Hostname: page-component-848d4c4894-xm8r8 Total loading time: 0 Render date: 2024-06-15T12:42:23.208Z Has data issue: false hasContentIssue false
  • English
  • Français

The role of chaplains in end-of-life decision making: Results of a pilot survey

Published online by Cambridge University Press:  18 October 2013

Stephanie Clemm ,
Ralf J. Jox ,
Gian Domenico Borasio  and
Traugott Roser
Stephanie Clemm*
Affiliation:
Interdisciplinary Center for Palliative Medicine, Munich University Hospital, Munich, Germany
Ralf J. Jox
Affiliation:
Interdisciplinary Center for Palliative Medicine, Munich University Hospital, Munich, Germany Institute for Ethics, History and Theory of Medicine, Munich University Hospital, Munich, Germany
Gian Domenico Borasio
Affiliation:
Service de Soins Palliatifs, University of Lausanne, Lausanne, Switzerland
Traugott Roser
Affiliation:
Interdisciplinary Center for Palliative Medicine, Munich University Hospital, Munich, Germany Department for Protestant Theology, University Münster, Münster, Germany
*
Address correspondence and reprint requests to: Stephanie Clemm, Interdisciplinary Center for Palliative Medicine, Munich University Hospital, Professorship for Spiritualcare, Marchioninistraße 15, D-81377 Munich, Germany. E-mail: Steffi.clemm@web.de
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The overall aim of this study was to discover how chaplains assess their role within ethically complex end-of-life decisions.

Methods:

A questionnaire was sent to 256 chaplains working for German health care institutions. Questions about their role and satisfaction as well as demographic data were collected, which included information about the chaplains' integration within multi-professional teams.

Results:

The response rate was 59%, 141 questionnaires were analyzed. Respondents reported being confronted with decisions concerning the limitation of life-sustaining treatment on average two to three times per month. Nearly 74% were satisfied with the decisions made within these situations. However, only 48% were satisfied with the communication process. Whenever chaplains were integrated within a multi-professional team there was a significantly higher satisfaction with both: the decisions made (p = 0.000) and the communication process (p = 0.000).

Significance of the results:

Although the results of this study show a relatively high satisfaction among surveyed chaplains with regard to the outcome of decisions, one of the major problems seems to reside in the communication process. A clear integration of chaplains within multi-professional teams (such as palliative care teams) appears to increase the satisfaction with the communication in ethically critical situations.

