Selling Spiritual Care

In March, the Republicans introduced the American Health Care Act to replace their long-derided Obamacare (Affordable Care Act) — even though Obamacare, which is most inadequate itself, has provided health care coverage for about 20 million uninsured Americans of various racial and ethnic groups.  The wealthy-favored Republican plan — the nonpartisan Congressional Budget Office determined — would knock 14 million people off healthcare in one year and 24 million by 2026.  With such a loss in coverage, “approximately 17,000 people could die next year who’d otherwise live, and that number would climb to 29,000 people dying per year in 2026.” (“Trump admits his health care plan would benefit rich investors, screw over people who voted for him,” By Zack Ford, LGBT Editor at ThinkProgress.org, Mar. 16, 2017)  This stark prediction contradicts President Trump’s repeated  campaign promise, “We’re going to have insurance for everybody.” (“6 promises Trump has made about health care,” By Henry C. Jackson, POLITICO, Mar. 13, 2017)

In the midst of this pending attack on the health care of so many low income (younger, older and disabled) Americans, two leading healthcare-specializing faith organizations created and began circulating a petition to Congress.  They are: the internationally-expanding Spiritual Care Association (SCA), birthed a year ago, and its affiliate, HealthCare Chaplaincy Network (HCCN), out of New York, with Rev. Eric J. Hall the CEO of both.  The issues driving their petition?

One would think that a primary issue of these two prominent spiritual care organizations would be the drastic increase in the number of uninsured Americans – and the number of deaths — that would result from the Republican’s health care plan.   Indeed, both faith organizations profess deep commitment to “patient-centered” spiritual care for more patients and their families in hospitals and other institutional settings.

Moreover, because physical, mental and spiritual health are dependent on economic, political, legal and environmental factors, one would also assume that these two faith organizations, dedicated to stated “whole-person care,” would be alarmed by and oppose the Trump administration’s proposed budget.  A budget that would add $54 billion to a military already the most powerful in the world by far, while cutting programs that support foreign aid and diplomacy abroad and the pursuit of happiness here.  A budget that would spend billions to build a wall to keep Mexicans out, and cut programs that protect America’s own environmental homeland from pollution within.   A budget that would pour billions into hiring Homeland Security immigration enforcement agents and expanding detention centers, while undermining the security of Americans by cutting health, educational, housing, urban development, job training, anti-poverty and other life-enabling programs. (See “Who Wins and Loses in Trump’s Proposed Budget,” By Alicia Parlapiano and Gregor Aisch, The New York Times, Mar. 16, 2017)

Sadly, the issue driving the SCA and HCCN’s petition to Congress is not the millions of Americans who would lose their health care coverage if the Republicans’ original American Health Care bill had passed.  Nor is their issue the immorality of building walls and waging wars at the expense of building lives and reconciling international conflicts, called for by their faith traditions.

The announced issue of these two recognized “leading nonprofit organizations in the field of spiritual care?”  They “are urging consumers and health care professionals to sign the online petition to send a strong message to Congress that ‘spiritual care matters.’”  This issue is emphasized by SCA and HCCN President and CEO Rev. Eric J. Hall, who states, “A unified call for action is critical to ensure that spiritual care becomes more mainstream, so that patients and their families receive optimal support in what is often their greatest time of need.” (“Spiritual Care Association Urges Consumers, Health Professionals to Tell Congtress ‘Spiritual Care Matters,’” www.prweb.com, Mar. 27, 2017)

SCA and HCCN’s stated issue is not that health care matters to everyone, but that “spiritual care matters” and should be provided to those who have health care, as if spiritual care were a commodity.  Their issue is not that more people have health insurance in “their greatest time of need,” but that those who can afford coverage have access to “spiritual care.”  Most unfortunately, their petition’s issue is not the shrinking of the health care pie, but ensuring that these organizations and types of missions are not left out of the new health care framework.  It is about getting a piece of the shrinking pie for themselves.

