Chapter IV. On the Subject of Extreme Unction

689. • The subjects of this Sacrament are all and only sinners who are sick and in danger of death. This is established: first, from the words of St. James: Is any man sick among you? Let him bring in the Priests of the Church, etc.; but the Greek word is sick signifies a dangerous illness. Second, from the definition of the Church. For thus in the Decree of Union: This Sacrament ought not to be given except to a sick person concerning whose death there is fear. The Council of Trent, session 14, chapter 3, agrees.

Hence children before the use of reason and the perpetually insane are not capable of this Sacrament, because they have committed no actual sins.

690. Questions. - QUESTION 1. Must Extreme Unction be conferred upon delirious sick persons?

Reply. Yes, if they previously asked for the Sacrament, or would have asked for it if they had thought of this, or showed a sign of sorrow for sins. Indeed, also upon sick persons deprived of the senses, as is established from the Roman Ritual. - Recall what was said concerning the Sacraments in general, no. 230.

QUESTION 2. Can this Sacrament licitly be conferred upon a sick person in doubtful, or probable, danger of death?

Reply. Yes, with the common and true opinion, because for administering this Sacrament validly and licitly, it suffices that the sick person labor under a disease so grave that he is prudently judged to be in danger of death. This is confirmed from the Roman Ritual, where it is thus established: This Sacrament must be furnished to the sick who labor so gravely that the danger of death appears imminent. - St. Ligorius, no. 714, etc.

QUESTION 3. Can Extreme Unction be conferred upon children?

Reply. Yes, provided they are possessed of reason and are judged capable of malice and fault. Thus Benedict XIV (On the Synod, book 8, chapter 6), who sharply condemns certain synodal Constitutions by which a determinate age was fixed before which children could not be anointed.

691. • QUESTION 4. Can this Sacrament be repeated, or when can it be repeated?

Reply 1. It can certainly be repeated whenever a sick person anointed in a dangerous illness recovers and again falls into a dangerous disease. This is established from the Council of Trent, session 14, On Extreme Unction, chapter 3, where it is said: But if the sick, after receiving this anointing, recover, they can again be assisted by the aid of this Sacrament when they fall into another similar danger of life.

Reply 2. It can also be repeated in the same illness if it has been prolonged and the sick person has notably recovered, so that he appeared to have been rescued from the danger of death, and falls into the same danger again. The reason is that then there is truly a new danger of death. This is established from the Roman Ritual, where it is said: In the same illness this Sacrament ought not to be repeated unless it is prolonged, as when the sick person, after having recovered, falls again into danger of death.

QUESTION 5. Can it be repeated in the same prolonged disease if it is doubted whether the state of the disease has truly changed?

Reply. More probably, yes, if the doubt is truly positive, namely, when it is truly probable that the sick person has passed out of the danger of death; for this repetition in these cases is more conformable to the ancient custom of the Church. - St. Ligorius, no. 715.

692. • QUESTION 6. Is there a grave obligation to receive this Sacrament?

Reply. There is a twofold probable opinion.

The first OPINION affirms it. First, it is evident (they say) from the words of the Apostle James himself: Is any man sick among you? Let him bring in the Priests of the Church, etc. But the word let him bring in contains a precept. Therefore, etc. Second, there is added the practice of the Church, which has always taken the greatest care that it be received by all the sick. It also appears to be established from the custom and sense of the faithful. Third, in addition, it is grave and contrary to the charity which each owes to himself to omit a means so efficacious and a most firm protection, as the Council of Trent says, against the attempts of the demon in the final agony. - Thus Roncaglia with others.

The second OPINION denies it. The reason is that neither from Tradition nor from the Decrees of Councils is a precept of receiving this Sacrament established. But what St. James says, let him bring in the Priests..., is understood and explained as counsel. Therefore, a grave obligation of receiving Extreme Unction cannot be imposed. - Thus Billuart, article 7, after St. Thomas, part 5, question 65, article 4; Sporer, no. 106, etc.; and St. Ligorius, no. 733, where he calls this opinion common, although he thinks the first altogether to be recommended, chiefly by reason of the charity which each owes to himself: For in so great a danger, he says, he appears to expose himself to succumbing to temptations who neglects to fortify himself with this Sacrament instituted by Christ the Lord as a most firm protection in so great a conflict.

693. • QUESTION 7. What disposition is required for the reception of this Sacrament?

Reply 1. Confession of sins, if the sick person is in mortal sin; for this Sacrament is the complement of Penance, and therefore Penance must precede it. - Billuart, article 7, at the end.

Reply 2. But if the sick person cannot confess his sins, it is necessary that at least contrition precede; for this Sacrament of Extreme Unction is primarily a Sacrament of the living and was instituted chiefly for removing the remnants of sins. - Billuart, ibid. But in such a case attrition itself seems able to suffice; for it is at the same time a Sacrament of the dead and can remit mortal sins with attrition. - The Salmanticenses, no. 13, and others.