The Distinctive Nature of Pastoral Care in Hospital Setting

Pastoral care usually refers to the assistance given by ordained priests, ministers, and other people with chosen religious responsibilities such as adherents of Roman Catholic religious ranks and deacons to perplexed, troubled, or suffering individuals. In the most philosophical and simplest logic, pastoral care has been outlined from a Christian approach as the effort to assist others, through relationships, acts, and words, to encounter as wholly as possible the actuality of the presence of God and love in their lives. The phrase is basically Christian but it is occasionally used analogously in other faith backgrounds for example in Judaism to imply Rabbi’s care. Currently, the phrase spiritual care has been instituted into secular hospital environments as a less particularly Christian substitute phrase. In whichever situation, when spiritual or pastoral care is offered in hospitals by rabbis or pastors funded by the facility, it is referred to as healthcare or hospital chaplaincy.  This essay largely focuses on the distinctive nature of pastoral care and its application to the hospital setting.

Generally, pastors have stretched their care to an array of personal concerns and needs, from doubt, struggles of faith, issues of conscience, moral failure, to family dispute and marriage and the agony involved in tragedy, illness, and death. In Christian care, the notable, ritualized means of grace- prayer, scripture, and sacrament- remain to be vital resources of pastoral care, particularly in circumstances of calamity, for example, dying (Allain-Chapman, 2012). However, on numerous occasions, casual methods prevail. Pastoral dialogue highlights the caregiver’s cognitive understanding and capacity to nurture a healing or therapeutic manner of relationship and mode of conversation with the individual getting the care. This comprises the capacity to establish emotionally authentic, unquestionable affiliations, empathic listening, and the care receiver’s lively engagement with the pastor in search of wholeness and healing. At the core of their care, pastoral caregivers assist individuals get the sort of faith and moral commitments that may withstand, enhance, and give delivering sense to their lives, and to encounter as wholly as possible the actuality of the presence of God and love in their lives.

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Pastoral care and hospital chaplaincy are usually separated from another ministerial specialty- pastoral counseling. When this separation is made, pastoral counseling is often designated as a specified kind of ministry categorized by a planned agreement between the pastoral caregiver and the individual or family needing assistance, normally involving a sequence of pre-arranged counseling periods. This planned kind of care contrasts with the more spontaneous and diverse kinds of caring affiliations that hospital chaplains and parish pastors characteristically offer. Although several priests, ministers, hospital chaplains, and rabbis offer short-term counseling of the more official form, pastoral counseling as a specialty ministry is committed wholly to this work. To a wide range, it is a kind of psychoanalysis or family psychotherapy and it is usually referred to as pastoral psychotherapy, and typically involves several periods and the payment of a fee. Pastoral counselors, like hospital chaplain, have specialized training requirements, professional organizations, and standards of certification. They serve on the staffs of bigger churches, in pastoral counseling centers, and in other professional environments, and are usually authorized by state governments as family and marriage therapists, psychologists, or pastoral counselors (Ramsay, 2005).

Much of what hospital chaplains do entails assisting individuals and families of all denominations with the spiritual and emotional dimensions of the healing course, providing support and healing care in circumstances of disaster and loss, assisting to resolve disputes and communication hardships, and consulting in circumstances of bioethical and other decision-making. Many chaplains similarly develop a wide ministry with doctors, nurses, administrators, aides, and others in hospital settings who carry considerable emotional pressures and moral issues. Chaplains enhance communication between families, patients, and personnel on matters affecting cultural and religious customs that might bear upon medical choices for example concerning the use of life-support technologies, abortion, and blood transfusion. Doehring (2006) denotes that they usually become engrossed in dialogues with all parties involved in medical choices. Additionally, hospital chaplains create educational affiliations with regional priesthood and parishioners, take up a role as links between the hospital facility and the community, and serve on the panels of related community establishments. As more and more health care is offered on an outpatient basis, and as more parishioners develop hospital prominences and plans, these elements of their work are anticipated to escalate.

Burns (2015) asserts that chaplains usually take up a considerable role in hospital ethics committees, on several occasions, they assisted to plan these committees in the late 1980s and 1970s. The role of the chaplains in ethics panels, as in their consulting with patients and families on bioethical choices, comprises widely in enhancing good communication and common understanding, deducing cultural and religious customs, resolving disputes, expounding on moral concerns, and endorsing free and accountable ethical decision-making. It is a fundamental philosophy of the Association of the Professional Chaplains, the National Association of Catholic Chaplains, and comparable national authorizing establishments that hospital chaplains esteem the conviction and beliefs structures of others and desist from persuading or trying to force their personal beliefs on them.

Several hospital facilities fund professional training in pastoral care referred to as Clinical Pastoral Education (C.P.E). These programs not only train upcoming chaplains in pastoral care, but similarly big numbers of theological scholars, priests, and affiliates of religious ranks not pursuing specialty ministry authorization. C.P.E. scholars minister under the eye of a greatly skilled and authorized chaplain overseer with whom they meet personally and as a group to evaluate and contemplate on their work. Such contemplation entails profound analysis of comprehensive case accounts, individual contemplation on the trainees’ modes of caring for other individuals, and regard of the mental, cultural, social, ethical, and theological questions entailed in their encounters.  Pastoral supervision developed in the last half of the 20th century into a distinctive and essential specialty in hospital chaplaincy (Johnson, Dodd-McCue, Tartaglia, and McDaniel, 2013).

Most pastors serving in hospital settings have a comprehensive, substantial understanding of themselves and their ministries that allows them to work easily with the healthcare profession and to cooperate pastorally with an array of people. They do not confine their ministries to people with issues that are clearly designated in moral or religious terms but pursue to become affiliated to people in therapeutic and supportive means whatever the instantaneous presenting issues or needs might be.

