Section 6: Extreme Unction

1. SUBJECT OF THE SACRAMENT. —The Sacrament of Extreme Unction (extrema unctio) was instituted for the corporal as well as spiritual well-being of the sick. One of its special effects is to confer upon the dying the grace of a happy death. While it is essential for the validity of this Sacrament that the recipient be seriously ill or, as the technical phrase runs, in periculo mortis,¹ it is altogether immaterial whether this condition be due to disease or to old age.² Hence the sacra infirmorum unctio may not be administered to persons who are ex- 188 posed to the danger of death but are not seriously ill, e. g., soldiers going into battle, condemned criminals preparing for execution, etc. The Sacrament may, however, be given to those in danger of dying from an operation or after confinement, but not to those who have not yet attained the use of reason or have not committed a personal sin, that is to say, infants and permanently insane adults (perpetuo amentes).³ If an insane person enjoyed the use of reason at any moment of his previous life, or has occasional lucid intervals, he may and should be given Extreme Unction,⁴ because a habitual and interpretative intention suffices for the valid reception of this Sacrament, and there is a well-founded presumption that many insane persons temporarily regain the use of reason at the approach of death, though they are unable to manifest their sanity by definite signs.

¹ Jas. V, 14-15. —Cfr. the Deereturn pro Armenis of Eugene IV: "This Sacrament ought not be given except to a sick person whose death is feared." (Denzinger-Bannwart, n. 595). — The Council of Trent says (Sess. XIV, De Extr. Unct.t c. 3): "It is also declared that this anointing is to be applied to the sick, but especially to those who lie so dangerously ill that they seem to be placed at the departure from life, whence it is also called the Sacrament of the departing." —Cfr. Cat. Rom., P. II, c. 6, qu. 9: "Since only those who suffer from illness need healing, therefore this Sacrament ought to be given to those also who seem so dangerously ill that it must be feared that their last day of life is at hand."

² Rit. Rom., tit. 5, c. 1, n. 5: "This Sacrament ought to be given to sick persons who, after attaining the use of reason, labor so gravely that danger of death seems imminent, and to those who are failing from old age and seem likely to die from day to day, even without another illness." —"Senectus est morbus," was a received axiom among the Scholastics.

³ Cat. Rom., P. II, c. 6, qu. 9.— Rit. Rom., tit. 5, c. 1, qu. 9; cfr. Codex Iuris Canonici, can. 940, 941, 943. —Cfr. H. Noldin, S. J., Summa Theologiae Moralis, 11th ed., Innsbruck 1914, Vol. III, pp. 543 sqq. —J. P. Gury, Compendium Theol. Mor., Vol. II, n. 519, says: "The subjects of this Sacrament are all and only sinful human beings in danger of their lives. Hence children before the use of reason and the perpetually insane are not capable of this Sacrament, because they have committed no actual sins; Extreme Unction can be conferred upon those mute, deaf, and blind from birth, for they can be anointed near the organs they lack, since even if they did not sin outwardly through those organs, they could nevertheless sin through the interior powers of the soul to which those organs correspond."

⁴ Cat. Rom., P. II, c. 6, qu. 9: "The insane and the delirious also are not fit to receive this Sacrament unless they sometimes had the use of reason and at that time especially gave an indication of a pious disposition and asked to be anointed with sacred oil. For one who from birth was never possessed of mind and reason is not to be anointed; but it is otherwise if the sick person, while his mind was still sound, wished to partake of this Sacrament and afterward fell into insanity and frenzy."

Extreme Unction may be administered to a sick man who is really or apparently unconscious, provided there is reason to think that he would ask for, or at least not refuse, the Sacrament if he had full control of his faculties.⁵

⁵ Rit. Rom., tit. 5, c. 1, n. 6: “But it is nevertheless to be given to sick persons who, while of sound mind and in possession of their senses, asked for it, or would probably have asked for it, or gave signs of contrition, even if afterward they lost speech, became insane, are delirious, or are unconscious.” —Ibid., n. 7: "But if the sick person, while suffering frenzy or insanity, might probably do something contrary to reverence for the Sacrament, let him not be anointed unless the danger is removed." —Cfr. Gury, Comp. Theol. Mor., II, n. 520: "This Sacrament ought to be given to the delirious if they asked for it beforehand, would have asked for it if they had thought of it, or showed a sign of sorrow for sins."

Even impenitent sinners and those who have lost consciousness while in the act of sinning (e. g., habitual drunkards) should not be deprived of Extreme Unction, unless they consciously and positively refuse to receive the Sacrament, because a possible subsequent attrition would make it operative.⁶

⁶ Rit. Rom., tit. 5, c. 1, n. 8: "But it is to be entirely denied to the impenitent, to those dying in manifest mortal sin, to the excommunicated, and to the not yet baptized."

In conformity with the axiom, "In dubio pars tutior est eligenda," ⁷ the Sacrament of Extreme Unction may be validly and licitly administered if the danger of death is merely probable or even doubtful.

