Medical Assistance in Dying: A Complex Conversation in Hospice Care

Hello (again) world! I know it’s been some time since my last post. The reasons are plentiful: word weariness after finishing my book, the breakneck pace of my caseload, and guitar lessons. Although, in all honesty, the guitar lessons and the following practice only account for probably 0.023% of my time. But given some prior conversations and a free afternoon, I thought I’d pick up the keyboard again.


The topic of physician-assisted suicide, more commonly referred to as medical assistance in dying (or simply MAiD), has been an interest of mine for some time. In 2014 I offered a presentation at the annual Association of Professional Chaplains conference regarding the debate regarding voluntary euthanasia, offering my own opinion on what I saw as the key underlying concerns of those for and against physician-assisted suicide, as well as how hospice and palliative care were uniquely situated to address those concerns.

Now, over ten years later, a lot has changed in this landscape. The number of states offering legal MAiD went from four in 2014 to twelve in 2024. Several states are considering legislation this year to offer MAiD, which, if they all pass, would make MAiD legal in over half of the states in the country.

Continue reading

“Sacred Texts” Now on Kindle!

I’m very happy to announce that my book Sacred Texts: Finding Faith Among the Dying is now available on Amazon as a Kindle ebook! If you prefer pixels to paper or just want to save some money, download it today!

Thank you to all those who’ve told me that the book has helped and inspired them. It means a lot to me and I’m so grateful for your support.

Lessons

Last year, I thought I needed a spiritual director. It turns out I needed music lessons.

About 6 months ago I was at a bit of a crisis point. Work was really getting to me and I was very concerned about burnout. I polished my resume, looked at the possibility of changing careers, and got a counselor to help me discern what to do in the middle of what seemed to be a gigantic mess. I thought maybe I needed a spiritual director as well, seeing that this was weighing on me spiritually.

Just before that all began, I also decided to do something I had thought about doing for a while: learning guitar. I had played tenor saxophone for many years, starting in elementary school and playing consistently all through high school and college. It was something I enjoyed tremendously, allowing me to socialize with my fellow “band geeks” while being creative and expressive. After college my sax sat in its case for a long time – it’s really hard to just play sax by yourself it turns out – until I eventually sold it. While I was sad to see it go, I also couldn’t see the use of keeping it when my kids weren’t interested in it.

Continue reading

Sacred Texts: Finding Faith Among the Dying is now available

I’m very excited to announce that my first book is now available to purchase on Amazon. It’s been quite a labor of love (and frustration), and quite a learning process as well.

While it’s written from the perspective of hospice chaplaincy, it’s designed to be accessible to a broad audience. My hope is that readers will be able to find stories and experiences that resonate with their own, and open their eyes to how God may be speaking to them and reaching them through the lives of others.

Please share this with anyone you feel would benefit from it! I welcome all correspondence as well and would appreciate the opportunity to talk with podcasters and others regarding this work.

email: scblair@chaplainsreport.com

Navigating Politics in Chaplain Interactions: Nicholas Collura on The Chaplain’s Compass

The Association of Professional Chaplains has a new podcast series called The Chaplain’s Compass that I highly recommend. It is still very new, with a few bugs being worked out, but the content is all very good so far. Recently they featured a discussion with Dr Nicholas Collura, Director of the Radius Program in ethics at MIT, and the author of “When Patients Talk Politics: Opportunities for Recontextualizing Ministerial Theory and Practice.” His presentation on dealing with political discussions with patients ended up being a highlight of the 2024 APC annual conference.

In this podcast, Dr Collura discusses the tricky landscape of political talk with patients. He gives insight as to how to address the deep core issues that may be at play in discussion of politics, including how to bring those issues out during assessment. He also talks about how to handle our own personal issues that may be triggered when our patients bring up politics.

It’s a very insightful and worthwhile discussion. You can find the episode here on Apple podcasts or wherever you listen to your podcasts.

Almost Done!

My book, entitled (for now) “Sacred Texts: Finding faith among the dying”, is nearing completion! The manuscript is finished save for a few minor edits and additions. After that I’m going to enlist the help of a typesetter and graphic designer to get it ready for final publication. I’ll likely publish it directly through Amazon, as that seems to be what most people are doing now anyway.

It’s been a very long road, and more difficult than I expected. But I’m hopeful that people will find it meaningful and useful. More information will be coming soon.

