The essence of Christianity is to live in relationship with God and each other, and from this flow the principles that have made the Christian community ripe for the development of nursing. They are principles such as love for your neighbor, hospitality to the stranger, compassion, and a holistic view of the person in which the body cannot be divorced from the spirit. Western nursing has grown out of the Christian church and so Christianity and nursing have historically had strong associations. This chapter aims to show how these core principles have influenced the development of health care, as well as informing Christian health ethics. It will also show how Christian principles have the potential to inform nursing theory and practice for all nurses, enabling them to practice their art to the highest level. Nursing has always taken its knowledge from a variety of sources and theological models have their own contribution to make in nursing. However, for Christian nurses, these principles will not only be an informing factor, but also an obligation.
The chapter falls into six main parts:
1. The core beliefs of Christianity and the authority for those beliefs. This section focuses on those beliefs that are most likely to affect health care practices.
2. The individual and the community: hospitality to the stranger.
3. Health and medicine in the Christian tradition.
4. Christian health care ethics.
5. Nurses in the Christian tradition.
6. Christian patients.
Christianity is an ancient global religion. Consequently, a wide range of practice and belief exists among Christians and even within groups belonging to the same denomination or subgroup of belief. This is not a negative factor but rather reflects the variety of human experience and character. Different denominations tend to place emphasis on different aspects of belief. The sources used here have deliberately been taken from a variety of denominations.
Christianity may be unique in its central belief that God lived on earth as a man and a Jew. This man was Jesus Christ; Christ means, anointed by God. The names Jesus, Christ, and Jesus Christ are used interchangeably by Christians. Christians believe that they know God principally through the fact that he was born on earth as a human being. God is known not only because a person somewhere was told about him, or because he invisibly acted through any event; God’s purpose and nature is known primarily because God lived as a human here on earth.1 The eye witness accounts about his life and death contained in the scriptures of the New Testament are, however, not the only basis for Christian beliefs. Accounts or “revelations” have been reflected on and written about by theologians and other Christians for 2000 years. Such writings, together with the lives of saints and martyrs, the rituals and prayers used in services of worship, and many other sources have formed a living repository of knowledge that are collectively known as the Tradition. This knowledge, which has been subjected to inspired and devoted interpretation, together with study, prayer, and sacramental practice is imbued, Christians might say, with the Holy Spirit. Tradition is the result of participation, relationship and fellowship with Christ, in the community of the Church (italicized words are explained in the glossary at the end of the book). It is the continuation of the scriptures, making the scriptures “understandable and meaningful”2 and bringing the revelation in the scriptures into the present day, facing present day situations. Therefore, the New Testament and Old Testament with the Tradition form the main historical source of Christian belief.
Tertullian (160–220 CE), an early theologian, said that scripture was easy to understand correctly if it was read as a whole, but that read in parts, it was possible to make it mean anything you wished, thus correct interpretation, with reference to the Tradition, was crucial.3
The first clue about the importance of the concept of relationship to Christian spirituality comes from the fact that Christ called God his Father and related to him as his son. After Christ was crucified, the Bible teaches that the Holy Spirit descended to his disciples. Here is the second clue about relationship, because here is born the idea of the Trinity of Father, Son, and Holy Spirit. Not three Gods, but one. The Christian God is a communion of “persons,” “divine and human, in loving relation.”4 It is this idea of equal, reciprocal, and mutual relationship which, as Downey, a Catholic theologian, referred to above, says forms a template for relationships between people and is the basis of Christian ethics.5 This understanding of a community of persons is not only an example for Christians to follow, but in a mystical sense, is also seen as a pattern stamped on humanity that should be fulfilled in our lives in order to be fully human. “I need you in order to be myself.”6
Similarly, the person is also understood as being a composite or “community” of three parts: body, soul, and spirit, each part being in relation or communion with the other two. In Eastern Orthodox Christian theology, each “person” of the Holy Trinity is said to relate to the two others by a process of perichoresis, meaning the soul and spirit always transmigrating into the body, and the body into the soul and spirit. This notion of being constantly permeated by spirit, as well as the belief that humans are made in the image of God (Genesis 1:27), gives rise to the belief that human beings are equally spiritual and material. People therefore live in a paradox that they are constantly striving to resolve. They are higher than the angels because they possess a body and so contain potential that not even the angels can aspire to.7 As imago mundi (an image of the world) reflecting the two different aspects of the created universe, Maximus (580–662 CE) said that each person was a microcosm of the whole universe, a laboratory “in which everything is concentrated.” The person’s unique ability to move between the two levels of matter and spirit, linking the two levels “as a natural bond,” defines their vocation as mediator between heaven and earth.8
Christian theology tells of how at some point humans chose to rebel against God’s will, an event depicted in the Garden of Eden when Adam and Eve ate from the tree of knowledge of good and evil from which God forbade them to eat. Therefore humans came to reflect the cosmos in a disordered way. However, through the practice of love, Christians believe that they can renew their relationship with each other and restore their relationship with God. This Christian love is called agape: the unconditional act of will that is indifferent to the value of the thing it loves, whereas eros is the love dependent on attraction and yearning.9 Thus, Christians are commanded to love even their enemies.
