ASK FATHER: Anointing in the Time of Ebola

From a reader…

QUAERITUR:

I´m writing from Spain where sadly, a nurse is extremely ill with Ebola virus. She was infected while treating a Spanish missionary who was brought back from Africa to get treated.

My question is this: imagine she asks for the sacrament of extreme unction. [Anointing of the Sick, at the end of life, is “Extreme Unction”.] Is there a protocol or any instructions as how to proceed? Can she be refused by a priest? Can she be refused by the Government?

Right now it seems like an absurd question, but since you always say to prepare for TEOTWAWKI and we don’t know how or when it will come, it doesn’t seem like such a far off question…

And we had therefore better immediately stop the Sign of Peace!   It’s far more likely to spread disease.

It is rare that one canon of the Code of Canon Law answers a question, but here we have not just one canon, but one paragraph of one canon: can. 1000 § 2:

“The minister is to anoint with his own hand, unless a grave reason indicates the use of an instrument”.

The danger of infection with Ebola provide a grave reason.

The anointing can be done with an instrument, such as a long-stemmed swab, or even, if the patient is quarantined, with those isolation glove box things.  I once anointed someone in an ER by reaching in with sponge forceps.

The related question is going to be: Can a bishop forbid Communion administered on the tongue during a pandemic?  We ran into this with the H1N1 scare.

I suppose a bishop can do so.

It would be petty, small, and nasty were a bishop to use the crisis of an infectious disease to push his personal ideological liturgical agenda.

I don’t buy that Communion on the tongue spreads diseases more than Communion in the hand.  In general.  Ebola virus is contagious, but not highly so. But it is really really horrible.

However, one of the ways that the Ebola virus is spread is through body fluids: including saliva.  Yes, it is possible to transfer saliva, but rare if the priest knows what he is doing and people present themselves properly for administration of the host.

People: Please!  When you want to receive Communion on the tongue, lift your chin a bit and stick your tongue out! Not just the tip of the tongue with your chin tucked against your chest.  Okay?  Okay?

Now that we have that out of the way, have any of you read Tom Clancy’s Executive Orders?

NUTSHELL: Iranians manage to weaponize Ebola and seek to release it in these USA.

A ripping good yarn and surely pure fiction.  Pure fiction.  I mean, no problems with Islamic fanatics these days.

All in all, I’d rather have a Pres. Ryan, if you get me.

But… what could go wrong?

And… pray for these poor people, those coming here and those in Africa.  Ask the Archangel Michael to contain and avert this horrible plague.

Historically, in times of plague, Holy Church has held public processions.  We should do so again.

UPDATE:

I just received a note:

Hi. My heart is heavy. Our Bishop on Las Vegas is instructing the Priest’s at our Parishes to ONLY distribute Holy Communion in the hand, due to Ebola.
I know that the Church Documents, Cannon Law and even the GIRM, is clear and allows the Faithful to choose how to receive Our Lord themself. Our right is being taken away.
My Mother who is 88 was forced to receive our Lord today in her hands. The first time ever.
What is the best course of action?
I have emailed our Diocesan office, no reply yet.

If this is being done for ideological reasons, you might drop a line to the Congregation for Divine Worship.  However, I am not sure there is much recourse, other than besieging the man with prayers.

But hey! Who am I to judge? Maybe with so many people travelling in and out of Las Vegas, and going to various… places, there may be an outbreak there soon.

Also, no one is forced to receive Communion.

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46 Responses to ASK FATHER: Anointing in the Time of Ebola

  1. Dr. Edward Peters says:

    “It is rare that one canon of the Code of Canon Law answers a question…”
    Luvit.

  2. The Masked Chicken says:

    There is a podcast called, This Week in Microbiology, (no, seriously) and they have done specials on Ebola. There are 4 different types. The one with the highest kill rate, Ebola Zaire, has a kill rate of 90%. The current strain has a kill rate of 70%. It is not air-borne, but it is droplet-borne, which means that any watery substance large enough to see in a shaft of light contains enough viral concentration to infect someone. Ebola does not survive in dry conditions and is UV sensitive. Those who survive carry anti-bodies, so, eventually, blood transfusions will become a common method of treatment and the kill rate will, eventually, fall off after reaching a plateau, even in the worst case-scenario.

