Death Can Be Joyous

The Sacrament of Extreme Unction.

By the Rev. Francis J. Connell, C.SS.R., S.T.D.
Catholic Truth Society of Oregon No.sa040 (1940)

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[‘Extreme’ means ‘the last’ or the ‘end’. ‘Unction’ means ‘anointing’. So the Sacrament of the Anointing of the Sick has often, throughout its history, especially since the 12th century, been known as Extreme Unction. See Section I, paragraphs 8 and 9, for more information on this matter.]

I. THE SACRAMENT OF THE DEPARTING.

1) ONE of the most touching incidents narrated in Sacred Scripture is that which describes the manner in which our divine Savior rendered assistance to a man on his deathbed. The man was a criminal, the deathbed was a cross, the time was the afternoon of the first Good Friday. On Calvary's heights our blessed Lord was breathing forth His soul in agony. To the right and left of the cross on which He hung were set up two other crosses, bearing two robbers who were making atonement by their lives for their many deeds of injustice and violence. Suddenly the thief on the right, touched with contrition, addressed the dying Redeemer imploringly: "Lord, remember me when You shall come into Your kingdom." And from the compassionate heart of Christ came the answer: "Amen, I say to you, this day you shall be with Me in paradise" (Luke 23: 42-43). Thus did the Son of God grant the grace of a happy death even to a poor outcast from society.

2) It is impossible to believe that He who soothed the last hours of a dying sinner with the assurance of an immediate entrance into the kingdom of heaven would be unmindful of the needs of His faithful followers in the final hours of their earthly pilgrimage. Indeed, when we remember that His plan for the sanctification of mankind included the institution of certain rites capable of conferring divine grace in abundant measure and specially adapted to the more important events and the principal needs of human life — rites which we call sacraments — it seems almost a foregone conclusion that He must have provided for the members of His Church a sacrament for the hour of death. For surely the soul needs abundant comfort and strength when it is about to pass into eternity and appear before the judgment-seat of God.

3) However, the Gospels contain no mention of the establishment of any sacrament of this nature by our Lord. There is, indeed, a passage in the Gospel of St. Mark relating that the apostles at Christ's command went forth on one occasion to preach the necessity of penance "and anointed with oil many that were sick, and healed them" (Mark 6: 13). However, this ceremony can hardly have been a sacrament, since our Savior laid down the law that Baptism must be received before the reception of any other sacrament, and those who were anointed on this occasion do not seem to have been baptized. But it must be remembered that not all the doings and sayings of our Lord are recorded in the Gospels, as St. John tells us (John 21: 25). And so, the fact that the Gospels make no mention of the establishment by our Savior of a special sacrament for the dying is no proof that He did not institute such a sacrament.

4) There is however a passage in the Epistle of St. James which furnishes an argument for the existence of a divinely established means of assisting the members of the Church in time of grave illness. The apostle writes thus: "Is any man sick among you? Let him bring in the 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 shall save the sick man, and the Lord shall raise him up, and if he be in sins, they shall be forgiven him" (James 5: 14-15).

5) A careful study of this text will show that the ceremony described by St. James contains all the requirements of a sacrament. These are three — it must be an external rite, it must be capable of conferring grace, it must have been instituted by Christ. Certainly the apostle is speaking of an external rite, for he expressly details its constituent elements as the anointing of the sick person and prayers recited by the priests — evidently recited aloud, since they are the prayers of several persons acting conjointly. That this ceremony is capable of conferring grace is indicated by the expressions "shall save the sick man," "shall raise him up," which in the original Greek express not merely bodily alleviation but chiefly spiritual helps or supernatural graces. Moreover, St. James asserts that the ceremony will remit sins, if the sick person's conscience is burdened; and the remission of grave sins is effected only by the infusion of grace.

6) The third requirement of a sacrament — that it be instituted by Christ — is not indeed explicitly ascribed by St. James to the ceremony of which he writes. However, there is some indication of this factor in the apostle's injunction that the anointing be given "in the name of the Lord." For, as other passages of the New Testament show (Acts 2: 38; 8: 12), this phrase is frequently used to denote that something is being done at the command and by the authority of Christ. A stronger proof is found in the general principle, acknowledged in the Church from the early centuries, that all ceremonies possessing the inherent power to confer grace have been established by Christ. Accordingly, inasmuch as St. James ascribes such a power to the ceremony of the anointing of the sick, we can conclude that our Lord Himself on some occasion before He left this earth prescribed the administration of this rite to the members of His Church afflicted with grave illness. Very probably He did this in the period between His resurrection and His ascension when, as the Scripture tells us, He appeared often to the Apostles and spoke of the kingdom of God — that is, of matters pertaining to the Christian religion.

7) The sacraments established by Jesus Christ are intended to be used until the end of time. St. James evidently visualized the ceremony of anointing the sick as a permanent rite in the Church; and this is corroborated by statements found in the works of the early Christian writers. Thus, it is related in the life of St. Hypatius, a holy monk who lived about the year 400, that in his early years he took care of the sick in his monastery. "And when there was need for one who was sick to be anointed with holy oil, he informed the abbot, who was a priest, and had the anointing performed by him." St. Innocent I, who was Pope from 402 to 417, after quoting the text of St. James which we have just studied, adds: "Undoubtedly, these words are to be understood of the faithful oppressed by illness who can be anointed with the holy oil of chrism, blessed by a bishop." The English saint, Venerable Bede, writing about 700, said: "The custom of the Church holds that the sick should be anointed with consecrated oil by the priests, and that by the added prayer they should be healed."

8) Various names have been given to this sacrament. It has been known as "the imposition of hands on the sick," "the anointing with blessed oil," "chrism," "the holy unction of God," "the anointing of the sick." The Christians of the Orient generally call it "Prayer-anointing," and sometimes "the function of seven priests," since that number of clergymen administer it in its solemn form in the Oriental rites. The Council of Trent designated it as "the sacrament of the departing." The old English word for "anoint" was "anele." Shakespeare uses it in Hamlet, Act I, Scene 5, where the spirit of Hamlet's father complains that he was slain "unaneled" — that is, without being given the opportunity of receiving the anointing of Extreme Unction.

