Throughout history, Catholic churches and hospitals have functioned not only as centers for religious worship and care but also as sanctuaries and places of refuge for those in need. Rooted in the teachings of Christ, the Church has long been seen as a protector and provider for society's most vulnerable members. From the early Christian era to the modern day, both churches and hospitals have been spaces where people seek physical, emotional and spiritual solace.
Yet, recent political decisions in the United States to violate the Church's exercise of sanctuary in the name of immigration enforcement are troubling because they ignore the valuable tradition of sanctuary and its role in furthering the common good. Sanctuary has often been a friction point between government leaders and the Church. However, historically, many government leaders, while pushing against sanctuary, have not violated its boundaries because to do so would place government into a sacred space. That is not true today. Looking back at the historical origins of sanctuary, we find its implications in today's current environment.
EARLY CHRISTIAN BEGINNINGS
In the early centuries of Christianity, the concept of sanctuary was rooted in the Gospel teachings of compassion and mercy. Jesus' life and ministry, as recorded in the New Testament, emphasized care for the marginalized — healing the sick, sheltering the homeless and offering comfort to those in distress. These principles would come to shape the Church's role in society, laying the foundation for its involvement in providing sanctuary and protection. As one author has noted, "The Church's ministry of healing is essentially related to its ministry of proclaiming the Word of God … ."1 Sanctuary emerged as both a recognition of holiness and the actions that resulted from that.
In the early Christian period, there was no distinct separation between places of worship and sites of sanctuary. Churches were often seen as havens for those fleeing persecution. This practice can be traced back to the time of the Roman Empire, particularly in the post-Constantinian period, when Christianity began to gain imperial favor.2 After the Edict of Milan in 313 A.D. legalized Christianity, Christians could openly practice their faith but still faced sporadic persecution from local authorities. As a result, churches became places where individuals, especially clergy and persecuted Christians, could find refuge from political or military authorities. There was an acknowledgment that the power of the Church was different from that of political authority.3
The notion of sanctuary was formalized under later Roman law, notably during the reign of Emperor Theodosius I from 379-395 A.D., who not only encouraged the construction of churches but also provided legal protection for those seeking asylum within them. During this time, churches became places where individuals could flee from both secular justice and threats of violence. In the centuries that followed, this tradition evolved, especially during times of war or political upheaval, when churches became havens from the violence of invading forces or feuding local warlords.
THE EMERGENCE OF HOSPITALS
Alongside the Church's role as a sanctuary, medieval Europe saw the rise of hospitals, which were also rooted in Christian charity and mercy. The word "hospital" itself derives from the Latin hospitale, meaning a place of care or refuge, and from hospes, meaning guest or stranger. Early Christian hospitals were often established by monasteries and religious orders to care for the sick, the poor and travelers.
The establishment of these early hospitals was inspired by the Christian mandate to care for the "least among us," as outlined in Christ's teachings. The first hospitals were not hospitals in the modern sense but rather places where the sick could be cared for by religious communities. These institutions were often attached to monasteries, and the labor of caring for others was considered an act of charity, where monks and sisters would offer healing through both physical care and spiritual counsel. The hospital's function as a sanctuary extended beyond its role in health care, as it was a place where people could seek rest and protection from both disease and social marginalization.
One of the most influential early hospital systems was that established by the Benedictine order. Monasteries under the Benedictines often had infirmaries to care for monks who fell ill, but these spaces also served local populations. Hospitals like those founded in the Holy Land during the Crusades, particularly by the Knights Hospitaller, served dual roles as places of medical care and military refuge. As these religious orders expanded across Europe, their hospitals became places of both sanctuary and healing, where the wounded and ill from all walks of life could find refuge.
CHURCHES AS SANCTUARIES IN THE MIDDLE AGES
While hospitals developed as centers of care, churches continued to serve as vital sanctuaries throughout the Middle Ages. During this period, the concept of sanctuary expanded to include not only religious asylum but also protection from criminal justice systems. The right of sanctuary was formalized in many parts of medieval Europe, granting individuals accused of crimes the opportunity to seek refuge in a church to avoid immediate punishment.
The practice of sanctuary was especially important during times of social and political turmoil. The medieval church, with its vast land holdings and influential position in society, wielded significant power and autonomy. Church leaders could offer protection to individuals, and the boundaries of the church or cathedral often marked a space where secular authorities had no jurisdiction. This was a significant development, as it gave individuals a degree of security from what could often be brutal legal and social systems.
However, this protection was not always guaranteed. One notable example of the failure of the Church's sanctuary role took place at Canterbury Cathedral in England. Thomas Beckett, at the time, the Catholic Archbishop of Canterbury, quarreled with King Henry II in the 12th century. The Archbishop of Canterbury had the power to offer protection to fugitives and those who sought asylum from the crown's justice. The Church's role as a mediator between the law and the individual was crucial during this period, as it allowed individuals to seek refuge within church walls without the immediate threat of execution or other punishments. So, Beckett fled to the cathedral for protection. The soldiers that Henry II sent to kill him ignored the tradition of sanctuary and murdered him at the altar.
