Taking Up the Gauntlet - At Least to Examine It

The Archbishop of Canterbury has responded to the Statement of the Global Anglican Futures Conference (GAFCON) and its included Jerusalem Declaration. You can read the statement here. You can read comments on it at all the usual suspects.

Most folks out there – at least, most folks in the basically progressive blogs that I peruse – think this is a good statement. Some think it better than others, of course, but most approve. I certainly think it is clearer than most statements from Canterbury; but then in this case the issues, or at least those addressed in the response, are more political and institutional than theological. However, it seems to me that this will turn out to be an example of how we talk past each other.

Take, for example, this assertion:

The 'tenets of orthodoxy' spelled out in the document will be acceptable to and shared by the vast majority of Anglicans in every province, even if there may be differences of emphasis and perspective on some issues. I agree that the Communion needs to be united in its commitments on these matters, and I have no doubt that the Lambeth Conference will wish to affirm all these positive aspects of GAFCON's deliberations. Despite the claims of some, the conviction of the uniqueness of Jesus Christ as Lord and God and the absolute imperative of evangelism are not in dispute in the common life of the Communion.

First and foremost, while these “tenets of orthodoxy” may well be shared by “the vast majority of Anglicans in every province,” those who wrote and who signed on to the GAFCON Statement find the differences of emphasis and perspective to be critical. Differences over how we interpret Scripture (largely literally, or largely through the lens of historical critical method); the role of bishops in the Church (pastoral or educational, monarchical or collegial); the authority of the “historic Anglican formularies,” as the Covenant Design Group has described them; the meaning of relationships and boundaries within a communion of churches (Anglican, “Fellowship of Confessing Anglicans” (GAFCON separatists), or others): all of these reflect differences of emphases and perspectives that are significant and formative for those affirming the Statement.

Second, I think it remains to be seen in what form or manner “the Lambeth Conference will wish to affirm all these positive aspects of GAFCON's deliberations.” Once again, there are aspects of both the statement and the Jerusalem Declaration that will have wide support; but hardly all. I sincerely hope that Lambeth will not affirm elevation of issues of human sexuality to the importance of Scripture and the historic Creeds, or even to the level of the historic Anglican formularies. In light of the structure that has been given to this Lambeth, I hardly expect any statement at all. I doubt that the Lambeth Conference will wish to affirm all these positive aspects of GAFCON's deliberations” in any way that the new Fellowship of Confessing Anglicans will accept, or even acknowledge.

Third, the Archbishop comments, “Despite the claims of some, the conviction of the uniqueness of Jesus Christ as Lord and God and the absolute imperative of evangelism are not in dispute in the common life of the Communion.” The problem with this is that those most committed to this Statement and to FOCA are precisely those who are making the claims. I don’t agree with them, but I believe that they really believe the claims they make. They believe and are committed to the claim that the Episcopal Church and the Anglican Church of Canada (not to mention those who might actually agree) are proclaiming “a new gospel.” They also believe that the Archbishop of Canterbury has essentially lost his moral authority, for lack of exercising moral authority over those two provinces. They will not be persuaded by this statement from this source. The same is true of his later statement, “I believe that it is wrong to assume we are now so far apart that all those outside the GAFCON network are simply proclaiming another gospel. This is not the case; it is not the experience of millions of faithful and biblically focused Anglicans in every province.”

All the issues of division raised by Archbishop Williams’ response are meaningful. His speaking to them will be welcomed by those who wish to retain some possibility of reconciliation, and/or some sense of the Anglican-Communion-as-we-have-known-it. It will, however, be dismissed by those who have despaired of both.

I said in my last post that Canterbury cannot ignore the metaphorical gauntlet thrown at his ecclesiastical feet. To his credit, he has not ignored it. He has perhaps offered some comfort to those who will still work with him. It won’t change the trajectory implied by the GAFCON Statement and the Jerusalem Declaration.

The Gauntlet is Thrown Down.

