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Spiritual Care in a Medical Setting: Do We Really Need It?
Dan Lioy, Th.D., D.Min.
Dean of Online Studies,
Trinity College & Theological Seminary
Years ago parish ministers would volunteer their time to visit the sick and the dying in hospitals, nursing homes, and hospices. They might offer prayer or grief ministry, or perform a specific rite or ritual such as baptism. Times have changed, and now spiritual caregivers are typically paid staff members who have received significant amounts of specialized training (Brock and Nelson 1991, 1428). As chaplains become increasingly present with physicians and nurses at the patient's bedside, healthcare providers are asking whether spiritual care is needed in a hospital setting (Marty 1985, viii).
Some administrators, taking a purely bottom line approach, argue that spiritual care isn't income producing. Because it doesn't contribute to the overall profit margin of the organization, it supposedly doesn't make good financial sense to retain one or more paid staff chaplains. Instead, the institution should ask local ministers to provide spiritual care as needed, either in a volunteer status or as independent contractors.
Others, favoring a more holistic approach to healthcare, maintain that chaplains are an essential part of the patient care team. Who else, it is asked, can best address the anxiety and grief of patients, family members, and staff than chaplains? Spiritual caregivers are said to be the main individuals within the hospital who can meet with others in an unhurried fashion, and offer comfort and hope in times of crisis. It is maintained that while the services of a chaplain are not directly income producing, their ministry to the sick and dying is still of inestimable value.
With such a dichotomy of opinion about the role of chaplains within a healthcare setting, researching this topic seems useful. This paper, therefore, will investigate the following question: What place does spiritual care have within a medical setting? The intent will be to delineate the general role and functions of chaplains within institutions such as hospitals, nursing homes, and hospices.
To achieve this goal, I will begin by overviewing what people in ancient times had to say about spiritual care to the sick and dying. Then I will explore the perspective of the early church on this subject. Next, I will delineate the views of the medical community (principally physicians and nurses). Lastly, I will focus on the perspective of chaplains. In the concluding section of this paper, I will summarize what has been said and offer some final thoughts.
People in antiquity were concerned about issues involving health and healing. Egyptian papyri and Mesopotamian cuneiform texts indicate that a variety of diseases plagued individuals (Sussman 1992, 6:6). These ailments included malaria, smallpox, boils, water-borne infections (such as cholera and typhoid fever), and environmental afflictions (such as sandy fever; Harrison 1979, 1:954).
In these pre-scientific societies, priest-physicians shouldered the care of the sick and the dying (Adolph 1976, 3:55). They used a combination of methodical and superstitious methods to treat the afflicted (Harrison 1982, 2:641). For instance, in Egypt fiber splints might be advocated for treating fractures, but then magic incantations would be utilized to reduce a severe fever (Pousma 1976, 4:788). In Babylonia, practitioners might use an empirical approach to deal with common eye problems, but then attribute other ailments to demonic activity (Harrison 1979, 1:954).
People in other ancient cultures also believed that evil powers had to be exorcised and the patient given relief and peace of mind as part of the therapeutic process (Adolph 1976, 3:55). This might seem irrational. But it does underscore a truth made evident in the late twentieth century, namely, that “the healing of tissues is hindered if the patient is greatly worried or otherwise disturbed emotionally” (Harrison 1982, 2:641).
The ancients made use of a variety of therapeutic substances, especially herbs (Eakins 1991, 369). The Sumerians were the first to discover the numbing qualities of the drug most commonly found in modern day aspirin. They also figured out that castor oil has certain cathartic qualities. Other groups of people followed well-established procedures for the treatment of the sick. In fact, in some cultures “penalties were prescribed for malpractice” (Harrison 1982, 2:642).
The ancient Hebrews were bound to the one living and true God by a covenant relationship. This pact was intended to make the Israelites a kingdom of priests and a holy nation (Exod. 19:6). They believed that obedience to God’s will was central to their spiritual, emotional, and physical health (Adolph 1976, 3:55). Thus, resorting to the superstitious practices of their pagan neighbors meant a lack of faith in God as the one who healed them (Exod. 15:26; Kee 1992, 4:659).
The Hebrews “concept of preventive medicine and absolute repudiation of anything that resembled magic fundamentally differed from ancient medical or hygienic procedure” (Harrison 1982, 2:642). In fact, “the ethos of the Mosaic legislation repudiated entirely any magical or demonic etiology of disease” (Harrison 1979, 1:955).
The Mosaic covenant stipulated a number of practices that seem to promote not only spiritual health but also physical and emotional well being (Adolph 1976, 3:56). For instance, the observance of the Sabbath—which occurred every seven days—was based on the divine rest from creative activity on the seventh day (Gen. 2:3). The Lord commanded His people to keep the Sabbath holy by worshiping Him and ceasing from all normal work (Exod. 20:8). Modern medical science has shown that “the ideal rest period for the healthy operation of the human body and mind is that of one day in seven” (Harrison 1982, 2:642).
