Caroline Petrie: praying for your clients

I have just listened to Caroline Petrie being interviewed on the Jeremy Vine show on BBC Radio 2. She works as a community nurse, for a Primary Care Trust. It would appear that she had been asked already to stop giving prayer cards to her patients, a request that I understand she had complied with. She is now suspended from work while an investigation is carried out into her asking a patient if she would like her to pray for her. The "investigatory meeting" is due to take place later this week. Within disciplinary procedures, this meeting looks at the evidence gathered by an investigating officer on behalf of the employer and makes a decision as to whether further disciplinary action should be taken.

Professional Reflections

The relationship of a healthcare professional to their patient of client involves a special kind of trust. The patient is potentially, to a lesser or greater extent depending on their condition, in a situation where they are vulnerable. The understanding in the relationship of professional to patient is that the professional is to carry out a professional/clinical role towards the patient, and this understanding is of the essence of the trust in the relationship. A professional who tries to do anything else as part of this relationship takes an inappropriate advantage of the element of trust.

Hospital Trusts certainly recognise that patients have pastoral and spiritual needs, which may also be religious needs. Provision for this is made through Chaplaincy arrangements, though this is usually now termed "Pastoral Care". My own local hospital, that I can see out of my window, trains and deploys a range of lay pastoral visitors who do what their name suggests - they visit patients in the wards to give pastoral care. It would be interesting to know how far Primary Care Trusts do the same.

But the role of the pastoral visitor - and hence the "content" of the relationship of trust they have with a patient, even on a one off visit - is different than that of a nurse or doctor. They come to the patient for a different reason.

But for both the pastoral visitor and the medical staff, there is a need to respect the patient as a person in the situation where the patient finds themselves. So, in seeking to pray with or for a patient, a pastoral visitor is trained to be sensitive to the fact that the patient may well not have any religious belief at all, or that they may belong to a religion that is different than that of the pastoral visitor ... and so there are a series of points on which the patient's agreement needs to be established before you start to talk about prayer (or even about religion at all). There is a parallel to the way in which a patient consents to the treatment given by a doctor. A tremendous sensitivity is needed, for example, if I as a Catholic wish to pray with someone who is of a religious belief other than Christianity - will we share a spoken prayer of some sort, or will we just spend a few moments together in silent prayer?

Has Caroline Petrie suffered from a combination of a misunderstanding of the relationship of trust proper to her as a nurse and not having the training with regard to sensitivity that is available to pastoral visitors?

The Christian Legal Centre have a report giving more details of the case here. Their report cites a letter sent to Caroline Petrie after the incident involving a prayer card, which says in part:

Your NMC [Nursing Midwifery Council] code states that “you must demonstrate a personal and professional commitment to equality and diversity” and “you must not use your professional status to promote causes that are not related to health”.

From the point of view of public policy, these two grounds for possible disciplinary action are quite different. The former grounds would touch on the question of religious freedom, whilst it is not clear to me that the latter ground would do so. As the Christian Legal Centre comment:

Andrea Williams, the founder and Director of the Christian Legal Centre, said: ‘It is of huge concern that Christian citizens, whose desire is to do their jobs well, are increasingly being silenced and pushed out of the ‘public square’ because of Equality and Diversity Policies. It is extraordinary, that these policies which purport to ensure tolerance are ushering in a new form of censorship and intolerance which should concern us all’

A statement from the Christian Medical Fellowship sheds more light on the role of pastoral and spiritual care for patients in the NHS. The statement can be found here.

Catholic Reflections

There is a tendency within Evangelical Christianity to see something like praying with people as an important part of their mission to spread the Christian faith. In some situations this is clearly right, but not in all situations.

Catholic thinking on evangelisation talks about different stages, and includes a first stage of "presence in charity". So a Catholic pastoral visitor, for example, can see their hospital visiting as being an evangelising activity in the sense of "presence in charity" that from time to time, and in appropriate circumstances, leads to an opportunity for a more explicit evangelising activity such as praying with a patient. Similarly, a nurse can see her clinical care for patients as "presence in charity" without a need for explicit evangelising activity. This question of "presence in charity" expresses also the need to respect a patient by not putting on to them something to which they have not really agreed. There is a story about Madeleine Delbrel visiting the house of Communist neigbour who had died soon after her arrival in a working class suburb of Paris. She took some flowers in the shape of a cross - which she had to quickly rearrange into a circle after getting a cold reaction from the family. I think this rearranging of the cross into a circle is quite a nice image of "presence in charity".

I suspect that Evangelical Christians do not have this developed understanding of evangelisation that is available to Catholics, and so find themselves not being able to see any alternative to an explicit step of evangelisation. As a result, I think they may at times be getting themselves into difficulties that could be avoided without any compromise of conscience.