Dilexit Nos, Catholic Healthcare and a Call to Action
Claudia Ruiz Sotomayor MD, DBe…Chief of the Ethics Consultation Service Pellegrino Center for Clinical Bioethics, Assistant Professor Georgetown University Medical Center.
Myles N. Sheehan, SJ, MD…Director Pellegrino Center for Clinical Bioethics, Professor of Medicine, David Lauler Chair of Catholic Health Care Ethics, Georgetown University Medical Center.
Christopher Spevak MD MPH JD… Clinical Ethicist Pellegrino Center for Clinical Bioethics, Professor of Anesthesiology Georgetown School of Medicine.
In October 2024, Pope Francis issued an encyclical, Dilexit Nos (He Loved Us), focused on the contemporary meaning of devotion to the Sacred Heart of Jesus. While the devotion to the Sacred Heart of Jesus may initially appear as a straightforward and sentimental religious practice, the encyclical emerges at a pivotal moment in history, urging a shift from excessive rationalization to deeper reflection and ultimately it is a call to action. It invites us to consider how these concepts fundamentally inform our decisions and our actions. This is a relatable encyclical that can be adapted to various aspects of life, and we argue that it has a particularly strong connection to the field of healthcare. This article discusses its meaning for the ministry of Catholic health care. The focus is threefold: the relevance of the devotion as described in the encyclical, themes of particular resonance to those who work in Catholic health care, and suggestions for how the insights of the encyclical can be shared in our hospitals and health care systems.
THE RELEVANCE OF DILEXIT NOS TO CATHOLIC HEALTH CARE
Catholic health care in the United States has a remarkable heritage forged by the women who began the health care ministry in this country. It is a story of bold change, bravery, tenacity, sacrifice, and commitment that these women and their religious congregations brought forth. Serving the poor, the ill, and, frequently, the marginalized and sometimes despised immigrant population of the United States, the founding congregations faced religious prejudice, poverty, a variety of harsh living conditions, some ecclesiastical opposition, as well as effects of illness contracted from those whom they served.
The force that motivated the founders of Catholic health care was their faith in Jesus Christ and their commitment to follow the Gospel mandate to care for those who are the least. With the unique distinctiveness of their congregational charisms, they embodied their faith in Jesus through their attitudes, actions, and ministry. Unwavering in their commitment to their vocation, they courageously embraced their calling. Empowered by love, they enacted significant change, leaving a profound and enduring impact. This serves as a vital reminder that fostering bold change necessitates a confluence of energy, talent, thoughtful reflection, and discernment, especially when such change is directed toward the ultimate aim of elevating human flourishing.
At a time when Catholic health care is a diverse ministry, encompassing people from many religious traditions and no religious belief, the challenge in our day is to bring together all who work in Catholic health care with a profound source of inspiration. The love of God, as manifested in Jesus’ love for all, especially the sick, the poor, and the neglected, is at the center of the devotion to the Sacred Heart of Jesus. Just as that love inspired our founders, it can inspire us to continue the healing ministry of Jesus, even as we respect the diversity of all who participate in this ministry.
Many objections might arise to emphasizing the Sacred Heart of Jesus as a touchstone for our ministry in the United States. Let us consider some of the possible concerns.
Talking about the Sacred Heart of Jesus seems too Catholic, and it might turn off other Christians and those of different religions, or none, who work with us. There are ways to talk about Catholic health care that authentically represent who we are without offending. The phrase “the healing ministry of Jesus Christ” pervades Catholic health systems and hospitals. How one discusses and explains a devotion like the Sacred Heart, deeply rooted in Catholic tradition, can provide an opportunity to get to the core of our mission. The emphasis is found in a love that animates our actions and directs us to care for those most in need of our care. The love celebrated in the Sacred Heart is an inclusive love that reaches beyond boundaries. We do not believe that the love of Christ calls us only to care for those who share our religious beliefs. That would be a travesty and a complete betrayal of Jesus’ memory.
How this devotion has been artistically portrayed could be more attractive and appealing to modern people. It may be true that our hospitals might have some artwork and older statues that are, charitably, ugly. But there is more to this devotion than pictures and statues. It is about finding a source of love that inspires us, directs us to share this love with others, and to cooperate with the work of God in Christ to make this world more authentically human. The point of the Sacred Heart of Jesus in theology and devotion manifests Jesus’ divine and human love for all of humanity. We are not worshiping a divine myocardium but attending to the center of Jesus, who drove him on his mission on Earth and is still a source of his care for all of us today.
