Jeffrey Cohen

Religion, Spirituality and Health Care Treatment Decisions: The Role of Chaplains in the Australian Clinical Context

This paper summarizes the views of Australian health care chaplains concerning their role and involvement in patient/family health care treatment decisions. In general terms the findings indicated that the majority of chaplains surveyed believed that it was part of their pastoral role to help patients and their families make decisions about their health care treatment. Differences in involvement of volunteer and staff chaplains, Catholic and Protestant, male and female chaplains are noted, as are the perspectives of chaplaincy informants regarding their role in relation to health care treatment decisions. Some implications of this study with respect to quality patient centered care, chaplaincy utility, and training are noted.

Chaplain–Physician Consultancy: When Chaplains and Doctors Meet in the Clinical Context

This paper summarizes the perspectives of 327 Australian health care chaplains concerning their interaction with physicians within the clinical context. In general terms the findings indicated that nearly 90% of chaplains believed that it was part of their professional role to consult with physicians regarding patient/family issues. Differences of involvement between volunteer and staff chaplains, Catholic and Protestant, male and female chaplains and the type of chaplaincy training are noted, as are the perspectives of chaplaincy informants regarding their role in relation to physicians. Some implications of this study with respect to chaplaincy utility and training are noted.

Organ Procurement and Health Care Chaplaincy in Australia

As part of an Australian national project, quantitative data via a survey were retrospectively obtained from 327 Australian health care chaplains (staff and volunteer chaplains) to initially identify chaplaincy participation in various bioethical issues—including organ procurement. Over a third of surveyed staff chaplains (38%) and almost a fifth of volunteer chaplains (19.2%) indicted that they had, in some way, been involved in organ procurement issues with patients and/or their families. Nearly one-fifth of staff chaplains (19%) and 12% of volunteer chaplains had also assisted clinical staff concerning various organ procurement issues. One hundred of the surveyed chaplains volunteered to an interview. Qualitative data were subsequently coded from 42 of the chaplains who had been involved in organ procurement requests. These data were thematically coded using the World Health Organization ‘Pastoral Intervention Codings’ (WHO-PICs). The qualitative data revealed that through a variety of pastoral interventions a number of chaplains (the majority being staff chaplains) were engaged in the critical and sensitive issues of organ procurement. It is argued that while such involvement can help to ensure a holistic and ethically appropriate practice, it is suggested that chaplains could be better utilized not only in the organ procurement process but also for the training of other chaplains and clinicians.

Health care chaplains and their role on institutional ethics committees : an Australia study.

This paper presents the results of the largest Australian pastoral study concerning the perceptions of health care chaplains about their involvement on hospital research ethics committees (also known in some contexts as institutional ethics committees). Survey results from over 300 Australian health care chaplains indicated that nearly 90% of chaplains believed there was merit in chaplains serving on hospital research ethics committees, yet only a minority (22.7%) had ever participated on such committees. Data from in-depth interviews is also presented exploring the reasons for the lack of participation and the varying opinions regarding the role, appropriateness, and value of chaplains on ethics committees. Some implications of this study with respect to chaplaincy, hospital research ethics committees, health care institutions, ecclesiastical institutions, and government responsibilities are discussed.

Moral Injury: Unseen Wounds in an Age of Barbarism

This very substantial and well-structured anthology, by former Anglican Bishop Tom Frame (Australia), is a collection of essays from Australian military historians, ex-soldiers, ethicists, psychologists and chaplains, who attempt to identify and explain something of the ‘unseen wounds’ or ‘soul wounds’ that may be attributed to ‘moral injury’. Moral injury is gaining increasing societal awareness. This is due to greater recognition that trauma (in its various forms) can cause much deeper inflictions than just biological or even psychological damage— for there may also be wounds affecting the ‘soul’ that are far more difficult to heal, if at all. It is important to note at the outset that no single review could do this book justice; it is a substantial text containing a great deal of controversy and challenge. To assist the reader to comprehend the depth of this book, it is nicely structured into six major sections supposedly reflecting the key disciplines or perspectives relevant to moral injury, namely (1) historical perspectives, (2) personal perspectives, (3) ethical perspectives, (4) psychological perspectives, (5) practical perspectives and lastly, (6) religious perspectives. Each section is further divided into chapters, not all of which seem particularly passionate or focussed upon moral injury per se. Rather each chapter reflects the author’s own idiosyncratic area of expertise, which they have attempted to reshape to consider moral injury. Indeed as revealed in the introduction, the whole purpose of the text seems to be motivated not so much by an investigation into moral injury but rather ‘...the focus of this book is [about] the descent into barbarism that has drawn into its wake mainly young men and women from stable and prosperous Western democracies who have been tasked with preventing anarchy, restoring order and offering hope’ (p. 6). Nevertheless, all of the chapters are invaluable for understanding something about the effects of barbarism—one of which, it can be argued, is moral injury.

