Question Four: On the Subject of Extreme Unction

S. Th., Suppl., q. 32 and 33.

704. The capable subject of Extreme Unction is a baptized wayfarer, having attained the use of reason and capable of malice, who by reason of infirmity is placed in grave danger of death. - This is clear from the testimony of James, from the tradition and practice of the Church, from the Council of Florence, decree for the Armenians, and Trent, sess. 14, c. 3, from the Ritual, tit. 5, c. 1, n. 8, and from can. 940.

It is said: 1) wayfarer, both generally because the sacraments are destined for wayfarers, and specifically because this sacrament prepares for death;

2. baptized or faithful, as is indicated by the words of James: Is anyone sick among you? for by Baptism man becomes capable of receiving the other sacraments;

3. having attained the use of reason and capable of malice, as is implied by the word: let him bring in the presbyters, which says a human act, and is clear from the primary end of the sacrament, which was instituted against the remnants of actual sin, as the form has it: May he forgive whatever you have sinned. Hence an adult who is baptized while dying can receive this sacrament immediately after Baptism, so that he may be freed from the infirmity left from actual sins (S. C. P. F., Sept. 26, 1821);

4. who by reason of infirmity is placed in grave danger of death, as is indicated by the word: is sick (n. 689), and is taught explicitly by the Council of Florence; but since old age is a true infirmity, the aged also can receive the sacrament if, by reason of weakness from old age, they are in grave danger of death. The danger of death is not required to be wholly imminent, but grave danger suffices; hence the sacrament can be conferred not only at the exit of life or article of death, but upon every sick person whose death is feared.

For the primary effect of Extreme Unction is the relief and strengthening of the soul of the sick person, the secondary effect is the restoration of bodily health; each supposes mortal infirmity; otherwise the sick person would not need a special sacrament by which he might be strengthened or healed. St. Thomas says, q. 32: "This sacrament a) is a certain spiritual healing, which indeed is signified by a certain manner of bodily healing. And therefore this sacrament must not be conferred upon those to whom bodily healing does not belong, namely, the healthy... b) it is the last remedy which the Church can confer, as immediately disposing for glory. And therefore it must be exhibited only to those sick persons who are in the state of departing, because their sickness is by nature apt to bring on death, and danger is feared" (a. 1 and 2).

Hence: 1. The following are not capable of this sacrament: the dead, - infidels or catechumens, - children and the perpetually insane, as incapable of sin, because "it is not given against the remnants of original sin except according as they are in some way strengthened through actual sins; hence it is given principally against actual sins, which are not in children" (a. 4, ad 2), - likewise, as it seems, the Blessed Virgin Mary, who neither had sin nor needed relief, - finally, the healthy or those lightly sick, although exposed to proximate extrinsic danger of death, such as those condemned to death, those about to sail or fight dangerously unless after they have received a lethal wound, those about to undergo a dangerous operation unless from an infirmity contracted they are already in danger of death or danger arises after the operation has been done, women who regularly give birth with some danger, unless because of a special infirmity death is to be feared, or from childbirth their strength has already been very much weakened.

2. On the contrary, those can receive the sacrament for whom from infirmity there is not only imminent but also probable intrinsic danger of death, such as all who have contracted an infirmity which will probably bring death, those infected with poison, those gravely wounded, those who after a surgical incision are greatly weakened, and decrepit old people even if they labor under no special disease, since old age itself is for them an incurable disease.

3. If there is doubt whether the sick person has attained the use of reason, whether he is truly placed in danger of death, or whether he is dead, the sacrament is to be ministered under condition (can. 941).

4. In a case in which, true grave danger being lacking, the sacrament was ministered in a merely supposed danger of death, if then a true danger arises, it is to be repeated at least under condition, for example: if you have not yet been validly anointed.

705. Conditions required for the reception of Extreme Unction. - There is required:

1. for valid reception of the sacrament, intention, because the sacrament must be received by an adult in a human manner; but a habitual intention not retracted suffices, even an implicit one, such as exists in all who wish to live or die as Catholics: for thus they have already implicitly sought the sacrament, or would probably have sought it explicitly if the occasion had been given;

2. for fruitful or licit reception, the state of grace, at least legitimately presumed, because it is a sacrament of the living, and the complement of Penance. Hence one who has sinned mortally must first receive the sacrament of Penance; or if this here and now is impossible, he must at least elicit perfect contrition; nevertheless one who in good faith thinks that he is disposed obtains the effects of the sacrament even with attrition alone.

