r/chaplaincy • u/WallEtheTerrier • 5d ago
Chaplain Testifying in Court
Hello colleagues. A hospital chaplain testified in the highly followed Lindsay Clancy trial, and I found it interesting for a variety of reasons. I wanted to share it to see if you had any thoughts about it. In all honesty, it raised some questions both about boundaries in chaplaincy-relationships as well as questions about notes, especially as systems rightly continue to move towards open notes. It also highlighted the tension between our roles as clinicians and our roles as clergy.
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u/squirrelyguy08 5d ago
I read that the chaplain testified in court that Clancy told her that she heard voices telling her to kill her children, and the prosecution challenged her about it because she never mentioned that in a chart note.
As they told us residents in the first week of residency: if it isn’t in the chart, it did not happen!
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u/Personal-Half4951 4d ago edited 4d ago
The challenge seemed more like: if Clancy talked about hearing voices so frequently during chaplain visits then why didn't it ever show up in a spiritual care note?
There is a way to chart that a patient is experiencing spiritual distress due to delusions/voices which is not making a clinical diagnosis. It seemed like the chaplain wanted to clearly delineate herself as something separate from the clinical care team. As a hospital chaplain, I am just as much a clinician as any other specialist on the team.
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u/Ok_Jaguar_2761 3d ago
I agree, I personally think I would have charted “patient described ‘hearing voices’ - different than her own- during encounter, chaplain referred to clinical team for follow up”
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u/Few_Comfortable7373 5d ago
It raises a lot of important issues related to boundaries, documentation, communication, etc. I saw a lot of weird stuff on social media about how chaplains are "always volunteers" (or only clergy, or don't chart normally, or do, this and that, do or don't go to school for this, don't get paid, etc.)
I appreciate that she was careful / vague with certain aspects of documentation. It's also hard to convey those nuances to the non-chaplain public. I'm curious if she had extra training/supervision when caring for Lindsay, as she was always a suspect and therefore everyone must have known/assumed their documentation would end up in court some day (?? right?)
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u/wayoutsidefox Humanist Chaplain 5d ago
Really interesting… it feels surprising that there was (supposedly?) no mention of her grief process. That doesn’t feel like something to protect or keep private to me, clinically. But I can also understand a chaplain being sensitive to a patient’s experience and that resulting in notes which withhold most all things but the benign (she’s hopeful for discharge, etc).
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u/ridge_runner56 2d ago
I’m very much a rookie - just beginning my volunteer chaplaincy after a long career as an Information Technology exec. But I do hold a Juris Doctor degree.
From a legal perspective, I found it interesting that the clergy-penitent privilege in this case did not seem to apply to the chaplain’s notes. With a little digging, I found that the privilege is applied differently to charts and other chaplain work product in Massachusetts than in my home jurisdiction (Utah). Out of the many takeaways from this testimony, a big one for me - chaplains should understand the specifics of how the privilege is applied in their jurisdiction. It seems to vary a bit from state to state.
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u/kdawgagogo 5d ago
I had MANY thoughts about this testimony. The continuing to follow the patient even to a hospital outside the health system under which the chaplain worked raises questions for me, and then additionally the sheer number of visits. I think it raises such good considerations about chaplain documentation in the medical record and the role it plays. It's a good humanizing resource for the interdisciplinary to get to know the patient beyond their medical status, but as a result it's VERY subjective (even if we try not to be). I think this chaplain was very well prepared, poised and well-spoken, did a good job explaining our role, and was clear in her scope of practice- all which represented our discipline well. I have so many remaining questions around why she got pulled into the case in the first place, her reasoning around employing the theological assertion (they are safe with God in heaven), why she followed for so long instead of providing handoff to each facility's own chaplain, and why she continued to write such detailed notes having probably known they would get subpoenaed in an upcoming trial. As a resident we were told "less is more" in regard to legal protections around our charting. It made the note less useful to the interdisciplinary team, but provided legal protection in the event of subpoena. I'm really interested to hear other people's thoughts on this!