Giles is the Francis Greenwood Peabody Senior Lecture on Pastoral Care and Counseling at Harvard University. She is a member of the Buddhist Ministry Initiative. Her books include the co-edited pioneering work, The Arts of Contemplative Care: Pioneering Voices in Buddhist Chaplaincy and Pastoral Work, which gathered voices from a variety of Buddhist lineages to explore contemplative care in hospital chaplaincy, prison ministry, college and military chaplaincy, and end-of-life care. Her Buddhist-Christian writings include "Self-Care for the Beloved Community" in The Christian Century (2016), which asks important questions about compassionate leadership and the preparation and resources needed for the work.1 Her work focuses on adolescent psychology, healthcare and African Americans, and contemplative care—providing spiritual, emotional, and pastoral support in a way that is informed by a "personal, consistent contemplative, or mediation practice"2—at the end of life. A practitioner of Tibetan meditation, she is a member of the Natural Dharma Fellowship. In "Beyond the Color Line: Cultivating Fearlessness in Contemplative Care" in The Arts of Contemplative Care, Giles confronting the racism present in Buddhism and, therefore, in care, asks us to cultivate fearlessness and to bring this to our meditation, to our work, and to our interactions. None of us will ever be perfect nor can we expect to live without fear. But we can aspire to be open to the unfolding present moment. We can help in this small way to make a real impact: we can vow to practice fearlessness every day for ourselves and others to alleviate suffering. We can stay true to a strong intention while opening to our own vulnerability and that of...

Spiritual care in the intensive care unit.

The aim of the present paper is to describe the real possibilities of providing spiritual care in intensive care units (ICUs) in Poland. Faced with suffering and death, critically ill patients and their families need asource of comfort and hope. Spiritual care is intended to bring relief to them by responding to their spiritual needs. The literature review indicates the positive effects of providing spiritual care in ICUs. Spiritual care improves the quality of life of patients, satisfaction with medical care and even prevents or alleviates the negative psychological consequences of hospitalization. Moreover, it is beneficial to the ICU personnel, to their motivation, work efficiency, well-being and reduces the risk of burnout. Basic spiritual care that can be provided by any ICU physician on adaily basis is nothing more than the way of behaving towards apatient: seeing an individual who has his/her dignity, history, personality, beliefs, fears and hopes. Whenever disease-associated stress has led to an existential crisis, the ICU staff may request ahospital chaplain's visit. The physician can support the conscious patient by establishing arelationship with him: by showing concern, compassion and solicituide. According to some researchers, each patient admitted to the ICU should be asked questions about spiritual issues. If faith is important to the patient, it is necessary to allow him/her to use religious resources, which requires cooperation with ahospital chaplain. The paper discusses the ways the hospital chaplaincy operates in Poland and worldwide. Furthermore, the education of chaplains abroad and the scope of their tasks and activities are described.

