This paper discusses the gradual steps leading to the legal establishment of pastoral care in the health care system of the Czech Republic. It is written both from the position of confessional law and from the position of the theology of the Catholic Church. The Czech model was formed gradually and does not fully correspond to the definition of the healthcare chaplain in canon law. Its starting point is a superconfessional approach, focused on the patient, on his loved ones, but also on hospital staff, which in the Czech environment is not confessionally uniform (or predominantly Catholic). This model has worked better in this environment than the model focused solely on the provision of sacraments to Catholics. This is mainly because it deals with environments that do not encounter disease (or death) and because it is set up as a combination of spiritual care, some kind of psychological accompaniment and personal human accompaniment, especially in understanding life-threatening situations and seeking encouragement that can result in the context of the biopsycho-socio-spiritual model of man in holistic healing.