9) The name applied nowadays most commonly to the sacrament which we are considering — "Extreme Unction" — has been in general use in the Latin Church since the twelfth century. The word "extreme" in this connection means "last," and according to some scholars it has been selected for this sacrament because it confers the last of the several anointings received by a Catholic in the course of his lifetime. He has previously been anointed in Baptism, in Confirmation and — if he is a priest — in Holy Orders. Others however explain the name "Extreme Unction" in connection with the fact that it is administered toward the end of life. This explanation derives considerable probability from the fact that the name arose in the twelfth century, when the unfortunate custom prevailed of calling the priest to administer this sacrament only when it was certain that a sick person was in his last agony. [Since Vatican II, the Church has resumed the general habit of calling it the Anointing of the Sick so as to avoid this sad custom of many Catholics.]

10) The founders of Protestantism in the sixteenth century refused to acknowledge Extreme Unction as a sacrament. Calvin even called it a "hypocritical show," implying that in giving this rite for the welfare of the sick the Church pretends to possess a power which she does not actually possess. Most Protestants of the present day also exclude Extreme Unction from the category of sacraments, although some ministers practice a ceremony of anointing the sick, chiefly to benefit their bodily health. The High Church Anglicans and Episcopalians — Anglo-Catholics, as they call themselves — venerate and administer Extreme Unction as a sacrament; but Catholics cannot regard this administration as valid, inasmuch as Anglican and Episcopal ministers do not possess the priestly power.

11) It must be remembered that there is a large number of Christians in the Orient who, though not Catholics, practice substantially the same form of worship as Catholics and accept most of the doctrines believed by Catholics. They are the descendants of those Orientals who left the Catholic Church in the eleventh century, refusing to recognize the divinely instituted primacy of the Pope; and although they have been separated from Catholic unity for hundreds of years, they have true priests and bishops, because they have continued to administer Holy Orders properly. The largest groups are the so-called Orthodox Churches of Greece and Russia. These Orientals acknowledge the same seven sacraments as the Catholic Church. The sacrament of Extreme Unction is known to the Greeks as "Prayer-anointing" to the Russians as "anointing with oil." The former are prone to confer it not only on the sick but even on those in good health as a preparation for Holy Communion on the more solemn feasts. Among the Russian Orthodox Christians it is given only to the sick.

II. THE LITURGY OF EXTREME UNCTION.

The essential factors of Extreme Unction are the anointing of the sick person with oil and the prayer of the priest. St. James prescribed these elements when he said: "Let them pray over him (the sick person), anointing him with oil in the name of the Lord" (James 5: 14). In the language of Catholic theology the oil is called the remote matter, the anointing or unction the proximate matter, and the prayer of the priest the form.

Although the Epistle of St. James in our English version does not specify the particular kind of oil to be employed, the Church has always interpreted this passage as referring to olive oil. Indeed, the Greek word used in the original text has this specific meaning. In the Latin Church pure olive oil is employed, but the Russians sometimes add a little wine as a reminder of our Lord's parable of the Good Samaritan, who poured oil and wine into the wounds of the unfortunate traveler whom he befriended. (Luke 10: 34).

Before it can serve as matter for Extreme Unction, the oil must be blessed. This requirement is not indeed mentioned by St. James, but it is consistently prescribed in the tradition of the Church from earliest times. Thus, there is extant a book of prayers used by a bishop of the fourth century named Serapion, containing the formula to be employed in the blessing of oil for the sick. The blessing is so important that if unblessed oil were accidentally used, the sacrament would be null and void. In the Latin Church the oil is blessed solemnly on Holy Thursday by each diocesan bishop for the priests of his diocese. [In an emergency the oil can be blessed by the celebrating priest. See the Catechism of the Catholic Church number 1530.] The blessing takes place in the solemn Mass before the Pater Noster (the ‘Our Father’). In the Eastern Churches the oil of the sick is usually blessed by priests, who receive the power to give this blessing from the Pope. A portion of the prayer which the bishop recites in the Latin rite for the blessing of this oil is as follows [Father Connell is using an English translation of the Latin in the rubrics for the Liturgy of Pope Saint Pius V]: "Send forth, we beseech You, O Lord, the Holy Ghost, Your Paraclete, from the heavens into this rich olive oil which You have deigned to produce from a flourishing tree for the refreshment of soul and of body; so that for every one who is anointed with this ointment of heavenly medicine it may be a protection of soul and of body to dispel all pains and infirmities and all spiritual and physical ailment."

While our Lord evidently prescribed the anointing of the sick person's body as the proximate matter of Extreme Unction, He did not determine the precise manner in which this is to be done, but left it to be specified by the legislation of the Church. Accordingly, there has been a great diversity in the course of time, both as to the number of unctions and the portions of the body anointed. In some places it was the custom to anoint the sick person only on the head, while in other regions as many as fifteen anointings were given. Frequently the neck, the shoulders and the breast, in addition to the five senses, were anointed. Even today in the churches of the East a variety of customs prevails in this matter, the number of unctions ranging from four to seven. Some Oriental Catholic priests anoint in the same way as priests of the Latin rite, while others anoint the forehead, the chin, the cheeks, the breast, the hands and the feet (Kilker, Extreme Unction, p. 67).

In the Latin rite at the present day [that is, using the rubrics of Pius V – Vatican II under Pope Paul VI introduced considerable changes in these rubrics] the priest anoints the sick person in six parts of the body — the eyes, the ears, the nostrils, the mouth, the hands and the feet. These particular senses and members are appropriately selected to receive the sacred unction because it is through the use of one or more of these bodily organs that most sins are committed, and hence they stand in special need of spiritual strength. The anointings are made in the form of a cross, the sign of salvation, which comforts the dying Christian with the assurance that he has received through the death of Christ a claim to eternal life. The hands are anointed on the palms, except in the case of a priest, who receives this unction on the back of his hands, because the palms and fingers have been hallowed by contact with the sacrament of our Lord's Body and Blood, so that it seems incongruous to imply that they have been defiled by sin (Kilker, Extreme Unction, p. 370).