Medical Student Experience in the Wake of COVID-19 Pandemic and Next Steps

Back to table of contents Previous article ViewpointsFull AccessMedical Student Experience in the Wake of COVID-19 Pandemic and Next StepsGrace AnGrace AnSearch for more papers by this authorPublished Online:16 Nov 2020https://doi.org/10.1176/appi.pn.2020.11b30AbstractThe year 2020 has brought much stunning news. From deadly wildfires and giant hornets to racial injustice and a heated presidential election, there has been no shortage of events to challenge our mental well-being. But at the top of the list is COVID-19, which has universally affected people so much that nowadays conversations often start with “before COVID” and “after COVID.” When quarantine For COVID-19 was implemented and medical student clinical rotations were canceled in March, medical students at Rutgers New Jersey Medical School (NJMS) jumped into action to support the community and front-line workers. We volunteered for childcare, delivery of fresh groceries, collection and production of personal protective equipment, clinical research, and the creation of “wellness spaces” in the hospital.I volunteered at the New Jersey COVID-19 Hotline. Most callers requested information on testing locations and hours. Others asked which emergency rooms were safe for getting care for their grandparents for emergencies unrelated to COVID-19. Many people avoided the hospital altogether. Back on the floors, I encountered patients who had been severely affected by COVID-19. I distinctly remember the patient with diabetes who needed a below-the-knee amputation due to a worsening ulcer that progressed to osteomyelitis. He delayed care because he was afraid of contracting coronavirus in the hospital.In June, I was on the consultation-liaison service, and we consulted on a number of cases for anxiety and depression. Many patients had lost their jobs due to the pandemic, and one patient had lost her husband to COVID-19, home, and dog while she was recovering from the virus at the hospital. Psychiatry patients experienced interruptions to their care.Aside from losing friends and loved ones to COVID-19, we must recognize how the pandemic has impacted people in broader ways. Those who have recovered continue to have lingering symptoms. Others have been affected through socioeconomic impacts or delayed care. Therefore, medical students should approach patients with more humanism and compassion than ever, seeking to learn about their social history and determine how the pandemic has impacted their lives. Because medical students have more time to spend with patients, we should be trained to screen all patients for depression, trauma, domestic violence, life events, and stressors. Also, we should pay particular attention to patients with preexisting mental disorders to prevent progression of their illness.NJMS students get strong didactics on health equity and social justice. The curriculum and clinical opportunities should be expanded on breaking bad news, palliative care, and bereavement support for patients’ families. Through collaboration with the University Hospital Chaplaincy team, eight senior medical students provided spiritual care and virtual family support to those affected by the pandemic. With the changing public health environment and needs of our community, such learning and experiences should start during the preclinical years for all students.We know that the pandemic is far from over. The number of COVID-19 cases continues to rise, not only in the United States, but in other countries as well. Eager to return to campus life, many college students have fallen ill with the virus. Rather than becoming lax about following public health guidelines, people need to learn more about the consequences of COVID-19, even if they have already had the virus.Looking forward, medical students should receive early training on how to critically read research articles in order to be up to date with the latest scientific findings, as we expect that patients will seek care for long-term COVID-related neurological and psychiatric symptoms. Clinical students should be more vigilant about mental health, physical and sexual abuse, and substance abuse. Therefore, we should be equipped with the PHQ-9, Trauma Screening Questionnaire, and Stressful Life Events Screening Questionnaire, and the communication skills necessary for hard conversations. We should also gain experience in other aspects of mental health care such as social work services, community resources, and group or family therapy, whether it is during mandatory clerkships or electives.We medical students have learned much this past year beyond the usual curriculum. Perhaps the most important skill we have learned is the ability to be flexible and adaptable to an extent that we had never imagined. We stand ready to respond to our patients’ needs, whatever they may be. ■Grace An is a fourth-year medical student at the Rutgers New Jersey Medical School. She is applying for residencies in psychiatry and combined psychiatry/family medicine. ISSUES NewArchived

Towards Designing a Better Death: A Retrospective Analysis of Planned In-Hospital LVAD Deactivation Cases

Despite rapid growth of implanted durable mechanical circulatory support devices, best practices for device deactivation and end of life (EOL) care have yet to be elucidated. We wished to describe current practices in LVAD deactivation at EOL, identify unmet needs of dying patients, and develop best-practice protocols for LVAD deactivation. Retrospective analysis of patients admitted at MedStar Washington Hospital Center who had planned LVAD deactivation prior to death between January 2017 and August 2019. EHR review extracted information regarding patient demographics, underlying cardiac history, LVAD implant course/complications, reasons for LVAD deactivation, clinical details of deactivation process including symptom management issues, unit of death, consultant participation, and family presence. Data was analyzed using descriptive statistics. Fifty-three patients (32% women, 67% African American, 64% non-ischemic cardiomyopathy) with median 267 days on durable MCS support (range 10-3326 days) were included in the analysis. Fourteen deaths occurred during LVAD index hospitalization; for the rest, patients sought hospital or emergency room care a median of twice in the year prior to death (range 0-16 occurrences). Final hospital length-of-stay was median 21 days (range 1-106). During planning for LVAD deactivation, PC was consulted in 33 cases (66%), hospital chaplaincy in 27 (51%), and ethics in 13 (25%). Forty deaths occurred in the hospitals cardiac ICUs, 12 in the advanced heart failure step-down unit, and 1 in the ED. Family members were present at deactivation in 39 cases (74%). Regarding EOL symptom management, at the time of deactivation most patients received opioids (94%) and benzodiazepines (66%). LVAD deactivation time was documented in only 18 cases (34%); in these cases, time from device deactivation to death was median 11 minutes (range 1 min to nearly 28 hours). Our early outcomes identify existing practices that should be continued as well as opportunities to develop and implement best-practice protocols for LVAD deactivation, palliative symptom management, psychosocial/spiritual support, and ongoing education for involved providers.This retrospective case series review informs the creation and implementation of future collaborative LVAD deactivation policies and workflow guidelines.