Blessed are The Mourners: Reflections on All Saints and All Souls Days

“Now when Jesus saw the crowds, he went up on a mountainside and sat down. His disciples came to him, and he began to teach them. He said:

“Blessed are the poor in spirit,
    for theirs is the kingdom of heaven.
Blessed are those who mourn,
    for they will be comforted.
Blessed are the meek,
    for they will inherit the earth.
Blessed are those who hunger and thirst for righteousness,
    for they will be filled.
Blessed are the merciful,
    for they will be shown mercy.
Blessed are the pure in heart,
    for they will see God.
Blessed are the peacemakers,
    for they will be called children of God.
Blessed are those who are persecuted because of righteousness,
    for theirs is the kingdom of heaven.

Blessed are you when people insult you, persecute you and falsely say all kinds of evil against you because of me. Rejoice and be glad, because great is your reward in heaven, for in the same way they persecuted the prophets who were before you.”

Matthew 5:1-12

As I was preparing a message for an upcoming series of memorial services coinciding with All Saints and All Souls Days, I decided to look at the lectionary to see what the assigned passages for those days to help me get started. I don’t come from a liturgical tradition, and am a bit more familiar with the practice of having a theme in mind and then finding a passage or passages that fit that theme. Not the best practice, I know, which is why I diverted from it in this case.

I was a little surprised when the Beatitudes came up as the reading for the day, even though I shouldn’t have been. After all, the passage specifically calls to those who mourn, calling them “blessed”.

Continue reading

Read an Excerpt From My (Hopefully) Upcoming Book!

I thought I’d offer a bite of what I’m working on in my upcoming book, which is tentatively titled “Sacred Texts: Stories of Living With the Dying”. This is still very much a work in progress, but at least progress is being made. I welcome your comments!


528Hz

“You know that the universe vibrates at 528 Hertz, right?”

This was part of the first conversation I had with Neil, who had just come on hospice and was living at home with his mother. It was my initial visit with him, and it was already off to an interesting start. When I arrived at the time we had set up, he wasn’t available. The neighbors who were sitting outside his apartment building in Pittsburgh’s South Hills said that he had just gone out to the local Rite-Aid with his girlfriend. I waited on the patio until he arrived.

Neil right off the bat struck me as an interesting guy when he arrived. He was in his mid-50’s, and his long white hair, thin build, pale Hawaiian shirt and straw fedora made him look like a wandering beachcomber. He carried a portable oxygen concentrator, the only visible indicator of his end-stage lung cancer. “Hey man! Sorry I’m late. I had to go get my meds and some toothpaste.” He introduced me to his friends and then escorted me inside, chatting the whole time.

Continue reading

I’m leaving CPSP. Here’s why.

After months of working with others to try and halt or at least slow down CPSP’s descent over the past year, I’ve decided to hang it up. The organization is hemorrhaging members, and I’ve talked to many who aren’t renewing their membership after this year, which is what I’m doing. I’ve stepped down from my leadership roles and have gone from trying to steer the Titanic away from the iceberg to getting people to lifeboats.

Rather than rehash a bunch of stuff, I’m going to simply include the text of my resignation letter which I sent to Raymond Lawrence and the Governing Council of CPSP this past weekend, July 20, 2023.

To The Executive Chapter and Governing Council of CPSP,

Colleagues,

I have been a member of the College of Pastoral Supervision and Psychotherapy for several years. Since initially joining, I have served as a member, a Chapter Convener, an alternate Representative for Region 2, and served as Co-Convener for the Chapter of Chapters alongside Rita Bakr. I have been a certified Clinical Chaplain and Pastoral Counselor since 2016. I have seen and experienced amazing growth personally and professionally, and have come to treasure and appreciate my fellow chapter members who have shepherded me through so much, as well as the tireless leaders I’ve worked alongside in the Chapter of Chapters and Chapter of Diplomates.

However, I feel I must now vacate my position and resign from CPSP. This has not been a hasty decision and has been made through consultation with my chapter and other members of CPSP. My reason for this is that CPSP is no longer a viable, healthy and functioning organization. Therefore, I will be vacating my position effective July 23, 2023 and will not be renewing my membership any further.

Problems within CPSP have always been present, as they are with any major organization. However significant issues were raised in 2022 regarding the behavior of Raymond Lawrence towards members of the community. Two very important members of the organization resigned in November of 2022 because these issues were not addressed. Since that time, efforts by members of the Chapter of Chapters and the Chapter of Diplomates as well as key committee members to address these issues and others, specifically whether the current General Secretary should continue in his position, have been intentionally sidelined by members of the Executive Chapter and Raymond Lawrence. This avoidance of responsibility and accountability continues to this day. Yet this is not the only reason why I believe CPSP is not a functioning organization.

