Center to Advance Palliative Care

I agree that the gold standard should be a full spiritual assessment of any newly admitted patient by a board certified chaplain. The benefits are, not only protection against ethical violations, but having someone who is fully qualified to see the depth of spiritual issues and structure an intervention that is both respectful and effective. While many programs find it necessary for good reasons to employ community clergy in this role, it is important to be aware of some of the risks. Beside the possible lack of training, community clergy can have inherent conflicts of interest in this role. What happens if the new patient they are asked to visit as a chaplain is also a member of their congregation who may or may not want the clergy to know about their medical condition? Another interesting issue is that there is not significant agreement among professional chaplains about what constitutes a spiritual assessment. It might be helpful if others in this forum would share the basic elements of the spiritual assessment they do. Finally, it is important to maintain the distinction between a screening tool like George Fitchett's that is meant to be used by nurses and others and an assessment tool that is meant to be used by trained chaplains.

The Rev.George Handzo, BCC
Vice President
Pastoral Care Leadership & Practice
The HealthCare Chaplaincy
New York, NY