Bishop James T. Ruggieri delivered an address for the Covenant Health 2026 Governance Institute earlier this year. His remarks about Catholic healthcare resonated with those in attendance and an excerpt is shared here with his permission. Covenant Health is a regional healthcare delivery network covering New England and part of Pennsylvania.
The theme of Catholic service to the poor and vulnerable is familiar to us, perhaps so familiar that we can pass over it too quickly. We speak often about service, mission, compassion, dignity, access and care for those most in need. These words rightly belong to Catholic healthcare and to the wider mission of the Church. Yet familiar words need to be renewed by returning to their source. For Christians, that source is not first a policy, a program or an institutional structure. It is Jesus Christ.
Catholic service to the poor and vulnerable begins with the way Jesus sees the human person. It begins with the way he encounters the sick, the suffering, the forgotten and the excluded. It begins with the way he reveals, in word and deed, that every person is loved by the Father and called to fullness of life. The Church's ministry of healing, including the ministry carried out through Catholic healthcare, is therefore not simply the provision of services under Catholic sponsorship. It is a participation in the healing mission of Christ.
The Ethical and Religious Directives for Catholic Health Care Services place Catholic healthcare within the Church's broader mission. They remind us that Catholic healthcare continues Christ's healing ministry, a ministry concerned not only with physical affliction but with the whole person. Christ healed bodies, but he also restored relationships. He forgave sins, reconciled people to the community, brought the isolated back into communion, and revealed the mercy of the Father. In this sense, Catholic service to the poor and vulnerable can never be reduced merely to the delivery of care. It is always an encounter with someone loved by God.
I would like to reflect on two Gospel encounters that can help us understand this more deeply. The first is the woman who suffered from hemorrhages and reached out to touch the cloak of Jesus (Mark 5:25-34). The second is blind Bartimaeus, who cried out for mercy and heard Jesus ask him, "What do you want me to do for you?" (Mark 10:46-52). These two encounters illuminate two principles essential to Catholic social teaching and Catholic service: human dignity and subsidiarity. The woman who touches Jesus' cloak teaches us that the vulnerable person must be seen, acknowledged and restored to dignity. Bartimaeus teaches us that the vulnerable person must be heard, respected and engaged as someone with a voice, a desire and a role in his own healing.
Together, these two Gospel stories offer a way to understand what Catholic service must always be. It is not service from above or service at a distance. It is not assistance that reduces people to needs, categories, costs or outcomes. It is service as encounter, service as accompaniment, and service as a manifestation of Christ's own compassion.
THE WOMAN IN THE CROWD: HUMAN DIGNITY RESTORED
In the Gospel according to Mark, we meet a woman who had been suffering from hemorrhages for 12 years. Twelve years is a long time to suffer. It is a long time to seek help, to live with uncertainty, to endure disappointment, to carry fatigue, and to wonder whether healing will ever come. The Gospel tells us that she suffered greatly at the hands of many doctors and had spent all that she had. Instead of improving, she had grown worse. By the time she comes to Jesus, she is not only physically ill. She is financially exhausted, socially isolated, religiously burdened and emotionally worn down.
The poor and vulnerable do not always come with confidence. Sometimes they come quietly. Sometimes they come with distrust because they have already been disappointed. Sometimes they come ashamed of their need.
She comes to Jesus in the crowd, but she does not approach him openly. She comes from behind. She says to herself, "If I but touch his clothes, I shall be cured." There is something profoundly human in that gesture.
She reaches out quietly, almost secretly, hoping that contact with Jesus will be enough. In a sense, she is hidden in plain sight. That is often the condition of the poor and vulnerable. They may be present, but unseen: part of the crowd, but not truly recognized. Their suffering may be real, but hidden beneath shame, fear, social stigma or the exhaustion of having asked for help too many times. The poor and vulnerable do not always come with confidence. Sometimes they come quietly. Sometimes they come with distrust because they have already been disappointed. Sometimes they come ashamed of their need. Sometimes they come convinced that no one really wants to see them.
The woman reaches out and touches the cloak of Jesus. Immediately, she is healed. Yet Jesus does not allow the encounter to end there. He stops, even though the crowd is pressing upon him and even though another urgent situation is unfolding. Jairus has already come to ask Jesus to heal his daughter, who is near death. Jesus is on the way to another crisis, and yet he stops for this hidden woman.
Then Jesus asks, "Who has touched my clothes?" The disciples are confused. How can he ask who touched him when the crowd is pressing on every side? But Jesus knows that something more than physical contact has taken place. He knows that healing power has gone forth from him, and he also knows that this woman, who has been hidden in suffering, must not remain hidden in healing.
