Case LVII: Administration of the Holy Viaticum to One Unconscious from a Paralytic Stroke

The curate Lucius is called to Caius, who, nearly eighty years of age, and never before seriously ill in his life, had now suffered a stroke of paralysis. Lucius found him fully conscious, heard his confession and prepared to leave, not considering the man’s condition critical. Only at the urgent request of the anxious wife, and at the patient’s own solicitation, decided Lucius to give Caius Extreme Unction. Thereupon the patient asks for the Holy Viaticum, saying he felt his end approaching. Lucius hastened away to get the Viaticum. Meanwhile the daughter prayed with her father short acts of preparation for Holy Communion. Just before the priest returned with the Holy Viaticum Caius lost consciousness. Thus Lucius found him and waited a while for consciousness to return. But in vain. He was sorry not to be able to give the Viaticum to the unconscious man. He bestowed absolutio in articulo mortis, and bore the Holy Sacrament back again to the Church. Caius died shortly after, without regaining consciousness, and of course without the Viaticum. The question is, did Lucius act correctly in not giving the Viaticum to the unconscious man? Does unconsciousness of itself preclude the reception of the Holy Viaticum? To both questions the answer is briefly: No!

Now the argument. The actual reception of Holy Communion is necessary in general, necessitate praecepti divini et ecclesiastice. The divine Saviour expressly imposed actual reception, not merely upon the priests, but also upon the faithful. This is plainly evident from the Lord’s words at the institution of the Holy Sacrament of the Altar: “Take and eat... Do this in commemoration of me.” The Apostle (I Cor. ii, 23-27) confirms this beyond any doubt, by concluding the account of the institution of the most Holy Eucharist with the words: “For as often as you shall eat this bread and drink the chalice, you shall proclaim the death of the Lord until he comes.” The Council of Trent (sess. 13, cap. 2) confirms the divine command of actual reception as follows: “Our Saviour, when about to depart from this world to the Father, instituted this sacrament, in which he poured forth, as it were, the riches of his divine love toward men, making a memorial of his wonders; and in its reception he commanded us to cherish his memory and to proclaim his death until he himself comes to judge the world.”

St. THOMAS AQUINAS (3 qu., 80 a., II) refers, in further proof, also to the following words of the Lord (John 6, 54): “Unless you eat the flesh of the Son of man and drink his blood, you shall not have life in you.”

In the early centuries of Christianity the ardor of the faithful in the actual reception of Holy Communion was so great that the Church had no need of issuing a command in regard to it. This became necessary only when this ardor lessened. Since that time we have had many decrees of Popes and councils, by which the obligation of receiving Holy Communion is emphasized. For brevity’s sake we refer only to the fourth Lateran Council, under Pope Innocent III (can. 21), and to the Council of Trent (sess. 13, can. 9).

The reception of Holy Communion is directed especially in danger of death. This duty follows from the very purpose for which Our Lord chiefly commanded the reception of Holy Communion. The Council of Trent, in reference to this, says: “He wished this Sacrament to be received as the spiritual food of souls, by which those living by the life of him who said, ‘He who eats me shall also live because of me,’ may be nourished and strengthened; and as an antidote by which we may be freed from daily faults and preserved from mortal sins. Moreover, he wished it to be a pledge of our future glory and perpetual happiness, and therefore a symbol of that one body of which he himself exists as head, and to which he wished us, as members, to be bound by the closest bond of faith, hope, and charity.”

When, however, are we more in need of this spiritual food for the soul, this antidote against the poison of sin, this pledge of future glory and eternal bliss, as also of the most intimate union with Christ, our Head, as the living members of His mysterious Body, as when in danger of death, in that important moment upon which the whole of our eternity depends and when Satan once again employs all his cunning and power to plunge the soul into eternal ruin.

Hence St. JEROME (in Evang. St. Matt., c. 15) says with reference to the dangerously sick: “Jesus does not wish to send them away fasting, lest they faint on the way. Therefore he is endangered who hastens to reach the desired dwelling without the heavenly Bread. Hence the Angel also speaks to Elias: Arise and eat, because thou hast a great way to go.”

Similarly the Council of Trent expresses itself (1. c. cap. 8): “May that supersubstantial Bread truly be for the Christian faithful the life of the soul and perpetual health of mind, by whose strength, fortified on the journey of this wretched pilgrimage, they may be able to reach the heavenly fatherland, there to eat without any veil the same Bread of Angels which they now eat beneath sacred veils” (Compare Cat. Rom., p. 2, C. 4, nn. §4, 70).

The ecclesiastical precept of the reception of the Holy Viaticum is expressed unmistakably also in the constant practise of Holy Church. It has always been her chief concern that none should depart this life without the Holy Viaticum. Innumerable instances from the Church’s history bear witness to this constant concern of the Church. St. Dyonisius of Alexandria gives an account (Euseb. Hist. Eccl., 1, 4, c. 44) of an aged man, named Serapion, who perished in the persecution. Before his death he sent for the priest so as to receive the Holy Viaticum, The priest himself was seriously sick and could not possibly journey the long distance. In order, however, not to let the sick man die without the Holy Viaticum, he entrusted it to the messenger. “He handed a small portion of the Eucharist to the boy, ordering him to steep it in water and pour it drop by drop into the old man’s mouth... The boy steeped the morsel and poured it into the old man’s mouth. After gradually swallowing it, he immediately breathed forth his soul.”

