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Canwest News Service
An unusually broad coalition of religious and secular leaders has come together to press for the re-instatement of the 12 spiritual care directors who were unceremoniously fired late last year by the Fraser Health Authority.
In the name of providing humanistic support for B.C. patients struggling with grim medical conditions, I hope this multi-spiritual coalition of religious leaders, holistic health advocates and secular politicians succeeds.
While leading-edge medical organizations around the world are providing more spiritual and emotional support for patients — aware of hundreds of studies showing a correlation with greater health — the Fraser Health Authority has turned the opposite direction and wiped out its entire spiritual care team.
The giant Fraser Health Authority, which covers the region from Hope to Burnaby, is behaving as if the spiritual directors are even less important than other health care providers it lamely defines as "non-core."
That is, Fraser Health has also unwisely trimmed social workers and psychological counsellors, but not to the same extent as its entirely eradicated spiritual care staff.
Fraser Health CEO Nigel Murray's decision to suddenly fire the spiritual care team was "radical," "unprecedented" and "horrendous," Philip Crowell, director of spiritual care at Vancouver's Children's and Women's Health Centre, said in an interview his week.
Crowell is one of the roughly 45 spiritual care directors who remain on the job in B.C.'s five other health regions.
Crowell has a PhD in ethics and spirituality. He teaches University of B.C. medical students about the social, moral and psychological implications of working with patients. In a moment I'll explain what he and his colleagues actually do in hospitals.
I will do so to address the main argument made by those readers who firmly disagreed with my earlier column on this subject, which defended spiritual directors as a necessary and probably cost-effective form of health care.
The strongest complaint of the supporters of Murray's decision to reduce his $2.48 billion budget by cutting the spiritual care directors, also known as chaplains, was that governments should never provide financial support to anything smacking of religion.
They maintained the separation of religion and state should be absolute.
However, I'm concerned that many people in B.C., where two in three don't regularly attend a religious institution, fail to appreciate why so many public hospitals in the rest of "secular" North America and Europe still pay for spiritual directors.
Government funding of spiritual care directors occurs widely in many strongly "secular" and politically "progressive" countries, including the Netherlands, Germany and particularly Scotland, which Crowell holds up as a model.
But since Canadians often hear the U.S. mantra about how "church and state" should be strictly and legally separate at all times, we sometimes forget that we actually blend state and religion quite a bit in this country.
For instance, six Canadian provinces, including B.C., fund religious schools to various degrees. And many levels of Canadian government provide major financial grants to numerous non-profit religious groups to build social housing, run food banks and assist the homeless.
In other words, taxpayer-funded chaplains are not exactly an anomaly in this country.
But what do spiritual care directors like Crowell actually do in hospitals (not to mention in Canadian prisons and in the military)?
Such government-backed spiritual care directors, particularly those in eclectic B.C., are trained to provide what Crowell called "multifaith" support for patients.
They are strictly forbidden from proselytizing.
As Crowell said, these chaplains try to meet the spiritual and emotional needs of the patient as the patient presents them, regardless of the patients' religion or lack of it.
Interestingly enough, Crowell says the most common thing that patients who ask to speak to him in Vancouver first tell him is: "I'm not religious, but I'm spiritual."
Though they yearn to talk about transcendent meaning, they rarely ask Crowell about his denominational status, which happens to be Presbyterian. Chaplains come from a wide range of spiritual paths. Many are not ordained clergy, but have simply obtained masters' degrees combining psychology and religion.
Crowell believes a spiritual director's job is mainly to listen to patients, including by helping them grieve, enhance often-troubled relationships and make agonizingly important decisions.
Even though in this way spiritual care directors operate somewhat like professional secular counsellors, there is a key difference.
They have a sophisticated university-based understanding of multiple spiritual perspectives, and many understand the issues that go into individuals making ethical decisions in a complex medical world.
Patients speak to spiritual directors about often-harrowing existential issues, Crowell said. They might involve dealing with a severely damaged fetus, whether to go ahead with surgery that might leave them in a wheelchair or how to make decisions around the end of their own lives or those of their family.
