ACC Ethical Practices & Professional Conduct 3 — Questions and Answers
Question 1: A chaplain is called to support a patient who is a member of the same religious congregation. What ethical concern does this create?
- It creates a potential dual relationship that may compromise professional boundaries (Correct answer)
- It is ideal because shared faith ensures better rapport
- It requires the chaplain to conduct a religious service
- It has no ethical implications as long as the patient consents
Correct answer: It creates a potential dual relationship that may compromise professional boundaries
Pre-existing personal relationships create dual-relationship risks that can blur professional boundaries and compromise objectivity.
Question 2: Which of the following best illustrates the ethical principle of 'do no harm' (nonmaleficence) in chaplaincy practice?
- Praying with every patient regardless of their faith preferences
- Refraining from imposing spiritual practices on patients who have not requested them (Correct answer)
- Documenting all spiritual assessments in the medical record
- Referring all patients to religious counselors
Correct answer: Refraining from imposing spiritual practices on patients who have not requested them
Imposing unwanted spiritual practices can cause spiritual or emotional harm, so nonmaleficence requires waiting for patient invitation or consent.
Question 3: A chaplain working in a correctional facility is asked by security staff to gather information about an inmate's religious activities for surveillance purposes. The chaplain should:
- Comply, as institutional security supersedes chaplaincy ethics
- Refuse and explain that pastoral confidentiality prohibits this use (Correct answer)
- Gather only the information requested and report to supervisors
- Stop providing religious services to the inmate immediately
Correct answer: Refuse and explain that pastoral confidentiality prohibits this use
Using pastoral relationships for surveillance violates confidentiality and the trust fundamental to chaplaincy, even in correctional settings.
Question 4: A chaplain notices signs of depression in a patient but is not a licensed mental health provider. The ethical response is to:
- Conduct an informal psychiatric assessment
- Offer supportive presence and refer to mental health professionals (Correct answer)
- Prescribe self-help spiritual exercises to address the depression
- Avoid the topic to prevent distressing the patient further
Correct answer: Offer supportive presence and refer to mental health professionals
Chaplains must recognize the limits of their role and facilitate referrals to licensed clinicians while providing compassionate presence.
Question 5: When documenting spiritual care in a medical record, a chaplain should:
- Record verbatim quotes from all pastoral conversations
- Document only clinically relevant spiritual care observations using professional language (Correct answer)
- Avoid documentation to protect pastoral confidentiality
- Copy and paste the same note for efficiency
Correct answer: Document only clinically relevant spiritual care observations using professional language
Chaplains document clinically relevant spiritual care observations professionally while respecting the confidential nature of pastoral conversations.
Question 6: A chaplain is approached by a media reporter requesting information about a high-profile patient's spiritual condition. The chaplain must:
- Provide a general statement to reassure the public
- Decline to confirm or deny any information about the patient
- Refer the reporter to the hospital's public relations department and say nothing more (Correct answer)
- Share only non-identifying information
Correct answer: Refer the reporter to the hospital's public relations department and say nothing more
HIPAA and professional ethics prohibit sharing any patient information with media; the chaplain should redirect to public relations and disclose nothing.
Question 7: Which situation best represents an appropriate use of self-disclosure by a chaplain?
- Sharing extensive personal trauma history to build rapport with a grieving patient
- Briefly mentioning a personal experience of loss to normalize a patient's grief, when therapeutically appropriate (Correct answer)
- Discussing personal religious beliefs to encourage the patient to adopt similar practices
- Revealing details of other patients' experiences to illustrate common challenges
Correct answer: Briefly mentioning a personal experience of loss to normalize a patient's grief, when therapeutically appropriate
Therapeutic self-disclosure is brief, intentional, and serves the patient's needs rather than the chaplain's, used only when clinically appropriate.
ACC Ethical Practices & Professional Conduct 3
A chaplain is called to support a patient who is a member of the same religious congregation.
What ethical concern does this create?