Considerations of physical and spiritual health also underlay the decrees concerning sexual relationships (Harrison 1979, 1:955). For example, the Decalogue prohibited adultery (Exod. 20:14), and the law decreed that the bestiality found among the Hittites and Egyptians was a capital offense (22:19). The legislation of sexual activity was intended to preserve the spiritual distinctiveness of the Israelites. But it also had the advantage of shielding them from certain forms of sexually transmitted diseases (Adolph 1976, 3:57).
The Mosaic legislation declared that many unions found frequently in ancient Near Eastern nations were incestuous. The intent behind these decrees was the moral and spiritual health of God’s people. Nevertheless, the physical benefit of such legislation is confirmed by modern genetic studies, which have shown that “the closer the blood relationship between husband and wife, the more probable is the incidence of detrimental or lethal genes” (Harrison 1982, 2:643).
The law contained rules governing the diet of the Israelites. This benefited God’s people both physically and spiritually. “Many diseases, both ancient and modern, have been shown to result from dietary deficiencies or imbalances that reduce the blood’s ability to combat infection or repair damaged tissues” (Harrison 1982, 2:643). The Mosaic legislation, which was unique in the ancient Near East, helped to protect God’s people from infections or epidemic disease.
Consider the biblical prohibition against ingesting blood, the symbol of life (Lev. 7:26-27). Modern medicine has discovered that “blood sustains bodily health when its components are properly balanced, but it can cause death when that balance is impaired” (Harrison 1982, 2:644). The Israelites, by observing the Mosaic restrictions on ingesting blood, avoided the risk of being infected by parasitic organisms that could cause illness and death in humans.
As was noted above, Scripture presents the Lord as the divine healer (Exod. 23:25; Deut. 32:39; Ps. 41:3-4; Kee 1992, 4:659). The Old Testament prophets, as God’s representatives, were used by Him to predict sickness and death (Blaiklock 1976, 4:159). This was true of Nathan (2 Sam. 12:14), Ahijah (1 Kings 14:4-6), Elijah (2 Kings 1:4), and Elisha (5:27; 8:10). The prophets also intervened to bring about the healing of such people as the son of the Zarephath widow (1 Kings 17:19-23), the son of the Shunammite (2 Kings 4:18-37), Naaman (5:3-14), and Hezekiah (20:1-7; Kee 1992, 4:660).
In Jesus’ day, there were many diseases and infirmities that plagued people (Harrison 1979, 1:958). And ill individuals selected eclectically from whatever was available. These sources included a number of healing cults and their shrines, various magical potions, spells, amulets, and sacred inscriptions, and a hodgepodge of physicians who were “trained to some degree in a combination of the healing arts of the Greek or Roman type” (Davids 1997, 436).
Jesus was “vitally concerned with healing the physical, moral, and mental diseases of persons” (Graham 1990, 498). Thus, it should come as no surprise that the four Gospels are filled with accounts of Christ curing the afflicted (Blaiklock 1976, 4:159). This undoubtedly left in the minds of His followers that God is the divine physician (Kee 1992, 4:662). Jesus saw people as body-spirit complexes (Graham 1990, 498). Thus, it is not surprising that He expressed a deep concern for the sick, disabled, and oppressed (Luke 4:18; see also Isa. 61:1).
People in ancient times tended to think of sickness as punishment for sin (Eakins 1991, 367). The Book of Job makes it clear, however, that ailments are not necessarily caused by iniquity. Jesus likewise did not teach that disease was a punishment sent by God (John 9:1-3). Rather, Christ was firmly convinced that God’s will for humankind included health, wholeness, and salvation (John 3:17; 10:10).
The Messiah’s healing ministry was continued by the disciples in the early church (Acts 2:43; 3:2-8; 5:12; 8:7; 9:40; 14:8-10; 28:8). It was their desire that their fellow believers would enjoy both good health and spiritual fitness (3 John 2). They affirmed that health and healing ultimately came from God (Kee 1992, 4:663).
In summary, Scripture affirms the unity of body and mind in the overall health of an individual. In other words, the treatment of ailments in people is not simply restricted to either the physical or spiritual dimensions of human existence. Rather, a holistic approach is advocated. Thus, the biblical perspective would affirm the value of providing spiritual care for the infirm and dying.
Amundsen and Ferngren (1982b, 116) note that during the early Middle Ages, monasteries both in the Latin West and in the Byzantine East “became the refuge of the sick, the poor, and the persecuted.” This is not surprising, for the writings of the early church leaders indicate they viewed the care of the sick as being profoundly important (Vaux 1984, 30). They advocated that the treatment of the infirm should be holistic in nature (Davids 1997, 438). These clerics saw their care of the ailing and vulnerable under the analogy of the shepherd and his/her flock. Like a good shepherd, the spiritual caregiver goes out to look for and treat the sick (Oden 1994, 26).
Burnet (1818, 174) observed that there are strong mandates in Scripture and church tradition to visit the sick on some regularized basis and in an intentional manner. The way in which this is done is not as important as the fact that it is done in a disciplined, consistent, and deliberate way. Baxter (1656, 43) echoed this sentiment when he suggested the use of a conscious, well-conceived method for deepening the quality of the spiritual care being provided.