The Statement on the Global Anglican Future has been released at the close of the Global Anglican Futures Conference. Some of its highlights:

…we grieve for the spiritual decline in the most economically developed nations, where the forces of militant secularism and pluralism are eating away the fabric of society and churches are compromised and enfeebled in their witness…. To meet these challenges will require Christians to work together to understand and oppose these forces and to liberate those under their sway. It will entail the planting of new churches among unreached peoples and also committed action to restore authentic Christianity to compromised churches.

The first fact is the acceptance and promotion within the provinces of the Anglican Communion of a different ‘gospel’ (cf. Galatians 1:6-8) which is contrary to the apostolic gospel.

The second fact is the declaration by provincial bodies in the Global South that they are out of communion with bishops and churches that promote this false gospel.

The third fact is the manifest failure of the Communion Instruments to exercise discipline in the face of overt heterodoxy. The Episcopal Church USA and the Anglican Church of Canada, in proclaiming this false gospel, have consistently defied the 1998 Lambeth statement of biblical moral principle (Resolution 1.10). Despite numerous meetings and reports to and from the ‘Instruments of Unity,’ no effective action has been taken, and the bishops of these unrepentant churches are welcomed to Lambeth 2008.

Published as a part of it is the Jerusalem Declaration. Some of its points:

The Bible is to be translated, read, preached, taught and obeyed in its plain and canonical sense, respectful of the church’s historic and consensual reading.

We uphold the Thirty-nine Articles as containing the true doctrine of the Church agreeing with God’s Word and as authoritative for Anglicans today.

…we uphold the 1662 Book of Common Prayer as a true and authoritative standard of worship and prayer, to be translated and locally adapted for each culture.

We acknowledge God’s creation of humankind as male and female and the unchangeable standard of Christian marriage between one man and one woman as the proper place for sexual intimacy and the basis of the family. We repent of our failures to maintain this standard and call for a renewed commitment to lifelong fidelity in marriage and abstinence for those who are not married.

We uphold the classic Anglican Ordinal as an authoritative standard of clerical orders.

We recognise the orders and jurisdiction of those Anglicans who uphold orthodox faith and practice, and we encourage them to join us in this declaration.

We celebrate the God-given diversity among us which enriches our global fellowship, and we acknowledge freedom in secondary matters. We pledge to work together to seek the mind of Christ on issues that divide us.

We reject the authority of those churches and leaders who have denied the orthodox faith in word or deed. We pray for them and call on them to repent and return to the Lord.

So, in all of this is the gauntlet thrown down. The Episcopal Church and the Anglican Church of Canada are “compromised and enfeebled,” “proclaiming this false gospel.” “The unchangeable standard of Christian marriage between one man and one woman” is, in the Jerusalem Declaration, elevated to equity with Scripture, Creeds, the threefold ministry, and the historical Anglican Formularies.

All of this, then, justifies not only “the planting of new churches among unreached peoples [but] also committed action to restore authentic Christianity to compromised churches;” for “we reject the authority of those churches and leaders who have denied the orthodox faith in word or deed.” So, incursions across provincial lines are valid responses to the failures of American and Canadian bishops (and surely others soon enough) to “uphold orthodox faith and practice.”

Well, we in the Episcopal Church and the Anglican Church of Canada have some sense of having experienced this before. The Global Anglican Future Statement and the Jerusalem Declaration are remarkably reminiscent of the Affirmation of St. Louis, in intent and consequence, if not literally in language. The Affirmation of St. Louis has been the distinctive formative statement of “continuing Anglican” bodies in North America, including some who are now part of the Common Cause movement.

And having seen it before, we can predict what it will mean, at least here. It will provide justification for those who chose to leave the Episcopal Church, and especially those who have left in all but name long ago and now find a new body more congenial. Some will leave, if not nearly as many as the separatists hope. New bodies will coalesce and splinter and coalesce again over time, until new bodies reach some level of stability. They are not likely, however, to ever grow dramatically from what they are now.