From ministry to hospitality: welcoming the stranger in Judaism as a practical model for contemporary healthcare chaplaincy

ABSTRACT Judaism is a religion of practice with many of its laws aiming to maintain a cohesive community living on a shared planet. It is, thus highly useful in hospital chaplaincy which, in an increasingly globalised world the patient and staff population are not a homogeneous community of faith or belief groups and many may be secular. Care, visiting the sick and hospitality of the ‘other’, the stranger, form very strong narratives in the ancient Hebrew texts, with ethical behaviour exemplified by the patriarch, Abraham. Within Judaism itself, these texts are constantly being reviewed and interpreted in a tradition of deep exegesis and hermeneutics. These textual meanings inform values and ethics of care. This paper explores the meanings in the text to illustrate the basis of care and hospitality as central to Judaism and to show its relevance in contemporary multifaith and secular hospitals.

The role of religious beliefs for the acceptance of xenotransplantation. Exploring dimensions of xenotransplantation in the field of hospital chaplaincy

The Changsha Communiqué (2008) calls for a greater account to be taken of the ethical aspects of xenotransplantation as well as of public perception. This also applies to the field of hospital chaplaincy. So far, there has been no empirical exploration of the assessment and acceptance of xenotransplantation by pastoral workers in German-speaking countries. In view of the prospect of clinical trials, in-depth research is both sensible and necessary, since both xeno- and allotransplantation can have far-reaching consequences for patients, their relatives, and the social environment. In addition to the tasks of health monitoring, questions of the individual handling with and integration of a xenotransplant must also be considered. They can affect one's own identity and self-image and thus also affect religious dimensions. Hence, they make a comprehensive range of accompaniment necessary. This paper presents the first explorative results of a Dialogue Board with Christian, Jewish, and Muslim hospital chaplains. It explores pastoral challenges of xenotransplantation for the German-speaking countries, in particular (a) self-image and tasks of hospital pastoral care, (b) religious aspects of transplantation, and (c) religious aspects of xenotransplantation as anticipated by the hospital pastors. Depending on their religious background, hospital chaplains see different pastoral challenges when xenotransplantation reaches clinical stage. In particular, the effects on the identity and religious self-image of those affected must be taken into account. Three desiderata or recommendations for action emerged from the Dialogue Board: (a) initial, advanced and further training for hospital pastoral workers, (b) contact points for patients, and (c) interreligious cooperation and a joint statement. All participants of the Dialogue Board emphasized the chances of xenotransplantation and expressed their hope that xenogenic transplants could save patients or improve the quality of their life substantially. Xenotransplantation can affect the identity work of patients and relatives also in religious terms. In order to provide better pastoral and psychosocial support for these persons within the framework of the hospital, it is important to reflect on such challenges at an early stage and to develop concepts for pastoral further training and pastoral care in xenotransplantation.

Examining the Distribution of Services: How Hospital Chaplaincy Screens the Religiously Unaffiliated

The proportion of religiously unaffiliated Americans has grown dramatically over the last few decades. Using updated data from the author’s previous study, “Non-religious people's experiences with spiritual care when seriously ill or injured,” 1,040 people expressed a willingness to be interviewed or part of a focus group concerning their spiritual care experiences, indicating significant interest among non-religious patients. Participant candidates self-identified as “religious and affiliated,” “religious and unaffiliated,” “spiritual but not religious,” “neither spiritual nor religious,” “none of the above,” or “other.” Patients in these groups were not offered hospital chaplaincy services evenly: “none of the above” (50%) were most likely to have not been offered chaplain services, and “religious and unaffiliated” (40%) the least. Findings and quotes from the interviews and focus groups help illustrate additional sentiments. These findings are relevant for managers of healthcare chaplaincy services in revising how they screen patients for spiritual care needs.