Duties of the Recipient and the Minister of Extreme Unction

Special Duties.—In addition to the duties that are common in all the Sacraments, the following duties should be noted in reference to Extreme Unction.

(a) The Recipient.—Per se, Extreme Unction is not necessary as a means to salvation, for sanctifying grace may be had or recovered without it; but per accidens it would be necessary as a means, if a dying person were in mortal sin and could not recover grace except through it. He who omits Extreme Unction unwillingly or for a good reason (e.g., because he is well prepared for death and cannot get a priest without very grave inconvenience) does not sin. He who omits the Sacrament voluntarily and without good reason, is guilty of grave sin if he acts from contempt, or gives scandal, or exposes himself to eternal damnation; but if there is no contempt, scandal or danger to salvation, sin is indeed committed by the neglect at such a crisis of so important a spiritual aid, but only venial sin, since there is no grave precept to receive this Sacrament. The recipient of Extreme Unction should be in the state of grace; and hence, if he has mortal sin on his conscience, he must beforehand make an act of contrition or receive absolution with attrition, or, if neither is possible, he must make an act of attrition. The custom of the Church calls for confession before Extreme Unction, and divine law commands confession if one is in mortal sin and in danger of death.

(b) The Minister.—The pastor is gravely bound in justice to give or have given the Sacrament of Extreme Unction to all his subjects who reasonably request it; other priests not charged with the spiritual care of the dying person are held in charity to anoint him, if he has not received the last rites and cannot otherwise be anointed. It is clear that sick calls should be attended to promptly, and it would be a serious matter to delay so long as to put the sick person in danger of dying without Extreme Unction or of receiving it when he had become unconscious and could not dispose himself properly. If the person has been pronounced dead before the priest’s arrival, he should nevertheless be absolved and anointed conditionally if the last breath was not long before; because physicians teach that death takes possession gradually, life lingering in the body for some time after its external signs have ceased, for about a half hour when the end has come after long illness, for one or two hours when death is sudden or accidental. The ceremonies are obligatory under pain of sin, and it is considered a serious matter to neglect the more notable parts, that is, without reason to omit all or nearly all the prayers, or to give the Sacrament without any sacred vestment.

(c) The Pastor.—The oil of the sick should be kept in a neat and properly decorated place, and should be contained in a vessel of silver or white metal. Only in exceptional cases is it lawful to keep it in the rectory (Canon 946). The Catechism of the Council of Trent (page 307) declares that Extreme Unction should form a subject of frequent instruction. It is important to exhort the people not to delay in sending for the priest till the sick person has become insensible, nor to omit to send for him in case of sudden death, since, as already said, life remains for some time in the body after apparent death.

(d) The People.—All those who are responsible for the good of the dying person, such as members of the family, physicians, nurses, relatives, friends, or neighbors, should beware of deceiving him about his condition and his need of preparation for death; on the contrary, they should see to it as far as they can, that he receives the last Sacraments in good time and while he has the full use of his senses, when the spiritual benefit and the comfort of mind will be of greater assistance and the bodily cure more likely.

"The very words of divine utterance having been inspected, it is easily clear that the Sacrament of Extreme Unction, even in a case of necessity, namely when another Presbyter is absent, cannot be ministered by a sick Missionary to himself." S. C. de P. F. 23 March 1844.

1509. Questions. - Quaer. 1° Whether the sick are to be visited, when, how often, and who especially?

Resp. to the 1st. Affirmatively. The reason is 1° because the sick need priestly care more than the healthy; 2° because the time of infirmity is most opportune for procuring the salvation of souls; 3° because the priest receives the stipend of sustenance not only for care in the life of parishioners, but also for care in their death.

Hence the Pastor: a) "Let him exhort" publicly and more often "his parishioners," and likewise, if it can be done, the physician, "that they admonish him when it happens that someone in his parish is sick, especially if the disease is more grave." b) "But if the Pastor, legitimately impeded, cannot sometimes be free for the visitation of the sick, as when they are several, he will take care that this be performed by other priests, if he has any in his parish, or at least by lay men pious and endowed with Christian charity." c) When the disease grows worse, let him admonish even the domestics of the sick person to summon him. d) Especially in large parishes, let him have a catalogue of the sick, so that he may know the state and condition of each, and may more easily retain memory of them and assist them opportunely.

Resp. to the 2nd. The Pastor, "as soon as he has known," says the Roman Ritual, "that any of the faithful committed to his care is sick, will not wait until he is called to him," and a fortiori he will not by his own manner of acting or that of his people be the cause why the faithful are deterred from summoning him at the opportune time; "but he will go to him of his own accord," at least if the disease is more grave. Yet especially they are to be visited when the disease grows worse and in the article of death.