The Christian life is not only about looking inward but also about looking outward toward other people. It is about community rather than individuality and the only purpose in perfecting the inner spiritual life is to learn how to love others more and better. Christianity is a religion of encounter: with God, with other human beings, and encountering our own selves. Christian living is dominated by learning about how to live closer to God and more in alignment with what are perceived to be God’s wishes for us.
The relationship portrayed in the Trinity and told about in the Gospels gives a template and guide for how people should act. The scriptures and the Tradition teach that God loves humanity and wants only the best for people, tolerates their faults, seeks their spiritual growth, is forgiving and just, and gives us freedom, therefore we know that this is how we should relate to others.
Hospitality is a natural part of Christian practice because it describes how people should act in encounters with the stranger: with welcome, protection, help, and comfort. To Christians, Christ’s image is in each person perceived as a stranger. When Christ described how people will be judged in the future he said, “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, naked and you clothed me, sick and you visited me in prison and you came to see me. . . . In so far as you did this to one of the least of these brothers of mine, you did it to me.” (Matthew 25, 34–40)10
What is known as the “great” or “first” commandment, that is, “to love God and also to love your neighbor as yourself” led to Christ being asked “who is my neighbor?” (Luke 10:29), to which he told the story of a Jew who had been set upon and beaten by thieves. A priest came across him, as well as a man from his own country who both ignored him. Then a Samaritan saw him, treated his wounds and took him to an inn where he cared for him overnight, then gave the innkeeper instructions to continue his care for payment on his return (Luke 10, 30–35). The Samaritans and the Jews reviled each other and were in constant dispute over how they interpreted religious laws, yet it was a Samaritan who cared for the Jew, showing how a neighbor could be any stranger.
In an increasingly diverse society, the concept of hospitality to strangers comes into sharp focus bringing a powerful message about the need for love and inclusiveness. It speaks of how those who are outside our immediate circle should be treated. Sutherland uses the theology of the stranger to explore how people relate to different types of people on the margins of society, be they ill, poor, or foreign. He suggests that what these “outsiders” have in common is that their appearance “is disconcerting and confusing to others; they cause consternation and discomfort.”11 They challenge our settled ideas and ordered lives. They force us to think about our own mortality and how easily our own contentment could be upset.
The Protestant theologian Karl Barth (1886–1968) argues that human beings should strive toward health as the way to exercise being fully individual, fully satisfying their needs, and fully using their reason and the way to be fully human.12 Christians see it as their vocation to be fully what God has made them, that is, fully human, seeing it as an obligation to seek good health.
