Wendy Cadge

Religious Service Attendance Among Immigrants Evidence From the New Immigrant Survey-Pilot

A growing body of research by scholars of religion and immigration analyzes the religious organizations started by post-1965 immigrants to the United States. Little research, however, focuses on patterns in religious service attendance. The authors use pilot data from the New Immigrant Survey, a nationally representative sample of new legal immigrants to the United States, to systematically consider, for the first time, how demographic, familial, employment, household language, and migration factors influence regular religious service attendance for new immigrants from different religious traditions. Findings lend some support to the theory that immigrants who are less integrated into American society are more likely than others to regularly attend religious services. These preliminary conclusions generate broader hypotheses and potential theories about ways in which the norms of different religious traditions, the availability of religious centers, and the extent of immigrants’ ties to their ethnic communities influence their regular religious service attendance.

The provision of hospital chaplaincy in the United States: A national overview

Over the past 25 years, the Joint Commission for the Accreditation of Healthcare Organizations has changed its guidelines regarding religious/spiritual care of hospitalized patients to increase attention concerning this aspect of hospital-based care. Little empirical evidence assesses the extent to which hospitals relied on hospital chaplains as care providers during these years. This study investigates (1) the extent of chaplaincy service availability in US hospitals between 1980 and 2003; (2) the predictors of having chaplaincy services in 1993 and 2003; and (3) the change in the magnitude of these predictors between years. This study examines the presence or absence of chaplaincy or pastoral care services in hospitals using the American Hospital Association Annual Survey of Hospitals (ranging from 4,946–6,353 hospitals) in 1980–1985, 1992–1993, and 2002–2003. Between 54% and 64% of hospitals had chaplaincy services between 1980 and 2003, with no systematic trend over this period. In 1993 and 2003, hospital size, location, and church affiliation were central factors influencing the presence of chaplaincy services. Smaller hospitals and those in rural areas were less likely to have chaplaincy services. Church-operated hospitals were much more likely to have chaplaincy services; but between 1993 and 2003, church-operated hospitals were more likely to drop chaplaincy services than to add them. Not-for-profit hospitals were more likely than investor-owned hospitals to add chaplaincy services. Changes to Joint Commission for the Accreditation of Healthcare Organizations policies about the religious/spiritual care of hospitalized patients between 1980 and 2003 seem to have had no discernible effect on the fraction of US hospitals that had chaplaincy services. Rather, characteristics of hospitals, their surroundings, and their religious affiliations influenced whether they provided chaplaincy services to patients.

Talking about Homosexuality: The Views of Mainline Protestant Clergy

Homosexuality is one of the most divisive issues within mainline Protestantism today. In this article we portray the many sides of mainline Protestantism’s debates about homosexuality through the lens of statements clergy made about the issue in early 2000. In interviews with 62 mainline Protestant clergy across the United States, 40 volunteered their views on homosexuality without being prompted. We describe the frames through which clergy understand and articulate issues related to homosexuality in the midst of contentious denominational debate about the subject. The majority of clergy who discussed homosexuality focused on the issue in their churches instead of in society at large, and in their denominations rather than in their own congregations. Moreover, virtually none of the clergy interviewed took hard and fast stands on the issue of homosexuality. Most approach the issue in a pragmatic, rather than prophetic, way. Our interviews also show that pastors who choose to speak on homosexuality tend to frame the issue in terms of the diffuse notion of “homosexuality,” rather than talking about gay men and lesbians as people.

Early factors leading to college graduation for Asians and non-Asians in the United States

This article explores factors that lead Asian Americans, both as a group and as subgroups, to obtain a college degree in comparison to members of other racial/ethnic groups in the United States. Using data from the 2000 wave of the National Education Longitudinal Study, we find that the effects of race on educational attainment virtually disappear once individual and family factors are controlled. However, there is significant heterogeneity in college attainment among Asian Americans. In addition, we find that the effects of socioeconomic status, parental expectations, eighth-grade grade point average, and family structure are generally weaker for Asian Americans relative to non-Asians while parental immigrant status and standardized test scores are stronger. Asians appear to be “protected” from many of the usual factors that negatively affect educational outcomes while receiving an enhanced benefit from being of an immigrant family.

The Spiritual and Religious Identities, Beliefs, and Practices of Academic Pediatricians in the United States

Purpose Physicians’ spiritual and religious identities, beliefs, and practices are beginning to be explored. The objective of this study was to gather descriptive information about personal religion and spirituality from a random sample of academic American pediatricians and to compare this information with similar data from the public. Method In 2005, a Web-based survey of a random sample of 208 pediatrician faculty from 13 academic centers ranked by the US News & World Report as “honor roll” hospitals was conducted. Surveys elicited information about personal beliefs and practices as well as their influence on decisions about patient care and clinical practice. Multiple questions were replicated from the General Social Survey to enable comparisons with the public. Descriptive statistics were generated, and logistic regression analyses were conducted on relevant variables. Results Nearly 88% of respondents were raised in a religious tradition, but just 67.2% claimed current religious identification. More than half (52.6%) reported praying privately; additional spiritual practices reported included relaxation techniques (38.8%), meditation (29.3%), sacred readings (26.7%), and yoga (19%). The majority of academic pediatricians (58.6%) believed that personal spiritual or religious beliefs influenced their interactions with patients/colleagues. These odds increased 5.1-fold when academic pediatricians attended religious services monthly or more (P < .05). Conclusions Compared with the American public, a notably smaller proportion of academic pediatricians reported a personal religious identity. The majority believed spiritual and religious beliefs influenced their practice of pediatrics. Whether secular or faith-based belief systems measurably modify academic pediatric practice is unknown.

