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Health Care Chaplaincy in Germany
PROTESTANT CHURCH
Rev Kathrin Jahns
I have worked as a health care chaplain at the Red Cross Hospital in
Kassel (Hessen) since 1993 and also at the Elisabeth-Hospital since 2000.
The main emphasises of my work are two special wards: one dealing with
palliative care and one with women suffering from breast cancer.
From 2000 to 2003 I had been the speaker of the health care chaplains in
the district round Kassel, which belongs to the Protestant Church of
Kurhessen-Waldeck (member church of the EKD/Protestant Church in Germany).
From January 2003 to the present I have been the speaker of the Conference
of Health Care Chaplaincy in the church to which I belong. The chaplains
working in old people’s homes also belong to our conference. All together
we are 104 chaplains in our conference; 26 have a full, 27 a half time
post, the others serve as chaplains in addition to their work in the
parish.
I am responsible for our assembly, which is held once a year. Also I have
to prepare the meetings of the managing board, where we coordinate work,
answer special questions and discuss problems concerning health care
chaplaincy etc.
With this position as a speaker I have also become a member of the
Conference for Health Care Chaplaincy in the EKD (Evangelische Kirche in
Deutschland/ Protestant Church of Germany). Since 2003 to the present I
have been part of the managing committee, which includes together with me,
four other hospital chaplains. We hold our yearly assembly inviting the
representatives of each regional Lutheran, Reformed or United Church in
Germany for four days. The managing committee has its meetings four or
five times a year at different places.
In March 2004 I became the representative speaker and since March 2005 I
am the leading speaker of the Conference.
As the leading speaker of the Conference I was send as the representative
of the EKD to the ENHCC.
Health Care Chaplaincy in the EKD
Our church is organised as a regional denominational church with one
leading organisation, the EKD which includes all the others. But the EKD
is not authorized to make decisions which concern the regional churches.
Normally health care chaplaincy is provided and financed by the church and
the church has the responsibility for the health care chaplaincy. In the
meantime in some regional churches chaplaincy is becoming more and more a
part of the hospital, including the financial affairs.
We have standards, which are obligatory for the regional churches and
every hospital chaplain has to observe this, but not in every case the
standards are observed; exceptional cases are usual.
In summer 2004 a guide for Protestant Health Care Chaplaincy was published
giving information about work and standards.
Becoming a health care chaplain goes in steps, at first you have to apply
for this position. If you are chosen, you have to prove that you have the
knowledge. This knowledge you receive by taking part in courses of
clinical pastoral training. If you take part in several courses, at last
it is possible to become a supervisor, but this last step isn’t necessary
to work as a health care chaplain.
Developing Health Care Chaplaincy – visions and steps
Changes in our hospitals are going on. More and more patients stay for a
shorter term (less then five days) in the hospital. The patients who
cannot be treated any longer go back home or are brought to a hospice, to
an old people’s home or to a nursing home, where they will end their
lives.
Chaplaincy will keep its character as a support in the hospital, but also
it has to become more professional. A discussion is taking place that
chaplaincy has to demonstrate its effect, by writing down its work, like
nurses or doctors do it. At the moment great efforts are made to develop
cooperation between structures inside and outside the hospitals to
guarantee the best possible treatment for the patients and to consider
their wishes about treatment and quality of life, for example in
palliative care or treatment of persons in need of care.
The guide mentioned above is one answer of the Conference for Health Care
Chaplaincy in the EKD to this problem. In future it will be necessary to
overwork this guide, because the conditions work in hospitals are changing
very quickly.
Also chaplaincy will change its character. It will become popular in the
hospitals. It is something, which you can make money with. That means:
qualified health care chaplaincy possibly is able to increase the
popularity of the hospital and patients may choose this special hospital
again.
Recently lots of the regional churches have got into financial
difficulties. All of the member churches of the EKD have to establish new
priorities of work. Mostly at first they take a look at the several
different chaplaincy services – obviously also at the health care
chaplaincy – in order to find special parts of work to economize.
Churches and hospitals are struggling about the way to finance health care
chaplaincy. The churches want the hospitals to contribute to the expenses,
but the hospitals don’t agree, because they are also in financial
difficulties. It is difficult to manage refinancing health care chaplaincy
. There are extensive conflicts of interests between hospitals and
churches. Health care chaplains often find themselves between the lines.
But the basic value of chaplaincy in general and of health care chaplaincy
specially as the native language of the church is not in question at all.
The question is how to communicate this main value inside and outside the
churches to find the appropriate attention.
