Repeating Extreme Unction

This sacrament may only be given once in the same sickness and in the same danger, but if the sickness be prolonged and after partial recovery the sick person again becomes dangerously ill, Extreme Unction may be repeated. According to some good authors, it may be repeated after a month’s interval, for as a general rule the danger may be considered a new one after such a period of time.

No good Catholic would wish to depart this life without the help of this and the other sacraments; still there is no obligation under grave sin to receive Extreme Unction. But although the faithful who, without despising it, neglect to receive this sacrament do not thereby commit grave sin, yet a priest who has the cure of souls would sin grievously if he neglected to give those under his charge the opportunity of receiving this sacrament in their last sickness. As soon as there is probable danger of death the last sacraments may be given in the following order: Penance, Viaticum, Extreme Unction, and finally the papal blessing for the moment of death.

Canon 941 prescribes that when it is doubtful whether a sick person has attained the use of reason, whether he is really in danger of death, or whether he is dead, this sacrament should be administered conditionally.

The Council of Trent¹ declares: "But if the sick recover after receiving this Unction, they will be able to be helped again by the aid of this Sacrament when they fall into another like danger of life." And canon 940, § 2 says: "In the same infirmity this sacrament cannot be repeated, unless the sick person after receiving the Unction has recovered and has fallen into another danger of life." So also the Roman Ritual.² With these things premised, I say:

I. Extreme Unction can be repeated in another infirmity; in other words, it can be repeated: 1. as often as someone after an infirmity has been driven out, or after health has been recovered, is again dangerously sick; 2. as often as in the same infirmity the danger of death has vanished and afterwards arises again (St. Thomas, Supplement, q. 33, a. 2; St. Alphonsus, VI, 715). This follows from the Council of Trent and canon 940, § 2 cited above. The reason is that Extreme Unction was instituted precisely for the danger of death; hence it can at least then be repeated when the danger is repeated.

Question. Can Extreme Unction be repeated if a grave danger is increased, or if, while a danger endures, another disparate danger is added?

Response. It seems that it must be altogether denied; for the Council of Trent above and canon 940, § 2 require that the sick person, after he has recovered, become gravely sick again. Some indeed permit Extreme Unction to be repeated if the sick person, after the same grave danger has endured for a long time, is in much graver danger. They allege as reason that in this hypothesis the danger, according to common estimation, is morally considered another danger. But even this opinion cannot be reconciled with the words of the Council of Trent and the cited canon.

Objection. Canon 940, § 2 declares: "In the same infirmity this sacrament cannot be repeated." But in the hypothesis posited a new infirmity or new danger is added.

Response. From the cited words of the Council of Trent, and likewise from the words of the canon which follow the opposed words, it follows that by "the same infirmity" is understood the same lethal condition of the sick person; this condition is aggravated by a new infirmity or new danger. Meanwhile the sacrament continues to confer helps against the new illness.

Corollary. As often as Extreme Unction according to what has been said is licitly repeated, so often also it must be repeated. This seems to be commonly admitted if someone after recovering health becomes dangerously sick again; not so if in the same illness the danger of death vanished and afterwards arises again. But since the obligation is founded, as it were, in the danger of life, likewise the obligation of repeating seems to be present as often as the danger is repeated.

II. Extreme Unction cannot licitly be repeated in the same infirmity; whether it can validly be repeated is doubtful. Kern³ and others affirm, especially because for several centuries in a great part of the Church there prevailed the use of repeating the sacrament seven times⁴ in the same danger. Others deny or doubt; and to the argument of their adversaries they respond that it seems doubtful whether the said repetition of which Kern speaks was regarded as a repetition of the sacrament. That is, according to some,⁵ all the anointings taken together were regarded as one sacrament; according to others,⁶ the repeated anointings, that is, those which followed the first ministration, were like sacramentals strengthened by liturgical prayers.

Question. Does a most grave cause excuse from the prohibition, for example if someone after receiving Extreme Unction has certainly or probably sinned gravely, and, not yet having confessed, is deprived of the senses?