There are differences, of course. The connections with foreign bishops will add a certain panache, at least for a while. However, such connections will not make the new bodies more attractive than they already were for their doctrinal positions; and time will tell just how ready American and Canadian Christians are to live with very different models of authority from other cultures.

In any case, and once again, the gauntlet is thrown down. This new movement, led by its primates, exists to challenge the existing relationships and structures of the Anglican Communion, from Canterbury on out. While it begins its work with the Episcopal Church and the Anglican Church of Canada, it can hardly stop there. It can only come soon to the British Isles; and one wonders what the approach will be to other conservative Anglican provinces that choose to remain with Canterbury instead of joining the movement.

It seems a long time ago that I described Archbishop Williams’ efforts to maintain the Communion as “cowboy poker,” won by those who stayed longest at the table (here and here). Well, clearly some have made a decision. They have attended GAFCON, and have disparaged the Lambeth Conference that they will not attend. They have determined that some are acceptable and some are not, and have stated their standards. Some will certainly back away from this; but just as certainly some will chart their course by this map. Are you watching, Archbishop Williams? These have chosen to walk away.

We Have Been Here Before: an Update

I wanted to update you on one of the cases I cited recently in reflecting again on care in extremis.

This past Tuesday, Sam Golubchuk died in the Intensive Care Unit of Grace Hospital in Winnipeg, Manitoba. I had cited Mr. Golubchuk’s case because of a difference in goals between his family and his physicians. The case gained attention initially when one of his physicians resigned his privileges in the hospital rather than continue to provide care for Mr. Golubchuk that the physician considered futile and unethical. Since that resignation, two other physicians also resigned their privileges for the same reason. While the hospital was able to work with other physicians to keep the ICU unit open, there was concern that more resignations by physicians, or resignations by nurses, might force closure of the unit, and disrupt care for all ICU patients, including Mr. Golubchuk.

In the end, it did not come to that. Mr. Golubchuk died while still receiving therapeutic care. (I have come to call that a celestial discharge.)

This satisfied his family. They felt Mr. Golubchuk’s Orthodox Jewish faith required continued therapeutic care unless and until he died. They went to court, and were successful in getting an injunction so as to continue care until the court could review the case. His death has made the legal issue moot.

However, it hasn’t made the ethical issues moot. Again, what are appropriate goals when best medical advice is that further care is futile? What in such cases are the limits of the autonomy of the patient, exercised by the patient’s surrogates? What are the limits of the autonomy of the professionals? How should a patient’s religious values be respected? What are the rights of other patients who might be affected by these decisions?

Mr. Golubchuk rests with his ancestors. His family feels they have fulfilled the requirements of his and his family’s faith. This is well and good. On the other hand, we in health care can’t yet rest. We still have a lot of thinking and conversing to do to determine how we might act in similar cases in the future.

More Good Listening for Chaplains

I’ve been listening to the radio again, and I’ve heard something that I think worth sharing.

I was listening to Fresh Air with Terry Gross this past Wednesday, June 25; or at least it’s what I had on in the background. In the midst of it, I heard Terry ask her guest, “I think your father was an Episcopal minister, wasn’t he?” With that, I started to pay more attention. I determined it was worth hearing again – something pretty easy if you have enough NPR stations in your “Favorites” or “Bookmarks” folder – and when I listened again, I thought it worth sharing here.

Jill Bolte Taylor, a Ph.D. neuroanatomist, has spent her career in researching brain functioning. In 1996 she became her own subject when she experienced a bleed affecting the left hemisphere of her brain. In her new book, My Stroke of Insight, she has described her experience of her stroke and her rehabilitation.

While I am sure the book will be worth reading, the interview itself is worth the time to listen, especially for chaplains. Let me share some of her statements that struck me as particularly interesting.

She spoke, for example, of her experience of those who visited her, and especially of those whose visits she felt helpful.

