Chapter Nineteen: Ethics and Chaplaincy (Peter Sedgewick - St.Michael’s College, Llandaff - January 2007)
Introduction
1. Moral Diversity
2. Making Moral Decisions
3. Ethics in Institutions- the External Voice
4. Political Realities
5. Spirituality
Conclusion
Introduction
In this paper I wish to set the context in which chaplains work. I will not argue from a Christian viewpoint though that is my own tradition and I will use examples from this. Nevertheless I hope that the arguments are valid for any religious tradition. I want to argue that there are a particular set of circumstances which make the practice of moral decision making by chaplains very complex, not to say difficult. Again it is my hope that this consultation may spell out how academics and chaplains might work together on the agenda which I am sketching out here.
What are the particular circumstances which affect chaplains? Clearly a chaplain is primarily a pastoral person, and someone who carries out a ministry of prayer and worship. That has to be at the centre of any chaplain’s ministry. Nevertheless ethical issues can intrude, and frequently do. So this paper is not arguing that chaplaincy is primarily to do with ethics. All I am doing is sketching out some of the issues as and when they arise.
I think there are five issues to do with ethics and chaplaincy. First there is the sheer fact of moral diversity. This affects all religious traditions but it affects chaplaincy especially. I think of my colleague Stephen Roberts who used to be a chaplain at Brunel University in a multifaith chaplaincy. Students and staff came from a very diverse background, and it was appropriate that the chaplaincy team reflected this. It is a new way of being a chaplain. That diversity is combined with the sometimes very amoral world of new public management, in which an institution can operate on efficiency, value for money, criteria alone. So there is both diversity and amoral practice for chaplaincy to work with. Secondly, a chaplain has to make difficult moral decisions. A newborn’s life is in danger, and the parents resist the idea of the end of treatment if the possible outcome is severely impaired functioning. The hospital chaplain is called in to talk to the parents. A military chaplain is caught up in peacekeeping operations and there are issues about how the military relate to the local faith communities. The chaplain becomes involved. There are issues about the treatment of prisoners in a segregation unit in a Youth Offending Institution. The chaplain is involved. What I wish to do here is to show that there are at least four ways in which moral decisions can be taken.
Thirdly there is the contrast between medical ethics and ethics in medicine, or military ethics and ethics in the military, and so on. This point, developed by Alastair Campbell, argues that institutions need a public conscience, an external voice, or an appeal to the outside world. The chaplain does not have to fulfil this role, but they often end up doing so. This is not about making a moral decision, as in the last set of examples, but rather about recognising that an institution needs a way of reflecting on itself, of thinking about how it is seen by the outside world. Fourthly there are political realities. It is clear that many institutions have been strongly shaped by political choices in recent years. In particular this is true of secondary education, and the creation of Academies which may well have chaplains, but it could be widened out to any institution. The challenge as to whether Iraq is a just war is one that the courts have ruled against recently. Flt Lt Malcolm Kendall-Smith was the first member of the armed forces to be charged with disobeying orders to deploy in Iraq. He was an RAF doctor who was sentenced to eight months imprisonment for disobeying orders in April 2006. This need not involve chaplains but it could well do so, and it is a political issue. Finally there is the issue of how ethics relates to spirituality. This point is especially raised by James Hanvey, a Jesuit theologian at Heythrop College. Ethics and spirituality are inseparable. Michael Mayne’s book The Enduring Melody is a moving account of how he reflects on his own dying from cancer. It is a book that many chaplains have found invaluable, but it needs to be related to ethical issues as well. Let me turn to each of these five points in turn. In each case I will be raising issues for discussion, not seeking to provide a definite answer.
1. Moral Diversity
A chaplain, from any faith tradition, has to walk the difficult road of interpreting their moral tradition for the particular demands of the context in which they work. That is no more and no less than any other religious person, but it is the constant testing of that tradition against the values of the institution, in which they minister, that will give rise to judgements about how that moral tradition is to be affirmed. There has been an intense debate in the academic world as to whether such traditions are able to be in dialogue with other traditions and with other discourses, such as the secular discourse of much public life embodied in the careful delineation of aims and objectives that can be described as bureaucratic rationality, but for the chaplain that communication has to be a daily reality which they cannot neglect.