Herbert (1905, 75) recommended that the pastoral visit to the sick be done in an unpretentious manner. The spiritual caregiver should not disdain any who are ill or dying, for in making a personal visitation, the minister is allowing the sufferer to experience something of God’s presence.
According to Oden (1994, 29), early church leaders realized that “illness may constitute a crisis not only for the body, but for self-esteem, hope, understanding, and faith.” And Burnet (1818, 175) noted that ailments, whether mild or serious, should be seen as a special opportunity to provide spiritual care. The minister should not provide it in a perfunctory manner but rather with attentiveness and promptness. Clementia (59) similarly noted that ministrations to the sick should be done in a sincere manner and with sensitivity to the individual’s personal needs.
Doddridge (108) related that the spiritual caregiver should evidence candor, self-constraint, caring attentiveness, and deeply felt empathy for the infirm. The goal is not to foist one’s own agenda on the patient. Rather, it is to let the patient’s needs and concerns naturally unfold through the course of the pastoral visitation. Doddridge (109) also stressed both the importance of active listening and the asking of discerning questions. The spiritual caregiver should elicit responses that encourage the patient to engage in deeper spiritual self-examination.
Jeremy Taylor noted that like the physician’s ethics, the spiritual caregiver responds immediately to the need at hand (1661, 23). Like the shepherd of Psalm 23, he/she walks with the afflicted through their times of darkness. The minister encourages the infirm to remain faithful to God and to experience His unfailing love.
The leaders of the early church recognized the unique role that spiritual caregivers serve in helping the terminally ill prepare for death. Oden (1994, 34) remarks that “sickness is an unwelcome, yet potentially growth-laden opportunity for decisive spiritual formation. Whether it asks us absolutely about our death or relatively about the numerous limitations in terms of which we constantly live our lives, any illness may become a spiritual test. Sick visitation may be the only service the pastor is permitted to render to some.”
Saint Gregory I (591, 35) observed that with the help of a minister, the infirm can come to realize their own mortality. They see that they are vulnerable, transient, and physically limited. This in turn can bring about spiritual cleansing and renewal. It is also an opportunity for God, in one’s time of weakness, to manifest His grace and strength (2 Cor. 12:9-10).
Ambrose noted that illness is filled with spiritual opportunity and challenge (401). The minister’s job is to help the infirm respond to the affliction in a positive and constructive way (the opportunity), not in a negative and counterproductive way (the challenge). For instance, the spiritual caregiver can underscore that even in such a difficult experience, God’s comfort and compassion are abundantly present. He will never leave us in our illness but will always stay by our side (Heb. 13:5-6).
Early church leaders recognized that the experience of sickness has a way of prompting people to wrestle with guilt. Menno Simons (1956, 1052-1053) remarked that misdeeds and infirmities are endemic to the human situation. In other words, there often isn’t a direct moral cause for a physical illness. The spiritual caregiver is in a unique position to help the infirm recognize this and thereby be relived from the stress and anxiety created by inordinate scruples. The minister can encourage the patient to focus on the joyful reality of divine forgiveness, “instead of a wretched, continual awareness of sin” (Oden 1994, 39).
Sparrow (1655, 521-522) noted that there is a long history of physicians and ministers being companion professionals in the care of the sick and dying. He noted that the two are not competing against each other but rather working with one another to bring about the holistic healing of the infirm. In this way medicine and ministry are seen as complementary views, not opposing views, regarding the care of the patient. Thus there should be a cooperative relationship between physician and pastor.
Oden (1994, 41) noted that the calling of a spiritual caregiver to the bedside of a patient is often done at the last moment. The patient then takes this as a grave sign and creates within him/her despair. The remedy is to “bring the minister from the beginning into the healing team so that body and spirit can be treated together.” Donne (1624, 26) similarly remarked that it is best when the two physicians—one for the body and the other for the soul—can learn to work together. As a team they can effectively deal with anxiety within a patient concerning the medical treatment to be given (35).
In summary, the early church leaders saw a place for both medicine and ministry in the treatment of the afflicted. Their collective opinion was that the care of the sick and dying was a holistic endeavor, one involving both the body and the spirit (Vaux 1984, 117). Thus there is a needed and welcome place for the pastor, along with the physician, in the treatment team. Together their collective wisdom and efforts can promote maximum healing within the patient.
Jonsen (1990, 39) states that in the first centuries of the Christian era and throughout the Middle Ages, the parable of the Good Samaritan (Luke 10:29-37) was used to exemplify the duties of the Christian physician. “In particular, the tale reinforced the duty to care for the needy sick, whether friend or enemy, even at cost to oneself.” Though this lesson was originally taught to monks and nuns, who provided much of the care for the infirm, “it has persisted into our secular era as a principle of medical ethics.”
Throughout history there has existed four basic relationships between religion and medicine (Amundsen and Ferngren 1982a, 53). Medicine has operated as a manifestation or function of religion; medicine and religion have been functionally separate but allied and complementary; the two have simply coexisted; and they have enjoyed “both a hostile and competitive relationship.”
