Question One. Concerning the Nature of Extreme Unction.

428. Definition. Extreme unction is a sacrament by which, through an anointing with olive oil and the prayer of a priest, health of soul and sometimes also of body is conferred on one gravely sick.²

a. The common source from which those things are taken which theologians teach concerning this sacrament is the words of the Apostle James: Is any man sick among you? Let him bring in the priests of the Church, and let them pray over him, anointing him with oil in the name of the Lord. And the prayer of faith shall save the sick man, and the Lord shall raise him up; and if he is in sins, they shall be remitted to him.³

b. It is called extreme unction because of all the anointings which Christ instituted or entrusted to the Church to institute, it is the last which is administered. This sacrament is the complement of penance in almost the same way that confirmation is the complement of baptism.

c. Extreme unction is of itself a sacrament of the living, because it was instituted primarily not for destroying mortal sins, but for removing the remains of sins. Yet because by the force of its institution it also destroys mortal sins, it can per accidens be called a sacrament of the dead.

¹ St. Thomas, Suppl. q. 29-32; St. Alphonsus, l. 6, n. 706-733; Coninck, De sacramentis II, disp. 19; Sporer-Kazenberger, Supplementum theol. sacram. c. 2, sect. 3-4; Suarez, De poenitentia, disp. 39-44; Ballerini-Palmieri, Opus theol. mor. V, n. 840-881; Ign. Schmitz, De effectibus sacramenti extremae unctionis (Friburgi: Herder, 1893); J. Kern, De sacramento extremae unctionis (Ratisbonae: Pustet, 1907); Heimbucher, Die hl. Olung (Regensburg: Manz, 1888).

² Cn. 937 sets forth a description of the sacrament.

³ James 5, 14-15. Cf. Council of Trent, sess. 14, De extr. unct., can. 1.

429. Effects in General. The proper effect of this sacrament is fourfold: a. strength of soul; b. cleansing of venial sin and of punishments; c. remission of mortal sin; d. health of body. They are taken from the words of James cited above.

a. This sacrament was instituted for disposing and preparing the soul proximately, so that without delay it may be able to enter the kingdom of heaven. Now, for obtaining this end, extreme unction especially does two things: alpha. it strengthens the soul by actual graces, so that it may persevere in good until death; beta. it purges the soul from sins and punishments which delay entrance into eternal glory.

b. Of these effects some are intended primarily and principally, others indeed per se, but only secondarily. The first among those named above, the strengthening of the soul, belongs to the primary effects; the same seems to have to be said of the second, the cleansing of sin and of punishments. The third and fourth, remission of mortal sin and healing of the body, constitute, by the consent of all, secondary effects of extreme unction.

c. All theologians teach that extreme unction removes the remains of sin, both original and actual, but not all explain in the same way what those remains are. The infirmities of soul to be enumerated below primarily pertain to these remains.¹

d. This sacrament completes and perfects the sacrament of penance. For penance was instituted for destroying sins, both mortal and venial; extreme unction was instituted for destroying the remains of sin, both original and actual. Therefore, just as penance, so likewise extreme unction must be called a sacrament of divine mercy, which supplies to man a means of disposing and preparing the soul so that, separated from the body, it may immediately be able to enter the kingdom of heaven.

¹ Cf. Suarez, disp. 40, sect. 1, n. 8 ss.

430. Effects in Species. 1. Strength of soul: for with an increase of sanctifying grace there is conferred on the sick man a right to actual graces by which he is strengthened and comforted for overcoming those difficulties which threaten at the time of death: The Lord shall raise him up.

These difficulties arise from spiritual infirmities, of which sort are: a. weakness of soul left from past sins, by which it happens that one more easily relapses into sins; b. weakness arising from the fact that God, on account of past sins, deprives the soul of more abundant helps of grace; c. fear, sadness, and lack of confidence, because the sick man indeed knows that he has sinned, but does not know that God has already forgiven the sins committed; d. temptations of the devil, by which at death he tries to reduce the soul into perpetual servitude to himself; e. weakness of soul arising from the very bodily infirmity itself, for a man pressed by the gravity and pains of disease is hindered from attending to spiritual things.

2. Cleansing of venial sins and punishments which hinder immediate passage to eternal glory. a. That the sacrament produces this effect, because grace infused through the sacrament from divine ordination has the force of destroying sins and all of them, unless there is an obstacle in the soul of the sick man, and of remitting punishment, of itself indeed all punishment unless defect of disposition in the recipient stands in the way, is clear from the words of James: And if he is in sins, they shall be remitted to him. Then, through the form the proper effect of the sacrament is signified; but remission of sins is signified; therefore at least venial sins are remitted. b. Since the sacrament was instituted to remove those things which hinder immediate passage to heavenly glory, it must be said that, as much as is of itself, it destroys both venial sins and punishments of sins.