    As for anointing someone, it depends on the state of the disease. If someone is near death, a priest has no business being in the same room without a level-4 bio-containment suit. Even a cotton swab is a lethal weapon after it touches the individual, so, the priest will have to be trained in disposal techniques. He will also have to go through decontamination protocols after being in the room and taking off a level-4 suit is an art, in itself.

    This is not like the flu, by any means. Indeed, if current theory is correct and one is not contagious until symptoms occur, unlike some illness, then, in theory, one simply ought not approach the Communion rail if one has a fever. Otherwise, in a perfect world, there would be no reason to restrict Communion in the tongue if people could adhere to this restriction. Of course, people don’t often have a lot of knowledge or restrain, so eventually, someone who is infected would approach the rail. Receiving in the hand really doesn’t solve the problem, as sweat is considered a possible (but unproven) transmission method with Ebola, once one is displaying symptoms, so, technically, receiving in the hand does not solve the problem.

    The best way to solve this problem is simply to not dispense Communion at all. See, this kills two birds with one stone: not only is the disease not spread, but the divorced and re-married don’t have to worry about receiving Communion.

    As for Extreme Unction, would a remote-controlled robot be considered an instrument? Also, could a priest confect the Eucharist wearing a level-4 bio-containment suit? I know, it is possible to get really silly in all of this mess, but I’ll bet you, if they had had level-4 suits during the plague era, the canons might be a bit different, today :) Of course, if they had had bio-suits back in the Middle Ages, I suspect they would have had rat poison, as well.

    The Chicken

  3. acardnal says:

    You could always wear a hazmat suit when giving communion ….be a “bubble priest.”

    The flu kills thousands more every year …even daily than Ebola.

  4. John Grammaticus says:

    Yup read executive orders over a decade ago……….. oh for Irish Americans like John Patrick Ryan, especially since your current president has spent so much time on the golf course that one wonders if he’s considering going pro when he leaves the white house.

  5. The Masked Chicken says:

    “The flu kills thousands more every year …even daily than Ebola.”

    Well, the nice thing about Ebola, unlike the flu, is that it is not air-borne (cross your fingers that it does not mutate and become air-borne – otherwise, it would be the Fourth Horseman of the Apocalypse) and it does not infect until symptomatic (the flu can infect a day before symptoms appear). This means that, in a crowded Church, there would be radial infection around infected/symptomatic individuals and given the long incubation period, these small circles would, within the space of two weeks coalesce due to echo-infection until virtually the entire congregation were unknowingly infected.

    Ebola is a disease of the crowd. The churches that would survive would be the ones with the smallest attendance. So, another silver lining: the TLM parishes would be the ones that are most likely to survive.

    Man, I’m in a rare mood, today.

    The Chicken

  6. Mary Jane says:

    Thank you Fr Z for posting and answering this question. I was thinking about Extreme Unction in the case of ebola patients myself and wondering, “What would Fr Z say about this…”. Ebola is very frightening…I’ve been having a lot of nightmares about it.

  7. majuscule says:

    I’m discerning whether (if it comes to pass that priests are not allowed to give communion on the tongue) whether to just stay in the pew and make a spiritual communion for the duration.

  8. The Masked Chicken says:

    Ooppps…flag on the play…

    There would be radial infection, but not echo-infection unless everyone originally infected showed up at church after they were symptomatic. Given a bleed-though of infected people greater than zero percent (some infected people show up), there would be some echo-infection, but not widespread, so this would not become ergodic.

    Danger, theorist at work. Proceed at your own risk.

    The Chicken

  9. Muv says:

    As the crow flies, Dallas is approximately 1070 miles from Las Vegas.

    If one were to take Madrid as the centre of a circle with a radius of 1070 miles, you would end up drawing a huge arc from points near the following cities – Glasgow, Hamburg, Zagreb, Bari, before slicing through the Mediterranean and carving out a great chunk of North Africa to the central Sahara.

