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Spirituality Gains Ground In
Treatment Of Ill Veterans

Saturday September 20, 2008

By Mallika Rao
Religion News Service

BALTIMORE -- "I have dreams," said Vietnam veteran Raymond Ratajczak Jr., his mouth wet and tears on his face. "Dreams of recovery."

Ratajczak sat up in a cot at the Baltimore VA Medical Center in a room shared with three other patients. Every few minutes, his face wrinkled and he began to cry.

"What did we talk about earlier today, Raymond?" asked hospital chaplain Charles Thomas. Ratajczak looked up from his bed.

"So a man thinketh, so he be," Ratajczak said, paraphrasing proverbs.

Thomas smiled. "Think positive!"

Chaplains such as Thomas are one of the newest methods used by the Department of Veterans Affairs to treat the nation's veterans. Their job: to assess the spiritual and emotional health of such veterans as Ratajczak and report back to nurses and doctors, in hopes of developing a more "holistic" course of treatment.

Ratajczak, 63, has Stage IV cancer. He admits that although his cancer was detected years ago with regular checkups, "I neglected my health for years," he said, his eyes welling up with tears.

Ratajczak was crying so hard he could no longer speak. His uncontrollable tears are a "reaction," Thomas explained, one provoked even when Ratajczak is not exactly sad. "Sometimes he's better," Thomas said. "But today he's not doing too well."

Such "spiritual assessments" are now routinely conducted on entering patients, though they are not mandatory. Critics, however, say the program runs afoul of the separation of church and state, and say a patient's "spiritual" health should have no bearing on his or her physical treatment.

"They're asking invasive questions, like how many times a day do you pray, and then they're evaluating them," said Annie Laurie Gaylor, founder of the Madison, Wis.-based Freedom From Religion Foundation. "If you don't pass the test, the answer is to give you more religion."

Earlier this summer, Gaylor's foundation lost a case against the VA when an appeals court in Madison rejected a challenge to the VA's use of religion in its health-care practices.

The ruling rested on a Supreme Court decision last year that said taxpayers lack standing in challenging the White House's Office of Faith-Based and Community Initiatives.

Since the creation of the White House office in 2001, VA hospitals have found ready cash to use for chaplains, spiritual assessments and spiritually based substance-abuse programs.

Chaplains at the Baltimore VA hospital do not promote any particular religion, said Thomas, a Protestant, but add a "spiritual dimension" that patients -- many of whom shy away from psychiatric treatment for fear of being labeled "crazy" -- often need.

Still, there are allegations of improper proselytizing in VA hospitals. David Miller, a 47-year-old Navy veteran, alleged that he has been denied treatment for kidney stones at the Iowa City VA Medical Center since 2005 after objecting to the hospital chaplain's aggressive bedside preaching. Miller, an orthodox Jew, alerted hospital staff continuously that he didn't want a chaplain visit, but the Protestant pastor continued to see him, he said, claiming Miller might die soon and would go to hell if he didn't accept Jesus Christ as his savior.

"I didn't have a lot of energy," Miller said. "I was sedated and hooked up to heart monitors. But the patient advocate said I should have objected more strenuously."

The hospital refused to treat Miller after he lodged complaints, he said. It has since agreed to pay for his treatment elsewhere, and the VA is investigating Miller's charges.

Such scenes don't happen in Baltimore, Thomas said. The Baltimore VA hospital employs 12 Jewish, Protestant and Catholic chaplains. Patients like Ratajczak, who lapsed from his faith years ago, say the presence of these religious advisers has changed their lives.

"I've found faith again," said Ratajczak, who is Catholic. "There has to be something higher than where we are. I have to believe that."

Although the VA has said that it believes spirituality can and should be incorporated into care -- for instance, in substance abuse programs -- it differentiates between spirituality and religion, arguing that patients can decide whether a particular religion should enter into their treatment.

Ratajczak, for example, is attended by a Protestant chaplain. "It's all one God," he explained. "It's all one Jesus."

Some secular aid groups, however, say it can be difficult to tap into government funding if they do not incorporate some element of religious counseling.

In 2003, a nonprofit shelter for homeless vets that claimed it lost funding to a Catholic Charities group had to prove it emphasized faith-based values to reclaim its money, said John Downing, president of the Leeds, Mass.-based United Veterans of America.

