The Perspectives and Institutional
Realities of Hospital Chaplains
Wendy Cadge
Brandeis University
(Photo: Muslim Prayer Room, Texas Children’s Hospital)
Fraction of Articles in PubMed Related to
Religion/Spirituality
0.4
0.35
0.25
Religion
0.2
Spirituality
Religion or Spirituality
0.15
0.1
0.05
0
19
50
19
55
19
60
19
65
19
70
19
75
19
80
19
85
19
90
19
95
20
00
20
05
% of all PubMed articles
0.3
Year
JCAHO 2009 Standards
“The hospital respects the patient’s cultural and
personal values, beliefs and preferences.”
“The hospital accommodates the patient’s right to
religious and other spiritual services.”
Other regulations pertain to food; education; care
for substance abuse, emotional and behavioral
issues; end-of-life care, etc.
(See: http://www.uphs.upenn.edu/pastoral/resed/JCAHOrefs.pdf)
Recent Statistics
• 70-85% of Americans regularly pray for good or
better health for themselves or a family member
• 72% believe God can cure people given no
chance of survival by medical science
• 60% of the public and 20% of medical
professionals think someone in a persistent
vegetative state can be saved by a miracle
(Jacobs, Burns, and Jacobs 2008).
Paging God: Religion in the Halls of Medicine
(Working Outline)
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•
•
•
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Preface
c.1 Introduction
c.2 Religion in the History and Development of Hospitals
c.3 From Symbols to Silence: The Design and Use of Hospital
Chapels
c.4 Spirituality and Hope….The Contributions of Hospital Chaplains
c.5 Chaplains at Work: Existing Institutional Arrangements
c.6 Religion and Spirituality in Intensive Care: Staff’s Perspectives
and Professional Responses
c.7 Why Sickness and Death: How Intensive Care Unit Staff
Personally Make Meaning
c.8 Managing Death: The Personal and Institutional Dirty Work of
Chaplains
c.9 Conclusions
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Methodological Appendix
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Chaplaincy Service in U.S. Hospitals
(1980 - 2003)
20
03
20
02
19
93
19
92
19
85
19
84
19
83
19
82
19
81
19
80
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
(Source: Cadge, Wendy, Jeremy Freese, and Nicholas Christakis.
2008. “Hospital Chaplaincy in the United States: A National Overview.”
Southern Medical Journal. 101(6):626-630.)
Data Presented Here
• Interviews with the director and one staff chaplain at the
17 most highly ranked hospitals according to U.S. News
and World Report 2004 (N=37 interviews)
• In-depth study of one of these 17 chaplaincy
departments – attended meetings and retreats,
interviewed the 32 staff and volunteers.
• The majority of directors were male, Protestant, white,
and in their mid-60s. Slightly more staff chaplains were
female, not-Protestant, and younger.
Logic of Analysis
• Essential Work?
• Consistent Work?
• Ideal Types:
– where situated administratively
– whether paid by the hospital
– training required to be hired
– part of protocols
– how volunteers and CPE students are included in the
department.
• Ideal Types: Professional (N=4), Transitional (N=3),
Traditional (N=10)
Explaining Variation
• Departments started by people within hospitals or with
financial support from hospitals tend to fall into
professional or transitional ideal types
• Departments in professional and transitional ideal types
have directors who learned to speak the language of the
healthcare system
• Departments in professional and transitional ideal types
have continually broadened their visions, generally away
from an exclusive focus on CPE.