Devotion to the Sacred Heart may seem excessively privatized and removed from the day-to-day concerns of those who work in Catholic health care. The devotion does have a vital element of a private relationship with Jesus, but it also, as emphasized by Pope Francis, has a robust communal commitment. It calls us forth to care for others and show our love for them while giving us the strength to be seen as loving people. Reflecting on Jesus’ deep personal love for us as individuals encourages us in our daily struggles. Much has been written about burnout among healthcare workers and the stresses of daily practice. A deep sense of being personally loved by Jesus can be a source of deep personal strength and depth. It will not make a bad day at the hospital a wonderful experience, but it may allow us to share our feelings and concerns with Jesus and be a source of personal strength and resilience. Being supported in our work by the love of God brings us to share that love in the deeds we perform in health care.
While John Paul II and Benedict XVI were known for their intellectually rigorous encyclicals, rich in philosophical and theological depth, Dilexit Nos takes a different approach. It is more practical and accessible, offering clear and direct insights that are easy to understand and deeply relevant to everyday life. This practical focus makes the encyclical particularly meaningful for professionals in healthcare, where its teachings can inspire and guide daily work.
Was this a mere coincidence, or is God guiding us toward a deeper understanding of what it means to love boldly? What might this encyclical bring to us in Catholic health care? Are there essential themes that deserve reflection and ways to emphasize a devotion that expresses the human and divine love of Jesus, which seeks to care for us in our neediness and encourages us to display our love for others? The Sacred Heart invites us to move beyond surface-level expressions of love, embracing a steady, wholehearted devotion to the well-being of others, even in the face of life’s most significant challenges.
THE THEMES OF THE ENCYCLICAL
Before diving into the document, we begin with definitions and history. The encyclical was issued in honor of the 350th anniversary of the apparitions of the Sacred Heart to Saint Margaret Mary Alacoque. With over 200 footnotes citing the Bible, Plato, Homer, Rahner, and Heidegger, to name a few, it reminds us of the century’s old tradition of renewal and hope. The twenty-eighth General of the Society of Jesus, Fr. Pedro Arrupe, describes the meaning of the word “heart”: “We refer to the Heart of Christ, to sum up in one word all the values we find in Him. There is no other expression more apt to convey the breadth, length, height, and depth of the love of Christ, which is beyond all knowledge.” What follows is a document summary along with implications for Catholic healthcare.
In the first chapter, Pope Francis emphasizes the importance of the heart, beginning with a meditation on St. Paul’s assertion that nothing can separate us from Christ’s love. He emphasizes the significance of love represented by the Sacred Heart and the need to return to compassion, mercy, and unity in a world increasingly disconnected from these values. He explores the concept of the heart from both ancient Greek thought and biblical perspectives, arguing that modern society’s focus on technology and distraction leads to alienation and questions of identity and purpose. He asserts that our true identity and genuine relationships are rooted in the heart and advocates for an engagement with our inner selves to foster spiritual growth and societal renewal. Drawing inspiration from Saints Ignatius of Loyola and John Henry Newman, Pope Francis emphasizes that true transformation begins with experiencing God’s love in our hearts, a vital foundation for healing and change.
Devotion to the Sacred Heart is not just a personal spiritual endeavor; it has significant social implications, serving as a source of reconciliation and peace. When our hearts align with Christ’s, they bring about profound social change. It calls us forth to care for others and show our love for them while giving us the strength to be seen as loving people.
In the second chapter, “Actions and Words of Love,” Pope Francis reflects on the profound love of Christ, emphasizing that Jesus’s heart symbolizes the essence of the gospel. He illustrates how Jesus’ comforting the sick and forgiving sinners demonstrates God’s personal and compassionate love. Jesus displays deep insight into the people’s hearts through his humanity, emotions, and ultimate sacrifice on the cross. The Pope encourages readers to center their lives on this sacrificial love, echoing Saint Paul’s declaration of Christ’s love. This love is the path to true fulfillment and flourishing for humanity because it invites us to participate in a profoundly enriching and radically transformative love. Far from being just an ideal, it is a life-giving force that reshapes hearts, inspires selflessness and fosters authentic relationships.
“Actions and Words of Love” necessitate practicing hospitality. Bruce Malina describes hospitality as “the process by means of which an outsider’s status is changed from stranger to guest.” Attentiveness, in this context, involves actively listening to others and demonstrating genuine care and presence. Together, these virtues foster an openness to encountering others with love, an awareness of their needs, and a commitment to offering meaningful support to those we meet.
The virtues of attentiveness and hospitality are especially significant in healthcare, forming the foundation of compassionate and effective care. These virtues align closely with the concept of Cura Personalis, a Latin phrase meaning “care for the person.” Rooted in Ignatian spirituality, Cura Personalis emphasizes concern and care for the personal development of the whole person. This holistic approach is essential to providing good medical attention, as it addresses physical ailments and the individual’s social, emotional, and spiritual dimensions.