The anointing of the feet can be omitted for any reasonable cause. This would be the case if the sick person's feet were swathed in bandages, or if he had been stricken down fully clothed in the street, where it would be difficult to remove his shoes and stockings. Furthermore, the Church has decreed that in case of necessity — which would occur especially if death were imminent or if it is only probable that the person is still alive — the priest may give this sacrament with only one unction. This single anointing is preferably made on the forehead, but it can be given on any part of the body. This bears out the statement made before — that our Lord requires for the administration of Extreme Unction only that the sick person be anointed, and allows the Church to determine the manner and the number of the anointings. It is interesting to note that the priest is permitted, for a very grave reason, to use a brush or other similar instrument to perform the anointing. This could be done if the recipient were afflicted with a serious contagious disease.

The form of the sacrament, or the prayer recited at each unction, in the Latin rite is [again we reference the rubrics of Saint Pius V, as it is useful to know the historical and theological background of our Catholic Sacraments]: "Through this holy anointing and His most benign mercy, may the Lord pardon you whatever transgressions you have committed by sight (or hearing,'smell,' taste and speech,'touch' and `walking') Amen." Before and after the anointings, very beautiful prayers are recited by the priest, if time permits. When, however, the sacrament is conferred with a single anointing, in urgent necessity, the words spoken by the priest are simply: "Through this holy anointing may the Lord pardon you whatever transgressions you have committed. Amen."

As in the methods of anointing, so in the words used for the administration of Extreme Unction there has been much variation in the course of time. Evidently our Lord has prescribed nothing more regarding the form than that it express a petition to God for the welfare of the sick person. Some of the ancient forms were more explicit in asking bodily health than spiritual benefits; however, these latter were mentioned in the prayers immediately preceding the anointing. The form used in the Greek Church is more lengthy than that employed in the Latin rite and asks that the Almighty, through the love He bears to our Savior, may free the recipient from illness of both soul and body. This prayer also invokes the intercession of our Blessed Lady and several of the saints, particularly Saints Cosmas and Damian, who were physicians (Kern, De Extrema Unctione, p. 142).

[The modern form of the Sacrament for the Latin or Roman Rite can be accessed by consulting the Vatican web-site and reading the Apostolic Constitution Sacram Unctionem infirmorum of 1972. The most relevant section reads: “The Sacrament of Anointing of the Sick is given to those who are seriously ill by anointing them on the forehead and hands with duly blessed oil – pressed from olives or from other plants – saying, only once: ‘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’.”]

Extreme Unction is given nowadays as the last of the sacraments for the dying, following Penance and the Holy Eucharist. In the early centuries it was more usual to administer Extreme Unction after Penance and before the Holy Eucharist, the idea being that the dying person would be thus purified more perfectly from the remains of sin and rendered more worthy to receive the benefits of Holy Communion. Even today a priest could anoint a sick person before giving him the Viaticum if there were a good reason for such a change — for example, if he happened to have the holy oil with him but not the Blessed Sacrament, and feared that the dying person might not survive until he had gone to the church for the Holy Eucharist and returned. And of course, after a person has received Extreme Unction he may receive Holy Communion as Viaticum subsequently, even every day, as long as he is in danger of death. [Vatican II has restored the more ancient practice and the Catechism of the Catholic Church (CCC) paragraph 1517 states that it is preferable that ‘the Eucharist should always be the last sacrament of the earthly journey, the “viaticum” for “passing over’ to eternal life.’ The CCC 1499 to 1532 should be consulted as a whole to be enlightened on the whole glory of this Sacrament. We have reproduced this section of the Catechism as an appendix to this Booklet.]

Only a priest can administer Extreme Unction. One might argue that if a lay person is empowered to baptize in case of necessity, and even to administer the Viaticum to a dying Catholic when no priest can be had, he could in the same circumstances give Extreme Unction. But such a conclusion is opposed to the constant tradition and practice of the Church, the authentic interpreter of Christ's doctrines and laws. The Church bases its teaching on the words of St. James: "Let him call in the priests of the Church." The word used in this text for "priests" in the original Greek primarily signifies "elders"; but in the language of the New Testament, especially in conjunction with the words "of the Church" it designates those who have been ordained to the priesthood (e. g., Acts 20: 17 and 28).

In the Oriental Churches several priests join in the administration of Extreme Unction, when they can be obtained — if possible, seven. This was also the custom in the Latin Church in the early ages; and it is more in accordance with the use of the plural ‘priests’ by St. James. Nowadays, however, in the Latin rite only one priest administers this sacrament.

Any priest has the power to confer Extreme Unction validly, even outside his own parish or diocese. However, by the law of the Church each pastor is the ordinary minister of this sacrament within the limits of his own parish; and either he or one of his assistants should be summoned when someone in the parish is in need of the last rites. Of course, when a person is in imminent danger of death, the nearest priest should be called at once.

The Church commands that special reverence be manifested toward the consecrated oil intended for the anointing of the sick. Usually it is kept, together with the other two kinds of blessed oil, chrism and the oil of catechumens, in a small closet, known as an ambry, placed in the sanctuary or the sacristy of the church. These holy oils are preserved in small metal tubes, called oil stocks. Every Holy Week, after the bishop has blessed the new oils in his cathedral, they are apportioned to the several parishes as soon as possible, and from this time on must be used, the oils of the previous year being burned, usually in the sanctuary lamp.

III. THE BLESSINGS OF EXTREME UNCTION.

The benefits conferred by Extreme Unction can be classified under two general headings — those bestowed on the soul and those conferred on the body. The former are the more important, and consist of supernatural graces. Like all the other sacraments, Extreme Unction imparts grace to all who receive it worthily. And like all the other sacraments it gives a twofold grace — sanctifying and sacramental.

All the sacraments are intended to give sanctifying grace to the soul at the very moment they are received. Baptism and Penance are primarily intended to bestow this divine quality on souls that are dead in sin; hence they are called sacraments of the dead. The other five sacraments are primarily intended to give an increase of grace to souls already living the supernatural life of sanctifying grace, and accordingly are known as sacraments of the living. The measure of sanctifying grace which a sacrament confers is proportionate to the fervor with which one prepares for its reception. However, the preparation need not be made immediately before the sacrament is administered. Thus, a good Catholic could prepare himself over a period of years for the reception of Extreme Unction, by praying devoutly every day that he may be privileged to receive this sacrament when his time comes, and that he may derive abundant fruit from its reception. One who disposes his soul in this way will undoubtedly procure rich graces from Extreme Unction, even though he is suddenly stricken unconscious and is unable to make any immediate preparation for this sacrament.