Rev Kathrin Jahns
Health Care Chaplain, Kassel
[May 2008]
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Roman-Catholic Health Care Chaplaincy in Germany
The 27 dioceses of the Roman-Catholic Church in Germany employ about 1,500
hospital chaplains. The staff involves priests, deacons and religious as
well as lay people. As a rule, they are highly qualified for their
service, as high standards have been established in the training of
hospital chaplains in the past 20 years. In many dioceses there are
special institutes for clinical pastoral training.
The ultimate responsibility for hospital chaplaincy rests with the local
bishop, who appoints a diocesan commissioner for hospital chaplaincy in
his diocese. All diocesan commissioners meet once a year for a conference
in order to exchange experiences and to discuss topical issues, such as
the scope of hospital chaplaincy, pastoral care in hospitals and for
patients at home, ethical questions in hospitals or consequences of the
development of health care policy. In 2007, for instance, they discussed
palliative care.
At local level, the catholic hospital chaplains have an excellent and
close ecumenical cooperation with chaplains of the protestant church. At
national level, too, the protestant and catholic representatives in charge
of hospital chaplaincy meet on a regular basis to exchange experiences.
[May 2008]
PD Dr Hans-Gerd Angel
After a three years professorship for social ethics at the University
of Bonn I am back at the secretariat of the German Bishops’ Conference
since October 2006. From 1992 to 2003 I worked at the department for World
Church affairs mainly on peace keeping and development questions. Now
within the department for pastoral care I’m responsible for the
coordination of some pastoral fields: the catholic hospital chaplaincy,
the catholic part of the ecumenical crisis line, the handicapped persons
and the serious ill and dying people including burial questions. Moreover
I coordinate an annual ecumenical ‘event’ called Week for life existing
for nearly 20 years promoting the human dignity.
I have studied theology and German science, did a doctorate in moral
theology and I’m associate professor at the University of Münster.
[May 2008]
Thomas Hiemenz
I am a male nurse and a theologian. One of my functions in the ASSOCIATION
OF GERMAN CATHOLIC HOSPITALS (about 500) is to compose an annual programme
for hospital chaplaincies supplementary to the training and advanced
training of the dioceses. In the CONFERERENCE OF ROMAN CATHOLIC HOSPITAL
CHAPLAINCY IN GERMANY I am member of the managing committee. At the same
time I am the representative for hospice in the German Caritas Association
in Freiburg.
[May 2008]
Legislation regarding “Hospital Chaplaincy” in Germany
Hospital chaplaincy (pastoral care in hospitals) in Germany is legally
regulated and accepted. It is guaranteed by law in non-profit
(ecclesiastical or charity organisations as supporters), in public and
private hospitals (basic law art. 140, in link with art. 141 of the
“Weimarer Verfassung”). This legal approach of the churches is according
to the legal claim of the citizens for free religious practice (basic law
art. 4, p. 2). With these legal foundations not only the practice of
pastoral care is guaranteed but also the discharge of all claims which are
necessary for delivery (e.g. making available suitable rooms for pastoral
care conversations and divine services).
These laws and their consequences explicitly apply to the public hospitals
(the hospitals under the authority of the state and communal hospitals).
For the private hospitals, this claim also applies.. Ecclesiastical
hospitals increase the legal scope by making clear the meaning of hospital
chaplaincy as a characteristic part of their organisation and trying to
rise to this demand.
Doing his work in the hospital each pastoral caretaker is bound by the
relevant valid data protection laws of the Federal Government and its
counties, to ecclesiastical data protection, to the area-specific data
protection regulation as well as to the official professional discretion
and he is protected from third person due to the official secret.
Because of the significance of hospital pastoral care it is especially
important that the hospital management, medical directors and ward nurses,
and as many as possible members of the hospital staff are informed about
the aims, contents and the practice of pastoral care. Hospital pastoral
care should be a part of educational training and further training, and
exchange of experiences should take place between the staff of the
hospital and the pastoral caretakers. The best way to get knowledge of
hospital chaplaincy is by experiencing the work of hospital chaplaincy in
person. Furthermore it is necessary that the pastoral caretaker is
regularly present in the wards and through his work in the hospital.
The responsible person for hospital chaplaincy – either the manager of a
team or the parish clergyman – is responsible for making arrangements to
get pastoral caretakers in his absence. Changes in the staff of hospital
chaplaincy often burden those people being concerned: Who will be able to
do this important pastoral tasks in a suitable way?
(in: The German Bishops no 60, The concern of the church
for the sick, April 20th, 1998, 34 and 35)
[May 2008]
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