⁷ Cfr. St. Alphonsus, Theol. Mor., 1. VI, n. 714. —J. P. Gury, Comp. Theol. Mor., Vol. II, n. 520: "Can this Sacrament lawfully be conferred upon a sick person in doubtful or probable danger of death? The answer is affirmative according to the common and true opinion, because for administering this Sacrament validly and lawfully it suffices that the sick person suffer from an illness so grave that he is prudently judged to be in proximate danger of death."

The name Extreme Unction or Last Anointing, which is of popular origin, is not a very fortunate one because of the implication that the Sacrament forebodes death. But as this name correctly describes the primary purpose of the rite, i. e., to prepare and fortify the soul for its last journey, it was adopted by the Church after it had obtained currency among the people. The Council of Trent employs the older term, "sacra infirmorum unctio" and the modern " extrema unctio" indiscriminately.

As Father Kern has pointed out, the custom, which has grown wide-spread since the twelfth century, of demanding and administering Extreme Unction only when all hope of recovery has vanished and death is imminent, "is opposed to the usage of the ancient Church and owes its existence to such causes as popular superstition, false theological teaching, and avarice, which have nothing in common with the operation of the Holy Ghost. This deplorable practice endangers to a very large extent the attainment of the object for which Extreme Unction was instituted by Christ. The principal effect of this Sacrament is the supernatural strengthening of the sick in order to enable them to bear the sufferings and temptations by which they are harassed, for the honor of God, so that, to apply St. Paul's dictum, 'that which is at present momentary and light of our tribulation, worketh for us above measure exceedingly an eternal weight of glory.'⁸ This supernatural strengthening of soul and body is intended also to induce the sick man, with the extraordinary assistance of divine mercy, to which he is commended in the name of Christ, to make acts of confidence, resignation, patience, contrition, and charity, and thereby to obtain forgiveness of his sins and the complete remission of the temporal punishments due to them. Thus he will be ready, when God calls him hence, to enter straightway into eternal bliss, without passing through the fiery furnace of purification. It was for this reason that the early Christians appropriately called Extreme Unction 'sanantis divinae gratiae dulcedo' Its true purpose is to restore the soul to complete health and to prepare it for immediate entrance into glory. This is intimated by the Fathers, clearly expressed in the liturgical prayers of the ancient Church, taught as a revealed truth by the leading Scholastics —including Bl. Albert the Great, St. Thomas, St. Bonaventure, Duns Scotus, Richard a Mediavilla, Peter de Palude, Innocent V, Aureolus, and Capreolus —and acknowledged by the Council of Trent. It often happens that the full recovery of the soul involves such a strong alleviation of bodily suffering that the power of disease is broken and physical recovery follows. In that case the fruition of eternal beatitude is postponed, but it will be all the more glorious if he to whom the privilege has been granted cooperates with the graces bestowed by this wonderful Sacrament." ⁹

⁹ J. Kern, S.J., in the Zeitschrift fur kath. Theologie, Innsbruck 1906, pp. 617 sqq.

⁸ 2 Cor. IV, 17.

Though Extreme Unction is not strictly necessary for salvation, every Catholic who is dangerously ill, is in duty bound to receive this Sacrament, and should receive it as soon as there is probable danger of death, and not wait till he has become unconscious or entered into agony.¹⁰ Hence when it is possible to receive this Sacrament, a Catholic in danger of death is bound under pain of mortal sin to ask for it, if failure to do so would give grave scandal or involve contempt of the Sacrament,¹¹ or if Extreme Unction were the only Sacrament the patient was still able to receive. According to the commonly accepted teaching of St. Thomas, however, refusal to do so is not per se a mortal sin.

¹⁰ Cfr. St. Alphonsus, Theol. Mor., 1. VI, n. 733; Gury, Cotnp. Theol. Mor., II, n. 522.

¹¹ Conc. Trident., Sess. XIV, De Extr. Unct., c. 3: "Contempt for so great a Sacrament cannot be without enormous wickedness and injury to the Holy Spirit Himself."

The state of grace is required for the worthy reception of Extreme Unction, and hence the administration of this Sacrament is generally preceded by Confession and Communion. Extreme Unction, in fact, is the consummation of Penance.¹² When Penance and Holy Communion can no longer be administered, it is sufficient that the patient give a sign of contrition, or, if he be unconscious, that he may be reasonably presumed to desire the Sacraments of the dying.

¹² Conc. Trident., Sess. XIV, De Extr. Unct., c. 3; Cat. Rom., P. II, c. 6, qu. 12; Pohle-Preuss, The Sacraments, Vol. IV, p. 1, 2nd ed., St. Louis 1918.