Response. I think that in the proposed case the sacrament can be repeated conditionally, namely because in this way provision is made for the salvation of the dying person much more securely than through absolution.

III. In doubt whether the danger was absent, a sick person who again becomes gravely sick can be anointed again, and indeed conditionally if grave doubt persists; absolutely if it is sufficiently established that the danger was absent. Nevertheless, commonly it will not be sufficiently established unless the sick person has been better for a notable time, for example for several weeks (cf. St. Alphonsus, VI, 715).

Practical Note.

¹ Session 14, De extrema unctione, cap. 3.

² Title V, cap. 1, n. 8.

³ Op. cit., p. 338 sq.

⁴ That is, here the anointings were repeated for seven continuous days; there seven priests, one after another, performed the complete sacramental rite.

⁵ Schmid, in Zeitschrift fur katholische Theologie, t. XXV, p. 258 sq.

⁶ De Smet, in Collationes Brugenses, 1910, p. 192 sq.

It is useful to note two practical things:

I. Especially through Extreme Unction provision is made for the salvation of the dying person, above all of one deprived of the senses. That is: 1. attrition suffices for Extreme Unction; for Penance confession is also required; 2. habitual attrition suffices for Extreme Unction; the same cannot be said quite so absolutely about Penance (n. 41); 3. Extreme Unction received without attrition can revive; Penance received in that way is received invalidly, so that there can be no question of reviviscence.

II. Care must be taken that Extreme Unction be given in good time, both so that the sick person may sooner receive the spiritual fruits of the sacrament, and so that, if it is expedient for the soul, he may also recover bodily health.

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.

S. Th., Suppl., q. 32 and 33.

704. The capable subject of Extreme Unction is a baptized wayfarer, having attained the use of reason and capable of malice, who by reason of infirmity is placed in grave danger of death. - This is clear from the testimony of James, from the tradition and practice of the Church, from the Council of Florence, decree for the Armenians, and Trent, sess. 14, c. 3, from the Ritual, tit. 5, c. 1, n. 8, and from can. 940.

It is said: 1) wayfarer, both generally because the sacraments are destined for wayfarers, and specifically because this sacrament prepares for death;

2. baptized or faithful, as is indicated by the words of James: Is anyone sick among you? for by Baptism man becomes capable of receiving the other sacraments;

3. having attained the use of reason and capable of malice, as is implied by the word: let him bring in the presbyters, which says a human act, and is clear from the primary end of the sacrament, which was instituted against the remnants of actual sin, as the form has it: May he forgive whatever you have sinned. Hence an adult who is baptized while dying can receive this sacrament immediately after Baptism, so that he may be freed from the infirmity left from actual sins (S. C. P. F., Sept. 26, 1821);

4. who by reason of infirmity is placed in grave danger of death, as is indicated by the word: is sick (n. 689), and is taught explicitly by the Council of Florence; but since old age is a true infirmity, the aged also can receive the sacrament if, by reason of weakness from old age, they are in grave danger of death. The danger of death is not required to be wholly imminent, but grave danger suffices; hence the sacrament can be conferred not only at the exit of life or article of death, but upon every sick person whose death is feared.

For the primary effect of Extreme Unction is the relief and strengthening of the soul of the sick person, the secondary effect is the restoration of bodily health; each supposes mortal infirmity; otherwise the sick person would not need a special sacrament by which he might be strengthened or healed. St. Thomas says, q. 32: "This sacrament a) is a certain spiritual healing, which indeed is signified by a certain manner of bodily healing. And therefore this sacrament must not be conferred upon those to whom bodily healing does not belong, namely, the healthy... b) it is the last remedy which the Church can confer, as immediately disposing for glory. And therefore it must be exhibited only to those sick persons who are in the state of departing, because their sickness is by nature apt to bring on death, and danger is feared" (a. 1 and 2).

