THE SACRAMENT OF THE ANOINTING OF THE SICK

(Latin: inunctio, besmearing) To touch any part of the body with oil.  In Baptism it means the laying on of oil of catechumens, signifying a life of faith and good works, and oil of chrism, symbolizing union with Christ.  It is also used in Extreme Unction and Holy Orders, and at the coronation of monarchs.

A symbol of the Holy Spirit, whose "anointing" of Jesus as Messiah fulfilled the prophecies of the Old Testament.  Christ (in Hebrew Messiah) means the one "anointed" by the Holy Spirit.  Anointing is the sacramental sign of Confirmation, called Chrismation in the Churches of the East.  Anointing form part of the liturgical rites of the catechumenate, and of the Sacraments of Baptism and Holy Orders (695).

 

A sacrament of the New Law instituted by Christ to give spiritual aid and comfort and perfect spiritual health, including, if need be, the remission of sins, and also, conditionally, to restore bodily health, to Christians who are seriously ill; it consists essentially in the unction by a priest of the body of the sick person, accompanied by a suitable form of words.  The several points embodied in this descriptive definition will be more fully explained in the following sections into which this article is divided:


I. Actual Rite of Administration;   II. Name;  
  III. Sacramental Efficacy of the Rite;   IV. Matter and Form;
V. Minister;   VI. Subject;  
  VII. Effects;   VIII. Necessity;
IX. Repetition;   X. Reviviscence of the Sacrament.  

I. ACTUAL RITE OF ADMINISTRATIONAs

administered in the Western Church today according to the rite of the Roman Ritual, the sacrament consists (apart from certain non-essential prayers) in the unction with oil, specially blessed by the bishop, of the organs of the five external senses (eyes, ears, nostrils, lips, hands), of the feet, and, for men (where the custom exists and the condition of the patient permits of his being moved), of the loins or reins; and in the following form repeated at each unction with mention of the corresponding sense or faculty: "Through this holy unction and His own most tender mercy may the Lord pardon thee whatever sins or faults thou hast committed [quidquid deliquisti] by sight [by hearing, smell, taste, touch, walking, carnal delectation]". The unction of the loins is generally, if not universally, omitted in English-speaking countries, and it is of course everywhere forbidden in case of women. To perform this rite fully takes an appreciable time, but in cases of urgent necessity, when death is likely to occur before it can be completed, it is sufficient to employ a single unction (on the forehead, for instance) with the general form: "Through this holy unction may the Lord pardon thee whatever sins or faults thou hast committed." By the decree of 25 April, 1906, the Holy Office has expressly approved of this form for cases of urgent necessity.In the Eastern Orthodox (schismatical) Church this sacrament is normally administered by a number of priests (seven, five, three; but in case of necessity even one is enough); and it is the priests themselves who bless the oil on each occasion before use. The parts usually anointed are the forehead, chin, cheeks, hands, nostrils, and breast, and the form used is the following: "Holy Father, physician of souls and of bodies, Who didst send Thy Only- Begotten Son as the healer of every disease and our deliverer from death, heal also Thy servant N. from the bodily infirmity that holds him, and make him live through the grace of Christ, by the intercessions of [certain saints who are named], and of all the saints." (Goar, Euchologion, p. 417.) Each of the priests who are present repeats the whole rite.

 

II. NAME

The name Extreme Unction did not become technical in the West till towards the end of the twelfth century, and has never become current in the East. Some theologians would explain its origin on the ground that this unction was regarded as the last in order of the sacramental or quasi-sacramental unctions, being preceded by those of baptism, confirmation, and Holy orders; but, having regard to the conditions prevailing at the time when the name was introduced (see below, VI), it is much more probable that it was intended originally to mean "the unction of those in extremis", i.e. of the dying, especially as the corresponding name, sacramentum exeuntium, came into common use during the same period.In previous ages the sacrament was known by a variety of names, e.g., the holy oil, or unction, of the sick; the unction or blessing of consecrated oil; the unction of God; the office of the unction; etc. In the Eastern Church the later technical name is euchelaion (i.e. prayer-oil); but other names have been and still are in use, e.g. elaion hagion (holy), or hegismenon (consecrated), elaion, elaiou Chrisis, chrisma, etc.

 
 
 
 