    From a geographical point of view, the bishop in Las Vegas would seem to be forbidding Communion on the tongue for idealogical reasons. Either that, or the bishops in the greater part of Western Europe couldn’t give a fig for the health of their flock.

  10. jbpolhamus says:

    I’m happy to make a spiritual communion…it’s much more medieval. And for Easter duty I can go to the Byzantines.

  11. B Knotts says:

    Re: Holy Communion on the tongue, it seems to me that when communicants are kneeling at the altar rail, they must hold their head upwards to receive, making the process somewhat easier for the ordinary minister of the Eucharist.

  12. markomalley says:

    Father Z said: And we had therefore better immediately stop the Sign of Peace! It’s far more likely to spread disease.

    Well, apparently Father Z and Archbishop Lwanga of Kampala are on the same page. From the Uganda New Vision: Kampala Archdiocese bans hand shaking in Church:

    The Archbishop of Kampala Archdiocese, Dr Cyprian Kizito Lwanga has banned Christians from shaking hands as is the norm of the Catholic Church during peace giving.

    Lwanga made the directive following the reported cases of Marburg that has so far claimed one.

    Catholics shake hands during mass while others hug as a sign of peace.

  13. acardnal says:

    I just heard the the World Health Organization (WHO) is forecasting 10,000 Ebola deaths per WEEK in West Africa. *** 10,000*** I think it is time for Masses to be said for the dead, the ill and families.

  14. Ceile De says:

    Is that a picture of the equipment for handling yesterday’s relatio?

  15. The Chicken says that extraordinary form parishes would be most likely to survive Ebola on account of their lower attendance, but actually, I’ve been to many ordinary form parishes with even lower attendance.

  16. papaefidelis says:

    But Father! But Father! Is it not possible, as well, for a bishop to make use of the terrible, media-driven fear of contagious diseases (real or imaginary) to put an end to hand-holding during the Pater Noster AND hand-shaking during the Signum Pacis AND general distribution of the Precious Blood all in ONE FELL SWOOP? Perish the thought! Think of the children and how some people’s entire faith is predicated upon how many people shake their hands. {shudder}

  17. Bea says:

    I’ve been worrying about this, myself. I know a priest in the Dallas area.

  18. Norah says:

    I wonder if the Ebola scare will prompt the Greek Orthodox to change the way they distribute Holy Communion: Host and precious blood on spoon placed into the mouth – only one spoon is used.
    I seem to remember that they didn’t change their distribution practise during thev”swine flu” scare

    I don’t know how other orthodox distribute Holy Communion.

  19. acardnal says:

    One person has died from Ebola in he U.S. ONE PERSON! Calm down. Have a drink. Watch the MLB playoffs.

  20. Traductora says:

    Er…if they’re worried about ebola, shouldn’t they stop “the cup”? There’s a much greater chance of infection through the “cup” and the Handshake of Peace.

  21. chantgirl says:

    Masked Chicken- Given how many young children are at a typical EF Mass, it would probably spread more quickly among EF communities. More than one of mine has attempted to cut teeth on the pew in front of them before I could pry them away!

  22. steve51b31 says:

    I am a Deacon who is bioterrorism/ WMD trained. Of course, I can not annoint. General absolution would be warranted.

  23. Giuseppe says:

    Big debate at lunch today. Did God create Ebola virus. Or HIV. Or even back to biblical times, Mycobacterium leprae (leprosy). My answer is yes, that God created all things. But that when Adam and Eve ate from the tree of life, they were protected by God-given antiviral agents. After the banishment and the fruit from the Tree of Knowledge, they were left to fend for themselves.

    God created animals whose natural purpose was to destroy another animal (e.g. tigers, snakes, spiders, etc), so I argued that He created bacteria and viruses to do likewise, but gave humans immunity only in Eden. A tangential argument was that embedded in the God-created fruit in the Tree of Knowledge were viruses and bacteria, that while God-created and inherently destructive, Man would have never touched had he not disobeyed God.