In healthcare, attentiveness can be understood as another expression of love because it is a deliberate act of focusing on the needs of others. By paying attention, we move beyond self-centered preoccupations, shifting our consciousness toward the other, whether that “other” is a patient, a colleague, or a broader situation requiring care. When grounded in Cura Personalis, this attentiveness takes on a more profound significance, fostering a genuine concern for the individual’s complete well-being. When rooted in Christ, this outward focus is further enriched, bringing peace and healing to all hearts through prayer and service. Thus, integrating attentiveness, hospitality, and Cura Personalis transforms medical care into a sacred ministry that honors each person’s dignity and wholeness.
In the third chapter- “The Heart That Has Loved Greatly,” Pope Francis clarifies that devotion to the Sacred Heart is about fostering a deep personal relationship with Christ and not merely venerating a religious image. The Sacred Heart represents the boundless love of Jesus, which invites believers into an intimate relationship grounded in divine and human love. This devotion, rooted in trinitarian love, allows us to meet Jesus, not as an abstract concept, but as a living savior who invites us into trust. The Pope explains that the Sacred Heart is not about focusing on a single part of Jesus but contemplating his entire personal love for us. True contemplation of this love begins with exercising our freedom. We can open ourselves to love, embrace it thoroughly, and ultimately share it with others. Pope Francis emphasizes that devotion to the Sacred Heart remains relevant as it counters the increasing secularization of the world. The Heart of Jesus invites us into a form of love beyond fleeting emotion or surface-level attachment.
One of the elements of the devotion to the Sacred Heart is Jesus’s suffering and pain in his love for human beings. We know the Sacred Heart as a heart that is wounded. That woundedness is the site of Christ’s openness to the suffering of those we care for. Jesus’ healing mission, which we continue, is motivated by a love for others, even to the point of self-sacrifice. The Sacred Heart calls us to love our patients in imitation of Jesus, and it calls us to be with Him and know his love as we continue his mission.
In chapter four, Pope Francis explores the symbolism of water as a life-giving purifying force. He considers the biblical, patristic, and more recent sources of devotion to the Sacred Heart. Francis reflects on biblical images of water in prophecies from Isaiah, Ezekiel, and Zachariah, where water symbolizes new life. In the Gospel of John, Jesus extends the invitation to the thirsty, culminating on the cross as blood and water flow from his side. The Pope traces devotion to the Sacred Heart, from the early Church Fathers to Saints Bernard and Bonaventure, as a prelude to Saint Margaret Mary Alacoque, whose revelations emphasized Jesus’ Immense love. Devotion to the Sacred Heart is not an outdated pious practice but, as described by Pope Francis, it is witnessed by St. Ignatius of Loyola, Sr. Faustina Kowalska, Saint John Paul II, and others, who understood that the Sacred Heart is a path to understanding God’s mercy and compassion. From the encyclical, we read, “In union with Christ, amid the ruins we have left in this world by our sins, we are called to build a new civilization of love. That is what it means to make reparation as the heart of Christ would have us do. Amid the devastation wrought by evil, the heart of Christ desires that we cooperate with him in restoring goodness and beauty to our world”.
The wounded Heart of Jesus invites us to find joy even as we, so often do in health care, encounter suffering. We can see beyond the pain and look to the possibility of redemption and restoration. The wounded Heart of Jesus offers a profound lesson in the healing ministry. In healthcare, we are called to recognize that healing is not just physical; it encompasses emotional, spiritual, and relational dimensions. The Sacred Heart, wounded as it is, reminds us that true healing often comes through the acknowledgment of suffering, empathy, and love that reaches out to others in their pain. This healing ministry reflecting the love of the Sacred Heart has no biomedical limits but expands to offering compassion, presence, and care that can bring emotional and spiritual healing.
In the final chapter, Pope Francis invites the faithful to respond to this divine love, mainly through the Eucharist and living lives of love and service, especially to the marginalized. This transcends private devotion and piety in acts of charity and service to transform the world. He reflects on the concept of reparation to address the harm caused by sin. Reparation, he notes, has social significance and goes beyond ritual. It requires us to repair society through active love and service.
The Pope stresses the missionary dimension of the devotion. By sharing Christ’s love with others, we build a society of Justice, peace, and fraternity. This is part of the missionary role of Catholic health care: not as people seeking religious conversions but as people on a mission to love.
Francis concludes by encouraging missionaries in love with Christ, eager to share the joy and transformative grace of his love with the world. Catholic health care works to repair the effects of sin and evil through our care for the sick and our commitment to transform our nation’s health system in ways that promote equity, accessibility, and universal care for all in need.