Resp. to the 3rd. "Not only once," says the Ritual again, "but more often, insofar as there shall be need"; more often, namely, when the disease is more grave, or longer-lasting, or more sharp; likewise more often when the sick person is less well disposed, or more dejected in soul or anxious, or is attacked by graver temptations. - If nevertheless the sick person is insane, phrenetic, or deprived of the use of reason, visits can be rarer.

Resp. to the 4th. Especially to be visited are: 1° the poor, who, destitute of human helps, require the charity and work of a benign and provident pastor; to these he will succor from his own, as he ought, and if means do not suffice, by the alms of others; 2° sinners, and those spiritually sick and tempted, especially if they spurn the ministry of the priest, that they may be directed into the way of salvation; 3° those more gravely sick; 4° all, other things being equal, are to be visited equally, without acceptance of persons. - It is clear per se that the obligation does not cease, although either the journey is longer, or the way difficult, or the weather stormy, or the disease contagious.

Quaer. 2° What things are to be noted concerning the visitation of the sick?

Resp. 1° "Visiting the sick," says the Roman Ritual, "let him bear himself with that honesty and gravity which befits the priests of the Lord," especially with women, chiefly those who have not yet reached canonical age; namely, let him not enter the room of the sick woman unless she has been forewarned; without necessity let him not be alone with one alone, and, while he consoles her or testifies compassion to her, let him abstain from every discourse, or even word, which he would not wish to be heard by others. Yet honesty and gravity, especially in the first visitation, ought to be joined to charity, courtesy, and Christian affability, so that the priest may win the soul of the sick person and have easier access to him.

Resp. 2° "But first of all let him undertake the spiritual care of the sick, and place all diligence in this, that he direct them into the way of salvation, and defend and protect them by the help of salutary aids from diabolical snares." Wherefore he ought diligently and prudently to inquire under what disease the soul labors; to what temptations especially or depraved opinions the sick person is subject; what is his nature, defects, and passions, that he may prudently apply suitable remedies. Hence the priest, when he is first called to the sick person, will prudently investigate all those things which concern the same, for example his disease, state, morals, life, etc.; likewise whether he ordered him to be called, or at least knows that he has been called.

Resp. 3° Visits ordinarily should not be too prolonged.

Resp. 4° Let it be the priest's care that dangerous objects be removed from the room of the sick person, and that persons who in some way can furnish an occasion of sin not approach him at all; likewise that he not mention persons loved impurely, held in hatred, or by whom he was injured; nor let him speak about lawsuits, children, goods, and other similar things, unless necessity presses; and if the sick person speaks about these things, let the priest turn the conversation to other things.

Resp. 5° Let the priest take care that images of the Crucified, of the Blessed Virgin Mary, and of the Saint whom the sick person especially venerates be placed before his eyes; likewise that there be present a small vessel of blessed water, with which he may be sprinkled frequently.

Resp. 6° Let him console the sick person both by words and examples, and by saying that he is going to pray for him in Mass and other prayers, and will take care that others likewise do so for him; likewise let him arouse, strengthen, and exhort him.

1510. - Quaer. 3° What things are to be noted concerning exhortations?

Resp. 1° Let them be suggested opportunely and discreetly, lest they bring annoyance to the sick person, but relief; 2° let the priest approach so prepared that he has ready arguments apt for persuading, and especially examples of the Saints, which have very great force; 3° let not always the same things be said, but various things according to the various quality and state of the sick person, namely to the learned few and grave things, to the rude common things, to the devout and little ones sweet things, to sinners consolatory, arousing, manifest things; likewise some things before Confession, others after the last Sacraments, others in agony; 4° let the speech be familiar, candid, and not affected, brief and often interrupted, so that the sick person may be able to meditate on what has been said; 5° let the sound be not loud, nor clamorous, nor hard, and, if threats and rebukes are required, let them be softened with mild words; 6° the speech can often be directed to the bystanders concerning the miseries of life, the vanity of the world, etc.

Quaer. 4° To what things ought the priest exhort the sick person?

Resp. 1° a) "That he place all his hope in God, repent of his sins, implore the divine mercy, and patiently bear the pains of infirmity as a paternal visitation of God, and believe that it has happened for his salvation, that he may institute his life and morals better"; b) to eliciting often acts of faith, hope, charity, contrition, patience, and other virtues; c) to praying and meditating frequently, as his condition will bear, and to invoking the patronage of the Blessed Virgin Mary and other Saints, at least by ejaculatory prayers and pious sighs; to which end he will propose some brief prayers and pious exercises of the mind toward God; likewise the meditation of the Passion of Our Lord, the martyrdoms and examples of the Saints, and the blessedness of heavenly glory. - To Religious and the learned he will also suggest verses from the Psalms, but to the uneducated the Lord's Prayer, the Angelic Salutation, the Symbol of Faith, and especially the invocation of the Most Holy Names of Jesus, Mary, Joseph, etc. d) to exercising good works of which he is capable, to giving alms, to taking care that prayers and Masses be made for him, while nevertheless taking good care concerning the advantage of his own profit, and not taking the burden upon himself unless the sick person of his own accord has asked; in which case he ought not refuse the stipends; e) that for bodily health he not employ anything which is turned into detriment of the soul; f) concerning Confession, see the question next following.