V. MINISTER (1) The Council of Trent has defined in accordance with the words of St. James that the proper ministers (proprios ministros) of this sacrament are the priests of the Church alone, that is bishops or priests ordained by them (Sess. XIV, cap. iii, and can. iv, De Extr. Unct.). And this has been the constant teaching of tradition, as is clear from the testimonies given above. Yet Launoi (Opp., I, 569 sq.) has maintained that deacons can be validly delegated by the bishop to administer extreme unction, appealing in support of his view to certain cases in which they were authorized in the absence of a priest to reconcile dying penitents and give them the Viaticum. But in none of these cases is extreme unction once mentioned or referred to, and one may not gratuitously assume that the permission given extended to this sacrament, all the more so as there is not a particle of evidence from any other source to support the assumption. The Carmelite Thomas Waldensis (d. 1430) inferred from the passage of Innocent I [see above, under III (C), (2), (b)] that, in case of necessity when no priest could be got, a layman or woman might validly anoint (Doctrinale Antiq. Fidei, II, clxiii, 3), and quite recently Boudinhon (Revue Cath. des Eglises, July, 1905, p. 401 sq.) has defended the same view and improved upon it by allowing the sick person to administer the sacrament to himself or herself. This opinion, however, seems to be clearly excluded by the definition of the Council of Trent that the priest alone is the "proper" minister of extreme unction. The word proper cannot be taken as equivalent merely to ordinary, and can only mean "Divinely authorized". And as to the unction of themselves or others by lay persons with the consecrated oil, it is clear that Pope Innocent, while sanctioning the pious practice, could not have supposed it to be efficacious in the same way as the unction by a priest or bishop, to whom alone in his view the administration of the Jacobean rite belonged. This lay unction was merely what we call today a sacramental. Clericatus (Decisiones de Extr. Unct., decis. lxxv) has held that a sick priest in case of necessity can validly administer extreme unction to himself; but he has no argument of any weight to offer for this opinion, which is opposed to all sacramental analogy (outside the case of the Eucharist) and to a decision of the Congregation of Propaganda issued 23 March, 1844. These several singular opinions are rejected with practical unanimity by theologians, and the doctrine is maintained that the priests of the Church, and they alone, can validly confer extreme unction.(2) The use of the plural in St. James--"the priests of the Church"--does not imply that several priests are required for the valid administration of the sacrament. Writing, as we may suppose, to Christian communities in each of which there was a number of priests, and where several, if it seemed well, could easily be summoned, it was natural for the Apostle to use the plural without intending to lay down as a matter of necessity that several should actually be called in. The expression used is merely a popular and familiar way of saying: "Let the sick man call for priestly ministrations", just as one might say, "Let him call in the doctors", meaning, "Let him procure medical aid". The plural in either case suggests at the very most the desirability, if the circumstances permit, of calling in more than one priest or doctor, but does not exclude, as is obvious, the services of only one, if only one is available, or if for a variety of possible reasons it is better that only one should be summoned. As is evident from several of the witnesses quoted above (III), not only in the West but in the East the unction was often administered in the early centuries by a single priest; this has been indeed at all times the almost universal practice in the West (for exceptions cf. Martène, op. cit., I, vii, 3; Kern, op. cit., p. 259). In the East, however, it has been more generally the custom for several priests to take part in the administration of the sacrament. Although the number seven, chosen for mystical reasons, was the ordinary number in many parts of the East from an earlier period, it does not seem to have been prescribed by law for the Orthodox Church before the thirteenth century (cf. Kern, op. cit., p. 260). But even those Oriental theologians who with Symeon of Thessalonica (fifteenth century) seem to deny the validity of unction by a single priest, do not insist on more than three as necessary, while most Easterns admit that one is enough in case of necessity (cf. Kern, op. cit., p. 261). The Catholic position is that either one or several priests may validly administer extreme unction; but when several officiate it is forbidden by Benedict XIV for the Italo-Greeks (Const. "Etsi Pastoralis", 1742) for one priest merely to anoint and another merely to pronounce the form, and most theologians deny the validity of the unction conferred in this way. The actual practice, however, of the schismatical churches is for each priest in turn to repeat the whole rite, both matter and form, with variations only in the non-essential prayers. This gives rise to an interesting question which will best be discussed in connection with the repetition of the sacrament (below, IX).

 