So she comes forward. The Gospel says she comes in fear and trembling. She falls down before him and tells him the whole truth. Then Jesus says to her, "Daughter, your faith has saved you. Go in peace and be cured of your affliction." That word "daughter" is central to the whole encounter. Jesus does not identify her by her condition, her interruption of his journey or the burden of her need. He calls her daughter, and in doing so, he restores not only her body but her place within relationship and community.
Her physical healing is real, but Jesus gives her more than physical healing. He restores her to visibility. He restores her to dignity. He allows her to speak the whole truth in a place where she had previously remained hidden. This is the first great lesson for Catholic service to the poor and the vulnerable: The person must be seen as a person, not merely as a need to be addressed.
HUMAN DIGNITY: SEEING THE PERSON BENEATH THE CIRCUMSTANCE
Human dignity is not simply a beautiful phrase in Catholic social teaching. It is the truth that each person before us has a sacred worth that does not depend on health, usefulness, productivity, wealth, social status, age, ability, autonomy or the capacity to repay. Human dignity is not granted by the market, assigned by the state, or measured by efficiency. It is not lost through illness, diminished by poverty, or erased by addiction, disability, mental illness, dependence or old age. It is given by God.
Every human person is created in the image and likeness of God (Genesis 1:26-27). Every person is loved into existence by God. Every person is someone for whom Christ died. Every person is called to communion with God. This is why Catholic service can never treat the poor and vulnerable as a secondary concern. They are not an optional addition to the mission. They are not simply recipients of institutional charity. They are persons in whom Christ himself comes to meet us.
Catholic tradition speaks often of a preferential love for the poor. This does not mean that God loves some people and not others. It means that God has a special tenderness for those most easily forgotten, wounded, excluded or cast aside. It means that when we draw near to the poor and vulnerable, we are not moving away from the center of the Gospel. We are moving toward it.
The woman in the Gospel shows us that vulnerability is not always obvious. The crowd saw a woman among many others. Jesus perceived faith, suffering and a hidden cry for healing. The crowd almost swallowed her anonymity. Jesus restored her name, her voice and her dignity. This is an important lesson for every work of healing and service, because vulnerability takes many forms. It can be illness, poverty, loneliness, old age, disability, mental illness, addiction, trauma, the fear of being a burden, the confusion of a family facing difficult medical choices, the isolation of the immigrant, the anxiety of the uninsured, the exhaustion of the caregiver or the hidden suffering of someone who outwardly appears strong.
Catholic service begins when we learn to see the person beneath the circumstance. This is not always easy, especially in large institutions. Healthcare systems necessarily use forms, charts, diagnoses, billing codes, policies, procedures and metrics. Good order matters. Professional competence matters. Accountability matters. Indeed, those entrusted with governance know well that responsible systems, reliable processes and careful measurement are not opposed to mission.
But the Gospel always recalls us to the person. A chart can describe a condition, but it cannot exhaust the mystery of a person. A diagnosis can name an illness, but it cannot name a human being. A financial report can identify a challenge, but it cannot measure the worth of someone who is poor. A strategic plan can establish priorities, but it cannot replace the act of recognizing the son or daughter before us.
Catholic service begins when we learn to see the person beneath the circumstance. This is not always easy, especially in large institutions.
The woman with the hemorrhage teaches us that healing must include acknowledgment. It is possible to treat someone and still leave that person unseen. It is possible to provide a service and still fail to restore dignity. It is possible to help someone and still make that person feel small. Jesus does not do that. He allows her to be healed, but he also allows her to be known. He receives her truth and sends her in peace. That is the first movement of Catholic service: to restore dignity through encounter.
BARTIMAEUS: THE DIGNITY OF BEING ASKED
Now let us turn to Bartimaeus. The Gospel tells us that Bartimaeus was sitting by the roadside outside Jericho. He was blind and he was begging. When he hears that Jesus of Nazareth is passing, he begins to cry out, "Jesus, son of David, have pity on me." The crowd tries to silence him. Bartimaeus is not only blind; he is treated as a disturbance. He is not only poor; he is inconvenient.
The vulnerable are often silenced, sometimes directly, sometimes indirectly. They may be silenced because their suffering is uncomfortable, because systems are too complicated for them to navigate, or because they are not included in the conversations in which decisions are made. Sometimes their lives are discussed, interpreted, planned and managed by others without anyone stopping to ask what they themselves are experiencing.
