A study of the Herston Hospital complex (Royal Brisbane and Women’s Hospitals and the Royal Children’s Hospital) has traced the evolution of chaplaincy in an avowedly secular health care service at the Royal Brisbane Hospital since its foundation in 1867 with more than 300+ chaplains over the intervening 150 years. In the first period from 1867 to 1924, the focus was on pastoral care and visitation by clergy, nuns (both Anglican and Catholic) and lay volunteers. A second phase from 1924 – 1981 saw the nationalization of health services which included the appointment of an Anglican minister as the first full-time chaplain in 1931 and the development of a chaplaincy department which was accompanied by the development of hospital chaplaincy by the churches themselves as a specialist service within the broader range of hospital and medical specialist services. But the role did not move beyond the visiting, sacramental and occasional pastoral role.
Since 1981, there has been a dramatic change with, firstly, the identity formation as a professional chaplain and the rapid evolution of the specialized professional discipline of modern hospital chaplaincy and, secondly, the modifying effects of societal influences in the delivery of pastoral care. In 1982, the chaplains themselves formed the Ecumenical Hospital Chaplain Committee followed in 1993 by the Multifaith Academy for Chaplaincy and Community Ministries. Apart from the previous pastoral and sacramental work, for perhaps the first time, sick and injured patients came into contact with a chaplain who also was forced to acquire specialist knowledge of disease processes and health care. Chaplains became not only counsellors to patients and their families but also to medical and nursing staff. The first hospital chapel was not constructed until 1976 but now the State is providing multifaith resources in recognition that hospital chaplaincy is a true professional sub-speciality which complements the other health care specialities.
Spiritual Health Victoria
In the Victorian context, it is the health care chaplaincy that has most moved to the spiritual care paradigm with the emergence of Spiritual Health Victoria (SHV) which has shown leadership even to the other States, including assisting them in the design and delivery of training programs. In hospitals, chaplains are generally grouped under the Pastoral Care Department or the Spiritual Care Department or the Chaplains’ Department. In asking for a chaplain, patients raise issues related to their illness, treatment and end-of-life, feelings related to anxiety and distress, situations such as prior to an operation or a change in prognosis and advance care planning.
A major emerging area concerns ethical challenges related to pain control, withdrawal of life support, organ donation and transplantation, abortion, not for resuscitation issues and euthanasia, including participation on hospital ethics committees, although less than a quarter participate on these committees (Carey 2012). Chaplains are often consulted on these ethical dilemmas. Chaplains as well have an important function in advocating for patients and facilitating key conversations in hospital and hospice contexts.
Spiritual Health Victoria, previously known as the Healthcare Chaplaincy Council of Victoria, is the peak body in the health sector providing quality leadership and education in the strategic development, promotion and provision of chaplaincy, pastoral care and spiritual care services throughout the state. It works with 42 hospitals and health care agencies, and is moving towards serving community health centres. Its website shows how it has moved towards an interfaith chaplaincy model with a list of resources documenting the health care principles and practices for Buddhists, Christian Orthodox, Jewish, Muslim and Sikh clients.
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