Hence: 1. The following are not capable of this sacrament: the dead, - infidels or catechumens, - children and the perpetually insane, as incapable of sin, because "it is not given against the remnants of original sin except according as they are in some way strengthened through actual sins; hence it is given principally against actual sins, which are not in children" (a. 4, ad 2), - likewise, as it seems, the Blessed Virgin Mary, who neither had sin nor needed relief, - finally, the healthy or those lightly sick, although exposed to proximate extrinsic danger of death, such as those condemned to death, those about to sail or fight dangerously unless after they have received a lethal wound, those about to undergo a dangerous operation unless from an infirmity contracted they are already in danger of death or danger arises after the operation has been done, women who regularly give birth with some danger, unless because of a special infirmity death is to be feared, or from childbirth their strength has already been very much weakened.

2. On the contrary, those can receive the sacrament for whom from infirmity there is not only imminent but also probable intrinsic danger of death, such as all who have contracted an infirmity which will probably bring death, those infected with poison, those gravely wounded, those who after a surgical incision are greatly weakened, and decrepit old people even if they labor under no special disease, since old age itself is for them an incurable disease.

3. If there is doubt whether the sick person has attained the use of reason, whether he is truly placed in danger of death, or whether he is dead, the sacrament is to be ministered under condition (can. 941).

4. In a case in which, true grave danger being lacking, the sacrament was ministered in a merely supposed danger of death, if then a true danger arises, it is to be repeated at least under condition, for example: if you have not yet been validly anointed.

705. Conditions required for the reception of Extreme Unction. - There is required:

1. for valid reception of the sacrament, intention, because the sacrament must be received by an adult in a human manner; but a habitual intention not retracted suffices, even an implicit one, such as exists in all who wish to live or die as Catholics: for thus they have already implicitly sought the sacrament, or would probably have sought it explicitly if the occasion had been given;

2. for fruitful or licit reception, the state of grace, at least legitimately presumed, because it is a sacrament of the living, and the complement of Penance. Hence one who has sinned mortally must first receive the sacrament of Penance; or if this here and now is impossible, he must at least elicit perfect contrition; nevertheless one who in good faith thinks that he is disposed obtains the effects of the sacrament even with attrition alone.

Hence: 1) It is to be provided absolutely to sick persons who, when they were in possession of a sound mind, at least implicitly sought it or probably would have sought it, even if afterward they lost the senses or the use of reason. Thus can. 943.

2. To unknown persons and others about whom it can be doubted whether they have the aforesaid intention of seeking the sacrament, it is to be ministered under condition.

3. To the insane who have had the use of reason, it can be conferred, provided they then had at least an implicit intention of receiving it and did not revoke it.

4. Likewise to the furious and delirious: nevertheless the sacrament is not to be conferred upon them except in lucid intervals; but, when necessity is altogether urgent, it can be ministered even in the crisis, provided there is no danger of irreverence toward the sacrament.

5. To schismatics or heretics, while they enjoy the use of reason, the sacrament is not to be ministered unless they first have cast away heresy or schism; if they are destitute of the senses and are in good faith, it can be ministered under condition and with scandal removed, but regularly only to those who admit that Extreme Unction is a sacrament, as was said above, n. 653.

6. The sacrament is not to be conferred upon those who, impenitent, contumaciously persevere in manifest mortal sin; but if this is doubtful, let it be conferred under condition (can. 942), with scandal however removed.

The condition to be added is that which regards the validity of the sacrament, not however that which regards the disposition for the fruit of the sacrament, because the reviviscence of the sacrament is not to be impeded. This is the general principle which has force for all the sacraments; hence Extreme Unction should be conferred under the condition: if you are capable, or another similar one, not under the condition: if you are disposed. Nor should it be thought that in can. 942 an exception is placed to this rule, because in those who contumaciously persevere in manifest sin, an intention of receiving the sacrament can no longer be supposed with any probability; hence if there is doubt concerning this contumacy, there will likewise be doubt concerning the intention, not concerning the disposition alone. Therefore the general rule has force.

706. A special precept of receiving Extreme Unction is not proved to be given in itself, because the sacrament is not necessary for salvation, nor was it commanded by James but commended, as the Council of Trent says, sess. 14, c. 1.

Hence: 1) Those who do not receive it do not sin gravely in itself.