Policy makers have themselves been concerned about the impact of the changes in public institutions in the last two decades. David Faulkner, a senior Home Office civil servant and now an academic at Oxford University, writes:
“There is now decreasing respect for professional judgement or professional status in the original, more narrow, sense. Successive governments have seen some professions as obstructing progress and protecting their own provider interests against what the government regards as a necessary programme of modernisation and reform. They have seen the Probation Service and social services as holding attitudes and assumptions associated with their ‘ profession’ which have no place in the modern world as they see it. They are suspicious of all forms of expertise which appeal to experience of the past, or to abstract principles or values, or which cannot demonstrate their benefits in quantative and preferably ‘ value for money’ terms.”[i]
I will return to the issue of any sense of a public service ethos later. For the moment, what is important is that there is a strong tension between the moral tradition which the chaplain represents and two factors. One is the existence of other moral traditions and beliefs in the plural world that makes up modern Britain. The other is that this moral tradition has to interact with the world of what is called ‘new public management’ where the provider- purchaser relationship is dominant. The imperative of communication (how do we speak the word of God into this situation?) rubs uncomfortably and sometimes harshly against the stark reality of the many different viewpoints, and plural worlds of meaning in which we live in modern Western society. This is the world that chaplains of all faith traditions have to minister in, of whatever faith tradition or set of beliefs. It is put well by Daniel Bell: “In the West, reflection on justice has traditionally taken as its starting-point the ancient definition suum cuique, “to each what is due.” Yet…how this is understood is far from monolithic “What is due?” can be calculated according to a host of different logics.”[ii] In short, there is the logic of the chaplain’s own beliefs and values, and the two contrasting worlds of other belief systems on the one hand and the world of performance management, with outputs, inputs, and quantified indicators of effectiveness, on the other.
The chaplaincies which I know best are those of mental health and prisons, since I worked as a policy officer for eight years for the Church of England in these areas. Policy was the setting for an intense debate , bringing one into communication with professionals from mental health and criminal justice, civil servants and politicians, interest groups, service users, carers and families and of course both churches and other faith communities.. There were many conferences in dialogue with other faith traditions than my own, and occasionally joint publications, such as the Health Education Authority’s Promoting Mental Health- Jewish and Christian Perspectives.[iii] In this world of ongoing debate I was deeply aware that for chaplaincies the issues which were debated were also embedded in personal relations, the carrying out of daily ministry, and the ‘being present’ in institutions . In all these way they helped to promote an ethical dialogue. Among such chaplains in mental health it is worth mentioning Julia Head at the Bishop Robinson Chaplaincy at the Maudsley Hospital and in Norwich the Anne Frank annual lectures founded by Arthur Hawes.
There are of course serious constraints on when a chaplain can speak and when they have to be silent. In my previous work at the Board for Social Responsibility in the Church of England I drafted possible speeches for bishops in the Lords (and sometimes for lay peers as well) that could be put to ministers. The primary areas were the highly sensitive ones of prisons and mental health. I was often approached by prison and mental health chaplains who would volunteer background information which could not be used directly because of the institutional loyalty they owed to the Prison Service, or the N.H.S. That is even more the case in the military. Dialogue therefore is constrained by institutional factors which have to be taken very seriously.
2. Making Moral Decisions
Archbishop John Habgood outlines four ways of making moral decisions. The first method of making moral decisions is by appeal to direct authority. There can be written authority (in the case of the three Abrahamic faiths, this will be by appeal to the authority of scripture), ecclesiastical or institutional, or thirdly personal authority. What matters is that authority is directly mediated. It is unchallengeable authority, and it provides clear, binding answers to moral questions. In both Protestantism and Roman Catholicism there have been strong tendencies for the Bible or Papal documents to be seen as analogous to a handbook to understand the workings of a particularly complex operating system in Information Technology. It may not be easy to understand, the operations may be very complex, but the experienced practioner can throw light on any problem and find an authoritative answer there.
The second method of moral decision making is parabolic. It operates through telling stories, and it creates links in the person’s experience between the story told and the situation being encountered. Put simply, the penny drops. It is a powerful method, and it operates in much moral education in schools. It also lies behind the diverse worlds of many novels: Dickens on the intransigence of the law in Bleak House, EM Forster on his own homosexuality in Maurice, Zadie Smith in White Teeth today. In the Christian tradition it is important to notice the story telling aspect of Jesus’ own ministry. Other faith traditions can give similar examples.
