At that the chaplain felt braver. "So, tell me Doctor, how are things with you and God?" The
psychiatrist was sort of stunned at the question, but then relaxed, and thoughtfully replied,
"I will tell you this: I've seen a lot of simple operations get a little fouled up over the years. My
operation will be open heart surgery. I know full well that if something were to go wrong . . .
well, I guess I'm saying . . . I'm not sure about God."
"Go on," the young chaplain whispered.
"Well, what does that Bible say about what happens when you die?" (1)
II. MODERN PROBLEMS IN PASTORAL CARE OF THE SICK AND DYING
Whether the minister of the gospel is a solo pastor with an older congregation or the senior
pastor of a mega church, or even a professor of a college or seminary who may also serve on the
staff of a suburban congregation, all ministers usually wind their way into hospital parking lots,
climb stairs, and maneuver endless corridors to enter the rooms of people in hospital beds.
Some the minister will know quite well. Others will be friends or relatives of the congregation,
and the minister will have never met them.
Few clergy would dispute the proposition that hospital visitation is a necessary part of the
minister's work. The biblical references on the matter are so many and so clear that pastoral
visitation of the sick and dying is an expected work of the minister of the gospel in carrying out
a biblically faithful pastorate.
"Now Naaman, commander of the army of the king of Syria, was a great and honorable man in
the eyes of his master, because by him the LORD had given victory to Syria. He was also a
mighty man of valor, but a leper. Now bands from Aram had gone out and had taken captive a
young girl from Israel, and she served Naaman's wife. She said to her mistress, "If only my
master would see the prophet who is in Samaria! He would cure him of his leprosy""(2 Kings
"I was naked and you clothed Me; I was sick and you visited Me; I was in prison and you came
to Me" (Matthew 25:36).
"I was a stranger and you did not take Me in, naked and you did not clothe Me, sick and in
prison and you did not visit Me" (Matthew 25:43).
"Is anyone among you sick? Let him call for the elders of the church, and let them pray over
him, anointing him with oil in the name of the Lord" (James 5:14). (2)
However, a real question might be: "What is the role of the minister of the gospel on hospital
visitations?" Or, in keeping with the theme of a recent Annual Meeting of our society, "What are
Evangelicalism's 'boundaries' in the work of pastoral care of the sick and dying?" (3) We might
even borrow the sarcastic patient's question as an authentic and pressing question to every
minister of the gospel prying open a hospital room door: "So, what are you doing here?"
On this vital matter of ministry the visitation of the sick The Book of Church Order of the
Presbyterian Church in America instructs its officers and members that: "It is the privilege and
duty of the pastor to visit the sick and to minister to their physical, mental, and spiritual
welfare. In view of the varying circumstances of the sick, the minister should use discretion in
the performance of this duty." (4)
Patrick Fairbairn, the Scottish prince of pastoral theology, and a representative of the
traditional evangelical approach to visitation of the sick, wrote:
The ministration of counsel and comfort to the "diseased, the dying, or the bereaved" is
undoubtedly a most important branch of pastoral duty. It is such, indeed, that the neglect or
slovenly discharge of it will go far to neutralize the effect of all other services. For the pastor
who makes himself strange in the households of his flock, while they are involved in sorrow or
stricken with disease and death, will invariably be regarded as devoid of the tenderness and
consideration which are the most appropriate characteristics of his calling. (5)
C. W. Brister in his outstanding work Pastoral Care in the Church addressed the nature of the
experience of the hospitalized person:
Accidents, hospitalized illnesses, and surgical procedures disrupt life's serenity and threaten
the security of persons and their families. Hospitalization creates a crisis as the ill or injured
person experiences his own finitude, suffers pain, and copes with alien forces and persons. (6)
I would suggest that there is always the potential for another sort of crisis: a crisis of role and
identity of the minister of the gospel on the care giving team to the sick and dying. So this paper
seeks to address the issue of the role of ministers of the gospel in hospital visitation. In
particular, I want to suggest that liberalizing tendencies in modern pastoral care, as well as
ordinary but errant pastoral identities, require professors of practical or pastoral or applied
theology to recognize the persistent possibility of crisis in this important aspect of the pastor's
work and to be intentional in re orientating future pastors toward a biblically faithful,
vocationally satisfying, and historically evangelical approach to the visitation of the sick and
dying. An important caveat to be made at this point is that this paper is primarily concerned
with raising and addressing concerns about the visitation of the sick by generalists, generally
speaking, parish ministers, not specialists such as hospital or military chaplains. (Although
what I propose in this paper would, I think, be of some value to them as well.) (8)
1. Liberalizing tendencies.
"So what are you doing here?" should provoke a prompt and decisive answer. There have been
a variety of helpful theologians and pastors and writers who have helped form our response.
