Toward An Episcopal Culture for Health Care: Prayer

I have commented that my discipline as an Associate of the Order of the Holy Cross includes saying Morning Prayer, as best I can, each day. In fact, on days when I am in the hospital I say Morning Prayer in my office. An important part in the Office, as well as in my midweek Eucharist in the hospital chapel, is to pray by first name for each patient in the hospital, as well as for those employees who have requested prayer, or whose particular needs have come to my attention.

I don’t think many patients are aware of this, although it is mentioned in the announcement of the Eucharist. I don’t think many employees are aware of it, although they are informed at New Employee Orientation. I do think it’s very important – on some days the most important ministry I have for patients – that I pray regularly for patients, families, and staff in my hospital.

Which raises this question: what is the role of prayer in an Episcopal culture for health care? That’s both too easy and complex a question. Most would, I think, say that prayer at the bedside is appropriate in health care, regardless of the faith culture, or lack thereof, of the institution. Perhaps; but, then, what would make it particularly Episcopal? Some might suggest that in modern health care prayer may be of personal value, but not of clinical value. Perhaps; but, then, how could that possibly be Episcopal? And what of prayers away from the bedside? If this is an Episcopal institution, when and how should prayer be a part of institutional life?

In an Episcopal culture for health care I would expect prayer for patients would be acceptable and even encouraged. However, there would still be an expectation that the decision whether or not to pray with the patient would lie with the patient and/or the family. (I am making a distinction here between praying with a patient, in the patient’s presence, and praying for the patient outside the patient’s presence.) To pray when prayer is not welcome demonstrates lack of respect for the patient’s own spiritual life (or decision not to have one). It would be a moral violation at least; and those of us who believe prayer has clinical value will also believe inappropriate prayer could do clinical harm, at least to the extent that the patient’s stress and anger would inhibit clinical benefit. Prayer requested by the patient or family, or offered by the practitioner and welcomed by the family, would seem an important intervention to be available in the institution.

And who would be the appropriate practitioner? Should prayer be reserved to religious practitioners – chaplains, clergy, and trained volunteers – or should it be approved from any provider? As Episcopalians we believe that the Laity are the first order of ministry. According to the Baptismal Covenant, all Christians are called to “continue in the apostles’ teaching and fellowship, in the breaking of bread, and in the prayers.” (Book of Common Prayer, page 304) The Outline of the Faith states, “The ministry of lay persons is to represent Christ and his Church; to bear witness to him wherever they may be; and, according to the gifts given them, to carry on Christ’s work of reconciliation in the world; and to take their place in the life, worship, and governance of the Church.” (Book of Common Prayer, p. 855) Might not a Christian surgeon have gifts to pray with a patient before surgery, as well as to do the surgery itself? On the other hand, will that Christian surgeon have the sensitivity – a gift in itself – to recognize the patient for whom prayer would be inappropriate? Some chaplain colleagues are wary of non-trained pray-ers, often out of experiences in which a sincere Christian lay person had fervor but lacked sensitivity. In my own hospital I emphasize that there must be an invitation to prayer, that the person invited must be free to accept or decline (a point of particular sensitivity with respect to the vulnerability of patients and families), and a free acceptance based on the comfort of both parties with the invitation. Rather than discourage such encounters, I hope that I will be informed of such encounters. When they go well I can support and encourage the layperson for spiritual care of patients and families. When they don’t go well, I can address with the layperson the reasons, and teach about appropriate spiritual support. Anecdotal information I have received is that these encounters are almost always welcome. Even those patients who decline the prayer appreciate the good wishes and good faith of the person who offers.

And what of prayer in the life of the institution? Should meetings begin with prayer? All meetings? No meetings? Some meetings? And if only some meetings, which meetings? In some religious cultures for health care, every meeting throughout the institution begins with some sort of devotion or prayer. What sort is determined by the person presenting it, and responsibility is usually rotated among regular participants. In my own hospital, a few meetings related to organizational leadership – meetings of the Board, of the Leadership, and of the Ethics Committee – begin regularly with prayer. They always begin with prayer if I’m present. If I’m not, and I don’t have a substitute, I’m pretty sure they don’t, inasmuch as no one has ever accepted my invitation to participate.

I haven’t chosen to make that an issue. But for an Episcopal culture for health care, perhaps it should be. We say that we express our faith, our principles, in common prayer. If so, in an Episcopal culture for health care should prayer not be a part of the expression of the principles of the institution? In fact this health system, or at least its central referral hospital, does have a semi-official prayer, shared with employees and others on a hospital bookmark. Should it not have a greater visibility, a greater place in the life of the institution?

And if prayer has a place in the institution itself, what sort of prayer? That is, how should prayer in and for the institution reflect the multifaith community that is the institution? This question should be the topic of its own individual post. However, we are all, I think, aware of the controversies regarding whether Christian clergy must prayer with reference specifically to Jesus. My own practice is to pray in God’s holy Name, and to use other Biblical images of God. I know that there is at least one practicing non-Christian in most of those meetings (not to mention all the non-practicing Christians), and I choose to pray in a way that doesn’t challenge that other faith. At the same time I am aware of and sensitive to the concerns of clergy who feel that not to pray in the name of Jesus is to violate their own faith. I will not resolve that here. I only note and acknowledge the problem.

Surely prayer as some place in an Episcopal culture for health care. Prayer is fundamental to our faith, to our relationships with God, and to our ministry. If health care institutions are part of the ministry of the Church, prayer must in some way be fundamental to that ministry as well. There still remains much reflection to be done on how that might be lived out, made incarnate, in the life of the institution and in the experience of patients, families, and staff.