Saturday, November 25, 2006
There’s been a good discussion going on the past few days over at Fr. Jake’s place. It’s related to – well, I’ll just let you look at it over there. It started with a statement from Bishop Jefferts Schori, and it’s gone on. Thinking Anglicans has also referenced the issue and the discussion here.
The topic moved to the numbers in the Episcopal Church. Discussion included the reasons for recent decline, and the experiences of several readers of healthy, active, and growing Episcopal congregations. It also included how effective we are or aren’t at evangelism, and what acts of evangelism might work for us.
That got me to thinking about my own experience of folks talking about their churches, and how they came to be members. In very few cases was it a matter of the theological tradition of a denomination. As a hospital chaplain, I hear so very often in the American scene that folks don't note the theological differences between denominations. Presbyterian, Methodist, Baptist (of whatever variety), United Church of Christ (from the Congregationalist tradition), or Disciples of Christ (from early 19th century efforts at ecumenism - an interesting history indeed!), are all seen as pretty much alike. Folks tell me they joined a particular church because 1) it was convenient to their life and home; 2) they found the preaching moving; and 3) they found the community welcoming (usually, activities for families or children seem to fall under either category 1 or category 3). The theological distinctions above can be significant; but the worship is so similar most people don't care about the theological differences. By the same token, I've heard many Roman Catholics and Lutherans, and some few Orthodox comment on learning that I’m an Episcopal priest, "Well, Episcopal is almost like (Catholic or Lutheran or Orthodox as appropriate)."
Now, they do notice worship styles, and those familiar with sermon-oriented worship don't often settle in churches of table-oriented worship; but they don't base those differences on self-conscious reflection on theology. Those who move from table to word may feel moved by strong preaching that they had not experienced before. Those who move from word to table are often aesthetically moved by the music and poetry of the liturgy. But, again, it’s usually more emotional and less theological.
There are other factors, of course. In our multifaith society, a religiously mixed marriage is probably more common than a marriage between folks from the same faith tradition. Indeed, I often get the feeling we’ve defined more broadly what constitutes a religiously “mixed marriage.” Two generations ago a wedding involving an Episcopalian and a Southern Baptist would have been considered significantly “mixed.” These days, for good or ill, the fact that both were in some sense Christian would be enough. More common, at least in my experience of talking to newly married folks, only one person in the couple is religious, or neither is. Certainly, couples with significantly different religious backgrounds, meet, love, and marry with almost no thought about the differences. These issues continue to rest quiet until there are children. Even then, couples will often put off the concern until some specific age, whether for a rite of passage, or until teen years “to allow the children to decide for themselves.”
Now, this observation is entirely unscientific. At the same time, it comes from a “parish” which is as multifaith as American society. I attend to all hospital patients and all hospital staff as best I can, and so I encounter, I think, as broad a sample of American religious life as one might find anywhere (or, at least in a large city in the Midwest).
While there are many arguments about whether churches are growing or declining in numbers, and why, my own experience is that it isn’t a matter of theology, sound or otherwise. Rather, folks seeking a spiritual home find it where they are welcomed and loved. Much of the time they will think little of the theology, or of differences of theology between churches they see as similar. So, perhaps as we seek to offer folks a church home, perhaps we need to make sure we make it a church home.
Wednesday, November 22, 2006
I bake bread. I don’t know that I would call it a hobby. My other cooking is a hobby – my barbecue, my playing on the stove – but the bread is something different.
Indeed, the bread is ritual. I’ve been baking bread for almost 15 years now, and in those years I’ve baked almost all the bread we’ve eaten. I’ve always worked from a live bread starter, making every loaf sour dough, even if it doesn’t taste like it came from San Francisco (the yeast out there are different). Oh, once or twice in all that time I’ve had start die. A few times we’ve had “store-bought” bread, when both of us were sick and were afraid we’d contaminate the start. But mostly we’ve had my bread, what my sons call “Dad bread.”
The bread is ritual. I bake almost every weekend. Each batch takes about 24 hours, although the actual work within that time runs to perhaps an hour, hour and a half tops. Tonight I have fed the start with flour and water. In the morning I will take that start, likely to have bubbled out of its crock and onto the protective wax paper, and add flour and water to make the sponge. Sometime tomorrow afternoon – it can be any time from five to ten hours – I will add more flour (white and whole wheat), salt, sugar, and a mix of assorted grains I refer to as “birdseed,” and make a dough. I’ll knead it until I’m ready, and then set it aside to rise. After two hours I will knead it again gently, add a little more sugar, divide it, and set it in loaf pans, to rise again. Finally, after another two to two and a half hours, I will bake. I attend to a lot of other things in all those gaps, but over all, from cold start to hot bread and butter is about 24 hours.
