Case XLV: What Are the Conditions Under Which the Sick May Receive Holy Communion Though Not Fasting?

Leaving out of consideration the dangerously sick, whose condition calls for the last sacraments, we may consider of the other sick three classes, who can remain fasting until holy Communion can be given them either not at all, or only with great hardship. We do not include in this classification religious houses that have their own priest; for there the priest can give Communion soon after midnight, so that fasting would cause no inconvenience. We refer to the conditions in every-day life in which the sick must wait until some time in the morning to receive.

The first class embraces patients who have received the last sacraments and whose condition has not appreciably bettered. Moralists teach unanimously that such persons may receive without fasting. But they disagree as to how often. St. Alphonsus accepts the communior sententia that such sick persons may receive once a week (even daily if they have been used to receive daily), and as Benedict XIV. (De Syn. Dioec. lib. 7, c. 12) bids the bishops to require pastors to give Communion to such sick persons iterum et tertio, and since the bishops are empowered to punish pastors who are insubordinate on this point, we may without danger of appearing lax say that such sick may receive on as many days as they wish, even without fasting. We go still further and say the confessor should, unless the patients’ spiritual condition makes this inadvisable, urge them to receive frequently, not anxiously counting how many days have gone since their last Communion. Scruples of the patients about fasting he may remove by informing them that they may take whatever drugs or food are ordered for them. No need of asking anxiously how often they used to receive before their illness—in sickness persons have even more need than in health for Holy Communion as their spiritual food, nor need inquiry be made until what hour in the morning they are able to refrain from food or medicine. Moralists in general, and St. Alphonsus and Benedict XIV. in particular, speak simply of non jejuni without examining at what hour of the morning the priest should take the sacraments to the sick in order to let them remain fasting. All this applies to those who have received the last sacraments, and who are still in about the same condition.

The second class embraces those who, on account of stomach or nerve trouble, or kindred ailments, are not able to remain fasting until the morning, although they are not grievously or dangerously ill. Not infrequently such persons can go about and do much work of mind or body, but they cannot fast without bad results. For such there is only one thing to do. They must make application to the S. R. et Universalis Inquisitio, the supreme tribunal for matters of faith and morals. If they present a testification utriusque medici, physician and confessor, preferably through the bishop, they will without difficulty receive permission to partake before Communion of something per modum potus (more about this further on), and according to circumstances this permission is granted for receiving more or less frequently. Without this permission they are, of course, not allowed to partake of anything before Communion.

To the third class belong those who have been bed-ridden for a considerable time, but are not so ill as to call for the last sacraments, yet on the other hand can not strictly observe the command to fast before receiving, and about whom no certain hope exists that they may soon recover. For such sick persons Pope Pius X. has provided, in a very generous manner, by a decree of the Congregation of the Council, December 7, 1916. In a previous decree (December 20, 1905) the Pope exhorted the faithful to more frequent and even daily Communion, and required as the condition for this frequent reception of the sacraments only the state of sanctifying grace and the right intention, thus rejecting the rigor of Moralists and ascetics who often demand most minute precautionary measures and conditions. Referring to this decree an eminent ecclesiastic of Belgium suggested to the Congregation that if the wish of the Holy Father for more frequent and even daily Communion were to be carried out in the widest circles of the Church, then these sick, who often long for Holy Communion, should be given the same opportunity. On September 15 this matter was laid before the Congregation and it was decided to recommend to the Holy Father that the law of the Church for such sick persons should be amended, so that Holy Communion might be given to them oftener. It was proposed that the bishops should be empowered to give these sick persons the privilege to receive, on the great feasts for instance, even after partaking of some food. The Holy Father went even beyond this, and thereby manifested again his desire to promote the frequent reception of Holy Communion.