2. Accidentally grave sin can be present, by reason of special danger of temptations, or contempt, or scandal.

3. Indeed, to omit so great a means of salvation and firm protection, when the occasion is offered and a sufficiently great inconvenience is excluded, in proximate danger of death, regularly is not done from a reasonable motive, and therefore is accustomed to include light fault. Hence can. 944: "Although this sacrament is not of the necessity of means for salvation, nevertheless it is lawful for no one to neglect it; and it must be cared for with every zeal and diligence that the sick, while they are fully in possession of themselves, receive it."

The care belongs to the pastor, and indeed under grave obligation; also to blood relatives and relatives by marriage, who by a special title have care of the sick person, or even to friends: these are bound under grave obligation at least if the sacrament is necessary for salvation; indeed then, if they are lacking, every man is bound. But care must be taken that the sick person, fully in possession of himself, receive the sacrament, so that he may perceive the fruits more fully and more certainly.

707. Extreme Unction can be repeated, because it does not confer a character (q. 30, a. 3) nor a perpetual effect, since health of mind and body can be lost (q. 33, a. 1). Nevertheless it cannot be repeated in the same infirmity and in the same danger of death, because the commending or placing back of the sick person into the hands of divine mercy, which is reality and sacrament, is made for the whole danger and confers helps during the whole time of the danger and in the very article of death.

But when the danger has ceased through convalescence, if a new danger arises even in the same infirmity, as is accustomed to happen in long-lasting illnesses, the sacrament can be repeated (a. 2), as the Council of Trent says, sess. 14, c. 3. Hence can. 940, § 2: "In the same infirmity this sacrament cannot be repeated, unless the sick person after receiving the anointing has recovered and has fallen into another danger of life."

Few of those who have devoted any attention to the matter will differ from the main conclusion at which Dr. Toner arrived in his article on this subject in the April number of the Theological Quarterly. That conclusion was that it is a solidly probable opinion that Extreme Unction may be validly repeated on the same person in the same sickness even though there has been no change in the state of the sickness. Dr. Toner, of course, admitted that such a proceeding would be contrary to present discipline. But present discipline, he maintains, defers to the common opinion among theologians that Extreme Unction cannot be validly administered to a sick person as long as he remains in the same state of sickness. Some would seem to look forward to a change of discipline in this matter if only the common opinion can be dislodged.

I think something may be said concerning this supposed common opinion and concerning the desirability of a change of discipline, and so I will accept Dr. Toner’s courteous invitation to discuss these two points in the following article.

I do not think that, at any rate since the time of Benedict XIV, it can be said that the common opinion of theologians has been against the validity of a repetition of Extreme Unction in the same state of the same sickness. There can hardly be question about the opinion of Benedict XIV himself. Catalanus dedicated his commentaries on the Roman Ritual to him. With rather fulsome flattery he says in the Dedicatory Epistle that he has altogether neglected the Casuists, who, he asserts, have for the most part done no little injury to Christian discipline and morality by their lax, foolish, and erroneous opinions about the sacraments and their administration. He professes to have derived much of his information from the synodal Acts of St. Charles Borromeo and from what Benedict XIV himself has most wisely taught in his most renowned work, De Synodo Dioecesana. If we turn to his commentary on the rubric which prescribes that Extreme Unction should not be repeated in the same sickness unless it is protracted, so that after recovery the sick person falls again into the danger of death, we find that Catalanus has the following: —

“Neither the Council of Trent nor its Catechism determined whether Extreme Unction can be repeated while the same illness and the same state of illness continue, because they knew that this depended upon discipline, as Van Espen observed.” So that, according to Catalanus, it is merely a question of discipline whether Extreme Unction should be repeated or not during the same dangerous state of the same sickness. If now we turn to the De Synodo of Catalanus’ patron we there find that Benedict XIV had before his mind practically all the evidence on this question which we possess to-day. He says that there used to be a variety of opinions on the point. Some held in the eleventh and twelfth centuries that Extreme Unction can only be received once lawfully in a lifetime; others later on maintained that it could not lawfully be received oftener than once a year; while others held that it could be repeated often in the same sickness, and that in early times it was repeated on seven successive days. Then the learned Pontiff adds: —

