Question — Noldin, Summa of Moral Theology
Question Five. Concerning the Subject of Extreme Unction.
442. The Subject of extreme unction is every baptized man who has attained the use of reason and is in danger of death from disease or old age.1
For the valid reception of this sacrament, three conditions are required in the subject:
That the one to be anointed be baptized. This sacrament can also be conferred on an adult immediately after baptism has been received absolutely and duly, because the effect of this sacrament is both to strengthen the sick against the temptations of the devil and to wipe away the remains of sins; but an adult recently baptized can perceive both of these effects.2
That he has attained the use of reason, or that he is capable of sin; for before the use of reason man is not yet capable of the effects of this sacrament, which was instituted as the complement of penance for wiping away the remains of sins. Moreover the form of the sacrament does not apply to one who has not yet attained the use of reason, since he could not yet have sinned through the senses; but as soon as man is capable of sin, he is also capable of this sacrament.
a. Therefore children before the use of reason are not capable of this sacrament; but as soon as they are capable of sin, they are altogether to be anointed, although they have neither approached first communion nor confession, nor completed the seventh year. And in doubt concerning the use of reason they are to be anointed conditionally: if thou art capable.3
b. Those perpetually insane are not capable of this sacrament; nevertheless those who have had lucid intervals are to be anointed absolutely, and those who probably have had them are to be anointed conditionally.
1 Cn. 940, 1.
2 S. C. de prop. fide, September 26, 1821.
3 Benedict XIV, De synodo, l. 8, c. 6, n. 2. Cn. 941.
443. 3. That he is in danger of life from disease; for the word of the Apostle: is any man sick, and that other word: shall save the sick man, if not of itself, certainly from the interpretation of the Church, signifies a sick man lying dangerously ill.
a. Grave disease is judged to be that which of itself and by its nature can have a lethal outcome and has progressed to that point at which it can probably be judged that it will bring death. As soon as this probable danger of death is judged to be present, extreme unction can be conferred, because the subject is capable of it; but it ought not yet immediately be given. It ought to be given at least when death with moral certainty is now imminent.1 Nevertheless, in order to perceive all effects more certainly, it is expedient that the sacrament be received as soon as the danger of death is judged to be present.
b. Therefore if extreme unction is conferred on a sick man who is thought to be in danger of death, but in reality is not, the sacrament is invalid; for the capable subject from the institution of Christ is a sick man who in reality is in danger of death, just as the capable subject of absolution is a penitent who in reality is disposed.2
If a healthy man, or one oppressed by only a light infirmity which is not joined with probable danger of death, is anointed, the sacrament is invalid, as conferred on an incapable subject.
Likewise those who are constituted in danger of death not from disease but from another cause can receive this sacrament neither licitly nor validly. Therefore those are not to be anointed who are soon to be beheaded; soldiers who are about to enter battle; those who are about to undertake a voyage, even a very dangerous one; women who are about to give birth, even for the first time.
Those who undergo a difficult surgical operation can be anointed before the operation if they are already laboring under a dangerous disease, but not if the operation itself only then brings the danger of death.
c. It suffices, however, that the infirmity will probably have a lethal outcome, even if the danger is still remote. Therefore a sick man who labors under hectic fever or a similar long-lasting disease can be validly and licitly anointed, even if it is foreseen that he will still live for several months or even a whole year.
d. Those can be anointed for whom danger of death is imminent from a wound received, from poison drunk, or from old age without another infirmity; for old age itself is a disease. Therefore when viaticum can be ministered to a sick man who is not fasting, extreme unction can also be given to him.
e. In positive doubt whether the infirmity is dangerous, extreme unction can be given, but conditionally: if thou art capable, lest the sacrament and its effect be frustrated.
1 St. Alphonsus, n. 714.
2 Cf. Reuter, n. 438.
444. In Order That Extreme Unction Can Be Received Licitly and with Fruit, the state of grace is required. Therefore these things are to be observed:
a. Confession is to be premised if the sick man is in the state of mortal sin; and if the sick man cannot confess, sorrow with at least conditional absolution is to be premised.
