Part III. On the Effects of Extreme Unction

The primary effect, to which all the other effects are reduced, is disputed. According to the Scotists, Extreme Unction is ordered to the final remission of venial sins in the dying person who is now incapable of helping himself; from this remission of venial sins follows the relief of sorrow and sluggishness, which are effects of sin. They argue from the form of the sacrament, which seems directly destructive of sin. According to St. Thomas (Supplement, q. 30, a. 1) and St. Alphonsus (VI, 721, 731), it is ordered primarily to helping and strengthening the soul of the sick person, or to healing his spiritual infirmity, which is left in us from original and actual sin and which must especially be healed in the last struggle. But sins are remitted secondarily, namely insofar as they obstruct spiritual strengthening. This opinion is supported by the words of St. James, who seems to mention the remission of sins as a secondary effect: "And 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 forgiven him."¹ In particular, the following are enumerated:

I. Sanctifying grace, in itself and primarily second grace, or the increase of grace; likewise in itself but secondarily first grace, as follows from the things said above (n. 574).

II. Sacramental grace, which consists in this, that the sanctifying grace which Extreme Unction increases is ordered to this: that the sick person not be cast down by illness, but on the contrary be strengthened in illness, and, having been strengthened, vigorously fight against the last temptations and readily bear the final pains; and it brings with itself a right to actual graces to be received in order to those effects. Now, that the sacramental grace of this sacrament is what we have described is supported first by these words of St. James: "And the Lord shall raise him up," that is, shall stir him up and strengthen him.² Then the Council of Florence says: "The effect of this sacrament is the healing of the mind and, insofar as it is expedient, also of the body."³ And the Council of Trent says: "Our most merciful Redeemer, who wished that at every time there be provided for His servants salutary remedies against all the weapons of all enemies, just as in the other sacraments He prepared the greatest helps by which Christians could preserve themselves whole, while they lived, from every graver harm of the spirit, so by the Sacrament of Extreme Unction He fortified the end of life as by a certain strongest protection. For although our adversary seeks and seizes occasions throughout the whole of life so that he may in any way be able to devour our souls, nevertheless there is no time at which he more vehemently strains every nerve of his cunning to destroy us utterly and, if he can, to disturb us even from confidence in the divine mercy, than when he perceives that the end of life is impending for us."⁴ Tradition is added, whose testimonies Kern brings forward (St. Thomas, Supplement, q. 30, a. 1, ad 2; St. Alphonsus, VI, 731).⁵

III. The remission of mortal sins; this is clearly gathered from the words of St. James and Trent cited above (St. Thomas, Supplement, q. 30, a. 1; St. Alphonsus, VI, 731). It is required, however, that the sick person be attrite, at least habitually. But this also suffices, since that cannot be demanded which already of itself remits mortal sins, namely contrition.

IV. The remission of venial sins. For St. James and the Council of Trent do not distinguish between mortal and venial sins. Besides, there is no reason to exclude venial sins; indeed, since lesser offenses are more easily remitted, there is rather reason to include them. Nevertheless they are not remitted unless the sick person is at least habitually attrite for them.

V. The remains of sins, as the Council of Trent cited above expressly states (St. Thomas, Supplement, q. 30, a. 1, ad 2; St. Alphonsus, VI, 731). "But the remains of sin here are not called dispositions left from acts, which are certain begun habits, but a certain spiritual weakness existing in the mind itself; when it has been removed, even if the same habits or dispositions remain, the mind cannot be inclined to sin in the same way" (St. Thomas, loc. cit.; St. Alphonsus, loc. cit.).

VI. The remission of punishments, which by some is also referred to the remains of sins of which we have just spoken, more or less fully according to the disposition of the recipient. Thus it is taught not improbably: for since the end of this sacrament is also the consummation of the Christian life, as the Council of Trent speaks,⁶ or the final disposition of the soul so that it may enter glory, it also remits temporal punishment; but, because Extreme Unction works by way of medicine, whose effect depends on the disposition of the subject, a greater or lesser remission of punishment is given according as the disposition of the subject is better or less good.

VII. Health of the body. This is clear both from the words of the Council of Florence cited above and from the Council of Trent, according to which the anointed person "sometimes obtains health of body, where it is expedient for the salvation of the soul."⁷ Besides, note:

1. Extreme Unction does not confer health of body if it is not expedient for the salvation of the soul. "The operative reason," says St. Thomas, "never induces a secondary effect except insofar 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" (Supplement, q. 30, a. 2). But it is disputed whether this sacrament confers health whenever it is expedient for the soul, or only sometimes, that is, according to the order of divine wisdom and providence, as is said. Some deny that it always produces that effect whenever it profits the soul. They deduce that this happens only sometimes from the words of the Council of Trent cited above. Others teach the contrary, and think that the sense of the words of the Council of Trent is this: "sometimes, namely, where it is expedient for the salvation of the soul."

2. Extreme Unction confers health not by way of miracle, but insofar as spiritual strengthening overflows into the body, and brings with it a right that the means of recovering health be directed by the special Providence of God. "The unction," as the Council of Trent teaches, "raises up and confirms the soul of the sick person, exciting in him great confidence in the divine mercy; by this confidence the sick person, being relieved, bears the inconveniences and labors of illness more lightly, resists more easily the temptations of the devil lying in wait for his heel, and sometimes obtains health of body, where it is expedient for the salvation of the soul."⁸ And St. Thomas teaches that in Extreme Unction grace is conferred "not only so that it may remove guilt, but also the remains of guilt and the infirmity of the body" (Supplement, q. 29, a. 5), so that healing according to the holy Doctor must be called an effect of the grace conferred. Hence they are deprived of the aforesaid effect who defer reception of the sacrament so long that health cannot be expected without a miracle (St. Alphonsus, VI, 714).

¹ James 5:15.

² James 5:15.

³ Denzinger-Bannwart, n. 700.

⁴ Session XIV, De extrema unctione, Prooemium.

⁵ Op. cit., p. 238.

⁶ Session XIV, doctrine on the Sacrament of Extreme Unction.

⁷ Session XIV, De extrema unctione, cap. 2.

⁸ Loc. cit.