Since Extreme Unction is intended primarily for those already in possession of sanctifying grace, one who would deliberately receive it in mortal sin would be guilty of a grave sacrilege. Sometimes it happens that a careless Catholic is suddenly bereft of his senses and being in danger of death is anointed. If his soul is burdened with mortal sin for which he has not made an act of contrition (at least imperfect) Extreme Unction gives him no grace. However, the reception of the sacrament does not add to his guilt, because he was unable to realize that it was being administered unfruitfully.

A person in mortal sin before receiving Extreme Unction should ordinarily go to confession. For, the law of God commands that one guilty of grievous sin shall receive the Sacrament of Penance before his death; moreover, Holy Communion is normally received at the same time that one is anointed, and the worthy reception of the Holy Eucharist in the case we are considering requires previous sacramental confession. However, strictly speaking, one in mortal sin can dispose himself for a worthy reception of Extreme Unction — if for some reason he is not receiving also the Holy Eucharist — merely by an act of perfect contrition. However, he must be able to foresee with great probability that he will have an opportunity of going to confession before death, and must intend to make use of that opportunity.

There are even occasions when a person in mortal sin can obtain the pardon of his sins and acquire the state of grace from Extreme Unction. In other words, this sacrament, though meant primarily as a sacrament of the living, can at times perform the functions of a sacrament of the dead. Theologians come to this conclusion from the words of St. James: "If he be in sins, they shall be forgiven him" (James 5: 15).

It is necessary that the person in question receive Extreme Unction with good faith and attrition. This means: first that he is not aware that he is indisposed for the proper reception of this sacrament; which would be the case especially when he is unconscious. Secondly, he must be sorry for his sins because by them he deserves God's punishments or because they are so heinous in the light of Christian principles or because of some other motive derived from faith but not including love of God.*

*(Footnote:) If a person were sorry for his sins because they are opposed to the love that is due to God, he would be making an act of perfect contrition and would be in the state of grace before receiving the sacrament. We are considering the case of one who receives the state of grace from the reception of Extreme Unction.

(Let me repeat:) Secondly, he must be sorry for his sins because by them he deserves God's punishments or because they are so heinous in the light of Christian principles or because of some other motive derived from faith but not including love of God. This kind of contrition — -imperfect contrition, or attrition, as it is called — does not suffice of itself to restore one to the state of grace, but when it is supplemented with the efficacy of Extreme Unction the soul of the sinner is purified and enriched with the divine life of sanctifying grace. We can readily understand how one who has the faith, even though he may have been guilty of many sins, would instinctively repent of his sins, at least out of fear of God's justice, if he were suddenly stricken and had even a moment of consciousness; and doubtless, there are many poor sinners who are saved in this manner by Extreme Unction. As is evident, grave sins forgiven by this sacrament must subsequently be confessed, if this is possible.

The sacramental grace given by a sacrament is a special mode of supernatural help annexed to the sanctifying grace, enabling the recipient to attain the purpose of the particular sacrament. Thus, the sacramental grace of Holy Orders helps the priest to fulfill the duties of his sacred ministry, the sacramental grace of Matrimony helps the married couple to be faithful to the grave obligations of the marital state. Theologians are not fully in agreement as to what constitutes the special sacramental grace of Extreme Unction, because this sacrament produces a number of beneficial effects and it is not easy to determine which is the predominating grace. Accordingly, some have regarded as the chief sacramental grace of this sacrament the remission of venial sins, others have viewed it as the removal of the remains of sin, etc.

A very probable and consoling view that has gained the approval of many theologians in recent years proposes as the main purpose of Extreme Unction the preparation of the soul for immediate entrance into heaven. These theologians believe that our Lord established this sacrament to enable the faithful to pass directly from the present life to everlasting happiness without being obliged to remain even for a moment in purgatory. It might be objected to this doctrine that if the purpose of Extreme Unction is to render the soul worthy of heaven immediately after death, it is unnecessary to pray for those of our departed relatives and friends who were anointed before they passed away. To this we reply: first, the view we have expounded is by no means certain, but is only probable; hence, we are not sure that even those who have received Extreme Unction with the most fervent dispositions are now in heaven. Second, even if this opinion is true, we cannot be sure that any particular individual had the requisite dispositions when he was anointed. Accordingly, while we can ardently hope that our Lord has actually endowed this sacrament with the power to prepare for immediate entrance into heaven the souls of those who receive it with the proper sentiments of faith, humility, and especially with contrition for all their sins, we should continue to pray for the faithful departed.

In the supposition that this view is correct, one of the effects of Extreme Unction — indeed, its chief sacramental grace, it would seem — is the remission of all the temporal punishment that burdens the soul of the recipient and constitutes an obstacle to his immediate admission into heaven. However, abstracting from this mooted question, it is certain that among the sacramental graces of Extreme Unction is to be reckoned the strengthening of the soul of the sick person, so that he is able to endure the sufferings of his last hours with courage and serenity. Doctors and nurses who have had extensive experience with Catholic patients, even though they themselves may be non-Catholics, admit unhesitatingly that dying persons are rendered calm and cheerful by the reception of this sacrament. Another sacramental grace of Extreme Unction is certainly the removal of some of the remains of sin, such as the weakness of will and the excessive affection for the present life, which cling tenaciously to the soul even after it has been purified of its sins.

That Extreme Unction is intended to contribute toward the recipient's bodily as well as spiritual health has been the constant belief of the Catholic Church. However, two important points must be noted. First, this effect is dependent on the spiritual objectives of the sacrament. As both the Council of Florence and the Council of Trent assert (Denzinger's Enchiridion, numbers. 700, and 909), Extreme Unction is profitable to bodily health "when this is expedient to health of soul." [Hereafter DS shall stand for Denzinger’s Enchiridion.] In His infinite wisdom God knows that sometimes the very restoration to health would constitute for the sick person a grave occasion of sin, and in such a case the Almighty would certainly not endow a sacrament with power to promote the recipient's spiritual harm. It is infinitely preferable to die in the state of grace than to be restored to health and live a few years longer, but at the same time to fall into grievous sin and to die unforgiven.

