MEDICAL CARE AND SPIRITUAL SUPPORT IN TIMES OF WAR

We are currently living in a time of serious challenges for humanity, which has split into two camps: those who stand for freedom of choice, free life, democracy, truth, morality, and spirituality, and those who perpetuate violence, the oppression of peoples, conquest, aggression, cynicism, corruption, and commercialism. This side is led by immoral monsters. The Pontiff spoke well of them: “The masters of war — ‘a handful of tyrants’ — pretend not to know: destruction can happen in an instant, but restoration often takes more than a lifetime… billions of dollars are spent on killing and destruction, while there are no funds for healthcare, education, and reconstruction… they are devastating the world” [1]. How can the first part of humanity resist this evolutionary anomaly in the development of civilization? Ukraine feels this particularly acutely and has been resisting for more than ten years the unjust and horrific war waged by the imperial monster — the Russian Federation, while facing ethical challenges posed by some of its international partners, which, unfortunately, have become especially acute in recent years. Ukrainian society understands that we must be spiritually strong, physically resilient, and unite with the spiritual part of humanity. This is a war for survival. It bears all the hallmarks of genocide against the Ukrainian nation. Without spiritual strength, it is very difficult to survive in wartime conditions. Religion helps in this regard by defining the meaning of life and fostering resilience in the face of wartime stressors. An example is the concept of the eminent Austrian psychotherapist Viktor Frankl, who survived Nazi death camps. He demonstrated that life becomes unbearable only because of a lack of meaning. Everything can be taken away from a person except one thing — human freedom, which allows one to choose one’s own path [2]. Challenges related to people’s health and psychological well-being are particularly acute today, as the enemy seeks to deprive Ukrainians of their freedom. Therefore, Ukraine’s healthcare system was forced to urgently shift its operations to a wartime footing in 2022 when the full-scale Russian-Ukrainian war began, and it became clear to a large extent that we would not be able to cope without a spiritual foundation. Consequently, the Orthodox Church of Ukraine and the Ukrainian Greek Catholic Church — later joined by Protestant churches — voluntarily stepped in to help the medical community, the military, and society address patients’ mental health issues. Clergy assisted people in Ukraine — on the frontline, in the rear, in hospitals, and abroad — by providing spiritual support to soldiers, refugees, victims, and the families of the fallen and wounded, as well as by organizing volunteer religious movements and similar initiatives. Particularly significant work was carried out in providing spiritual support to Ukraine and Ukrainians within the Ukrainian Greek Catholic community of the Archdiocese of Philadelphia in the United States during the Russo-Ukrainian war [3]. In recent years, there have been changes in military medicine, namely the standardization of medical management, the development of tactical medicine, psychological and rehabilitative care, its integration into NATO standards, digitalization, and the training of combat medics. There has been an active transformation of medical science in military and reconstructive surgery and prosthetics, as well as significant progress in psychological and physical rehabilitation and infection control. This has greatly enhanced international cooperation and academic mobility. International standards, digital technologies, and practical training have been introduced into medical education [4, 5, 6]. Yes, we must provide our soldiers and the people living in wartime conditions with the most advanced medical care so that they can preserve their lives and strength to fight the enemy. But without spiritual strength and mental motivation, it is difficult to resist the enemy. Therefore, Ukraine’s intellectual medical elite has joined forces with the nation’s spiritual leaders, and the Directorate of Medical Personnel, Science, and Education of the Ministry of Health of Ukraine has lent its support. The meaning of life and the purpose of fighting disease and the enemy require spiritual support and motivation. Medical chaplains have become the bearers of this need within our nation’s society. In the medical field, this was a challenge yet a vital necessity. This process took place in parallel with the reform of the healthcare system under the direct impact of Russia’s armed aggression against Ukraine, which sharply increased the demand for spiritual support in medical facilities — especially in hospitals, rehabilitation centers, and hospices. A key step in formalizing the practice was the introduction of the positions of “healthcare chaplain” and “assistant healthcare chaplain” into the Directory of Qualification Characteristics for Professions, approved by the Ministry of Health of Ukraine [7]. In 2025, medical chaplaincy was introduced [8]. In Ukraine, it has evolved from a volunteer initiative into a systematic professional discipline with its own educational standards, qualification frameworks, and support mechanisms for practitioners [9]. An analysis of the experience of implementing this practice allows us to identify several fundamental characteristics of medical chaplaincy: its interfaith nature, the value of life, and its role in overcoming psychological trauma. Interdenominationality is not an option but a structural prerequisite for medical chaplaincy. Illness, suffering, and death do not stop at denominational boundaries — accordingly, spiritual care in a medical facility cannot be monopolized by any single religious tradition. The training of a medical chaplain that does not foster genuine interfaith competence remains incomplete. The value of medical chaplaincy lies in its ability to address dimensions of human suffering to which medicine and psychology have limited access: questions of meaning, guilt, dignity, forgiveness, and reconciliation with one’s own experience. These dimensions take on particular urgency in Ukraine amid the ongoing Russian war, which has generated a massive demand for spiritual and existential support. The concept of moral trauma is the conceptual key that most accurately describes the gap filled by the medical chaplain. Whereas PTSD is treated with protocols and depression with medication, moral trauma requires access to the language and practices of spiritual tradition — a language embodied within healthcare facilities by the chaplain. In the context of Russia’s war against Ukraine, this gap has grown to such an extent that the institutional development of medical chaplaincy has become a matter of urgent public necessity. The need for a unified approach to supporting our people in Ukraine and around the world is met not only through medical chaplaincy, but also through the opportunity to pray at various religious institutions, support for the families of the fallen and wounded, help in overcoming feelings of loss and despair, and fostering a deep love for the land and the people suffering at the hands of the enemy invader who treacherously attacked Ukraine. It is precisely this assistance from various religious denominations within the country and the medical community — as well as from abroad — that helps strengthen public solidarity, develop the volunteer movement, support the families of military personnel, and foster a culture of mutual aid and empathy in wartime. In Ukraine, tremendous attention is paid to the development of military medicine, medical science and education in general, and their integration with the spiritual potential of the nation and humanity. They serve as a shield capable of countering and destroying these monsters of human civilization. Archbishop Yosyf Slipyi [10], Patriarch Mstyslav (Skrypnyk) [11], and Patriarch Liubomyr Husar [12] all emphasized the importance of combining medicine and religion. Thus, spiritual and medical care are complementary components of support for individuals during wartime. Medical care ensures the preservation of life and the restoration of health, while spiritual care helps people find meaning, hope, and inner resources to overcome difficulties. Their combination forms the basis for effective personal rehabilitation, the strengthening of Ukrainian society in times of severe trials, and the creation of prospects for a civilized future for Ukraine.