Chapter III: On The Subject Of Extreme Unction

1881. Principles. I. The SUBJECT of Extreme Unction is only a baptized man, who has attained the use of reason and is in danger of life from disease. - It is clear: 1. from the words of St. James: Is any one of you sick?, etc.; 2. from Trent (sess. 14, cap. 3), where it is declared: "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 exit of life."

Hence, for the VALID reception of this Sacrament the following things are required:

It is required, 1. that the one to be anointed BE BAPTIZED; for Baptism is the gate of the Sacraments. But this Sacrament can be conferred on an adult immediately after Baptism. "The reason is both because, more truly, through Baptism the remnants of mortal faults committed before Baptism are not wiped away, such as torpor toward good and proneness toward evil; and because the primary effect of this Sacrament is not so much the remission of faults as the strengthening of the sick person against the temptations of the devil, as Suarez and others commonly say."¹³

It is required, 2. that the one to be anointed HAS ATTAINED THE USE OF REASON. For otherwise the form would become vain: May the Lord forgive thee, etc. Hence it follows: 1) Children who have not yet attained the use of reason cannot be anointed. On the contrary, whatever Soto with others may say, children endowed with reason are to be anointed, although they cannot receive the Sacrament of the Eucharist and have not yet reached the age of seven, as Benedict XIV teaches.¹⁴ In doubt concerning the use of reason, let them not be deprived of so salutary a remedy, but let them be anointed under condition: If thou art capable.¹⁵ - 2) The perpetually insane cannot be anointed; otherwise, if they have had lucid intervals; or even if it is probable that they had them, in which case they ought to be anointed under condition. But the RITUAL admonishes: "If the sick person, while he labors under frenzy or insanity, likely could do anything against the reverence of the Sacrament, let him not be anointed, unless the danger is removed altogether," for instance, if he is held or even bound. - 3) The sick who are destitute of the senses ought to be anointed, and indeed without condition, if they have given a sign of a pious soul, or have lived as Christians, so that it can be presumed that they would have asked for the Sacrament if they had been masters of reason: or, as the Ritual speaks, if they likely would have asked. And the reason is that, in one receiving this Sacrament, an interpretative intention suffices (cf. n. 1434, 3).

It is required, 3. that the sick person BE SICK UNTO DEATH, "so that there is fear concerning his death," as the Council of Florence says in the Decree to the Armenians. - Hence, neither validly nor licitly can the healthy be anointed, even if they are in open danger of death, such as those in danger at sea, in battle, etc.; those to be punished by public death; women laboring only with common pains in childbirth, even if they give birth for the first time, or at other times have been in danger of life; otherwise, if most grave torments supervene, through which illness with danger of death is verified. But those can be anointed who are infected with lethal poison; likewise those laboring under some evil on account of which they are about to undergo a difficult operation of surgery; likewise decrepit old persons "who fail from old age (as the Ritual speaks) and seem to die day by day, even without another infirmity": for old age itself is a disease.¹⁶

To the following question: "Sometimes, when Missionaries are visiting Christians committed to themselves, there occurs a sick person laboring with hectic fever or a similar disease, who according to experience will live still several months, but within a year will die. - It is asked whether, in such a case, the Missionary can administer Viaticum and Extreme Unction to him, because when the truer case for receiving them will be present, a Missionary will not be able to be had present, on account of the great distance and other circumstances impeding this?" The S. C. DE PROPAG. FIDE responded on February 20, 1801: Affirmatively.¹⁷

1882. II. For the LICIT and FRUITFUL reception of Extreme Unction, certain dispositions of the subject are required besides. For it is primarily, and of itself, a Sacrament of the living (cf. n. 1395).

Hence, besides the intention, at least presumed, of receiving the Sacrament, which is also necessary for validity, there IS REQUIRED: 1. Confession of sins, if the sick person is in the state of mortal sin. - 2. Contrition, at least estimated, in the case in which he cannot confess; for he must be at least putatively in grace; but if he has only attrition, the Sacrament will not lack its effect (cf. n. 1395 and 1397, qu. 2). - 3. The Most Holy Eucharist, from the general custom of the Church (but at most under venial sin), must be premised, unless vomiting or another reasonable cause excuses.¹⁸ - The other dispositions, such as lively faith, firm hope, perfect conformity with the divine will, etc., effect that a richer fruit is perceived from the Sacrament (cf. n. 1437).

