Monday, August 28, 2006

More on Volunteers in Chaplaincy: Education and Training

Let me continue my reflection the use of volunteers in chaplaincy.

Several professional colleagues have sent responses to my article in PlainViews, and the editor kindly forwarded them to me. The first one was from an old friend, Chaplain Dick Cathell. Dick is currently Chair of the Commission on Advocacy of the Association of Professional Chaplains. His primary concern was a question for the editor, and the decision to post my article under “Advocacy,” rather than under another category. However, in addition, his response included this statement:

I would suggest Chaplain Scott and other single-chaplain pastoral care departments first explore ideas of becoming a satellite CPE program, or at least having a CPE student or two from a nearby program assist with their pastoral care needs....or partner with a nearby seminary or faith-based college to start a field education assignment. [His] area, and especially [his] System has (sic) ample resources to access without advocating for volunteer chaplains.


His response points to two related arguments raised by professional chaplains who believe it unwise to use volunteers in chaplaincy. The first is that volunteers cannot provide the quality of care that these chaplains want to provide in their program. The second, related argument is that the programs that might teach appropriate skills are not available. That’s particularly highlighted by Chaplain Cathell’s reference to CPE programs. The first is worthy of a post all its own. For the moment, let me acknowledge that there is a level of quality that we as professional chaplains expect of ourselves, and that it takes training to provide that.

So, what is the requisite level of training? The norm to function as a professional chaplain is four units (1600 contact hours) of clinical pastoral education (CPE). This is agreed by all the major professional organizations of professional chaplains in North America. Should this be expected if someone is to volunteer? There are many congregational clergy that have had one unit (400 contact hours), whether required or recommended by church or seminary. In most metropolitan areas there are lay people who have pursued CPE, either in exploration of vocation or for personal growth. Is that required to assist a professional chaplain?

Graduate seminaries, and some undergraduate religious programs, provide courses in pastoral care and counseling, including some with supervised clinical experience. While many who take those courses go on to pursue certification as pastoral counselors and psychotherapists (a different professional practice from clinical chaplaincy), what about the congregational minister who took such courses? Some seminaries, at least in my area, have provided something called clinical pastoral training (CPT). These were programs of exposure to chaplaincy and pastoral care experiences, including use of verbatim case studies and small groups experiences, for a period of several weeks. Or, what about other kinds of training in giving support and care? I have known students who came to CPE programs who were clinical psychologists or licensed clinical social workers. What would the value be of these backgrounds in extending the work of a professional chaplain?

What about other programs? There are a number of programs currently used to train lay people in parishes for various ministries. One that was created by a chaplaincy program is the Community of Hope of St. Luke’s Episcopal Hospital of Houston. Another would be Stephen Ministries, based in St. Louis. Both programs provide training in relating sensitively one on one to a person in crisis. Other programs exist, and some have been developed by individual congregations to train their own members on giving care and support. Some chaplain departments have developed their own programs for the own needs and contexts.

On the other hand, there are programs to provide theological education by extension. As a Sewanee graduate I’m most familiar with the Education for Ministry (EFM) program based in that seminary. These programs provide a level of theological education and sophistication and experience in personal growth and reflection. So, with programs providing either some level of functional training or of theological education for lay people, do any of these provide the training appropriate to extend the work of a professional chaplain?

And what about basic skills? Of what value is a sense of vocation to caring, or a reputation as “a good listener?” Knowledge can be shared, and skills taught; but on what base should that education build? There are faith groups for whom the requisite credential for ministry is the call of the Spirit. How important is the call of the Spirit (or whatever phrase would best parallel in a different faith tradition) for a potential volunteer to work with a chaplain?

I’ve proposed a number of different tracks and backgrounds. They differ quite a bit, over all; and yet any of them would give a potential volunteer something to bring to extending the ministry of a chaplain. But because they differ so much, because what each would bring differs so much, knowing all these possibilities doesn’t really answer our question. They don’t answer our question because they beg the previous question: specifically, if a chaplain were to accept using volunteers to extend the ministry, what would the chaplain want the volunteers to do?

You see, we can talk a lot about what I have posed as the second question. There are a variety of backgrounds, and I’ve had some person ask me about professional chaplaincy, much less volunteering, based on most of them. But I want to hold to my premise that the clinically trained professional chaplain is an advanced practice minister. I think that at least some of what we do we cannot delegate without a clear and fairly high level of preparation. So, before we make a decision about what is the appropriate training, we need to think further about the first concern, stated a little differently. If there are tasks and aspects of chaplaincy that volunteers may not be prepared to do, what tasks can they do? Then, the appropriate preparation would be that relevant to the tasks assigned.

So, what can volunteers do? And that will be the topic of the next post on this issue.

Saturday, August 26, 2006

Looking Again for an Episcopal/Anglican Middle

Not long ago I wrote this post arguing that in the General Convention “the middle held.” That was in response to an interview with Dr. Kendall Harmon, available on line, in which he argued “the middle did not hold.” In no small part, the interest of my post was to consider what I might mean, or what Kendall might mean, by “the middle,” and what context we were describing in the process.

That got some interesting responses from Kendall’s blog, titusonenine. For the record (and once again), the responses were civil and not rude, and mostly thoughtful. They were also helpful, both in suggesting some other ideas about “the middle,” and about my post specifically.

Many identified me as being more toward the (reappraiser/liberal/progressive) side of the discussion, and I am. They stated, and accurately, that this shapes where I see “the middle.” I don’t argue with that. However, what it tells me first is that I wasn’t as clear in my first post as I could have been about my referents. When I said there that the middle held, I was making an observation about the bishops and deputies and alternates debating Resolution B033 specifically, and the resolutions of the Special Commission in general. I can’t say that more people would have agreed with my statement, but it would have made my presentation more clear.

There were those who felt the specific issue was about the authority of Scripture. Some of those who asserted that on that issue there was no middle ground: one either respected Scripture, demonstrated by accepting as normative the verses of Scripture condemning homosexual behavior; or one did not. One saw the Holy Scriptures of the Old and New Testaments as unchallengeable revelation (they never used the language of “verbally inspired, literally true, inerrant and infallible,” but they came blessedly close); or one saw them as hardly scripture at all. To “contain all things necessary to salvation” meant to see all things in Scripture as necessary to salvation. Sadly, a few such voices were indeed prepared to define out of the faith all who didn’t agree.