Thirdly, there are arguments from general principles. These can be ethical norms enshrined in utilitarianism or Kantian ethics on respect for persons, and much else. They can be combined with religious arguments, and again much Christian morality in the past as practiced by chaplains was a combination of reasoned arguments and biblical exegesis. Today chaplains who serve on hospital ethical committees have to find a method of addressing very complex moral problems. My former colleague Claire Foster in the Church of England has written on this area.
Fourthly, there is the starting point of empirical facts. It tries to bring theological insight to bear on these facts, and so to discern possible courses of action as a response to what is going on. I suspect many chaplains intuitively move between the penny dropping approach telling stories, and the empirical combined with theological insight. To give an example from the much disputed area of sexuality, the scientific facts about its genesis in individuals and prevalence in society have to be combined with theological insights about relationships, human flourishing, diversity, etc. In moral theory this way can be called ‘middle axioms’ and it has been associated with John Habgood himself and Ronald Preston. What matters is that there are theological reflections on empirical reality.
Chaplains will use all these methods of making moral decisions. As I teach on the M Th course in chaplaincy I find that different approaches- the deductive, the parabolic, the rational, and the empirical and theological- will resonate with each of them. Often there is a variety of different methods being used unconsciously.
3. Ethics in Institutions- the External Voice
However this living out of ethical witness is more complex than it seems. I have found helpful a distinction made recently by the distinguished ethicist and pastoral theologian Alastair Campbell. He was asked: “What is the difference between ethics in medicine and medical ethics?” He replied:
“A very important difference is conveyed in the titles. Rightly or wrongly, medical ethics tends to make people think only of the medical profession, that it is a form of professional ethics controlled by doctors. Ethics in medicine on the other hand, implies something much broader which is not necessarily professionally controlled by doctors, but concerns all of the ethical issues which arise in the practice of medicine and delivered health care. These issues will be of concern to doctors, nurses and other health professionals, but most of all to patients, their families, and the general public. Ethics in medicine does involve doctors' decisions, and we are of course training medical students, but at the same time the perspective is one which is broader than simply professional concern”[iv]
I think this is an illuminating distinction. Chaplaincy is not only concerned with the theory of the just war in military combat; the theory of the just wage in employment practice; or the theory of dying well in medicine. He or she must know the literature, which pertains to the field in which they work, but they must transform it. The perspective is broader, and it involves those who are affected by the decisions made by the agents to whom the person is chaplain. It is therefore no surprise that military chaplains in Kosovo have written in their M. Th. Chaplaincy essay about ministry to Muslim communities caught up in the fighting. In an earlier life I taught an M.A. entitled Theological Understanding of Industrial Society, T.U.I.S., later amended to Theological Understanding of Contemporary Society. It was taken by industrial chaplains, but also by managers, unionists, and parish priests. The latter would reflect on how the nature of a town would be affected by the decisions made in a particular workplace. It is well put by Peter Stubley who was the assistant director of the course and a distinguished industrial chaplain. Stubley wrote an account of Middlesborough on the eve of the twentieth century. He writes: “The churches were mostly concerned with their own internal life, as embattled minorities in a hostile culture which they were powerless to overcome. . .They never really understood the industrial dynamic producing the culture in which they were set, and so failed to engage with that culture.”[v]
Stubley writes of the failure of churches to understand a wider culture. But many institutions are like that too. How do institutions become aware of the wider context, both that of its clients or users, and that of the wider context generally? This is where Campbell’s distinction comes into its own. Medical ethics is about making moral decisions. Ethics in medicine is about the wider picture. If this distinction is correct, chaplains are those who operate within an institution as its conscience. They are not the only ones who do so, and the relationship between conscience and religious belief is a subtle one. There is no direct link between religious faith and ethical choices except in a narrow, almost fundamentalist, understanding of religious belief.[vi] The chaplain then is one who is concerned with ethics, but not simply with the ethical choices made in the institution or profession in which they work. They represent a wider viewpoint. This is where the public service ethos which I mentioned earlier returns. For the emphasis on efficiency and measurable outcomes can conflict with the public service ethos, as Faulkner emphasises in his book again and again, giving examples from the Prison and Probation Services.