Secondly, the manner in which Extreme Unction normally produces bodily benefits is through its beneficial effects in the soul. When a sick person's soul is comforted and strengthened, it is quite natural that his bodily condition should improve and that he should have better prospects of recovery. Hence, by giving fortitude and joy to the souls of the sick, Extreme Unction exerts indirectly a salutary effect on their bodies. Of course, there are times when God directly and almost miraculously restores bodily health to one who has been anointed, but this is to be ascribed to His fatherly tenderness rather than to the normal efficacy of Extreme Unction.

A practical conclusion from this doctrine is that a Catholic should be anointed as soon as it is even probable that he is in danger of death from sickness or accident or old age, so that an opportunity may be given the sacrament to confer its physical benefits. For if the administration of the sacred rite is deferred until the patient is at the point of death, his bodily forces will be so weakened that a favorable reaction to the spiritual effects of the sacrament cannot reasonably be expected.

IV. WHO SHOULD BE ANOINTED?

Only a baptized person is capable of receiving Extreme Unction. For it is a law laid down by Christ Himself that a person must be spiritually reborn by Baptism before any other sacrament can be administered to him. If through mistake a priest would anoint an unbaptized person — as might happen after a disastrous battle when many soldiers are dying — the sacrament (as sacrament) would be null and void (though certain ‘accidental’ spiritual benefits may accrue to the recipient).

To receive Extreme Unction it is also necessary that a person have come to the use of reason. He need not possess the power of intelligence at the actual time when the sacrament is given. He may be unconscious or insane; but he must at one time have been capable of at least that measure of intellectual activity that a child can exercise when it is about seven years of age. Accordingly, very young children and those unfortunates who are equivalent to little children by reason of their stunted intellectual growth cannot be anointed. This requirement of the age of reason is implied in the text of St. James, inasmuch as he prescribes that the sick person himself shall call for the priests — something that can be done only by one who has come to the use of intelligence. The best argument, however, is the immemorial practice of the Church, the authoritative interpreter of Christ's law. Ecclesiastical legislation always prescribed that the recipient of this sacrament be one who had reached the years of discretion. Indeed, in the Middle Ages and even down to the sixteenth century it was the custom in some sections of Europe to anoint no one below the age of fourteen or even eighteen years. Nowadays the law of the Church demands only probability that a child has reached the use of reason in order that he may be permitted to receive Extreme Unction. At times even a child of five endowed with exceptional mental ability could be anointed, at least conditionally, if it were in danger of death; and in such circumstances the parents of the child should not hesitate to summon the priest.

The recipient must have the intention of receiving Extreme Unction, since this is a general requisite for the reception of any sacrament by one who has acquired the use of reason. As St. Augustine puts it: "He that made you without your consent does not sanctify you without your consent." However, it is not necessary to have an explicit intention, made at the actual time when the sacrament is administered. A general intention made at some previous time carries over sufficiently into the reception of the last rites. Thus, when a person lives as a Catholic he naturally intends to die as a Catholic, and in this is contained the purpose of receiving the sacraments of the dying when they are needed. And even though one may be neglectful in the fulfillment of his Catholic duties, he presumably wishes to be reconciled to God before death, and a priest would anoint such a person if he were dying unconscious. Indeed, it is an illustration of the loving mercy of the Catholic Church toward even her unfaithful children that a Catholic bereft of consciousness in the very act of sin and in danger of death can be anointed. For, despite his transgressions he would in all likelihood desire the sacraments if he knew that death were at hand, and it may well be that in his last conscious moment he made an act of contrition for his sins. But, as is very evident, one who deliberately and explicitly refuses to receive Extreme Unction cannot be anointed.

To receive Extreme Unction a person must be in danger of death from some cause that is actually affecting his bodily condition. This may consist in a serious ailment, or in a wound, or in that advanced old age which brings such grave debility that death is liable to occur suddenly at any time. The passage of St. James referring to this sacrament does not specify that the illness must be such as to render death likely; although the fact that the sick man cannot leave the house but must have the priests visit him indicates more than a slight ailment. But the tradition of the Catholic Church from the beginning has commonly regarded the sacramental anointing of the sick as intended only for persons in danger of death. As was stated previously, the Greek Churches separated from the Catholic Church have the custom of anointing not only those who are slightly ill but sometimes even those in perfect health. However, their own ancient writings show that this was not the usual practice in the Orient in the early centuries when the Eastern Christians were members of the Catholic Church.

It is important to note that the danger of death must arise from some cause actually affecting the body. The mere fact that one is in danger of death, even though it be certain, does not of itself justify the administration of Extreme Unction. Thus, a criminal about to be executed cannot be anointed, although he can receive Holy Communion as Viaticum, without fasting. The reason is that Extreme Unction is intended precisely to alleviate persons suffering from the mental and bodily weakness that normally follows from serious illness; and hence, if one is not actually afflicted with some form of grave ailment he is not capable of receiving this sacrament, even though he is about to die from some extraneous cause.

It is now a recognized medical principle that real death may not take place until several hours after apparent death. In other words, all signs of life may have ceased, yet the soul may still be in the body. The Catholic Church allows priests to act on this principle, by administering Extreme Unction to one who has been suddenly stricken down and has apparently been dead for three or four hours. Hence, when a Catholic has been the victim of an accident or a stroke and is seemingly lifeless a priest should be called as soon as possible, so that he may anoint the unfortunate person conditionally — that is, with the intention of giving the sacrament only on condition that life still remains.