More common were those who didn’t assert infallibility, but still felt those who couldn’t support moratoria on ordaining practicing LGBT persons as bishops and on blessing committed relationships of LGBT persons didn’t acknowledge sufficiently the authority that Scripture did have. Within that context the poles seemed to be defined by the common historic interpretation of the relevant verses by the majority – whether the majority is defined chronologically (what the Church has believed longest) or numerically (what most Christians have believed), definitions that are not identical in standard, but are largely the same in result. They did not deny that (reappraiser/liberal/progressive) could argue from Scripture. However, they did not find compelling those Scriptural arguments, or the history of scholarly criticism of Scripture on which the arguments were based.

Another group wanted to argue a context of standards, theological or institutional or both. That is, they argued from a position of the importance of standards per se, and then questioned whether the actions of General Convention, or of specific Episcopalians in recent history, fell within the necessary standards, whether specifically Anglican or generally Christian. That is, they argued that those events suggested at least (there is no “at best” in this) that the General Convention and/or significant persons or leaders in the Episcopal Church did not adhere to appropriate standards; or at worst (and, yes, in contrast I do think there is an “at worst”) had no defining standards whatsoever. These voices included certain standards of the authority of Scripture, but included other standards as well - communion too open, liturgical exploration too wide, morals too accepting. They did not all seem identical as to how wide or narrow the standards should be. They did all agree that the limits should be hard, fast, and defended; and that actions of the Episcopal Church fell outside.

Finally, some spoke with more sensitivity than I of those folks in “the middle” in my third sense: that constructed middle of folks who had opinions on issues, but were not united or motivated by a particular issue; and were not motivated by the intensity of the opinions they held to change behavior and change institutions. Those who spoke of them agreed (and I agree with them) that they may well be the numerical majority in the Episcopal Church. Some felt more of those folks would eventually find an issue or cluster of issues that would become important enough to change behaviors and institutions. Others felt that most would not, but that a progressive Episcopal Church would fail in evangelism; and that as the folks in the undriven “middle” died off, the Episcopal Church would fade away. Folks of both opinions also agreed that we need definitely and always to be concerned about the spiritual welfare of those folks in that “middle.”

Events have moved us past my initial framework. The “middle” as I saw it in General Convention in Columbus is dispersed, waiting and watching with many of us new events, and especially upcoming meetings of bishops in New York and in Texas. Those who focused on the construct “middle” do have one valid point: we are all interested in how people vote with their feet. I agree with those who feel this will be the most notable context within which to recognize the middle, or at least the poles that attract folks from the middle.

At the same time I’m more hopeful about that “middle” than in my first post, and on both points. That is, I believe that while all of those folks have some issues important to them, and all have opinions on most issues, they are also precisely the community to believe that not only the standards of the Episcopal Church but also the standards of the Gospel are quite wide. I believe that they will stay because they continue to meet Christ in the life and worship of this Church; and that because they continue to meet Christ in the Episcopal Church they will provide a welcoming Christian environment for new souls who come to us. And certainly I agree with those on both ends of our current issues that the care of the souls before us is a primary concern for us, however they or we may be moved.

Changes are coming in the Episcopal Church and the Anglican Communion. It appears that some - my siblings for whom Christ died - will stay and some will leave. It is important to me to remember that those who leave remain siblings for whom Christ died. We may not agree where “the middle” is, or even whether there can even be a “middle.” They are still Christ’s, and so still somehow members with me of his Body.

Friday, August 25, 2006

Maynard Ferguson: Gonna Fly Now

I’m part of the TV generation – the part that grew up with three networks, when the antenna worked right, that remembers when PBS was new and daring and exciting. One consequence is that I’m one who prefers to work with some noise in the background. So, when I’m out in the back yard working in the garden, I have the radio on. When it’s not NPR, it’s one of the local classic rock stations. They regularly tell me they are playing “the music of my life;” and at least in an historical sense they are.

The irony of that is that I’m hearing a lot of songs that were current then that I never knew. You see, as a teenager I was already out of step. When others were listening to the last of the psychedelic rockers or the first of the power rockers, those ancestors of metal, I was listening to jazz. More specifically, I was listening to Maynard Ferguson. There were a couple of other stratospheric trumpet players who were also out there. I recognized and appreciated the genius and uniqueness of Dizzy Gillespie. I knew Doc Severinsen was great. There was another one-hit wonder whose arpeggios I still hear but whose name has long been lost. But my daily fare, my vinyl staple, was Maynard Ferguson.

I played brass myself: I had started on the trumpet and had moved on to the french horn, and so I felt a certain identification with Maynard. Others admired athletes who showed skills they might aspire to but never really believe they could reach; I looked at Maynard.

My best friend in those days was also a trumpet player. We would listen together. His father was a producer of industrial films and regional commercials, and he had a sound studio on his home. It was the first set up I knew that had tower speakers, using the internal column to really enhance the bass. We used to go into the studio, and while one of us held his head between the speakers the other would put on Maynard, playing one of those waterfall arpeggios at full volume. It altered my consciousness. My vices in those days were alcohol and women. It was the music that gave me a psychedelic experience.

I remember when Maynard came and played in my high school auditorium. Now, don’t underestimate that: at the time it was, at least in its acoustics, really one of the best places in my city and region to play and hear music. My band and orchestra director, himself a jazz trombonist, even got to jam with them. He held his own, and for us who loved him it was no small matter of pride. It was a nice group of folks that evening, who knew what they were hearing: a sparkling mix of jazz and rock by a stellar performer.

Yeah, like so many, as I aged my tastes widened, and to some extent drifted. I really do appreciate more now than then the “guitar gods” of my youth. I continue to be out of phase, and usually somewhere chronologically behind, most of the folks around me. And it’s possible that I romanticize a bit a bright spot in what I remember as a somewhat depressed adolescence (and that may be redundant). But Maynard Ferguson is a bright memory. His was indeed a stratospheric sound, hardly matched in its own time, and not matched since. I can only imagine now the challenge to Gabriel for first chair in the trumpet section.

