As we have explored the institutions of charity in the late Middle Ages, we have seen some very marked change, into whose nature we must now finally and tentatively inquire.

The medieval doctrine of charity brought people together in a network of reciprocal help in which the individual could be a source of comfort to his fellow. The contents of religious and social instruction offered by the Church sought to internalise external values, so as to create an artificial yet intimate link between members of the Christian community. One product of this line of thought is the concept of service developed in the Christian West, an idea which far transcended the preexisting norms of family and feudal loyalties. Through service to one's fellow men God was served, humility and renunciation of self were achieved. By dispossessing themselves of part of their property, medieval men and women sought their own salvation, contributed to society's solidarity and promoted trust in its piety, virtue and affluence.

In the growing towns of twelfth- and thirteenth-century Europe groups of leading citizens were developing an ethos of duty and cooperation in which the common weal became a cherished value entrusted to their hands. The ability to contribute to the general welfare became a test of status and prosperity as well as a reflection of moral health and virtue. In this framework alleviation of poverty secured both social and spiritual benefits which rendered it a doubly attractive and effective activity.