I chuckle that I found a ritual in bread. I’m proud of it, of course: I make good bread, and I enjoy eating. At the same time, I was long the person who hated to get his hands tacky. I was no more attracted to kneading bread than I was to gardening – and if you’ve been paying attention, you know that I love to harvest, not garden. Somehow, encouraged by my cousin Susie, I took it up. It was therapy for me late nights when I couldn’t settle down. It was productive work in times when my career seemed to have little to show. It was a gift to my wife and my children, something no one else could give them exactly. And over time, it became a ritual. I do not think about those things, although they’re all still sometimes true. Now, I simply think, “It’s time for bread.”
I have come to enjoy, though, the physicality. When the dough is stiff, it’s resistance training. When the dough is silky, it’s finesse, the delicate touch of a musician. In either case, it is an upper body workout.
And tomorrow there will be bread. There won’t be turkey tomorrow. For so many years I worked on Thanksgiving Day that we’ve formed the habit of eating our big meal on Saturday. It makes it a lot easier to pick up the turkey on Friday. But, there won’t be turkey tomorrow. We’ll be working around the house, preparing for guests to come before Christmas. There will be cleaning and storing and even some concrete patching.
So, there won’t be turkey. But, the start is fed, and is waiting, working, rising. Tomorrow there will be bread. That will be reason enough for thanksgiving.
Tuesday, November 21, 2006
Not that participants had been Pollyannaish about the concerns. “Men looked forward to the assembling of that convention with great anxiety; they accompanied it with prayers that never ceased.” He acknowledged the fear that the events of the war would shape the life of the Convention. “Were the scenes, the sounds, presented in and heard from those completely secularized bodies, to be reproduced among us? Could the North and the South meet together in peace? the North without offensive condescension, the South without the consciousness of humiliation? Could everything be forgotten save this, that we are all one in Christ Jesus?” These were the questions that hung over that Convention.
The questions, according to the Fr. Dix, “began to be answered the first day.”
When the Convention assembled in St. Luke’s Church, for the opening service, one of the southern Bishops was there. He came alone, and took a seat among the congregation: he looked like a stranger. That was a sight which his brethren in the Apostolic Episcopate could not bear. They saw him; they became uneasy. At last they sent a dignified messenger to tell him that he must come to them. Then he hesitated no longer; he arose, and just as he was, with no vestment or robe of office, passed up to the chancel and went to his brethren. I was told there was not a dry eye in that august company at that moment. Men felt that GOD was giving the answer to the question whether this Church could be one again.
He goes on to describe “two of those test questions, which in the mode of their answer, sweep off at once a hundred side-issues and settle a thousand minor difficulties forever.”
The first was the question about the Bishopric of Tennessee. That Diocese had sent a priest to Philadelphia as its Bishop Elect; a godly and learned man, but one who had been most intimately connected with the revolted States, and with their military operations, as a chaplain in their army. How many points would be settled in his acceptance, or his rejection? Rejected he could not be, he was not. Accepted, and welcomed as few have ever been, he was consecrated on the 6th day of the session, in presence of an overwhelming congregation of clergy and laity, and with circumstances designed to show the significance of the act. Then, the next day, when the hearts of men were softened as by the dew of Hermon which upon the hill of Zion, came the second question and the last; that of the reception of the Bishop of Alabama. He was consecrated some two years ago, in the midst of the war, by Southern Bishops, by men who thought the disruption of the Nation a final one, and the rebellion a success. He was consecrated a Bishop of the Protestant Episcopal Church in the “Confederate States;” he belonged to us no more than a Bishop of the Church of England, or Scotland. Should he be received? If so, on what terms? Must not this man be required to make some act of abjuration, to sign some pledge of allegiance to the Government, to speak some confession of penitence acknowledging the error of his ways? Must he not, in the popular phrase of the day, “give evidence that he had repented him of his sins”? Not so thought the Council of the Church. Their idea was, “Let Caesar look to the things that are Caesar’s; we legislate only for the Church of God.”... After two days of earnest debate, they knelt in silent prayer; the stillness seemed almost supernatural. Then they arose, and, by their vote, said: “Let the Bishop of Alabama send full evidence that he has been duly into the office which we doubt not he possesses; and let him send, in writing, and properly certified, that promise of conformity to the doctrine, discipline, and worship of the Church, which every Bishop takes among us, and we ask no more.” It seemed as though the Lord had arisen and said, “Peace be to this house and to all that are therein.” If any man had previously doubted concerning the reunion of the Church, he cast, at that moment, every doubt away.
