Since the mid-20th century numerous factors have emerged which have substantially influenced the change in the form of spiritual service to the sick. In medical sciences we are currently witnessing the passage from the biomedical paradigm to the holistic one, which implies an appreciation of cultural factor influence on the treatment process. This results in recognising the value of the chaplain service in the hospital. As far as the civil law is concerned, in the 90s of the 20th century in Poland regulations were introduced which regulate relationships between the state and religious communities. These regulations ensured legal guarantees for the chaplain service in hospitals. The Second Vatican Council initiated a reform of the sacrament of anointing of the sick, which has deeply transformed the form of the pastoral sick care. In this respect, the author analyses the recent instruction on this subject, issued by the Polish Bishops’ Conference. Finally, the forth part of the paper outlines the ecumenical dimension of the spiritual help for the sick of other denominations, which is currently of an increasing practical importance in view of the growing migration movements in Europe.