The RITUAL admonishes: "But to the impenitent, and those who die in manifest mortal sin, and the excommunicated... (the Sacrament) is to be denied." - Nevertheless, it is given both to the drunken now about to die, and to those wounded in a brawl now destitute of senses, and to any others whatever concerning whom it is doubted whether they are in the state of mortal sin or are sufficiently disposed. - Benedict XIV also says:¹⁹ "Concerning any faithful person, concerning whom the contrary is not established, it must be presumed that he would have asked for this Sacrament, if he could have."²⁰

1883. Questions. Q. 1. In what degree of infirmity CAN or OUGHT Extreme Unction be conferred?

Resp. 1. It CAN be conferred validly and licitly as soon as the sick person is prudently or probably judged to be in danger of death, although not yet proximate. It is proved from Trent (sess. 14, cap. 3, on Extreme Unction), where it is had: "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 exit of life." That particle especially sufficiently indicates that Extreme Unction can be ministered also to the sick who do not yet seem to be at the exit of life. The matter is proved more strongly from the Bull Ex quo of Benedict XIV,²¹ in which it is read: "Let the Sacrament of Extreme Unction not be administered to those well in health, but only to those who labor under a grave disease." Wherefore, whenever Viaticum can be furnished to a sick person who is not fasting, Extreme Unction can also be given to him; indeed, it is expedient that it then be given. - But if it were given in a GRAVE disease, though danger of death at least remote were not judged to be present, it would indeed be given validly, but illicitly; if in a LIGHT disease, it would be administered neither licitly nor validly.²²

2. It OUGHT to be given when danger of death urges; for thus the RITUAL speaks: "This Sacrament ought to be furnished to the sick who labor so gravely that danger of death seems to be imminent." - Nor is the last time of life to be awaited, as the Roman Catechism says:²³ "They sin most gravely (priests) who are accustomed to observe that time for anointing the sick person when already, all hope of health having been lost, he begins to lack life and senses." The reason is, says St. Alphonsus, because the sick person is deprived of the richer fruit which he would have received if, master of himself, he had received the Sacrament; likewise because he is deprived of spiritual strength for resisting the devil and for bearing the inconveniences of disease; he is perhaps deprived also of health of body, if he had been anointed at the suitable time, according to what was said at n. 1872; indeed also of the eternal salvation itself of the soul, in the case in which, existing in mortal sin, he would have attained grace with the help of attrition. - All these things, at least heaped together, seem to bring grave damage to the sick person.²⁴

Q. 2. Whether and when can this Sacrament be REPEATED?

Resp. It must be repeated: - 1. In a different and dangerous infirmity; for it is ordered to healing; "but healing medicine ought to be repeated as often as infirmity is repeated," as D. Thomas says.²⁵ - 2. In a different danger of a long infirmity; for the RITUAL says: "In the same infirmity it ought not to be repeated, unless it is long-lasting, as when the sick person has grown better and again falls into danger of death."

Hence, IN A LONG-LASTING DISEASE, such as phthisis and dropsy, if the sick person after anointing certainly has remained in the same state of infirmity, or only for a brief time, for instance for 4 or 5 days, has had himself better, it ought not to be repeated. - But if such a change has intervened in his state that with probability it must be judged that he had exited from the danger of death, because for a notable time, for instance for a month, he had had himself better than before, in such a case, with Benedict XIV as witness,²⁶ one must stand for repetition of the Sacrament, "because," he says, "this repetition is more conformed to the ancient custom of the Church, and through it a new spiritual help comes to the sick person."

Q. 3. Whether the reception of this Sacrament is NECESSARY for salvation?

Resp. 1. It is not necessary by necessity of means, since salvation can be obtained without this Sacrament. Thus all. - But whether it is necessary by necessity of precept is controverted. St. Alphonsus judges the affirmative opinion as very probable, and altogether to be advised in practice: but this, not now by reason of a precept, concerning whose grave obligation it is not established; but by reason of charity which the sick person owes to himself, and which urges especially in the extreme article of life. For although other protections, with which he can fortify himself, are not lacking to him, nevertheless he would act mercilessly toward himself if willingly he deprived himself of this most powerful protection. For he who is in danger of death, on the one hand, is able to excite himself to good acts only with great difficulty, and on the other hand is subject to strong attacks of enemies, since "in this point of time (as Trent speaks), the snares of the devil are more vehement." Hence (thus the Blessed Doctor concludes) he seems to expose himself to great danger of 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.

2. Although of itself it is not established that there is a grave obligation of receiving Extreme Unction, nevertheless all agree that the sick person PER ACCIDENS is held, and indeed UNDER GRAVE SIN, to the reception of the Sacrament, whether by reason of special necessity, namely if, existing in mortal sin, he could not receive another Sacrament, or by reason of scandal to be avoided, or finally by reason of contempt. - For it is certain that formal contempt induces grave fault. Moreover, contempt is censured formal when the sick person refuses this Sacrament because he values it little; but not when he refuses from some repugnance or ignorance. It is confirmed from the Bull of Martin V: This Sacrament can neither be neglected without fault, nor contemned without mortal sin. "Hence, the Pontiff seems sufficiently to have expressed that contempt of this Sacrament indeed carries grave fault, but negligence no more than light fault."²⁷

Note. Concerning ASSISTANCE TOWARD THE DYING, see the Opuscule of St. Alphonsus at the end of the Praxis Confessarii, or in Hom. Apost., last Treatise, Appendix II. - Concerning the Indulgence to be imparted to the dying²⁸ (cf. n. 1854, 9).