So even though it is of course the case that the chaplain is at least normally a religious person (there may of course be humanist chaplains but they are not the norm), their understanding of ethics is not usually deduced directly from a rulebook of their faith. The chaplain is therefore concerned with ethics but in an indirect way, and he or she is concerned with religious faith, but again in an indirect way. They are therefore people who, in a phrase often used by Peter Baelz, have to imagine the truth. That is not the same as making it up. Rather it involves the use of imagination in seeing outside the confines of both the profession in which they work and the practice of the faith they represent, and so appealing to a moral insight which might prescribe different ways of acting. A military chaplain who has taken the M Th Chaplaincy degree, Philip McCormack, calls the search for this insight the “external voice”.[vii]
Campbell gives an example of what ethics in medicine means, although it should be noted that Campbell is not himself a chaplain but an ethicist. Nevertheless I am claiming that his work has a particular affinity with chaplaincy. Campbell writes
:” We have to see Ethics in Medicine within an interfaculty, interdisciplinary context, and therefore whilst appropriately it is within the medical faculty, is not restricted to Medicine…. Obviously questions from doctors may relate to life and death issue, but what other issues crop up which are not purely medical? First year students are not yet doctors, but members of the general public if you like, and so they or their family members will have experience of what it is, to be a patient. This is our point of entry; we talk about patients, and consider the patient's perspective first, before we ever discuss principles, which might guide medical decision-making.”
The issue of choice thus comes to the fore.[viii]This is clearly both a cultural and political issue of great importance in the present climate. First of all, in cultural terms, it means that chaplaincy is faced with ethical issues that relate to the nature of what it means to be human in contemporary society. Campbell places ethics in the context of mortality, suffering and the choices a human being might make .He goes on:
“We try to avoid some of the hackneyed topics in the first year, such as genetic engineering, euthanasia or abortion, all those issues which everyone associates with the subject. Instead we talk about dilemmas patients face concerning long-term illness, wanting treatment or wanting to refuse treatment.”[ix]
I discussed this argument with a consultant psychiatrist recently who chairs the General Medical Council’s Fitness to Practice Committee. He confirmed that increasingly the G.M.C. was influenced by the viewpoint that what matters when deciding whether to discipline a doctor was not merely the ethics of the profession but also what the public would find acceptable. There are three issues in tension in his view. On the one hand there are the reasonably straightforward issues of medical ethics. The psychiatrist I talked with was not a religious person but he knew religious traditions reasonably well. Particular religious traditions will handle medical ethics in terms of their own codes of values, and he respected that. Secondly there are medical ethics as practiced by the medical profession: the Hippocratic Oath and the G.M.C. Proposal on Health Care Professional Regulation issued in November 2006. Thirdly in individual cases there is a need in the decisions made by the Fitness to Practice Committee to take account of the wider public interest.
Whether or not an institution builds a wider public dimension into its disciplinary panels, and it probably should do so, it remains important that institutions have a way of looking at themselves. They need to develop a means of reflecting how society sees them back to themselves. Some will argue of course that such work is no business of chaplains. Nevertheless it has been an important part of many chaplains’ ministry.
4. Political Realities
Campbell refers to the dilemmas faced by patients about length of waiting lists, wanting to refuse treatment or to consent to treatment. This relates directly to resources, and sometimes as in the case of the Worcester N.H.S. Trust to the fact of chaplains being made redundant. So chaplaincy is inevitably caught up in directly political questions. The political biographer Anthony Seddon wrote recently of Tony Blair:
” At home Blair’s distinctive choice and diversity agenda would have been far more advanced by now had it not taken him until 2001 to discover it. By the time his own agenda crystallized, much of the bonanza of extra stake spending had already been allocated, with debatable gains in efficiency…Academies are a particular concern. Last month, he announced they would double in number: in time they may be regarded as among his greatest achievement”.[x]
The inescapable point is that a chaplain in such an institution as an Academy has to confront the implications of political decisions. There are then political questions in terms of resources in the NHS, and how this affects treatment offered. There are political questions in secondary education, with the choice and diversity agenda. There are most of all political questions about military operations. Let me return to the case of Iraq, and the trial of the RAF doctor. Judge Advocate Bayliss in a military court accused Dr. Kendall-Smith, a former university tutor of moral philosophy, of "amazing arrogance" and seeking to be a "martyr". The sentence was intended to make an example of him and serve as a warning to others in the forces.
