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Coming to the Aid of Those in Need: The Lesson of the Good Samaritan

Catholic health care institutions [are] powerful witnesses to the
charity of the Good Samaritan because, in caring for the sick, we
fulfill the Lord's will and contribute to realizing the Kingdom of God.

--from the address of John Paul II to the
17th International Conference on the Identity
of Catholic Health Care Institutions,
November 7, 2002

The story of the Good Samaritan is one of several inspirations for Christians to become involved in providing health care to those in need. The parable is relayed in the gospel of Luke. Luke, who may himself have been a physician (and is considered the Patron Saint of Physicians), was a disciple of Paul, who guided the early development of the Church through his visits and letters. In this passage (Luke 10:25-37), Jesus is challenged to give a clear instruction on how to gain eternal life:

And now a lawyer stood up and, to test him, asked, 'Master, what must I do to inherit eternal life?' He said to him, 'What is written in the Law? What is your reading of it?' He replied, 'You must love the Lord your God with all your heart, with all your soul, with all your strength, and with all your mind, and your neighbor as yourself.' Jesus said to him, 'You have answered right, do this and life is yours.'

But the man was anxious to justify himself and said to Jesus, 'And who is my neighbor?' In answer Jesus said, 'A man was once on his way down from Jerusalem to Jericho and fell into the hands of bandits; they stripped him, beat him and then made off, leaving him half dead. Now a priest happened to be traveling down the same road, but when he saw the man, he passed by on the other side. In the same way a Levite who came to the place saw him, and passed by on the other side. But a Samaritan traveler who came on him was moved with compassion when he saw him. He went up to him and bandaged his wounds, pouring oil and wine on them. He then lifted him onto his own mount and took him to an inn and looked after him. Next day, he took out two denarii and handed them to the innkeeper and said, "Look after him, and on my way back I will make good any extra expense you have." Which of these three, do you think, proved himself a neighbor to the man who fell into the bandits' hands?' He replied, 'The one who showed pity towards him.' Jesus said to him, 'Go, and do the same yourself.'

The man going from Jerusalem to Jericho who was victimized, not described further, was likely a Jew. The priest and the Levite were Jewish temple officials traveling on the same road; it could be said that both were the man's "neighbor" by community. Both of these religious men passed by the person in trouble without offering assistance. The Samaritans and Jews did not normally interact with one another and did not share the same religious interpretations, so it could be properly said that the Samaritan was not a "neighbor" to the victim by community and beliefs. Yet, the Samaritan was moved by compassion for a person injured and helped, indeed, he assisted beyond simply bandaging the man's wounds: he made sure that the injured man was cared for thereafter. This response to a human in need is what defines him as truly the neighbor that is intended in the teaching "love thy neighbor as yourself:" he treated the man, a complete stranger, as he himself would like to have been treated. We can feel shame for the actions of the priest and the Levite in this story, who did not follow the spirit of the Law that they served, and admiration for the good Samaritan. We learn from this parable that being a good neighbor is not determined by whom we live near nor who shares our culture and religion, but by how we behave; we learn also the type of behavior expected of us by God.

This story is not solely about the need to provide medical care, but because the example depicts medical assistance, it is the one frequently used as an example of how Christians are to respond to those who have medical needs (and, it provides other useful insights to be described below). The more general teaching about gaining eternal life and being a good neighbor is relayed in this teaching from Matthew's gospel (25: 31-46):

'When the Son of man comes in his glory, escorted by all the angels, then he will take his seat on his throne of glory. All nations will be assembled before him and he will separate people one from another as the shepherd separates sheep from goats. He will place the sheep on his right hand and the goats on his left. Then the King will say to those on his right hand, Come, you whom my Father has blessed, take as your heritage the kingdom prepared for you since the foundation of the world. For I was hungry and you gave me food, I was thirsty and you gave me drink, I was a stranger and you made me welcome, lacking clothes and you clothed me, sick and you visited me, in prison and you came to see me." Then the upright will say to him in reply, "Lord, when did we see you hungry and feed you, or thirsty and give you drink? When did we see you a stranger and make you welcome, lacking clothes and clothe you? When did we find you sick or in prison and go to see you?" And the King will answer, "In truth I tell you, in so far as you did this to one of the least of these brothers of mine, you did it to me."