The two passages from the decree of the Congregation of December 7th, 1916, which are of importance here, read: it was asked whether some provision could perhaps be made for the sick who labor under a long illness and desire to be strengthened more than once by the Eucharistic Bread, but who are unable to preserve the natural fast in its integrity;... the Pontiff graciously granted that sick persons who had already been bedridden for a month without certain hope that they would soon recover, upon the advice of their confessor, may receive the Most Holy Eucharist once or twice a week if the sick persons reside in pious houses where the Most Holy Sacrament is reserved, or if they enjoy the privilege of the celebration of Mass in a domestic oratory; but once or twice a month for the others, even if they have previously taken something by way of drink. There is question here of sick persons who, for at least a calendar month, have been bedridden, and whose early recovery can not be expected with certainty; not of such, therefore, who suffer of a slight illness, but of persons seriously ill, yet not on this account in danger of death. It is further said absque certa spe. ut cito convalescant; so long, therefore, as there is no moral certainty (such as the opinion of the attending physician would give) that the patient will soon, perhaps in a week, recover his strength sufficiently to get out of bed, the patient has a right to the benefit of the decree, and may receive Communion even after having partaken of food or drink. The word decumberent does not imply that the patient must steadily keep to his bed. There are diseases that make patients feel more comfortable if they use an armchair. The decree concerns the sick who cannot remain fasting (until morning, as explained under 1 and 2). Those sick who can remain fasting without any particular detriment must not partake of anything before receiving, and they are strictly bound by the ecclesiastical law. The sick considered under 2 do not belong here, for while of them it may be said that a speedy recovery cannot be looked for, yet it cannot be said that they are decumbentes. They must therefore make their appeal to the Inquisition at Rome. The decree distinguishes two classes of such sick persons; first of all those who sojourn in piis domibus; by these are meant the inmates of convents, of schools kept by Religious, hospitals, seminaries, etc., having their own chapel, where the Blessed Sacramentis kept, or where Mass is said. Then the decree goes on to speak of patients not inmates of such houses. The former may twice a week partake of food, per modum potus, before receiving, the latter twice a month.^* For both classes, however, the decree provides confessarii consilio. The reason for this is obvious. The Church has given the decision about receiving Holy Communion into the confessor’s hands. He alone decides whether the penitent is worthy to receive; he alone may judge as to how often. We may translate the words de confessarii consilio: “with the confessor’s permission.”

^* Canon 858 of the new Code extends this privilege to once or twice a week. Thus after Pentecost of 1918 invalids, whether or not they reside in a dwelling where the Blessed Sacrament is kept, may, de prudenti confessarii consilio, receive Holy Communion even after having taken medicine or liquid refreshment.

It is quite clear that the confessor of penitents, who according to the decree of December 20th, 1905, may receive twice a week, or twice a month, cannot prohibit them from previously taking food, all the more as the permission of the confessor is directly concerned only with the frequency of receiving holy Communion, and only indirectly with the partaking of food. The permission to receive presupposes the other permission. The Pope allows the previous use of food, or drink, as often as the confessor allows such patients to receive, to the limit of twice per week, or month. What must we understand by per modum potus? The holy Inquisition explained this under September 7th, 1897, and this explanation was ratified by the Pope on September 10th, 1897: “quando si dice per modum potus, s’intende bensì che si possa prendere brodo, caffè od altro cibo liquido, in cui sia mescolata qualche sostanza, come p. e. semolino, pangrattato ecc., purchè l’insieme non venga a perdere la natura di cibo liquido.” One may therefore take broth, coffee, or other liquids, such as milk, tea, chocolate, and of course water, and with these may be mixed solid food, as, for instance, cereal or bread crumbs; the whole, being boiled perhaps, provided it does not lose its character of liquid food, may be partaken of before Communion. In other words any liquid nourishment may be taken; this would seem to exclude alcohol.

Finally we ask what is meant by aliquid? It means that hunger should not be fully satisfied but that the patient should be aided in his bodily condition to receive the Holy Eucharist with the requisite devotions. The contents of a coffee cup may, with regard to the intention of the law, not be considered too large a quantity. But if the doctor, or the patient’s experience, require a larger quantity, even as much again, the confessor in our opinion may agree to this. Much depends upon the individual himself and the character of his malady. We must not identify aliquid with minimum. Fasting is broken by a minimum. When therefore the Church suspends this command to fast in a certain case, and this she did by the decree of December 7th, 1906, the principle parum pro nihilo putatur applies.

In conclusion it is to be pointed out that the decree speaks only of Holy Communion, and not of saying Mass. The decree allows such patients, as above described, be they laymen or clerics, priests or bishops, to partake of something under certain restrictions before receiving Holy Communion, but to say Mass non-fasting is a different matter. It is not to be expected that such a privilege will be generally decreed for saying Mass, as Rome is minded to insist strictly on fasting before saying Mass. Leo XIII., when his physician would not let him celebrate solemn Mass toward noon, on his twenty-fifth papal jubilee, unless he partook of something first, said Mass early in the morning, fasting, and then merely assisted at the solemn high Mass in St. Peter’s, celebrated by a Cardinal.