It must always be remembered that a person can be anointed even if the danger of death is only probable. It is most regrettable that some Catholics, otherwise devout and faithful to their religious duties, hesitate to summon a priest when a member of the family is seriously ill, and because of this it not infrequently happens that a Catholic dies without the sacraments. Those who act thus protest that if the priest appears at the sickbed the patient will become disheartened and more liable to die. But this argument is utterly unsound, for in the first place, experience shows that the sick are usually quite happy to see the priest and to receive the sacraments, and that instead of inducing discouragement, Extreme Unction imparts a feeling of serenity and cheerfulness that is most helpful toward the sick person's bodily condition. Secondly, even if his death were somewhat accelerated by his being informed of his dangerous state, is it not better that this should happen than that he should die without the sacraments, and thus be obliged to suffer much longer in purgatory or even to be condemned to the everlasting torments of hell? The relatives of a dying Catholic who refrain from calling a priest under the pretext of kindness to their dear one, are in reality guilty of cruel and un-Christian conduct.

Can one who is baptized on his deathbed receive Extreme Unction immediately afterward? It might seem that he does not need this sacrament, since his sins and all the punishment due to them have been remitted by Baptism and there is nothing to hinder his immediate admission to heaven. However, the Church has decreed that such a person can and should be anointed. For he can obtain an increase of grace, courage and strength, and his soul can receive its final adornment to fit it for the kingdom of Christ. Similarly, we can argue that our Blessed Lady received Extreme Unction before her death. She had indeed no sins nor remains of sin nor proclivity to sin; yet as long as she lived she could receive more grace, and so we can reasonably suppose that when the hour of her departure drew nigh, the beloved disciple of St. John anointed her virginal body so that her pure soul might receive its final perfection of grace before entering into the eternal joys of paradise.

Extreme Unction can be received only once in the same dangerous illness. Even though it has been received unworthily, it cannot be repeated; however, in such a case the recipient can subsequently obtain its beneficial effects by recovering the state of grace. Of course, if a person has regained his health after receiving this sacrament, and later in life falls into another dangerous illness, he can and should be anointed again. In fact, one suffering from a chronic ailment who survives for a considerable time after receiving this sacrament-three or four months, for example-can be anointed again on the presumption that there must have been some fluctuation in the condition of his health during the interval, so that his present state can be regarded as a new illness. Some theologians think that the repetition of Extreme Unction in the same sickness, though unlawful because of the prohibition of the Church, would be a valid sacramental rite; but the majority believe that it would be null and void. [The CCC has clarified this in paragraph 1529 by stating: ‘Each time a Christian falls seriously ill, he may receive the Anointing of the Sick, and when, after he has received it, the illness worsens’. Also one should read paragraph 1515.]

Is a dying Catholic obliged to receive Extreme Unction? This sacrament is not indeed necessary in the same manner as are Baptism and Penance, which are of obligation as means to salvation — the former for all human beings, the latter for those who have sinned mortally after Baptism. Nor are theologians agreed as to whether there is a law of Christ or of the Church making the reception of Extreme Unction necessary by reason of grave precept. However, no practical Catholic would refuse to be anointed when he is told that he should prepare for the last rites. On the contrary, all Catholics should make it one of the objects of their prayers — especially of their petitions to St. Joseph, the patron of a happy death — that they may have the happiness to receive the sacred unction of this sublime sacrament when they are entering into the valley of the shadow of death. For through the fervent reception of Extreme Unction not only are the terrors of death removed and the pains of the last hour soothed, but the passing into eternity is rendered positively joyous. For this grace let us often pray in the words of the indulgenced ejaculations:

Jesus, Mary, Joseph, I give you my heart and my soul.

Jesus, Mary, Joseph, assist me in my last agony.

Jesus, Mary, Joseph, may I breathe forth my soul in peace with you.

APPENDIX – From THE CATECHISM OF THE CATHOLIC CHURCH.

THE ANOINTING OF THE SICK.

"By the sacred anointing of the sick and the prayer of the priests the whole Church commends those who are ill to the suffering and glorified Lord, that he may raise them up and save them. And indeed she exhorts them to contribute to the good of the People of God by freely uniting themselves to the Passion and death of Christ." [Footnote: 98 Lumen Gentium 11; cf. James 5:14-16; Rom 8:17; Col 1:24; 2 Tim 2:11-12; 1 Pet 4:13.]

I. ITS FOUNDATIONS IN THE ECONOMY OF SALVATION.

Illness in human life.

Illness and suffering have always been among the gravest problems confronted in human life. In illness, man experiences his powerlessness, his limitations, and his finitude. Every illness can make us glimpse death.
Illness can lead to anguish, self-absorption, sometimes even despair and revolt against God. It can also make a person more mature, helping him discern in his life what is not essential so that he can turn toward that which is. Very often illness provokes a search for God and a return to him.

The sick person before God.

The man of the Old Testament lives his sickness in the presence of God. It is before God that he laments his illness, and it is of God, Master of life and death, that he implores healing. [Footnote: Cf. Psalm 6:3; 38; Isa 38.] Illness becomes a way to conversion; God's forgiveness initiates the healing. [Footnote: Cf. Psalms 32:5; 38:5; 39:9, 12; 107:20; cf. Mk 2:5-12.] It is the experience of Israel that illness is mysteriously linked to sin and evil, and that faithfulness to God according to his law restores life: "For I am the Lord, your healer." [Footnote: Exodus 15:26.] The prophet intuits that suffering can also have a redemptive meaning for the sins of others. [Footnote: Cf. Isa 53:11.] Finally Isaiah announces that God will usher in a time for Zion when he will pardon every offense and heal every illness. [Footnote: Cf. Isa 33:24.]

Christ the physician.

