The Role of the Sacraments in Hospital Chaplain Ministry

This paper seeks to explore the important and necessary role sacraments play in hospital
ministry. The doctrine of the sacraments has been a widely debated issue throughout the history
of the early church with a number of debates on the number of sacraments, as viewed by various
religions and denominations, as well as the meaning of certain sacraments such as the Lords
Supper and Baptism. While this paper will address general doctrinal issues and historical
debates, as well as pertinent Biblical passages, the impetus of the paper will key on the
sacraments as they relate to patients and families within hospital settings who come from a
variety of spiritual backgrounds. Thus, the prime issues for this discussion center around the
types of sacraments and rites delivered in hospital settings and who is responsible for that
delivery.
First, it is important to understand how sacramental theology developed, and the
definition and functions of sacraments. The word sacrament is generally accredited in early
history to Tertullian and Augustine of Hippo, but surprisingly not generally discussed from a
biblical historical point due to the fact the word is never mentioned in the Bible. However,
sacrament is a Latin word and sacramentum does occur in the Latin New Testament.1 In order
to understand how the idea of sacraments is conveyed in the New Testament, it is important to
have a clear understanding of the word. C. K. Barrett relates that sacraments are defined
theologically and liturgically not only in words, but in actions, and it is these actions, with water
1 C. K. Barrett, Church Ministry and Sacraments in the New Testament, Eerdmans Publishing
Co., Grand Rapids, Mich., 1985, 55.

in baptism and with bread and wine in the eucharist, that provides us with a starting-point from
which we ourselves proceed to formulate in our own minds the meaning of what takes place.2
In the Third and Fourth Centuries, Tertullian related sacramental theology to the Latin
sacramentum, already mentioned as well as the Greek word mysterion (mystery). For him, the
singular word, sacrament refers to the mystery spoken of in the New Testament and the plural
form refers to the actual actions referenced by the mystery. He saw a parallel between
sacraments and military oaths as the Latin sacramentum means a sacred oath. This point will be
revisited later in reference to other rites or services performed in the hospital which are not one
of the recognized sacraments, but are definitely sacramentum in nature. Also during this early
time period, Augustine of Hippo refers to sacraments as visible forms of grace which both
signify and evoke or enable.3 Further, Peter Lombard concludes, Something can be called a
sacrament if it is a sign of the grace of God and a form of invisible grace, so that it bears its
image and exists as its cause . . . . therefore instituted for the sake of sanctifying as well as
signifying.4
With these various definitions and views, we can return to the issue of New Testament examples
of sacraments and sacramentum. Because hospital ministry is most often concerned with
baptism (specifically infant baptism) and the Eucharist, references for these sacraments will be
discussed along with some of the controversy surrounding these issues. The New Testament
documents adult baptism through examples of John the Baptist and Jesus, Himself in Matthew 3.

2 Ibid, 57
3 Alister E. McGrath, Christian Theology: An Introduction, 5th Edition, WileyBlackwell, a John Wiley and Sons Publ., 2011, 401.
4 Ibid, 404
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Acts 1:5 signifies there are two types of baptism, one with water by John and one by the Holy
Spirit. While this brings up a debate over whether these two baptisms are separate, that is not a
concern for the chaplain in hospital ministry as chaplains deal with each person based on their
own community and tradition-mediated spirituality. In actuality, baptism is only administered in
hospitals to infants. The Biblical basis for infant baptism, although not an issue debated by
chaplains, but accepted and performed based on the request of the family, is sometimes debated
within various denominations. McGrath gives several Biblical examples which could relate to
infant baptism. Although not specifically stated condoned in the Bible, it is not forbidden either
and one could say that references to an entire household could relate to infant baptism (Acts
16:15, 33; 1 Cor. 1:16). While Zwingli viewed baptism as the New Testament version of
circumcision from the Old Testament, Paul, in the New Testament gives reference to baptism as
a spiritual counterpart to circumcision (Col. 2:11-12), suggesting that the parallel may extend to
its application to infants.5
Referencing the Eucharist or Lords Supper biblically, we find that the book of Acts does
not refer to a Eucharist, but does refer to the breaking of bread or a common meal as in Acts 2:42
and 2:46. Acts 27 utilizes Eucharistic language when Paul exhorted crew members to take some
food, After he said this, he took some bread and gave thanks to God in front of them all.6 The
debate here is whether or not this passage implies the Christian meal was open to all.7 Again,
these references to both infant baptism and the Eucharist are made to support the Biblical history
5 McGrath, 410, 420.
6 Acts 27:35, NIV. All subsequent Scripture quotations are taken from the New
International Version unless otherwise stated.
7 Barrett, pp. 60, 61

