Article — Prümmer, Manuale Theologiae Moralis
Article IV. On The Subject Of Extreme Unction
580. Principle. The subject of Extreme Unction is every baptized man capable of malice and placed in probable danger of death, and this not from another source, but from illness or old age.
Thus it follows from the words of the Code of Canon Law, c. 940: "Extreme Unction cannot be given except to a member of the faithful who, after attaining the use of reason, is placed in danger of death because of illness or old age."
It is said, first: a baptized man, because Baptism is the gateway of all the sacraments. But Baptism of water is required, nor does Baptism of desire suffice, which indeed confers sanctifying grace but is not a sacrament. Therefore neither pagans nor catechumens can receive this sacrament; but if a gravely ill adult pagan is baptized, he can receive Extreme Unction immediately after Baptism, because he is capable of an increase of grace and still needs strengthening against diabolical temptations. Thus the Sacred Congregation for the Propagation of the Faith on September 26, 1821, and the Holy Office on May 10, 1703,49 appear to have determined. Nor is St. Thomas contrary to this doctrine when he says: "[Extreme Unction] is not given against the remnants of original sin, except insofar as they are in some manner strengthened by actual sins. Hence it is given principally against actual sins, which are not in children."50 For the Angelic Doctor: a) speaks only of children incapable of actual sin; b) teaches that Extreme Unction is principally against the remnants of actual sin. But in a baptized adult there can be remnants of actual sins committed before Baptism, for example, if perhaps his attrition did not extend to all sins.
More probably, however, the Blessed Virgin neither received nor was capable of receiving Extreme Unction, because she was without every sin and the fomes of sin, nor did she need strengthening against diabolical temptations.
It is said, secondly: capable of malice, that is, capable of personal sins. For children before the use of reason, as also those perpetually insane, cannot sin by their senses, and therefore in them the form is not verified: "Whatever you have sinned through hearing, sight," and so forth. But as soon as children are capable of sin, they are to be anointed when placed in a dangerous illness, although they have not yet approached first confession nor completed their seventh year. Insane persons who have or have had lucid intervals are capable of sin and consequently also of Extreme Unction.
It is said, thirdly: placed in probable danger of death, and this not from another source, but from illness or old age. Therefore a probable danger of death arising from a grave illness is altogether required. Consequently, if the danger of death arises from another source and not from illness, this sacrament cannot be validly administered; for example, Extreme Unction can be conferred neither licitly nor validly upon soldiers setting out for battle or upon those soon to be punished by death. The reason is that St. James expressly says: "Is anyone among you sick?" (ἀσθενεῖ), and: "shall save the sick man" (τὸν κάμνοντα). Therefore, as long as someone is healthy or not gravely ill, he is incapable of Extreme Unction.
Since advanced old age is itself an illness, Extreme Unction is to be administered to a decrepit old person placed in probable danger of death, as is evident from the cited words of the Code of Canon Law.
Note. 1. This sacrament is not to be conferred upon those who contumaciously persevere impenitent in manifest mortal sin.51 But if this impenitence is not altogether certain but doubtful, Extreme Unction is to be conferred under condition. Similarly, it is to be conferred under condition in three other cases, namely, when it is doubted: a) whether the sick person has attained the use of reason; b) whether he is actually placed in danger of death; c) whether he is dead. The condition added must be: "if you are capable," and not: "if you are disposed." For otherwise, in a case in which the sick person was indeed indisposed but capable, the sacrament would not afterward revive when the obstacle had been removed.
Before childbirth this sacrament cannot be administered to a healthy woman, just as neither can Viaticum. But if a danger to life arises during childbirth, it is lawful to confer both sacraments, because then an illness is also truly present.
It is not required that the danger of death be altogether imminent and certain. Indeed, it is counseled that Extreme Unction not be deferred until the very end of life, because then the effect of recovering health is always frustrated.
Since Extreme Unction is a sacrament of the living, the sick person must make confession beforehand if he is in the state of mortal sin. But if confession is impossible, there must be made beforehand: a) an act of supernatural sorrow on the part of the sick person, and b) sacramental absolution, at least conditionally.52
49 Collect. de Prop. Fide, nn. 768 and 256.
51 Code of Canon Law, c. 942.
52 Ibid., c. 941.
581. The obligation of receiving Extreme Unction is not considered grave, apart from scandal or contempt. The reason is: a) because no certain precept concerning this matter is found either in Sacred Scripture, in tradition, or in ecclesiastical law; b) because this sacrament is ordinarily not of such necessity for salvation; and therefore, in the time of an interdict, Extreme Unction formerly could not be administered to those who were able to receive other sacraments, for example, Penance and the Eucharist.53 But since even in the time of an interdict the Church permits sacraments necessary for salvation to be administered, it follows from this that Extreme Unction is not altogether necessary.54 It is evident of itself that one who refuses the reception of Extreme Unction with grave scandal (for example, a bishop or priest), or who contemns this sacrament, sins gravely.
Although ordinarily there is only a light obligation of receiving Extreme Unction, nevertheless the faithful are to be strenuously exhorted not to deprive themselves of so excellent an assistance in the danger of death. Therefore the Code of Canon Law, c. 944, establishes: "Although this sacrament is not of itself of the necessity of means for salvation, nevertheless no one is permitted to neglect it; and it is to be ensured with every zeal and diligence that the sick receive it while they are fully in possession of themselves."
53 Cf. c. 11, X 5, 38. According to the discipline in force, it is lawful during the time of an interdict to administer sacraments and sacramentals to the dying (Code of Canon Law, c. 2270, § 1).
54 Cf. St. Thomas, Suppl., q. 29, a. 2 ad 1; St. Alphonsus, Theol. mor., l. 6, n. 733.
582. Extreme Unction cannot be repeated (validly and licitly)55 in the same illness and in the same danger of death, because the efficacy of this sacrament endures as long as the same danger of death remains for which it was conferred. This repetition remains prohibited even when this sacrament (validly conferred) was sacrilegiously received. For such a sacrilegious sacrament afterward revives when the obstacle has been removed through Penance.
Concerning this matter the Council of Trent56 defined: "But if the sick recover after receiving this anointing, they will be able to be aided again by the assistance of this sacrament when they fall into another similar danger of life"; and the Code of Canon Law, c. 940, § 2, establishes: "In the same illness this sacrament cannot be repeated unless the sick person, after receiving the anointing, has recovered and has fallen into another danger of life." The general rule is this: As often as an imminent danger of death departs and a new one succeeds, even during the same prolonged illness, so often is it lawful to repeat this sacrament.57 In practice it is not infrequently difficult, indeed impossible, to decide whether the same danger of death has remained or not. If the sick person for some time, for example, for a month or even for a week, has been notably better, and then falls again into danger of death or "another danger of life," it is lawful to repeat Extreme Unction; but if the change for the better is very doubtful, the same danger of death is considered to continue.
55 A few theologians (for example, Kern, De extr. unct., l. 5, prop. XIII) teach that Extreme Unction is validly conferred in the same illness and in the same danger of death.
56 Sess. 14, c. 3, De extr. unct. (Denz., n. 910).
57 Cf. St. Thomas, Suppl., q. 33, a. 2. Blessed Albert (IV, d. 23, a. 21) and other older Scholastics thought that Extreme Unction could not be repeated in the same illness except once each year.