Christ's compassion toward the sick and his many healings of every kind of infirmity are a resplendent sign that "God has visited his people" [Footnote: Luke 7:16; cf. Mt 4:24.] and that the Kingdom of God is close at hand. Jesus has the power not only to heal, but also to forgive sins; [Footnote: Cf. Mk 2:5-12.] he has come to heal the whole man, soul and body; he is the physician the sick have need of. [Footnote: Cf. Mark 2:17.] His compassion toward all who suffer goes so far that he identifies himself with them: "I was sick and you visited me." [Footnote: Mt 25:36.] His preferential love for the sick has not ceased through the centuries to draw the very special attention of Christians toward all those who suffer in body and soul. It is the source of tireless efforts to comfort them.
Often Jesus asks the sick to believe. [Footnote: Cf. Mk 5:34, 36; 9:23.] He makes use of signs to heal: spittle and the laying on of hands, [Footnote: Cf. Mk 7:32-36; 8:22-25.] mud and washing. [Footnote: Cf. John 9:6-7.] The sick try to touch him, "for power came forth from him and healed them all." [Footnote: Luke 6:19; cf. Mark 1:41; 3:10; 6:56.] And so in the sacraments Christ continues to "touch" us in order to heal us.
Moved by so much suffering Christ not only allows himself to be touched by the sick, but he makes their miseries his own: "He took our infirmities and bore our diseases." [Footnote: Mt 8:17; cf. Isa 53:4.] But he did not heal all the sick. His healings were signs of the coming of the Kingdom of God. They announced a more radical healing: the victory over sin and death through his Passover. On the cross Christ took upon himself the whole weight of evil and took away the "sin of the world," [Footnote: John 1:29; cf. Isa 53:4-6.] of which illness is only a consequence. By his passion and death on the cross Christ has given a new meaning to suffering: it can henceforth configure us to him and unite us with his redemptive Passion.

"Heal the sick..."

Christ invites his disciples to follow him by taking up their cross in their turn. [Footnote: Cf. Matthew 10:38.] By following him they acquire a new outlook on illness and the sick. Jesus associates them with his own life of poverty and service. He makes them share in his ministry of compassion and healing: "So they went out and preached that men should repent. And they cast out many demons, and anointed with oil many that were sick and healed them." [Footnote: Mk 6:12-13.]
The risen Lord renews this mission ("In my name... they will lay their hands on the sick, and they will recover.") [Footnote: Mk 16:17-18.] and confirms it through the signs that the Church performs by invoking his name. [Footnote: Cf. Acts 9:34; 14:3.] These signs demonstrate in a special way that Jesus is truly "God who saves." [Footnote: Cf. Matthew 1:21; Acts 4:12.]
The Holy Spirit gives to some a special charism of healing [Footnote: Cf. 1 Cor 12:9, 28, 30.] so as to make manifest the power of the grace of the risen Lord. But even the most intense prayers do not always obtain the healing of all illnesses. Thus St. Paul must learn from the Lord that "my grace is sufficient for you, for my power is made perfect in weakness," and that the sufferings to be endured can mean that "in my flesh I complete what is lacking in Christ's afflictions for the sake of his Body, that is, the Church." [Footnote: 2 Cor 12:9; Col 1:24.]
"Heal the sick!" [Footnote: Mt 10:8.] The Church has received this charge from the Lord and strives to carry it out by taking care of the sick as well as by accompanying them with her prayer of intercession. She believes in the life-giving presence of Christ, the physician of souls and bodies. This presence is particularly active through the sacraments, and in an altogether special way through the Eucharist, the bread that gives eternal life and that St. Paul suggests is connected with bodily health. [Footnote: Cf. John 6:54, 58; 1 Cor 11:30.]
However, the apostolic Church has its own rite for the sick, attested to by St. James: "Is any among you sick? Let him call for the elders [presbyters] 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 has committed sins, he will be forgiven." [Footnote: James 5:14-15.] Tradition has recognized in this rite one of the seven sacraments. [Footnote: Cf. Council of Constantinople II (553) DS 216; Council of Florence (1439) 1324- 1325; Council of Trent (1551) 1695-1696; 1716-1717.]

A sacrament of the sick.

The Church believes and confesses that among the seven sacraments there is one especially intended to strengthen those who are being tried by illness, the Anointing of the Sick:

This sacred anointing of the sick was instituted by Christ our Lord as a true and proper sacrament of the New Testament. It is alluded to indeed by Mark, but is recommended to the faithful and promulgated by James the apostle and brother of the Lord. [Footnote: Council of Trent (1551): DS 1695; cf. Mk 6:13; Jas 5:14-15.]

From ancient times in the liturgical traditions of both East and West, we have testimonies to the practice of anointings of the sick with blessed oil. Over the centuries the Anointing of the Sick was conferred more and more exclusively on those at the point of death. Because of this it received the name "Extreme Unction." Notwithstanding this evolution the liturgy has never failed to beg the Lord that the sick person may recover his health if it would be conducive to his salvation. [Footnote: Cf. Council of Trent (1551): DS 1696.]
The Apostolic Constitution Sacram unctionem infirmorum, [Footnote: Paul VI, apostolic constitution, Sacram unctionem infirmorum, November 30, 1972.] following upon the Second Vatican Council, [Footnote: Cf. SC 73.]established that henceforth, in the Roman Rite, the following be observed:

The sacrament of Anointing of the Sick is given to those who are seriously ill by anointing them on the forehead and hands with duly blessed oil - pressed from olives or from other plants - saying, only once: "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." [Footnote: Cf. CIC, Can. 847 § 1.] [From the Code of Canon Law.]

II. WHO RECEIVES AND WHO ADMINISTERS THIS SACRAMENT?

In case of grave illness...

The Anointing of the Sick "is not a sacrament for those only who are at the point of death. Hence, as soon as anyone of the faithful begins to be in danger of death from sickness or old age, the fitting time for him to receive this sacrament has certainly already arrived." [Footnote: 130 SC 73 (Vatican II); cf. CIC, Cann. 1004 § 1; 1005; 1007; CCEO, Can. 738. (Canon Law of the Oriental Rites.)]
If a sick person who received this anointing recovers his health, he can in the case of another grave illness receive this sacrament again. If during the same illness the person's condition becomes more serious, the sacrament may be repeated. It is fitting to receive the Anointing of the Sick just prior to a serious operation. The same holds for the elderly whose frailty becomes more pronounced.

"... let him call for the presbyters of the Church."

Only priests (bishops and presbyters) are ministers of the Anointing of the Sick. [Footnote: Cf. Council of Trent (1551): DS 1697; 1719; CIC, Can. 1003; CCEO, Can. 739 § 1.] It is the duty of pastors to instruct the faithful on the benefits of this sacrament. The faithful should encourage the sick to call for a priest to receive this sacrament. The sick should prepare themselves to receive it with good dispositions, assisted by their pastor and the whole ecclesial community, which is invited to surround the sick in a special way through their prayers and fraternal attention.