of the doctrine itself, but do not really have any bearing on the issue of whether or not
sacraments belong in the hospital.
The relevant debates concerning sacraments in a hospital center more on the issue of who
is responsible for performing the sacraments than whether or not they belong in this setting to
begin with. However, it is important to note that from a chaplains point of view, their ministry,
while not in a church setting, is still a viable ministry to a group of believers and non-believers
who have spiritual needs. In my Clinical Pastoral Education training, my supervisor encouraged
us to view the hospital areas in which we served as our parish. That leads us back to who the
responsible party or parties are to deliver these sacraments.
Concerning baptism, if a baby or unbaptized Catholic persons life is in danger, a priest or
chaplain is called to baptize by anointing the head with water and saying, I baptize you in the
name of the Father and of the Son and of the Holy Spirit. In our hospital, we always have a
chaplain on duty so we do not authorize baptism by a lay person on an emergency basis,
however, that can be done in some hospitals according to the Hospital Handbook on
Multiculturalism and Religion.8 The purpose of this sacrament for the Catholic is to bring the
person to share in the life of Christ.
Holy Communion for Catholics may be administered by either a Catholic Priest or a
Protestant or Catholic chaplain. Care should be taken to consult the nursing staff concerning the
patients physical ability to receive Communion. For the Catholic, they believe Jesus is present
at this sacrament.
Anointing of the Sick for a Catholic can only be administered by a Catholic priest, who
should be called to come administer this sacrament if one is not available at the hospital. It is
8 Neville A. Kirkwood, Hospital Handbook on Multiculturalism and Religion,
Morehouse Publ., Harrisburg, PA., 2005, 12.
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important to note that a Roman Catholic priest can deliver the sacrament to members of other
Catholic churches if their own priest is not available.
Protestant believers sometimes request infant baptism due to fetal demise or infant death after
birth. Believers also may request Holy Communion. In either case, these sacraments are
performed by one of the chaplains on duty at the hospital; however, there are instances in other
hospitals where lay persons deliver these on an emergency basis, or in the case of Holy
Communion, may be delivered by an elder or deacon of the persons church.
My perspective is that sacraments are vitally needed in hospital chaplain ministry.
Receiving sacraments is not only important for the patient from a religious standpoint, but it also
has a therapeutic benefit, offering spiritual and emotional relief to the patient. Not only are these
sacraments of benefit to the patient, but many times are important to family members, especially
when the patient is declining and death is imminent. Another group that might surprise a lay
person is the hospital staff themselves. Earlier in this paper, I said the word sacramentum would
be important in relation to other rites and services performed. I believe as Augustine that
sacraments signify, evoke and enable, and I believe, as Peter Lombard that they sanctify and
signify. I have not discussed all seven of the recognized sacraments in the Catholic Church
because they do not all relate to a hospital setting while they two Protestant sacraments, also
Catholic sacraments, do relate. These are the recognized acts of the sacraments, however I want
to propose that the singular sacrament or sacramentum, as was discussed earlier is also important
as evidenced by a particular sacramental type service we perform several times a year for our
hospital staff from doctors and nurses to cafeteria workers and environmental specialists along
with any other person desiring to participate.