VI. SUBJECT

(1) Extreme Unction may be validly administered only to Christians who have had the use of reason and who are in danger of death from sickness. That the subject must be baptized is obvious, since all the sacraments, besides baptism itself, are subject to this condition. This is implied in the text of St. James: "Is any man sick among you?" i.e. any member of the Christian community; and tradition is so clear on the subject that it is unnecessary to delay in giving proof. It is not so easy to explain on internal grounds why extreme unction must be denied to baptized infants who are sick or dying, while confirmation, for instance, may be validly administered to them; but such is undoubtedly the traditional teaching and practice. Except to those who were capable of penance extreme unction has never been given. If we assume, however, that the principal effect of extreme unction is to give, with sanctifying grace or its increase, the right to certain actual graces for strengthening and comforting and alleviating the sick person in the needs and temptations which specially beset him in a state of dangerous illness, and that the other effects are dependent on the principal, it will be seen that for those who have not attained, and will not attain, the use of reason till the sickness has ended in death or recovery, the right in question would be meaningless, whereas the similar right bestowed with the character in confirmation may, and normally does, realize its object in later life. It is to be observed in regard to children, that no age can be specified at which they cease to be incapable of receiving extreme unction. If they have attained sufficient use of reason to be capable of sinning even venially, they may certainly be admitted to this sacrament, even though considered too young according to modern practice to receive their First Communion; and in cases of doubt the unction should be administered conditionally. Those who have always been insane or idiotic are to be treated in the same way as children; but anyone who has ever had the use of reason, though temporarily delirious by reason of the disease or even incurable insane, is to be given the benefit of the sacrament in case of serious illness.(2) Grave or serious bodily illness is required for the valid reception of extreme unction. This implied in the text of St. James and in Catholic tradition (see above, III), and is formally stated in the decree of Eugene IV for the Armenians: "This sacrament is not to be given except to the sick person, of whose death fears are entertained" (Denzinger, no. 700--old no. 595), and in the teaching of the Council of Trent that "this unction is to be administered to the sick, but especially to those who seem to be at the point of death [in exitu vitæ]" (Sess. XIV, cap. iii, De Extr. Unct.). It is clear from these words of Trent that extreme unction is not for the dying alone, but for all the faithful who are seriously ill with any sickness as involves danger of death (discrimen vitæ, ibid.), i.e. as may probably terminate fatally. How grave must be the illness or how proximate the danger of death is not determined by the council, but is left to be decided by the speculations of theologians and the practical judgment of priests directly charged with the duty of administering the sacrament. And there have been, and perhaps still are, differences of opinion and of practice in this matter.(3) Down to the twelfth century in the Western Church the practice was to give the unction freely to all (except public penitents) who were suffering from any serious illness, without waiting to decide whether danger of death was imminent. This is clear from many testimonies quoted above (III). But during the twelfth and thirteenth centuries a change of practice took place, and the sacrament came to be regarded by many as intended only for the dying. The causes contributing to this change were: (a) the extortionate demands of the clergy on the occasion of administering the unction which prevented the poor or even those of moderate means from asking for it except as a last resource; (b) the influence of certain popular superstitions, as, for instance, that the person anointed could not, in case of recovery, use the rights of marriage, eat flesh meat, make a will, walk with bare feet, etc.; and (c) the teaching of the Scotist School and of other theologians that, as the principal effect of the sacrament was the final remission of venial sins, it should not be given except to those who could not recover, and were no longer able or at least likely to fall again into venial sin (St. Bonaventure, "Breviloquium", P. VI, c. xi; Scotus, "Report. Parisien.", dist. xxiii, Q. unica). It was doubtless under the influence of this teaching that one or two provincial synods of the sixteenth century described the subject of extreme unction as "the dangerously sick and almost dying" (Hardouin, X, 1848, 1535); and the neglect of the sacrament induced by these several causes resulted, during the disturbances of the sixteenth century, in its total abandonment in many parts of Germany and especially of Bavaria (Knöpfler, "Die Kelchbewegung in Bayern unter Herzog Albrecht V.", pp. 61 sq.; and on this whole matter see Kern, op. cit., pp. 282 sq.). In view of these facts, the oft-repeated accusation of the Eastern schismatics, that the Latins gave the sacrament only to the dying and withheld it from the seriously ill who were capable of receiving it, is not without foundation (Kern, op. cit., p. 274); but they were wrong in assuming that the Western Church as a whole or the Holy See is responsible for abuses of this kind. Church authority earnestly tried to correct the avarice of the clergy and the superstitions of the people, while the Scotist teaching, regarding the chief effect of the unction, was never generally admitted in the schools, and its post-Tridentine adherents have felt compelled to modify the practical conclusion which St. Bonaventure and Scotus had logically drawn from it. There still linger in the popular mind traces of the erroneous opinion that extreme unction is to be postponed till a sickness otherwise serious has taken a critical turn for the worse, and the danger of death become imminent; and priests do not always combat this idea as strongly as they ought to, with the result that possibly in many cases the Divinely ordained effect of corporal healing is rendered impossible except by a miracle. The best and most recent theological teaching is in favor of a lenient, rather than of a severe, view of the gravity of the sickness, or the proximity of the danger of death, required to qualify for the valid reception of extreme unction; and this is clearly compatible with the teaching of the Council of Trent and is supported by the traditional practice of the first twelve centuries.But if the Easterns have had some justification for their charge against the Westerns of unduly restricting the administration of this sacrament, the Orthodox Church is officially responsible for a widespread abuse of the opposite kind which allows the euchelaion to be given to persons in perfect health as a complement of penance and a preparation for Holy Communion. Many Western theologians, following Goar (Euchologion, pp. 349 sq.), have denied that this rite was understood and intended to be sacramental, though the matter and form were employed precisely as in the case of the sick; but, whatever may have been the intention in the past, it is quite certain at the present time that at least in the Constantinopolitan and Hellenic branches of the Orthodox Church the intention is to give the sacrament itself and no mere sacramental to those in sound health who are anointed (Kern, op. cit., 281). On the other hand, in the Russian Church, except in the metropolitan churches of Moscow and Novgorod on Maundy Thursday each year, this practice is reprobated, and priests are expressly forbidden in their faculties to give the euchelaion to people who are not sick (Kern, pp. 279 sq.; Fortescue, The Orthodox Eastern Church, London, 1907, p. 425). We have already noticed (III) among Nestorians what appears to have been a similar abuse, but in the Orthodox Church till long after the schism there is no evidence of its existence, and the teaching of Eastern theologians down to modern times, to which the Russians still adhere, has been at one with the Western tradition in insisting that the subject of this sacrament must be labouring under a serious sickness.(4) Nor will danger, or even certainty, of death from any other cause than sickness qualify a person for extreme unction. Hence criminals or martyrs about to suffer death and other similarly circumstanced may not be validly anointed unless they should happen to be seriously ill. But illness caused by violence, as by a dangerous or fatal wound, is sufficient; and old age itself without any specific disease is held by all Western theologians to qualify for extreme unction, i.e. when senile decay has advanced so far that death already seems probable. In cases of lingering diseases, like phthisis or cancer, once the danger has become really serious, extreme unction may be validly administered even though in all human probability the patient will live for a considerable time, say several months; and the lawfulness of administering it in such cases is to be decided by the rules of pastoral theology. If in the opinion of doctors the sickness will certainly be cured, and all probable danger of death removed by a surgical operation, theologians are not agreed whether the person who consents to undergo the operation ceases thereby to be a valid subject for the sacrament. Kern holds that he does (op. cit., p. 299), but his argument is by no means convincing.
 