Therefore, their work normally closely resembles, in particular respects, that of psychologists, psychiatrists, psychiatric nurses, patient representatives, and social workers. According to Calder, Badcoe, and Harms (2011), the chaplain acts as an integral member of the medical team. She or he is cross-trained in a number of institutionally valued skills practically incorporated into a single career: spiritual and psychosocial counselor, patient representative and ombudsperson, medical ethicist, spiritual trainee and anthropologist, public relations specialist and gatekeeper of community resources, and advocate of health. However, the chaplain’s array of proficiencies likewise raises questions of occupational individuality and distinctiveness for other experts and occasionally for themselves. The circumstance is made further puzzling by the actuality that pastoral distinctiveness in hospital amenities is normally not articulated primarily or exclusively via the performance of religious ceremonies or dialogue limited to explicitly religious issues.

Generally, nonetheless, pastoral distinctiveness in hospital settings has dual intimately linked poles of consideration: health and healing, and religion. Chaplains are considerably recognized with each. The uniqueness of the career lies in the manner these dual poles interconnect in an unclear but creative harmony in the enactment of the chaplain’s professional role. At one pole there is a consideration for and involvement in the courses of healing and health. Whereas medical chaplains do not practice psychiatry or medicine, they suppose that the values and implications by which individuals live, and the quality of their individual affiliations, take up an essential part in the organic courses of health and illness (Cadge and Bandini, 2015). They likewise suppose that a wide consideration for human wellbeing, comprising healing and health, is fundamental to the faith customs they embody. Therefore, chaplains suppose that religion advocates for the basic purposes of healthcare and medicine. And they regard their ministries as importantly involved in the course of healing, which they appreciate in wide-ranging terms as healing of the entire person, spirit, mind, and body. As a result, they perceive themselves as considerable affiliates of the healthcare personnel, and progressively they are being perceived in that manner by the health professions.

At the other pole, hospital chaplains are devoted to embodying religious implications and principles that entail but surpass the principles of healing and health. They pursue to enable individuals to get an encounter, which eventually may satisfy their lives and convert them from the risks of worthless guilt, shame, and death that encompass all of life, in sickness as well as in wellbeing.  And they set healing and health as principles into a covering faith outlook that confirms the significance of life whether or not healing happens. Binon (2012) asserts that for the hospital chaplain, this wider background is eventually rooted in actuality and affectionate power of God, who makes health conceivable, but who likewise makes implication, confidence, and love conceivable in all life circumstances, in sickness and hardship as well as in wholeness and health.

Therefore, Dykstra (2004) affirms that pastoral distinctiveness is bipolar, devoted to both religious conviction and healing and to their important interrelationship. It is the unclear but disciplined interaction of these polar dedications that found the individual positioning of hospital chaplaincy.

The great level of expert cooperation present today between health experts and pastoral caregivers exhibit an outstanding and comparatively contemporary improvement in both religion and medicine. In past and medieval times religion and medicine commonly enjoyed a close connection; exorcisms, healing ceremonies, health cults, and pilgrimages thrived (Barletta and Witteveen, 2007). However, with the Protestant Reformation and the ensuing emergence of contemporary scientific medicine and science, Christian ministry started a long retreat from its custom of engagement in healing, and theology grew progressively cautious of making scientific, practical statements on the natural realm. A professional and scholarly division between medicine and religion ensued. As medicine became technical and ministry became limited to concerns of God and the soul, parallel scopes of professional impact were outlined: doctors cared technically for the body, ministry cared spiritually for the soul. Health science consigned emotional and mental illnesses, conventionally considered issues of the soul, to the body as naturally caused, and considered them as at least possibly curable by physical, that is, medicinal means.

Several of the ways pastors have ministered to suffering and troubled individuals over the centuries might be considered as a useful implementation of the ethical values of the pastors’ religious communities and customs. The practice has tended to follow theory, relating it. However, human problems and needs do not usually fit neatly into prescribed categories and practices, and cultural and social forces change over time; modern issues of bioethics provide many instances in point. In such circumstances, pastoral care cannot function as an upfront application of established principles and moral theories. Careful extemporizing becomes essential, particularly in times of dramatic technological, cultural, and social change.


Allain-Chapman, J. (2013). Resilient Pastors. London: SPCK.

Barletta, J., & Witteveen, K. (2007). Pastoral Care in Hospitals: An Overview of Issues. Australian Journal of Primary Health13(1), 97–105.

Binon, J. (2012). Ethical Implications of Diversity in Pastoral Care: Power at Play? Journal of Spirituality in Mental Health14(1), 2–22.

Burns, S. (2015). Pastoral theology for public ministry.

Cadge, W., & Bandini, J. (2015). The Evolution of Spiritual Assessment Tools in Healthcare. Society52(5), 430–437. Retrieved from

Calder, A., Badcoe, A., & Harms, L. (2011). Broken bodies, healing spirits: road trauma survivor’s perceptions of pastoral care during inpatient orthopedic rehabilitation. Disability & Rehabilitation33(15/16), 1358–1366. Retrieved from

Doehring, C. (2006). The practice of pastoral care.

Dykstra, R. (2004). Images of Pastoral Care. Saint Louis: Chalice Press.

Johnson, E., Dodd-McCue, D., Tartaglia, A., & McDaniel, J. (2013). Mapping the literature of health care chaplaincy. Journal of the Medical Library Association101(3), 199–204.

Ramsay, N. (2005). Pastoral care and counseling. Nashville, Tenn.: Abingdon.


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