Furthermore, the sanctuary provided by churches was not unconditional. It was often limited by certain rules and time frames, and individuals had to demonstrate remorse or a willingness to stand trial for their crimes. Despite these limitations, the Church's sanctuary system represented a form of justice that balanced the power of secular authorities with a Christian understanding of mercy and rehabilitation.
CHANGING ROLES AND CHALLENGES
As the Renaissance and Enlightenment periods brought about shifts in political and social thinking, the role of the Church as both a sanctuary and provider of health care evolved. The rise of nation-states and centralized monarchies reduced the power of local churches to offer sanctuary from secular justice, and the increasingly secular nature of the state meant that the legal right to sanctuary gradually waned, but was not lost. The Church's role in offering refuge remained in some regions, and in others, religious institutions continued to operate as places of sanctuary for those fleeing oppression.
Similarly, hospitals continued to play an important role in providing care for the poor and sick, but the rise of scientific medicine and the development of public health systems led to a gradual separation between church-run hospitals and the secular medical establishments that began to emerge. Hospitals operated by religious orders continued to provide care for marginalized populations. And secular governments began to take on a more active role in health care provision, especially in Europe after World War II, when health care provided by the state became the norm.4
CATHOLIC CHURCHES AND HOSPITALS AS REFUGES TODAY
By the 19th and 20th centuries, Catholic hospitals had fully integrated into modern health care systems, and while the sanctuary role of churches and hospitals diminished but did not disappear in the secularized West, it persisted in many parts of the world. In many developing nations, Catholic hospitals remain among the few providers of quality medical care, particularly in rural areas. Even in the West, however, the right to sanctuary continued to be respected by most governments.5
The Church's role in providing care to the poor, the sick and refugees is still evident, with institutions like the Vatican, through Caritas Internationalis, and Catholic health care and Catholic Charities in the United States continuing to provide both emergency assistance and long-term health care solutions worldwide.
Despite the challenges posed by secularization, the principles that undergird the role of churches and hospitals as sanctuaries and refuges remain integral to Catholic social teaching. Pope Francis, for example, has emphasized the importance of the Church as a refuge for migrants and the oppressed, advocating for policies that ensure safe spaces for those in need of protection. In late 2024, for example, he made the offer of refuge at the Vatican to Aung San Suu Kyi, the former leader of Myanmar and Nobel Peace Prize winner.6
CONTINUING COMPASSION'S TIMELESS LEGACY
The historical development of Catholic churches and hospitals as sanctuaries and places of refuge reflects the enduring Christian commitment to mercy, justice and care for the marginalized. Catholic Churches, and by extension, the locations where Catholic ministries operate, such as health care facilities, are sacred spaces that should be honored as such. From the early Christian period through the Middle Ages, churches and hospitals offered sanctuary both from physical dangers and from the injustices of secular systems.
While the role of the Church as a political and legal sanctuary diminished somewhat with the rise of nation-states, the Church's dedication to serving those in need continues today. Catholic hospitals remain essential to providing care for those who cannot access medical services elsewhere, and churches continue to be places of refuge for those suffering, reflecting the timeless legacy of compassion that has defined Catholic social teaching for centuries. Even when secular political authorities do not recognize this work and its corresponding respect for sacred spaces to promote the human good, that does not mean that we should accept that view of the world.7
BRIAN M. KANE, PhD, is senior director, ethics, for the Catholic Health Association, St. Louis.
NOTES
- Dennis Krouse, "Health and Healing in Traditional Catholic Expression," in Liturgical Foundations of Social Policy in the Catholic and Jewish Traditions, ed. Daniel F. Polish and Eugene J. Fisher (University of Notre Dame Press, 1983), 63.
- Tertullian, Apology, 37.
- The scope of this essay doesn't go into the details of this event, but the standoff in the 11th century between Pope Gregory VII and Henry IV, the Holy Roman Emperor, can give some sense of the two powers.
- The earliest state-supported health system was established in Germany in 1883 by Otto von Bismarck, under the concept of social insurance. In the aftermath of World War II, other nations, like the U.K., adopted similar programs. There, it is known as the Beveridge model, and it is slightly different, but its goals are the same: to provide a level of health care that will keep all citizens healthy. They discourage profit as the driving force for health care.
- The challenge between the influence of the Church versus the state is important in contemporary international politics. The suppression of the Church occurs within political systems that are threatened by its message. Modern-day examples include China and El Salvador.
- Salvatore Cernuzio, "Pope: Free Aung San Suu Kyi; Vatican Ready to Welcome Her," Vatican News, September 24, 2024, https://www.vaticannews.va/en/pope/news/2024-09/pope-free-aung-san-suu-kyi.html.
- The recent statement by Bishop Mark J. Seitz, chairman of the U.S. Conference of Catholic Bishops' Committee on Migration, Sr. Mary Haddad, RSM, president and CEO of CHA, and Kerry Alys Robinson, president and CEO of Catholic Charities USA, demonstrates this determination: "Human Dignity is Not Dependent on a Person's Citizenship or Immigration Status," United States Conference of Catholic Bishops Office of Public Affairs, January 23, 2025, https://www.usccb.org/news/2025/human-dignity-not-dependent-persons-citizenship-or-immigration-status.