Thus, medicine has a long history in Christianity, beginning with the healing miracles in the New Testament setting the example of the importance of healing disease. The first known hospital in the Christian world, the Basileias, was established by Basil the Great, Bishop of Caesarea in Cappadocia in 372.13 Basil begged the authorities for permission to provide a place for strangers and “people who need attendance in consequence of infirmity . . . nurses, medical attendants and a means of conveying them.”14 Such hospitals were built as parts of monasteries because Basil believed that caring for the sick and suffering was part of the monk’s calling, putting the message of love into practice. Early Christians were encouraged to care for the sick and their enthusiasm for doing so has often been called reckless. For instance, Eusebius writing during 263 CE records how Christians acted during a plague in Caesarea. “Everything is tears and everyone is mourning, and wailings resound daily through the city because of the multitude of the dead and dying . . . our brethren were unsparing in their exceeding love and brotherly kindness. They . . . visited the sick fearlessly, and ministered to them continually, serving them in Christ.”15
Bishops were well-known for organizing health services and relief in times of pestilence. Smith and Cheetham give the example of how Placilla, the Christian wife of Emperor Theodosius (347–395 CE), cared for the sick not by delegating the task to others lower than herself, but by working with her own hands in the hospital. She “handled the pots” of those confined to bed, preparing food, feeding and washing the sick; doing work which was “generally done by domestics.”16 The Emperor Julian (332–363 CE) was scathing, saying of Christians that they “give themselves to this kind of humanity . . . starting from what they call love” in order to create converts.17 Nevertheless, it is clear from these accounts and many others that by the 4th century, Christians had become known for their care of the sick both as individuals and in institutions, as well as their tendency toward “hands on” care and their willingness to sacrifice their own safety and dignity to help others, and not only their family and friends or soldiers, but also strangers. What was also revolutionary about early Christians and what put them in opposition to the surrounding culture was the belief that everyone was of equal status and equally deserving of care when in Greco-Roman society status was based on citizenship, family, and virtue.
The first nurses came from religious orders, such as the charity of St. Vincent de Paul in the 17th century. In the 1830s, a Lutheran pastor in Kaiswerwerth in Germany established an order of deaconesses (female church officials able to carry out some of the functions of clergy, such as helping at baptisms) to nurse the sick and it was when Florence Nightingale saw this that she went on to create her secular version of this model. As supernatural explanations for disease gave way to scientific reason, Christian doctors embraced the new order so that there are now few differences in medical practice between secular and Christian doctors.
The origin for much Christian health care and ethics lies in the stories of Christ’s healing ministry in the Synoptic Gospels. Gill (2006) has analyzed the repeated themes of these stories to see what they have to say that is distinctly Christian about behaving ethically toward sick and disabled people.18 His qualitative analysis reveals that incidents of healing were often accompanied by displays of emotion by Christ himself, together with touching, despite notions of uncleanness, and acting with faith, compassion, care, and humility. There is also an element of being willing to act outside the law, to do something different from the expected, to be prepared to shock and to take a risk. Christ’s actions seem to demonstrate commitment to the person you feel compassionate about and a willingness to risk your own reputation or freedom to help them. For example, Christ healed a woman in the synagogue on a Saturday (the Jewish Sabbath), an act that was outside the Jewish law. He did this not in some discrete place, but in full view of the officials (Luke 13:10–17), causing shock and consternation that he was willing to counter fearlessly.
Gill used the word compassion to describe how Christ not only expressed sympathy at the predicament of the people he met, but he was willing to take action to allay it. Christ often showed anger during these incidents, forming a common combination of sympathy, action, and anger. For instance, in Mark’s account of the healing of the leper (Mark 1:40–45), the characteristics of care, compassion, touch, anger, and the willingness to touch someone who is considered ritually unclean, come together. A number of things could render a person ritually unclean, such as menstruation, sexual activity, or death. To touch someone who was ritually unclean in ancient times would have been seen as shocking. For instance, ritual bathing was required before visiting the temple. The theologian Hooker20 suggests that the anger is indignation at the cause of disease. To Jews at this time, lepers were outside the rest of society and anyone who touched them took on, not only the possibility of disease, but according to Mosaic law (the law that came from God through Moses), also their unclean state. Yet, Jesus voluntarily touched the man. Gill makes the point that given the persistent belief in some nations that disease is associated with uncleanness of spirit, it is not surprising that most health care in those nations is delivered through Christian agencies. The common demands for faith on behalf of those being healed or their family and friends, Gill argues, should be interpreted as confidence or trust rather than faith, meaning religious belief.