Maynard Ferguson, RIP.

Thursday, August 24, 2006

A Medical Ethics Issue Trod Under Foot

During my commute each day I listen to NPR. Indeed, if my wife hears me begin a sentence with, “I heard on the news today….” she’s pretty sure I heard it on NPR. This morning during my commute I heard on NPR’s Morning Edition three reports on health care that have raised significant ethical issues. One was on the possibility of producing embryonic stem cells without destroying the embryo. Another was on approval by the FDA of “Plan B,” the morning after pill to prevent pregnancy a a non-prescription drug. Both of those were interesting and important. And both of them would, I was sure, get lots of attention from news and blog writers.

I, however, was concerned with a health report that I fear won’t get near the attention it deserves, much less the attention of the other two issues. I heard this report on the search for new antibiotics – and the lack of interest of the commercial pharmaceutical industry in the research. Later on this morning when one of our physicians smiled and said, “So, let me think: is there an ethical issue today?” this one was my immediate response.

And make no mistake, this is a serious issue in medical ethics. We have wonderful medications, and a commercial pharmaceutical industry that has produced them. At the same time, the connection of drug research and drug development to profits does indeed put the research and development in jeopardy, and our health as well.

We in health care have been hearing for years about “drug resistant” bacteria. The causes are probably many, although a few have come to stand out. No antibiotic is perfect, and so some few bacteria will survive. When things go well those few that survive the antibiotic will not survive the patient’s strengthened and renewed immune system. But the patient who stops taking the antibiotic too soon because he or she has started to feel good again creates a gap. The bacteria, and especially those that are naturally resistant to the medicine, have a chance to multiply before the body is really strong enough to stop them. The patient who insists on taking an antibiotic for a condition that’s really viral creates a different sort of gap. Bacteria get exposed to the medicine, and some will prove resistant, while the immune system is weakened to fight the virus. Either way, evolution takes its course, and the bacteria that survive are those resistant to the medication. Finally, after years with no new mechanism for an antibiotic – no different way of attacking the bacteria – the resistant bacteria have had time to develop anyway.

All this is well known; and to some extent our health behaviors have changed. Family practice and pediatric physicians are less likely to prescribe an antibiotic at the first hint of discomfort, whether to the patient or to the family member taking care of the patient. Physicians and pharmacists have made efforts to do more education about the importance of completing a prescription. There is that classic story: the patient looks at the doctor or pharmacist and asks, “Tell me the truth: which of these pills will really cure my illness?” The answer? “The last one.”

But we continue to see a problem. Around hospitals one hears about multi-drug-resistant tuberculosis, or multiply-resistant enterococcus or Vancomycin-Resistant Enterococcus or Methicillin-resistant Staphylococcus Aureus. We use acronyms for them, of course – MDRTB or MRE or VRE or MRSA – but we see them more and more often. Once these were rare conditions, virtually unknown outside center city hospitals and immune-suppressed populations. Not anymore.

These are circumstances when our commitment to market-oriented approaches to almost everything fall short. Antibiotics in general, and new drugs for these diseases in particular, just don’t have the return that other drugs do. The NPR story referred to medications that one takes for the rest of one’s life, like blood pressure or cholesterol drugs; or medications that have a high profile lifestyle attraction, like drugs to treat erectile dysfunction. These are very profitable, either because the market for them will be very steady, or because the demand of the market will bear a pretty high price. Antibiotics, on the other hand, are designed for limited use: once your body’s back in order you don’t need them; and there’s no glamour to the conditions they treat.

At the same time, the effects of our failure to pursue them will far outweigh the effects of either of the other two health issues I mentioned. This is not to downplay the potential value of stem-cell based treatments, or the importance of the morning after pill to a woman who fears a pregnancy that should not have happened. But neither is likely to affect as many people as better treatments for tuberculosis or whooping cough or salmonella or strep throat. Indeed, there has been a frightening resurgence of tuberculosis among HIV/AIDS victims abroad, and of whooping cough here at home. The potential public health benefits of new antibiotics should be important to every one of us, because every one of us is at risk of infection.

I am not in principle opposed to the market or to profit. However, this is one of those places where I think we as a society, and our leaders especially, demonstrate misplaced values. There are some roles that government must appropriately play because they affect the common welfare, and because without government’s action nobody else will. We need to call on our elected and appointed leaders to take on this burden, to fund this research. While I still believe for-profit health care is a sin, if it will get new drugs sooner to those who need them, I can live with a government-corporate partnership. But partnerships for new antibiotics and for other important but low-profit drugs will only come about if our political leaders express our political will to make it happen.

I have been known to say from the pulpit that I will believe this is a Christian nation when I see a social policy based on and thoroughly focused on service to “the least of these.” This should be an issue that really evokes that possibility; because in this case, “the least of these” may well include all of us.

Tuesday, August 22, 2006

On Chaplaincy and Volunteers

Let me begin by calling to your attention the PlainViews web site. PlainViews is an online newletter on healthcare chaplaincy. Each issue includes a variety of articles for chaplains, usually by chaplains, along with other useful information and resources. It's worth subscribing and checking regularly.

The August 16 edition includes an article of mine (you saw that coming, didn't you?). The topic is using volunteers in chaplaincy programs. While it's not long, rather than reproduce it here, I encourage you to link and read it here. Go on. Take a minute and read it, and then come back.

Done? Okay; let's continue.

As you might guess from the colleague's comment to which I was reacting, the use of volunteers has long been a hot topic among professional chaplains for some time. I participate in a Yahoo Group of chaplains in one person departments, and it's a particularly hot topic there. Those who think it's a bad idea to use chaplains are especially ardent.

My colleagues in one person departments are divided on the topic. Many of them are in small towns in small regional hospitals. They fear administrators who do not see the distinction among clergy, much less between congregational clergy and, as I describe us, “advanced practice clergy.” They fear being eliminated by administrators who believe they can be replaced by well meaning lay volunteers, supervised by a volunteer coordinator, and trained (to the extent they are trained) by a local pastor from a church that does not require graduate education for ordination. They fear spiritual abuse of patients by folks who, while arguably well intended, don’t understand that patients are better served by pastoral support than by encouragement to conviction.

