Chaplaincy in the Modern Health Care System: Presence, Dying, and Community in the Advance and Subversion of Biopolitics

Abstract

The dissertation begins with an autoethnographic account of my own experiences as a CPE chaplain resident and current PRN hospital chaplain in order to explore wider relationships between pastoral care and dominant health care trajectories and politics. Using empirical studies, personal accounts by health care professionals, and the political theories of Michel Foucault, I argue that current trends and practices in the hospital both marginalize those who cannot buy into the system and render the human experience of decline and death invisible. Chaplains contribute to these trends through their pastoral presence, assessment, and recording of the patient’s spirituality. These practices are heavily laden with the therapeutic ideals of acceptance and self-realization, which further medicine’s power and management of death rather than reckoning with the realities of loss in human experience. However, employing the theories of Julia Kristeva and Jean-Luc Nancy, I also argue that chaplains nonetheless experience a sense of loss in their work of care and articulate this loss with families and patients in the terms of spirituality. These experiences and language recognize and honor loss within the hospital, thus subverting the excesses of biomedicine today that can speak only of progress and commodification.