Then he will say to those on his left hand, "Go away from me, with your curse upon you, to the eternal fire prepared for the devil and his angels. For I was hungry and you never gave me food, I was thirsty and you never gave me anything to drink, I was a stranger and you never made me welcome, lacking clothes and you never clothed me, sick and in prison and you never visited me." Then it will be their turn to ask, "Lord, when did we see you hungry or thirsty, a stranger or lacking clothes, sick or in prison, and did not come to your help?" Then he will answer, "In truth I tell you, in so far as you neglected to do this to one of the least of these, you neglected to do it to me." And they will go away to eternal punishment, and the upright to eternal life.'

Based on the behavior demonstrated in the parable relayed by Luke, the good Samaritan is in the first group, but the priest and Levite fall into the second group; if their behavior in this instance was characteristic of these two individuals, the priest and Levite should have great cause for concern. In the examples given in this teaching of various kind acts-feeding the hungry, giving refreshment to the thirsty, visiting the sick-they are all considered to be of a similar nature. A person offering assistance of the sort depicted here, particularly to a stranger, would be considered a good Samaritan.

The value of willingness to assist even those with whom we do not have a personal relationship is further explained by Jesus, as relayed by Luke (6:31-35). The reference to one's "enemy" in this passage does not necessarily imply an immediate struggle, but someone who may not share common background and goals, like the Samaritan in relation to the Jew in the story above:

Treat others as you would like people to treat you. If you love those who love you, what credit can you expect? Even sinners love those who love them. And if you do good to those who do good to you, what credit can you expect? For even sinners do that much. And if you lend to those from whom you hope to get money back, what credit can you expect? Even sinners lend to sinners to get back the same amount. Instead, love your enemies and do good to them, and lend without any hope of return. You will have a great reward, and you will be children of the Most High, for he himself is kind to the ungrateful and the wicked.

This teaching also suggests that one's charity should be exactly that: charity, without expectation of reward. Nothing here suggests that one should not help a loved one, a friend or colleague, or someone who pays in full for the services received; but giving such aid is something we might ordinarily do because there is a reward of love, appreciation, or money. Giving aid when one cannot expect anything back, even when, for various reasons, no gratitude is expressed, is a Christian ideal.

Since it is clearly taught that people who are sick, injured, or otherwise suffering are to be helped, it is incumbent on all to find ways of providing assistance. Some may become a healing practitioner, such as a medical doctor, dentist, nurse, pharmacist, or other role where one routinely provides direct assistance, or may take the position of a helper behind the scenes, such as a medical or pharmaceutical researcher, a diagnostic laboratory technician, or designer of medical devices. Still others may bring their skills to this field and work as assistants, secretaries, policy makers, managers, medical publishers, and so on, in support of those who provide remedies for the sick. Aside from those who make a career in these fields, others may undertake a variety of charitable acts such as visiting the sick, contributing or raising funds, being an inspiration to their neighbors through their deeds, and by praying for those in need.

Good Samaritans on a Large Scale

The details provided in the story of the good Samaritan foretell a Catholic health care system, one which began developing almost immediately, developing into an extensive network. The Samaritan provided bandages, oil, and wine for the treatment; these are the forerunners of modern medical devices and medicines. He also evidently had some knowledge of properly using them to help the injured man, which prefigures more formal medical education that is needed for technological medicine as we have today. The Samaritan took the injured man on his cart to a place of hospitality, prefiguring ambulances and hospitals. Further, the Samaritan paid out of his own pocket for the cost of the Inn and agreed to pay any other expenses that would be incurred, such as for food, prefiguring the charitable and other financial arrangements essential for providing for and managing the needs of the sick, and the development of support services to help with the various requirements for recovery. And, the Samaritan asked that the Inn keeper look after the injured man, prefiguring nurses and other health care workers.

Clearly, one cannot rely upon a person like the Samaritan to happen by for everyone who becomes sick or injured, nor could a person be expected to oversee the long-term medical requirements of a stranger with a chronic illness. So, it became necessary to establish a systematic means of providing health care, and this has been accomplished through a Catholic health care system that has been evolving along with the growth and development of the Church.