But this also leaves my colleagues in small regional hospitals in a bind. One chaplain can only do so much. And these days there is much for chaplains to be involved in. Ethics committees, programs in cultural diversity, and organ and tissue donation are all programs in which chaplains have been intimately involved. Privacy issues have become important, and chaplains have worked to defend the rights of patients to visits by their clergy, and the rights of congregational clergy to have access to their members. Chaplains, too, have all the administrative responsibilities of any other manager. There are budgets to prepare, statistics to track, and reports to prepare. And there is ministry to the staff of the institutions themselves, from the administration and medical staff to the cook and the housekeeper. These activities are no more “optional” for chaplains than they are for any other member of the institution’s leadership. Chaplains are particularly clear on the issues of being “wise as serpents and innocent as doves.”

Too, many are sufficiently remote from any theological educational institution, clinical or academic, as to make recruitment of "more trained" volunteer support difficult at best. One can be that remote either geographically or theologically. I have certainly been interviewed by students interested in chaplaincy whose background is in a small, fundamentalist Christian community with a high reverence for evangelizing (as opposed to a ministry of evangelism). They're vision of a medical crisis as an obvious opportunity for conversion excludes them from my consideration.

And so in many instances, and not all of them rural, using volunteers to extend the chaplain’s ministry isn’t a luxury but a necessity. For those chaplains, to proclaim that this undermines chaplaincy isn’t helpful. Not using volunteers undermines the ministry, the patients, and the chaplain himself or herself. Should the chaplain tough it out, either trying to do too much or telling the institution to expect little? Or, should the chaplain take the initiative and be the professional to set the standards, both of what volunteers might do, and what training they might require for those tasks? At the other end, are our "advanced practices" so different from simple Christian caring that none of them can be delegated? Or have we so delimited the definition of chaplaincy as to eliminate from consideration those functions that might be delegated?

Central to my argument is this image of "advanced practice ministry," in parallel to differences among practices of nurses, physicians, and rehab therapy professionals, and perhaps educators and attorneys, as well. Perhaps this is a place to continue this reflection. I'd love to hear from others on this. I'll let this become another ongoing project for the blog, and share what my colleagues have to share.

Saturday, August 19, 2006

Rhapsody with Tomatoes and Peppers

I have been too serious lately. I will be serious again; but not for the moment.

We are coming to my time in the garden. It is late summer. At night the cicadas seek an evening’s – a lifetime’s – courtship, calling with that scraping ratcheting that has been the stock sound effect in a hundred cheap science fiction movies. The exceptional heat of the summer has kept fisherman of the lakes, and has kept us out of our old Ford Escort, at least until we can get the air conditioner repaired. And we’re harvesting.

We have a garden. It is small but intensive – four kinds of tomatoes; two kinds of eggplants; two of sweet peppers and two of hot peppers; four kinds of bush beans and two of runner beans (one for snap beans and one largely ornamental); watermelon; and a new rhubarb. There are herbs: parsley and marjoram, two kinds of oregano, and two kinds of basil. And then there are the perennials: blueberries, blackberries (both thorny and thornless), raspberries, and the peach tree. We really don’t have that much yard. It’s simply packed tight. There’s not much to mow back there, but it’s complicated.

And that brings up my description of our work: my wife loves to garden; I love to harvest. She enjoys the dirt beneath her fingernails. She loves to watch the seeds sprout, to watch the sprouts grow. I love to harvest and eat. I participate in the garden not for its own sake, but because that is the price of harvesting.

Actually, we’ve been harvesting for a while. Peaches came in through the first two weeks of July, as did the blueberries. Beans have been coming in for several weeks, and we’ve been picking basil for a while now (it’s a great substitute for lettuce on a burger!). But we began to process our tomatoes last night. We have one variety specifically for sauces and another specifically for drying; and we began working with both last night. The house is rich with the smell of them

Now, I’m not the biggest fan of tomatoes fresh. The hankering I satisfied at lunch today with a BLT shocked her. Normally I don’t put them in salads except in compliance because “they’re good for me.” But give me some cooking to do, and I’m there. The roasting that was the first step in preparing tomato sauce produces odors and flavors to make you stomp your feet, speechless with any appreciation more articulate. Come winter, dried tomatoes, rehydrated with red wine, will bring an incredible brightness to those sautéed chicken thighs.

And my peppers are starting to come in. My wife has grown for me this year two rare hot peppers. One produces a fruit the size of a fingertip, that is first purple, then white, yellow, orange, and red. I dry and grind them, and use them literally flakes at a time because they are so hot. And new this year is a little Peruvian pepper, lemon yellow, and brightly hot without being injurious. Small amounts will last me through this winter’s cooking; but I so enjoy them as they come in.

We do cook. Indeed, it is perhaps my most dependable form of recreation. Sure, I watch TV, and I spend time blogging – but that’s sometimes recreation and sometimes work. The craft I pursue, what really seems like a hobby, is my cooking. Today I have sourdough bread in process – as I’ve baked almost every weekend for the past fifteen years or so. I’ll help my wife process the sauce tomatoes in the food mill. We’ll have for dinner left over pulled pork, smoked over a long night last month and stored in the freezer since. I’ll watch The Food Network, in part for ideas, but in part just to imagine how I would enjoy what someone else cooks. I was a real “Iron Chef” junkie for a while – that unique blend of cooking, sumo, and American sports color commentary.

We do cook. We wonder why more people don’t. We eat well and cheap, and we don’t find it arduous or complicated. We sit at dinner, enjoying what we’ve prepared, and guessing how much we’d pay for it if we’d eaten it out. We can do it for a fifth of the retail price, and usually in the same amount of time we would have waited for and at the table. It makes me sad to think of those folks who are afraid to cook. Sometimes I think of giving lessons – more like Rachel Ray or Alton Brown than Emeril, simple principles to produce easily quickly stuff that really tastes good.