As healthcare professionals, we have a particularly nuanced mission: to encounter and love Christ through the vulnerable patients who come to us seeking healing, compassion, and care. This calling is both a privilege and a responsibility. Each patient—especially in moments of pain, fear, or uncertainty—offers us the opportunity to encounter Christ. In this way, our work becomes a profound form of ministry, a space where the healing love of Christ can be witnessed and shared. Living this mission means embracing the call to serve as Christ served, to love as He loved, and, as many saints have stated, to be instruments of his peace and healing. Through this mission-centered identity, we find our purpose as healthcare professionals, letting the love and truth represented in the Sacred Heart of Jesus flow through each interaction and every act of care.
Living an authentic mission will inevitably lead us to what Pope Francis describes and urges us to embrace, “a culture of encounter.” These encounters are crucial for our ministry and play a key role in shaping our identity. Through interactions, we grow, learn, and draw closer to the person or institution we are meant to be. Each encounter provides an opportunity to reflect on Christ’s love while also deepening our understanding of who we are in Him. Our mission in Catholic healthcare is rooted in Christ and requires for its vitality that those who work for this mission have a deep relationship with Christ. For our coworkers who may not share this faith, they, too, are called to act for the mission out of a profound source of love.
As Pope Francis reminds us in a simple yet profound way: “As Jesus did: not just seeing, but looking; not just hearing, but listening; not just passing people by, but stopping with them; not just saying ‘what a shame, poor people,’ but allowing yourself to be moved with compassion; and then to draw near, to touch, and to say: ‘Do not weep,’ and to give at least a drop of life.” These words speak directly to how healthcare institutions are called to engage with those they serve—not merely offering treatment but responding with deep empathy, compassion, and a genuine commitment to healing. This approach shapes the very identity of the institution, making it a place not just of medical care but of profound human connection. These encounters foster a deeper relationship with Christ as we encounter his presence in the people we serve. By embodying Christ’s love in each interaction, healthcare institutions reflect his healing power and compassion, drawing near to those in need.
Pope Francis connects the teachings of his previous encyclicals. With this message about the Sacred Heart, Laudato Si, and Fratelli Tutti emphasize that our encounter with Christ’s love empowers us to build fraternity, respect human dignity, and care for a shared environment. He criticizes a society driven by consumerism and the accumulation of wealth. Christ can free us from this cycle and inspire true, selfless love. He calls for the Church to renew its focus on Christ’s unending love, symbolized by his pierced side. Pope Francis prays for Christ’s Sacred Heart to heal humanity’s wounds and deepen our capacity to love, serve, and guide us to a just and fraternal world. He envisions a future unity in Christ’s presence, celebrating a world transformed by his love. The encyclical is a spiritual and practical guide for building trust and compassion in our world through the transformative power of Christ.
SHARING THE ENCYCLICAL IN OUR WORKPLACES
Pope Francis’s encyclical provides a source of inspiration and material for reflection on the love of Jesus as recognized in the devotion to the Sacred Heart of Jesus that can refresh, energize, and encourage us to pursue our vision.
How might this message be shared where we work, keeping in mind that people are busy and may have limited time to do long readings, and showing respect for our colleagues who may not share our faith or be resistant, for whatever reason, to talking about the Sacred Heart of Jesus?
- Begin with a small group of mission leaders, nurses, doctors, and other associates who can read and think through the encyclical and consider how best to share its message in the local context.
- Prepare a presentation, perhaps using this article as a resource, for the Board and senior leadership, encouraging them to reflect on, discuss, and make visible the power of God’s love that compels our mission and allows us to strive to meet our vision.
- Develop prayer resources to share with all our employees. These resources would include a brief quote from the encyclical, a prayer, and a question for reflection.
- Emphasize the call to love as an inclusive call, one to which all who work in Catholic health care are encouraged to answer in a way most consistent with their personal beliefs.
- If talent and other resources are available, commission artwork that compellingly represents Jesus’s love as the heart of what we do. This might help overcome some prejudices from those not attracted to some of the more traditional representations of the Sacred Heart.
- Do not expect everyone in a particular healthcare facility to partake of this devotion, but let yourself imagine how it might affect care if significant numbers of our colleagues found themselves deeply motivated by the love that Christ has shown them and thus sent out to share that same love with our patients in all their need.
1.- Bruce J. Malina, “The received view and what it cannot do: III John and hospitality,” in Semeia 35: Social-Scientific Criticism of the New Testament and its Social World (Decatur:Scholars Press, 1986): 181.
2.- Francis. For a culture of Encounter. 2016. available at: https://www.vatican.va/content/francesco/en/cotidie/2016/documents/papa-francesco-cotidie_20160913_for-a-culture-of-encounter.html.
3.- Francis. For a culture of encounter | Francis. 13 Sept. 2016, available at: www.vatican.va/content/francesco/en/cotidie/2016/documents/papa-francesco-cotidie_20160913_for-a-culture-of-encounter.html.
