The current manner of practicing chaplaincy in health care is one which prizes the multi-faith chaplain. When one asks multi-faith chaplain, “To whom are you beholden?” they will respond, “The patient.” This is evident in the way that chaplaincy is currently practiced and taught, which prizes the use of psychology over recourse to theology. Chaplaincy’s recourse to practices whose aims are directed toward the efficient rather than the eternal challenges its original telos. This paper looks at this question by blending (...) a Catholic and Engelhardtian approach to conclude that chaplains should recognize that they are beholden to God, rather than to patients’ autonomy. (shrink)

In this issue of Christian Bioethics, we invite chaplains and theologians to examine the role of the hospital chaplain in the contemporary institutional setting of the hospital. The simplicity of the chaplain’s role is often taken for granted; yet, this role is actually multivalent, with duties and loyalties pulling from many different sides. Chaplains are people of faith, ordained and/or endorsed ministers, and pastoral care professionals; they are at once beholden to God, to their own faith expression, and to their (...) sense of vocation, to the hospital, and to the patient. With various loyalties and responsibilities in mind, we must ask the question, “To whom is the chaplain beholden?” The responses in this issue critically and constructively examine this question, providing theological resources that call chaplaincy away from the dominant modes of medicine. Whether through a primary loyalty to their calling, to God, to Divine presence, or to the spiritual formation of the patient, the authors in this special issue aim to help chaplains find theological resources to faithfully withstand the tensions they face in modern medical institutions. (shrink)

The essays in this issue of JMP are devoted to critical engagement of my book, The Anticipatory Corpse. The essays, for the most part, accept the main thrust of my critique of medicine. The main thrust of the criticism is whether the scope of the critique is too totalizing, and whether the proposed remedy is sufficient. I greatly appreciate these interventions because they allow me this occasion to respond and clarify, and to even further extend the argument of my book. (...) In this response essay, I maintain that the regnant social imaginary of medicine is the regnant social imaginary of our time. It is grounded in a specific ontotheology: where ontology is a power ontology; where material is malleable to the open-ended organization of power and dependent only on working out the efficient mechanisms of its enactment; where ethically it is oriented only to the immanent telos of utility maximization in the short run, and ultimately to some posthuman future in the long run. This ontotheology originates in the anticipatory corpse and is ordered toward some god-like posthuman being. The entire ontotheology finds enactment through the political economy of neoliberalism. This social imaginary constantly works to insulate itself from other social imaginaries through the use of its institutional power, through marginalization, circumscription, or absorption. The modern social imaginary of neoliberal societies marginalizes and politically isolates other social imaginaries, or transforms them into something acceptable to the neoliberal imaginary. Yet, these other social imaginaries could influence the larger social imaginary in novel ways, sometimes through withdrawal and sometimes through challenges. These other practices—again, usually practices ordered according to different ontological and teleological purposes—might serve as a source of renewal and transformation, but only if the practitioners of these other social imaginaries understand the ontotheological powers that they are up against. (shrink)

The roots of much of Western medicine lie in the Christian monastic tradition and its commitment to nonstigmatizing compassionate care throughout the life cycle and to the ideal of empathic personal connection between physicians, patients, and the communities and relationships in which both of these are embedded. In the modern West, these Christianly informed aspects of medicine are increasingly being undercut as medical care becomes ever more specialized, technologized, and depersonalized. At the same time, there exist a variety of efforts (...) to counter these tendencies and to foster a practice of medicine that is more sensitive to the personal, relational, familial, and narrative dimensions of health, illness, and medical care. There are, in particular, considerable numbers of physicians, psychologists, and psychotherapists working at the intersections of biomedical and psychosocial care, of care for individuals and care for families, and of the body and the mind. Given the natural affinity that Christian bioethicists might be expected to have to communitarian, narrative, and family-oriented approaches to health care, it is thus remarkable that there appears to be no work of Christian bioethics that interacts in any discernible way with this psychotherapeutic literature concerning health, illness, families, and the mind-body interface. Instead, Christian bioethicists appear to endorse a narrowly reductionistic biomedical view of health and illness while either ignoring the psychosocial, integrative, and collaborative literature, or actively blaming and shaming those pastors or lay Christians who might have anything to do with psychotherapy or psychosocial care. This is unbecoming and unhelpful. In the fragmented, complex, and potentially dehumanizing world that is modern medical care, those who would think Christianly about the care of the sick cannot afford to despise psychology and psychosocial care. On the contrary, the church needs psychotherapy. In this article, I will thus consider, first, what the state of the conversation is where Christian bioethics and psychosocial and psychotherapeutic care are concerned. I will then turn to some of the principal landmarks in the professional literature concerning psychotherapeutic work with the sick, the disabled, the dying, and the bereaved, particularly as these are considered in contexts that include families and lay and professional caregivers. I will then identify a few opportunities for practical and theological reflection that present themselves in this literature, and will conclude with a few comments on the substance and relationship of salvation and health. (shrink)

In The Sublime Object of Ideology, Slavoj Žižek tells a story about Buddhist prayer wheels in Tibet as a model of secularization: a belief machine. When routine actions are being performed, the animating principles or belief are no longer foregrounded in the process. While the developers of the scientific method were mostly devout Christians and believed in God’s direct involvement in the affairs of earth, carefully repeating situations through controlled experiments convinced them any potential variance in the processes they investigated (...) could be ignored. Applied generally, through the process of secularization, religious acts are automated so that people can go about their business without requiring constant awareness of God’s presence. While the foundations of science and innovations in healthcare have many connections with religion, the professionalization of medicine acts as a superstructure supporting the belief. A Christian hospital today is like a prayer flag in the wind: operating automatically through set policies but actualizing theology through its repetition of care. (shrink)

Engelhardt’s critiques of “generic chaplaincy” rely on the argument that chaplains are secular; however, professionally certified chaplains must maintain ordination with an ecclesial body. Engelhardt’s concerns are better directed at the academic subfield that supports and trains chaplains: pastoral theology. That field is somewhat guilty of forced ecumenism because it attempts a universal theology rooted in experience and the social sciences rather than the authority of creeds, ecclesial bodies, or traditions. Pastoral theology makes too many sacrifices to the authority of (...) the behavioral sciences without sufficient appreciation for sacramental theology and the spiritual bonds that rituals effect in communities of shared belief. In this model, ritual is reduced to its instrumental value in addressing the emotional needs of patients rather than viewed as efficacious spiritual care. Chaplains should take a holistic approach to theology so that they can better identify the duties and scope of interfaith spiritual care. (shrink)

Hospital chaplaincy, in its exposure to clients, colleagues, and care-takers from different faith backgrounds, can be understood in either generic or catholic terms. The first understanding, often merely implicit in denominationalist approaches, assumes that some “Absolute” can be prayerfully invoked through the medium of diverse rituals, confessions, and symbols. This position combines the advantage of unprejudiced acceptance of other creeds and traditions with the disadvantage of lacking resources for discriminating among the spiritualities that may be operative within those other creeds (...) and traditions. Catholicism, in linking true spirituality with the one true church as the mystical body of the Tri-une God, secures such a criterion but fails to satisfy the tolerance-of-acknowledgement in the secular sense, which is canonical in contemporary ecumenism. The Orthodox understanding of Catholicism is portrayed as imposing a non-judgemental humility and repentance which provides a solution to that spiritual-human dilemma of inter-faith cooperation in the hospital. (shrink)