Which reminds me: it’s almost time to take the next step with the bread; and then it will be time to mill the roasted tomatoes. Yeah, there’s some work in it. I suppose it’s like my friends that get into collecting or into woodworking. But this sauce bodes well to be excellent; and I haven’t chewed on furniture since I was a child.

I’ll get back to professional stuff next time. Right now, I’ve got stuff harvesting to attend to and cooking to do.

Friday, August 18, 2006

What General Convention Did: St. John Eye Hospital in Jerusalem

As I was preparing for General Convention and reading through the resolutions that had been submitted, I was particularly intrigued by Resolution B005:

Whereas The Most Venerable Order of the Hospital of St. John of Jerusalem has served in missions of charitable outreach in Jerusalem, the Middle East, and other places in need most especially through the St. John Eye Hospital, under the auspices of the British Crown since the nineteenth century; and
Whereas 2007 marks the 125th Anniversary of the Foundation of St. John Eye Hospital in Jerusalem, and the Fiftieth Anniversary of the foundation of the American Society of the Order of St, John; and
Whereas 2006 marks the Tenth Anniversary of the constitution of the Priory in the United States of America as the seventh Priory of the Order of St. John and the first outside of the British Commonwealth; and
Whereas the charitable work of this Order continues unabated in meeting the needs of the sick, the injured and the poor, without regard to their religious affiliation or nationality, in a part of the world held as holy by the Three Great Monotheistic Faiths, but sadly torn by strife and division; therefore be it
Resolved, That the 75th General Convention of the Episcopal Church congratulate the Most Venerable Order of the Hospital of St. John of Jerusalem and commend it for its continued work and witness.


Now, I must admit that I was intrigued in no small part by the reference to The Most Venerable Order of the Hospital of St. John of Jerusalem. Surely, this was the institution founded by, and the source of the name of, the Knights Hospitaller, those colleagues of and competitors with the Knights Templar. Yes, there was a time in my life when I was awfully intrigued with all the purported mystery and the occultism associated with those orders. Foucault's Pendulum by Umberto Eco remains a favorite book; and having read that could have a good laugh reading Holy Blood and Holy Grail. (As an interesting side note, I couldn’t finish The DaVinci Code. It didn’t maintain my interest.) So what in Heaven’s name was a reference to that hospital doing in a General Convention resolution?

By the way, if you haven’t read Foucault’s Pendulum by Eco, I recommend it highly. Yeah, it can be dense and complex, and sometimes it’s painfully evident that it was written by a professor of semiotics. But it is, ultimately, wonderful fun. I have particularly treasured his discussion of “cretins, fools, morons, and lunatics.” I once, briefly, tried to develop an education theory based on this typology.

Back to topic: what was this doing in a General Convention resolution? It turns out that the Knights continue to exist. (You can read a history of the Order here.) The continuing Papal Order and related orders, among them an order of British nobility, continue to support hospitals. The American Society of the Order of St. John is an American association of the British order, which, as noted in the resolution, has supported the St. John Eye Hospital in Jerusalem since its establishment in the 19th Century. Today they provide care to all who come to them, working across lines of faith, language, and political affiliation in that most complex of milieus. The Order has a web site, including extensive information on the hospital.

The real value of this resolution is to note one of many health ministries supported by the Episcopal Church, whether as individuals, congregations, dioceses, or the national Church. While many of us may know of one or two that have some local visibility, we can’t have a real sense of the variety and scope of these extensions of our ministries in the world. There are many more, I think, than any of us knows. I appreciate the decision of Bishop Mark Sisk, himself Sub-prelate of the Priory in the United States, to bring this work to the attention of the larger Church through this resolution. I hope we will look for and share in other ways information on these health ministries throughout the world. In these days when the Church seems consumed with internal struggles, these ministries are clear evidence that we are reaching beyond ourselves, and continuing to get on with reflecting in the world the healing ministry of Christ.

Saturday, August 12, 2006

What General Convention Did: Clergy and Clergy Family Health

Once again, I want to review the actions of the 75th General Convention related to health care. Two of the actions taken at the General Convention in Columbus that related to health and health care arguably should be of very personal concern. That is because they relate to the health of clergy and of their families. Specifically, these were passage of Resolutions D033 and B001.

The text of Resolution D033 reads as follows:

Resolved, That the 75th General Convention commend CREDO Institute, Inc. for Episcopal Clergy Wellness: A Report to The Church on the State of Clergy Wellness and affirms the recommendations contained therein; and be it further
Resolved, That CREDO Institute, Inc. be encouraged to work collaboratively with other offices, agencies, and organizations to address the recommendations in a systemic and strategic manner in order to strengthen the ordained leadership of this Church, and that a report on the progress be made to the 76th General Convention.


I would encourage everyone to review Episcopal Clergy Wellness: A Report to The Church on the State of Clergy Wellness, available to download here. The CREDO Institute has been offering programs for clergy wellness and vocational exploration. They’re best known for the CREDO Conferences, opportunities for clerics to get away for eight days with others at roughly the same stage of their careers, for spiritual renewal and vocational reflection.

On a similar theme is Resolution B001. It’s worth noting that this resolution was submitted by Bishop Katherine Jefferts Schori, Bishop of Nevada and Presiding Bishop-elect.

Resolved, That the 75th General Convention recognize the urgent need for an ongoing program devoted to the wellness of families of clergy and clergy; and be it further
Resolved, That the 75th General Convention commend the Families of Clergy United in Support (FOCUS) for its creation of a resource guide to assist the wellness of families of clergy and clergy; and be it further
Resolved, That the 75th General Convention empower FOCUS to lead dioceses and congregations in the use of this resource guide through publicity, consultation, and seed money to promote the health of families of clergy, clergy and congregations; and be it further
Resolved, That the 75th General Convention ask the Office of Ministry Development to provide oversight and coordination with FOCUS and other programs that support the well-being of clergy and clergy families, and assist in seeking funding for such programs, including for Families of Clergy United in Support; and be it further
Resolved, That the 75th General Convention request that the Joint Standing Committee of Program, Budget and Finance consider a budget allocation of $97,000 per year for the implementation of this resolution.