"Obedience of orders is at the heart of any disciplined force. Refusal to obey orders means the force is not a disciplined force but a rabble. Those who wear the Queen's uniform cannot pick and choose which orders they will obey. Those who seek to do so must face the serious consequences," he said.
"We have considered carefully whether it would be sufficient to dismiss you from the Royal Air Force and fine you as well. We do not think that we could possibly be justified in taking such a lenient course. It would send a message to all those who wear the Queen's uniform that it does not matter if they refuse to carry out the policy of Her Majesty's government."
A spokeswoman for the Royal Air Force Prosecuting Authority said: "It is right that Flt Lt Kendall-Smith was prosecuted for disobeying legal orders. British troops are operating in Iraq under a United Nations mandate and at the invitation of the Iraqi government." Bitter accusations and recriminations dominated the trial, which took place at Aldershot barracks. At an earlier hearing, Assistant Judge Advocate Jack Bayliss had ruled the doctor could not use the defence that in refusing military orders he had acted according to his conscience. The judge maintained that the US and British forces were now in Iraq at the invitation of the Iraqi government. During the hearing Kendall-Smith repeatedly expressed his view that an order for him to deploy to Basra was illegal. He also described the actions of the Americans in Iraq as being akin to the Nazis.
A different viewpoint was expressed by the former Labour MP Tam Dalyell, who said: "Any servicemen has obligations, but a doctrine was laid down at Nuremberg [trials of Nazis for war crimes] that when orders seem to be a crime against humanity, it was not a sufficient excuse to say simply: 'They were orders and I was doing what I was told.”[xi] These are the political dimensions of any ethical decisions. In terms of my earlier point about whether a chaplain seeks to be in some way the conscience of an organisation the difficulties are obvious. Yet let me also repeat that in my previous job of writing speeches for the House of Lords I was well aware on a daily basis of the confidentiality which chaplains, especially in the Prison Service, had to adhere to. There is no easy resolution of this dilemma.
My general point is that chaplains may be faced with political dimensions of ethical issues. They do not have to become involved. But if they do so there are immensely difficult issues involved. I remember personally when I was Theological Consultant to the North East Churches in 1984 spending many hours with Steve Kendall, chaplain to the coal industry, during the miners’ strike. The bitterness of the ethical issues and the political dimension meant that there was often a breakdown in communication which involved the chaplain himself. At this point the very existence of chaplaincy itself can become at risk. Others however felt that he was a vital point of communication in a polarised situation, or from a very different viewpoint the advocate for communities threatened by the closure of their industry. Depending on how the argument was set up, the chaplain could be seen in very different ways. [xii]
5. Spirituality
The final issue to be addressed is that of spirituality. From a Christian viewpoint the most significant aspect of a theology of chaplaincy, which needs to be developed at length, is how the Fatherhood of God relates to the spirituality inherent in all people by virtue of their humanity; how a Christological focus will balance this with the shape of human flourishing in the ministry of Jesus; and how the Spirit indicates the direction of our flourishing, both individually and corporately. This in turn feeds a theology of community or koinonia, and the key question here is the relationship of the chaplain to the church they represent... In other words, a Trinitarian theology can enable chaplains to work with a spiritual audit in ways that recognises the diversity of spirituality while not undermining the integrity of the Christian faith .That is a compressed way of indicating that a Trinitarian spirituality is at the heart of a Christian understanding of spirituality.
James Hanvey writes of the healing power of spirituality, precisely because it keeps before us the wholeness of the person.[xiii] It can become a therapeutic process, enabling the discovery of integrity, helping people discover who they are in the midst of illness, and to see the wider picture. Even if recovery is impossible in physical or mental health, spirituality can offer what Hanvey calls “a spiritual and psychological development or realignment” which offers to a person a sense of wholeness and wellbeing. But spirituality is not only for the patient. It can assist the practioner in honouring the trust placed in them. In Hanvey’s profound words, “spirituality recontextualises the relationship of power.” Even when a person is fragile , the reverence owed to the body means that an ethic of attentiveness becomes central. The person is never an object to be disposed of. It is interesting to see how spirituality might also work on the battlefield, in the university, in the prison. Ethics and spirituality thus become central.