Thankfully, the modern wall between medicine and religion is gradually coming down. The medical community is progressively coming to recognize that just as illness is multidimensional, so too are the resources to promote health (Staunton 1982, vii). There is also a growing acknowledgment that within people exist physical, social, emotional, intellectual, and spiritual strengths. In order for maximum wellness to be achieved, all of these capacities need to be mobilized and channeled (Wynder and Sullivan 1982, 233). Physicians, nurses, and social workers cannot do this alone. The service of theologically, psychologically, and clinically trained chaplains is also needed.
Foster (1982, 246) states that there are at least four reasons why physicians must deal with religion in the routine care of patients. First, the feelings and actions of many people are influenced by religion. If the medical team discounts or disregards such views, the result can be disastrous for the patient and the hospital. That’s why the patient’s views—regardless of how irrational, naive, or abhorrent they may seem—need to be treated seriously and sympathetically (247). This is where the services of a chaplain can prove invaluable.
Second, patients often place the physician in the role of a secular priest (250). This is understandable when it is remembered that part of the physician’s function is to “cure disease and prevent premature death (when that is possible), to relieve suffering (when cure is not possible), and to comfort (always).” It’s no wonder that patients and their loved ones desire the medical team do more than just technically sophisticated treatment. There is also a desire for the staff to be communicative and supportive. But clinicians are not necessarily trained to treat such things as emotional responses to stress, social isolation, and fear, each of which can bring about physical disorders (251). This is where spiritual caregivers can make a tremendous contribution.
Third, illness prompts people to ask serious religious questions (253). In the midst of a debilitating infirmity, patients may wonder what’s wrong with them physically. They might also ask how they will possibly make it through their current crisis (254). Moreover, they might wonder whether their illness is fatal or potentially fatal, or whether it will seriously degrade their current lifestyle (255). There are also musings over the fairness and justice of God and in making sense of one’s pain. Furthermore, in the midst of the suffering, patients and their loved ones wonder whether they can find any glimmer of hope in their deplorable situation (256). For instance, what are the chances of getting well, or of somehow limiting the disability?
Fourth, a physician’s own belief system can impinge on and influence the way he/she cares for a patient (258). The point of conflict is over the diverging views of the physician and patient. When the first has no religious beliefs and the second has very strongly held views (or vice versa), tensions can arise and misunderstandings can occur. Regardless of the differences, the foremost goal for the medical team is to “help the patient, not to win arguments.” It should be clear that the presence and ministry of a chaplain can help navigate such rough and ambiguous waters.
In summary, increasing numbers of clinicians in the medical community are recognizing that there is a spiritual dimension of human existence and that it “contributes to a person’s sense of wholeness and wellness” (Waldfogel 1997, 964). In fact, optimal well being, while including biological factors, should not be limited to the physical realm of life. The spiritual dimension is also important “in the recovery process from acute or chronic sickness.” Clearly, the chaplain is uniquely qualified to address this important aspect of the patient’s holistic care.
Morse (1982, 265) states that the hospital chaplain is a “duly ordained minister, priest, or rabbi charged with the spiritual care of patients, their families, and the staff that cares for them.” The chaplain seeks to merge theological understanding with “sociological and psychological principles of growth, development, and mental health.”
Marty (1985, xi) carries this discussion further by relating that chaplains are uniquely equipped by education, training, and aptitude, to help foster the intersection of divergent realities, such as living and dying, mental and physical care, bodily and spiritual concerns, and approaches to ethics and understanding. Ministers of the spirit have the rare opportunity to empower patients to integrate these divergent realms in ways that are meaningful for them.
In his discussion, Holst (1985a, xii) notes that chaplains are engaged in a “ministry of dialogue.” In other words, spiritual caregivers deliberately seek to connect with people through ideas and feelings, whether verbally or nonverbally. Such dialogue is voluntary, not forced; and it is mutual, not one-sided. In order for this to be effectively done, the minister must be willing to listen as well as speak. As Holst observes, “Dialogue that is pastoral seeks to contribute toward another’s personal awareness, understanding, growth, and integration in the emotional, spiritual, social, and interpersonal dimensions of life.”
But the question remains: What does a chaplain do? To put it another way, what purpose does a minister serve within a hospital? Holst (1985b, 46) makes the insightful observation that “all pastoral care has a basic, primary, definable, fundamental role.” To be specific, it is to help others to experience as fully as possible the reality of God’s presence and love in their lives. This is done through “words, acts, and relationships.”
While the chaplain’s role is singular in focus, it is carried out in a variety of functions. As Holst observes, some pastoral functions are done in an overt way. “They are performed specifically, distinctly, and, in many cases, exclusively by an ordained pastor” (47). Through various words and rituals, the spiritual caregiver enables the recipient to experience the love and presence of God.
Other pastoral functions, however, are more veiled. As Holst indicates, “they do not require the pastoral office and may indeed include the employment of skills and methods derived from nontheological disciplines” (47). Though ministry in this sense is somewhat indirect (and often nonverbal in nature), it is still a viable way to help the patient encounter God and experience His compassion.