Gill’s analysis shows that the core of these stories is compassion, a slightly mistrusted concept in modern health care where it has somehow come to be associated with disempowerment and dependence. Gill argues that even Christian health ethics has failed to give compassion the importance it deserves and suggests that “principled scruples” and empathy have often been placed before it.21 Whereas empathy means that we can identify with the feelings of the sufferer, compassion can be a spur to action to alleviate the suffering. Davies analyzes the theology of compassion and suggests that “In compassion we see another’s distress (cognition), we feel moved by it (affectively) and we actively seek to remedy it (volition).”22 Mercy is sometimes used in the Bible to mean compassion, but it should be seen as compassion shown to someone over whom you have power.
In the stories of healing in the Synoptic Gospels, Christ is seen being moved to anger at the suffering before him, then seeking to find a solution. These notions of compassion, care, touch, righteous anger, the willingness to deal with the “unclean” and the need to inspire trust, all have something to teach nurses; however, arguably it is compassion that lies at the core of Christian ethics.
One of the problems for Christians in finding solutions to ethical problems that do not contradict their religious beliefs, is in harmonizing the relief of suffering with the upholding of principles. In a belief system where all life is valued, infused with God’s spirit and in the image of God, the question of how to reduce suffering when it seems the only way is to end life, have always perplexed Christians. To Gill, holding to principles must give way sometimes to compassion, which is a more risky ethical stance underpinned by the notion that rules and principles were created to smooth the path of humankind on the earth. When they become obstacles to compassionate care, they may need to be discarded. This calls for discernment and judgment with love; clearly a difficult path. As Christ says in the Gospel according to Mark, “The Sabbath was made for man, not man for the Sabbath.” (2:27) This might mean that treatments should be discontinued when they cease to bring benefit and the burden of misery they impose is overwhelming.23
Borg puts the dilemma in a historical context. He argues that in the dominant paradigm of the Jewish Torah (the first five books of the Old Testament), holiness gave way to the “compassion code.” This new paradigm was ushered in by the “new covenant,” meaning a new relationship with God mediated by Jesus Christ. Jesus contrasts holiness with compassion in the Synoptic Gospels saying “I desire mercy (compassion) not sacrifice,” (Mathew 9:13).24 Healing on the Sabbath was allowed because it was exercising compassion even though it was against the religious law. Borg reminds us that Christ taught that we were children and should do as children do, imitating their father, making a compassionate God their role model. “The fitting response of those who lived under the compassion of God was compassion”25 as demonstrated in the parable of the wicked servants who were criticized by Jesus because instead of releasing their debtors from their debt as their master had done to them, they forced their own debtors to pay up on pain of punishment (Matthew 18:23–35). Whereas Leviticus 9:2 states “Be holy as God is holy,” Luke says “Be compassionate as God is compassionate.” (6:36)
Another characteristic of the new covenant is inclusiveness. The compassion demonstrated in the Torah is usually compassion for your own social group, starting with your family and ending with your tribe. Whereas the compassion of the New Testament is to be offered to everyone with whom you come into contact and anyone can be seen as your neighbor, if they are in need.26 As Matthew (5:45) has, “God causes his sun to rise on bad men as well as good, and his rain to fall on honest and dishonest men alike.” Thus, Christian ethics is inclusive and dominated by compassion rather than slavishly following principles.
This viewpoint is reflected in the principles proposed by the Anglican bishops of the Lambeth Conference, the decision-making body of the Church of England, in 1998, which suggested some principles that should guide ethical decision making:
1. Life is God-given and therefore has intrinsic sanctity, significance, and worth.
2. Human beings are in relationship with the created order and that relationship is characterized by such words as respect, enjoyment, and responsibility.
3. Human beings, while flawed by sin, nevertheless have the capacity to make free and responsible moral choices.
4. Human meaning and purpose is found in our relationship with God, in the exercise of freedom, critical self-knowledge, and in our relationship with one another and the wider community.