    But I was roundly attacked for both arguments and really felt like an idiot. Help! References?

  24. Jacob says:

    Ah, Executive Orders. The last decent book Clancy wrote. It really is too bad he became preachy.

  25. Giuseppe says:

    Thinking back to a sermon I heard during a previous SARS mini- epidemic, I am paraphrasing something I heard:

    A priest who anoints an Ebola penitent and then dies wears a martyr’s crown. A layman unable to locate a priest who baptizes a dying Ebola victim and then dies wears a martyr’s crown. They gave up a chance at living to tend to a brother or sister in need with knowledge that they could die for their act of faith and love.

  26. Xopher says:

    Currently reading Executive Orders. Started about a week before the outbreak started in Africa (yes, it’s taking me some time). It seems like every time I reach a significant new development in the story about Ebola, another headline pops up with a new real-life development. It’s very coincident-y, but I guess someone had to be that guy who just had to be reading it at exactly the wrong time at exactly the wrong pace, right?

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  28. JLC says:

    In the parish I attend (Our Lady of Lebanon/St. Joseph Parish) here in Monrovia, they have stopped communion on the tongue. I’m not sure if it was an order from the Archbishop, but suspect it was. It wasn’t that widespread, but several of us would receive kneeling, on the tongue. Now, it’s kneeling and in the hand. However, I note that there is little/no risk of profanation–they use the ushers as communion guards, and there is very deep reverence for the Sacrament and clear belief in the Real Presence.
    They have also stopped the sign of peace, and handholding during the Our Father (never that common) has stopped.
    I look forward to when this epidemic is over, and we can get our lives back to normal. Prayers would be much appreciated.

  29. Brooklyn says:

    You can have the sign of peace without shaking hands or touching anyone, just merely acknowledging one another, which is what I usually do.

  30. arickett says:

    Jack Ryan would be a shoe in again any president in my life time

  31. Dr. Edward Peters says:

    btw, I’ve seen baptism administered “to the baby in the box”, too.

  32. The Masked Chicken says:

    “One person has died from Ebola in he U.S. ONE PERSON! Calm down. Have a drink. Watch the MLB playoffs.”

    Epidemiology can be very non-linear. It is better to be safe, than sorry. The idea that Ebola will not spread in the U. S. is an untested hypothesis. Let’s keep it that way. We will know how things have played out in three months.

    The Chicken

  33. MrsMacD says:

    Can you imagine being the person abandoned, without human comfort, or knowing that anyone who helps you, touches you, will probably die?! St. Damien of Molokai, pray for us!

    I recommend silk satin handkerchiefs or gloves, if the only way to access Our Lord, who we need, is by receiving him in the hand.

  34. I have anointed people while I was wearing hospital gloves. The trick is to get a bit of oil from the vial and smudge it in the palm of the gloved hand, and then put the vial away, all while holding the ritual book, all before approaching the patient. The reason for this are two fold. First, it’s not very easy to get things in and out of ones pocket while wearing gown and gloves. Second, and more important, if this patient is infectious, then I don’t want to have my oil vial open in that situation, nor do I want to handle it after I’ve touched the patient.

  35. LarryW2LJ says:

    “One person has died from Ebola in he U.S. ONE PERSON! Calm down. Have a drink. Watch the MLB playoffs.”

    While this is true, the fact is that Ebola is a merciless killer with a 70 to 90% mortality rate. If not contained or controlled, there is always the possibility that it could mutate to become an air-borne agent. If that ever happened, it would become the Plague or Black Death of our time. Yes, it’s not time to panic, but I think being VERY concerned is prudent – keep your eyes and ears open.

    With all this stuff that is going on – Ebola, droughts, storms, riots, violence, ISIS – I can’t help but thinking of the Marian apparitions and the warnings of the chastisement. The United States, as a nation, seems Hell bent on kicking God out of the public square (which is folly). I think the chastisement is here, we are living through it, in a world too vain and proud to recognize it for what it is – too proud to get on their knees and beg for Divine mercy and forgiveness. Modern man has become so vain and proud of technology and accomplishments that we see things in scientific terms only and no longer recognize the Hand of God on our lives.