The positive disposition required for the worthy reception of Extreme Unction consists in acts of faith and hope, and confidence in God's mercy.¹³ The Roman Catechism admonishes pastors to preach often on Ex- treme Unction in order to remind the faithful of their last end and to aid them in repressing evil desires and leading a good Christian life.¹⁴

¹³ Cat. Rom., P. II, c. 6, qu. 9: "Fides et religiosa animi voluntas." —Cfr. Gury, Comp. Theol. Mor., II, n. 523: "What disposition is required for the reception of this Sacrament? Confession of sins, if the sick person is in mortal sin, for this Sacrament is the complement of Penance and therefore confession ought to precede it. But if the sick person cannot confess his sins, it is necessary that contrition at least precede, for the Sacrament of Extreme Unction is primarily a Sacrament of the living and was instituted especially to remove the remnants of sins. Yet in such a case attrition itself seems able to suffice, for it is at the same time also a Sacrament of the dead and can remit mortal sins with attrition."

¹⁴ Cat. Rom., P. II. c. 6, qu. 1, 14. —Conc. Trident., Sess. XIV, De Extr. Unct., Prooem. 14a Codex Iuris Can., c. 938 sq.

3. DUTY OF ADMINISTERING EXTREME UNCTION. —Every pastor engaged in the cure of souls is bound in justice and under pain of mortal sin (ex iustitia et sub gravi) to administer Extreme Unction, either himself or through another priest, whenever he is asked to do so and able to comply with the request. There are, however, excuses exempting him from this obligation, e. g., serious danger to his own life arising from contagious disease or other causes, but even this excuse would not be valid unless he were sure that the patient to whom he is called is properly prepared for death. Needless to say, a good shepherd will risk his life for his sheep, especially if there are no other priests available. Priests who are not pastors are bound to administer this Sacrament under pain of mortal sin only ex caritate in case of extreme necessity.14a A special duty incumbent upon pastors is to administer Extreme Unction in time, i. e., before the patient has lost consciousness and all reasonable hope for his recovery has vanished. This obligation is shared by relatives, physicians, and nurses, who should see to it that the priest is called before it is too late. To leave a Catholic die without the Sacrament of Extreme Unction is often a mortal sin.¹⁵ The duty of calling the priest and administering Extreme Unction arises also when the patient, after having at least partially recovered his health, again falls dangerously ill. ¹⁶ Extreme Unction should be administered whenever there is actual danger of death. Here, if anywhere, the principle applies: "In extremis extrema sunt tentanda." However, care must be taken not to administer the Sacrament prematurely, because it can be received but once (semel tantum) in the course of the same illness, i. e., the same danger of death.

¹⁵ Cat. Rom., P. II, c. 6, qu. 9: "Those sin most gravely who are accustomed to wait for that time to anoint the sick person when, all hope of recovery now lost, he begins to lose life and his senses; for it is evident that it contributes very greatly to receiving more abundant grace from the Sacrament if the sick person is anointed with sacred oil while his mind and reason are still vigorous and he can bring faith and a religious disposition of soul."

¹⁶ Cfr. John XI, 3; Conc. Trident., Sess. XIV, De Extr. Unct., c. 3.— Cat. Rom., P. II, c. 6, qu. 9, 11.— Rit. Rom., tit. 5, c. 1, n. 14: "In the same illness this Sacrament ought not be repeated unless the illness is prolonged, as when, after the sick person has recovered, he again falls into danger of death." —Cfr. J. Kern, S.J., De Sacr. Extr. Unctionis, pp. 331 sqq.

The anointments must be given according to the Ritual. In urgent necessity one anointment (on the forehead), with the abbreviated formula, is sufficient, though if the patient live long enough, the omitted anointments must be supplied.¹⁷ The anointment of the loins is now always omitted.¹⁸ The anointment of the feet may be omitted for any reasonable cause.¹⁹

¹⁷ Codex Iuris Can., can. 947, § 1.

¹⁸ Codex Iuris Can., can. 947, § 2.

¹⁹ Codex Iuris Can., can. 947, § 3.

Holy Communion, which should be given to the sick frequently, should be administered as viaticum (per modum viatici) when it seems reasonably certain that the patient will not be able to receive it again.²⁰

²⁰ Rit. Rom., tit. 4, c. 4, n. 16-17.

READINGS. —Th. Slater, S.J., A Compendium of Moral Theology, Vol. II, pp. 233 sqq. —Sabetti-Barrett, S.J., Compendium Theologiae Moralis, pp. 766 sqq.—F. P. Kenrick, Theologia Moralis, Vol. II, pp. 261 sqq. —J. Kern, S.J., De Sacramento Extremae Unctionis, Ratisbon 1907. —Pohle-Preuss, The Sacraments, Vol. IV, pp. 1 sqq. —P. J. Hanley, Treatise on the Sacrament of Extreme Unction, New York 1907. —H. Noldin, S.J., Summa Theologiae Moralis, Vol. III, 11th ed., Innsbruck 1914, pp. 521 sqq.—M. J. O'Donnell, "Extreme Unction in the New Code," in the Irish Ecclesiastical Record, No. 604 (April 1918), pp. 286-297. —Stan. Woywod, O.F.M., in the Ecclesiastical Review, Vol. LIX, No. 2 (Aug. 1918), pp. 155 sqq.