There has been no actual vote regarding current roles as set out clearly in the CPSP By-Laws (i.e., Article V, Section 5.02). The fact that the General Secretary has in effect ignored what the currently ratified and approved By-Laws state in favor of an autocratic style of governance is a significant concern and sign of dysfunction at the highest levels. Efforts to follow the By-Laws at Governing Council meetings in order to approve leaders have been subverted on multiple occasions.

CPSP’s financial standing and current balances are speculative at best. The issue of CPSP’s financial standing was raised in a March 5th, 2023 town hall, and it has not sufficiently been addressed as of this date. Members of the Governing Council are uncertain about our finances, how much we have and where those funds are. Meanwhile, requests from Raymond Lawrence for members to pay dues have continued, in spite of folks being unable to find out how to do so or if they are paid up in a timely manner.

The current web site is still barely useable. It is impossible to find other members’ contact information, and what information is available is at times outdated or incorrect. This poses a major problem not only for our leaders and members to be in touch with one another, but to those on the outside looking for chapter information. It also has hindered the work of the Chapter Certification committee and CPSP’s own communications efforts. To have a non-functioning, out-of-date and inaccurate web site tells the world that you are not to be taken seriously. Members have reached out to Raymond Lawrence offering to fix the site, but the problems remain. Current efforts to solve the web site problem by the Executive Chapter come too little and far too late.

The current Communications Chair has not had access to the means of communication through CPSP’s email services. As a result, she has not been able to pass along important information to the CPSP body in a timely manner. Emails to the CPSP body have had to go through alternate channels such as personal email lists, other than those coming directly from Raymond Lawrence.

The General Secretary has not implemented recommendations from committees, including the Succession Committee and By-Laws committee. This has caused confusion regarding roles and authority in critical situations, including who is even on these committees, and has led to stagnation and lack of direction.

There has been a significant lack of accountability and transparency on the part of the General Secretary to the overall body of CPSP. There have been months of listening sessions, letters demanding accountability and the raising of significant concerns regarding the viability of CPSP in the future. All of these have been met with no accountability and no real action.

This organizational breakdown, as well as current and former actions of the General Secretary, have significantly impeded the work of CPSP among other professional groups. It is becoming a second-rate body when compared to newer groups such as SCA and CPEI. Many members have left CPSP entirely, or have detached from the larger body while remaining with their chapter. Others have sought dual credentialing in an effort to ensure that they can maintain certification and, in some cases, their jobs.

To summarize, the College of Pastoral Supervision and Psychotherapy is not able to follow its own system of governance, the By-Laws, and its spiritual foundational document, the Covenant. It is not a healthy, functioning organization. I can no longer recommend membership or certification within CPSP to members of my community and to those looking at professional training and certification as long as the status quo remains the status quo.

The College of Pastoral Supervision and Psychotherapy runs on the blood, sweat and tears of its volunteer leaders. I have come to know many during my time in CPSP, and their commitment to this organization and to its members is beyond anything that I have seen in other organizations. Over the past several months we have spent valuable time over weekends and evenings to try and right the ship and bail the water out as fast we can. I commend all of them in their ongoing efforts to make CPSP a healthy and relevant organization. They have tried to foster accountability and address the many needs that have been brought up by its members around the country and around the world. Unfortunately, the failures of a few at our highest levels of leadership have hindered any resolution to these concerns. Right now, for my own emotional and spiritual health, CPSP is not an organization I can continue to be a part of. I’m deeply saddened in that others must now shoulder what had been my responsibilities, and I ask for their forgiveness.

Sincerely,

Samuel Blair

The book writing continueth and other news!

Hi everyone! I thought I’d keep the site active and update folks on my writing and some other significant news.

First, writing has proven to be quite a challenge. I’ve never been the most disciplined writer, or most disciplined anything for that matter, so writing tends to come in fits and starts when I have time. Even when I do have time, I often find it interrupted by something, either a dog needing to go outside or my own brain working overtime on something else. But I have begun looking at publishing options, so we are at least reaching that stage. More to come, including maybe some sample chapters!

Second, I’ve been strongly reconsidering my membership in CPSP. As I’ve worked more and more in leadership positions, I’ve seen more and more dysfunction. Over the past year, things have really come to a head to the point where I don’t believe I can continue on in CPSP much longer unless things change drastically at the national level. Because of this, I’ve taken off a few articles that I had written about certification through CPSP, because I don’t think I can recommend it right now.

Finally, on a better note, I recently got back from a trip with my wife to Colorado. It was a wonderful time to reconnect and simply relax in nature. We’d never been there before and it was a great experience, although my wife would also add “terrifying” to that description. The term “road” in Colorado is applied very loosely.

Thank you everyone and I will try and keep things updated more often.

Colorado Springs from an abandoned railway. I wasn’t driving, which made my wife happy.