Bartimaeus, however, cries out all the more: "Son of David, have pity on me." And once again, Jesus stops. Just as he stopped for the woman in the crowd, he stops for the man by the roadside. Then Jesus says, "Call him." The same crowd that had tried to silence him now says, "Take courage; get up, he is calling you." Bartimaeus comes to Jesus. Then Jesus asks him a question that is both simple and profound: "What do you want me to do for you?"
At first, the question may seem unnecessary. Bartimaeus is blind. He is begging. His need appears obvious. But Jesus does not presume to speak for him. He asks. That question reveals deep respect. Jesus does not reduce Bartimaeus to his blindness or define him only by his need. He allows Bartimaeus to speak, to name his desire and to participate in the encounter. Bartimaeus replies, "Master, I want to see." Jesus heals him, and the Gospel tells us that Bartimaeus follows him on the way. This encounter helps us understand the Catholic social principle of subsidiarity.
Subsidiarity means that persons, families and local communities have a dignity and responsibility that should not be ignored or replaced by larger structures. Higher levels of organization and authority should support what is closest to the person, not absorb it, silence it or unnecessarily control it.
SOLIDARITY AND SUBSIDIARITY: COMPASSION THAT RESPECTS AGENCY
It is important to place subsidiarity alongside solidarity. Solidarity teaches us that we belong to one another. It moves us toward those who suffer and reminds us that the burdens of the poor and vulnerable are not someone else's concern. Their suffering has a claim on us because of our shared human dignity and our communion in the human family. In the light of faith, solidarity is deepened even further because in the suffering person we encounter Christ himself (Matthew 25:35-40).
Solidarity without subsidiarity can become a form of well-intended paternalism. It may rush to help, but without listening. It may provide, but without empowering. It may assume that those with resources, authority or expertise already know what is best. Subsidiarity without solidarity also can become neglect. It may speak of local responsibility while leaving persons and communities without the support they need. Catholic social teaching refuses both errors. It calls us to a form of service that is compassionate enough to draw near and humble enough to listen.
In the Gospel, Jesus gives us a living image of this union. He knows what Bartimaeus needs. Yet he asks him, "What do you want me to do for you?" That question does not weaken Jesus' compassion. It reveals its depth. Jesus draws near in solidarity, but he acts in a way that honors the voice and agency of the person before him.
This is essential for service to the poor and vulnerable. There is a kind of service that provides but does not empower. There is a kind of service that assumes it knows what others need without asking them. There is even a form of compassion that can become paternalistic when it forgets that the person in need remains a person with gifts, wisdom, desires, relationships, responsibilities and a voice. Jesus shows us a better way. He calls Bartimaeus forward, asks him what he desires, receives his answer and restores him not only to sight but to movement, freedom and discipleship.
Catholic service should always seek that kind of restoration. It is not simply to address immediate need, but to honor the deeper vocation of the person. It is not simply to manage vulnerability, but to accompany persons toward fuller life.
GOVERNANCE AS STEWARDSHIP OF MISSION
This has direct implications for those who lead and govern ministries of care. Governance, especially in large institutions, can easily become distant from the immediate experience of those being served.
I say this with appreciation for the difficulty of this work. Governance often requires decisions that are not simple and sometimes are painful. Leaders must weigh real needs, limited resources and obligations that cannot be ignored. They are asked to think not only about today's needs but also about whether the ministry will remain strong enough to serve tomorrow's needs. This is not a small responsibility. Precisely because it is so serious, it must be continually grounded in mission.
Governance in a Catholic setting is not only fiduciary responsibility. It is stewardship of mission. It requires financial seriousness, strategic clarity, ethical integrity and operational competence. But it also requires moral imagination. It requires leaders to ask who is not being heard, who is closest to the suffering, whose dignity is at stake, and whose voice should inform the decisions being made.
This is why human dignity, solidarity and subsidiarity belong together. Human dignity tells us who the person is: someone sacred, someone loved by God, someone of incomparable worth. Solidarity tells us that we must draw near to that person and share responsibility for his or her good. Subsidiarity tells us that we must do so in a way that respects agency, strengthens local relationships and supports rather than replaces the persons and communities closest to the need. Together, these principles form a Catholic pattern of service rooted in the way of Christ.
THE CONTEMPORARY NEED FOR A CATHOLIC PATTERN OF SERVICE
This pattern is deeply needed today. We live in a time of remarkable medical capability and deep social fragmentation. We have extraordinary technology, but many people are lonely. We have complex systems, but many people do not know how to enter them. We have increasing awareness of social needs, but many communities remain isolated, poor and wounded.