There often are times when the direct and indirect pastoral functions blend together in the provision of spiritual care. For instance, the chaplain’s administering of a sacrament (an overt pastoral function) might give way to a counseling opportunity (an indirect pastoral function). Conversely, a seemingly nonchalant pastoral visit may lead to a time in which the patient wrestles with feelings of guilt (48).
There are clear reasons why chaplains, though having a singular role, express it in a variety of direct and indirect ways. Perhaps the most obvious is the fact that hospital chaplains are called upon to operate between the worlds of religion and medicine (Holst 1982, 293). The spiritual caregiver “is both pastor and clinician, theologically educated and clinically trained, endorsed by both church and hospital.”
Of course, the bedside of the suffering patient is the meeting point between these two realms (294). Though receiving medical care is the main concern of the sick and dying, this doesn’t mean they are without spiritual needs. In fact, a holistic view of treatment would indicate that the metaphysical aspect of the patients’ existence, if ignored, can be detrimental to their overall well-being and recovery (295).
By being sincere and welcoming, the chaplain encourages the patient to work through issues he/she is experiencing while in the hospital. No one else on staff at the hospital may be better trained and equipped to visit with patients and their loved ones and help them process their feelings and impressions. This is hard work, and it requires on the part of the spiritual caregiver “sensitive listening, accurate empathy, [and] nonpossessive warmth” (296).
A second reason for chaplains engaging in a variety of functions centers around their diversity of training (Holst 1985b, 49). They typically may study theology, philosophy, psychology, administration, teaching, and so on. Diversity of functions furthermore recognizes that people are holistic entities, being both physical and spiritual in nature. For the chaplain to focus on the immaterial and not the material dimensions of a patient’s existence would be to deny his/her totality of personhood.
A third reason is that a variety of functions acknowledges that God’s love can (and should) be communicated in a variety of ways. As Holst correctly notes, God’s presence and power are just as evident in the performing of a ritual as in silent but empathetic listening (50). “In both functions, the pastoral role remains unaltered, but the means by which that role is carried out varies according to the needs of people and the setting in which those personal needs are found.”
In summary, modern day chaplains would see their role within the hospital setting as being immeasurably important. Because they affirm the holistic existence of all people, the medical treatment of them, while principally clinical in nature, is not limited to that. It also includes the spiritual care of patients and their loved ones. Chaplains seek to comfort and sustain the sick and the dying, and to help them experience God’s presence and love even in the midst of their suffering (Holst 1985c, 8-9).
The care of the sick and dying is a holistic endeavor, one involving the treatment of both the body and the Spirit. In this regard, the chaplain can operate in a meaningful way along with the physician in the cure of the sick and dying. The spiritual caregiver can regularly visit with the infirm and help him/her get more in touch with the divine in the midst of the illness. The minister can work with physicians in the conjoint psychosomatic healing of both body and soul. Together they make a great team; but when divided, the benefit of their contributions is greatly diminished.
Perhaps no more fitting summary can be found than in the remarks made by Atkinson (1997, 366):
The Old Testament health laws, the attitude of Jesus Christ towards the sick, and the ministry of healing within the church affirmed the sacred humanity of the sick person. Christians stressed the motive and duty of compassion in the care of the sick. There [thus] has been a strong relationship between Judaeo-Christian faith and medical practice.
 Wright (1998, 81) defines spirituality as “the dimension of a person that involves one’s relationship with self, others, the natural order, and a higher power manifested through creative expressions, familiar rituals, meaningful work, and religious practices.” She also says that spirituality “involves finding deep meaning in everything including illness and death and living life according to a set of values.” On the other hand, she notes that spiritual care “involves helping people identify and develop their spiritual perspective and personal awareness of spirituality and its components. Spiritual care is also helping people meet their spiritual needs.”
 As Holst (1985a, xii) has noted, part of the reason for this questioning is the enigma surrounding hospital chaplains. “In this context, it is the role and functions of chaplains that are enigmatic, not their personal characteristics.”
 Marty (1985, ix) makes this observation: “Just as pluralist and state universities squeezed religion out of the classroom, pushed theology into satellite or alienated seminaries, and sequestered spiritual care in off-campus chapels, modern hospitals did not know what to do with the religious professional who embodied wholistic concepts of care.”
 Florell (1990, 1320) defines wholistic health care as “an interdisciplinary approach…. in which patients play an active part in their own health planning. The emphasis is as much on health as on treating illness and involves treating the whole person physically, emotionally, and spiritually.”
 Pruyser (1990, 501) remarked that “health and illness are not the discrete, reciprocal, precisely, and physiologically defined categories commonly supposed, any more than is the distinction between mental and physical health (or illness). It is useful to distinguish between “unwellness” (the subjective experience of the individual), “patienthood” (a social role), and “disease” (the medically identifiable disorder). . . . Health can be regarded as a set of positive attributes.”
