Teaching Ethical Decision-Making Through Chaplaincy:
Lessons from End-of-Life Care and Marginalized Populations
Rev. Dr. Julie La May Vaughn, D.Min., D.Bioethics, M.Div., MACE, BCC
Abstract
Hospital chaplains serve at the intersection of spirituality, ethics, and clinical practice, making them uniquely positioned to contribute to ethics and humanities education. Drawing upon published scholarship examining end-of-life care and community-based chaplaincy among marginalized youth and young adults, this presentation explores how chaplaincy case studies can be utilized as teaching tools to foster ethical reflection, compassionate care, and patient-centered decision-making.
Using lessons from Role of Chaplains in End-of-Life Care: Case Studies on Healing, this presentation examines the chaplain's role in addressing spiritual distress, facilitating communication among patients, families, and healthcare teams, supporting values clarification, and assisting with ethical decision-making during complex clinical situations. The presentation also incorporates insights from Providing Chaplaincy to the Youth and Young Adults Marginalized in King County, highlighting the ethical and humanistic dimensions of serving vulnerable populations whose experiences may be shaped by homelessness, social exclusion, trauma, disparities in access to care, and unmet spiritual needs. The end-of-life care publication is documented in the author's scholarly work. [Document 6 | Word], [Document 7 | Word]
These case-based examples provide educators with practical tools for teaching ethical concepts such as dignity, autonomy, justice, cultural humility, health equity, moral distress, and compassionate presence. Through examination of real-world chaplaincy encounters, learners are encouraged to reflect upon the human experience of illness, suffering, loss, identity, resilience, and meaning making. The presentation demonstrates how chaplain-led narratives can enrich ethics and humanities curricula by helping healthcare professionals move beyond theoretical frameworks and engage the lived experiences of patients, families, and communities.
By integrating chaplaincy scholarship into ethics and humanities education, educators can strengthen interprofessional learning and cultivate reflective practitioners who are prepared to address the spiritual, ethical, cultural, and psychosocial needs of diverse populations. This presentation offers a framework for incorporating chaplaincy case studies into healthcare ethics education and illustrates how spiritual care contributes to whole-person care and ethical healthcare practice.
Educational Objectives
Following this presentation, participants will be able to:
1. Describe the role of chaplains in ethical decision-making and patient-centered care.
2. Analyze how chaplaincy case studies can be used as teaching tools in ethics and humanities education.
3. Examine ethical challenges encountered in end-of-life care and in serving marginalized youth and young adults.
4. Evaluate the relationship between spirituality, human dignity, health equity, and ethical healthcare practice.
5. Identify strategies for integrating chaplain led narratives into interprofessional ethics and humanities curricula.
Presenter Biography
Rev. Dr. Julie La May Vaughn, D.Min., D.Bioethics,MA., M.Div., MACE, BCC, is a Board Certified Chaplain at St. Anne Hospital and a Clinical Ethicist at Kindred Long Term Acute Care Hospital (LTACH). She is a member of the Association of Professional Chaplains (APC) and the American Society for Bioethics and Humanities (ASBH). Dr. Vaughn serves as Director of Christian Education and President of Women's Ministry at Mount Zion Baptist Church in Seattle, Washington. Her scholarship focuses on healthcare ethics, spiritual care, health equity, chaplaincy practice, and care for vulnerable populations. Her published work includes Role of Chaplains in End-of-Life Care: Case Studies on Healing. [Document 6 | Word], [Document 7 | Word]
Teaching Ethical Decision-Making Through Chaplaincy
"To understand why chaplaincy stories are valuable teaching tools, we must first consider the unique
role chaplains play within healthcare and community settings."
Why Chaplaincy Matters in Ethics Education
Chaplains practice at the intersection of spirituality, ethics, healthcare, and human experience.
Because chaplains are often present during moments of uncertainty, suffering, decision-making, and loss, they frequently encounter ethical issues before they become formal ethics consultations.
Chaplains help patients and families clarify values, communicate concerns, and explore meaning during complex situations.
These experiences provide rich opportunities for ethics education because they reveal how ethical principles operate in lived experiences rather than theoretical scenarios.
"If chaplaincy offers a unique lens into ethical decision-making, what can learners gain from studying these experiences?"
Educational Objectives
This presentation has five objectives.
We will examine the role of chaplains in ethical decision-making and patient-centered care.
We will explore how chaplaincy narratives function as effective teaching tools.
We will analyze ethical challenges in end-of-life care and marginalized populations.
We will consider the relationship between spirituality, dignity, health equity, and ethical practice.
Finally, we will identify strategies for incorporating chaplain narratives into ethics education.
"A useful place to begin is understanding why stories and case studies are such effective educational methods."
Case-Based Learning Framework
Ethics often becomes easier to understand when attached to a person's story.
Instead of discussing principles in the abstract, case studies allow learners to examine real situations where values, beliefs, healthcare realities, and relationships intersect.
Chaplain narratives capture emotional, spiritual, cultural, and ethical dimensions of care that may not appear in standard clinical analyses.
These stories encourage reflection and help learners appreciate the complexity of ethical decision making.
"One setting where chaplain narratives provide particularly rich educational opportunities is end-of life care.
End-of-Life Care Case Study
Chaplains frequently accompany patients and families through difficult decisions involving serious illness, advance directives, life-sustaining treatment, and goals of care.
Through spiritual assessment and attentive listening, chaplains help identify values and beliefs that influence medical decisions.