VII. EFFECTS

The decree of Eugene IV for the Armenians describes the effects of extreme unction briefly as "the healing of the mind and, so far as it is expedient, of the body also" (Denzinger, no. 700--old no. 595). In Sess. XIV, can. ii, De Extr. Unct., the Council of Trent mentions the conferring of grace, the remission of sins, and the alleviation of the sick, and in the corresponding chapter explains as follows the effects of the unction: "This effect is the grace of the Holy Ghost, whose unction blots out sins, if any remain to be expiated, and the consequences [reliquias] of sin, and alleviates and strengthens the soul of the sick person, by exciting in him a great confidence in the Divine mercy, sustained by which [confidence] he bears more lightly the troubles and sufferings of disease, and more easily resists the temptations of the demon lying in wait for his heel, and sometimes, when it is expedient for his soul's salvation, recovers bodily health." The remission of sins, as we have seen, is explicitly mentioned by St. James, and the other spiritual effects specified by the Council of Trent are implicitly contained, side by side with bodily healing, in what the Apostle describes as the saving and raising up of the sick man (see above, II).(1) It is therefore a doctrine of Catholic faith that sins are remitted by extreme unction, and, since neither St. James nor Catholic tradition nor the Council of Trent limits this effect to venial sins, it is quite certain that it applies to mortal sins also. But according to Catholic teaching there is per se a grave obligation imposed by Divine law of confessing all mortal sins committed after baptism and obtaining absolution from them; from which it follows that one guilty of mortal sin is bound per se to receive the Sacrament of Penance before receiving extreme unction. Whether he is further bound, in case penance cannot be received, to prepare himself for extreme unction by an act of perfect contrition is not so clear; but the affirmative opinion is more commonly held by the theologians, on the ground that extreme unction is primarily a sacrament of the living, i.e. intended for those in the state of grace, and that every effort should be made by the subject to possess this primary disposition. That the remission at least of mortal sins is not the primary end of extreme unction is evident from the conditional way in which St. James speaks of this effect; "and if he be in sins" etc.; but, on the other hand, this effect is attributed, if conditionally and secondarily, yet directly and per se to the unction--not indirectly and per accidens as we attribute it to other sacraments of the living--which means that extreme unction has been instituted secondarily as a sacrament of the dead, i.e. for the purpose not merely of increasing but of conferring sanctifying grace sacramentally. Hence, if for any reason the subject in mortal sin is excused from the obligation of confessing or of eliciting an act of perfect contrition, extreme unction will remit his sin and confer sanctifying grace, provided he has actual, or at least habitual, attrition, or provided (say on recovering the use of reason) he elicits an act of attrition so that the sacrament may take effect by way of reviviscence (see below, X). By habitual attrition in this connection is meant an act of sorrow or detestation for sins committed, elicited since their commission and not retracted in the interval before the sacrament is received. The ordinary example occurs when the act of attrition has been elicited before the sick person lapses into unconsciousness or loses the use of reason. That such attrition is necessary, follows from the teaching of Trent (Sess. XIV, cap. i, De Poenit.) regarding the absolute and universal necessity of repentance for the remission, even in baptism, of personal mortal sins. Schell has maintained (Kathol. Dogmatik, III, pp. 629 sq.) that such attrition is not required for the validity of extreme unction, but that the general purpose and intention, which a Christian sinner may retain even when he is sinning, of afterwards formally repenting and dying in the friendship of God, is sufficient; but this view seems irreconcilable with the teaching of Trent, and has the whole weight of theological tradition against it.Extreme unction likewise remits venial sins provided the subject has at least habitual attrition for them; and, following the analogy of penance, which with attrition remits mortal sins, for the remission of which outside the sacrament perfect contrition would be required, theologians hold that with extreme unction a less perfect attrition suffices for the remission of venial sins than would suffice without the sacrament. But besides thus directly remitting venial sins, extreme unction also excites dispositions which procure their remission ex opere operantis.The relics or effects of sin mentioned by the Council of Trent are variously understood by theologians to mean one, or more, or all of the following: spiritual debility and depression caused by the consciousness of having sinned; the influence of evil habits induced by sin; temporal penalties remaining after the guilt of sin has been forgiven; and venial, or even mortal, sins themselves. Of these only the remission of temporal punishment is distinct from the other effects of which the council speaks; and though some theologians have been loath to admit this effect at all, lest they might seem to do away with the raison d'être of purgatory and of prayers and indulgences for the dying and dead, there is really no solid ground for objecting to it, if passing controversial interests are subordinated to Catholic theory. It is not suggested that extreme unction, like baptism, sacramentally remits all temporal punishment due to sin, and the extent to which it actually does so in any particular case may, as with baptism, fall short of what was Divinely intended, owing to obstacles or defective dispositions in the recipient. Hence there is still room and need for Indulgences for the dying, and if the Church offers her prayers and applies Indulgences for adults who die immediately after baptism, she ought, a fortiori, to offer them for those who have died after extreme unction. And if temporal punishment be, as it certainly is, one of the reliquioe of sin, and if extreme unction be truly what the Council of Trent describes (Sess. XIV, De Extr. Unct., introduct.) as "the consummation not merely of [the Sacrament of] Penance, but of the whole Christian life, which ought to be a perpetual penance", it is impossible to deny that the remission of temporal punishment is one of the effects of this sacrament.(2) The second effect of extreme unction mentioned by the Council of Trent is the alleviation and strengthening of the soul by inspiring the sick person with such confidence in the Divine mercy as will enable him patiently and even cheerfully to bear the pains and worries of sickness, and with resolute courage to repel the assaults of the tempter in what is likely to be the last and decisive conflict in the warfare of eternal salvation. The outlook on eternity is brought vividly before the Christian by the probability of death inseparable from serious sickness, and this sacrament has been instituted for the purpose of conferring the graces specially needed to fortify him in facing this tremendous issue. It is unnecessary to explain in detail the appropriateness of such an institution, which, were other reasons wanting, would justify itself to the Christian mind by the observed results of its use.