Chapter IV. On the Subject of Extreme Unction

1507. - The subject of this Sacrament is all, and only, sinners, i.e. those who are capable of sin or at some time were capable, and these sick persons whose life is in danger. It is established 1° from the words of St. James: Is anyone sick among you? Let him bring in the priests of the Church, etc.; but the Greek word is sick signifies a dangerous disease; 2° 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. Trent agrees. - But that they ought to be sinners is clear from the Form itself.

Hence children before the use of reason are not capable of this Sacrament, nor those perpetually insane, because they have committed no actual sins, nor could they commit them. In doubt concerning capacity, let it be conferred under condition.

1508. Questions. - Quaer. 1° Whether Extreme Unction ought to be conferred on the delirious sick?

Resp. Affirmatively, if previously they asked for the Sacrament, or probably would have asked for it if they had thought about this, or showed a sign of sorrow for sins. Indeed also to the sick destitute of the senses, as is established from the Roman Ritual. Cf. n. 1240. R. 4°. - But to one laboring under frenzy or insanity, who probably could do something against the reverence of the Sacrament, it is not to be ministered unless the danger is altogether removed, for example by binding him.

Quaer. 2° Whether this Sacrament can licitly be conferred on a sick person in doubtful or probable danger of death?

Resp. Affirmatively, with the common and true opinion, because for ministering 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. It is confirmed from the Roman Ritual, where it is thus established: this Sacrament ought to be given to the sick who labor so gravely that the danger of death seems to threaten. I said: 1° that he is prudently judged to be in danger of death. For in mere doubt, i.e. unless there is truly probability of danger present, it will not be administered, since then it cannot be said that danger of life is present. - I said: 2° for ministering this Sacrament validly AND licitly. For St. Alphonsus judges that this Sacrament is always validly conferred if the infirmity is grave. This opinion, especially among us, can be brought into practice in this sense: that the priest ought to be much less anxious in judgment concerning the danger, if he is far distant from the sick person and cannot easily return. (29) p. 421.

Quaer. 3° Whether Extreme Unction can be conferred: a) on a woman laboring in childbirth; b) on those about to undergo a difficult surgical operation; those failing from old age; those infected by poison; c) on those to be punished capitally; those about to join battle; those placed in danger of shipwreck?

Resp. to a) Distinguish. Negatively, if there is question of a woman laboring under ordinary pains in childbirth, even if she gives birth for the first time, or at other times was in danger of life; affirmatively, if she labors under extraordinary and lethal pains. For in the latter case, not in the former, danger exists from disease.

Resp. to b) Affirmatively, because danger exists from disease. (51) p. 430.

Resp. to c) Negatively, for the contrary reason.

Quaer. 4° Whether Extreme Unction can be conferred on children?

Resp. Affirmatively, provided they "are in possession of reason, and are judged capable of deceit and fault." Thus Benedict XIV. Indeed in doubt concerning the use of reason, according to the opinion more probable to St. Alphonsus, they are to be anointed under condition. Cf. n. 1507.

Quaer. 5° Whether, or when, this Sacrament can be repeated?

Resp. 1° Certainly it can be repeated as often as a sick person anointed in a dangerous disease has recovered, and again falls into a dangerous disease. It is established from Trent.

Resp. 2° It can also be repeated in the same infirmity, if it has been long-lasting and the sick person notably recovered, so that he seemed to have been rescued from the danger of death, and again has fallen into the same danger. The reason is that then there is truly a new danger of death. It is established from the Roman Ritual, where it is said: "in the same infirmity this Sacrament ought not be repeated, unless it is long-lasting, as if, when the sick person has recovered, he again falls into danger of death."

Quaer. 6° Whether it can be repeated in the same long-lasting disease, if it is doubted whether the state of the disease has really been changed?

Resp. Affirmatively, more probably, if the doubt is truly positive, namely when it is truly probable that the sick person has come out of the danger of death; for this repetition in these cases is more conformable to the ancient custom of the Church. But a doubt of this kind will be present if the sick person seems to have escaped danger of death for a notable time, say for a month.

Quaer. 7° Whether there is a grave obligation of receiving this Sacrament?

Resp. There is a twofold probable opinion.

The first affirms. 1° It is clear, they say, from the words of the Apostle James himself: Is anyone 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. 2° There is added the practice of the Church, which with the greatest solicitude has always taken care that it be received by all the sick. It seems to be established also from the custom and sense of the faithful. 3° Moreover it is grave, and against the charity which each one owes to himself, to omit a means so efficacious, and a most firm protection, as Trent says, against the efforts of the demon in the last struggle. - Thus Roncaglia with others.

The second denies. The reason is that neither from Tradition nor from the Decrees of Councils is there evidence of a precept of receiving this Sacrament. But what St. James says, let him bring in the priests, etc., is received and explained as counsel. Therefore a grave obligation of receiving Extreme Unction cannot be imposed. - Thus Billuart, after St. Thomas, Sporer, and St. Alphonsus, who calls this opinion common. Yet the first pleases St. Alphonsus more, and he calls it very probable in the case in which the sick person, exhortations having been employed, should continue to be unwilling to be anointed.

But he certainly would sin gravely: 1° who from contempt refused this Sacrament; or 2° could not overcome grave temptations without it; or 3° would give grave scandal by not receiving it.

Moreover Extreme Unction would be necessary for salvation to one placed in mortal sin, lacking contrition, and unable to give a sign of Confession. "But Suarez and Palaus say well that this case can scarcely occur," i.e. then indeed the necessity of Extreme Unction for salvation would be present, but not the obligation of asking for it, as being impossible to fulfill.

Quaer. 8° What disposition is required for the reception of this Sacrament?

Resp. 1° Confession of sins, if the sick person is in mortal sin, practically.

Resp. 2° But if the sick person cannot confess his sins, let contrition, at least estimated, precede: for this Sacrament of Extreme Unction is primarily a Sacrament of the living, and was instituted chiefly for taking away the remnants of sins. - But in such a case attrition itself suffices and is required; for it is at the same time a Sacrament of the dead, and can remit mortal sins with attrition. - The Salmanticenses, Benedict XIV, and others.

Hence it is clear that this Sacrament, as the Roman Ritual says, is to be denied to "the impenitent, ... and those who die in manifest mortal sin."

It is said: to the impenitent and those who die in MANIFEST mortal sin. But under these words there ought not to be comprehended the dying who, in the act of mortal sin, are destitute of the senses; for it is not altogether certain that they die in manifest sin. Therefore, absolution being given under condition, this Sacrament can be conferred on these conditionally. (30) p. 421.

Note. - He also can be anointed who is baptized in grave infirmity. (31) p. 422.