  36. FrJohnDowney says:

    So far I am not afraid of ebola. But if it comes to an area near me I’ll do what I can to avoid the disease for myself and the people I serve and come in contact with. I find nothing wrong in anointing a person with forceps and a sponge if necessary. And if people want to receive Holy Communion on the tongue I see no reason why the Priest could not wear latex gloves and change them between each communicant. Of course that would make Mass longer and some of the same people who want a 20 minute Mass AND receive only from a Priest on the tongue while kneeling might be inconvenienced. But, hey, extraordinary situations call for sacrifice. And don’t forget, those gloves are going to cost money, especially if there is a shortage. Some folks might want to consider putting more than $1 in the collection to make sure that their parish can do all of this. The folks who are putting $20 and $50 and $100 in the collection are getting to be fewer and fewer.

    By the way, we have no “right” in the Catholic Church but the right to Christian Burial. Everything else is a Gift from God. That’s how Grace works. Demanding that God give the gift in a certain way according to our preference is just a little disrespectful. If your Priest is still alive, during an ebola crisis, just be thankful that there is someone there who is still able to celebrate Mass and administer the other Sacraments. Don’t complain if his shoes aren’t shined properly and he looks a little tired.

  37. JesusFreak84 says:

    Oi, I’ve picked up colds from closing my mouth on the communion “spoon” (please forgive me for not knowing the proper term,) at my Ukrainian parish =-\ But as I’ve said before, receiving there isn’t as much of a given, so there’d be zero pressure or stigma from NOT receiving, especially if one was sick. Maybe this would be a good time to ween the western faithful from receiving under both kinds and every single week =-p

  38. aviva meriam says:

    Living in Dallas where the SECOND nurse has tested positive for Ebola leaves me with the following observations:
    1. the medical staff have neither the equipment nor the training on the required equipment to prevent infection from close contact. It is Grossly Unfair to expect them to care for patients without both.
    2. Fr. Fox, I think All priests and clergy should have the requisite masks, equipment and training to allow you to minister to the sick and dying. Mere gloves are not sufficient.
    3. Dallas has stopped communion in the cup for the laity and most priests have encouraged people to withhold the hand-shakes during the sign of peace. I don’t think this will STOP the spread of Ebola but it will help with other viruses like the flu.
    4. More than one church has actively encouraged people to use liberal amounts of antibacterial/antiviral hand solution right before they enter the Church. Again, it won’t necessarily help with Ebola but it will with other illnesses.

    Just listened to an academic biologist with over 13 years of active study of Ebola disclaim that Ebola COULD go airborne and be infectious (not that it already has, but the mechanism that would allow for infection through the lungs exists) . Panic is not helpful but neither is willful ignorance. The chicken is right that Epidemiology can be nonlinear…..

  39. Kathleen10 says:

    @LarryW2LJ, my sentiments exactly. All the signs make sense in that way, a chastisement, and don’t we have it coming. On this general topic we find agreement between some Catholics and some Protestants. Our Lady of Fatima indicates that “the cup is filling up and God is already too much offended”, and some Protestants have been pointing to these as days of chastisement and end times. I realize Catholics aren’t generally interested in this, but we just had the second of what some Protestants call the “Blood Moons”, the lunar eclipse. There is an unusual tetrad (collection of four) of these which end next year. At this point, I’m a believer we are seeing, and going to see, amazing things in our time. It is certainly a time we need great trust in Jesus and Mary.
    I would be interested in knowing the Catholic perspective on Revelations. It seems a reasonable topic considering what we are seeing happen in our world today. I don’t understand why Revelations is not generally discussed, as if it’s too “literal” to be taken seriously. Protestants are gaining some comfort from hearing their religious leaders openly point to Revelations and End Times theory. I do believe I would be comforted too, by a general viewpoint on what Revelations might mean. These are very upsetting times for the reasons we all know too well. What do Catholics believe about the age? Do we have no theories?