“But the usage afterward received by the universal Church, approved by theologians with common assent, and strengthened by the authority of Synods and Rituals, has prevailed, so that Extreme Unction is applied only once in the same illness; for one unction supplies the necessary strength for avoiding those troubles which the illness from which the sick person is actually suffering brings. . . . During the same illness, however, if after Extreme Unction has been received the illness so abates that the sick person seems to have escaped the danger of death, but before he recovers he again relapses into danger of life, even according to the present discipline he can without scruple be fortified anew by sacred Unction; . . . as may be seen in the cited Van Espen, who not inopportunely warns parish priests not to act too scrupulously in this matter; but if they doubt whether the state of the illness has truly changed, or whether the danger of life in which the sick person is situated is the same or different, he says that it is expedient that they incline to a repetition of the Sacrament, because this repetition is more conformable to the ancient custom of the Church, and through it new spiritual help and consolation come to the sick person.” Although in these passages Benedict XIV does not expressly say that Extreme Unction can be repeated validly during the continuance of the same danger in the same 1 Lib. VIII., c. 8, n. 4.

sickness, it is plain that he regards the whole question as one of mere discipline, as Catalanus expressly says that it is. He attributes the present rule on the subject to the usus ab universa Ecclesia receptus; he refers to it as juxta præsentem disciplinam; and he approves of the advice of Van Espen to parish priests that they should not be too scrupulous about repeating Extreme Unction. In case of doubt, he says, whether the state of the sickness has changed or remains the same, or whether the danger of death is different or not, it is well to lean to a repetition of the sacrament, because such a repetition is more in keeping with the ancient practice of the Church, and thereby new spiritual help and consolation is given to the sick person. It is to be observed that Benedict XIV could hardly have written in this way if he had thought that the opinion was even probable that Extreme Unction cannot validly be administered during the same state of the same sickness. For such an opinion would touch the valid administration of a sacrament, and we may not, except in case of necessity of which there can be no question here, use a merely probable opinion concerning the validity of a sacrament. What we read in Dr. Heiner’s recently published Opera inedita of Benedict XIV throws additional light on the Pontiff’s opinion on this question. Referring to the Greek practice, according to which several priests together administer Extreme Unction, he says: — Conosciamo che imbevuti i Teologi Latini della massima di non ripetere nella stessa malattia ’Estrema Unzione, vedono mal volentieri che i Sacerdoti chiamati per amministrare quel Sacramento, ungono uno dopo l’altro ciaschedun membro che deve ungersi, proferendo ciaschedun d’essi nell’ ungere le parole della forma, valutando cio per contrario al loro sistema, e come una vera piu volte ripetita amministrazione dell’ Estrema Unzione. Ma per andare al riparo di questo, che credono grave inconveniente,” &c.² It is clear, I think, from this extract that Benedict XIV himself did not think much of the difficulty felt by many theologians about the repetition of the sacrament of Extreme Unction. This conviction will be strengthened if we quote here the words of Van Espen to which Benedict XIV refers. Van Espen says: —

² Page 367.

“In these matters, therefore, each person must follow the law and custom of his own Church; otherwise, if discipline did not stand in the way, it would not be absurd to confer this sacrament several times even in the same illness and the same state of illness, according to the ancient custom of the Latin Church and the present custom of the Greeks. . . . From these things let the parish priest learn that he ought not scrupulously to abstain from repeating this sacrament because of a danger of the sacrament’s nullity, but only lest he offend against the discipline now established. Accordingly, if it is doubtful whether perhaps the state of the illness has so changed that it may be repeated even according to modern discipline, one should incline rather to repetition, both because this repetition is more conformable to the ancient custom of the Church and because through it new spiritual help may be hoped for the sick person himself.” There we have the definite reason assigned why a parish priest need not be scrupulous about repeating this sacrament when he is in doubt whether the sick man is in the same danger of death; it is merely a question of discipline, there is no doubt about the validity of the sacrament.