(8) Most of the great patristic figures have answered this central question about the role of the
minister in caring for the sick. Among them, we would name Tertullian, Origen, Chrysostom,
Cyril of Jerusalem, and the great Augustine. Classical Roman Catholic voices such as Ambrose,
Gregory, and Thomas Aquinas have answered the question. Classical Protestant voices such as
Luther, Calvin, Bucer, Herbert, Gouge, Bunyan, Owen, Baxter, and Wesley have weighed in.
Modern voices like Kierkegaard, Niebuhr, Earth, Bonhoeffer, Geoffrey Nuttal, and Thomas Oden
have added their comments. We shall consider some of them momentarily.
But, amazingly, in the presence of so many of those voices saying remarkably similar things
about the work of pastoral visitation of the sick, there have been answers that could only be
described as novel. These voices might be characterized as liberalizing tendencies in the work
of pastoral visitation. These voices have tended to pare the theological edge off of a distinctively
evangelical or perhaps we should say, "classical" response, in favor of a new voice. This new
voice carries with it the familiarly unbiblical echoes of the modern psychological movement.
Among these new voices Thomas Oden lists the following: "Stolze (1940), Waterhouse (1940),
Goulooze (1950), Bergsten (1951), Johnson (1953), and Hiltner (1959)." (9)
The force of their teaching, while offering much that would surely be welcomed as helpful by
evangelical pastors, was to supplant the sufficiency of Scripture with an unhealthy and unwise
dependence on the teachings of modern psychology. Frederic Greeves, author of Theology and
the Cure of Souls and an eminent British pastoral theologian, visited the United States in the late
1950s and remarked (and I quote from C. W. Brister) "that ministers are primarily consulted as
psychologists rather than as pastors." (10) Indeed, Seward Hiltner, who may be called the
father of the modern pastoral care movement in seminary education, relied heavily on the
behavioral science work of Karl Menninger and, indeed, was a professor at the Menninger
Institute in Topeka, Kansas, in 1957. He was also the chief spokesman for a distinctively
Rogerian form of pastoral care. Carroll Wise, another prominent member of this school, taught
that "[w]e ministers do not solve anybody's problems. . . . We are simply a means by which a
person is enabled to work out his own destiny." (11) I will not go into his thoughts on
preaching, but his statement that "exhortation . . . may do a lot of harm . . ." (12) fairly
represents his assessment of the older Biblical approaches to pastoral care and, particularly,
the role of the minister in visiting the sick and dying.
After Hiltner, the name of Dr. Howard Clinebell, who labored as Professor of Pastoral
Psychology and Counseling at the School of Theology at Claremont, Claremont, California, must
surely rank as the key teacher of these innovative ideas about the ordinary work of the pastor
in the cure of souls. There was nothing ordinary and certainly little that was biblical in this
man's work. Clinebell, in his Basic Types of Pastoral Care and Counseling (in the 1990 eighth
printing of the 1966 original), which emerged as a primary textbook in pastoral counseling in
many mainline seminaries, proposed that a key goal of a pastoral counselor was to help
parishioners to "develop and cherish a nurturing interaction with our great mother Mother
Nature." (13) Drawing from feminist theology, Clinebell encouraged an "androgynous
wholeness" to the self as a goal of pastoral counselors. (14) Clinebell is helpful to the
evangelical only in this: he records the history of what he calls the "contemporary flowering of
this ancient ministry . . ." [of cure of souls] by listing the chief pioneers. (15) He includes
"Richard Cabot, Anton Boisen, Philip Guiles, [and] Russell Dicks . . ." (16)
I say this is helpful to evangelicals, because in listing the names he exposes the progenitors of
the false doctrines. Other than this, his textbook, which is grounded in psychology, feminist
theology, and liberation theology, with limited references to Scripture and the casuistic
practices of most of Christian history, the book has no value for the work of an evangelical
minister. Yet, many evangelicals in mainline denominations were educated in it.
All of this is to say that there was enormous synergy between psychologists, philosophers, and
psychiatrists and the modern pastoral care movement and thus potential enormous influence
on those trained in it. Again, Thomas Oden, a theologian who at one time claimed the theology
of Niebuhr and Tillich which undergirded the movement, but who later rejected it in favor of
traditional evangelicalism, lists the following as major influencers on the modern pastoral care
movement: "James (1897), Freud (d. 1939), Jung (1959ff), C. R. Rogers (1951, 1961), [and] . . .
Menninger (1972)." (17) Paul Vitz includes theorists and therapists such as Maslow, Skinner,
Masters, and Johnson, Sanford, and Kohlberg. While these thinkers have shaped and influenced
the pastoral care movement and consequently the seminary students who were trained under
their adherents, I would add that the popular works of people like Wayne Dyer and Rollo May
have no doubt had an impact as well on the approach of pastors to the work of cure of souls.