The accomplishments in this task of helping the sick are revealed, in part, by the extent of this system as it exists now. Although the following data is limited to that for the U.S., Catholic health care is provided to varying extents in all countries. The Catholic health care system is the largest private nonprofit provider of health services and Catholic hospitals are the largest single group of nonprofit hospitals, accounting for over 11 percent of the nation's community hospitals, 16 percent of community hospital beds and 16 percent of all community hospital admissions. According to the Catholic Health Association (CHA), there are 622 Catholic hospitals in the U.S., an increase of 80 hospitals since 1997. In addition, there are 61 Catholic health care corporations of one or more hospitals plus related health care services (such as outpatient clinics and laboratories); 10 of the nation's 20 largest hospital systems are Catholic. In addition to facilities established and run by Catholic organizations, there are also many institutions run by other Christian denominations, such as Lutheran, Baptist, and Orthodox, and there are numerous Jewish hospitals and clinics.

Health care assistance can be provided to people in a variety of settings, most of which are outside the Catholic health care system, in numerous secular as well as other religious institutions. In 2002 (last year having statistics published), there were nearly 13 million people counted as being employed in the health services field in the U.S. (making up about 9% of the total employment in the U.S.). Many of the positions contributed to important support services. Among the main occupations involved in patient care were the following (with more than 10,000 members each), making up about 6 million of the positions:

Profession Designation Number
Registered nurses 1,892,000
Nursing aids, orderlies, and attendants 1,163,000
Licensed practical and licensed vocational nurses 577,000
Physicians and surgeons 418,000
Medical assistants 330,000
Personal and home care aides 266,000
Dental assistants 256,000
Health diagnosing and treating practitioner support technicians 216,000
Dental hygienists 144,000
Physical therapists 117,000
Emergency medical technicians and paramedics 115,000
Occupational and physical therapist assistants and aides 103,000
Dentists 87,000
Respiratory therapists 80,000
Pharmacists 60,000
Occupational therapists 58,000
Physician assistants 55,000
Clinical, counseling, and school psychologists 37,000
Chiropractors 19,000
Acupuncturists 15,000

The need for people to be employed in the medical fields and supportive jobs is increasing as the population increases, as the population ages, as social improvements allow for a larger portion of the population to gain access to medical services, and as medical advances allow for treatment of diseases that were previously virtually untreatable.

What Makes A Catholic Health Service Unique?

Catholic health services, aside for being non-profit, have certain unique qualities. A primary defining characteristic is related to the understanding that people's needs encompass not only physical and mental health, but also spiritual health, and that this concern for patients integrates with the spiritual environment of the health care institution and the Church The range of important spiritual and practical components of providing this type of care-as they fit into the modern situation-has been outlined in the document Ethical and Religious Directives for Catholic Health Care Services (Fourth Edition, June 15, 2001), issued by the U.S. Conference of Catholic Bishops. A review of the origins of the current health care system presented in that document helps define its orientation:

Jesus' healing mission went further than caring only for physical affliction. He touched people at the deepest level of their existence; he sought their physical, mental, and spiritual healing (John 6:35, 11:25-27). He "came so that they might have life and have it more abundantly" (John 10:10).

The mystery of Christ casts light on every facet of Catholic health care: to see Christian love as the animating principle of health care; to see healing and compassion as a continuation of Christ's mission; to see suffering as a participation in the redemptive power of Christ's passion, death, and resurrection; and to see death, transformed by the resurrection, as an opportunity for a final act of communion with Christ.

The unique nature of Catholic health care had been described by John Paul II in a letter in which he announced formation of the Pontifical Commission for the Apostolate of Health Care Workers (February 11, 1985; on the one year anniversary of his apostolic letter on suffering):

In her approach to the sick and to the mystery of suffering, the Church is guided by a precise concept of the human person and of his destiny in God's plan. She holds that medicine and therapeutic cures be directed not only to the good and the health of the body, but to the person as such who, in his body, is stricken by evil. In fact, illness and suffering are not experiences which concern only man's physical substance, but man in his entirety and in his somatic-spiritual unity.

To focus further attention on these needs of people who are sick, John Paul II instituted the annual World Day of the Sick. In his address for the first such event, on February 11, 1993, he noted that:

The Christian community has always paid particular attention to the sick and the world of suffering in its multiple manifestations. In the wake of such a long tradition, the universal Church, with a renewed spirit of service, is preparing to celebrate the first World Day of the Sick as a special occasion for growth, with an attitude of listening, reflection, and effective commitment in the face of the great mystery of pain and illness.