Downing testified before Congress in 2004 and received the money the next year. He now registers the shelter as a faith-based group to increase his chances of getting funding. The White House office's Web site says it will help "eliminate" all barriers to grant money for Downing's group, as it does for all faith-based groups.

At one level, the distinction between faith-based and secular may be irrelevant in the case of health care, Downing said. "When you treat people with dignity, there's not a faith-based benchmark you don't hit," he said.

And as soldiers and Marines return home from Iraq and Afghanistan, VA hospitals will be focused on doing that, allowing men like Ratajczak access to a chaplain as he struggles with thoughts of death.

"If God wants me to die," he told Thomas, "that's okay."

"Think positive," the chaplain responded.



MRFF's Akiva David Miller responds

Monday September 22, 2008

I read with trepidation Malika Rao's article, entitled "Spirituality Gains Ground In Treatment Of Ill Veterans", that appeared in Saturday's Washington Post. I am a 100% service-connected, disabled U.S. Navy Veteran, I'm Jewish and I have experienced first hand how Christian chaplains at the Iowa City VAMC have used their directive to perform a "spiritual assessment" to determine that I was both "un-churched" and in need of salvation. As a result of this assessment I was aggressively proselytized while hospitalized with acute chest pains at the Iowa City VAMC.

During two separate hospitalizations at the Iowa City VAMC, both times while wired to a heart monitor, an Assembly of God Chaplain entered my room against my expressed wishes (made clear both verbally and in writing at the time of both admissions) and proceeded to inform me that Jesus Christ was the Messiah of the Jews and that unless I accepted him as my personal savior I was going to hell. I was further told that in my poor state of health it was foolish for me to put off accepting Jesus any longer because one never knew when I might die. Despite my protestations, on both occasions the Chaplain refused to leave my room and continued witnessing to me for an extended period of time, and later, when my rabbi and I met with representatives from both the chaplain's office and the patient advocate's office to lodge a complaint, I was informed that the hospital did nothing wrong and that if I was at fault for not more strenuously objecting – despite the fact that I had been both sedated and wired to a heart monitor on both occasions.

In my case the administration of the Iowa City VAMC justified their actions and those of their chaplain by insisting that they were only complying with a directive to perform spiritual assessments. To them proselytizing was only the natural next step because, as it has been made clear by both officials within the Department of Veterans Affairs and the U.S. Armed Forces, Christian chaplain's and the command structure itself reserves "their right" to "minister" to whomever they deem to be "un-churched".

This policy of spiritual assessments only serves to paint a target on the backs of all veterans who don't meet the subjective standards of Fundamentalist Christian Chaplains and/or command personnel – it is not just non-Christians who are targeted, but mainstream Protestants and Catholics as well. More than 90% of the servicemen / women and veterans who contact the Military Religious Freedom Foundation to report religious discrimination and/or harassment by Fundamentalist Christians (more often than not in positions of authority) are Christians themselves.

Our veterans have served our Country honorably and our servicemen / women are under fire every day in both Iraq and Afghanistan, it is dishonorable for agents of the U.S. Government, acting under orders from their superiors, to use spiritual assessments to further target these loyal Americans. These assessments serve only to divide us and subject those who have sacrificed so much for service to the Country to harassment and abuse – that is un-American!

When I entered the U.S. Navy so many years ago I took an oath to uphold and defend the Constitution of the United States of America against all enemies, foreign and domestic. I took that oath seriously – I have never abrogated that responsibility nor forgotten that oath. When I experienced religious discrimination and abuse at the hands of my government I didn't just stand around and complain about what happened to me, I got involved because I saw clearly that if since this thing happened to me it could obviously happen to others. I joined with the Military Religious Freedom Foundation as a volunteer, ultimately as its Director of Veterans Affairs. In that capacity I have worked with and advocated for veterans all over the United States, veterans who have been discriminated against, harassed and even denied benefits because, according to someone else, they either weren't Christian, or they weren't Christian enough.

Religious assessments conducted either by the U.S. Military or the Department of Veterans Affairs are nothing prettier than the yellow star of the Nazis; they single out those who are different and subject them to "special treatment", i.e., aggressive proselytizing, harassment and even abuse. I won't stand by and let this happen to my fellow soldiers, sailors, airmen and marines without standing up and objecting, without fighting with all of my strength, without using every mechanism at my disposal to expose the truth. Never again? It's happening right here, right now at the hands of our own government. What will you do about it?

Akiva David Miller
Director of Veterans Affairs
Military Religious Freedom Foundation


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