 Graham (1990, 497) defined healing as “the process of being restored to bodily wholeness, emotional well-being, mental functioning, and spiritual aliveness.” Aldoph (1976, 3:54) noted that “in the Scriptures healing is the restoration to a state of health by physical means or by miracle; the methods not necessarily mutually exclusive.” And Harrison (1982, 2:640) made the following observation: “Healing is a process, often involving medical, surgical, or psychiatric treatment of a pathological condition, that culminates in the functional repair, and sometimes the actual regeneration, of a previously diseased or damaged part of the body or mind.”
 Pousma (1976, 4:788) remarks, “Perhaps the earliest recorded physician in history was Imhotep of Egypt. He lived and practiced medicine nearly 3,000 b.c., and was so highly regarded by the Egyptians that they worshiped him as a god.”
 Unless otherwise noted, all Scripture references and quotations are from the New Revised Standard Version.
 Eakins (1991, 370) observed that people flocked to Jesus “in large numbers, often after having tried all the remedies available in their day. They were desperate for help.”
 This was a very different attitude from that of Jesus’ contemporaries, “who found the sick and infirm exasperating and contemptible” (Harrison 1982, 2:645).
 The four Gospels leave one with the impression that while Jesus was always concerned to heal the sick in body, He also paid close attention to the minds and the spirits of those who suffered.
 Harrison (1979, 1:955) notes the following concerning the mindset of the Hebrew people: “In its assumption of the fundamental holism or unity of the human physical-metaphysical entity, it has laid an assured theoretical foundation for modern psychosomatic medical investigation.”
 According to Graham (1990, 498), the early church “affirmed the goodness of the body and regarded the human being as a unity of mind, body, and spirit.”
 Jonsen (1990, 39-40) later remarks, “Two broad ethical traditions flow through Western medicine: competence and compassion. The ideal physician has always been seen as the bearer of both virtues, and departures from either have been deplored.”
 According to Hamilton (1998, 276), recent research has demonstrated that the spiritual dimension of existence is an important and fundamental aspect of human functioning. Also, medical practitioners who take their patients’ spirituality into account can positively affect the healing process. The research of Levin (1994, 1475, 1480-1481) seems to affirm these sentiments.
 Thomsen (1998, 1444) made the following admission: “The reality is that science-based medicine can only go so far in caring for people. The unspoken scientific paradigm that permeates modern medical care says that everything can be explained by the scientific model if only we do more research. That is a flawed model. Everything cannot be explained. . . . There is something more. It can be called faith, and that is where spirituality is applied.”
 Holst (1985d, 25) stated the following: “The approaches to health care are broadening. There has also come an increased recognition of the need for interdisciplinary understanding and interaction. As illness is now seen in more complex terms, so has followed the recognition that no one profession or method or service can independently or exclusively meet all the forces of illness. . . . In many sectors pastoral care has won a place of relevance and respect in and by the clinical world.”
 Foster (1982, 250) notes, “Doctors are not required themselves to believe, but they need to know that others believe, sometimes intensely.”
 Amundsen and Frengren (1982, 53) stated that “religion fulfills a strictly spiritual or pastoral role that complements the efforts of medical personnel.”
 Marty (1982, 29) makes a similar observation.
 Rosenburg (1990, 505) observed that “whether an illness is catastrophic or not, it is emotionally charged with the universally frightening realm of the unknown. For perhaps the first time in their lives, patients do not have the control they thought they had over their body and, by extension, their life; they encounter their own mortality” (emphasis his).
 Barnard, Dayringer, and Cassel (1995, 807) offer similar thoughts: “Illness raises questions of meaning in several senses. The patient seeks the meaning of symptoms (what do they signify?); the patient seeks the implications of illness (what does my illness portend for me?); and the patient needs to integrate the reality or threat of illness into an ongoing life picture and life story (what is the meaning of my life and what may I hope for, given this illness?).
 Lueking (1982, 279) offers this helpful thought: “When people encounter serious disease with firm religious grounding and in the fellowship of caring people, it does make a difference for good. People are equipped to face the reality of illness, to accept dire changes in their lives and schedules with humility, to trust that God works for good in circumstances that are not good, that the core of their faith is tested and not found wanting, that new directions and focused values can emerge from the crucible of suffering, and that recovery can mean more than the body restored—the spirit deepened as well.”
 Waldfogel (1997, 975) says that “it is equally important for the physician to explore and to recognize his or her own religious and spiritual needs. This self-inquiry will minimize the potential bias that personal beliefs may have in the clinical encounter, and will enhance the clinician’s ability to respond to patients’ concerns both empathically and effectively.”
 Doyle (1992, 302) candidly admits that physicians generally are hesitant to delve into the realm of the spiritual with their patients because they feel they neither have the time nor the skill to tackle this issue. “Physicans feel inexperienced, untrained, unsure, and all too aware of their own spiritual doubts and questions. Their sense of amateurism in the spiritual realm is in stark contrast to their day-to-day professional confidence in their own discipline or specialty” (303). Wright (1998, 82) similarly notes that nurses too are reluctant to get involved in the spiritual care of their patients because of lack of education in spiritual care, fear of invading a patient’s privacy, lack of time, and lack of awareness of one’s own spirituality.