Resp. 2° If the disease is more grave or dangerous, he will exhort him that, while he is sound of mind, he rightly set in order his whole affair; if he has anything belonging to another, let him restore it; let him pay debts, or take care that they be paid, or at least furnish security; let him establish peace; let him be reconciled to enemies; let him make a just testament, lest any discord arise among heirs, and for the refreshment of his soul let him dispose according to his means what shall please him in the Lord; but in suggesting these things, let every mark of avarice be avoided.

Resp. 3° Where danger threatens, which the sick themselves for the most part are ignorant of, it is incumbent upon the priest, if another does not do it, to reveal the truth to the sick person and indicate the dangerous state; and "he will admonish the sick person that he in no way allow himself to be deceived by the craft of demons, nor by the promises of physicians, nor by the blandishments of relatives or friends; that he not on that account procure opportunely those things which pertain to the salvation of the soul; and that with fitting devotion and speed he religiously receive the Most Holy Sacraments while the mind is sound and the senses intact, without that deceitful and pernicious procrastination, which has led very many to eternal punishments, and day by day, the devil deceiving, leads them." This can be done by addressing the sick person in this or a similar way: my friend, although your health is not despaired of, nevertheless it is in danger; and therefore it is best that, as quickly as you can, you receive the last Sacraments; for Christ will restore you to your former health if this is expedient for your eternal salvation; but if nevertheless you must die, you greatly need graces, and through the Sacraments copious graces will be poured into you, by which you will soon come to the heavenly fatherland.

Resp. 4° After the last Sacraments have been received, he will continue to exhort the sick person to all those things which have been said above, especially to patience, perseverance, resignation, prayers, acts of faith, etc.; likewise to repeated Confession, if there is need, and Holy Communion.

Resp. 5° He will exhort those recovering that before all things they come to church; give thanks to God; rightly confess their sins, if perhaps Confession from a cause of necessity was imperfect or not materially integral; devoutly receive Sacred Communion; and thereafter hold a better discipline of life.

1511. - Quaer. 5° What things are to be noted concerning the Confession of the sick?

Resp. 1° a) Although from natural law there is incumbent upon physicians a grave obligation of timely admonishing the sick in dangerous diseases concerning Confession (see n. 1078. 14° and 1080. q. 1°), not on that account however is the Pastor freed from his care, since he himself, and not the physician, stands for the souls entrusted to him. Therefore, knowing that the infirmity is mortal - even by procuring for himself knowledge of this matter secretly from the physician, if it cannot be done otherwise - he ought to induce the sick person to Confession, although proximate danger is not yet present; yet not ordinarily in the first visit, unless necessity presses, and always with that prudence and charity which is fitting; namely in the beginning not speaking about Confession, but kindly asking how he is, what is the cause of the disease, how great are his pains; then exhorting him to resign himself to the will of God, and patiently to bear the pains in satisfaction for sins; and thus gradually, with the prudence which is fitting, inquiring about the time from which he has confessed; and at the same time little by little bringing it about that the sick person recognize the danger of his infirmity; and finally, by saying that it belongs to the wise to provide for future things, he will take occasion to exhort him to Confession while the mind is strong, proposing at the same time that this will profit the health of the body, if it is expedient for the soul. If the sick person seeks delay, and there is not imminent danger of death, lethargy, or delirium, he can indulge him to a brief determined time, say evening, or the following day; but if danger is imminent, he cannot admit delay; but he ought to admonish him with St. Augustine that God did not promise to wait for sinners, but only to spare them if they do penance. He did not promise tomorrow; perhaps He will give it, perhaps He will not give it. But if the sick person cannot be brought to Confession even thus, let the priest not desert him; and let him take care that he be brought to it by the counsels of friends and domestics; but if he is not yet willing, then the matter is not altogether to be despaired of, but, as long as he lives, frequent, varied, and efficacious exhortations of priests and other pious men are to be repeated, and the losses of eternal salvation and the punishments of everlasting death are to be proposed, and the immense mercy of God, provoking him to penance and most ready to forgive, is to be shown. The sick person is also to be commended to the prayers of the faithful, and especially of Religious Communities and of other devout persons. Fervent prayers to God are also to be employed by the priest and the others standing by, who, if this can be obtained, should pray on bent knees in his presence, so that they may be seen and heard by him. If death is at hand and he is not moved, let the priest take on the person of the sick man, praying to God in his name for the remission of sins, eliciting acts of contrition, faith, etc., so that, provided he gives a sign of contrition, he may be absolved at the last instant. Cf. n. 1373. 4°.

