Pastoral care and AIDS: Assessing the stress and satisfaction from caring for persons with AIDS

Members from religious communities in New York City (17 men, 8 women) who volunteer pastoral care to persons with AIDS completed and returned through the mail the (AIDS) Caregiver Scale and the Attitudes toward AIDS Scale. Results indicated that satisfaction from providing care was related to pastoral training, an understanding of the spiritual nature of death, and a positive attitude toward persons with AIDS. Self-reported stress from providing care was inversely related to pastoral training to deal with death. The pastoral volunteers also reported greater satisfaction and lower stress from caregiving than volunteer buddies from upstate New York.     

Pastoral counseling challenges in the Javanese hospital: A cross-cultural perspective

The following article presents some of the challenges experienced by a European pastoral counselor during a two year service period in a Protestant hospital in Central Java, Indonesia. The incompatibility of some of the Western, First-world counseling approaches with Javanese culture suggests the urgent need for pastoral counselors to rethink their methods in the face of cultures not their own.     

Treating persons with ARC and AIDS in group psychotherapy

The authors describe a range of critical issues that are common within homogeneously composed groups for patients suffering from Acquired Immunodeficiency Syndrome (AIDS) and AIDS Related Complex (ARC). They examine the need for these patients to understand their physical symptomatology, to reconsider life's priorities, and to confront their ethical and moral dilemmas. The authors also highlight special effects, unique group atmosphere and process, and the nature of the group contract that is essential for these patients.     

Near-death veridicality research in the hospital setting: Problems and promise

We attempted to conduct near-death veridicality research in the hospital setting, the rationale for which (we presented previously (Holden, 1988).) This paper describes problems, both anticipated and unanticipated, that we encountered. Based on the successes and failures of this undertaking, we present recommendations for future research of this type.At the time of this study, Dr. Holden was a candidate for the Ed.D. degree at the Northern Illinois University Graduate SchoolThis study was funded in part by a Dissertation Completion Award granted to Dr. Holden by the Northern Illinois University Graduate School. The authors also express gratitude to Robert Stromberg, Chaplain of the Lutheran General Hospital CCU at the time of this study, for his assistance in this research.     

Children with AIDS in the public schools: The ethical issues

The question of whether to allow children with AIDS to attend public school generates explosive emotions and has wide-reaching consequences. This paper focuses on the perspective of parents of well children who may be asked to attend school with children who have AIDS. These parents are poised at the heart of the dilemma: they are the ethical “bottom line,” and an argument that fails to satisfy them ought not to satisfy anyone. The conflicting commitments these parents face are first to the parentchild covenant which requires them to act in their child's best interests, and second, to the principles of beneficence and justice, which require them not to further burden a sick child with ostracism and isolation. Almost exact parallels exist between this issue and that of proxy consent by parents for children's participation in low-risk, non-therapeutic research. The lengthy and important debate between Paul Ramsey and Richard McCormick on this question is analyzed, concluding that McCormick's position in favor of thoughtful proxy consent is the more compelling. Returning to the question of allowing children with AIDS to attend school, the essay shows why the parallels are persuasive. On the ethical level, the apparent conflict of obligations is almost exactly the same; on the pragmatic level, the essay shows why sharing a classroom with a child who has AIDS is comparable to the “low-risk” category that the National Commission for the Protection of Human Subjects found acceptable in its 1978 guidelines. The essay concludes that parents of healthy childrenmay and ought to accept the presence of children with AIDS in the public school.     

Fearful Saints: Comforting friends in a hospital setting

The article examines the role of courage in breaking barriers which prevent friends unfamiliar with the health care industry from providing the needed support to sustain a friend during critical illness. “Fearful Saints” offers ways of understanding the complex issues which distance friends during illness. Close friends feel compelled to enter the world of suffering, but must first confront the terrifying images of illness. By examining Henri Nouwen'sThe Wounded Healer, and the story of Jesus asking his disciple Peter to wait with him in the garden, the concept of extending compassionate understanding during times of adversity becomes manageable. Although miracle potions may not be accessible, the reader learns to identify the role of comforter as one who will not permit an afflicted friend to travel through the experience alone.     

Pastoral care of the severely emotionally distressed: An overview of potential pastoral roles in the clinical setting

Evidence suggests that more people wanting help for emotional problems go to the clergy than to any other professional group. Many of these distressed persons manifest psychotic symptoms; yet little attention has been given to pastors' opportunity and responsibility in aiding persons suffering from psychoses. A model of pastoral care of the severely emotionally distressed is presented by describing five potential pastoral roles: availability, assessment (present episode and past history, mental status, specific symptoms), synthesis (hierarchy of probabilities), treatment (linkage, primary care [in collaboration], primary care [alone], support), and follow-up. Clinical vignettes illustrate these various roles.     

Ethical and malpractice issues in hospital practice

Ethical and malpractice issues arising in hospital practice are reviewed. Topics include (a) preparation and authorization to carry out clinical responsibilities, (b) personnel procedures, (c) financial and political forces influencing hospital policies, (d) billing procedures, (e) clinical procedures for responding to patients' needs, (f) confidentiality, (g) discrimination, (h) internship and training issues, (i) sexual abuse of patients, and (j) staff conflicts influencing patient care.     