 Moyer (1990, 110) states that one of the objectives of visiting the sick is to “care for the growth of souls.” Foremost in this regard is giving unconditional love. “Loving the patient will engage the pastor in a dynamic strong enough to stand against those elements of modern health care which can be violently damaging to a person’s well-being” (111).
 Brock and Nelson (1991) state that chaplains perform four primary functions: (1) interpreter of the world view of the patient and/or family; (2) consultant to the staff regarding the faith issues present; (3) counselor (pastoral) to patients, families, and staff; and (4) member of the interdisciplinary health care team.
 Holst (1985b, 47) goes on to say that such functions include “worship leadership, preaching, administration of the sacraments, prayer, Scripture reading, confession, and absolution.”
 Rosenburg (1990, 506) notes that “the counselor may be needed to soothe the spirit through a crisis in one case, to prepare the patient and family for a chronic lifestyle change in another, or to help the patient and family accept an inevitable death in a third. The counselor may see signs of clinician burnout and can be of help. With such information, the counselor may determine where the need is greatest and, understanding the unique human problems of patients under various medical circumstances, can provide understanding and support.”
 Stauton (1982, vii) remarks, “Sick people cannot be made whole again if the essential nature of human beings is not grasped by those who care for them.” And Graham (1990, 499-500) notes, “The mind, body, and environment are understood to be interconnected in the processes of disease and healing, and religious perspectives and methodologies are broadly interpreted to play a potentially important role in the healing of persons.”
Adolph, P.E. 1976. Healing. In The Zondervan Pictorial Encyclopedia of the Bible. Edited by Merrill C. Tenny. Grand Rapids: Eerdmans, 3:54-58.
Ambrose, Saint. 397. Letters. n.d., n.p.
Amundsen, Darrel W., and Gary B. Ferngren. 1982a. Medicine and Religion: Pre-Christian Antiquity. In Health/Medicine and the Faith Traditions. Edited by Martin E. Marty and Kenneth L. Vaux. Philadelphia: Fortress, 53-92.
Amundsen, Darrel W., and Gary B. Ferngren. 1982b. Medicine and Religion: Early Christianity Through the Middle Ages. In Health/Medicine and the Faith Traditions. Edited by Martin E. Marty and Kenneth L. Vaux. Philadelphia: Fortress, 93-131.
Atkinson, David. 1997. Medical Ethics. In The Blackwell Encyclopedia of Modern Christian Thought. Edited by Alister E. McGrath. Malden, MA: Blackwell, 366-368.
Baxter, Richard. 1656. The Reformed Pastor. Carlyle, PA: Banner of Truth.
Barnard, David, Richard Dayringer, and Christine K. Cassel. September 1995. Toward a Person-centered Medicine: Religious Studies in the Medical Curriculum. In Academic Medicine. 70(9): 806-813.
Blaiklock, D.A. 1976. Medicine. In The Zondervan Pictorial Encyclopedia of the Bible. Edited by Merrill C. Tenny. Grand Rapids: Eerdmans, 4:159-163.
Brock, Gary, and Holly S. Nelson. December 1991. Chaplains and the Health Care Team. In Southern Medical Journal. Vol. 84. No. 12. 1428-1429.
Burnet, Gilbert. 1818. A Discourse on the Pastoral Care. London: W. Baynes.
Clementina. Two Epistles Concerning Virginity. n.p., n.d.
Davids, P.H. 1997. Healing, Illness. In Dictionary of the Later New Testament and Its Developments. Edited by Ralph P. Martin and Peter H. Davids. Downers Grove, IL: InterVarsity, 436-439.
Doddridge, Philip. Lectures on Preaching. London: Baynes and Son, n.d.
Donne, John. 1624. Devotions Upon Emergent Occasions. Ann Arbor: University of Michigan.
Doyle, Derek. July 1992. Have We Looked Beyond the Physical and Psychological? In Journal of Pain and Symptom Management. 7(5): 302-11.
Eakins, Kenneth. 1991. Diseases. In Holman Bible Dictionary. Edited by Trent C. Butler. Nashville: Holman, 367-370.
Florell, J.L. 1990. Holistic Health Care. In Dictionary of Pastoral Care and Counseling. Edited by Rodney J. Hunter. Nashville: Abingdon, 1320-1321.
Foster, Daniel W. 1982. Religion and Medicine: The Physician’s Perspective. In Health/Medicine and the Faith Traditions. Edited by Martin E. Marty and Kenneth L. Vaux. Philadelphia: Fortress, 245-270.
Graham, L.K. 1990. Healing. In Dictionary of Pastoral Care and Counseling. Edited by Rodney J. Hunter. Nashville: Abingdon, 497-501.
Hamilton, David G. September/October 1998. Believing in Patients’ Beliefs: Physician Attunement to the Spiritual Dimension as a Positive Factor in Patient Healing and Health. In The American Journal of Hospice and Palliative Care. 15(5): 276-279.
Harrison, R.K. 1979. Disease. In The International Standard Bible Encyclopedia. Edited by Geoffrey W. Bromiley. Grand Rapids: Eerdmans, 1:953-960.