This commentary on the SCA and HCCN is not to minimize the importance of spiritual care for patients and their families.  Spiritual care matters very much to patients and their loved ones — and also to their healthcare providers as well.  I witnessed this first hand as a hospital chaplain for almost 19 years at Boston Medical Center.  And my book, based on my experience, A Hospital Chaplains at the Crossroads of Humanity, is testimony to the importance of pastoral/spiritual care to patients and their families.

But another dynamic is at work here.  The SCA and HCCN reflect the practice of many specially trained chaplains and pastoral counselors: they have been trained to profess commitment to “the whole person,” but avoid their role as prophets of the people and settle for the safer role of being chaplains of the status quo.  Instead of speaking reality and moral truth to power, they are comfortable in accommodating power and settling for a piece of the shrinking pie.  Their comfort zone – and hiding place – is one-to-one relationships with ill and troubled persons behind hospital and other institutional walls.  The impact of political, economic and legal discrimination — and government war-making on people’s health and well-being — is beyond their clinical pastoral training and awareness.  They are moral and caring in the spiritual and institutional realm in which they operate.  But the extent of their moral caring is determined by the prevailing political, economic, legal and religious power structures.  Their morality is determined by the status quo’s public opinion, and by the interests of the wealthy and powerful.

The Spiritual Care Association (SCA) is an example of religion accommodating and seeking to thrive in, not transform, the status quo.  Last June, the SCA retained Akin Gump Strauss Hauer & Feld, a leading Washington-based international law and lobbying firm, to advocate for its interests on Capitol Hill.  In a press release, CEO Rev. Hall “said SCA is fortunate to have secured such a well-respected firm.”  Hall stated that retaining Akin Gump “paves the way for the first time for spiritual stakeholders to build a united and loud voice on Capitol Hill around this important aspect of whole-person care.”  Akin Gump will be SCA’s lobbying voice in its “plans to educate and engage federal legislators and policymakers with the intent of securing laws, policies, reimbursements and resources that support quality spiritual care for individuals and their family caregivers throughout the continuum of care and in all types of health care settings.” (“Spiritual Care Association Retains Leading Law Firm to Advance Advocacy Efforts for Quality Spiritual Support,” http://www.prweb.com/printer/13518874.htm, June 28, 2016)

Akin Gump is “a well-respected firm.”  Perhaps, but it should be noted that one of Akin Gump’s clients is Corrections Corporation of America (CCA), now called “CoreCivic,” which, as reported, “is the largest owner of for-profit prisons and immigration detention facilities in the United States.” (“Corrections Corporation of America,” From Source Watch, www.sourcewatch.org)  CCA paid “Akin Gump a reported $240,000 in lobbying fees last year.”  For what purpose?  Akin Gump represents CCA’s bottom line, which is not rehabilitation but “’tough on crime’ policies, three strike laws and mandatory minimum sentencing acts which put more people behind bars for longer periods of time.” (“Who’s taken money from private prisons?,” bulletin.represent.us, Oct. 30, 2016)

A report by Source Watch states that CCA “pushed bills like so-called ‘truth-in-sentencing’ and ‘three strikes’ legislation as models for states to adopt across the nation.”  The report also refers to “CCA’s profit-increasing strategies [which] constitute a vicious cycle where low wages and benefits for workers, high employment turnover, insufficient training, and chronic understaffing can lead to mistreatment of inmates, increased violence, security concerns, and riots” . . . [and] withholding medical care and inadequate nutrition add to the volatility.” (“Corrections Corporation of America,” From Source Watch, www.sourcewatch.org)

Corrections Corporation of America, now CoreCivic, is not about “whole person’s” rehabilitation or receptivity to spiritual care in the true sense.  A study by Lee Fang on “How Private Prisons Game the Immigration System,” published in The Nation,“ states, “Calls for more transparency have followed the private prison industry as news reports and lawsuits have revealed a striking pattern of violence, sexual abuse, inadequate staffing, medical neglect and death in facilities across the country.”  The study refers to “investigations by the American Civil Liberties Union [that] found multiple immigrant deaths at facilities managed by CCA.” (www.thenation.com, Feb. 27, 2013)  One wonders how many chaplains of the status quo are providing spiritual care for “the whole person” in for-profit prisons run by CCA.

