ACC Healthcare Chaplaincy Ethics 3 — Questions and Answers
Question 1: A chaplain is offered a significant gift by a grateful patient's family after a long hospitalization. The most ethically appropriate response is to:
- Accept the gift privately so as not to embarrass the family
- Decline graciously and explain the institution's gift policy (Correct answer)
- Accept only if the patient has been discharged
- Donate the gift to a hospital fund on the family's behalf without telling them
Correct answer: Decline graciously and explain the institution's gift policy
Most healthcare institutions prohibit accepting personal gifts from patients or families to avoid conflicts of interest; declining with explanation is appropriate.
Question 2: Which document most directly guides the ethical conduct of board-certified chaplains in the United States?
- The Hippocratic Oath
- The APC Code of Ethics and Professional Conduct (Correct answer)
- The Joint Commission Patient Rights Standards
- The AHA Patient Bill of Rights
Correct answer: The APC Code of Ethics and Professional Conduct
The Association of Professional Chaplains (APC) Code of Ethics and Professional Conduct is the primary ethical framework for certified chaplains.
Question 3: A chaplain notices that a patient's DNR order was placed without the patient's full understanding. Ethically, the chaplain should:
- Alter the order to reflect what the patient actually wants
- Raise the concern with the attending physician or patient advocate (Correct answer)
- Assume the medical team handled it correctly and say nothing
- Advise the family to override the patient's wishes
Correct answer: Raise the concern with the attending physician or patient advocate
Chaplains serve as patient advocates by raising informed-consent concerns to the appropriate members of the care team.
Question 4: During an ethics committee meeting, the chaplain's unique contribution is best described as:
- Making the final medical decision for the patient
- Representing the legal interests of the hospital
- Voicing the patient's spiritual, cultural, and values-based perspective (Correct answer)
- Providing clinical diagnosis relevant to the ethical dilemma
Correct answer: Voicing the patient's spiritual, cultural, and values-based perspective
Chaplains bring the patient's existential, spiritual, and values context to interdisciplinary ethics discussions.
Question 5: A nurse asks a chaplain to pray with a patient in a way that reflects the nurse's own religious beliefs rather than the patient's. The chaplain should:
- Comply to support the nursing staff relationship
- Pray in the nurse's tradition because it may be more powerful
- Center the prayer on the patient's own beliefs and spiritual language (Correct answer)
- Decline to pray at all to avoid any conflict
Correct answer: Center the prayer on the patient's own beliefs and spiritual language
The chaplain's primary obligation is to the patient's spiritual wellbeing and expressed beliefs, not to the preferences of colleagues.
Question 6: An ethics concept known as 'double effect' is relevant in chaplaincy when:
- A chaplain prays two different prayers for the same patient
- Palliative medication may hasten death while primarily intending to relieve suffering (Correct answer)
- A patient consents to two separate procedures simultaneously
- A chaplain serves both inpatient and outpatient units at once
Correct answer: Palliative medication may hasten death while primarily intending to relieve suffering
The doctrine of double effect addresses situations where an intended good action may have a foreseeable harmful secondary effect, such as palliative sedation.
Question 7: When a patient invokes their religious tradition to justify a decision the chaplain personally finds morally troubling, the chaplain's primary obligation is to:
- Challenge the patient's interpretation of their own tradition
- Respect the patient's autonomy while maintaining professional boundaries (Correct answer)
- Refuse spiritual care until the patient reconsiders
- Notify the ethics committee immediately
Correct answer: Respect the patient's autonomy while maintaining professional boundaries
Respecting patient autonomy requires chaplains to set aside personal moral reactions and support the patient's self-determined spiritual choices.
ACC Healthcare Chaplaincy Ethics 3
A chaplain is offered a significant gift by a grateful patient's family after a long hospitalization.
The most ethically appropriate response is to: