Spirituality Gains Ground In Treatment Of Ill Veterans

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.