Actually, Pastoral Services at our hospital do not NEED a permission such as in the JW's "No Blood" Advance Medical Directive.
What happens is that Pastoral Services receives a list of patients sorted by the patients' stated religious affiliation. The volunteer who has been granted permission by the hospital to work with Pastoral / Spiritual Services then makes rounds in the hospital to each patient who falls under their jurisdiction, depending on whether they stated on their intake form that they would like a visit from Pastoral Services or not. When they visit, they can document their visit in the patient's chart, and in the case of JW "Spiritual Services", conveniently this gives them an opportunity to look through the chart for something naughty.
For example, the Catholic patients receive a quick visit on Saturday and Sunday to invite them to attend Mass in the Chapel, but there usually isn't a need for documenting that kind of visit, and certainly no threat of being excommunicated if there was someone documenting the visit in a patient's chart.
Mind you, a patient's stating that they DO NOT wish to have a visit did not stop a JW Elder from visiting me when I was in hospital after one of my children was born. I was breastfeeding the baby, and had a curtain drawn around my bed, the door to my private room was closed, and I was specific on the intake form that a visit was NOT desired. Still, the Elder sneaked into my room (I didn't hear him, nor see him come in) and flung the curtain open while I was half naked feeding the baby. He startled the living crap out of me for one thing, and when he announced that he was making Pastoral Visits, I ripped him a new one because I had been very clear that I didn't require a visit.
I might just ask if I can look at my old chart to see if he documented anything.