The confirmation of that Bishop of Tennessee, the Rt. Rev. Dr. Charles Quintard, might certainly been the cause of concern. As a priest Dr. Quintard had served in the Confederate Army both as Chaplain and as Surgeon.
“Brethren, our Church has never been divided,” said Father Dix. “Our enemies said that it was, but they were wrong.” He spoke of the circumstances that had separated churches North and South, “but the life and the heart were one..”
If it had been GOD’s will that the rebellion has passed into a successful revolution, and that the Confederate States could have kept us apart. We should have been more closely allied with each other than we are with the Church of England: somehow we should have come together. How much more must it be so now? The Confederate States have ceased to exist; the causes of interruption to our intercourse are removed; we are one again. After what has occurred, no one can with truth affirm that the Episcopal Church has known a schism. We trust in the Lord for the future, as we trusted in him in the past. The Church has never been divided. Let those who long for Catholic Unity bear that in mind.
There is indeed much to think about in this sermon. I was particularly struck by the assertion that even had the division of United States and Confederate States been achieved, Episcopalians in those two nations would have been “more closely allied with each other than we are with the Church of England.” This answered his earlier question as to whether the Bishop of Alabama “belonged to us... more than a Bishop of the Church of England, or Scotland.” Clearly he did; and the straightforward expectations for his regularization, which involved no condescension or humiliation, followed in the heritage of James the Just. In these days of dueling primates, of images of communion broken or impaired, of gatherings and counter-gatherings of primates and bishops and congregations, this expression of community and coherence within this Anglican province is striking.
I find that this sermon leaves me hopeful in these difficult times in The Episcopal Church and the Anglican Communion. I’m sure it did not seem so easy or straightforward at the time as Fr. Dix described it; but, then, this was a sermon and not an historical report. But, still, I think we can look to this past and imagine some hope in our future.
Granted, the presenting issues are not the same. One could argue they were greater then, when blood had been spilled and the entire nation had been involved. Those who see the current issues as matters of essential doctrine rather than discipline, those who suggest those who disagree with them have left the Christian faith entirely, might even say the issues are greater now, or at least sufficiently different. Each day those committed to leaving The Episcopal Church seem closer to the door, and some committed to staying seem attracted to clarity, even if it also means finality.
But I remain hopeful. I have said often enough that I will trust in God through all of these difficulties. I have cited Gamaliel’s standard: “if this plan or this undertaking is of human origin, it will fail; 39 -->but if it is of God, you will not be able to overthrow them—in that case you may even be found fighting against God!” (Acts 5:38b-39) I believe that after these troubled times the Church, and specifically The Episcopal Church, will continue to proclaim Christ and serve him in all people. It is a happy thought to look at Fr. Dix’s sermon and think toward our future, and to hope for a time when reconciliation can be demonstrated so clearly and concretely as at that General Convention in Philadelphia after that bitter war. I continue to hope for the future of a united and reconciled Episcopal Church and a united and reconciled Anglican Communion. It may well take a long time. But, I will hope for that day; and I will look forward to the preacher and the sermon that will praise God for that reconciliation.
Saturday, November 18, 2006
In the current edition, I was struck by the “Thesis from a Seminary Door” column from the Very Rev. Paul F. M. Zahl, titled, “Anglican Without the Skin On.” I was immediately caught by the first paragraph:
Now that our old church has left us, what does it mean to be Anglican? Now that the form is changing, what is left of the heart and essence? What does it mean to be an Anglican without the comfortable and familiar wrapping?
Dean Zahl suggests three characteristics. First, “Anglican means the 1928 Prayer Book. Stated a little more deeply, Anglican means the incomparable liturgy that Thomas Cranmer and his friends put together in the 1540’s and ‘50’s, which is a unique and very precious treasure for the entire Christian Church.”
Second, “Anglican means to be non-lecturing. An actual empirical quality that emerges when you are with traditional or orthodox Episcopalians, in contrast to orthodox members of other churches, is the fact that they don’t lecture you..” The context is important to understanding his perspective: “When I am with other evangelicals, in particular, I often feel I am being talked down to.”
Finally, “Anglican means to be core and not penultimate.” The specific application of this is that “we do have a tradition of riding easy on secondary matters. It really is possible (despite what we have been told since 1979) to be a kosher Anglican and have Morning Prayer as the principal service most Sunday mornings and wear a cassock, surplice, and tippet.” The liturgical uniformity of the 1979 Prayer Book “doesn’t mean that wide latitude in secondary matters is not important. It is just that the core of ‘what is everywhere to be believed’ [in The Episcopal Church] has been shrunk to way too little.”