St. AMBROSE shortly before his death received the Holy Viaticum, as we are informed by Paulinus, his secretary. Furthermore many Popes and councils expressly ordained the administration of Holy Viaticum to those in grave illness. Thus the Popes Siricius, INNOCENT I, Sixtus III, Leo the Great, Gelasius I, Felix III, GREGORY THE GREAT, Gregory III. Of the councils we mention those of Nice, the fourth of Carthage, the third of Orleans, the seventh, eleventh and sixteenth of Toledo, the second of Aix La Chapelle. The Council of Trent directs: “That the sacred Eucharist itself be carried to the sick and be diligently preserved in churches for this use, besides being joined with the greatest equity and reason, is found commanded in many councils and has been observed by the most ancient custom of the Catholic Church. Therefore this holy synod decrees that this salutary and necessary custom is altogether to be retained” (Compare Cat. Rom., p. 2).

Sr, Alphonsus Liguori teaches positively (Theol. Mor., 1. 6, n. 290 q.): “The reception of the Eucharist is necessary for adult faithful by a necessity not of means but of a binding divine precept... at the point of death by way of Viaticum... Every member of the faithful in a danger of life which he foresees or reasonably fears, for example in a serious illness, is bound under mortal sin to receive Communion.”

This holy father does not leave us in doubt either as to what must be understood by articulus mortis. He explains (H. Ap., tr. 15, nn, 19, 46): “As regards Viaticum, we say here that every member of the faithful is bound to be fortified with it whenever, while sick, he is placed in probable danger of death, as is one who lies seriously ill with mortal signs... The Eucharist can be received by one not fasting when Communion is given as Viaticum in danger of death. We have said ‘in danger,’ because to receive Viaticum it is neither necessary nor praiseworthy to wait for the time when no hope of life remains; it suffices that a probable danger of death be present.”

If then the reception of the Holy Viaticum is ordered and of obligation in danger of death, then naturally priests are also bound, under such circumstances, to administer Holy Viaticum.

But is there no exception from this rule? And is simple unconsciousness among the exceptions? Only those sick persons are excepted who can not receive the Holy Viaticum with becoming reverence. The Rituale Romanum warns: “Care must diligently be taken that Viaticum not be given to those from whom, because of delirium, or because of a continual cough or another similar illness, some indecency with injury to so great a Sacrament may be feared.”

St. THOMAS AQUINAS gives to unconsciousness special mention. He makes a distinction between the so-called feeble minded and those deprived of all use of reason. He teaches that the Holy Eucharist is not to be refused to the feeble minded. Of the others he distinguishes such who never had the use of reason, and such to whom the use of reason was not always lacking. If the latter, while in command of their reason, showed devotion to the Most Blessed Sacrament, then it must be administered to them in danger of death, if no irreverence is to be feared. “Some are said not to have the use of reason in two ways: in one way because they have a feeble use of reason, just as one who sees badly is said not to see; and because such persons can conceive some devotion toward this sacrament, this sacrament is not to be denied them. In another way some are said totally not to have the use of reason. Either, therefore, they never had the use of reason but remained thus from birth; and so this sacrament is not to be given to such persons, because no devotion toward this sacrament preceded in them in any way; or they were not always without the use of reason, and then, if devotion toward this sacrament previously appeared in them when they were in possession of their mind, this sacrament ought to be given to them at the point of death, unless perhaps danger of vomiting or spitting it out is feared.” Hence in the Fourth Council of Carthage (can. 76) it is read: “He who asks for penance during illness, if by chance, while the summoned priest is coming to him, he is rendered speechless under the oppression of illness or is turned to delirium, let those who heard him give testimony and let him receive penance; and if he is believed to be about to die immediately, let him be reconciled by the imposition of hands and let the Eucharist be poured into his mouth,”

St. ALPHONSUS in this entirely agrees with St. THOMAS.

Our case must be judged on these principles, Caius, shortly before the priest’s return with the blessed Sacrament, possessed the use of reason, and plainly showed his devotion to this Sacrament by urgently asking for the Holy Viaticum. In his case there was no danger of vomiting, etc., and no profanation of the Most Holy was to be feared, therefore. If Lucius did fear any such thing he should have simply made a trial with an unconsecrated Host, so as to remove all doubt in this respect. Unconsciousness of itself was certainly no reason for Lucius to leave the sick man without having satisfied his desire. A doubt as to the proper disposition for the reception of the Holy Viaticum could not at all exist in this case.

The genuinely Christian life led by Caius, a devout Catholic, was an additional guarantee in this respect. It is all the more to be regretted that Caius’ ardent desire for the Holy Viaticum was not satisfied. Lucius should certainly hereafter proceed according to the views of our loving Mother, the Church, who is so solicitous for her dying children. The dying will thank him for it in eternity.

P. Jos. A Leon, O. M. Cap.