Atkin Gump is “a well-respected firm.”  Another of Akin Gump’s clients is Saudi Arabia.  Following is Human Rights Watch’s description of the human rights abuses committed by Saudi Arabia:

Saudi authorities in 2017 continued to arbitrarily arrest, try, and convict peaceful dissidents.  Dozens of human rights defenders and activists are serving long prison sentences for criticizing authorities or advocating political and rights reforms. Authorities systematically discriminate against women and religious minorities.  In 2016, Saudi Arabia carried out 154 executions, 23 for non-violent drug crimes.  On January 2, 2016, Saudi Arabia executed 47 men for terrorism-related offenses, including prominent Shia cleric Nimr al-Nimr, who was convicted following a deeply flawed trial.  A Saudi-led coalition continued an airstrike campaign against Houthi forces in Yemen that included the use of banned cluster munitions and apparently  unlawful strikes that killed civilians. https://www.hrw.org/middle-east/n-africa/saudi-arabia)

Akin Gump has a reputation as “a union-busting law firm.”  That’s who Starbucks turned to in an attempt to “crush” the union activity of its workers.  The union-busting methods: “surveillance, intelligence gathering, firing union activists – disparaging the IWW [Industrial Workers of the World] because of our long-term vision of democracy in the workplace,” writes freelance journalist Rowenna Davis. (“The barnstorming barista,” newint.org, Issue 410, 4/1/2008)

The above information on the “well-respected firm” of Akin Gump is quite public.  It would appear that the Spiritual Care Association is deeply embedded in, and committed to the status quo, and that its bottom line is power not patients, money not morality. (For a critique of SCA’s selling of spiritual care,” see Alberts, “Grandiose Marketing of Spirituality,” Counterpunch, Feb. 24, 2017)

Faith leaders who specialize in the clinical training and practice of spiritual care and counseling may argue that their role is not advocacy, but providing a much needed service to hurting individuals and their families.  That is very true — as far as it goes.  But the empathy that adversity elicits should also include advocacy.  Else spiritual care remains a bandage for the status quo, much needed, but oblivious to the political, economic, legal and religious forces that condemn countless millions of people to ill health, marginalization and death.

“Whole-person” spiritual care’s model is provided by a prophet who said, “The thief comes only to steal and kill and destroy; I have come that they might have life, and have it to the full.” (John 10: 10)  And by another prophet who said, “This is what the Lord says: ‘Do what is just and right.  Rescue from the hand of the oppressor the one who has been robbed.  Do no wrong or violence to the foreigner, the fatherless or the widow, and do not shed innocent blood in this place.’” (Jeremiah 22: 3)  And by the Qur’an which says, “It is not righteousness that you turn your faces towards the East and the West, but righteous is the one who believes in God, and the Last Day, and the angels and the Book and the prophets, and gives away wealth out of love for Him to the near of kin and the orphans and the needy and the wayfarer and to those who ask and set slaves free and keeps up prayer and pays the poor-rate; and the performers of this promise when they make a promise, and the patient in distress and affliction and in the time of conflict.  These are they who are truthful; and these are they who keep their duty.”  (Al Quran 2: 178)

The role of shepherd and prophet, of spiritual caregiver and social justice advocate, are inseparable, as the wellbeing and rights of people are interrelated.  Of course, “spiritual care matters.”  And it will matter to more people “in their greatest time of need” when there is enough health care pie for everyone.

Rev. William E. Alberts, Ph.D., a former hospital chaplain at Boston Medical Center is both a Unitarian Universalist and United Methodist minister. His newly published book, The Minister who Could Not Be “preyed” Away is available Amazon.com. Alberts is also author of The Counterpunching Minister and of A Hospital Chaplain at the Crossroads of Humanity, which “demonstrates what top-notch pastoral care looks like, feels like, maybe even smells like,” states the review of the book in the Journal of Pastoral Care & Counseling. His e-mail address is wm.alberts@gmail.com.