Whither Chaplaincy?

Note:  This reflection is a personal response to things I’ve recently read and conversations I’ve participated in. And I’ve made some revisions in response to some of the comments I’ve received.

Chaplaincy is ministry.  It is ministry in a specialized setting: hospital, military, college, prison, etc. But it is ministry. It is pastoral. I find it frustrating that I have to say the obvious.  Throughout the historical use of the term a chaplain has been a leader in a faith tradition in specialized ministry.  The connection between the chaplain and the tradition is inseparable–the chaplain has roots in that tradition, and maintains connection with it.

But today there are some within health care chaplaincy that would redefine a chaplain as anyone, clergy or not, who engages in “spiritual care” (which seems rather ill-defined). They say it’s all about outcomes, and that lack of religious title, seminary education, or ecclesial endorsement shouldn’t bar someone from chaplaincy. Those things are irrelevant to the ability of a chaplain to make a difference. Being a member of a faith group’s leadership is not an “evidence-based practice.”

This is a dangerous redefinition. If followed to its logical conclusion, there would be no reason for chaplaincy as a profession, because the chaplain wouldn’t be doing anything that couldn’t be done by some other employee of a hospital, like a nurse, or a social worker, or an administrator.

I think the military chaplaincy has been protected from this thinking because it has resisted those who wanted to define chaplaincy in terms of “spiritual care” and has insisted that the mission of the chaplaincy is Religious Support.  And military doctrinal publications like Army Regulation 165-1, Army Chaplain Corps Activities, stress that a chaplain is both a military officer and a religious leader.  When the chaplaincy was challenged as a violation of the Establishment Clause, chaplaincy leaders defended it as necessary to preserve the rights of service members guaranteed by the Free Exercise Clause.  The chaplaincy exists to protect Religious Freedom.  It exists so that service members can practice religion.

Now, healthcare chaplaincy has major differences from the military. But I think this historical understanding of chaplaincy as having to do with religion is something shared. A redefinition of chaplaincy in a non-religious manner, broaden it to include other professions beside religious leaders, has roots, it seems to me, in both an extreme anti-clericalism and a modern anti-religious outlook.

The anti-clerical strain claims to be a successor of the Protestant Reformation principle of the “priesthood of all believers.”  But the Protestant Reformers would have been shocked.  Their questioning of the Roman Catholic teachings of the Sacrament of Holy Orders and the Sacrifice of the Mass did not lead them to reject the ministry.

Having begun ministry in a Lutheran context, indulge my dwelling in that land for a moment, just as a historical reference point.  In Augsburg Confession Article 5, the Lutheran church confessed:

“That we may obtain this faith [that justifies], the Ministry of Teaching the Gospel and administering the Sacraments was instituted. For through the Word and Sacraments, as through instruments,  the Holy Ghost is given, who works faith; where and when it pleases God, in them that hear the Gospel, to wit, that God, not for our own merits, but for Christ’s sake, justifies those who believe that they are received into grace for Christ’s sake.”

Likewise, in Article 14, “Of Ecclesiastical Order they teach that no one should publicly teach in the Church or administer the Sacraments unless he be regularly called.”

The Lutherans rejected the idea that ordination gave an “indelible character,” or that it brought about an “ontological change” in the one ordained.  But they saw the ministry as a divine office of preaching (Predigt Amt)  and sacramental celebration that was necessary for good order.

The first chaplains, according to the old Catholic Encyclopedia, were Catholic priests assigned to royal palaces and to endowed chapels, or in the employ of families. Chaplains were also assigned to convents, and to hospitals, and to the military.  Reformed, Anglican, and Lutheran churches continued the practice (Ulrich Zwingli, the Swiss Reformer, besides being a pastor, was a military chaplain and died in battle).

The twentieth century saw a professionalization of chaplaincy (see here, for example), including programs of certification and of education.  The field was expanded from a male Christian base to include women and chaplains of many different faiths. Many of these faiths don’t have clergy in the traditional Protestant or Catholic or even Jewish sense.  The leading professional and education organizations incorporated these other faiths, and made paths to credentialing and certification available, yet never thought to deny that chaplaincy was “ministry” or “pastoral.”  The Association of  Professional Chaplains, for example, defines itself as having a “commitment to interfaith ministry,” and requires ecclesiastical endorsement for Board Certification.  The Association for Clinical Pastoral Education, Inc., has the word pastoral at the very center of its name. The webpage says, “We are a multicultural, multifaith organization devoted to providing education and improving the quality of ministry and pastoral care offered by spiritual caregivers of all faiths” (emphasis added).

The Health Care Chaplaincy Network recently established a new new “Spiritual Care Association.” It claims to be “multidisciplinary,” which I think is good and proper when speaking of spiritual care in the broadest sense.  But I think it goes too far when eliminating ministry experience, theological education, and endorsement by a faith group to be considered a “Credentialed” or “Board Certified” chaplain. They argue, “endorsement is not an evidence-based indicator of the person’s competency as a chaplain.”

I think some of the points made by those seeking an “evidence-based” foundation for chaplaincy are valid.  Can we point to positive outcomes in patient experience because of our presence, or the attention to spiritual needs by the full staff?  But I think it goes too far.  Connection to a faith community, and recognition as a leader by that faith community, is essential to the very definition of what a chaplain is.  They respond by arguing that this is a “Christian” perspective. I disagree.  The military has had no problem including chaplains who are Jewish, Muslim, Buddhist and Hindu.  The Association of Professional Chaplains includes chaplains from many more faith perspectives.  And they do this without watering down either the educational requirements or the understanding of the chaplain as a religious leader.

I see this attitude as not only anti-clerical, but also as succumbing to post-modernism’s anti-religious outlook as well–the final result of accepting the cliche that one can be “spiritual but not religious.”

So I can’t support the Spiritual Care Association’s rationale.  It is a break from the history and meaning of chaplaincy.  It divorces chaplaincy from both a religious context and from a ministerial context.  What’s left?  Ability to ask, “How does that make you feel?”  An ability to ask, “What values from your upbringing provide meaning?” I don’t think that’s going to increase Patient Satisfaction scores. It may, in the long run, actually serve to deprive patients of religious support at critical moments.  A chaplaincy that merely facilitates self-expression of a person’s spirituality is not a chaplaincy that preaches the Word, administers the Sacraments, consoles the despairing, announces absolution, anoints with oil for healing, gives Holy Communion, or represents to a lonely person the communion of saints of which they are a part. A chaplaincy that is not religious will not perform Salat, or say Kaddish, or answer a person’s faith questions with the authority of a religious community. A chaplaincy that is not religious will not know how to pray with the sick or the bereaved; will have no grounds on which to confront unethical behavior by hospital or military leaders; will have no connection to the history and tradition of chaplaincy itself.  It will be neither ministry nor pastoral care. It will not be chaplaincy.