Hence: 1) It is to be provided absolutely to sick persons who, when they were in possession of a sound mind, at least implicitly sought it or probably would have sought it, even if afterward they lost the senses or the use of reason. Thus can. 943.

2. To unknown persons and others about whom it can be doubted whether they have the aforesaid intention of seeking the sacrament, it is to be ministered under condition.

3. To the insane who have had the use of reason, it can be conferred, provided they then had at least an implicit intention of receiving it and did not revoke it.

4. Likewise to the furious and delirious: nevertheless the sacrament is not to be conferred upon them except in lucid intervals; but, when necessity is altogether urgent, it can be ministered even in the crisis, provided there is no danger of irreverence toward the sacrament.

5. To schismatics or heretics, while they enjoy the use of reason, the sacrament is not to be ministered unless they first have cast away heresy or schism; if they are destitute of the senses and are in good faith, it can be ministered under condition and with scandal removed, but regularly only to those who admit that Extreme Unction is a sacrament, as was said above, n. 653.

6. The sacrament is not to be conferred upon those who, impenitent, contumaciously persevere in manifest mortal sin; but if this is doubtful, let it be conferred under condition (can. 942), with scandal however removed.

The condition to be added is that which regards the validity of the sacrament, not however that which regards the disposition for the fruit of the sacrament, because the reviviscence of the sacrament is not to be impeded. This is the general principle which has force for all the sacraments; hence Extreme Unction should be conferred under the condition: if you are capable, or another similar one, not under the condition: if you are disposed. Nor should it be thought that in can. 942 an exception is placed to this rule, because in those who contumaciously persevere in manifest sin, an intention of receiving the sacrament can no longer be supposed with any probability; hence if there is doubt concerning this contumacy, there will likewise be doubt concerning the intention, not concerning the disposition alone. Therefore the general rule has force.

706. A special precept of receiving Extreme Unction is not proved to be given in itself, because the sacrament is not necessary for salvation, nor was it commanded by James but commended, as the Council of Trent says, sess. 14, c. 1.

Hence: 1) Those who do not receive it do not sin gravely in itself.

2. Accidentally grave sin can be present, by reason of special danger of temptations, or contempt, or scandal.

3. Indeed, to omit so great a means of salvation and firm protection, when the occasion is offered and a sufficiently great inconvenience is excluded, in proximate danger of death, regularly is not done from a reasonable motive, and therefore is accustomed to include light fault. Hence can. 944: "Although this sacrament is not of the necessity of means for salvation, nevertheless it is lawful for no one to neglect it; and it must be cared for with every zeal and diligence that the sick, while they are fully in possession of themselves, receive it."

The care belongs to the pastor, and indeed under grave obligation; also to blood relatives and relatives by marriage, who by a special title have care of the sick person, or even to friends: these are bound under grave obligation at least if the sacrament is necessary for salvation; indeed then, if they are lacking, every man is bound. But care must be taken that the sick person, fully in possession of himself, receive the sacrament, so that he may perceive the fruits more fully and more certainly.

707. Extreme Unction can be repeated, because it does not confer a character (q. 30, a. 3) nor a perpetual effect, since health of mind and body can be lost (q. 33, a. 1). Nevertheless it cannot be repeated in the same infirmity and in the same danger of death, because the commending or placing back of the sick person into the hands of divine mercy, which is reality and sacrament, is made for the whole danger and confers helps during the whole time of the danger and in the very article of death.

But when the danger has ceased through convalescence, if a new danger arises even in the same infirmity, as is accustomed to happen in long-lasting illnesses, the sacrament can be repeated (a. 2), as the Council of Trent says, sess. 14, c. 3. Hence can. 940, § 2: "In the same infirmity this sacrament cannot be repeated, unless the sick person after receiving the anointing has recovered and has fallen into another danger of life."