5. This life is not the sum total of human existence; we find our ultimate fulfillment in eternity with God through Christ.27
Such principles describe compassionate decision making where moral freedom is respected, the wider community acknowledged, and the responsibility to each other and the sanctity of life endorsed. The bishops proposed that the first, second, and fourth principles made all forms of euthanasia wrong. Yet in some circumstances, it was acceptable for treatment to be refused or stopped by patients because the fifth principle reminds us that Christians do not “need to cling to life at all costs.”28
Nursing has struggled to describe a truly holistic and integrative model of the human person, and the modern imperative to include spirituality has produced a flurry of updating that has not yet produced models that sufficiently account for how people’s spirit articulates with their body and their mind.29 Nursing is essentially about caring for embodied selves. Therefore, any model of nursing must be capable of encompassing and explaining the body not only as a mechanical and chemical system but as an embodied self which, for Christians anyway, contains spirit. Recent interpretations of nursing have tended to emphasize psychological and spiritual states in separation from the body.30 However, in the Christian model of the person, body, soul, and spirit are inextricably interrelated. Christians believe that God came to earth in human form, and so sanctified the human person, including the body.31 Because of the way that soul, spirit, and body constantly pour into each other, to care for the body means to touch both the soul and the spirit of the person: in caring for the physical body we care for the whole person. Therefore, a Christian theology of care is arguably innately holistic. The body is not just a housing for the soul; the body is the very condition of human existence. The body does not keep the person “earthbound,” because Christians believe that one can become close to God in this life, with a body. Luther saw the whole person as being spiritual, including the body,32 and Nouwen, a modern day writer about spirituality, thought that Christianity takes the body more seriously than other religions and wrote “the way one lives in the body, the way one relates to, cares for, exercises, and uses one’s own and other people’s bodies, is of crucial importance for one’s spiritual life.” The body is seen as a glorified place, a temple, a means of sanctification. Loving care of the body is a spiritual act.33 Therefore, Christian nurses are not repulsed by the physical body and do not consider it innately unclean; care of the body is an important activity and not to be denigrated or delegated to the least qualified or those of the least status.
Thus physical care is careful, attentive, and unflinching touch of the body, rather than a mechanical, instrumental, distracted touch that attempts to keep a person at arm’s length. The philosopher Levin proposed that through this kind of touch we can learn to know a person better and come into better relationship with a person. He suggests that when bodies are handled appropriately, the true nature of another person is allowed to emerge. He says, “. . . careful touch, which is open to feeling what it touches and uses, gets in touch with a thing’s essential nature more deeply and closely than the hand which willfully grasps . . . or than the hand which is indifferent to the beauty of the thing in the wholeness of its truth.”34
However, realizing this link between the body and the person—a truly embodied self—is only possible within a paradigm that is capable of valuing the body. Groenhout, Hotz, and Joldersma have analyzed interactions between patients and nurses using the framework of the Protestant tradition, and suggest that how nurses use the right level and type of touch affects their relationship with patients and governs the level of dependency between the two parties. This “dance” between two partners can contain elements of self-sacrifice and mutuality that make these embodied encounters spiritual. Physical care performed in this spirit can become a sacramental act.35
The parallel aspect of the nurses’ work, besides working with the body, is in relationship. Nurses constantly encounter “the other,” the stranger, and their work is devoted to bringing each “other” into relationship. Nurses have to engender trust quickly and inspire their patients to have faith in their helpers on whom they may depend. Campbell suggests that for all practitioners who work in this way, their task is almost religious whether they believe or not, because they hope for an end to suffering, however illusive. He calls the love, or agape, that gives birth to this hope “moderated love” and suggests that all good professionals will need this.36
Nurses straddle the “normal” or “outside” world of their home and family, and the world of disease, disorder, and taboo every working day. Nurses bring this outside world to patients and become their bridge to the outside. This is not only the physically outside world, but the world of normality, sanity, and certainty from which patients may feel estranged. Maximus, the 6th century theologian, said that the human being was the natural mediator between all the levels of the cosmos by holding the two poles of the material and the spiritual, transcending both by uniting them and aiming always toward unity and God. Because of the unique work that nurses do, they could be called a quintessential mediator, reminding people, by loving care of their body, that they are valued. Christian care of the whole person is not only aimed at healing the body, but through careful caring, to contribute toward healing of the whole person enabling them to move along their own path toward God. The principles of hospitality and holistic and compassionate care for strangers, who reflect the image of Christ, and the inclusivity that these principles encompass, bring each person in from the margins, direct the encounters of Christian nursing and provide an ethical backdrop to the nurse–patient relationship.