3 De Extrema Unctione, c. III., nn. 39, 40.

The theologians who have written on Extreme Unction since the time of Benedict XIV have for the most part been content to quote his doctrine on the question before us. Many of them like Sardagna and Voit merely synopsize the Pope’s teaching. Very few of them, as far as I have seen, face the question whether a repetition of Extreme Unction in the same danger of death would be valid or not. They say that it cannot be repeated in the same state of the same sickness, and quote the Council of Trent and the Ritual in proof of this doctrine, but they do not as a rule discuss the question whether such a repetition would be invalid as well as unlawful. Still the great majority imply at least that it is only a question of discipline. St. Alphonsus may be taken as the representative of the moralists. He quotes the doctrine of Benedict XIV given above, and then explains it by saying that there must be a positive doubt, or a probable opinion, that the sick person is in a new danger of death before Extreme Unction can be repeated, otherwise, he says, in mere negative doubt the precept of Trent must be observed. These words show that St. Alphonsus understood the question of the iteration of this sacrament to be merely disciplinary, and that there could be no question about the validity of the sacrament, as otherwise it would not be lawful to follow a probable opinion concerning its administration.

The Wirceburgenses, whom we may take as representatives of the dogmatic theologians of the latter half of the eighteenth century, teach that Extreme Unction is one of the sacraments which may be repeated since it does not impress a character on the soul. They mention the fact that formerly this sacrament was repeated during the same dangerous state of the same illness, but in the words of Benedict XIV they add that for many centuries the practice of the Church has been that it should only be administered once during the same danger of death arising from the same sickness.

Collet, who wrote about the same time as the Wirceburgenses, says:—

“Unction can be conferred several times. Indeed, it was formerly repeated in the same illness; this is forbidden today unless the sickness is physically or morally different.”⁴

⁴ De Extrema Unctione, n. 20.

Billuart, a few years earlier, wrote: —

“Whatever may be the case concerning the custom which is said formerly to have prevailed among some of repeating unctions several times in the same state of illness . . . it is certain that it is now not lawful.” Tom. xix., p. 51.

Reuter says:—

“In the same illness and state, however, strictly speaking, it is not lawful to receive it several times; it is otherwise in different ones.” Pt. IV., Tract. vi. q. 3.

All these are among the best and most representative theologians of the latter half of the eighteenth century; they were in common use in the nineteenth as they are still in the twentieth. It can hardly be said, I think, that the facts brought to light by the great historical theologians of the seventeenth and ' eighteenth centuries about the administration of Extreme Unction fell into oblivion during the latter half of the eighteenth and the beginning of the nineteenth century. There are, indeed, two or three theologians of this period who teach that the repetition of Extreme Unction in the same danger of death is invalid. Sasserath is one of these, who says:—

“While the same danger of death continues, it is also repeated invalidly, as Bosco holds with some others.”⁵

⁵ De Extrema Unctione, n. 12.

But neither Sasserath nor Bosco are in the front rank of theologians.

In the period before the time of Benedict XIV there were more theologians of note who taught that during the same danger of death Extreme Unction cannot be repeated validly. Among these are La Croix, G. Hurtado, Sporer, and Herincx, and the three last assert that this was the common opinion of Doctors. The words of Benedict XIV, which were quoted above, indicate the same, and so we may allow that before the time of Benedict XIV the view was commonly accepted that this sacrament cannot validly be repeated in the same danger of death. Most of the theologians of this period whom I have consulted do not expressly teach either one view or the other. Suarez, for example, says: —

“Hence it follows [because it does not imprint a character] that this sacrament is repeatable simply and absolutely . . . but in a qualified sense, or while the necessity of the same illness continues, this sacrament cannot be repeated.”⁶

⁶ Disp. 40, sec. 5.