(3) Finally, as a conditional and occasional effect of extreme unction, comes the restoration of bodily health, an effect which is vouched for by the witness of experience in past ages and in our own day. Theologians, however, have failed to agree in stating the condition on which this effect depends or in explaining the manner in which it is produced. "When it is expedient for the soul's salvation", is how Trent expresses the condition, and not a few theologians have understood this to mean that health will not be restored by the sacrament unless it is foreseen by God that a longer life will lead to a greater degree of glory--recovery being thus a sign or proof of predestination. But other theologians rightly reject this opinion, and of several explanations that are offered (cf. Kern, op. cit., pp. 195 sq.) the simplest and most reasonable is that which understands the condition mentioned not of the future and perhaps remote event of actual salvation, but of present spiritual advantage which, independently of the ultimate result, recovery may bring to the sick person; and holds, subject to this condition, that this physical effect, which is in itself natural, is obtained mediately through and dependently upon the spiritual effects already mentioned. The fortifying of the soul by manifold graces, by which over-anxious fears are banished, and a general feeling of comfort and courage, and of humble confidence in God's mercy and peaceful resignation to His Will inspired, reacts as a natural consequence on the physical condition of the patient, and this reaction is sometimes the factor that decides the issue of certain diseases. This mediate and dependent way of effecting restoration of health is the way indicated by the Council of Trent in the passage quoted above, and the view proposed is in conformity with the best and most ancient theoretical teaching on the subject and avoids the seemingly unanswerable difficulties involved in opposing views. Nor does it reduce this effect of extreme unction to the level of those perfectly natural phenomena known to modern science as "faith cures". For it is not maintained, in the first place, that recovery will follow in any particular case unless this result is spiritually profitable to the patient--and of this God alone is the judge--and it is admitted, in the second place, that the spiritual effect, from which the physical connaturally results, is itself strictly supernatural (cf. Kern, loc. cit.).(4) There remains the question, on which no little controversy has been expended, as to which of these several effects is the principal one. Bearing in mind the general theory that sacramental grace as such is sanctifying grace as imparted or increased by the sacrament, with the right or title to special actual graces corresponding to the special end of each sacrament, the meaning of the question is: Which of these effects is the sacramental grace imparted in extreme unction primarily and immediately intended to produce, so that the others are produced for the sake of, or by means of, it? Or, more ultimately, what, according to Christ's intention in instituting it, is the primary and distinctive purpose of this sacrament, its particular raison d'être as a sacrament? Now, clearly this cannot be either the remission of mortal sin or the restoration of physical health, since, as we have seen, extreme unction is primarily a sacrament of the living; and restoration of bodily health is not a normal effect, but only brought about, when at all, indirectly. There remain the remission of venial sins and of the temporal punishment due for sins already forgiven, and the invigoration of the soul in face of the probability of death. Reference has already been made to the Scotist view (VI) which singles out the final and complete remission of venial sin as the chief end or effect of extreme unction, and which logically leads to the practical conclusion, adopted by St. Bonaventure and Duns Scotus, that only the dying should receive the sacrament; and the same conclusion, which must in any case be rejected, would also follow from holding in a similarly exclusive sense that the principal effect is the remission of temporal punishment. Thus we are left in possession of the theory, held by many of the best theologians, that the supernatural invigoration of the soul in view of impending death is the chief end and effect of extreme unction. This effect, of course, is actually realized only when the subject is sui compos and capable of co-operating with grace; but the same is true of the principal effect of several other sacraments. It is no argument, therefore, against this view to point to the fact that sins are sometimes remitted by extreme unction while the recipient is unconscious and incapable of using the invigorating graces referred to. The infusion or increase of sanctifying grace is an effect common to all the sacraments; yet it is not by this of itself that they are distinguished from on another, but by reference to the special actual graces to which sanctifying grace as infused or increased gives a title; and if the realization of this title is sometimes suspended or frustrated, this is merely by way of an accidental exception to which, in general, sacramental efficacy is liable. It does not seem, however, that this theory should be urged in an exclusive sense, as implying, that is, that the remission of venial sin or of temporal punishment is not also a primary effect which may be obtained independently; rather should the theory be enlarged and modified, and the primary and essential end of the sacrament so described as to comprehend these effects. This is the solution of the whole question proposed by Kern (op. cit., pp. 81 sq., 215 sq.), who, with no little learning and ability, defends the thesis that the end of extreme unction is the perfect healing of the soul with a view to its immediate entry into glory, unless it should happen that the restoration of bodily health is more expedient. This view is quite in conformity with, and may even be said to be suggested by, the teaching of the Council of Trent to the effect that extreme unction is "the consummation of the whole Christian life"; and Kern has collected an imposing weight of evidence in favor of his thesis from ancient and medieval and modern writers of authority. Dr. Pohle (op. cit., pp. 535, 536) reviews Kern's suggestion sympathetically. Besides being self-consistent and free from any serious difficulty, it is recommended by many positive arguments, and in connection with the controverted point we have been discussing it has the advantage of combining and co-ordinating as parts of the principal effect--i.e. perfect spiritual health--not only the remission of venial sins and the invigoration of the soul, for which respectively Scotists and their opponents have contended too exclusively, but also the remission of temporal punishment, which not a few theologians have neglected.