There have been popular and scholarly works outlining a traditional evangelical criticism of
this movement (see especially the works of Paul Vitz, Jay Adams, and the Bobgans). (18) It is
not my interest in this paper to pursue this criticism further. However, I raise the issue because
the psychological therapeutic movement in the modern pastoral care school has, if it has been
integrated as a normative approach to pastoral care, been a chief contributor to an errant
answer to our pressing question.
The answer to the question, "So what are you doing here in my hospital room, pastor?" may be
answered this way by practitioners of the modern pastoral care movement, "I am here just to
listen." Or, if he is willing to stretch the Rogerian model a bit: "I am here to help you get in touch
with yourself before this operation."
At the very minimum, this is a departure from the normative answers provided by curators of
souls prior to the modern pastoral care movement. I shall have something to say about those
older practitioners in a moment, but I want to address another problematic approach to the
2. Ordinary but dangerous assumed identities
The work of the Christian pastor, a word whose etymology suggests its proper association, is
grounded in faithful biblical instruction, including faithful metaphors. When those metaphors
are mortgaged for handy or high impact or what we understand to be relevant, but biblically
groundless metaphors, the effect is not only to confuse or abandon the biblical identity of
pastor, but also to compromise if not sacrifice divinely attached blessings. The identity
powerfully and, yes, practically, relates to the blessings. In the pastoral care of the sick and
dying, nothing could be truer.
As a pastor, mentor of other pastors, and military chaplain, I want to suggest some of the wrong
identities assumed by mistaken pastors. I, too, have made these errors, yet while they are
understandable, they will, if left uncorrected in one's ministry, fail to produce the cure. Here are
some of the default settings that some ministers might have in their minds concerning hospital
a. Therapist I begin with the false identity of therapist. Given what we have seen is the ground
of the modern pastoral care movement, it is little wonder that pastors might be tempted to
assume the role of therapist as they go into the hospital room. Ralph Turnbull wrote
"Some pastors fear that greater emphasis on psychology will lead to confusion by eliminating
theology as the basis for the pastoral ministry. The pastor must always remember that the
nature of his work as comforter is defined by the basic concepts of the Christian gospel rather
than by modern psychology." (20)
The modern pastoral care movement is born, not of divine revelation, but out of at minimum a
syncretism of received traditions in the Church with what Scripture refers to as the "wisdom of
this world" (1 Cor 1:20; 2:6; 3:19). (21) At its worst, in the case of Clinebell. It is a wholesale
replacement of infallible biblical injunctions, principles, and traditions with broken, sensual,
and even idolatrous worldviews.
It is easy to see that when the role of the minister of the gospel becomes that of therapist, he is
then competing, if you will, with other care giving professionals. His "ministry," if that is an
appropriate term, has been rerouted from prophet priest pastor, ambassador of Jesus Christ, to
dispenser of psychological techniques whose traditions are shallow in terms of history and
I listened to the testimony of one parishioner: a seventy five year old Presbyterian man from a
conservative denomination, a deacon, and a life long follower of Christ. (22) The incident
happened in 1996 in a the cardiac ward of a large and well respected hospital in a Midwestern
city. The patient said the hospital chaplain came into the room, did not offer to pray or to read
Scripture, but proceeded along this line:
Chaplain: "So how do you feel about being here?"
Patient: "I am ready to go home, I guess. But, I know my old ticker needs a little repair, so I'm
just trusting in the Lord."
Chaplain: "So, you're feeling isolated."
Patient: "Actually, my wife comes and goes. I think I'm fine."
Chaplain: "How do you feel about being out of control at this time in your life?"
You can see what was happening. The chaplain, using Rogerian therapeutic techniques, engaged
the patient, with the apparent hopes of guiding the patient to get in touch with his feelings.
Now, there is something commendable in all of this as it touches upon empathy and an
incarnational approach to the visitation. However, particularly in the case of a believer, this
approach is entirely insufficient and unsatisfactory to the patient. They expect an ambassador
of Jesus Christ, not a therapist. They crave, as he related to me, a minister of the gospel to speak
the comfortable words of Scripture, to inquire as to the work of the Spirit in his soul, and to
perhaps lead him in prayer.
b. Medical expert Another assumed false identity for the pastor is the medical expert. John
Wesley, of course, along with many of the Methodist preachers, was instructed in and practiced
a sort of lay medicine in his day. Doctor Martin Lloyd Jones was a trained surgeon from St.
Bartholomew's in London before surrendering to a call to preach. But, apart from these unusual
instances, one historical and probably unlikely to be necessary again and the other a unique
vocational path, the rest of us should stay clear of offering medical advice in hospitals. In
Excerpt out of 15 pages
- Quote paper
- Michael Milton (Author), 2003, "So, What are You Doing Here?" The Role of the Minister of the Gospel in Hospital Visitation or a Theological Cure for the Crisis in Evangelical Pastoral Care, Munich, GRIN Verlag, https://www.grin.com/document/387358