The religious and spiritual beliefs and practices of academic pediatric oncologists in the United States.

Objectives Religion and spirituality are increasingly recognized as important in the care of seriously ill patients. This study evaluates religious and spiritual beliefs and practices among pediatric oncology faculty and compares their religiosity and spirituality to the general public. Methods Information was gathered from a sampling frame of all pediatric oncology faculty working in 13 US News and World Reports “honor role” hospitals. These data were compared with the general public (using the General Social Survey), through frequency distributions, descriptive crosstabs, and tests of significance, including χ2 statistics. Results Eighty-five percent of pediatric oncology faculty described themselves as spiritual. In all, 24.3% reported attending religious services 2 to 3 times a month or more in the past year. Twenty-seven percent of pediatric oncologists believed in God with no doubts. In all, 52.7% believed their spiritual or religious beliefs influence interactions with patients and colleagues. Among the general public 40.1% reported attending religious services 2 to 3 times a month or more in the past year (P<0.01) and 60.4% believed in God with no doubts (P<0.001). Conclusions Although many have no traditional religious identity, large fractions of pediatric oncology faculty described themselves as spiritual. This may have implications for the education of pediatric oncologists and the spiritual care of seriously ill children and their families.

Gendered Religious Organizations The Case of Theravada Buddhism in America

This article examines how organizational context shapes the way gender is socially constructed in two non-Judeo-Christian religious organizations in the United States, one Theravada Buddhist organization founded by immigrants and one started by converts. People at the two organizations disagree with each other about what Theravada Buddhism teaches about women in teaching and leadership positions but agree that outside of these positions, women and men are equally able to gain access to and practice the tradition. Despite these understandings, women and men have distinct gender roles and responsibilities at each organization that are in tension with what the leaders and attendees understand the tradition to teach. The extent to which teachers and attendees recognize these tensions and the ways they respond to them are explored, and their implications for each organization and for studies of gender and religious organizations are discussed.

After the DNR: Surrogates Who Persist in Requesting Cardiopulmonary Resuscitation

Some health care organizations allow physicians to withhold cardiopulmonary resuscitation from a patient, despite patient or surrogate requests that it be provided, when they believe it will be more harmful than beneficial. Such cases usually involve patients with terminal diagnoses whose medical teams argue that aggressive treatments are medically inappropriate or likely to be harmful. Although there is state-to-state variability and a considerable judicial gray area about the conditions and mechanisms for refusals to perform CPR, medical teams typically follow a set of clearly defined procedures for these decisions. The procedures are based on the principle of nonmaleficence and typically include consultation with hospital ethics committees, reflecting the guidelines of relevant professional associations. Ethical debates about when CPR can and should be limited tend to rely more on discussions of theory, principles, and case studies than systematic empirical study of the situations in which such limitations are applied. Sociologists of bioethics call for empirical study, arguing that what ethicists and health professionals believe they are doing when they draft policies or invoke principles does not always mirror what is happening on the ground. In this article, we begin the task of modeling the empirical analyses sociologists call for, focusing on a cohort at Massachusetts General Hospital. We inductively analyzed ethics committee notes and medical records of nineteen patients whose surrogates did not accept the decision to withhold CPR.

Experience with a hospital policy on not offering cardiopulmonary resuscitation when believed more harmful than beneficial

PURPOSE This study investigated the impact of age, race, and functional status on decisions not to offer cardiopulmonary resuscitation (CPR) despite patient or surrogate requests that CPR be performed. METHODS This was a retrospective cohort study of all ethics committee consultations between 2007 and 2013 at a large academic hospital with a not offering CPR policy. RESULTS There were 134 cases of disagreement over whether to provide CPR. In 45 cases (33.6%), the patient or surrogate agreed to a do-not-resuscitate (DNR) order after initial ethics consultation. In 67 (75.3%) of the remaining 89 cases, the ethics committee recommended not offering CPR. In the other 22 (24.7%) cases, the ethics committee recommended offering CPR. There was no significant relationship between age, race, or functional status and the recommendation not to offer CPR. Patients who were not offered CPR were more likely to be critically ill (61.2% vs 18.2%, P < .001). The 90-day mortality rate among patients who were not offered CPR was 90.2%. CONCLUSIONS There was no association between age, race, or functional status and the decision not to offer CPR made in consultation with an ethics committee. Orders to withhold CPR were more common among critically ill patients.

Making Sense of Suffering and Death: How Health Care Providers' Construct Meanings in a Neonatal Intensive Care Unit*

ABSTRACTBiomedical technology has progressed at a pace that has created a new set of patient care dilemmas. Health care providers in intensive care units where life-sustaining therapies are both initiated and withdrawn encounter clinical scenarios that raise new existential, theological, and moral questions. We hypothesized that there might be broad patterns in how such staff understand these questions and make sense and meaning from their work. Such meaning making might be the key to working with the critically ill and dying while helping to create and sustain a meaningful context for personal living. This article presents themes evident in an in depth analysis of open-text responses to a spiritual and religious questionnaire survey completed by staff in one neonatal intensive care unit. The data reveal the central roles of perceived infant suffering and death in these providers’ work experience and details how they understand the ultimate meaning of the suffering and death. We investigate patterns in how different providers articulate their individual attributes and motivations for working in intensive care. We found a surprising range of religious, spiritual, existential, and other meaning-making systems that underpin how staffs understand their work and how, certain of them, even define their purpose in life as caring for critically ill infants and their families.