"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

a. English Puritan casuistry. English Puritan casuistry-the process of arriving at God's wisdom for a given situation through questions and answers of a given case-was practiced by such luminaries as Joseph Hall (1574-1656), Jeremy Taylor (1613-1667), William Perkins (1430-1495) and the esteemed Richard Baxter (1615-1691). The material is weighty with Scripture and theological reflection and practical heart-felt sympathy and human endearment for those under physical and emotional stress. Above that, it is vocationally satisfying. Jeremy Taylor wrote in his Holy Dying:

In all the days of our religion, from our baptism to the resignation and delivery of our soul, God hath appointed his servants to minister to the necessities, and eternally to bless, and prudently to guide, and wisely to judge, concerning souls; and the Holy Ghost, that anointing from above, descends upon us in several effluxes, but ever by the ministries of the church. Our heads are anointed with that sacred unction, baptism, (not in ceremony, but in real and proper effect,) our foreheads in confirmation, our hands in ordinations, all our senses in the visitation of the sick; and all by the ministry of especially deputed and instructed persons: and we, who all our life-time derive blessings from the fountains of grace by the channels of ecclesiastical ministries, must do it then especially, when our needs are most pungent and actual.28

b. Liturgical and sacramental ministry. Another faithful approach to the visitation of the sick and dying is taken from more sacramental traditions. The Anglican Martin Thornton takes up the matter of Pastoral visitation in his Pastoral Theology: A Reorientation. Thornton values the pastoral visitation for its inherent "vicariousness" and "sacramental contact."29 The cure in the pastor's black bag, for Thornton, is "the Rule of the Church" (Word, Sacrament, and Prayer) which must be "used and interpreted."30 The "Rule of the Church," in this sacramental system, is also the ordinary means of grace no matter the gathered believers are meeting in the context of the Lord's Day or in some special time, such as the hospital room.

The Book of Common Prayer, in all of its revisions, up to and including the present 1979 edition used by the Episcopal Church and the 1928 edition used by the traditional continuing movement churches, is an excellent model of this approach. A synthesis of both casuistry and liturgy on the pastoral visitation of the sick might include the following rubrics:

Initial Contact

Prayer and Preparation of the Minister Prior to the Visit, Including a Study of the Scriptures Relevant to the Circumstances of the Parishioner

Entrance

Interview and Theological Reflection

Scripture Reading

Prayer

The Lord's Prayer

Sacrament (optional and used according to tradition; ordinarily the Sacrament of the Lord's Supper would not be administered on routine hospital visits, but when accompanied by someone from the local congregation with arrangements having been made for the special service)