Conclusion
Let me summarise the direction which this paper has taken. First the chaplain has to interpret their own religious tradition. They have to do this in the world of moral diversity, and yet have to be faithful to their tradition. That is itself very difficult. Secondly they have to make moral decisions. There are at least four ways of doings this: the deductive arguing from authority, the parabolic or penny dropping, the rational, and fourthly the theological and empirical, where there is reflection on the facts of a situation.
However this is not enough. I have argued at the heart of this paper that there is a distinction between medical ethics and ethics in medicine, military ethics and ethics in the military, employment ethics and ethics in employment –and so on. A chaplain will have to know about medical ethics, and talk to staff about the implications of euthanasia, or know about what is or is not a just military action, but they cannot simply rest there. Crucial to this distinction between medical ethics and ethics in medicine is the idea of a community of interest who are affected by decisions, choices and agents. Equally part of this distinction between these two understandings of ethics is that it is an ethical task to draw attention to this wider constituency and to tease out who or what is affected by the way the profession or institutions work. So I am arguing that a chaplain is uniquely positioned to articulate the implications of actions taken and choices made. A chaplain acts as a conscience of the institution as it is embedded in the constituency of which it is a part. He or she is not the only agent of conscience. Pressure groups, service user groups, carers, and the press, all may play a part, but the chaplain should be part of this.
However, fourthly, this comes to the very difficult aspect of such a role, which are the political dimensions of being cast in this light. That can virtually destroy a chaplain, and it is interesting that the post of chaplain to the mining industry in the North East of England was ended shortly after the strike. Finally I have alluded to the spirituality that is there at the heart of any chaplain’s ministry. Perhaps that should have been emphasised first. It is certainly a crucial element. Individual chaplains and chaplaincies will respond differently to how they respond to diversity; how they seek to be the conscience of an institution, or not; whether they recognise the political role. None of this is to change the reality that a chaplain will always be pastoral, caring, relating their spirituality to the world. All I have sought to do is to indicate some other ethical realities as well.
[i] David Faulkner Crime, State and Citizen Waterside Press, Winchester, 2001 pp..73-4
[ii] Daniel M Bell “ Deliberating: Justice and Liberation” in ed. S Hauerwas and Samuel Wells The Blackwell Companion to Christian Ethics , Blackwell, Oxford, 2004 p.182
[iii] Promoting Mental Health The Role of Faith Communities- Jewish and Christian Perspectives Health Education Authority, London 1999
[iv] http://www.bris.ac.uk/depts/Chap/episcope/3_ethics.html
[v] Peter Stubley Industrial Society and Church: Middlesbrough 1830-1914 Woodfield Press , West Susses 2001 p.111
[vi] Peter Baelz Ethics and Belief Sheldon Press, London 1977 p.26 and 62
[vii] Philip McCormack The External Voice. M Th. Dissertation, Faculty of Religious and Theological Studies Cardiff University, 2006.
[viii] Campbell interview http://www.bris.ac.uk/depts/Chap/episcope/3_ethics.html
[ix] Ibid
[x] Anthony Seddon ‘Whatever the Brownites say, history will judge Blair as a political colossus.’ The Guardian p.29 December 20 2006. Seddon is the author of Blair London 2004
[xi] The Independent 14 April 2006 http://news.independent.co.uk/uk/legal/article357656.ece
[xii] Coal Church and Community Easington District Council, 1984. John Habgood, ‘Church and State’, in Confessions of a Conservative Liberal SPCK London, 1988 p.19. The talk was broadcast during the miners’ strike on Radio Newcastle.
[xiii] James Hanvey S.J. Who Is This Patient? Unpublished paper, Heythrop College, London, 2006.to Ethical Perception, in Hamel and Hines eds pg ase
8 S Hauerwas; Against the Nations, pg 23
11 J Millbank’ Can Morality be Christian, Studies in Christian Ethics 8/1 pg47 -57
13 O O’Donovan; Resurrection and Moral Order, pg 11