 

VIII. NECESSITY

Theologians are agreed that extreme unction may in certain circumstances be the only, and therefore the necessary, means of salvation for a dying person. This happens when there is question of a person who is dying without the use of reason, and whose soul is burdened with the guilt of mortal sin for which he has only habitual attrition; and for this and similar cases in which other means of obtaining justification are certainly or even probably unavailing, there is no doubt as to the grave obligation of procuring extreme unction for the dying. But theologians are not agreed as to whether or not a sick person in the state of grace is per se under a grave obligation of seeking this sacrament before death. It is evident ex hypothesi that there is no obligation arising from the need of salvation (necessitate medii), and the great majority of theologians deny that a grave obligation per se has been imposed by Divine or ecclesiastical law. The injunction of St. James, it is said, may be understood as being merely a counsel or exhortation, not a command, and there is no convincing evidence form tradition that the Church has understood a Divine command to have been given, or has ever imposed one of her own. Yet it is recognized that, in the words of Trent, "contempt of so great a sacrament cannot take place without an enormous crime and an injury to the Holy Ghost Himself" (Sess. XIV, cap. iii); and it is held to depend on circumstances whether mere neglect or express refusal of the sacrament would amount to contempt of it. The soundness, however, of the reasons alleged for this common teaching is open to doubt, and the strength of the arguments advanced by so recent a theologian as Kern (pp. 364 sq.) to prove the existence of the obligation which so many have denied is calculated to weaken one's confidence in the received opinion.

 

IX. REPETITION

The Council of Trent teaches that "if the sick recover after receiving this unction, they can again receive the aid of this sacrament, when they fall anew into a similar danger of death" (Sess. XIV, cap. iii, De Extr. Unct.). In the Middle Ages doubts were entertained by some ecclesiastics on this subject, as we learn from the correspondence between Abbot (later Cardinal) Godfried and St. Yves, Bishop of Chartres (d. 1117). Godfried considered the custom in vogue in the Benedictine monasteries, of repeating extreme unction, reprehensible on the ground that "no sacrament ought to be repeated" (P.L., CLVII, 87 sq.); but he wished to have St. Yves's opinion, and the latter quite agreed with his friend (ibid., 88). Not long afterwards Peter the Venerable, Abbot of Cluny, was asked by Abbot Theobald to explain "why it was that the unction of the sick was the only unction [out of many] repeated, and why this took place only at Cluny", and Peter in reply gave a convincing explanation of the Benedictine practice, his main contention being that the person anointed may on recovery have sinned again and be in need of the remission of sins promised by St. James, and that the Apostle himself not only does not suggest that the unction may be given only once, but clearly implies the contrary--"ut quoties quis infirmatus fuerit, toties inungatur" (P.L., CLXXXIX, 392 sq.). After this all opposition to the repetition of the sacrament disappears, and subsequent writers unanimously teach, what has been defined by the Council of Trent, that it may under certain conditions be validly and lawfully repeated. It should be noted, moreover, that the practice of repeating it at this period was not confined to the Benedictines or to Cluny. The Cistercians of Clairvaux, for example, were also in the habit of repeating it, but subject to the restriction that it was not to be given more than once within a year; and several Ordines of particular Churches dating from the ninth, tenth, eleventh, and twelfth centuries, have a rubric prescribing the repetition of the unction for seven successive days (cf. Kern, op. cit., pp. 334, 338 sq.).Coming to the more accurate determination of the circumstances or conditions which justify the repetition of extreme unction, theologians, following the authority of Trent, are agreed that it may be validly and lawfully repeated as often as the sick person, after recovery, becomes seriously ill again, or, in cases of lingering illness where no complete recovery takes place, as often as the probable danger of death, after disappearing, returns. For verification of this latter condition some theologians would require the lapse of a certain interval, say a month, during which the danger would seem to have passed; but there is really no reason for insisting on this any more than on the year which medieval custom in some places was wont to require. St. Bonaventure's remark, that "it is absurd for a sacrament to be regulated by the motion of the stars" (in IV Semt., dist. xxiii, a. 2, q. iv, ad 2), applies to a month as well as to a year. Not a few theologians (among recent ones De Augustinis, "De Re Sacramentariâ, II, 408) understand, by the new danger of death, proximate or imminent danger, so that, once imminent danger has passed and returned, the sacrament may be repeated without waiting for any definite interval to elapse. The majority of theologians, however, deny the validity of extreme unction repeated while the danger of death remains the same, and they assume that this is the implicit teaching of the Council of Trent. But among contemporary authors, Kern, following the lead of several positive theologians eminent for their knowledge of sacramental history (Ménard, Launoi, Martène, Juénin, Drouven, Pouget, Pellicia, Binterim, Heinrich.--See references in Kern, op. cit., pp. 357, 538), maintains the probable validity of extreme unction repeated, no matter how often, during the same danger of death; and it will be found easier to ignore, than to meet and answer, the argument by which he supports his view. He furnishes, in the first place, abundant evidence of the widespread practice in the Western Church from the ninth to the twelfth, and even, in some places, to the thirteenth century, of repeating the unction for seven days, or indefinitely while the sickness lasted; and he is able to claim the authority of Oriental theologians for explaining the modern practice in the Eastern Church of a sevenfold anointing by seven priests as being due to a more ancient practice of repeating the unction for seven days--a practice to which the Coptic Liturgy bears witness. By admitting the validity of each repeated unction we are able to give a much more reasonable explanation of the medieval Western and modern Eastern practice than can possibly be given by those who deny its validity. The latter are bound to maintain either that the repeated rite is merely a sacramental--though clearly intended to be a sacrament--or that the repeated unctions coalesce to form one sacrament--an explanation which is open to several serious objections. In the next place, since extreme unction does not imprint a permanent "character", there is no reason why its proper sacramental effect may not be increased by repetition, as happens in Penance and Holy Communion--that is, with an increase of sanctifying grace, the right to spiritual invigoration may be increased, and more abundant actual graces become due. And this, on internal grounds, would suffice to justify repetition, although the effect of the previous administration remains. Finally, in reply to the principal dogmatic reason urged against his view--viz., the teaching of the Council of Trent--Kern fairly maintains that the intention of the council was merely positive, and not exclusive, i.e., it wished to define, in opposition to more restrictive views that had been held, the validity of extreme unction repeated in the circumstances it mentions, but without meaning to deny its validity if repeated in other circumstances not mentioned. The exhaustive examination of tradition which is supposed to precede a definition had not, so far as this particular point is concerned, been carried out at the time of Trent; and the point itself was not ripe for definition. Modern discipline in the Western Church can be explained on other than dogmatic grounds; and if it be urged as dogmatically decisive, this will imply a very sweeping condemnation of medieval Western and modern Eastern practice, which the prudent theologian will be slow to pronounce.