Now, what intrigued me in this was not his second point. I have my own experiences of feeling lectured to by Christians of other, more stereotypically Evangelical churches. I grew up, as I often say, breathing Southern Baptist air. I knew very young that when some folks asked me if I were a Christian or if I knew Jesus that my baptism and active participation in the United Presbyterian Church (or, as we said in the Southern Mountains, the Northern Presbyterians, to distinguish them, obviously, from the Southern Presbyterians) would not meet the questioner’s standards for either. (Yes, I am another Episcopal cleric who is a convert.)
I was more struck by the Dean’s liturgical observations. Now, I came into the Episcopal Church just at the beginning of the long process of revision that ended in the current Book of Common Prayer (1979). I came into the Episcopal Church in a church that had Morning Prayer from the previous Book of Common Prayer (1928) two Sundays a month (second and fourth, as I recall). I often say that as a young man who loved music, I fell in love with the liturgy of The Episcopal Church, and chanting the canticles of Morning Prayer was an essential part of that. I had a greater appreciation of that than I had of the Eucharistic prayer we had inherited largely from the Scottish Episcopal Church. Even with a longer sermon, Morning Prayer always seemed shorter than Holy Communion, probably because we participated more, and because once the sermon was over we were essentially done. Now, that was all a feeling. I came to realize that Holy Communion was a shorter service; but the perception that it was shorter was clear. Indeed, as our parish explored revised liturgies, it was a major concern: some people were afraid that a Eucharistic focus would keep them in church too long.
With all that, I grew into the Episcopal Church using the previous Prayer Book (if not only the previous Prayer Book), and, graduating from seminary as I did in 1980, was one of that last generation trained to use the previous Prayer Book. To this day in the midst of a Rite I service I will feel welling up inside of me such phrases as “and there is no health in us; “ and “that our sinful bodies may be made clean by his body, and our souls washed through his most precious blood.”
At the same time, it seems to me his liturgical concerns are hardly “secondary matters.” My reactions above are sentimental, and I fear his are as well. After all, as I recall the point of the Eucharistic focus was to recover Biblical practice – as in all those references in Acts to gathering “on the eighth day.” Certainly, our Orthodox siblings (Greek, Eastern, and Oriental) have maintained that practice in continuity from earliest days. Even if some of our Anglican ancestors were concerned that weekly Eucharist was “too Romish,” they would never have argued that it wasn’t the ancient practice of the Church.
I would suggest this was Cranmer’s expectation, as demonstrated by this rubric among the exhortations in the 1549 Prayer Book: "And if upon the Sunday or holydaye the people be negligent to come to the Communion: Then shall the Priest earnestly exhorte his parishoners, to dispose themselfes to the receiving of the holy communion more diligently, saiyng these or like wordes unto them." (I will acknowledge that Communion was commonly preceded by Matins; but that isn’t really the practice I knew as a new Episcopalian on those second and fourth Sundays of the month.) And while that rubric is not in the 1552 Prayer Book, this one has been added: "And in Cathedrall and Collegiate churches, where be many Priestes and Deacons, they shall at receyve the Communion wyth the minister every Sonday at the least, excepte they have a reasonable cause to the contrary." (Considering the changes in ceremonial from 1549 to 1552, this is an interesting consistency.) Marion Hatchett is of this opinion. He writes in Commentary on the American Prayer Book, “The rubrics presume… that the Eucharist will be celebrated in every church every Sunday and holy day for which a proper is provided” unless “…there is no one prepared to communicate with the priest.” (p. 300)
I am also struck with an argument for a return to a 19th century rendering of 16th century English, because that runs so counter to the intent of Cranmer’s work. After all, consider Article XXIV of the Articles of Religion, titled, “Of Speaking in the Congregation in such a Tongue as the people understandeth:” “It is a thing plainly repugnant to the Word of God, and the custom of the Primitive Church, to have public Prayer in the Church, or to minister the Sacraments, in a tongue not understanded of the people.” Now, I would never suggest that people today can’t understand Tudor English, in Prayer Book or Scripture, or Shakespeare for that matter; but we know well there is a certain amount of education required. As beautiful as it is, it would not be understood these days by many unchurched visitors.