Moral Injury: Unseen Wounds in an Age of Barbarism: By Tom Frame. 278 pp. Sydney: NewSouth Publishing, University of New South Wales.

This very substantial and well-structured anthology, by former Anglican Bishop Tom Frame (Australia), is a collection of essays from Australian military historians, ex-soldiers, ethicists, psychologists and chaplains, who attempt to identify and explain something of the ‘unseen wounds’ or ‘soul wounds’ that may be attributed to ‘moral injury’. Moral injury is gaining increasing societal awareness. This is due to greater recognition that trauma (in its various forms) can cause much deeper inflictions than just biological or even psychological damage— for there may also be wounds affecting the ‘soul’ that are far more difficult to heal, if at all. It is important to note at the outset that no single review could do this book justice; it is a substantial text containing a great deal of controversy and challenge. To assist the reader to comprehend the depth of this book, it is nicely structured into six major sections supposedly reflecting the key disciplines or perspectives relevant to moral injury, namely (1) historical perspectives, (2) personal perspectives, (3) ethical perspectives, (4) psychological perspectives, (5) practical perspectives and lastly, (6) religious perspectives. Each section is further divided into chapters, not all of which seem particularly passionate or focussed upon moral injury per se. Rather each chapter reflects the author’s own idiosyncratic area of expertise, which they have attempted to reshape to consider moral injury. Indeed as revealed in the introduction, the whole purpose of the text seems to be motivated not so much by an investigation into moral injury but rather ‘...the focus of this book is [about] the descent into barbarism that has drawn into its wake mainly young men and women from stable and prosperous Western democracies who have been tasked with preventing anarchy, restoring order and offering hope’ (p. 6). Nevertheless, all of the chapters are invaluable for understanding something about the effects of barbarism—one of which, it can be argued, is moral injury.

33.95, ISBN 9781742234656 (paperback)

This very substantial and well-structured anthology, by former Anglican Bishop Tom Frame (Australia), is a collection of essays from Australian military historians, ex-soldiers, ethicists, psychologists and chaplains, who attempt to identify and explain something of the ‘unseen wounds’ or ‘soul wounds’ that may be attributed to ‘moral injury’. Moral injury is gaining increasing societal awareness. This is due to greater recognition that trauma (in its various forms) can cause much deeper inflictions than just biological or even psychological damage— for there may also be wounds affecting the ‘soul’ that are far more difficult to heal, if at all. It is important to note at the outset that no single review could do this book justice; it is a substantial text containing a great deal of controversy and challenge. To assist the reader to comprehend the depth of this book, it is nicely structured into six major sections supposedly reflecting the key disciplines or perspectives relevant to moral injury, namely (1) historical perspectives, (2) personal perspectives, (3) ethical perspectives, (4) psychological perspectives, (5) practical perspectives and lastly, (6) religious perspectives. Each section is further divided into chapters, not all of which seem particularly passionate or focussed upon moral injury per se. Rather each chapter reflects the author’s own idiosyncratic area of expertise, which they have attempted to reshape to consider moral injury. Indeed as revealed in the introduction, the whole purpose of the text seems to be motivated not so much by an investigation into moral injury but rather ‘...the focus of this book is [about] the descent into barbarism that has drawn into its wake mainly young men and women from stable and prosperous Western democracies who have been tasked with preventing anarchy, restoring order and offering hope’ (p. 6). Nevertheless, all of the chapters are invaluable for understanding something about the effects of barbarism—one of which, it can be argued, is moral injury.