If the sick man cannot confess, in order to perceive the effect of the sacrament he ought to try to elicit at least putative contrition, since extreme unction is a sacrament of the living. But if it happens that he elicits only attrition, the sacrament does not lack its effect, because in this case it also confers first grace (n. 430).
alpha. Although the state of grace procured by contrition before reception of extreme unction suffices if only the nature of the sacrament is considered (n. 42), nevertheless, if it can be done, confession must be premised, because for one existing in mortal sin confession in danger of death is necessary by divine law (221). Moreover the Roman Ritual has these words: "From the general custom of the Church this is to be observed: if time and the condition of the sick man permit, before extreme unction the sacrament of penance and of the Eucharist are to be provided."1
beta. Although a dying man is to be absolved before the administration of extreme unction, because extreme unction is a sacrament of the living and the complement of the sacrament of penance, and because the Church so commands, nevertheless this is not required with such necessity that it is not licit to anoint the dying man before absolution where there is deserved fear that time for administering both sacraments will be lacking.
b. From the present practice of the Church, viaticum is to be administered before extreme unction; this precept, however, does not oblige under grave obligation, and therefore for a just cause the order can licitly be inverted. Another practice flourished in the Church in antiquity, since extreme unction was administered to the sick immediately after completed sacramental confession. The Roman Ritual (l. c.) decreed that the present practice is to be observed.
c. This sacrament is not to be conferred on those who, impenitent, persevere contumaciously in manifest mortal sin.2
Therefore one who, while in possession of himself, contumaciously rejected the sacraments of the Church is not to be anointed when he has lost the use of senses or reason; for there is no even probable foundation for supposing the intention of this sacrament.
1 Rituale rom., tit. 5, c. 1, n. 2.
2 Cn. 942.
445. When It Is To Be Given Conditionally. As often as doubt exists concerning the existence of a condition which is necessarily required for valid administration, extreme unction, no differently from the other sacraments, can and must be administered under the condition that that thing is present: if thou livest; if thou art baptized; if thou hast the use of reason or at some time hast had it; if thou art gravely sick; if this matter is valid; if thou hast not yet been anointed; if thou hast sufficient intention. But as often as there is doubt concerning the existence of the disposition on which fruitful administration depends, extreme unction is to be given not conditionally but absolutely; for, when the obstacle of bad disposition has been removed, extreme unction probably, others say certainly, revives. But if under the condition if thou art worthy it is conferred on an unworthy man, then, as null, it cannot revive.
a. Nor should it be thought illicit to confer extreme unction absolutely where the disposition of the recipient is doubtful and therefore the sacrament is exposed to frustration of its effect, if the sick man is in reality indisposed. For because the sacraments are for men, it is licit to confer a sacrament with danger of frustrating the effect not only when the sacrament is the only means of procuring certain salvation of the soul, but also when it brings great utility to the sick man.
b. To the sick who, while in possession of themselves, had an implicit or interpretative intention of this sacrament, it is to be provided absolutely, even if afterward they lost the use of senses or reason.1
c. Canon 942, which to some seems to offend against the doctrine and practice admitted up to this point by all, is rightly interpreted by Alb. Schmitt as affirming that there the question is not of disposition but of intention, and therefore in doubt the sacrament must be conferred conditionally. For the reason on account of which the sacrament is not to be conferred on those contumaciously impenitent consists in defect of intention.2
1 Cn. 943.
2 Linz.-Quartalschr. 1918, p. 419.
446. The Obligation of Receiving the Sacrament of Extreme Unction cannot be said to be grave; for no precept exists of receiving this sacrament.1 But the negligence by which someone, when occasion has been given, does not receive this sacrament from mere sloth is certainly a venial sin.
a. And indeed a precept of receiving extreme unction cannot be gathered: alpha. from the nature of the thing, since it is not of itself necessary for salvation; nor beta. from the words of St. James: let him bring in the priests, which words of themselves ought not to be taken as preceptive any more than the words immediately preceding; but the Church has never declared them to be preceptive; nor gamma. from the will of the Church, which has never given such a precept, for the words of Cn. 944, no one may neglect it, do not contain a precept obliging under grave obligation. Cf. Concerning confirmation, n. 92. Nor finally delta. from the institution of this sacrament; for it cannot be affirmed that it is for the dying the only ordinary means of procuring salvation, and that God denies to him who neglects receiving this sacrament the necessary graces by which he is helped in the last struggle. These things are confirmed from what the Roman Catechism has.2
Concerning the obligation of receiving extreme unction, up to this point the same question was debated as concerning confirmation. The new Code deliberately abstained from settling it, and concerning each sacrament says only: no one may neglect it. Therefore, since the state of the question has not been changed by these words, each opinion of authors retains its probability.
