Father Yuriy Pylypchak on the Work of a Medical Chaplain: Learning Humanity and Seeing the Image of God in Every Person

You studied bioethics in Rome. Why bioethics?
I chose bioethics because it presents a challenge—not only to us as priests, as ministers of the Church, but to all Christians. Ethics, whether in medicine or more broadly in human life, addresses aspects of human life that are still insufficiently explored.

When I began studying bioethics in seminary, I became very interested in the field. I wanted not only to deepen my knowledge but also to approach it practically: to see how it can be applied in practice and how this ministry can be shared with others.

It was this challenge that particularly interested me and motivated me to continue my studies, to further explore and truly deepen my knowledge of bioethics—both practical and theoretical.

What does knowledge of bioethics give to a priest?
Knowledge of bioethics gives a priest a great deal. I consider it a profound depth. We often delve deeply into theology, liturgics, and philosophy, which are all very good and important aspects of priestly ministry.

Bioethics, however, is another dimension that reveals the depth of human relationships: starting with the relationship with God, then with others and with oneself. There are many ethical moments when we ask ourselves whether we can do anything regarding ourselves, our own life, and dignity. This also applies to our relationships with others—in marriage, with friends, within the family, and in relations with children and neighbors.

It is fascinating to observe how the depth of bioethics as a discipline helps us better understand the sacraments of the Church. In particular, confession and the anointing of the sick—in moments of final touch, prayer, and blessing for a person experiencing serious illness. These are extremely profound moments. At the same time, in every sacrament, bioethics leaves a deep mark.

To be a medical chaplain, one doesn’t have to be a bioethicist. So how did your knowledge help when facing human pain and grief? Bioethics is a science, a general framework—but here it’s specific human grief and decisions. How did you combine this academic discipline with practical work?
Of course, to be a medical chaplain, it is not necessary to be a bioethicist. At the same time, bioethics is a practical discipline—if applied correctly.

A chaplain provides spiritual, psychological, emotional, and social support to patients, their families, and medical staff. This support is very deep. Very often it is reduced only to rituals or purely religious practices, but that is probably only 10% of what a chaplain can truly provide. That is why knowledge of bioethics is so important—especially in relationships and accompanying patients. One must know how to listen actively and empathetically.

Bioethics helps to delve more deeply into human suffering—to see it not only theoretically but in connection with what is important to the person at that moment. This could be the spiritual, psychological, or emotional sphere. This is where the key lies. A chaplain must have many such “keys,” many points of contact.

Understanding suffering through the lens of bioethics is one of these keys. It allows a deeper engagement and helps the person find the path they usually know themselves, but due to pain and grief, find difficult to walk without support.

Another important aspect is the chaplain’s relationship with medical personnel. This area often raises difficult questions: what can we do, where is the boundary of autonomy so widely promoted today, and where lies the value of a person as God’s creation, as an individual? It is important to have an approach not only personally but also socially and even academically. A chaplain must have a language, a vocabulary that allows them to act as a kind of translator between medical staff and patients.

In my nine years of chaplaincy, I often encountered a gap between the language and terminology used by medical staff and the understanding of a suffering patient. Patients often cannot accept medical terminology, yet they are the ones who must make decisions.

When I came to work at Shady Grove Medical Center, still as a student, I was invited to join the hospital’s Ethics Committee and the broader structure of Adventist HealthCare. The knowledge I gained there was very important. There are many people who think about ethics but, unfortunately, have little real contact with it. It is extremely important to rely not on subjective ethical principles but on objective ones—those that truly guide all actions toward the full and real good of the person.

What does a full-time medical chaplain’s day look like?
A full-time chaplain’s day is busy and rarely predictable. In the system I belonged to, we spent years developing the understanding of what a chaplain is in a hospital. Over nine years, we moved from seeing the chaplain as someone who only comes to pray, to understanding the chaplain as a professional providing spiritual, psychological, emotional, and social support to everyone in the hospital—patients, families, and medical staff.

Each chaplain on our team was responsible for a particular area or department. I was responsible for oncology and NICU and was also part of the palliative care team.

My day began at 7 a.m. First, I printed a list of patients in the departments I was responsible for and began rounds in the operating unit. Everyone going into surgery experiences fear, anxiety, and inner tension. Chaplains often have only two or three minutes to reach the patient’s heart and understand how to support them at this moment of preparation.

After that, we had a departmental meeting. We started with prayer, reflection, and discussion of what was most important that day, as well as reviewing the previous night to focus attention where it was needed. Our priority was always crisis situations—death of a patient or severe distress experienced by a patient or family, which could lead to emotional exhaustion for both family and medical staff. Crisis became our first concern.

Then we began rounds and met patients for what is called a “spiritual assessment.” This involves professionally understanding where the patient is: whether they have support, whether religion or spirituality is important to them, and what factors might help them during hospitalization. From a psychological and emotional perspective, we checked whether the patient had a support network, whether we needed to contact loved ones, and which resources helped them cope with the situation and trauma. All this information was documented.

During the day, we also participated in medical rounds. The chaplain was a full part of the medical team, because all aspects of the patient’s condition were considered—not only medical but also social: family environment, support from friends, insurance, and financial resources. All of this directly influences how the patient accepts treatment and collaborates with medical staff.

The second part of the day I spent with the palliative care team, which included a doctor, nurse, social worker, and chaplain. Together, we sought to understand what kind of support the patient needed: whether palliative care or transition to hospice, and which specific steps would help the patient and their family.

A distinct part of the work was emergency calls. The hospital has a system of codes—for example, a red code means cardiac arrest. In such cases, the entire medical team immediately gathers at the patient’s side. The chaplain is among them. While the medical team fights for the patient’s life, the chaplain fully supports the family—offering care, communication, and explanations. The chaplain acts as a bridge between staff and relatives because the doctors’ primary task is to save the patient’s life.

This describes a structured day. In reality, most days were chaotic, because the hospital rarely allows for a strict schedule.

Tell us about the hospital where you worked. How many chaplains were there?
Shady Grove Medical Center is part of Adventist HealthCare. In Maryland, this system includes three hospitals, two large psychiatric units, two rehabilitation centers, and emergency services. Chaplains work in every center and department.

Our hospital had two full-time chaplains and a manager responsible for administrative duties, who could also assist with pastoral care if staff were short.

We also had a CPE (Clinical Pastoral Education) program, providing professional training for future chaplains. Through this, students worked with us, assisting in daily ministry. Chaplaincy services were provided 24/7. On some days, chaplain and student served together.

There was also a system of on-call shifts: in a crisis, a chaplain had to arrive within 25–30 minutes.

Our team included Adventists, Protestants of various denominations, Muslims, Jews, Buddhists, and Roman Catholics. I belong to the Ukrainian Catholic Church, and we all worked together. The focus was always on the person and how best to support them.

If a patient requested a clergy member of a specific faith not represented on our team, we coordinated with volunteer clergy outside the hospital.