Care within this paradigm cannot stop at the bedside. The Old Testament, as well as the New, contains many exhortations to speak up for those whose voice is not heard or who are poor or strangers.37 Nurses working within this model will seek to eradicate the poverty and injustice that cause illness and disability and that may involve them in political and social action. This care transcends sentimentality. The righteous indignation of Christ, when he saw injustice, urges Christian nurses, using Christ as an example, to be prepared to face criticism to advocate on behalf of patients and to be prepared to fight for a better society. Similarly, at home after work, or in church, Christian nurses may pray for patients, bringing the world of their patients into their own world as though deriding the division.
Nursing seen in this light could truly be called a vocation. This is a spiritual calling that not only affects the person being cared for, but which could also affect nurses, helping them on their own path to God by giving the opportunities to practice what Christians might call the virtues of compassion, self-sacrifice, tolerance, and love.
Christians aim to place themselves in God’s hands and may see times of illness and anxiety as tests of their faith or as opportunities to come closer to God. Therefore, they are likely to try to be stoical and accepting about illness. However, in a paradoxical world, such trials may also cause loss of faith for some people as they face the reality of believing that God’s purpose is to provide what each person needs, and not to give each person what they want. Christians, as with any believer, who have not thought about their faith for a long time may rediscover it at times of crisis. Nurses serve these patients by prompting them to remember what had given them strength in the past and providing the circumstances for patients to reconnect with those things and, if they wish, practice their faith. As with all religions, devotional and scriptural reading, music, and nature can all help people to immerse themselves in their faith, or to rediscover it.
Of suffering, Weil says, “The extreme greatness of Christianity lies in the fact that it does not seek a supernatural remedy for suffering but a supernatural use for it.”38 While Christianity teaches that Christians should unashamedly pray to be relieved of suffering, they might at the same time pray that God’s will be done and that they will have the strength to accept it. Christians might feel that suffering is part of life, but that like all aspects of life, it must be capable somehow of being put to the service of God. Christians may try to find meaning in suffering by seeing it as an opportunity to draw closer to God and deepen their faith by increasing their dependence on God. Roman Catholics in particular may see suffering as redemptive and as punishment for their own or others’ sins. Therefore, although suffering should not to be sought or idealized, it can be seen by Christians to be an opportunity to learn more about themselves, to deepen their relationship with others, to empathize with others who are also suffering, to appreciate their own dependence on God, and to enable them to appreciate the preciousness of life. Consequently, for Christians, suffering could be tinged with hope, because there is always hope of a better reality to come.
If nurses are to be respectful of patients’ religious views, they must be able to accept those views, not necessarily believe them, but accept that their patients’ beliefs are a response to the sacred, and not just a response to social and psychological conditioning. Religious belief means living within a particular world view; it is not just a means of expression or a lifestyle choice. Just as nurses have had to learn to accept the modern definition of pain—that it is what the patients says it is and exists when the patient says it does—so nurses have to accept that religion is about responding to the sacred, as the patient sees the sacred, and is not a psychological or social need or prop.39 To people who live within the perspective of Christianity, the symbols of their religion are not just illustrative of a divine reality, nor are they only symbols of or for that reality, but they are pointers to an actual reality, which in some ways may be more real to them than daily life. To Christians, the sacraments, such as Holy Communion (also called Eucharist or the Lord’s Supper), are not just illustrative or symbolic of a truth, but they actually manifest a truth. As Florovsky writes, “The Eucharistic Sacrament is neither a mere remembrance nor a ‘repetition’ of the Last Supper. It is rather its ‘manifestation’ or extension. Worshippers are, as it were, taken back to the Upper Room and made participants of the same sacred Supper.” 40
Because of this, Christian rituals should be treated with seriousness and solemnity because to Christians, these are not just a comfort but are actually supernatural events that put them in touch with God. Therefore, it may be very important to receive Holy Communion, and especially at times of illness and crisis, because it is seen to have a healing function. In Eastern Orthodoxy, the last words the priest utters before giving Holy Communion are “for the healing of our souls and bodies.” Christians may experience a feeling of completeness and fulfillment after receiving Holy Communion, and following the service they should be given privacy for a while to contemplate what has taken place and to return slowly to the material world from the spiritual world.
