Patristic Roots for a Right to Health?
Divine Kinship, Citizenship, and COVID-19

by D. Brendan Johnson

stethoscope over paper money
Image: iStock.com/digicomphoto

Human rights are contentious: do they exist? Where are they from? And how do we know which specific rights should count as human rights? Is there an Orthodox case to be made for human rights? Indeed, the continuing COVID-19 pandemic raises the specific question of a right to health and healthcare, as does the current American political debate on capping prices on insulin, a life-saving medication which has been exponentially increasing in price in the last decade.

Any discussion of human rights must begin with what we mean by ‘human,’ and for Christians, the God in whose image we are created. This Creator-given human dignity is the divine stamp of blessing and value upon which rights—existential entitlements—are grounded. As Orthodox theologian Paul Ladouceur has written, “a holistic theology of the divine image, personhood and human rights is entirely consistent with the patristic vision of humanity,” and is a “solid rampart” against all manner of violence against Creation. Even outside of the modern Orthodox world, protestants and Catholics have read the tradition similarly. Prominent Reformed theologian Nicolas Wolterstorff, for example, reads Basil the Great, Ambrose, and John Chrysostom and writes that:

I see no other way to interpret what John [Chrysostom] is doing with his powerful rhetoric, than that he is reminding his audience, rich and poor alike, of the natural rights of the poor…. The recognition of natural rights is unmistakably there: The poor are wronged because they do not have what is theirs by natural right…

(Justice: Rights and Wrongs (Princeton, NJ: Princeton Univ. Press, 2008), 62, cited in Susan R. Holman, “Orthodox Humanitarianisms: Patristic Foundations,” The Review of Faith & International Affairs 14.1 [January 2, 2016])

Human society must do no less than honor such dignity if we are to live into the fullness of life, even in explicitly secular states. Of course, any right comes with the corresponding obligation of others to collectively meet that claim. In diverse and cosmopolitan societies, two questions become central: what is our relation to one another, and what do we owe one another?

Gregory of Nazianzus and Gregory of Nyssa offer provocative answers. They began with Greco-Roman bonds of obligation which were based on kin, patronage, or citizenship—and subverted them. For the Cappadocians, these bonds referred not first to human relations but to divine relations: we are God’s children, we are citizens in God’s city, and God is our patron:

Do not tear apart the unity of the Spirit, that is to say do not consider as strangers those beings who partake of our nature … [These poor are] human beings, dragging themselves along the road, half dead yet above all human; … You see a man and in him you have no respect for a brother?[2]

(Gregory of Nazianzus, Oration 14: 6, 23, 27, cited in Holman, “The Entitled Poor: Human Rights Language in the Cappadocians,” Pro Ecclesia 9.4 [November 1, 2000])

Such rhetoric transformed the sick and poor into the divine siblings of Christians (and in other texts, fellow divine citizens) with all the concomitant obligations which arise from such bonds. Materially, such admonitions may not change things much for the well-connected rich (who were already able to procure the basic necessities of life), but it certainly changed things for the penniless and stateless poor—an entire social category historian Peter Brown notes was “invented” by Christian bishops during the Patristic period (Robert Louis Wilken, The First Thousand Years: A Global History of Christianity, 154–62 and Holman, The Hungry Are Dying: Beggars and Bishops in Roman Cappadocia).

In another example, Nazianzen encourages his audience to think of Eden: “look back to our primary equality of rights [isonomia]. … As far as you can, … honor primeval liberty, … help to resist sickness, offer relief to human need” (cited in Holman, Beholden: Religion, Global Health, and Human Rights, 112). Likewise, Lactantius, 4th century tutor to Constantine’s son, writes that “the whole force of justice lies in the fact that everyone who comes into this human estate on equal terms is made equal by it.” He defines justice as when we provide for “the needy and the useless” with food, hospitality, ransom for captives, health care for the sick, and provide strangers and paupers with decent burial (cited in Holman, “Orthodox Humanitarianisms,” 30).

For the Cappadocians, the actions which were due to one another were found in Matthew 25, when Jesus discusses the actions which separate the sheep from the goats. These define those who Jesus calls the “righteous”—those blessed by God and heirs of eternity. These include those who feed the hungry, give water to the thirsty, welcome strangers, clothe the naked, provide medical care to the sick, and visit those in prison (Holman, Beholden, 95). When we compare this to Article 25 of the United Nation Declaration of Human Rights, the parallels become unmistakable:

Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

Though some contemporary thinkers have attempted to criticize human rights, they generally do so from the presumption that they are secular and arise from modernity (Alasdair MacIntyre, After Virtue: A Study in Moral Theory). Though the language and implementation may be modern and secular, this is simply due to the political forms of our present historical moment. The foundation for human rights is properly found in Christian theology.

A Patristic perspective, then, strongly affirms human rights, including the right to health. In a move which prefigured 20th century liberation theology, the Cappadocians give special attention to poverty and to the poor as the “favorites of heaven,” even as natural citizens of heaven who “may act as legal witnesses before the eternal Judge to prosecute the rich for their greed and injustice” (Mark Engler, “Toward the ‘Rights of the Poor’: Human Rights in Liberation Theology,” The Journal of Religious Ethics 28.3 [2000], 485). In America, the healthcare system and COVID-19 are in the business of making the poor poorer, which is a direct affront to the vision of justice and human rights that the Cappadocians offer.

At the end of the day, Christians should learn from their Patristic forebears that human rights are based upon the divine image, not upon earthly political agreement. Indeed, this also means that we must work for human rights outside our own political or religious borders. Christians concerned with healthcare must work against a profit-centered system, striving instead for one based on human rights, and especially for one which prioritizes the liberation and uplift of the poor. As he was fundraising for one of the first hospitals, Gregory of Nazianzus preached that “we must regard charity as the first and greatest of the commandments since it is the very sum of the Law and the Prophets, its most vital part I find is the love of the poor along with compassion and sympathy for our fellow man….” (Oration 14: 5-6). May we learn to embody this justice and love as the foundation for our medical care for one another.


D. Brendan Johnson is a student at the University of Minnesota and a recent fellow of the Duke Theology, Medicine, and Culture Initiative. He cohosts the podcast Social Medicine On Air and can be found online at @dbrendanjohnson

Public Orthodoxy seeks to promote conversation by providing a forum for diverse perspectives on contemporary issues related to Orthodox Christianity. The positions expressed in this essay are solely the author’s and do not necessarily represent the views of the editors or the Orthodox Christian Studies Center.