REVIEW: Sacrament of Anointing of the Sick – “in danger of death”

In the past week, the topic of the sacrament of Anointing of the Sick (aka Extreme Unction) has come across my screen or conversation.

A review is in order.

The effects of the Sacrament of Anointing or Anointing of the Sick or, sometimes, Extreme Unction, are:

• To increase sanctifying grace in a moment of great need (danger of death)
• To console the person
• To strengthen against temptation
• To heal the body
• To forgive mortal sins when a person is incapable of confessing them or is unaware of his state of soul

Anointing was placed in the category of “sacraments of the living”, a handy way of saying that for them to be as effective as they can be, we must receive them while “alive”, that is, not “dead in sin”, that is, in the state of grace.

If a person is compos sui and can make his own decisions and understand what is going on, he must be given a chance to make his confession before being anointed. Even if his communication is impeded, he should indicate by signs and respond to the priest’s questions.

If a person is not sui compos, cannot respond, and isn’t aware of what is going on, such a person can be anointed and, in that case, the sacrament can also impart forgiveness of mortal sins.

If a person in the state of mortal sin – who is able to confess and receive absolution – receives the sacrament of anointing, the sacrament will not be effective in her in the way Christ and the Church intend.

If a person is NOT able to confess, then the sacrament also forgives mortal sins so that the sacrament can be effective.

How merciful is our God?

Something must be clarified, because the sacrament is often administered when it is not appropriate.

The law is pretty clear.

Can.  1004 §1. The anointing of the sick can be administered to a member of the faithful who, having reached the use of reason, begins to be in danger due to sickness or old age.

This doesn’t say before execution or about to engage in battle or some other dangerous activity like driving in a NASCAR race.

And there is the Catechism of the Catholic Church:

1514 “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.”

NB: “At the point of death… danger of death”.

One can be in danger of death for many reasons.  For example, someone who is about to undergo surgery could be in danger of death, depending on the reason for surgery.  Cosmetic surgery is one thing, triple bypass is another.  In the latter case, the heart problem puts one in danger of death, thus calling for anointing.  People about to be executed or go into battle are in danger of death. Even general anesthesia can be dangerous.  Those are not occasions for the sacrament because they are external to the person.  Once damage is inflicted through a wound and danger of death is obvious, that’s another matter.

Soldiers and those to be executed along with people receiving a medical procedure that is not prompted by a life threatening condition ought to be given the opportunity to make their confession and receive Communion.

Some of you might be saying:

“But Father! But Father!  You must really hate Vatican II!  Vatican II did away with rules.  Francis said so!  All sacraments should be given to everyone all the time.  You make me cry.  I need to be anointed now.”

You, instead, need the face slap you didn’t receive at your Confirmation by the nice, delicately mustached bishop who doesn’t hold to all those mean traditions.

The sacrament of anointing is widely abused.  For example, there are “healing Masses” in which everyone, the young, perfectly healthy, are all anointed harum-scarum.  That’s just wrong, but it happens all over the place because the sacrament is not well-understood.

Following Vatican II, seminarians and priests were taught that the sacrament “formerly called Extreme Unction” was no longer to be reserved for the dying, but administered earlier in serious illness. It came to be known simply as the “Anointing of the Sick.” Yet the norms specify that “the sick” means those who are according to the USCCB, “seriously” ill or whose health is “seriously” impaired by old age (Pastoral Care of the Sick 9).   The problem is that the LATIN document to which they refer says “dangerously… periculose”.  The same USCCB (which didn’t honestly or accurately translate GIRM 299 on the position of the altar) downgraded the law and doctrine by using “seriously,” rather than “dangerously,” or “perilously”.  They say the sacrament “should be given to anyone whose health is seriously impaired” instead of “dangerously”.

Sacram Unctionem Infirmorum provides an important clarification: “as soon as anyone of the faithful begins to be in danger of death from sickness or old age, the fitting time for that person to receive the sacrament has certainly already arrived.” What this does is broaden the moment for administration of the sacrament to before the very point of death (extreme unction… in extremis … in the last moments of life).  But it’s clear that there should be an illness or condition involving a genuine danger of death, even if death is not imminent. The illness must be of a kind that could lead to death and thereby place the patient under a serious spiritual trial.

This distinction matters because the sacrament has a specifically spiritual purpose. Sacram Unctionem Infirmorum says that its anointing signifies the grace of the Holy Spirit, bringing forgiveness of sins and “the remnants of sin,” while strengthening the seriously ill person in the particular spiritual dangers accompanying grave sickness.