The true meaning of sin is not to do with being bad, but it literally means “to miss the mark.” It is a paradoxical aspect of being human that as soon as we begin to interact with other people, we are constantly “falling short” of where we want to be. As St. Paul said “I cannot understand my own behavior. I fail to carry out the things I want to do and I find myself doing the very things I hate” (Romans 7:15–16). Christians have the chance to deal with this paradox and the guilt it may engender by seeking confession to a priest and being given absolution (forgiveness) or by seeking Holy Communion or other forms of blessing, and anointing with oil, so that they can face the world anew. Especially when Christians are faced with the reality of their own mortality and their need for God, they may suddenly feel the need for confession, anointing, and forgiveness as part of a healing process that sees the whole person as in need of healing, not only the body. In the Roman Catholic and the Orthodox Churches, and in recent decades in Protestant Churches, a priest or pastor may be summoned to pray with a person and give a blessing by placing a hand on their head and making the sign of the cross; this may be accompanied by the anointing with oil on the forehead and hands. In the Roman Catholic Church, this is particularly requested by patients to prepare for death, but may also be requested in times of illness where it is called the sacrament of the sick. This is a subtle form of healing, where healing is seen as an acceptance of the burden life has placed on them and a willingness to place themselves in God’s hands and learn what this illness has to teach. Healing may mean receiving the courage to work with and through the illness and the fortitude to deal with whatever pain may be involved. In this way, it could be argued that if healing means to feel better, then it is possible to be healed by these means, although materially the disease may be the same. Likewise, prayer is a healing way to communicate desires and needs and therefore the privacy to pray is important, as well as the freedom from embarrassment. People may need to be invited to voice their religious needs in a world that is increasingly secular and where they may not wish to stand out. During illness and anxiety, prayer may become much more important and can be a great source of help in managing physical and spiritual pain.
Christian theology is innately holistic and relational. It offers ways of understanding the person and society that can enhance any nurses’ understanding of their role. Christianity holds deeply integrative views of the person that honor the body, the site of most nursing care. In addition, Christian models of relationship are inclusive and compassionate toward strangers. Indeed, Christian ethics holds that acting compassionately is more important than rigidly following principles. For non-Christian nurses, Christian theology offers pragmatic and comprehensible reasons to care and meaningful models of relationship. For Christian nurses who consciously works within the paradigm, their beliefs will motivate and enrich their daily work and they will strive to offer the best care, unconditionally, because that way they are every day fulfilling God’s purpose in their lives.
1. Ward, Keith. Religion and Revelation. Oxford: Oxford University Press, 1994.
2. Meyendorff, J. Living Tradition. New York: St. Vladimir’s Seminary Press, 1978. 16.
3. McGrath, Alistair, E. Christian Theology: An Introduction. Oxford UK: Blackwell, 2001. 15.
4. Downey, Michael, Understanding Christian Spirituality. New Jersey: Paulist Press, 1997. 39.
5. McGrath 326. Op. cit. McGrath also gives an overview of a number of classical and modern ideas on The Doctrine of the Trinity. 318–344.
6. Ware, Kallistos. “The Trinity: Heart of our Life.” Reclaiming the Great Tradition: Evangelical, Catholics and Orthodox in Dialogue. Ed. James S. Cutsinger. Illinois: Intervarsity Press, 1997. 141. 125–146.
7. Ware, Kallistos. “The Transfiguration of the Body.” Sacrament and Image. Ed. Allchin, A. M. London: The Fellowship of St. Sergius and St. Alban, 1967. 25. 17–33.
8. Maximus the Confessor. Difficulty 41,1305A in Louth, Andrew. Maximus the Confessor, London: Routledge, 1996. 157.
9. Nygren, Anders. Agape and Eros, (Parts 1 and 2). London: SPCK. 1953. ix.
10. All biblical quotations are from The Jerusalem Bible, Popular Edition. London: Darton, Longman & Todd, 1974.
11. Sutherland, Arthur, M. I Was a Stranger: A Christian Theology of Hospitality. Abingdon US: Abingdon Press, 2006. 13.
12. Barth, Karl. Church Dogmatics. Edinburgh: T & T Clark, 1961. 3/4. 357.
13. Amundsen, Darrel W., and Gary B. Ferngren. “The Early Christian Tradition.” Caring and Curing: Health and Medicine in the Western Religious Traditions. Eds. Ron L. Numbers and Darrel W. Amundsen. Baltimore: The Johns Hopkins University Press, 1998. 49. 40–64.