You can learn about Families of Clergy United in Support (FOCUS) here. I note as important that the resolution included delegation to a specific office (the Office of Ministry Development) and designation of funds for the program.

You can see why I would suggest that this has a personal interest for me. Certainly, I appreciate folks being concerned about my health. Intellectually I know that I can’t take care of anyone else if I don’t take enough care of myself. Viscerally I’m as likely as anyone else to push myself too far when I’m working, and not far enough when I’m not. As a hospital chaplain being called out of a sound sleep to a bedside is just part of the job, as is the sixteen hour day, or the seven day week. (I told someone yesterday I couldn’t straighten out whether my week went Monday through Sunday, or Sunday through Saturday; and in that indeterminacy my week never seemed to actually have an end.) That’s not really exceptional among clergy, although I may be called out at night more. It’s easy to think about the discipline of Morning Prayer; it’s not as easy, nor near as much fun sometimes, to thing about the discipline of morning exercise. The fact that someone would care – more to the point, that the Church I serve would care – about my health and my lifestyle is no little reassuring.

And with that, I’m even more pleased that someone is interested in my family and their health. I want to be a good husband, and wanted when my children were still at home to be a good father. (Yeah, yeah, I know that doesn’t end, either; but they’re taking responsibility for themselves these days, and it isn’t the same.) But I know that in the community I serve there are some who will project expectations of me onto my wife. My wife, bless her, is really pretty good at setting limits and not getting set up with expectations not appropriate for her. But, not all my colleagues are as blessed as I am; more to the point, not all of their spouses are as capable as mine is. And for all the changes that the world and the Church have seen, there are still a lot of folks with very traditional expectations of clergy and families. There are stresses on families of clergy based on our visibility and centrality in the Church community and the larger community. A commitment on the part of the Episcopal Church to the families of clergy will, I think, contribute to a healthier Church.

And that is no small thing. I have often reminded colleagues that clergy are not normative Christians. The normative Christian is a lay person. Rather, the cleric is called forth in the community to provide leadership in the faith and worship of the Church. A good part of the leadership can be provided by modeling, demonstrating in our own lives how the faith might be lived well. Certainly, that is in keeping with our incarnational theology. So, how we live our lives, both professional and personal, will be seen and noted as lay Christians consider how to live theirs. It is very important that we model good, healthy lifestyles, and good, healthy relationships. It is important that we are caring for ourselves and for our families in ways that honor the love Christ has shown for us and has called for us to show for one another.

Some of the blogs I read frequently are written by seminarians. Every now and again they put up with a comment from me that I hope will be helpful and supportive for them. Certainly, I hope they will begin good professional and personal practices in their ministries, and will maintain them throughout their careers. The interest expressed by General Convention in supporting them, and us more seasoned professional siblings, is hopeful and helpful. They are indeed confirmation of the theme of the General Convention, a call to all of us, clergy included, to “Come and Grow.”

Monday, August 07, 2006

Episcopal and Anglican Issues: Searching for the Middle

I found a video of an interview with Dr. Kendall Harmon of the blog titusonenine on the blog site of Dr. Dunlap, “Catholic in the Third Millennium.” I don’t know the source, but I appreciate Dr. Dunlap posting it. It is well worth watching. I listened to the interview last night, and, as usual, Kendall was thoughtful and measured in his comments. I certainly appreciated his noting that so much of the commentary in the blogosphere is neither.

Having said that, I wondered at his comments in the interview that "the middle did not hold." He questioned those who used that description after General Convention, and said that in fact he felt that was not true.

Which leads me to wonder how he understands "the middle." What is "the middle" between? It seems to me that there may be several answers.

Some who said “the middle held” were focusing on the how the Episcopal Church had dealt with a moral issue and a particular community. Those who were willing to live (I don't want to say happy) with the results of Convention, including Resolution B033, seemed to have had some sense that the poles were radical pursuit of a justice agenda, the consequence of which would be the fullest possible acceptance of GLBT persons, and of their own understanding of their own lives, within all aspects of the life of the Church; vs. radical pursuit of an agenda of traditionalist morality in personal life, supported and sustained by a literal reading of Scripture on at least some issues, and especially homosexuality. If that seems a narrow description, that’s deliberate. Folks at both poles would say that they have some sense of a call to justice and service to the poor; some sense of the content and intent of the Gospel, and how best to spread it; and of “what Jesus would do,” or at least have them do. However, over the issues relating to homosexual persons in the life of the Church, folks at either pole were prepared to let the other pole go, to allow the Church to lose someone. The middle, then, would be those who felt that there is an appropriate claim both for justice for GLBT persons, and so for their full participation in the life of the Episcopal Church; and that this also needed to be (and could be) articulated in Scriptural and traditional terms, applying critical and faithful reason to both Scripture and tradition, as we have done for generations.

Others, I think, spoke of those who felt the Anglican Communion was meaningful – not so meaningful as to be prescriptive for the Episcopal Church. but too meaningful to simply discard. One could take a page from our historic arguments about the historic episcopate, and suggest that some thought the Communion was of the esse of the Church – indispensable – and some of the bene esse of the Church – valuable, but dispensable. One could say, then, that the middle, the majority, held the position that the Communion was of the pleni esse of the Church: yeah, perhaps the Episcopal Church could live without it, but could not be the same without it. (I realize that the argument is actually related to the argument about the episcopate, but that would be a matter for a separate post.)

I think that these were separate considerations among Deputies (and probably among Bishops, but I wasn’t in that House), but there was an awful lot of overlap. That is, those who would have been in the middle for one perspective, would also have been in the middle for the other.

Now, there are also some commentators who have talked about “the middle” after essentially defining it away. That is, they have refused to see themselves in light of the full spectrum, insisting on seeing themselves as normative despite all evidence to the contrary. They look an awful lot like those in the polar groups in my first perspective above, except that they would not speak of or to those at the other pole. Thus, they would say, “I know that in fact I am in the middle, and those who stray too far are literally off the spectrum.” That is the meaning of the language coming from some voices, especially in Africa, who speak of the Episcopal Church majority as having described “a new religion.” (There are comparable voices at the other extreme, but this is such a clear example as to make the point easily.) By asserting that those with whom they disagree have left the faith, they remove those with whom they disagree from consideration at all.