Resp. 2° When the sick person consents to Confession, always, if it can be done, he is to be left free to confess to another, and also to be asked whether he wishes to confess to another. But the confessor is held to hear him, even if he wishes to confess the sins of his whole life, and to take care that the last Confession be well made, with vehement contrition, firm purpose, and that integrity which then can be had. He ought to exhort the sick person to confess truthfully and integrally, saying that now he can amend all defects committed, and also by questioning concerning previous Confessions, concerning sins perhaps voluntarily concealed, etc. Besides, the sick person is to be helped in narrating sins, in eliciting acts of contrition, faith, etc. Finally a small penance is to be imposed, which the sick person should immediately fulfill while the confessor is present, imposing only a just penance to be performed at a suitable time if he recovers.

Resp. 3° When the priest visits the sick person after Confession has been made, even if he did not hear his Confession, he prudently asks him again whether nothing remains which troubles his conscience; whether the good disposition of conscience endures, but always skillfully, and never while others are hearing, lest because of shame he not dare to say the truth.

Resp. 4° At the time of agony, while the sick person is still vigorous in his senses, it will help to confer absolution upon him several times after a brief reconciliation, so that thus he may be rendered more secure concerning the state of grace, if perhaps the past Confessions were invalid; or at least he may receive an increase of grace, and also the punishments of purgatory may be diminished for him; and, if perhaps from temptation he falls into sin, he may at once be absolved. See n. 1371. Note.

Quaer. 6° By what rite is the visitation made?

Resp. See Exc. ex Rit. R. Ed. 1872, p. 126 (p. 118. Ed. 1874). But note: 1° that this rite is not of precept, as is clear from the Ritual itself; 2° that it is very usefully employed, especially with those dangerously bedridden who have already received the last Sacraments; 3° that the priest, as Baruffaldus rightly notes, can moderately greet the sick person and those standing by before he says: Peace to this house, etc.

1512. - Quaer. 7° Whether and how great is the obligation of visiting the sick person even after the Sacraments have been received, of helping the dying or those in agony, and in what way these are to be helped?

Resp. to the 1st. Affirmatively, as is clear from the words of the Ritual: "When the disease grows worse, the pastor will visit the sick person" - even one destitute of the senses, since even this one can be helped by prayers, sacramentals, absolution, etc. - "more frequently, and will not cease diligently to help him unto salvation, and he will admonish that, when danger is at hand, he be called immediately, so that he may be present to the dying person in time."

Resp. to the 2nd. Per se it is grave. The reason is that the sick person, if ever, then certainly needs the help of his pastor, since the devil lies in wait for his heel. Add that not rarely it happens that the sick person needs the confessor again because of a new sin, or because of Confession sacrilegiously performed. - But primarily and from justice this obligation is incumbent upon the Pastor; but upon other priests subsidiarily, i.e. in necessity and from charity alone.

I said: PER SE it is grave, i.e. if it can conveniently be fulfilled. But although the words if it can conveniently be fulfilled are not to be interpreted broadly, as is clear per se, nevertheless they suggest the excuse which can be given from this obligation of helping the dying, especially those in agony, particularly in these provinces, both in cities on account of the scarcity of priests, and in the country on account of the often great distance. - Nevertheless the priest will take care that, if he himself cannot help those in agony, they be helped by some pious layman, if one can be had.

Resp. to the 3rd. See Exc. ex Rit. Rom. p. 149 sq. (p. 141. Ed. 1874) and cf. St. Alphonsus, Prax. Conf. n. 276. 277; and besides, note the following: The Litanies can be recited even though death is not so imminent; but the following prayers, Go forth, etc., are to be said only when in the agony of its departure the soul is anxious, or while the time of expiring is at hand; concerning which last time of life it is certainly difficult to judge, since the most skilled physicians are often mistaken in this. Wherefore the priest ought not be precipitate, but should proceed very cautiously to the recitation of the aforesaid prayers, the more so because in the prayer Go forth, it is announced to the soul that it should leave the body; and this can strike into those who are less strong such trembling that, if they are not in the article of death, by that very fact they may be placed in it, and death itself may be hastened. Therefore if, the litanies having been recited, the sick person is judged more probably not to be constituted in the very agony, the priest can advisedly either repeat the same litanies, or say the litanies of the Blessed Virgin Mary, or other pious prayers; or it is better, if the sick person is in possession of mind, to be occupied in acts of virtues and salutary admonitions.

Note. - Concerning the manner to be held with one condemned to capital punishment, consult St. Alphonsus, Praxis Conf. n. 108. 109.