Questions about treatment often involve deeper concerns regarding hope, suffering, faith, meaning, legacy, and identity.
Chaplains support communication and values clarification while helping healthcare teams appreciate the spiritual dimensions of ethical decision-making.
"These conversations frequently involve core ethical principles that guide healthcare decisions."
Ethical Concepts in End-of-Life Care
The concerns from the previous case can be organized around foundational bioethical principles.
Autonomy focuses on respecting patient wishes.
Beneficence involves promoting patient well-being.
Nonmaleficence requires avoiding unnecessary harm or suffering.
Justice emphasizes fairness and equitable treatment.
Underlying all these principles is human dignity.
Chaplains support ethical reflection by helping teams understand how these principles are experienced by individual patients and families.
"Even when ethical principles are clear, healthcare professionals may still experience significant moral and emotional challenges."
Moral Distress and Compassionate Presence
Moral distress occurs when individuals recognize an ethically appropriate course of action yet feel unable to pursue it because of barriers, uncertainty, or conflict.
Patients, family members, nurses, physicians, social workers, and chaplains may all experience moral distress.
Chaplaincy interventions such as active listening, reflection, presence, and interdisciplinary collaboration create space for dialogue and resilience.
"The themes of dignity, suffering, and ethical uncertainty extend beyond healthcare settings into communities experiencing significant vulnerability."
Marginalized Youth and Young Adults
My second case study shifts from the hospital to community-based chaplaincy.
Marginalized youth and young adults frequently face homelessness, trauma, social exclusion, financial instability, and barriers to healthcare access.
These realities create significant ethical challenges involving justice, inclusion, health equity, and human dignity.
Chaplaincy provides a framework for listening to lived experience and recognizing the impact of social determinants on health outcomes.
"These experiences illustrate why health equity and cultural humility are essential dimensions of ethical practice."
Health Equity and Cultural Humility
Ethical care requires more than equal treatment.
It requires recognizing barriers that prevent people from accessing opportunities for health and flourishing.
Cultural humility encourages lifelong learning, self-reflection, and openness to perspectives different from our own.
By listening before judging, healthcare professionals gain a deeper understanding of the experiences influencing ethical decisions.
"Across both case studies, one central value continues to emerge: human dignity."
Chaplaincy and Human Dignity
Patients facing serious illness seek affirmation of their worth and identity.
Marginalized youth seek recognition, inclusion, and meaningful participation in society.
In both settings, dignity remains central.
Chaplains help preserve dignity through storytelling, advocacy, presence, spiritual care, and authentic relationships.
"If chaplaincy contributes so significantly to ethical reflection, the question becomes how we can incorporate these perspectives into ethics education."
Integrating Chaplaincy into Ethics Education
Case discussions, reflective writing, ethics rounds, narrative medicine, simulation, and
interprofessional learning provide practical opportunities for integration.
Chaplain narratives help learners connect ethics, communication, spirituality, culture, and healthcare practice.
Stories often remain with learners long after theoretical concepts are forgotten.
"To help educators implement these ideas, I propose a simple teaching framework."
Proposed Teaching Framework
This framework guides learners from identifying an ethical issue to understanding the human experience behind it.
Beginning with the case, learners identify ethical concerns, explore patient values, examine spiritual dimensions, discuss interdisciplinary responses, and reflect on lessons learned.
This approach encourages deeper ethical reasoning and reflective practice.
"Having explored both examples and an educational framework, several key lessons emerge.
Key Takeaways
Chaplaincy case studies humanize ethics education.
They highlight lived experiences and deepen understanding of dignity, suffering, equity, spirituality, and decision-making.
Stories strengthen reflective practice and promote compassionate, patient-centered care.
Most importantly, chaplaincy provides a bridge between ethical theory and the realities of human experience.
"These lessons raise important questions for all of us who teach, practice, or consult in ethics."
Discussion Questions
Where might patient narratives deepen learning?
How can chaplain perspectives enrich ethics curricula?
What opportunities exist for greater interprofessional collaboration?
References
The Role of the Hospital Chaplain End of Life Care: Case Studies on Healing
Providing Chaplaincy to Youth and Young Adults Marginalized in King County by Julie Lamay Vaughn, DMin
Thank You
References & Resources
Vaughn, Julie La May
Role of Chaplains in End-of-Life Care: Case Studies on Healing
Providing Chaplaincy to the Youth and Young Adults Marginalized in King County
ASBH Core Competencies
Narrative Ethics Literature
Health Equity Literature
Chaplaincy and Spiritual Care Scholarship
Presenter Biography
Rev. Julie Vaughn, D.Min., D.Be., MA, MACE, M.Div., BCC
Rev. Dr. Julie Vaughn, D.Min., D.Be., MA, MACE, M.Div., BCC, is Founder and President of Hope Angels Ministry, an ordained minister, Board Certified Chaplain, bioethicist, educator, and community leader. Her ministry focuses on faith, education, compassionate care, and empowering individuals to serve their communities with purpose and hope.
Stay Connected
📧 julievaughn53@gmail.com
🌐 Hope Angels Ministry
Professional Interests:
Healthcare Ethics
Spiritual Care
Health Equity
Chaplaincy Education
Vulnerable Populations
Future Publications & Scholarship
Please revisit this page for future publications, conference presentations, educational resources, and scholarship related to healthcare ethics, chaplaincy, health equity, and spiritual care.