Now, I’m sure Dean Zahl is aware of this. His essay seems to me, as I said, a sentimental perspective, and not a theological argument; and he has certainly as much right to his sentimental perspective as I want to mine. The fact is, I’m not disturbed at the thought of Morning Prayer as the principle service on Sunday (although I would personally prefer using Morning Prayer as the Liturgy of the Word, not that far from early Anglican practice). Certainly, I miss singing in church the canticles of the offices, whether in traditional or contemporary language.
I would respectfully disagree, though, that some such return to my childhood would be all that Anglican, or at least any more Anglican than the current norms of the Episcopal Church. It seems to me less Anglican practice “without the comfortable and familiar wrapping,” than changing back into some worn, comfortable clothes. I return to such clothes precisely because they’re comfortable; but they’re no more effective as clothes – protecting me from the elements and from inappropriate exposure – than some of the newer items in my closet. (And, believe me, this is not an argument for what is stylish. No one has ever accused me of being stylish in my attire.)
No, while I can appreciate his opinion, I can’t share it. Has “the core… been shrunk to way too little?” So he believes. But, in a Church that believes lex orendi lex credendi, norms of worship can hardly be secondary, however much we might value being comprehensive. And so I cannot agree that considering such matters secondary could ever be considered Anglican.
Wednesday, November 15, 2006
Tuesday, November 14, 2006
According to the AHIP web site,
“The AHIP plan calls for enactment of federal legislation that provides significant financial incentives to states and makes changes to federal tax policy to make health coverage more affordable. Key elements of the AHIP plan include:
* Expanding the State Children’s Health Insurance Program (SCHIP) to make eligible all uninsured children from families with incomes under 200 percent of the Federal Poverty Level (FPL).
* Improving and expanding Medicaid to make eligible all uninsured adults, including single adults, with incomes under 100 percent of the Federal Poverty Line.
* Establishing a Universal Health Account (UHA) to allow all individuals to purchase any type of health care coverage and pay for qualified medical expenses with pre-tax dollars, with federal matching grants for contributions made by working families to the UHA.
* Establishing a health tax credit of up to $500 for low-income families who secure health insurance for their children.
* Establishing a new $50-billion Federal Performance Grant to assist states in expanding access to coverage.”
According to their estimates, this would allow coverage for all children within three years, and for 95% of adults within ten years, at a cost to the federal government of approximately $300 billion.
In an earlier post, I spoke of meeting with senior staff of one of my senators during the Waging Reconciliation Conference in 2003. At that meeting we discussed association health plans, which the senator supported. I felt at the time that association health plans were a band-aid; a big band-aid, a good band-aid, but a band-aid nonetheless. I find myself with something of the same suspicion about this proposal. It may bring welcome and productive changes. But I wouldn’t call it real reform.
First, it continues to assume that most of us will receive health insurance through an employer. This proposal expands significantly who would be included at the edges, but the center would remain unchanged. I can’t really say that this is a surprise. Any real change would significantly affect the way these companies to business.
With that assumption, it doesn’t seem to provide any assistance to or incentive for small businesses to provide the benefit, or to pay well enough for employees to obtain it themselves. After all, most of those now uninsured or under-insured are employed by companies that don’t provide health care. And if it’s true as we’ve been told that small businesses provide most jobs over all and most entry level jobs, there seems little here to assist those small companies in providing the benefit. Why not instead continue to hold wages down and allow more and more entry-level workers and their families into Medicaid and SCHIP plans?
This proposal does not address efforts to control the costs of health care. One way it might have would be to propose standardized paperwork and electronic communications, using a single, standard set of codes and forms. This was the one really useful proposal in the Health Insurance Portability and Accountability Act (the dreaded HIPAA), and apparently the least likely to come to pass. But with almost 1300 member companies, this might be difficult for AHIP to propose.
Finally, in the end this proposal continues to see health care, and the health insurance that pays for it, as commodities. There is no endorsement of the principle that health care, available and accessible and adequately funded quality health care, should be a human right, both for the citizen and for the sojourner that dwells in our land. That, I will note, has been the position of the Episcopal Church meeting in General Convention. It is the first principle of Resolution 1994-A057: “That universal access to quality, cost effective, health care services be considered necessary for everyone in the population.”
Now, the devils and angels are in the details, and there are few details in what has been published so far. This would require a great deal of commitment and statesmanship in Congress and the White House, characteristics that have been sorely lacking, at least in addressing health care needs. Like the experiment in Massachusetts, this is worth watching to see what good it might actually do. But I can’t see it as real reform. It may be a really, really big band-aid; but it remains a band-aid nonetheless.
