蜜芽传媒

Good morning

It was Benjamin Franklin who said nothing is more certain in life than death and taxes. But talking about death remains a major taboo. That is one likely explanation of the revelation, in a new report from the Royal College of Physicians, that fewer than half the patients in NHS hospitals who were known to be dying, were told the truth.

Surveys also tell us that the great majority of people say they would rather know than not know. But it's very personal, and requires doctors to overcome the emotional distance that they normally like to keep between themselves and their patients. Many of them haven't been trained to handle it. So understandably they shy away from it.

But in that case why are we neglecting one major resource that could help hospital staff cope with this? Under pressure to save money, many hospital trusts have been cutting back on chaplains. The Royal College report does call for "adequately staffed and accessible pastoral care, to ensure that the spiritual needs of dying patients and those close to them are met". But that's the only place in their report where this issue breaks through. In any case the phrase "spiritual needs" sounds very narrow. What chaplains do is much broader than that.

Above all they can improve communications with patients and relatives. The report says that across the healthcare system, communication with dying patients is generally poor. Communication is not just about "telling" but also about "listening", and chaplains are skilled listeners. In doing so they can soak up some of the stress and suffering that dying patients and their relatives are going through, take it away from the bedside and dump it elsewhere.

Dump it on God, you could say. Chaplains work across denominations and chaplaincy teams nowadays are mixed, but they can provide moral, emotional and spiritual support for each other so the job doesn't get on top of them. And they have their own religious life, through study, worship and prayer, to help them keep a balance. It's that quality of spiritual toughness and their desire to show God's compassion which is where their religious affiliation is relevant to their work, not in trying to make deathbed converts.

Most of their work, they tell us, is with people of other faiths than their own, or none at all, and no part of their work involves evangelising or proselytising. A survey in Sweden showed that less than ten per cent of the conversations that hospital chaplains have, are about religion. They are mainly with people reaching the end, who are trying to make sense of their lives and of what is now happening to them. But if they've not been told what that is, they are being denied that opportunity. They surely have a right to it.

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