Harrison, R.K. 1982. Heal. In The International Standard Bible Encyclopedia. Edited by Geoffrey W. Bromiley. Grand Rapids: Eerdmans, 2:640-647.
Herbert, George.1905. The Country Parson. Boston.
Holst, Lawrence E. 1985a. Preface. In Hospital Ministry: The Role of the Chaplain Today. Edited by Lawrence E. Holst. New York: Crossroad, xii-xiv.
Holst, Lawrence E. 1985b. The Hospital Chaplain: One Role, Many Functions. In Hospital Ministry: The Role of the Chaplain Today. Edited by Lawrence E. Holst. New York: Crossroad, 42-52.
Holst, Lawrence E. 1985c. A Ministry of Paradox in a Place of Paradox. In Hospital Ministry: The Role of the Chaplain Today. Edited by Lawrence E. Holst. New York: Crossroad, 3-11.
Holst, Lawrence E. 1985d. The Hospital Chaplain: Between Worlds. In Hospital Ministry: The Role of the Chaplain Today. Edited by Lawrence E. Holst. New York: Crossroad, 12-27.
Holst, Lawrence E. 1982. The Hospital Chaplain Between Two Worlds. In Health/Medicine and the Faith Traditions. Edited by Martin E. Marty and Kenneth L. Vaux. Philadelphia: Fortress, 293-309.
Jonsen, Albert R. 1990. The New Medicine and the Old Ethics. Cambridge, MA: Harvard University Press.
Kee, Howard C. 1992. Medicine and Healing. In The Anchor Bible Dictionary. Edited by David N. Freedman. New York: Doubleday, 4:659-664.
Levin, Jeffrey S. 1994. Religion and Health: Is There an Association, Is It Valid, and Is It Causal? In Social Science and Medicine. 38(11): 1475-1482.
Lueking, F. Dean. 1982. The Congregation: Place of Healing and Sending. In Health/Medicine and the Faith Traditions. Edited by Martin E. Marty and Kenneth L. Vaux. Philadelphia: Fortress, 273-291.
Marty, Martin E. 1982. The Intertwining of Religion and Health/Medicine in Culture: A View Through the Disciplines. In Health/Medicine and the Faith Traditions. Edited by Martin E. Marty and Kenneth L. Vaux. Philadelphia: Fortress, 27-50.
Marty, Martin E. 1985a. Forward. In Hospital Ministry: The Role of the Chaplain Today. Edited by Lawrence E. Holst. New York: Crossroad, vii-xi.
Morse, Hal. 1982. Religious Perspective. In Coping with Caring for Sick Newborns. Edited by Richard E. Marshall. Philadelphia: W.B. Saunders, 265-287.
Moyer, Frank S. 1990. Pastoral Care in the Hospital. In Primary Pastoral Care. Edited by Orlo Strunk. n.p., 97-113.
Oden, Thomas C. 1994. Classical Pastoral Care. Volume Four: Crisis Ministries. Grand Rapids: Baker.
Pousma, R.H. 1976. Physician. In The Zondervan Pictorial Encyclopedia of the Bible. Edited by Merrill C. Tenny. Grand Rapids: Eerdmans, 4:788-789.
Pruyser, P.W. 1990. Health and Illness. In Dictionary of Pastoral Care and Counseling. Edited by Rodney J. Hunter. Nashville: Abingdon, 501-505.
Rosenburg, M.S. 1990. Health Care Delivery. In Dictionary of Pastoral Care and Counseling. Edited by Rodney J. Hunter. Nashville: Abingdon, 505-506.
Saint Gregory I. 591. Book of Pastoral Rule. London: Burns and Oates.
Simons, Menno. 1956. Complete Works of Menno Simons. Scottdale, PA: Herald Press.
Sparrow, Anthony. 1655. A Rationale Upon the Book of Common Prayer. London.
Staunton, Patrick R. 1982. Forward. In Health/Medicine and the Faith Traditions. Edited by Martin E. Marty and Kenneth L. Vaux. Philadelphia: Fortress, vii-viii.
Sussman, M. 1992. Sickness and Disease. In The Anchor Bible Dictionary. Edited by David N. Freedman. New York: Doubleday, 6:6-15.
Taylor, Jeremy. 1661. Rules and Advices to the Clergy. London: Longman.
Thomsen, Robert J. November 1998. Spirituality in Medical Practice. In Archives of Dermatology. 134(11): 1443-1446.
Vaux, Kenneth L. 1984. Health and Medicine in the Reformed Tradition. New York: Crossroad.
Waldfogel, Shimon. December 1997. Spirituality in Medicine. In Primary Care. Vol. 24. No. 4, 963-976.
Wright, Kathy B. 1998. Professional, Ethical, and Legal Implications for Spiritual Care in Nursing. In Image: Journal of Nursing Scholarship. 30(1): 81-83.
Wynder, Ernst, and Mary-Carroll Sullivan. 1982. Preventative Medicine and Religion: Opportunities and Obstacles. In Health/Medicine and the Faith Traditions. Edited by Martin E. Marty and Kenneth L. Vaux. Philadelphia: Fortress, vii-viii.
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