Catholic service must offer something different. It must witness that the human person is never a burden to be discarded, a problem to be managed, a cost to be minimized, or a life to be judged unworthy of care. At the same time, Catholic service must witness that vulnerable persons are not merely passive recipients of charity. They are persons with voices, agency, gifts and wisdom. They are persons who can reveal Christ to us.
The poor are not only people we serve; they are people from whom we learn. They teach us where our systems are too complicated, where our assumptions are incomplete, where our compassion has become abstract, and where our mission must become more concrete. This is part of the genius of Catholic social teaching. It does not allow us to choose between charity and justice, between personal encounter and social responsibility, or between the dignity of the individual and the common good. It holds these together.
Catholic identity is not simply a label attached to an institution or a legacy inherited from the past. It is a living responsibility.
Catholic service must respond to the person before us while also asking about the conditions that leave so many people unseen and unheard.
This is where advocacy becomes part of service. The ministry of healing does not end with the direct encounter. It also asks how communities, institutions and public policies can better protect life, strengthen families, support the elderly, care for those with disabilities, respond to mental illness, accompany those suffering from addiction, serve immigrants and refugees, protect the unborn and ensure that the poor are not excluded from necessary care. Catholic service is personal, but not private. It is institutional, but not bureaucratic. It is spiritual, but not detached from the body. It is rooted in Christ, and therefore it must touch the real wounds of the world.
CATHOLIC HEALTHCARE AND THE WHOLE PERSON
Catholic identity is not simply a label attached to an institution or a legacy inherited from the past. It is a living responsibility. Those who serve in governance help make that identity concrete. Through the questions they ask, the priorities they set, the leaders they appoint, the partnerships they discern, and the resources they steward, they help determine whether Catholic identity remains a living mission or becomes merely a historical description.
In Catholic ministries, governance must ask questions that are both practical and evangelical. Financial sustainability is a necessary concern, but sustainability must always be ordered to mission. Strategic positioning matters, but Catholic leaders must also ask whom the strategy positions the ministry to serve. Risk management is necessary, but so is the courage to remain faithful to Christ and to the vulnerable even when fidelity carries a cost. Outcomes must be measured, but Catholic ministries must also ask whether they are measuring what truly matters. Care must be provided, but the deeper question is whether dignity is being restored.
These questions are not opposed to good governance. They are part of good Catholic governance. The Church does not ask Catholic institutions to be less competent because they are Catholic. She asks them to be more deeply human because they are Catholic. She asks them to unite professional excellence with moral clarity, financial stewardship with mercy, institutional strength with humility, and service with the encounter of Christ.
RETURNING TO CHRIST IN THE MIDST OF COMPLEXITY
The Gospel gives us a way to remain centered. When the pressures become great, we return to Christ and to his way of seeing. We return to the woman in the crowd and to Bartimaeus by the roadside. We ask who is hidden, who is being silenced, who is reaching out quietly, who is crying out, who needs to be called forward, and who needs to be asked rather than presumed upon.
The Gospel says that the woman told Jesus the whole truth. How many people served by our ministries are carrying a truth they have never been invited to speak: a truth about pain, fear, poverty, shame, grief, addiction, loneliness, family burdens, spiritual distress or the feeling of being forgotten? Bartimaeus tells Jesus his desire: "Master, I want to see." How many people in vulnerable situations have desires that are deeper than the immediate service they seek? They may want stability. They may want reconciliation. They may want to be treated with respect. They may want to go home. They may want to understand. They may want someone to tell them the truth. They may want to be forgiven. They may want to begin again. They may want hope.
Not every caregiver can do everything, and not every institution can provide every form of healing. But every Catholic ministry can cultivate a culture in which persons are not reduced to transactions. Every Catholic ministry can ask whether its practices communicate dignity or indifference and whether it listens to those closest to suffering. Every Catholic ministry can form leaders who understand that mission is not an ornament but the soul of the work.
Ultimately, governance in Catholic ministries is about fidelity: fidelity to Christ, the Church, the human person, the poor and vulnerable, and the healing ministry entrusted to us. Catholic service to the poor and vulnerable is the continuation of that healing mission. It is the conviction that no person is invisible to God, that no suffering person is merely an interruption, and that no human being loses dignity because of poverty, illness, disability, age, dependence, addiction or fear. It is the conviction that authentic help must respect the voice and agency of the person being helped. It is the conviction that the work of healing belongs to Christ before it belongs to us. And it is the conviction that when we serve the poor and vulnerable with love, we do not simply bring Christ to them. We meet Christ in them.
BISHOP JAMES T. RUGGIERI leads the diocese of Portland, which covers the entire state of Maine.