Question Two: On the Effects of Extreme Unction

S. Th., Suppl., q. 30; c. Gent. IV, 73.

697. The proper and principal effect of Extreme Unction is grace relieving and strengthening the soul of the sick person against the remnants of sins, or against spiritual languor and weakness which takes away perfect vigor for acts of the virtues; - not, however, the remission of mortal sin. That relief and strengthening of the soul are the effect of this sacrament is of faith, from the Council of Trent, sess. 14, on Extreme Unction, can. 2; that it is the primary effect and indeed exclusively so, is the opinion of St. Thomas.

The effect is indicated in the epistle of James, V, 15: The prayer of faith shall save the sick man and the Lord shall raise him up and if he be in sins they shall be remitted to him; and it is thus described by the Council of Trent, c. 2: "This reality is the grace of the Holy Spirit, whose anointing wipes away offenses, if any still remain to be expiated, and the remnants of sin, and relieves and strengthens the soul of the sick man, exciting in him great trust in divine mercy, by which the sick man a) being lifted up, and b) bears the inconveniences and labors of illness more lightly, and c) more easily resists the temptations of the demon lying in wait for the heel..."

It is proved from St. Thomas, q. 30, a. 1:

"Any sacrament is instituted principally for one effect, although it can also bring in other effects consequently. And because the sacrament effects what it figures, therefore its principal effect must be taken from the very signification of the sacrament. But this sacrament is applied according to the manner of a certain medication, as Baptism by the manner of washing. But medicine is for driving away infirmity. Hence principally this sacrament was instituted for healing the infirmity of sin. Hence just as Baptism is a certain spiritual regeneration, and Penance a certain spiritual raising, so also Extreme Unction is a certain spiritual healing or medication.

"But just as bodily medication presupposes bodily life in the one medicated, so spiritual medication presupposes spiritual life. And therefore this sacrament is not given against defects by which spiritual life is taken away, namely, against original or mortal sin; but against those defects by which man is spiritually infirm, so that he does not have perfect vigor for the acts of life, of grace or glory: and this defect is nothing other than a certain weakness and ineptitude which is left in us from actual or original sin, and against this weakness man is strengthened through this sacrament."

Hence the sacrament of Extreme Unction:

1. confers sanctifying grace with special vigor against the infirmity left from sin;

2. wipes away the remnants of sin, under whose name there do not come: the stain of fault and the guilt of eternal punishment, which are taken away with sin itself through Penance; nor evil dispositions or begun habits, which can exist at the same time with strengthening grace; nor properly temporal punishments due to sin; but a certain spiritual weakness existing in the mind itself, which having been removed, even with the same habits or dispositions remaining, the mind cannot so incline to sin (ad 2);

3. nevertheless, since it is an immediate preparation for entrance into glory (III, q. 65, a. 1, ad 4), it also takes away punishments consequently, not however always but only according to the disposition and devotion of the recipient.

698. The secondary effects are the remission of sins, even mortal sins, and sometimes bodily healing when it is expedient for the salvation of the soul. - It is certain from the Council of Trent, sess. 14, c. 2.

It is proved: First, both from the words of James: if he be in sins they shall be remitted to him, and because this follows from the primary effect, namely, strengthening grace.

"Because this strength (against weakness left from sin) is made by grace, which does not suffer sin with itself, therefore consequently, if it finds any sin either mortal or venial, as to fault it takes it away, provided an obstacle is not placed on the part of the recipient... And therefore James also speaks conditionally about the remission of sin, saying: if he be in sins, they shall be forgiven, namely, as to fault: for it does not always destroy sin, because it does not always find it; but it always remits as to the aforesaid weakness, which some call the remnants of sin... Hence it must be said that the principal effect of this sacrament is the remission of sins as to the remnants of sin; and consequently also as to fault, if it finds it" (a. 1).

This effect, which probably belongs accidentally to the other sacraments of the living, certainly belongs to this sacrament, and indeed, as it seems, in itself, although secondarily; for this sometimes attrition alone can suffice.

Secondly, it is explicitly stated in the words of James: the prayer of faith shall save the sick man, which by the obvious sense seems at least equally to be understood of the health of the body; moreover it is clear from universal tradition and from the Councils of Florence and Trent; but the effect comes from divine power, if it is expedient for salvation.

"Extreme Unction does not make bodily healing from a natural property of the matter, but from divine power, which works rationally. And because a rational agent never brings in a secondary effect except according as it is expedient for the principal effect, therefore from this sacrament bodily healing does not always follow, but when it is expedient for spiritual healing; and then it always brings it in, provided there is no impediment on the part of the recipient" (a. 2).

Hence: 1) This effect, as secondary, is derived through a certain redundancy from the principal effect, as is indicated by the Council of Trent, namely, from the relief of the soul, "by which the sick man, being lifted up... and health of the body sometimes, where it shall be expedient for salvation, follows."

1. Thus St. Bonaventure, IV Sent., in text. a. 1, q. 1, concl. 2; St. Albert the Great, ib., a. 23, 1, 11; St. Thomas, c. G. IV, 73.

2. Therefore it is not given except according as it is expedient for the principal effect, the healing of the soul, and indeed not according to the future but according to the present state and condition of the subject; for, as St. Thomas explains, c. G. IV, 73: "bodily infirmity is sometimes useful for the health of the soul, insofar as man sustains bodily infirmity humbly and patiently, and it is counted to him as if for satisfactory punishment; it is also sometimes impeding of spiritual salvation, insofar as virtues are impeded from bodily infirmity: therefore it was fitting that some spiritual medicine should be applied against sin, according as bodily infirmity is derived from sin; through this spiritual medicine bodily infirmity is healed sometimes, when it is thus expedient for salvation."

3. It is not given always when it is expedient for salvation, for the sacrament does not miraculously restore health: if the powers of the body are too weakened, there is an impediment on the part of the recipient. Yet the sick often feel some relief of illness from the reception of the sacrament.

699. Corollaries. - From the aforesaid it is concluded that Extreme Unction:

1. Was not instituted principally for the remission of venial sins, as St. Bonaventure and Scotus hold, because then either it would have to be granted even to the healthy, or it would not be granted except at the very last instant of life; both contradict the practice of the Church.

2. Nor principally for the remission of mortal sins, because it is a sacrament of the living, and Penance is a necessary means for obtaining the destruction of mortal sin (n. 433 and 449).

3. Therefore, neither indifferently for remission, according as it should find venial or mortal sins not remitted through Penance, as Bellarmine and Tournely said.

4. Much less for the remission of punishments, since it can be given to those for whom, after penance, no punishment to be paid remains; nor is it principally ordered to the health of the body.

5. It does not imprint a character, both because it can be repeated, and because "a character is not imprinted except in those sacraments by which man is deputed to something sacred; but this sacrament is only for a remedy, and through it man is not deputed to doing or receiving something sacred" (q. 30, a. 3).

6. It should opportunely be received while the sick person is not too weakened, and has full use of reason, so that from a more apt condition or a better disposition he may more fully and more certainly obtain the effects of the sacrament.

7. It revives while the same grave danger of the same infirmity remains, because then it cannot be repeated, but for the whole time of this danger it commends the sick man to divine mercy.