III. HOW IS THIS SACRAMENT CELEBRATED?

Like all the sacraments the Anointing of the Sick is a liturgical and communal celebration, [Footnote: Cf. SC 27.] whether it takes place in the family home, a hospital or church, for a single sick person or a whole group of sick persons. It is very fitting to celebrate it within the Eucharist, the memorial of the Lord's Passover. If circumstances suggest it, the celebration of the sacrament can be preceded by the sacrament of Penance and followed by the sacrament of the Eucharist. As the sacrament of Christ's Passover the Eucharist should always be the last sacrament of the earthly journey, the "viaticum" for "passing over" to eternal life.
Word and sacrament form an indivisible whole. The Liturgy of the Word, preceded by an act of repentance, opens the celebration. The words of Christ, the witness of the apostles, awaken the faith of the sick person and of the community to ask the Lord for the strength of his Spirit.
The celebration of the sacrament includes the following principal elements: the "priests of the Church" [Footnote: James 5:14.] - in silence - lay hands on the sick; they pray over them in the faith of the Church [Footnote: Cf. James 5:15.] - this is the epiclesis proper to this sacrament; they then anoint them with oil blessed, if possible, by the bishop.

These liturgical actions indicate what grace this sacrament confers upon the sick.

IV. THE EFFECTS OF THE CELEBRATION OF THIS SACRAMENT.

A particular gift of the Holy Spirit. The first grace of this sacrament is one of strengthening, peace and courage to overcome the difficulties that go with the condition of serious illness or the frailty of old age. This grace is a gift of the Holy Spirit, who renews trust and faith in God and strengthens against the temptations of the evil one, the temptation to discouragement and anguish in the face of death. [Footnote: Cf. Hebrews 2:15.] This assistance from the Lord by the power of his Spirit is meant to lead the sick person to healing of the soul, but also of the body if such is God's will. [Footnote: Cf. Council of Florence (1439): DS 1325.] Furthermore, "if he has committed sins, he will be forgiven." [Footnote: Jas 515; cf. Council of Trent (1551): DS 1717.]
Union with the passion of Christ. By the grace of this sacrament the sick person receives the strength and the gift of uniting himself more closely to Christ's Passion: in a certain way he is consecrated to bear fruit by configuration to the Savior's redemptive Passion. Suffering, a consequence of original sin, acquires a new meaning; it becomes a participation in the saving work of Jesus.
An ecclesial grace. The sick who receive this sacrament, "by freely uniting themselves to the passion and death of Christ," "contribute to the good of the People of God." [Footnote: Lumen Gentium 11 § 2.] By celebrating this sacrament the Church, in the communion of saints, intercedes for the benefit of the sick person, and he, for his part, through the grace of this sacrament, contributes to the sanctification of the Church and to the good of all men for whom the Church suffers and offers herself through Christ to God the Father.
A preparation for the final journey. If the sacrament of anointing of the sick is given to all who suffer from serious illness and infirmity, even more rightly is it given to those at the point of departing this life; so it is also called sacramentum exeuntium (the sacrament of those departing). [Footnote: Council of Trent (1551): DS 1698.] The Anointing of the Sick completes our conformity to the death and Resurrection of Christ, just as Baptism began it. It completes the holy anointings that mark the whole Christian life: that of Baptism which sealed the new life in us, and that of Confirmation which strengthened us for the combat of this life. This last anointing fortifies the end of our earthly life like a solid rampart for the final struggles before entering the Father's house. [Footnote: Council of Trent (1551): DS 1694.]

V. VIATICUM, THE LAST SACRAMENT OF THE CHRISTIAN.

In addition to the Anointing of the Sick, the Church offers those who are about to leave this life the Eucharist as viaticum. Communion in the body and blood of Christ, received at this moment of "passing over" to the Father, has a particular significance and importance. It is the seed of eternal life and the power of resurrection, according to the words of the Lord: "He who eats my flesh and drinks my blood has eternal life, and I will raise him up at the last day." [Footnote: John 6:54.] The sacrament of Christ once dead and now risen, the Eucharist is here the sacrament of passing over from death to life, from this world to the Father. [Footnote: Cf. John 13:1.]
Thus, just as the sacraments of Baptism, Confirmation, and the Eucharist form a unity called "the sacraments of Christian initiation," so too it can be said that Penance, the Anointing of the Sick and the Eucharist as viaticum constitute at the end of Christian life "the sacraments that prepare for our heavenly homeland" or the sacraments that complete the earthly pilgrimage.

IN BRIEF.

"Is any among you sick? Let him call for the presbyters 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 has committed sins, he will be forgiven" (James 5:14-15).
The sacrament of Anointing of the Sick has as its purpose the conferral of a special grace on the Christian experiencing the difficulties inherent in the condition of grave illness or old age.
The proper time for receiving this holy anointing has certainly arrived when the believer begins to be in danger of death because of illness or old age.
Each time a Christian falls seriously ill, he may receive the Anointing of the Sick, and also when, after he has received it, the illness worsens.
Only priests (presbyters and bishops) can give the sacrament of the Anointing of the Sick, using oil blessed by the bishop, or if necessary by the celebrating presbyter himself.
The celebration of the Anointing of the Sick consists essentially in the anointing of the forehead and hands of the sick person (in the Roman Rite) or of other parts of the body (in the Eastern rite), the anointing being accompanied by the liturgical prayer of the celebrant asking for the special grace of this sacrament.
The special grace of the sacrament of the Anointing of the Sick has as its effects:
the uniting of the sick person to the passion of Christ, for his own good and that of the whole Church;
the strengthening, peace, and courage to endure in a Christian manner the sufferings of illness or old age;
the forgiveness of sins, if the sick person was not able to obtain it through the sacrament of Penance;
the restoration of health, if it is conducive to the salvation of his soul;
the preparation for passing over to eternal life.

{For the grace of receiving this Sacrament, let us often pray in the words of the indulgenced ejaculations:

Jesus, Mary, Joseph, I give you my heart and my soul.

Jesus, Mary, Joseph, assist me in my last agony.

Jesus, Mary, Joseph, may I breathe forth my soul in peace with you.

Amen,}