 

X. REVIVISCENCE

The question of reviviscence arises when any sacrament is validly administered, but is hindered at the time from producing its effect, owing to the want of due dispositions in the recipient. Thus, in regard to extreme unction, the subject may be unconscious and incapable of spiritual invigoration in so far as this requires co-operation with actual grace. Or he may, for want of the necessary attrition, be indisposed to receive remission of sins, or indisposed in case of mortal sin for the infusion of sanctifying grace. And the want of disposition--the obstacle to the efficacy of the sacrament--may be inculpable or gravely culpable; in the latter case the reception of the sacrament will be sacrilegious. Now the question is, does extreme unction revive, that is does it afterwards (during the same serious illness) produce such effects as are hindered at the time of reception, if the obstacle is afterwards removed or the requisite disposition excited? And theologians all teach that it certainly does revive in this way; that for its reviviscence, if no sacrilege has been committed in its reception nor any grave sin in the interval, all that is needed is that the impeding defect should be removed, that consciousness, for instance, should be recovered, or habitual attrition excited; but that, when a grave sin has been committed at or since the reception, this sin must be remitted, and sanctifying grace obtained by other means (e.g. penance or perfect contrition) before extreme unction can take effect. From this doctrine of reviviscence--which is not, however, defined as a dogma--there follows an important practical rule in regard to the administration of extreme unction, viz., that, notwithstanding doubts about the dispositions of a certainly valid subject, the sacrament should always be conferred absolutely, never conditionally, since a condition making its validity dependent on the actual dispositions of the recipient would exclude the possibility of reviviscence. The conditional form (si capax es) should be used only when it is doubtful whether the person is a valid subject for the sacrament, e.g., whether he is not already dead, whether he has been baptized, has attained the use of reason, or has the implicit habitual intention of dying in a Christian manner

The Anointing of the Sick: 
Comfort and Healing

The Anointing of the Sick is a remarkable sign of God's great love for us. In his merciful efforts to bring us safely to himself in heaven, God seems to have gone to the very limit.

Jesus has given us the sacrament of Baptism, in which original sin and all pre-Baptismal sins are cleansed from the soul. Allowing for mankind's spiritual weakness, Jesus also gave us the sacrament of Penance, by which post-Baptismal sins could be forgiven. As though he were impatient lest a soul be delayed a single instant from its entry into heaven, Jesus gave to his Church the power to remit the temporal punishment due to sin, a power which the Church exercises in the granting of indulgences.

Finally, as though to make doubly sure that no one, except through his own deliberate fault, would lose heaven or even spend time in purgatory, Jesus instituted the sacrament of Anointing of the Sick.

A special sacrament for the sick & suffering

The Catechism of the Catholic Church's section on the Anointing of the Sick defines the purpose of the sacrament as "the conferral of a special grace on the Christian experiencing the difficulties inherent in the condition of grave illness or old age." (Catechism, 1527)

In his Gospel St. Mark (6:12-13) gives us an indication of this sacrament of the sick when he tells us that the apostles, going forth, "preached that men should repent, and they cast out many devils, and anointed with oil many sick people, and healed them."

However, the classical description which the Bible gives of the sacrament of Anointing of the Sick is found in the Epistle of St. James:

Is any one among you sick? Let him bring in the presbyters [priests] of the Church, and let them pray over him, anointing him with oil in the name of the Lord. And the prayer of faith will save the sick man, and the Lord will raise him up, and if he be in sins, they shall be forgiven him.