Keywords

Health care chaplaincyEnd-of-life treatment decisionsMulti-professional treatment teamPalliative care
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 1 , February 2015 , pp. 45 - 51
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Asch, D.A., Jedrziewski, M.K. & Christakis, N.A. (1997). Response rates to mail surveys published in medical journals. Journal of Clinical Epidemiology, 50, 1129–1136.CrossRefGoogle ScholarPubMed
Burns, J.P., Edwards, J., Johnson, J., et al. (2003). Do-not-resuscitate order after 25 years. Critical Care Medicine, 31, 1543–1550.CrossRefGoogle Scholar
Carey, L.B. & Newell, C.J. (2007a). Chaplaincy and resuscitation. (European Journal) Resuscitation, 75, 12–22.Google ScholarPubMed
Carey, L.B. & Newell, C.J. (2007b). Withdrawal of life support and chaplaincy in Australia. Critical Care and Resuscitation, 9, 34–39.Google Scholar
Carey, L.B. & Cohen, J. (2008). Religion, spirituality and health care treatment decisions: The role of chaplains in the Australian clinical context. Journal of Health Care Chaplaincy, 15, 25–39.Google Scholar
Carey, L.B. & Cohen, J. (2010). Health care chaplains and their role on institutional ethics committees: An Australia study. Journal of Religion and Health, 49, 221–232.Google Scholar
Carey, L.B. (2012a). Bioethical issues and healthcare chaplaincy in Aotearoa New Zealand. Journal of Religion and Health, 51, 323–35.Google Scholar
Carey, L.B. (2012b). The utility and commissioning of chaplains, In The Textbook of Spirituality in Healthcare, Cobb, M., Puchalski, C. & Rumbold, B. pp. 397–408. Oxford: Oxford University Press.Google Scholar
Deutscher Evangelischer Krankenhausverband, Katholischer Krankenhausverband Deutschlands (1997). Ethik-Komitee im Krankenhaus (Association of Protestant hospitals, Association of Catholic hospitals in Germany (1997). Hospital Ethics-committees). http://www.ev-medizinethik.de/pages/themen/gesundheitswesen_und_ethikberatung/themenfelder/klinische_ethikkomitees/index.html (Accessed on April 7, 2012).Google Scholar
Deutsche Gesellschaft für Pastoralpsychologie (2006). Sektion KSA Standards (German society for pastoral psychology (2006). Standards for clinical pastoral education). http://www.pastoralpsychologie.de/uploads/media/KSA-Standards_2006.pdf (Accessed January 23, 2013).Google Scholar
Evangelische Kirche im Rheinland – Statistischer Dienst im Landeskirchenamt (2010). Statistik zur Synode 2010 (Protestant church in the Rhineland - Statistical service at the national church agency (2010). Statistics for the synod 2010). http://www.ekir.de/ekir/dokumente/Tab01.pdf (Accessed February 11, 2012).Google Scholar
Fletcher, J.C. (1989). Decisions to forego life-sustaining treatment. Virginia Medical Quarterly, 116, 462–465.Google Scholar
Frick, E., Riedner, C., Fegg, M.J., et al. (2005). A clinical interview assessing cancer patients' spiritual needs and preferences. European Journal of Cancer Care, 15, 238–243.Google Scholar
Jox, R.J., Krebs, M., Fegg, M., et al. (2010). Limiting life sustaining treatment in German intensive care units: A multiprofessional survey. Journal of Critical Care, 25, 413–419.Google Scholar
Kuhse, H. & Singer, P. (1985). Should the Baby Live? The Problem of Handicapped Infants. Oxford: Oxford University Press.Google Scholar
Mallik, M. (1997). Patient representatives: A new role in patient advocacy. British Journal of nursing, 6(2), 108–113.Google Scholar
McDaniel, C. (1999). Clergy contributions to health care ethics committees. HEC Forum, 11, 140–154.Google Scholar
McNeill, P.M., Berglund, C.A. & Webster, I.W. (1994). Ethics at the borders of medical research: How much influence do various members have within research ethics committees? Cambridge Quarterly of Healthcare Ethics, 3, 522–532.Google Scholar
Puchalski, C.M. & Ferrell, B. (2010). Making Health Care Whole – Integrating Spirituality into Patient Care. West Conshohocken: Templeton Press.Google Scholar
Seal, C. (2010). The role of doctors' religious faith and ethnicity in taking ethically controversial decisions during end-of-life care. Journal of Medical Ethics, 36, 677–682.CrossRefGoogle Scholar
Sprung, C.L., Cohen, S.L., Sjokvist, P., et al. (2003). End-of-life practices in European intensive care units. The ETHICUS study. Journal of the American Medical Association, 290, 790–797.Google Scholar
Sprung, C.L., Woodcock, T., Sjokvist, P., et al. (2008). Reasons, considerations, difficulties and documentation of end-of-life decisions in European intensive care units: The ETHICUS study. Intensive Care Medicine, 34, 271–277.Google Scholar
Skinner, N., Roche, A.M., O'Connor, J., et al. (2005). Workforce development ‘TIP’. Clinical supervision. http://www.unodc.org/ddt-training/treatment/VOLUME%20D/Topic%202/8.Workforce%20Development%20TIPS.pdf (Accessed on April 25, 2012).Google Scholar
Stellungnahme der Zentralen Kommission zur Wahrung ethischer Grundsätze in der Medizin und ihren Grenzgebieten (Zentrale Ethikkommission) bei der Bundesärztekammer zur Ethikberatung in der klinischen Medizin (Statement of the central commission to uphold ethical standards in medicine (central ethics-commission) at the German medical association on ethics consults in clinical medicine). (2006). Deutsches Ärzteblatt, 103, A1703–A1707.Google Scholar
VandeCreek, L. (2004). How satisfied are patients with the ministry of chaplains? The Journal of Pastoral Care & Counseling, 58, 335–342.Google Scholar
Vollmann, J., Burchardi, N. & Weidtmann, A. (2004). Health care ethics committees in German university clinics. A survey of all medical directors and directors of nursing. Deutsche Medizinische Wochenschrift, 129, 1237–1242.Google Scholar
World Health Organization (2012). Definition of palliative care, http://www.who.int/cancer/palliative/definition/en/ (Accessed on February 12, 2012).Google Scholar