A light obligation of receiving this sacrament is to be presumed from the precept of charity, by which everyone is bound to procure for himself so useful a help in extreme danger. Yet he who refuses to receive this sacrament when occasion has been given can sin gravely either by reason of scandal or by reason of contempt.
b. Although the sick man is not bound under grave obligation to receive extreme unction, nevertheless the parish priest: alpha. is bound under grave obligation to administer it to one asking expressly or interpretatively, especially where it would be the only means of salvation, because the parish priest by force of his pastoral office is bound under grave obligation to procure for his subjects means not only necessary but also very useful for salvation; beta. either by himself or through another is bound to warn the gravely sick man concerning the danger and to induce him to receive the sacrament.
c. To the question what obligation there is of taking care that extreme unction be administered to the sick man, a distinction must be made: alpha. those who, by some special title of office or piety, have spiritual care of the sick man, such as superiors, parents, spouses, can be bound even under grave obligation to warn the sick man about the danger and to procure its administration if he asks for it; beta. those, however, who do not have spiritual care of the sick man, such as doctors, nurses, and other domestics, are not bound under grave obligation, except in the case in which this sacrament is necessary for the sick man's salvation. For these are bound only from charity to procure this sacrament for the sick man; but their obligation of charity toward the sick man cannot be greater than the sick man's obligation of charity toward himself, who is not bound under grave obligation to procure it for himself.
1 St. Thomas, Suppl. q. 29, a. 3, ad 1; Suarez, q. 44, sect. 1; St. Alphonsus, n. 733, who says that the negative opinion is sufficiently probable.
2 Part II, c. 6, q. 14.
447. Concerning the Iteration of Extreme Unction. This sacrament in the same infirmity and in the same danger of death can be administered only once, because the efficacy of the sacrament lasts as long as the same danger of death lasts in which it was conferred. But it can, or even ought to, be repeated as often as the sick man falls into a new danger of death.1
a. There are those who say that this sacrament can be validly repeated in the same infirmity and in the same danger of death, and that this was in reality done in antiquity; nevertheless, from the present discipline of the Church, it cannot licitly be repeated in the same danger of death. Whatever may be said about this matter, this is certain: the sacrament of extreme unction is given to those lying dangerously ill so that it may provide them the helps which they need in that state; therefore its effect endures until either they have died or have been freed from the danger of dying from that disease.
b. If the sick man received the sacrament of extreme unction validly indeed, but sacrilegiously and therefore without effect, it probably revives when the obstacle has been removed, others affirm that it certainly revives, and nevertheless in the same danger of death it cannot be repeated. For the Ritual, l. c., n. 14, says: "In the same infirmity this sacrament ought not to be repeated unless it is long-lasting"; and Cn. 940, 2 has these words: "In the same infirmity it cannot be repeated unless the sick man has recovered and has fallen into another danger of life." Since in this case the obstacle has been culpably placed, sacramental confession, and, if this cannot be made, perfect contrition, is required for removing it (n. 8).
In a new dangerous infirmity, namely if the sick man has recovered from a dangerous disease and has fallen into another likewise dangerous one; and in this case indeed the sacrament ought to be repeated.
In the same infirmity, if the sick man has recovered either certainly or at least probably from the danger of death and has fallen into another danger of death, as sometimes happens in phthisis or dropsy; and in this case indeed the sacrament can be repeated.
But in the same infirmity the sacrament is not to be repeated as long as certainly the same danger of death endures. But if, with a new disease coming on, the danger of death is increased, it is judged the same danger, not a new one.
The same danger is judged to endure if the sick man has been better only for a short time, namely for some days, unless from the nature of the disease another judgment is established. On the contrary, the danger is judged to have ceased if the sick man in a long-lasting infirmity has been better for a notable time, namely for a month. In doubt whether the danger of death is the same or another, the decision should rather stand for repetition, "because repetition is more conformed to the ancient custom of the Church, and through it a new spiritual help and alleviation will come to the sick man."2
Therefore if it is certainly established that the sick man after anointing has recovered from the danger, as can happen in asthmatics and consumptives, he can be anointed again when a new danger returns after even a brief interval, one week.
But if it is not certain that the danger ceased after the anointing, when a new danger returns he cannot be anointed unless a notable time has elapsed, namely one month after the first anointing.
1 Cf. Rituale rom., tit. 5, c. 1, n. 14; Council of Trent, sess. 14, c. 3, De extr. unct. Cn. 940, 2.
2 Benedict XIV, De synodo, l. 8, c. 8, n. 4.