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Pastoral Care Practicum Paper # 2: On Hospital Ministry & Chaplaincy.

Updated: Jan 11

This book report will explore the world of the Chaplain. I will look at how a Chaplain stands between the paradoxical world of hope and reality. I will also study how the Chaplain relates, with pastoral aspirations, to the medical paradigm. I will show how the two professions have worked together.


This book review will also explore the role of the Chaplain in today's Hospital. How the Chaplain can be a Prophet for the patient and an educator to the hospital within a Team Ministry concept. I will conclude with Lawrence E. Holst's vision of the future role of Chaplaincy. A Chaplaincy that will adapt quickly to changing times, as well as continuing to be accepted caregiving participants.


A Ministry Of Paradox In A Place Of Paradox:

Hope And Reality

There are paradoxes that are confronted within a hospital. These are the paradoxes of life: Suffering people's infinite aspirations running smack up against their finite boundaries. The paradox is as simple and complex as that. It is a timeless struggle, true to all peoples, for all generations and no less true for the Chaplain; in or out of the hospital.


Hospitals do not create these paradoxes and mysteries; they simply focus on them. Suffering shatters the illusions that we are infinite, without limits. In that regard, suffering can be moment of truth for the sufferer. When they are confronted with the reality of their situation. It is both the hospital Chaplain's privilege and responsibility to share in that rich moment of truth.

The Reality Of The Hospital Chaplain:

Between Two Worlds

The Chaplain walks between two powerful and  influential worlds. They are religion and medicine. The Chaplain identifies with both worlds; yet does not feel entirely at home in either. They must find there way through as best as possible ministering as they go along.


Chaplains are a mystery to both worlds. Medicine considers then not "medical enough" and quite often questions their very purpose and identity. But the fact is that despite the tensions and enigmas, the Hospital Chaplain is very much committed to both worlds and is a vital bond between them.


As Hospital Chaplaincy has grown in numbers and influence in the sixties, seventies and early eighties that Religion and Medicine  now find themselves in more serious engagement than at anytime in the twentieth century. Though it might seem contradictory, the Hospital Chaplain is also a reminder that the Worlds of Religion and Medicine are and must remain distinct from one another. For while thoese two Worlds need engagement with, they also need separation from one another; if both are to preserve their distinct and vital missions. So it can be expected and hoped that the hospital chaplain will always walk in two worlds.

Change In Perceived Needs:

The Chaplain Today

Issues were raised in a 1974 study that was commissioned by the Lutheran General Hospital in Chicago titled, Hospital Chaplains: Who needs them. It pointed out five major roles for the Chaplain.


The first role described the Chaplain as someone who raises the Medical - Ethical questions. According to the study, Chaplains feel the need for better addressing ethical issues and feel that they are better prepared by education and training to address them than any other Profession. In this situation, the Chaplain plays the role of Ethist who confronts the Hospital and tries to educate through seminars and symposia. In doing this, the Chaplain can be a Prophet, as someone who speaks out for the patient.


There is also a great need for Chaplains to Take The Initiative since patients rarely request a visit. Chaplains should always see themselves as part of a ministry team and seek the cooperation of other pastoral caregivers. Such a Team Role will ensure greater Visibility within the Hospital and to outside bodies such as government agencies and third party payers.


Chaplains Of The Future

There is no doubt in Lawrence E. Holst's mind that the Role of a Hospital Chaplainwill continue in both the near and distant future; and for at least two reasons. First, there will continue to be a need for it because suffering will not  lessen in the future. And secondly, the Chaplaincy has demonstrated in the past a capacity to meet many such needs. According to Holst, there is no doubt in his mind that Hospital Chaplaincy will need to be modified and that, in many ways, Hospital Chaplains face a crisis not dissimilar to the Patients to whom they Minister. In Holst's words, " Change and threats abound. "


The demands for Chaplains to adapt and grow are imperious. Like Patients, Chaplains will face new boundaries and limits. They, too, will need to make peace between their infinite aspirations and their finite possibilities. Like Patients, Chaplains have assets. Through their daily experiences with life and death, suffering and loss, Chaplains have learned to cope with change.


Like the Patients, Chaplains have struggled long and hard with personal doubts, as well as the doubts of others about their legitimacy within Health Care. According to Holst, the struggle has been fought and won. The Chaplain's place and role in the Hospital has won broad acceptance. But that place has changed. Now, Chaplains face new struggles, new limits, and new challenges. Like the Patients to whom they Minister, Chaplains face both perilous threats to the old patterns and enormous opportunities for new life and growth. And like so many of them, Chaplains also need new visions and the will to pursue them.


 Originally entitled Book Report on Hospital Ministry based on Lawrence E. Holst's book, Hospital Ministry: The Role of the Chaplain Today. submitted to the Rev. Dr. Avery Kempton as a Unit 1 Clinical Pastoral Education Practicum Paper. Acadia University St. Stephen's Theological College University of Alberta

Published on June 29th, 1998

{Revised December 14th, 2023}

© Dr. Charles Warner 2023

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