All indeed teach that this sacrament confers remission of temporal punishments, since it was instituted for wiping away the remains of sins, among which temporal punishments also are numbered; but concerning the manner and measure of remission, not all speak in the same way. From the sense of the Church it seems altogether necessary to say that this sacrament, ex opere operato, immediately indeed does not remit all punishments, but according to the measure which Christ determined when instituting the sacrament, provided the necessary disposition of the recipient is present; then, however, this sacrament ex opere operato confers actual graces by which the sick man can obtain for himself remission of all temporal punishments which delay entrance into eternal glory, by eliciting salutary acts and by acquiring indulgences.

3. Remission of mortal sin which cannot be destroyed by another means, provided attrition is had concerning it. For both the words of the Apostle James and the words of the sacramental form are altogether universal; for this reason they are not to be restricted to venial sins alone without manifest reason. But since this sacrament was instituted not per se first but only per se secondarily for destroying mortal sins, it remits these only if they cannot be remitted either by confession or by contrition.

a. That this effect is secondary is clear from the fact that the sacrament of penance was primarily instituted for destroying all mortal sins whatsoever. Therefore this sacrament was instituted not for destroying mortal sins simply, but only those which can no longer be destroyed through penance from whatever cause, while the obligation of confessing them, if this can be done, always remains.

b. Therefore he who is guilty of mortal sins and indeed cannot confess, but can elicit contrition, is bound to this before extreme unction, both because this means of destroying mortal sins is available and because extreme unction is a sacrament of the living. Hence it is not licit knowingly to receive it in the state of mortal sin.

c. Therefore he who is guilty of mortal sins but lacks the actual use of reason, likewise he who has actual use of reason but invincibly does not know that he is constituted in mortal sins, or invincibly thinks that he is contrite when he is not, obtains remission of mortal sins through extreme unction, provided he is attrite. But since this doctrine is morally certain, it is easily clear that for a dying man deprived of his senses extreme unction is a far more secure means of salvation than sacramental absolution itself.¹

4. Health of body likewise follows from the reception of this sacrament not per accidens but by the force of the institution; nevertheless, not always, but only when it is expedient for the salvation of the soul, and therefore conditionally. That this sacrament was instituted also for restoring health of body is gathered both from the words of St. James, the prayer of faith shall save the sick man, and from the Council of Trent, which counts also this among the effects of extreme unction: "and health of body sometimes, where it shall have been expedient for the salvation of the soul, the sick man obtains."²

a. From the added restriction, if it is expedient for the salvation of the soul, it is understood why that effect, although it is produced ex opere operato, nevertheless does not always and infallibly follow. For the secondary effect depends on the primary, which is the salvation of the soul, so that the secondary does not follow if it impedes the primary.

b. The sacrament does not work this effect suddenly after the manner of a miracle, but because by its supernatural force it helps and directs natural and free causes so that they effect health. Others derive this effect from the overflow of spiritual strengthening into the body; for they judge that supernatural strengthening of the soul has influence in producing health of body.³ Therefore the sacrament cannot produce this effect if health then cannot be restored through natural means but only by miracle. Therefore it is expedient that this sacrament be received as soon as the danger of death begins, so that there may be greater hope of recovering health by the force of the sacrament.

¹ Cf. Suarez, disp. 41, sect. 1, n. 19.

² L. c., c. 2.

³ Cf. Kern, l. c., p. 205 ss.

431. When It Produces Its Effect. More commonly theologians had taught that this sacrament produces its effect only at the last anointing. For they thought that the individual anointings by themselves alone did not have the character of a sacrament, but that all the partial anointings of the senses together with their forms were necessary for the perfect character of the sacrament. But after the recent declaration of the Church (n. 434), from which we learn that one anointing on some sense suffices for producing the essential effect of the sacrament, it now seems that this question can be determined thus. Each anointing with its form completely and perfectly signifies the effect of the sacrament, and therefore also produces it. Therefore by the first anointing the sacrament with its essential effect has already been conferred; then the following anointings increase and perfect the grace of the sacrament, especially if meanwhile the sick man has procured for himself a greater and more perfect disposition, in almost the same way in which, according to some theologians, in the most holy sacrament of the altar the reception of one species already suffices for perceiving the essential effect of the sacrament; then the reception of the other species increases and perfects this effect, especially if the communicant meanwhile has disposed himself better.

Note. Above (n. 8) we called the reviviscence of extreme unction probable. There are those who say that the reviviscence of this sacrament is plainly certain.¹ Their assertion has as much force as this argument has: Every sacrament validly conferred, even without the effect of grace, produces something in the recipient; this, however, is a right or title to the effect of grace, the obstacle having been removed afterward, if the recipient is still capable of it.

¹ Gihr, p. 94 ss.; Kern, l. c., p. 372 ss.