Not unlike this are those who postulate a “middle” that’s not really related to the issues themselves, not unlike that construct of “Middle America” that crops up in American political speech. It encompasses those who want enough stability for comfort, but also have enough flexibility to accept change at some (inevitably slow and) measured pace. This “middle” would include all those in the pew who might say, “I’ve been an Episcopalian forever; and while I’m unhappy with, maybe even actually against, all of this innovation, I’m going to suffer through as long as I can.” This group would be opposed to radical change in general, but might live with it as long as the frontier is somewhere else – some other Anglican province, some other diocese, some other congregation. The difficulty, of course, is that in fact this is a construct, a postulate. Folks in that "middle" have some issue or another, but are not all concerned about the same issue. It’s part of the dynamic, but can’t be measured by the evidence, or at least by the public rhetoric.

And my fear (and to some extent my hope) is that this last is the referent when Kendall says, “The middle did not hold.” He cannot be speaking of either of the first perspectives. In those perspectives the middle manifestly did hold. I hope he’s not speaking of the third perspective. That would suggest he is prepared to define out of the Body of Christ most Episcopalians (and I don’t think he’s prepared to do that). So, I can only imagine he’s thinking of the last group. That would make sense of his comments about “a trickle, and maybe even a stream” of folks leaving the Episcopal Church. It would make sense in light of the thought that even those on the constructed "middle" have a limit, and that eventually they would not be able to see themselves in the Episcopal Church anymore. There is perhaps - even probably – a perspective that I have missed to which Kendall is speaking; and if so, that would call for further reflection.

But if the “middle” is that constructed middle, moved to accept change only slowly, largely after it’s established “somewhere else,” there is a problem. Because it’s really not concerned either about Christian standards of justice or of personal morality, about whether our continuing relations with other Christians of this Anglican tradition are or are not worthwhile, or, for that matter, any other issue of the faith, it offers no motivation or reflection for Christian action. It may seem worth protecting, even if we only assume it exists, because we don’t really want anyone to have to be unhappy, or even because we fear more defections from our Episcopal congregations than we’ve seen so far. But there’s nothing particularly Christian about holding some constructed “middle” for its own sake. Indeed, if that’s our motivation, we have indeed fallen into slavery to the prevailing culture; for any “prevailing culture” will seek to defend stability against any motivation for change, however just or faithful or Scriptural.

So, Kendall feels “the middle did not hold.” From what I saw, I think it did. But to say that certainly begs the question: when we speak about “ the middle,” what is it the middle between?

Saturday, August 05, 2006

What General Convention Did: HIV/AIDS

Let me return to one of my ongoing projects. This time, I’m writing about actions of the 75th General Convention regarding health care.

In an earlier post I wrote about resolutions presented for General Convention addressing HIV/AIDS, and related issues. Four resolutions were considered, and passed in some form.

Resolution A131 resolved to continue the work of the Standing Committee on HIV/AIDS of the Executive Council for the next triennium. The particular focus stated in the resolutions was to “focus on mechanisms for increasing HIV/AIDS awareness in our Church, reducing the effects of stigmatization by HIV/AIDS and continue the process of identifying those whom we are called to serve but may overlook….” Resolution A131 was passed in both houses. It was, however, noted that the resolutions of the Standing Committee of General Convention on the Structure of the Church has passed, including one that moved Committee on HIV/AIDS from being a Standing Committee of the Executive Council to being a subcommittee of the reactivated Standing Commission of the General Convention on Health. A list of Committees, Commissions, Agencies, and Boards posted since Convention on the General Convention web site shows both the Standing Commission on Health and the Committee on HIV/AIDS. So, there’s some administrative work still to be done.

Resolution A132 addressed the continuing stigma of those living with HIV/AIDS. The resolution called for Episcopal congregations and individuals to:

“Acknowledge that the stigmatization of anyone due to disease, and particularly due to HIV/AIDS, creates impediments to seeking treatment and care…
Affirm that the teachings of Jesus Christ clearly state that sickness and disease are not the result of sin in the human family.
Acknowledge that our Baptismal Covenant vows obligate us to respect the dignity of every human being and to seek and serve Christ in all persons, loving our neighbor as ourselves and that the stigmatization of those among us with disease is a violation of those vows; and be it further
Educate their constituent members about HIV/AIDS with a goal of eliminating any stigma associated with the disease.
Educate their local, state and federal elected officials and representatives about HIV/AIDS with the goal of creating knowledgeable, compassionate, and sensitive public policy….”


A132 was also passed by both houses in its original form.

A133 called for the Communication Office of the Church to collaborate with the National Episcopal AIDS Coalition (NEAC) to form a working group to develop a campaign to raise awareness on HIV/AIDS. This was also passed as submitted. However, the resolution did not include funds for the purpose, and one can fear that the resources of the Communication Office may well be stretched to include this, no matter how valuable.

Resolution A134
called for

"the Office of Peace and Justice Ministries of the Episcopal Church, working in collaboration with the National Episcopal AIDS Coalition (NEAC) and the Executive Council Committee on HIV/AIDS [to] develop a HIV training curriculum by the 76th General Convention, thereafter to be updated each triennium…
[to] focus on information on the transmission, treatment and prevention of HIV/AIDS, addressing the demographic and social implications; and…
that this training curriculum be offered as [a] web-based, self-directed tutorial; and…
that each diocese will strongly encourage that lay and ordained leadership complete this training."


A134 was also passed as submitted. Once again, the resolution did not include designation of funds. We can hope that this will be possible within the combined resources of the Office of Peace and Justice Ministries and of the Committee on HIV/AIDS, wherever it winds up in the structures of the Church.

A135 called for a survey to list all the HIV/AIDS ministries and resources throughout the Church. Unfortunately, this resolution was never reported out of the designated legislative committee.