(James 5:14-15)

The Oil of the Sick

The oil used in administering the sacrament of Anointing of the Sick is called Oil of the Sick. It is one of the three Holy oils blessed by the bishop of the diocese at his cathedral on Holy Thursday morning, the other two Holy Oils being Holy Chrism and the Oil of Catechumens, which is used in Baptism.

Oil of the Sick is pure olive oil—nothing being added except the blessing of the bishop. Its appropriateness as part of the outward sign of Anointing of the Sick is evident from the healing and strengthening effects which are characteristic of olive oil.

The essence of the sacrament lies in the actual anointing and the short prayer which accompanies the anointing.

In giving the sacrament, the priest anoints the sick person on the forehead and hands. During this anointing, the priest says: "Through this holy anointing may the Lord in his love and mercy help you with the grace of the Holy Spirit. May the Lord who frees you from sin save you and raise you up."

Counteracting undue fear

When faced with the danger of death, a person normally will experience a feeling of great anxiety.

This is to be expected. God has planted in human nature a strong attachment to life which we commonly call the instinct for self-preservation. He has done so precisely in order to assure that we take due care of our physical well-being and do not expose ourselves to unnecessary danger to our life.

We need not feel ashamed, therefore, nor convicted of lack of faith if we find ourselves apprehensive when the shadow of death looms over us.

To counteract this fear of death when it needs to be counteracted, and to remove all cause for fear, God has given us the sacrament of Anointing of the Sick.

Graces of the sacrament

In common with all the sacraments, Anointing of the Sick confers sanctifying grace.

It is an increase in sanctifying grace that Anointing of the Sick gives, since it presupposes that the recipient already is free from mortal sin. Thus there is intensified in the soul that supernatural life, that oneness with God, which is the source of all spiritual strength as it is also the measure of our capacity for the happiness of heaven.

Besides this increase in sanctifying grace, Anointing of the Sick gives its own special sacramental grace.

The primary purpose of the special grace of Anointing of the Sick is to comfort and to strengthen the soul of the sick person.

  • This is the grace that quiets anxiety and dissipates fear.
  • It is the grace which enables the sick person to embrace God's will and to face the possibility of death without apprehension.
  • It is the grace which gives the soul the strength to face and conquer whatever temptations to doubt, despondency, or even despair may mark Satan's last effort to seize this soul for himself.

Doubtless some who read this have already received Anointing of the Sick, perhaps even several times. If so, they know by experience, as does the writer, what peace of mind and confidence in God this sacrament bestows.

Secondary effects

This spiritual tranquility and strength is further increased by the second effect of Anointing of the Sick. This is the preparation of the soul for entrance into heaven by the forgiveness of venial sins and the cleansing of the soul from the remains of sin.

If we are so blessed as to receive the sacrament of Anointing of the Sick in our last illness, we may have every confidence that we shall enter into the happiness of heaven immediately after death. We hope that our friends still will continue to pray for us after death, since we never can be sure of the adequacy of our own dispositions in receiving this sacrament; and if we do not need the prayers, someone else will profit by them.

Yet we should have a high degree of confidence, once we have received Anointing of the Sick, that we shall look upon the face of God moments after our soul leaves our body. The soul has been cleansed from all that might hold it back from God, from venial sins and from the temporal punishment due to sin.

The "remains of sin" from which Anointing of the Sick cleanses the soul include that moral weakness of soul which is the result of sin, both of original sin and our own sins. This weakness—even to the point of spiritual indifference—is likely to afflict that person especially who has been a habitual sinner.

Here again, the soul of the sick person is tempered and prepared against the possibility of any last-moment conflict with the world, the flesh, and the devil.

The Anointing of the Sick 
Complements Confession

Since Penance (Confession) is the sacrament by which God intends our mortal sins to be forgiven, a sick person who has mortal sins to confess must receive the sacrament of Penance before he receives the sacrament of Anointing of the Sick.

However, it is a comfort to know that Anointing of the Sick does forgive mortal sin also if the critically ill person is unable to receive the sacrament of Penance. This could happen, for example, if Anointing of the Sick were administered to an unconscious person who had made an act of imperfect contrition for his mortal sins before losing consciousness.

Healing the sick

It is plain that the principal purpose of the sacrament of Anointing of the Sick is a spiritual one: to prepare the soul for death, if death is to eventuate.

However, there is a secondary and conditional effect of Anointing of the Sick: the recovery of bodily health by the sick or injured person. The condition under which this secondary effect can be expected to operate is stated by the Council of Trent: "When it is expedient for the soul's salvation."

In other words, if it will be spiritually good for the sick person to recover, then his recovery can with certainty be expected.

The recovery, however, will not be a sudden miraculous recovery.

God does not multiply marvels unnecessarily. Whenever possible he works through natural causes. In this instance, recovery will be the result of the powers of nature, stimulated by the graces of the sacrament.

By eliminating anxiety, abolishing fear, inspiring confidence in God with resignation to his will, Anointing of the Sick reacts upon the bodily processes for the physical betterment of the patient. It is evident that we have no right to expect this physical result from Anointing of the Sick if the priest is not called until the body is hopelessly ravaged by disease.

But perhaps "hopelessly" is not a good word. Every priest who has had much experience in caring for the sick can recall some remarkable and unexpected recoveries that have followed after Anointing of the Sick.