Monday, November 13, 2006
Last week I attended the fall meeting of the Executive Committee of the Assembly of Episcopal Healthcare Chaplains (AEHC). You may have noticed the link to AEHC in my sidebar. I am the Immediate Past President, a position that in general means I get invited to all the parties, but have very little for which I'm actually responsible.
We met, as we have in recent years, on a seminary campus. This year we met at the Church Divinity School of the Pacific, where folks were very hospitable to our little group. We have chosen to meet at seminaries in hope that we will have some opportunity to talk to students, and to talk especially about a vocation to healthcare ministries.
That intent brings me back to one of my ongoing occasional topics: what we would look for in an Episcopal culture for health care. Specifically, in an Episcopal culture for health care, how would we see, or how would we consider, vocation?
The first question to address at that point would be, I think, whose vocation? That is, are we asking about the vocation of the institution, or are we asking about the individual vocations of the persons who work in the institution? As you might guess, I think both are worthy of consideration. This post will consider the vocation of the institution.
How would we speak of the "vocation" of the institution? We know, of course, that the institution has a purpose: it exists to provide health care. That is not a distinctively Christian purpose, much less distinctively Episcopalian. In the area I serve there are Jewish institutions, and civic or governmental institutions that would claim no faith connection at all. In the rest of the world health care institutions have been founded by faithful Muslims, Hindus, and Buddhists, and probably by others not familiar to us.
How would we look beyond the purpose of health care to find some sense of vocation? In that light, what do we mean when we speak of "vocation?" The word itself, as we know, comes from the Latin vocare, "to call." We use it in the church to speak of a specific call from God to a particular ministry. In the Preface to the Ordination Rites in the Book of Common Prayer, we find reference to "The persons who are chosen and recognized by the Church as being called by God to the ordained ministry...." (BCP p. 510) We tend to think of vocation in relation to these and other specialized ministries within the Church: ordained ministries, or monastic orders and communities. However, we recognize that all are called. The Catechism in the Book of Common Prayer notes that "The Church carries out its mission through the ministry of all its members;" and that "The ministers of the Church are lay persons, bishops, priests, and deacons." (BCP p. 855)
But, if we commonly use the concept of vocation to speak of the ministries of individuals, how would we speak of the vocation of an institution? If health care as a purpose is not specifically Christian, how would we see in it any sense of vocation?
I would think that in part we would look beyond the basic purpose of health care to understand how the institution was established, and how it sees itself now. For-profit institutions are as much intent on health care as are not-for-profit institutions; but the establishment and the culture would surely be different. Both are involved in service, but one serves patients to serve shareholders, and the other serves patients for their own sake. An institution founded by Episcopalians would, one hopes, be different in focus and culture than one by a government agency or founded for profit. An institution founded by Episcopalians that became part of another system would surely experience some cultural change, whether the new system was another faith community, or the local civil community.
I think the first place we would look to see that difference would be in the mission, vision, and values. In general, some evidence of that should be easy to find, for institutions and systems have been for a generation developing and refining explicit statements of mission and vision and values. What words have they chosen? What values have they espoused? Do the works they choose seem in any sense congruent with the faith as the Episcopal Church has received it? Even if not specifically so, are they values that we as Episcopalians would embrace?
On a side note, while we might think about looking first to the name of the institution, it might not be as helpful as one would think. Many of the hospitals started by Episcopalians were names in honor of St. Luke the Physician. Unfortunately, between the small size of the Episcopal Church and the sale over the years of many of those institutions to non-Episcopal organizations, and also the success of our Roman Catholic siblings in establishing and maintaining health care institutions, many people, at least in my experience, assume all those hospitals are or were Roman Catholic. It's named for a saint; therefore, it must be Roman. A few institutions include "Episcopal" in their names. For the rest of us, we live with the confusion. (And there’s no shame there. Roman Catholic hospitals are good hospitals. They're just not Episcopal.)
So, we would look to those mission, vision, and values statements. We would then want to see how they function in the life of the institution. How, for example, are new staff and professionals oriented to those values, and to the history from which they arise? How are they expressed by the Administration and leadership, and how are they reinforced in the day to day practice of the institution?
Speaking of leadership, does the founding tradition affect who serves in leadership? Are there members of the Episcopal Church on the Board, for example? Are they there by design, by custom, by courtesy, or by chance? Does a bishop, or representative member of the clergy serve, and in what capacity? While no guarantee, visible presence of Episcopal clergy and lay leaders would lend credence to congruence of the institution's values with those of the Episcopal Church.