Despite the humanistic perspective that spiritual care directors bring to health care, some secular critics still insist that Canadian governments should leave it solely up to churches, synagogues, mosques and temples to fund their own chaplains.
But many religious denominations can't afford to do so — except perhaps the denominations that might abuse the privilege to try to proselytize vulnerable patients.
And anyway, as Crowell noted, many B.C. patients who ask to speak to a spiritual care director aren't actively involved with a specific religion in the first place.
As well, most congregation-based clergy aren't trained in life-and-death situations involving tricky medical options. Congregational clergy have got enough challenges on their crowded plates.
What's more, and it might be surprising to some, Crowell says some patients actually want their own clergy kept away when they are struggling in hospital.
Such patients may, for example, not want their clergy to know they're going to have an abortion or a blood transfusion.
I maintained in my December column that the $650,000 Fraser Health spent in one year on spiritual care services was a pittance compared to the amount it provides its other 22,000 employees, some of whom are much, much more highly paid.
Murray, the CEO of Fraser Health, for instance, makes almost the same amount per year as all the 12 spiritual care directors did combined.
Even beyond the flood of new research suggesting spiritual care can improve the health of patients and reduce hospital stay times — thus saving taxpayers' money — there is an additional argument to be made for not being black-and-white about the need to separate religion and state.
Like many Canadians, I don't want to see our health budgets totally eaten up by only so-called "core" services, the technologically based ones such as acute care, surgery, pharmaceuticals and emergency care.
In a world where depression and chronic anxiety have reached epidemic proportions, we need to defend Canada's history as a nation that is willing, within reason, to invest serious amounts of money into public health, preventive medicine and various forms of counselling.
A truly healthy society, as even the World Health Organization has maintained, is one that cares for the whole person, physically, emotionally — and spiritually.
dtodd@vancouversun.com
Read Douglas Todd's blog at www.vancouversun.com/thesearch
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Thank you for this article. I am a member of the LMH Pastoral Care Advisory Committee, meeting, we hope on Wednesday with V.P.Arden Krystal regarding the situation at LMH. It has come to my attention that not only is there a CEO for Fraser Health, but also a considerable number of V.P.’s (probably 9) of whom 4 are directly related to Clinical Practise. It would be interesting to know how much of the budget these VP’s and their associated support staff claim.
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I have been looking for any reference to the existence of a “separation of Church and State” statute/law/princilpe/common law in Canada.
I believe we need a written statute to this principle, otherwise we “Church-adherents” are only allowed the status quo, that being allowed the Right to practise any religion the Supreme Court tells us to.
Regrads
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I support Fraser Health’s decision not to use public funds to pay pastoral directors. This should have been done a long time ago. Why? Here are two reasons
1) In one of the decided cases by Canada’s Supreme Court, the court explained that the “Charter does not require the state to take positive steps in support of the exercise of the fundamental freedoms provided for in s. 2(a), and …the state must refrain from implementing measures that could favour one religion over another”. [2004 SCR 650, 2004 SCC 48]
2) If these so called pastors are real Christians, they should follow Christ’s example. He did not ask money from the government nor from people whom he healed, fed, and even resurrected!
Hurrah to FHA for right decision
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Dear Friends
We are a committee that support chaplains in Halifax and Saint John Hospitals and have a strong belief of adequately trained Spiritual Care persons being available to patients who need their services. We are very much aware of the pressure on Hospital Budgets and the difficulty of setting priorities. We also believe that Spiritual Care persons who are trained to guide patients and families in their struggle to make informed decisions and live with their consequences is of vital importance. Studies have shown that when persons are present to say “what happens to you makes a difference to us” and helps persons make appropriate decissions that money is saved as a part of the bottom line. To lay off all these persons as a resource in our complicated world is surely short sighted. Thank you for permitting this presentation and thank you for airing this story.
Please continue discussion on the forum: link