  40. YoungLatinMassGuy says:

    Ebola virus is contagious, but not highly so.

    If that were so, why are the people dealing with infected people wearing Level-A hazmat suits, and putting infected people into quarantine that would make the biggest hypochondriac feel relaxed and at peace?

  41. Suburbanbanshee says:

    There are plenty of Catholic commentaries on the Book of Revelation, stretching back to antiquity. Here are some of the main ones:

    Tyconius. A Donatist whose book on Bible interpretation rules were championed by St. Augustine. His book on Revelation is available in fragmentary form (the Turin Fragments) and through numerous excerpts included by Catholic authors in their commentaries (notably St. Victorinus of Poetavium, Bishop Primasius of Hadrumetum, St. Caesarius of Arles, St. Apringius of Beja, St. Bede, and St. Beatus of Liebana). There’s a fix-up of all the known and suspected fragments and excerpts, edited by Gryson.

    St. Victorinus: available in translation on bombaxo.com in modern English. Also on the NPNF Fathers series in more archaic English, in the version with comments and changes by St. Jerome.

    Primasius: not available in English. Yeah, I know, it stinks.

    St. Caesarius of Arles: A looong series of homilies on the Book of Revelation. Some of the info is repeated or amplified several times because of this. Available in English in Weinrich’s Latin Commentaries on Revelation, from the Intervarsity Christian folks’ academic press.

    St. Apringius of Beja: Also available only in Weinrich, for English.

    St. Bede: Explanatio Apocalypsis has an old translation by Giles that’s available online, and he’s also in Weinrich. Probably the simplest, most straightforward, and shortest version of the Tyconius users.

    St. Beatus of Liebana: The introductory material and the first two books are available in translation by me on Amazon.

    There’s also Greek Commentaries on Revelation, another IVP Academic book, which includes folks like Andrew of Caesarea. The Revelation volume of Ancient Christian Commentary on Scripture is basically snippets and not snippets of everything, so it’s good for finding stuff for further research but the full text translation books are much less frustrating. St. Cassiodorus and Ambrosius Autpertus I’m not too familiar with, and I don’t think they’re in English.

    There used to be a great little site with Bede, Adso, and some other medieval commentaries, but it seems to have disappeared. (Sigh.) There’s an English translation of Geoffrey of Auxerre, and he’s pretty good. Joachim of Fiore tends to drive people nutso even though he was a saintly guy himself, so save him for way later.

    There’s a lot of Catholic commentaries and helper books on Revelation. Generally the readings fell between Pentecost and Advent, so there’s been plenty said about it. Catholics just can’t sit around pulling stuff out of their butts, though, so it perhaps cramps writers’ apocalyptic style. :)

  42. Suburbanbanshee says:

    It turns out that Francis Gumerlock, who has already translated a medieval commentary on the Seven Seals, has also now translated Gryson’s fixup of Tyconius. And three other short medieval commentaries. None of which will be out for a while, though, thanks to the vagaries of publishers.

    So yeah, I gotta put on the speed with Beatus. If it weren’t for footnotes and Bible citations, I’d be done by now.

  43. HeatherPA says:

    A second nurse is now infected. She also disregarded not traveling and flew to OH on a commercial flight before official diagnosis. She had only “low grade fever” at the time. How can people be so stupid?

    This sure seems to be contagious for not being that contagious. Ebola has existed for a very long time and has never spiraled out of control like now.
    Makes one wonder.

    http://abcnews.go.com/Health/nurse-infected-ebola-jetliner-diagnosis/story?id=26206090

  44. HeatherPA says:

    Kathleen10-
    EWTN has a good little summary on the Catechism’s teaching of the end times.
    http://www.ewtn.com/devotionals/mercy/catechism.htm

    Also, one of the greatest books I have read on end times from the Catholic view is one highly recommended by St. Therese, the Little Flower.

    It is called “End of the Present World and the Mysteries of the Future Life” by
    Fr. Charles Arminjon, translated by Susan Conroy, Peter McEnerny.

    http://www.amazon.com/gp/aw/d/1933184388/ref=redir_mdp_mobile