Tuesday, March 14, 2006

Toward an Episcopal Culture for Health Care

When I first thought about having a blog, and thought about what I might write, I found myself thinking about a continuing concern of mine: what would it mean to describe an Episcopal culture for health care? Now, from my blog heading and my profile you can recognize that I have a vested interest in the question. But, I’ve been playing with it for some time, and I still find the question intriguing, and even compelling.

I function within an Episcopal health care system – one of the few systems of hospitals remaining nationally that not only was founded by Episcopalians, but that still has some official relationship with a entity of the Episcopal Church. Moreover, as the number of hospitals connected with the Episcopal Church has fallen over the years, the number of long term care and retirement centers has grown. And even among health care institutions founded by the Church but no longer connected, many maintain some sense of Episcopal heritage or identity. Certainly, the Episcopal Church continues to be involved in health care.

For several years we also had within the System a Seventh-day Adventist hospital. Now, the Seventh-day Adventists have a strong tradition of health care, and a clear concept of the characteristics of an Adventist culture of health care. That clear concept in one institution at the time confronted me and others with what it means that an institution was related to the Episcopal Church.

I mean, look at the Adventists. Health issues, and particularly issues of diet, have long been a part of their ethos. In Adventist hospitals there is a stated expectation that the CEO has the same sort of responsibility for spiritual care that he has for physical and emotional care. Chaplaincy, led by (although not limited to) Adventist chaplains, is an important service of the institution. All meetings begin with prayer or a devotion, and responsibility for that is rotated among leaders. The vegetarian diet that has been so central for so many Adventists is supported in the kitchen, available both for patients and in the public cafeteria. To maintain this culture there is an explicit effort to maintain a high representation of Adventists among the hospital’s leadership.

By the same token, think of our Catholic colleagues. As has been said to me many times, “You always know when you’re in a Catholic hospital: it’s the crucifixes everywhere.” Those visible reflections of the Roman tradition may be taken down in an individual room at a patient’s request, but in general they’re visible throughout the facility and in every patient room. Again, chaplaincy, led by (but not limited to) Roman clergy and religious, is central to the services of the hospital. Many if not most have a position titled “Vice-president (or the equivalent) for Mission,” and that person’s responsibilities include determining how the institution will reflect Roman Catholic practice and teaching, not only in chaplaincy but throughout the institution. We know to expect Roman Catholic hospitals to reflect the teachings of the Roman Catholic Church regarding patient care at the end of life, and in maternity and reproductive care. And, of course, Roman Catholic hospitals also have a long tradition of Roman clergy and religious providing leadership in their hospitals.

So, what would it mean to have an Episcopal culture for health care? What would its characteristics be? I would certainly want to point to chaplaincy, but having a chaplain, and even an Episcopal chaplain, seems a pretty thin reed. Surely, an Episcopal culture for health care would include worship in the Episcopal tradition; for it is our worship that defines and forms us as a Church. It would, I think, reflect the faith as understood in the Book of Common Prayer, and especially the Baptismal Covenant. It would, I think, reflect our emphasis on the Incarnation, and on the continuing presence of Christ in his Body.

I think it would reflect all those things; but what would that look like? How would understand those values, and make them incarnate in practice? I think those are important questions, questions that ought to be important to us, inasmuch as we are indeed involved as a Church in providing health care. And so, some of my ongoing reflections here will be exploration of those issues. After all, if I am an Episcopal chaplain at bedside, working in an Episcopal setting, I need to think about what that means; and about how I and Episcopal colleagues live out in our work “the doctrine, discipline, and worship of Christ as this Church has received them.”

6 comments:

Bill said...

I can't wait to hear more about this. Even have some ideas myself.

Marshall said...

Do let me know. I'll be happy to hear them.

Bill said...

You know, I think I shot my mouth off before I engaged my brain. I'm pretty good at that some times. "Even have some ideas myself" was a little premature. Actually, I kind-of, sort-of had ideas, but on examination, I discovered that they weren't very good.

You've got me thinking though, and that's a good thing. I was thinking about some of the things you wrote and wondering how that fit with an Episcopal culture for health care. For example, you mentioned that people always know when they're in a Catholic institution because of the crucifixes all over the place. But the crucifixes aren't what establish the Catholic culture. As you noted, Catholic institutions "reflect the teachings of the Roman Catholic Church regarding patient care at the end of life, and in maternity and reproductive care."

Does the Episcopal Church have such teachings? We certainly have our Book of Common Prayer and you could extract much of our teaching from it. The way we pray forms the way we believe, but putting that in a succinct statement is difficult, don't you think?

You've given me lots to think about for a long time.

Connie said...

Interesting ideas, Marshall. I'm an Episcopal chaplain in a state facility, and as I read your post, I thought about how my Episcopal identity has formed my chaplaincy in this and the previous state hospital I served. This doesn't necessarily relate to the question of what an Episcopal culture of health care would look like, but I find being an Episcopal chaplain gives me an excellent foundation for outreach to Catholics, Protestants, and indeed Christians of every stripe. And by representing a church which, despite threats of schism and much whooping and hollering, is more welcoming to gays/lesbians/ bisexual/transgendered people has certainly been important, especially here in "Brokeback Mountain" territory. I would love to see more discussion about the ideas you present and I will certainly give more thought to them myself. Thanks.

Connie said...

P.S. Having co-authored a book with a physician ("The Faith Factor: Proof of the Healing Power of Prayer," with Dale Matthews, M.D., Viking 1998), and having participated in healing ministries in the church and in ecumenical organizations for many years, I have to wonder if the Episcopal Church has a special contribution to make in bridging the centuries-old gap between medicine and religion. We have helped to keep the church's ministry of healing alive in our own particular way (not exclusively, of course). Yes, I think you have raised some excellent topics for reflection!

Marshall said...

Thanks, Connie. I'll be interested in your reflections on this, too.

(Wow! Feedback from a published author!) ;-)