ACC Healthcare Chaplaincy Ethics 2 — Questions and Answers
Question 1: A patient asks the chaplain to keep a secret before disclosing that they plan to refuse a blood transfusion for religious reasons. What is the chaplain's best response?
- Promise confidentiality, then keep the secret regardless of outcome
- Decline to make a blanket promise before hearing the disclosure (Correct answer)
- Immediately notify the medical team before the patient says anything more
- Tell the patient that chaplains are not bound by confidentiality
Correct answer: Decline to make a blanket promise before hearing the disclosure
Chaplains should not promise unconditional confidentiality before knowing the content of a disclosure, as some information may require action.
Question 2: Which ethical principle is most directly invoked when a chaplain ensures a non-English-speaking patient has an interpreter for spiritual care conversations?
- Nonmaleficence
- Justice (Correct answer)
- Veracity
- Beneficence
Correct answer: Justice
Justice requires equitable access to care, including spiritual care services, regardless of language.
Question 3: A chaplain discovers that a colleague has been sharing patient prayer requests in a staff prayer group without patient consent. The chaplain should first:
- Report the colleague directly to the state licensing board
- Address the concern with the colleague and, if unresolved, escalate to supervisory channels (Correct answer)
- Ignore it because spiritual sharing is inherently benign
- Post a policy reminder anonymously on the staff bulletin board
Correct answer: Address the concern with the colleague and, if unresolved, escalate to supervisory channels
Ethical peer accountability begins with direct collegial conversation before escalating to formal reporting.
Question 4: In the ethical framework of principlism, which principle most directly addresses a patient's right to make their own healthcare decisions?
- Beneficence
- Nonmaleficence
- Autonomy (Correct answer)
- Justice
Correct answer: Autonomy
Autonomy is the principle that upholds each person's right to self-determination in healthcare decisions.
Question 5: A chaplain is asked by an administrator to report which patients are refusing treatment for religious reasons. The chaplain should:
- Comply fully because administrators outrank chaplains
- Provide aggregate trends but not identify individual patients without consent (Correct answer)
- Refuse all communication with administration about spiritual care
- Share only the names of patients who are expected to die
Correct answer: Provide aggregate trends but not identify individual patients without consent
Chaplains can share de-identified systemic information but must protect individual patient confidentiality.
Question 6: When a dying patient expresses guilt about past actions and asks the chaplain for absolution, a chaplain from a different tradition should:
- Perform the absolution to meet the patient's urgent need
- Dismiss the request as outside the chaplain's role
- Acknowledge the spiritual need and facilitate connection with an appropriate clergy person if desired (Correct answer)
- Encourage the patient to wait until a clergy of their tradition is available, regardless of prognosis
Correct answer: Acknowledge the spiritual need and facilitate connection with an appropriate clergy person if desired
Chaplains honor spiritual needs within their scope by facilitating appropriate resources rather than performing rites outside their tradition.
Question 7: A family member demands the chaplain not tell the patient about the patient's terminal diagnosis because 'it will crush them.' The chaplain's ethical obligation is to:
- Follow the family's wishes to avoid conflict
- Reinforce the patient's right to information while exploring family concerns with the care team (Correct answer)
- Immediately tell the patient everything the family disclosed
- Transfer care to another chaplain and exit the situation
Correct answer: Reinforce the patient's right to information while exploring family concerns with the care team
Patient autonomy and truth-telling take precedence; the chaplain collaborates with the team to navigate family concerns without overriding patient rights.
ACC Healthcare Chaplaincy Ethics 2
A patient asks the chaplain to keep a secret before disclosing that they plan to refuse a blood transfusion for religious reasons.
What is the chaplain's best response?