This sacramental service is called the Blessing of the Hands and it was first
instituted in the 19th century around the time of Florence Nightingale. It is not uncommon to
observe this ritual at nursing graduation ceremonies as it actually originated from a nursing
prospective. This ritual ceremony is practiced in hospitals, nursing homes, rehab centers, and
other medical facilities around the world. Human touch is an important component of health
care, both directly and indirectly. During the recent outbreak of the Ebola virus, both abroad and
in the United States, we are painfully aware of the importance of all work done in a hospital or
other medical facility. From the Chief Surgeon, doctors, nurses, and technicians, to the
administrative personnel, cafeteria workers and environmental service members, hands perform
important duties. Areas must be cleaned, nutritious food prepared, and proper records kept so the
hospital is a safe and reliable place for surgeons, doctors, nurses, technicians and other medical
personnel to properly perform their duties. Truly, every person at a medical center is responsible
for the healing of every patient. This responsibility places a tremendous emotional burden on all
staff and the service I will describe, provides a means of renewed strength and blessing as they
perform their duties.
Because this is a new concept to most people and not a recognized sacrament I will
describe it here. The Blessing of the Hands begins when I travel to the various patient floors and
departments with a cart draped and holding the items needed for the Blessing. On the cart I carry
the following supplies for the ceremony: a bowl with round rocks to collect the water, a pitcher
of warm water to pour over the hands, paper towels to dry the hands and cards to provide the
employee which contains the prayer of blessing and is then available for the employee to refer to
and remember how important their work is. When I arrive on the various patient floors or
departments, I ask the nursing supervisor, department head, or others in charge the best area to

set up to begin the ceremony. Then the participants are invited to form a line, single file. One at
a time, each individual will stand in front of the cart, facing me. I introduce myself to the staff
member and ask their name. Then as I reach my hands out, I ask if I may hold their hands. I then
proceed to pour the warm water over their hands, and offer the following prayer which is
contained on the card they will receive. It states:
May your hands bring Life, Hope and Joy,
May their work transform,
The lives of those you help,
And may your compassion, touch the heart of all our patients and families. 9
At the end of the Blessing, there are tears and smiles on the faces of the employees.
Many recount the sense of renewed hope and strength in their soul and a renewed spirit to bless
their patients with the attentive and compassionate care of their hands. Many reflect on the
interconnectedness of their own humanity with that of the patients they serve. As word spreads
around the hospital, others want to participate. I have seen a whole department who at first did
not want the blessing, have a change of mind and a deep desire to receive this blessing.
I believe through such a blessing, I extend Gods hands through mine. To me, it is a way of
reminding others of the sacredness of life and the service each person provides to the most
vulnerable of people, our patients. I am reminded I am serving, as pastors have through the
epochs of history that I serve in the role of priestly care through the ritual practice of The
Blessing of the Hands. I am reminded that through the blessing I perform, the Lord is working
through me to renew these caregivers and restore their souls so they, in turn, and through the
power of the Holy Spirit, renew and restore the lives of others. No, they cannot heal the patients,
only God can do that in His own way and in His own time. But each person that serves a patient
9 Card provided by JPS hospital which is used by chaplain and then given to
participants.
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in any way makes their path for the day a little easier and hopefully a little brighter with renewed
hope that the Lord will take care of them as he works through each person they see.
For these reasons, I believe it is important to include not only the delivery of recognized
sacraments to patients and families in the hospital, but to also minister to staff and even families
caring for their loved ones through sacramentum which evokes confidence and brings about an
enabling spirit in the person receiving the blessing so they walk in Christs authority as they
perform their daily tasks.
While there may be some of the Catholic belief that would not embrace sacramentum, I
believe it is important to include a variety of sacramental services and rites in hospitals and other
settings. James F. White sees the challenge of the future as a richness of Protestant sacramental
worship that consists in its diversity and its consequent ability to serve a wide variety of peoples
at different times and places.10 What better place to start than in a hospital.

10 James F. White, Sacraments in Protestant Practice and Faith, Abingdon Press,

Nashville, Tenn., 1999, 142
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Bibliography
Barrett, C. K. Church, Ministry, and Sacraments in the New Testament. Grands Rapids, Mich.:
W.B. Eerdmans Pub., 1985.
Kirkwood, Neville A. A Hospital Handbook on Multiculturalism and Religion. Harrisburg,
Penn.: Millennium Books, 2005.
McGrath, Alister E. Christian Theology: An Introduction. 5th ed. Oxford, UK and Cambridge,
MA: Blackwell, 2011.
White, James F. The Sacraments in Protestant Practice and Faith. Nashville: Abingdon Press,
1999.