The Passion to Heal: A Theological Pastoral Approach to HIV/AIDS

Abstract. The global pandemic of HIV/AIDS is the most significant challenge of our time. The ongoing conversation between religion and science comes to a critical juncture in this pandemic. The global community has not yet found a vaccine or cure for this virulent virus, which will likely claim five million more lives in the coming year. The global statistics challenge even the most sophisticated imagination, with projections in the tens of millions of people dead, orphaned children, and many more living in various stages of incapacitation or diminished lives. There is a common prophetic religious imperative among Western faith communities that urgently requires both science and religion to respond. Both disciplines define their scope and purpose as universal, and the global pandemic provides a significant challenge to that universal claim. Regardless of the many differences among the nations and peoples challenged by this pandemic, there is a common moral foundation to which the Western religious and scientific traditions must respond. Religion and science cannot deny their respective social responsibilities by claiming the role of neutral bystander. There are several critical ethical choices to be made in response to the pandemic, and the disciplines of religion and science are critical in formulating those choices.     

Rational emotive behavior therapy in a forensic setting: Practical issues

Incarceration results after a person cannot or will not adapt to societal rules. Inmates often hold irrational beliefs and practice self-defeating behaviors, which then lead to incarceration. By using REBT as a treatment modality, a forensic therapist can easily identify irrational thinking and teach the inmates to challenge these thoughts on both a cognitive and behavioral level.     

Perceptions of Social Support in Men with AIDS and ARC: Relationships with Distress and Hardiness1

Previous research has suggested that social support may act as a buffer against stress or in other ways may affect physiological adjustment, health, longevity, and sense of well-being. Perceptions of social support in persons newly diagnosed with Acquired Immune Deficiency Syndrome (AIDS) and AIDS-related Complex (ARC) were examined as a part of an ongoing longitudinal study. Social support was examined in terms of emotionally-sustaining and problem-solving types of help, based on Gottlieb's content analysis of informal helping behaviors. Representative examples of each of the four major categories of help were assessed in terms of their perceived desirability, availability, frequency of use, and usefulness if used. These social support data were then examined in relation to other behavioral, cognitive, affective, and medical indices. For persons with AIDS only, increased physical distress was associated with perceiving less availability of support. For both persons with AIDS and ARC, the more available social support was perceived to be, the less hopelessness and depression were reported. While all types of help were rated as desirable by both persons with AIDS and ARC, emotionally-sustaining types of help were rated as more desirable, more available, more frequently used, and more useful when used than were problem-solving types of help. Social support measures were most consistently and strongly correlated with the Commitment subscale of Kobasa's Hardiness Scale.     

Bioethics and Pastoral Concern: Some Possible New Directions in Pastoral Theology

This special issue of the journal is comprised of papers given at a conference in May 2011 at the University of Texas Health Science Center at Houston on the theme of “Social Justice and the Health Professions.” This article offers the following rationale for this special issue in particular and for pastoral theologians to contribute to bioethics in general: (1) two contemporary theological thinkers in bioethics, Karen Lebacqz and Lisa Cahill, argue that theological discussions of justice broaden and deepen discussions of justice in mainstream bioethics—thus the focus on social justice provides an area for interdisciplinary and intersectional work; (2) pastoral theologians have not, to a great extent, contributed to discussions of religion and bioethics—this has been the territory of theological ethicists, especially during the 1970s; (3) one influential pastoral theologian, Bonnie Miller-McLemore, has called for (a) a broader concern for health in pastoral theology beyond psychological health and (b) more disciplinary approaches within pastoral theology beyond psychology so as to attend to “the living human web”; and (4) one way to advance the theological contributions in bioethics is by inviting pastoral theologians to focus on matters of social justice (an established area of intersection) as identified by health professionals, thus providing (a) new areas for inquiry and (b) new theological perspectives in bioethics. This article also suggests that pastoral theologians can contribute to bioethics by focusing on both “macro” issues (issues relating to structures and groups) and “micro” issues (issues relating to persons and experiences) as a way of pursuing the topic of justice in bioethics. The bulk of this article focuses on “macro” issues, but, in closing, the author articulates how he has been addressing “micro” issues in his own work. The author argues that both of these approaches—“macro” and “micro”—are legitimate ways for pastoral theologians to express pastoral concerns in bioethics.     

Rationale and considerations for proposed near-death research in the hospital setting

Further research into the question of veridical perception during the naturalistic near-death out-of-body experience (nND OBE), that phase of the near-death experience in which the experiencer seems to be perceiving a normal earthly realm, would be of value to NDErs, their caregivers, and humanity in general. I propose a research procedure that targets visual perception during nND OBEs that occur in the hospital setting. I discuss unresolved issues in the design and implementation of such a procedure, and identify areas for further research.     

Return to work program in a hospital setting

This exploratory field study evaluated the impact of a formal return to work program in a hospital setting. Results from a case study suggest that the return to work program reduced the average number of lost work days among injured employees. Implications of these results are discussed and future research is suggested.