Are there positions in the institution held by Episcopal leaders by design? While this would be rare for most positions, it is not uncommon for an Episcopal institution to reserve a chaplain's position for an Episcopal cleric. And, to whom does the Chaplain report? One measure of how the institution values the position is to consider how high in the administration the reports. There is a distinct difference in the influence of a leader in an institution between reporting to a manager or to the chief executive officer.
Finally, does the institution acknowledge an explicit connection to the Episcopal Church, whether active or historic? Certainly, I would have higher expectations that an institution actively connected to the Episcopal Church would meet many of the criteria I’ve considered above. However, I would not disdain an institution that has had a change of ownership but continues to express Episcopal heritage by meeting many of those criteria.
It may feel a bit awkward to speak of the vocation of an institution, or at least of an institution that is not entirely religious in purpose or function. At the same time, we speak of the culture, the ethos of an organization; and that culture, that ethos gets expressed in specific actions. That culture, that ethos has a certain self-awareness about it. After all, it is to a great extent a matter of choices: “This is how we choose to act;” and, so, “This is who we choose to be.” When we explore the sense of vocation of an individual, that self perception, that sense of call by the Holy Spirit, is critical. We may be a Church in which personal call is examined for acknowledgement by the Church; but we don’t go forward unless and until that personal sense has been heard and examined. I think we can make a similar evaluation of the personal sense of call of an institution, expressed both in words and deeds. If an institution is an Episcopal institution, I think we can expect to see words and deeds that express not only a culture or ethos, but a consciousness of call. I think such a sense of vocation would be essential for an Episcopal culture for health care.
Sunday, November 05, 2006
So, I was looking at the lessons for All Saints Sunday in the Lutheran Lectionary – the Revised Common Lectionary, really, that I’ll be using for this feast next year in my Episcopal chapel. I was aware of the Episcopal Lectionary. This past week, on the Eve of All Saints, I preached on the Beatitudes. Tomorrow, though, I’ll be dealing with the Raising of Lazarus.
That’s not terrifying. I’m sure I’ve preached on it before, one Fifth Lent or another. I’m more struck by the difference. For years I’ve been preaching on the basic goodness shown in the Beatitudes, and the basic accessibility of fulfilling at least one of them. Granted, like any spiritual activity, any one of them could become a life’s work, a perpetual striving after perfection. However, any of them could be demonstrated in some way by every entirely ordinary Christian. Some are harder than others – hungering for righteousness may perhaps be harder than meekness, and less common than mourning – but almost all of us will encounter at least one of these in life, and probably opportunities for all of them. It speaks to me of what it means to be a saint in the Biblical sense: one of God’s servants, a member of the Body, without any pretence of being a hero of the faith. It recalls, as does Ecclesiasticus, all those who were unknown, forgotten beyond their lifetimes, who were also faithful, and who also rested (and rest still) in hope.
So, tomorrow I’ll be preaching on Lazarus. More to the point, I’ll be preaching on Christian hope, not in the sense of how easy it can be for ordinary folk to fit into God’s plan, but in the promise that God in Christ has offered to all of us, however ordinary we may be. The lessons, both the Gospel and the Isaiah, are almost funeral lessons: lessons of hope beyond the limits of death. So, these lessons are less about who the saints are and more about what the saints can expect.
Now, both points are good news. But the Lutheran lessons make more of God’s grace. In my Anglican background, in which speaking of the saints calls to mind the heroes and heroines, so that we have to remind ourselves that we’re all saints (and add All Souls’, just to make the point), we risk a certain false meritocracy. I have to preach how common it is to live the faith, in contrast to the dramatic examples of prophets, apostles, and martyrs. In the Lutheran lessons that doesn’t matter. God’s promise, made certain in Christ, is about life beyond death, and not about our qualification. We are all promised life – indeed, we are promised that God wishes to give all that life, whether “qualified” or not. It may be easy to experience mourning or meekness or poverty of spirit; but if we’re not careful it is still a work, a sense of participation in grace because of our good acts. Lazarus was raised. He believed. He knew Jesus, and loved him; and Jesus loved Lazarus in return. He even mourned him. But, Lazarus wasn’t raised to show Lazarus’s goodness. He was raised to show God’s goodness. He was raised to show Christ’s power to bring God’s goodness into the world, into even events so powerful and so common at the same time as death itself.
It’s certainly reassuring that I can show the faith in so many common events of life, as the Beatitudes make clear. It is even more reassuring that Christ’s promise of life is certain, even if I am not. It’s not about showing my goodness. It’s all about God’s.
