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  • Open to Interpretation
  • Tim Thorstenson

To the Editor: Raymond DeVries, Nancy Berlinger, and Wendy Cadge's article on chaplaincy ("Lost in Translation: Using Sociology to Help Define Chaplaincy's Role in Health Care," Nov-Dec 2008) is a helpful contribution to the angst of an emerging profession. Clearly, there is need for ongoing introspection in the field, cross-discipline dialogue, and clarification of identity and focus. What was underserved in the article—leading perhaps to the use of unfortunate metaphors—was the professional identity shaped by the theological and moral foundations of spiritual care.

The profession owes its focus to the work of moral theologians Paul Ramsey, James M. Gustafson, and Richard Mc Cormick—known for their early work in bioethics—as much as to its early practitioners such as Anton Boisen and Carroll Wise. The roots of our work lie not in "filling a void" left by other professions in health care, nor in "flying under the radar" as the article suggests, but in the transformative encounters of human suffering by persons who understand moral action in the face of ambiguity and who are able to reflect on the meaning and purpose of each individual's life and circumstance.

Chaplaincy, as noted, is no longer exclusively a "Christian" profession. Its potential and ultimate value lies in its universality. The core values of all the world's religious expressions center around the story of the Divine's engagement with us, of the Creator's love for Creation. It is a transformative story that has the power to shape us into the sorts of persons who want what is good and who then can and will act morally. The outcome of such moral desire is, as captured in the Christian scriptures, to "love God and others as we love ourselves"—that is, to honor personhood and work for justice and express compassion as ones who know brokenness and have integrated a capacity for trusting the natural processes of life and love.

I would suggest that chaplains are not "translators" of the work of other clinicians, but rather "interpreters" of human experience and "reflectors" who enable meaning-making in the midst of suffering. This is a much fuller and richer identity than the authors capture. It is one founded on the ability to listen deeply to another's life, to discern values and reflect on how to incorporate them into difficult circumstances, and to love fully by being truly present to another's pain. "Strong" dimensions such as advocacy, prophetic engagement, and direct intervention are as much key components of this identity as are the "softer" dimensions of caring and healing.

I teach spiritual care in a hospital, and I am a medical ethicist. As an organization responsible for the training and development of chaplains, we have developed clearly defined standards, competencies, and outcomes. To study our profession, I would ask the writers to be in dialogue with those of us who teach, as well as those who are practitioners. As we learn better how to engage all dimensions of health collaboratively and effectively, chaplaincy will emerge as valued cohort in health care delivery.

Tim Thorstenson
Park Nicollet - Methodist Hospital
St. Louis Park, Minnesota
  • Raymond De Vries replies:
  • Raymond De Vries III

Tim Thorstenson reminds us of the important work done by chaplains—offering spiritual guidance and support, honoring the dignity of those who receive and give care, seeking justice, and being a compassionate presence in health care organizations that all too easily lose sight of the suffering person. No one would deny the need for someone to do this work, but the good intentions of chaplains, the nobility of their work, and even the necessity of this kind of care are no guarantee that chaplains will be allowed "to engage all dimensions of health collaboratively and effectively." How can Thorstenson and other like-minded persons create the space chaplains need to fully exercise their calling?

A necessary first step in securing a place for chaplaincy among the other professions in health care is a clear-eyed look at what happens when we humans organize our work, create professional groups, and build bureaucracies. Often this "clear-eyed look" brings unwelcome news to...


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