These were certainly valuable actions. HIV/AIDS continues to be an important issue, and the Committee is right: it’s fallen off the radar screens, and lost the attention of many. If these actions are completed over the next triennium, we will have returned that attention to an issue that has ramifications for our own Church, for our commitment to the Millennium Development Goals, and for our relations with other Provinces of the Anglican Communion.

Friday, August 04, 2006

The Church, the Whole Church, and Nothing but the Church?

The current controversy in the Episcopal Church and in the Anglican Communion had been stirring around for a generation without really having much impact. There were arguments, but any effects tended to be local in scope. There wasn’t much impact, that is, until it involved the election and ordination of a bishop. It almost erupted in the Church of England; but then the Archbishop persuaded Jeffrey John to step back and step down. There was reaction to the decisions on blessing same sex unions in the diocese of New Westminster, but it was seen primarily as an issue local to Canada. The event that was a deal breaker, and perhaps a Communion breaker, was the election, confirmation by Convention, and ordination by Frank Griswold et al of Gene Robinson. It was the effect on the episcopate that brought issues of the inclusion in the church of gay, lesbian, bisexual, and transgendered persons to a communion-wide level.

That is, we are told, because bishops are ordained “for the whole church.” In the ordinal of the Book of Common Prayer of the Episcopal Church (1979) the celebrant notes that the candidate has been duly and lawfully elected to be a bishop of the Church of God to serve in the Diocese of N. (p. 514) The celebrant goes on to say in the Examination, “With your fellow bishops you will share in the leadership of the Church throughout the world.” (p. 517) The candidate is asked, “Will you share with your fellow bishops in the government of the whole Church…?” (p. 518; emphases mine in all quotations)

But, what can we really mean by “the whole Church?” For all our commitment to the historic episcopate, and our faith that our Episcopal orders are just as clearly rooted in apostolic order as anyone else’s, we make no pretence that our bishops might function in churches in communion with Rome or Antioch or Alexandria or Constantinople. They might address our bishops as bishops by courtesy, but they don’t recognize their orders. (The fact that we would recognize theirs only highlights their failure to recognize ours.) Until recently, the same was largely true among those Protestant churches that used the title of “bishop.” Prior to Called to Common Mission, the Evangelical Lutheran Church in American would recognize the administrative title of an Episcopal bishop, but would never see any effect on their orders that might be implied by the concept of “the whole Church.” We hope soon that those churches of the Methodist tradition will have some recognition of our bishops and our place in the historic episcopate. However, there’s no functional sense in which an Episcopal Bishop, or a bishop of any province of the Anglican Communion would be recognized by all members of the whole Body of Christ, nor even by those members of the Body that preserve and cherish the historic Episcopate.

Nor can we mean, really, the entire Anglican Communion. That is, of course, evident now. The provinces of Nigeria, Kenya, and Uganda have declared themselves out of communion with the Episcopal Church and with General Convention, and thus, in any real sense, bishops of the Episcopal Church. Granted, there is a fudge about bishops that “maintain the ancient Christian faith” as those provinces choose to define it; but it is clear that bishops can’t simply act in and for another province of the Communion without official recognition. There is greater recognition of ministries; but it is certainly not universal. The Presiding Bishop-elect of the Episcopal Church could not be ordained a deacon in most provinces of the Communion. Moreover, the integrity of boundaries between provinces and diocese, and thus the limitations of recognition of orders, was one point repeatedly held as important Lambeth Conferences, the Windsor Report, and the Dromantine Statement.

Functionally, when we speak of electing for “the whole Church,” we mean the whole Episcopal Church. The Constitution and Canons of the Episcopal Church define the duties of a bishop, and also the limitations. Thus,

No Bishop shall perform episcopal acts or officiate by preaching, ministering the Sacraments, or holding any public service in a Diocese other than that in which the Bishop is canonically resident, without permission or a license to perform occasional public services from the Ecclesiastical Authority of the Diocese in which the Bishop desires to officiate. (Title III, Canon 18.2. These are the 2003 Canons, but this wasn’t changed in Columbus.)


A bishop may function in the diocese that elected him or her, providing administration, ordaining clergy, and functioning to teach the faith of and defend the unity of the Church, as expressed in that diocese. That bishop will serve and represent that diocese in the House of Bishops, and participate in the unity of that House, and so contribute to the unity of the Church. However, while those in another diocese may recognize that person as a bishop, they would not recognize that person, and so respond to that person, as their bishop.

So, we speak of ordaining bishops “for the whole church” proleptically – looking forward to a time when in fact the whole Body of Christ is united, and we all recognize each other. It looks forward to the coming of the Kingdom; but in our current experience it has little tangible effect. Instead, we elect and ordain bishops for a diocese of the Episcopal Church, and in some sense for the whole Episcopal Church, at least in the sense that we elect and ordain bishops to participate in the House of Bishops and in the General Convention. While theologically there is some sense of “the whole Church,” and of the meaning of episkope in the whole Church, Episcopal bishops are functionally bishops only of the Episcopal Church; and there are limits even in that.

Note that even this is not consistent throughout the Communion. For example, the constitution of the Church in the Province of Central Africa includes a provision for appealing controversies to the Archbishop of Canterbury. There has been some discussion of making that appeal in light of the controversy surrounding Bishop Kunonga in Zimbabwe. That is a level of recognition of ministries beyond that of the Episcopal Church. We’ve been quite clear as recently as the General Convention that we value the opinions of the Archbishop of Canterbury, but don’t recognize any jurisdictional authority.

So, what do we mean when we say we believe we elect and ordain bishops “for the whole Church?” In fact any ordination is within the purview of the particular faith community within which it occurs. That’s as true of our bishops as it is of Roman bishops or Methodist bishops or, for that matter, bishops of the “Three-Self Patriotic Movement” churches in the Republic of China. When the Kingdom comes, any bishop may be recognized by all bishops, and be able to represent the unity of the Body to any member. Until then, all bishops are as local as all politics, both within the Church and without. In that light, should we really be that upset if some bishops don’t recognize us? Even if they’re bishops who have been among us who no longer wish to be? Until there is “one whole Church,” our statements on the ordination of bishops are a matter of hope, and of God’s grace, for the future. Institutionally and today, they mean hardly anything at all.