Should Hospital Chaplains Challenge Spiritual Beliefs?

The challenges of chaplaincy are no secret. The stressful interactions. The unknown family systems that fill every room. The 2 A.M. phone calls. But one of chaplaincy’s greatest challenges is managing interfaith engagement in stressful settings. Though we often think of interfaith dialogue as something that occurs on university campuses or community centers, the hospital room can also be a site of critical engagement and impetus for growth.

The challenges of interfaith engagement in medical settings are many as well. Unlike formal meetings to promote dialogue, no one is at the hospital for interfaith engagement. Everyone is there for another reason. Patients, families, and even chaplains are usually in a position of stress or emotional vulnerability.  It is a moment when faith is no longer defined on the basis of “if”, but “now that…” While medical chaplaincy is fraught with opportunity for misunderstanding, it can also be a great opportunity for interfaith engagement and mutual transformation. Any chaplain will have a story about engaging with someone of a different background and finding enough common ground to care for one another.

But there may also be times when interfaith engagement is problematic. In these cases, is there ever a time when the chaplain has a responsibility to change someone’s theological views or personal beliefs? Most of us would probably claim that someone engaging in interfaith dialogue should never try to change others’ beliefs, but does this hold true in medical settings as well? I’ve had personal occasion where I did feel like I had an ethical responsibility to challenge someone’s spiritual beliefs, but the incident left me uneasy and questioning my proper role as a chaplain. I don’t have a clear answer to this question, but below are some ideas that might help start the conversation.

What’s a “dangerous” theology? – I have asked this question to many people in the field and most of them have said that the chaplain should not attempt to change someone’s theology unless the patient or family member holds a “dangerous” theology. A dangerous theology, for example, might include refusing morphine out of a belief that suffering brings people closer to God. A dangerous theology is one that may cause someone physical harm. But can chaplains ever truly discern which theologies are dangerous and which are not? If we say “yes”, is there any metric on which to make this distinction? Is physical harm an acceptable standard? If we say “no”, might chaplains be making the suffering of the patient worse, compounding physical pain with theological anguish?

Advocacy, and the “sick role” – Hospital chaplaincy almost always occurs in the context of a complicated family system. Stresses that appear in relationships in normal times are stressed even more in times of medical uncertainty. The role of the chaplain, then, is not only to provide spiritual care for all parties, but to help everyone find their role in this new family environment. As scholars like Sharon Kaufman and Rachel Stanworth have shown, ensuring the patient’s wishes are respected is a complicated issue, especially if those wishes go against those of the family. Since patients’ wishes are often subjugated to those of the family for a myriad of factors, the chaplain may have a responsibility to advocate for the wishes of the patient. This may mean challenging the theological views of family members who are overriding the wishes of the patient.

The Chaplain as Guest – Unlike doctors, nurses, and other medical staff, chaplains can only work with patients and families at their request. In an environment where patients often experience a lack of agency and control, deciding whether or not to see a chaplain is one of the only choices patients have over who enters their space. For some patients, the ability to send a chaplain away is actually an empowering act. But if chaplains are only there at the behest of the patient, should they be able to challenge the patient’s views? Having been privileged with an invitation into someone’s experience, is it wrong to challenge their spiritual beliefs?

Medical chaplains face a unique challenge of doing pastoral care while navigating family systems, interfaith engagement, and the medicalization of death, just to name a few. Keeping these forces and systems in balance is a momentous task, for which chaplains deserve the utmost respect. On the question of whether or not chaplains should challenge patients’ theological views, I am torn. Religious beliefs that embrace suffering as a way to please God are problematic and a patient may need someone to advocate for her own religious beliefs. Yet the idea of a chaplain trying to change someone’s beliefs seems to sabotage the interfaith engagement that can make chaplaincy such a transformative experience for both parties. What is the relationship between caring for and challenging in the hospital room?