We’re in a society where, [if] someone is ill, we want to go visit them. There were two types of people in the world. There were people who brought me energy and people who took energy away from me…. If someone came in, they came in for maybe five minutes, they brought me love, there was no drama trauma, there was no “O woe is Jill.” There was only, ‘Oh, you are Jill, you’re going to be okay’…. There was only positive energy.

We wrestle in the profession, and especially in clinical training, with the question of what makes a “good visit.” We are to some extent trained that we haven’t done our job if we haven’t really dug into issues. For this patient that was not the case.

Dr. Taylor was asked by Terry whether she felt any “religious connection to what you’ve experienced?”

I do think my experience of that right-hemisphere bliss is what other populations would describe as a spiritual experience; and I think we’re wired to have spirituality. I think that’s why so many of us have an experience of spirituality. To me, religion is the story that different people tell themselves; because, you know, ultimately, whether your Christian-based or your Buddhist-based or whatever your choice of religion is, there’s a story that you tell yourself that gets you, allows you to quite your mind, whether it’s through mantra or prayer, to quite that left hemisphere language center in order for you to be able to feel that you are in relationship with something that is greater than you are as a single individual. So, I do think all religions are the left hemisphere story that helps us get into the right hemisphere experience.

As we seek to provide support at the bedside, I think chaplains do indeed value the patient’s faith story. We seek some commonality, something basically human, among the varying faith stories we hear. Dr. Taylor provides us her perspective on that.

A part of Dr. Taylor’s story, and no small part of her interest in the brain, is her brother’s experience of schizophrenia. In the interview Dr. Taylor spoke of what she had learned as a patient that is relevant to understanding mental illness.

I do think that I have a better understanding about how someone’s perception of reality can be so different from mine. You know, before it’s “You know, you walk like me and you talk like me, you’ve got to think like me,’ but I’ve really discovered that that is not true. The other insight that I’ve been given is how our society treats someone who is not totally cognitively connected to their reality; and it can be very hurtful. It can be a discriminating painfulness that makes somebody want to withdraw.

Asked what questions she had heard from families of other victims of stroke, she returned to her own experience as a patient.

You know, I think it’s really important that those of us who have left hemispheres, who would project drama and trauma onto the experience of stroke, we project our own fears onto the experience that this person is having; and that person may not be having as terrible a time as we’re projecting onto them. I think it’s very important that we love them, we come to them with love and celebration and gratitude for what they still have, and we focus on the ability instead of the disability, so they can feel that love and they don’t feel that they are less than, or viewed as less than they used to be before. So, to me it’s kind of approaching it with more of an open heart and an open mind, and being very cautious of what of our own fears are we projecting onto that person, when that may not be their reality.

That sense of projection is certainly an issue for chaplains, and for all in health care. Family and friends aren’t the only ones who project their own fears on the patient. We, too, are all too prone to do that. We need to be attentive to the patient as he or she is, and to base our care on what the patient experiences instead of what we fear experiencing.

And what about those whose experience of stroke is significantly different from hers? She recognizes that many do have a different experience, one that does not include the euphoria she herself experienced.

I’ve had individuals who have told me, “You know, I struggle now. I used to be very prayerful, and now I can’t find that big picture, I can’t find that experience that there is something greater than I am. And to these individuals I come right back to the most important message of my whole journey is our human brain is resilient. It is designed to heal itself. I firmly believe it. And you can try to reteach new cells in order to feel that again, and in order to create new function where you have had cells that have been lost.

In clinical chaplaincy we have long seen our work beginning with “exegeting the living human document.” We practice it in our verbatims, and many programs have supplemented that with interviews with patients. We learned that phrase, and see our profession founded, by Anton Boisen, whose autobiography Out of the Depths describes his own recovery from mental illness. Like Boisen, Dr. Taylor has analyzed her own experience as a “living human document.” She has shared with us something of her experience as a patient. I’m sure many will appreciate her book. In the meantime, I think this interview is well worth a listen.

Clean, not Unclean

Long ago in a hospital far, far away....

