Case LXXIX: Conditional and Unconditional Administration of Extreme Unction in the Case of Unconsciousness

Case.—Cajus, a young priest, was called hurriedly to a gravely sick man whom we will name Titius. He finds the patient already unconscious, which was all the more distressing to Cajus as he had heard of him as a man who had long neglected his religious duties, had seldom or never visited a church, and had for some years neglected to fulfill his Easter duty. Cajus bestows upon him conditional absolution, and then, also conditionally, administers Extreme Unction, together with the general absolution.

Question.—Has Cajus acted correctly, or prudently?

Solution.—That Cajus in this case gave absolution conditionally was quite proper, as according to what he had heard he was naturally in doubt as to the man’s moral disposition. It is somewhat different with the administration of Extreme Unction. Cajus should have administered this sacrament unconditionally, not conditionally, and this would have been the right and prudent way. And why? Cajus should have distinguished between the valid and the worthy reception of this sacrament. When there exists a reasonable doubt as to whether a person is physically capable of receiving Extreme Unction, it must always be administered sub conditione (“si capax es’); for in such a case there is a question of validity. Instances of this kind would be the case of a sick child when there is doubt whether the necessary maturity of understanding has been reached, or that of an imbecile, when it is question whether the sufficient use of reason has ever been present. The same applies to a

X ee case of doubt whether a person is in a passing faintness or whether death has already set in, or, finally, whether the recipient is a Catholic. Since for the valid reception of any sacrament an essential condition is the intention on the part of the recipient—in the case of this sacrament at least a presumable intention—a justified doubt as to the presence of the intention prescribes the conditional administration, for instance in the case that a person before becoming unconscious would have expressed his will not to receive the last sacraments. Indeed, had such a patient so positively refused that a defectus intentionis must with certainty be concluded, the sacrament must not be given, on account of the lack of an essential condition.

It is different where it is a matter not of the valid, but of the worthy reception of Extreme Unction, of the moral disposition, therefore, of the recipient. Since Extreme Unction is in the first place a sacramentum vivorum, and as such is first of all intended for the remission of only venial sins, it must ordinarily be received in the state of grace. In so far, however, as this sacrament may become a sacramentum mortuorum, and then takes the place/of the Sacrament of Penance, which is the case when a person in grievous sin but bona fide receives it, then there are required for its worthy reception at least the dispositions required for the worthy reception of the Sacrament of Penance. May we, therefore, conclude that, where there is a positively reasonable doubt as to the moral disposition of the recipient, this sacrament is to be administered sub conditione, and did, therefore, Cajus act quite correctly when he gave to the unconscious Titius Extreme Unction conditionally? No! In our case, despite the requirements of disposition just spoken of, Cajus should have administered the sacrament unconditionally. The Sacrament of Extreme Unction, like Baptism (and this applies also to Confirmation, Holy Orders and Matrimony), possesses the peculiarity that even where it is received without the necessary dispositions it will exercise its sacramental effects. It revives, reviviscit as the theologians say, as soon as the indisposition (obex gratiae), which is present on part of the recipient, is removed. This is accomplished by mere attrition provided that after receiving this sacrament the recipient does not commit anew a grievous sin, and is not capable of receiving the Sacrament of Penance (St. Alphonsus, lib. VI. n. 707; Lehmkuhl II. n. 50-52).^* But how would it be, if Titius had become unconscious in actu peccati mortalis, through intoxication perhaps, or through attempted suicide? Should Cajus then have administered Extreme Unction unconditionally? Again, if this Titius had lived an irreligious life, was a notorious drunkard, libertine, etc., could Cajus without irreverence anoint him unconditionally, when for this reason (irreverentia) many Moralists and Pastoral Theologians, amongst them even St. Alphonsus (Theol. Mor. l. VI. n. 82 and 732) favor a conditional administration? Let us suppose that Titius had really led a notorious and sinful life, or that he fell into his dangerous condition in actu peccati mortalis, without previously having given any sign of repentance. And now Cajus appears hurriedly, and gives to the unconscious Titius absolution with the condition “si es dispositus,” and administers also Extreme Unction under the same condition. Titius later regains consciousness, for some moments, and, realizing the peril of his soul, awakens sorrow for his past sins, although only an imperfect sorrow. Cajus, again sent for at once, arrives after Titius has passed away. Had he given Extreme Unction unconditionally, then Titius after arousing contrition would “per reviviscentiam” have been reinstated in the state of grace, and thus would have owed his salvation to Extreme Unction. But by administering it with the condition, “si es dispositus,” this means of grace of the Church became ineffective for Titius, though in his extreme peril it might have been for him at the last a saving anchor! What a misfortune!

^* In the preceding case perfect contrition or attrition with the Sacrament of Penance was said to be necessary for reviviscence; but it must be borne in mind that here there is no question of sacrilege and bad faith, as there was in that case,

If, therefore, the salvation of a poor sinner may, and often does, depend directly and at the last upon the unconditional administration of Extreme Unction, one may with good conscience follow the view that when a proper disposition has not been evident or is doubtful, Extreme Unction should be given unconditionally. The reflection that through the absolute administration of this means of grace to a possibly unworthy subject the sacrament might suffer irreverence should not have deterred Cajus from administering it absolutely; for, as was said, a subsequent dispositio sufficiens revives the sacrament and thus reinstates the poor sinner, perhaps at the last moment, in the state of grace, although at the moment of receiving the sacrament he was morally unworthy. Persons bereft of their senses cannot commit an actual sacrilege. And should not the mere possibility of such reviviscentia sacramenti suffice to administer bona conscientia Extreme Unction unconditionally? But must not the minister Sacramenti, as far as lies in his power, follow the sententia tutior, i. e., take the utmost care that the sacrament be not dispensed to the unworthy? Yes, the respect due a holy sacrament no doubt requires such caution; yet the case is somewhat different if the recipient of the sacrament is in extrema necessitate, which is most certainly true in our case, where every effort must be made to save a threatened soul at the last moment. More than ever, therefore, the principle “Sacramenta propter homines,” must be taken into account and to the very extent required by the hope of saving the sinner, for “in extremis extrema sunt tentanda.” And since in our case a possible reviviscentia sacramenti gives hope of salvation, therefore, the Sacrament of Extreme Unction may and must be administered in a manner that allows a reviviscentia to take place: hence, absolutely.

Our Cajus will do well in future cases of the administration of Extreme Unction, where unconsciousness has already taken place, to adopt these principles:

1. Where there is a reasonable doubt about the validity of the sacrament to be administered, always administer it conditionate (“si capax es’).

2. Where the worthy reception is in doubt, it is always to be administered absolute (with previous conditional absolution). This should be done unless it is positively certain that a person wills to die in his unbelief and unrepentance, and unreconciled with his God, which we may never assume with certainty of a person bereft of his senses “since even the worst and most abandoned people, when brought to the confines of death, earnestly desire to be saved” and hence to such person, even if he became unconscious after an irreligious life, or indeed in actu peccati mortalis, the sacrament should be dispensed absolute —of course excluso scandalo.