Friday, November 03, 2006
There are a number of his statements with which I agree in part, but differ with him about application or implication. For example, he states, “The functions he describes, such as passing ice water and distributing literature, are not truly nursing functions;” and goes on to say, “Today’s nurse is a true medical professional, charged with assessing the medical needs of the patient (this is not just a role for doctors) and helping to coordinate their overall care.” First, I would suggest that nurses would assert that they assess nursing needs rather than medical needs. Nursing as a profession has indeed worked hard to express it’s own distinct purview and body of knowledge (and some nurses of my acquaintance would be offended at the word "medical" in this context, as it smacks of still being the "handmaids of the physician"). Within that I would suggest, second, that historically these were functions of nurses of generations past, and while they are not now commonly done by RN’s or LPN’s, it is because those professionals have delegated those tasks, not because they have excluded them from their professional purview. Those functions are supervised and delegated by professional nurses, and so are within the sphere of the profession of nursing. (We can find an interesting perspective of a parallel professional debate among nurses on the web log “Nurse Ratched’s Place.”)
I would certainly agree with Chaplain Donovan that we are “an integral part of the health care team.” At the same time, we are part of the health care team to bring ministry. To be more clear, we are part of the team as spiritual providers, and not as medical, much less generic “health care” providers. We are there precisely because we are not physicians and not nurses, and so on; and that spiritual competence is our distinct purview and body of knowledge. We have noted recently physicians interested in being more spiritually informed (and nurses for a longer period), in much the same way – perhaps in exactly the same way – that they seek to be culturally competent. In general, despite the anxiety we sometimes feel, the result is physicians who are more interested in working with us and not somehow thinking they can do our job.
I can further appreciate the definition of the role of the Chaplain in Chaplain Donovan's department: “to assess the degree to which the patient's emotional and spiritual equilibrium has been disturbed by the healthcare event and to determine what interventions would be appropriate to help the patient restore his or her equilibrium and when such interventions should be employed.” It is remarkably parallel to his understanding of the role of the nurse: “charged with assessing the medical needs of the patient (this is not just a role for doctors) and helping to coordinate their overall care.” Nurses coordinate nursing care that they delegate rather than necessarily providing themselves. By the same token, Chaplain Donovan’s definition of the role of the chaplain speaks to assessing spiritual needs and determining interventions. That does not foreclose the delegation of some of those interventions to properly supervised students or to properly trained volunteers.
Let me make a specific example. In my center volunteer Extraordinary Ministers from a Roman Catholic parish come to the hospital to offer communion to Roman Catholic patients and to some staff members. While they may be from the local parish, they are there under my supervision. They are specifically there under an agreement with the local archdiocese. They are trained for their ministry by a chaplain Board Certified by NACC. Their training includes information about patient privacy and the requirements of HIPAA. They have their access to patients under my purview and through my coordination. At the same time, if there is a problem with one of them, I am the person the hospital holds responsible to address and resolve the problem. They offer a ministry that I can’t: sacramental care that I as an Episcopal Priest can’t authentically offer. Their care may come from the local parish, but they see patients from many parishes; and those patients see this first and foremost as a ministry of the hospital. This is not an intrusion of the church into the hospital; nor have I decided that rites and rituals for patients are not part of my responsibility. Instead, I meet this responsibility through a collaboration with the church. It is, I think, comparable to a physician specialist referring to a subspecialist.
As Chaplain Donovan notes, administrators certainly want those who “cook the best vegetables.” To follow that metaphor, we need to be clear that we are trained as chefs. And to helps us feed more people, it may well be poor use of our professional time to mop the floors when we need to be at the fresh market. This is not to say that the mopping is not important for health and safety, or that it is not our responsibility to see that it is done and done right. The importance of our clinical training, on which Chaplain Donovan and I agree, is that capacity for development and implementation of a broader vision of spiritual care for the patient, family members, and staff. To find ways to incorporate the ministries of people with gifts but less training, for those specific ministries for which they are or can be trained, expands our ministries, rather than diluting or diminishing them.
I continue to assert that providing caring presence and information about the availability of a clinical chaplain are within our professional purview, even though they don’t require our highest expertise. To delegate those functions does not make them less the responsibility of the chaplain, and does not make us less chaplains; but it may well mean more patients are aware of and have access to compassion and spiritual care.
Wednesday, November 01, 2006
Susan Palwick, a frequent reader and occasional commenter here, has offered her own reaction on her blog. She also points to an interesting article here reflecting on parallel issues in nursing.
I will be writing a response for the TalkBack page on PlainViews; and once I’ve completed it I’ll post it. In the meantime, these all make for interesting reading for reflection.