It was 1989. I was preparing to enter a hospital room, to support and care for the family of a young man who had died. The parents were at the bedside, focused on their child. The nurse stopped me at the door, clearly agitated. “Be careful not to touch him,” she said. “He has AIDS.”

I knew what he had, of course - would have known as soon as I saw him even if no one had told me. The purple lesions of Kaposi’s sarcoma were clear and plentiful on his skin. I touched both parents to comfort them; and then I placed my bare hand on the young man’s forehead to bless him and commend him to God.

I think of that story frequently enough, and regularly under some circumstances. One of those regular times is my annual visit to Employee Health.

The visit itself is simple enough, and simpler than it used to be. It once meant the annual tuberculosis (TB) test, the small, inordinately painful injection just under the surface of skin. Now that annual testing is no longer recommended (new associates are still tested – indeed, tested twice – but the annual test is no longer recommended), it’s a simple questionnaire to be sure I haven’t been exposed to anyone with TB, whether by patient contact or foreign travel. And there is, of course, the annual “fit test.”

Or at least there is for most people. For most people there is a check to see that an appropriate mask will fit securely over nose and mouth and around the chin, again to protect against TB and other illnesses, like flu, that can spread by spraying droplets from coughing or sneezing. For me, the Employee Health nurse and I simply laugh. Why? Take a look at my picture. The beard prevents any form-fitting mask from sealing completely. I have been tested at times over the past twenty years or so, and the results have always been the same. “Can you smell the test sample?” Yes, of course. Yes, always. I don’t even have that sensitive a sense of smell, but I always smell the test sample. So, there’s no point in the annual review in me actually putting on the mask to see.

There is an alternative. Every few years they come up with an improved sort of mask, and for a while each is suggested as the appropriate choice for someone like me. Now the appropriate choice is, in its way, the definitive answer. It’s a device with a full hood. The hood is attached to a pump and a filter to provide air. The pump and filter fit on a belt, and are about the size of, if a little heavier than, a fanny pack. I had to participate in a class to learn to use the thing. The full hood and the filter should protect me from about anything that might be floating in the air around me and a patient.

And this is where I come back to the story of the patient so long ago, the young man who died of AIDS. By the time I walked into that room we had been living with AIDS as a society for nine years or so. I knew the history and the acronyms that had changed with each new piece of information: “the Haitian disease” and “GRID” and AIDS and HIV. I also knew how difficult it actually was to transmit, and the importance of good hand washing – something, sadly, the nurse in question had apparently forgotten.

I had also heard over those early years the sad stories of how fear had separated those living with AIDS from those who cared for them. “Will no one touch me? Why won’t they touch me?” I never wanted a patient to feel I wouldn’t touch, unless there were real risks. More to the point, I never wanted a patient to fear that since I might not want to touch it meant God did not want to touch. I continue to feel that concern; and so, while I wash my hands frequently and use alcohol-based sanitizer even more, I tend to do it as I leave the room, after I’ve touched the patient, and not before, as I enter. I do it before, certainly; but before I enter the room, outside the patient’s presence.

What, then, should I do about that hood? Notwithstanding my joke over the years about my beard as my own organic air filter, I know that a mask intended to fit only from nose to chin will never provide a complete seal or complete protection. On the other hand, being smaller and used more commonly by others caring for the patient, I think it separates me from the patient much less than what looks for all intents and purposes like part of a hazmat suit. Will the patient notice? Perhaps not; but it seems to me a mask suggests I know the person is ill, while the power-assisted hood suggests I think the patient is non-human.

So, so far I use the standard masks, knowing they’re not perfect. I wash my hands, and even gown and glove if necessary; because if I convey the wrong contaminant into or out of the room I put at risk more people than just me. But I do my best to set as few barriers between me and the patient as are necessary for safety and dignity. It might not be a concern of any given patient; but I don’t want a patient to think I won’t touch because I am afraid. And I don’t want a patient to think that I won’t touch because I think God won’t touch.