Europe’s feudal system in the middle ages demanded absolute loyalty and zealous service to one’s lord.  The Order’s founder, Blessed Gerard, applied this principle to the Order's members, who came exclusively from the noble families of Europe.  Every member, himself a lord in the secular world, upon becoming invested in the Order took an oath to serve the poor and the sick as his lord.  Throughout the centuries, invested members of the Order have taken the same oath.  They continue to do so today.  

As explained in more detail below, the Western Association supports two free medical clinics that are independent non-profit organizations, operates several parish nurse programs, and provides financial and hands-on support to dozens of non-profit organizations.  In 2009, the Western Association's approximately 750 invested members and scores of Auxiliary members devoted roughly 89,000 hours of hands-on volunteer work to Western Association-supported projects. 

The Western Association's Hospitaller, Ralph Linzmeier, who chairs the Western Association's Hospitaller Committee, is responsible for coordinating the Western Association's humanitarian efforts.  He is assisted by nine Location Hospitallers who facilitate volunteer efforts in different geographic areas of the Western Assocation.  The Location Hospitallers are Richard Grant for Los Angeles, Todd Ganos for Monterey, Catherine Greerty for Oakland, Rand Sperry for Orange, Jack O'Brien for Phoenix, Sue Murchison for Sacramento, Art Carmichael for San Jose, Jeff Scales for San Francisco, and Tom Matthews for Seattle.   Each Western Association-sponsored or assisted project has a coordinator responsible for volunteer activities through that project.