14. Basil the Great’s Epistle 94, quoted in William Smith and Samuel Cheetham. A Dictionary of Christian Antiquities. Vol 1, London: John Murray, 1875. 786. Web. 12 Sept. 2011. <http://www.archive.org/details/christianantiqui01smituoft>
15. Eusebius. Chapter 7. “Ecclesiastical History,” Nicene and Post Nicene Fathers Series II Vol 1. Ethereal Classics. Web. 12 Sept. 2011. <http://www.ccel.org/ccel/schaff/npnf201.iii.xii.xxiii.html> Book 7, Chapter 7, p. 307. NPNF2-01. Eusebius Pamphilius: Church History, Life of Constantine, Oration in Praise of Constantine | Christian Classics Ethereal Library.
16. Smith and Cheetham 786.
17. Fragment from Emperor Julian, quoted in Smith and Cheetham. 786.
18. Gill, Robin. Health Care and Christian Ethics. Cambridge, UK: Cambridge University Press, 2006. 62–93.
19. Gill.
20. Hooker, Morna, D. The Gospel According to St. Mark. London: Continuum, 1991. 80.
21. Gill 94.
22. Davies, Oliver. A Theology of Compassion. London: SCM Press, 2001. 17–18.
23. Gill 116.
24. Borg, Marcus. Conflict, Holiness, and Politics in the Teachings of Jesus. Harrisburg, US: Trinity Press International, 1998. See: 135–151 for a biblical exegesis of the move from holiness, as the main content of religious life, to compassion.
25. Borg 138.
26. Borg 140.
27. Anglican Consultative Council. The Official Report of the Lambeth Conference July18-August 9, 1998, Lambeth Palace, Canterbury, England. Morehouse: London. 1999.
28. Gill 110.
29. Graham, Ian. V. “The Relationship of Nursing Theory to Practice and Research within the British Context: Identifying A way Forward.” Nursing Science Quarterly, 16. 94. (2003): 346–350. Oldnall, Andrew. S. “On the Absence of Spirituality in Nursing Theories and Models.” Journal of Advanced Nursing 21. (1995): 417–418.
30. Allen Shelly, Judith, and Arlene B. Miller, Called to Care: A Christian Theology of Nursing, Illinois: Intervarsity Press. 1999. 17.
31. For a detailed explanation of the spirituality of the body see pages 90–110 in Ware, Kallistos. “‘My Helper and My Enemy’: The Body in Greek Christianity.” Religion and the Body. Ed. S. Coakley. Cambridge: Cambridge University Press. 1997. 90–111.
32. Tripp, David. “The Image of the Body in the Protestant Reformation.” Religion and the Body. Ed. S. Coakley. Cambridge University Press: Cambridge, 1997. 131–155.
33. Nouwen, Henri, J. M. The Road to Daybreak: A Spiritual Journey, Memorial Edition. London: Darton, Longman & Todd, 1997. 202.
34. Levin, David, M. The Body’s Recollection of Being: Phenomenological Psychology and the Deconstruction of Nihilism. London: Routledge and Kegan Paul, 1985. 128.
35. Groenhout, Ruth, Kendra Hotz, and Clarence Joldersma. “Embodiment, Nursing Practice, and Religious Faith: A Perspective from One Tradition.” Journal of Religion and Health 44.2 (2005): 147–160. 152.
36. Campbell, Alistair. V. Moderated Love, London: SPCK, 1984. 14.
37. For example, see Isaiah 1 v17. “Search for justice, help the oppressed, be just to the orphan, plead for the widow.”
38. Weil, Simone. Gravity and Grace. London: Routledge, 2002. 81.
39. Clarke, Janice. “Religion and Reductionism: A Discussion Paper about Negativity, Reductionism and Differentiation in Nursing Texts.” International Journal of Nursing Studies 43. (2006): 775–785.
40. Florovsky, Georges. “The Worshipping Church” in The Festal Menaion, Mother Mary and Archimandrite Kallistos Ware. Pennsylvania: St. Tikhon’s Seminary Press, 1969. 21–38. 29.