The need to address the whole person and to do so in the most efficacious way, was a subject of John Paul II in his message for the 9th World Day of the Sick on February 11, 2001:

In recent years, there has been a growing interest in scientific research in the medical field and in the modernization of health-care structures. We can only look favorably at this trend, but at the same time it must be stressed that there is a constant need for it to be guided by the concern to offer the sick an effective service, supporting them efficaciously in the fight against disease. In this perspective, there is increasing discussion of "holistic" care, that is, care that pays attention to the biological, psychological, social, and spiritual needs of the sick and of those around them. It is particularly necessary, with regard to medicines, treatments, and surgical operations, for clinical experimentation to be conducted with absolute respect for the individual and with a clear awareness of the risks and, consequently, of the limits involved. In this area Christian professionals are called to bear witness to their ethical convictions and to be constantly enlightened by faith.

In addition to looking to the whole person in terms of the physical and spiritual unity, it is also necessary to consider their families and the patient's social condition, such as persons who are without family support and in poverty, and also to take into account the training of those who help them. John Paul II, in his message for the 11th World Day of the Sick (February 11, 2003) pointed out that:

Catholic hospitals should be centers of life and hope which promote-together with chaplaincies-ethics committees, training programs for lay health workers, personal and compassionate care of the sick, attention to the needs of their families and a particular sensitivity to the poor and the marginalized. Professional work should be done in a genuine witness to charity, bearing in mind that life is a gift from God, and man merely its steward and guardian.

Each Person Can Help

Some individuals have a particular talent to participate in the medical assistance for people, in treating sickness and/or in providing preventive health care (the role of the dental hygienist is a well-known example for the latter). Jesus directed the apostles and several of his disciples to heal others and gave them the power to do so, as long as their faith was strong (it is strengthened by the Holy Spirit, and the apostles received a unique grace of the Holy Spirit on Pentecost).

St. Paul describes how the people of the Church are united by the Holy Spirit and how each person receives gifts of the Holy Spirit that are talents to be used "for the general good" (1: Corinthians 12:7). Among these gifts is healing. Paul summarizes his discussion of these gifts in describing how the Church was established by God as the body of Christ (1 Corinthians 12:28):

Now Christ's body is yourselves, each of you with a part to play in the whole. And those whom God has appointed in the Church are, first apostles, secondly prophets, thirdly teachers; after them, miraculous powers, then gifts of healing, helpful acts, guidance, various kinds of tongues.

This is a partial list of those "appointed" by receiving such gifts (talents); Paul continues his letter pointing out that not everyone has the same gifts. Gifts of healing and providing helpful acts and guidance are among the talents that come to laypersons, among other talents needed for the Church to function as a whole. While those who have a gift for languages (tongues) may serve as translators or as ambassadors, others can serve people in various other capacities. Not everyone has medical talents; but some may help with administration (guidance) or with visiting the sick or various assisting tasks that benefit those who suffer (helpful acts).

Thus, having a job in the health care field is only one way to contribute to the task of helping those who are sick or injured. St. Alphonsus Liguori (1696-1787) gave a more general instruction suited to those who have other talents:

We must show charity towards the sick, who are in greater need of help. Let us take them some small gift if they are poor, or, at least, let us go and wait on them and comfort them.

As a summation for this presentation, we may turn to the words of John Paul II when he made the following commentary in his address for the 10th World Day of the Sick (February 2002):

It is right to fight sickness because health is a gift of GodůWorld Day of the Sick reminds us then, that beside every suffering person there must be a brother or sister motivated by charity. Like the Good Samaritan, of which Jesus speaks in the well-known Gospel parable, every believer is called to offer love to all who are suffering. Never "pass by"! On the contrary, he should stop to bend over the person who is crushed, suffering, and alleviate his burden and difficulties. This is how the Gospel of consolation and charity is proclaimed; this is the witness that the people of our time expect from all Christians.

Note: At least two important subjects were not dealt with in this article. One is bioethics, which was frequently mentioned in the messages delivered by John Paul II for the World Day of the Sick. This is an area where there has been considerable contention between Catholic and secular views. Bioethics is the subject of a separate article. Another matter is the nature of suffering, which is important in any full discussion of sickness. John Paul II made a vital contribution to this topic in his apostolic letter "Salvifici Doloris" which is also the subject of a separate article.