How unsafe it would be to conclude from these last words that Suarez held that Extreme Unction cannot be repeated validly in the same danger is shown by what Arriaga wrote a little later. He uses the same words as Suarez —

“not to be able to be repeated while the same danger continues”— but he adds: —

“Here there can still be a new question: whether it cannot be given twice within the same danger in such a way that this is only unlawful, or whether in such a way that the sacrament is also invalid or void because of a lack of capacity in the subject. I answer that the matter is altogether uncertain, because the Councils have defined nothing concerning this point.”⁷ He thinks, however, that if the question could be settled by the practice of the Church, we should have to conclude that a repetition of this sacrament in the same danger of death would be invalid.

⁷ De Extrema Unctione, disp. 53, n. 47.

If, however, we go back to the eleventh and twelfth centuries we shall find ourselves confronted with two opposite opinions and practices on the point at issue. One maintained that Extreme Unction could not be administered twice to the same person, any more than the anointing in Baptism, or the priesthood, or the consecration of a church or chalice could be repeated. The other, apparently much more common than the first, simply and without distinction, held that Extreme Unction was of the number of the sacraments that could be repeated. Peter Lombard held this view. His words are: —

“But the sacrament of the altar, and of penance, and of marriage seem to be repeated often, because the sacrament of the body is often received, penance is frequently performed, and marriage is often contracted. Why, then, can unction likewise not be repeated? If the illness does not return, the medicine should not be repeated. But if the illness cannot be restrained, why should the medicine be forbidden? Just as prayer can be repeated, so unction seems able to be repeated; for James mentions both there, and each cooperates with the other in conferring relief of body and soul. Why, then, is it denied that unction over the sick person can be repeated, to obtain more often health of mind and body, when because of the illness the same prayer must often be repeated? . . . But if the question concerns reception of the sacrament: of some it is true that they are not repeated by frequent reception, but of certain others it is not, because they are received frequently, as this sacrament of unction, which is repeated often in almost every Church.”⁸

⁸ Lib. IV., dist. 23.

His argument, therefore, is that doses of medicine are repeated until either the disease is conquered or it conquers the patient; prayer for health is repeated, why should not the unction also be repeated. The holy oil indeed is not consecrated twice, but as the same subject can repeatedly receive Penance, and the Eucharist, so this sacrament of Extreme Unction can be often received, and in fact in almost all the Churches it is frequently repeated.

Albert the Great, seeking to apply the well-known rule of law, discovered a distinction by means of which he reconciled the two opposite opinions. “It must be said,” he says,

“that this sacrament, like certain others, is repeated if their cause is repeated; as Augustine says expressly in the text: If the illness does not return, the medicine should not be repeated. But if the illness cannot be restrained, why should the medicine be forbidden? To the first, therefore, it must be said that no injury is done to a sacrament when it is repeated over the same subject, but when it is repeated over the same cause numerically. Hence those sacraments which have immovable causes are not repeated, such as baptism, because original sin never returns, and confirmation, because weakness from the fomes never returns. Likewise, deprivation of ecclesiastical power never returns in one who receives order, and therefore those are never repeated. But certain sacraments have movable causes in the same subject, and therefore they are repeated in the same person, although not from the same cause. Through this solution it is clear how the two opinions recited in the text are to be reconciled, and the solution to the last objection is clear.” 9 To the difficulty about prolonged sickness where the cause seems to be always numerically the same, and, therefore, according to his distinction the sacrament should not be repeated, Albert, not without serious doubts and misgivings, applies a physical theory of the time. The four humors of the human body were thought to undergo a change during the progress of the four seasons, and so after a year’s interval the sickness could not be the same. Extreme Unction, therefore, might be repeated after a year’s interval. Later theologians have sometimes laughed — at Albert’s application of physics, as he understood the science, to theology. Too many of them have failed to learn caution from his example, and like him they have tried to solve theological questions by the application of the philosophical or physical theories 9 In 4 Lib., Sent. XXIII, art. 20,

of their time. Almost up to the period of the Council of Trent many local synods in France and in England applied Blessed Albert’s rule in practice and forbade the administration of Extreme Unction to the same person oftener than once a year. St. Thomas, the great disciple of Albert, saw what was sound in the distinction of his master and put it in a truer light. He teaches that this sacrament may be repeated inasmuch as it does not produce an effect which is perpetual. This may be done even in the same sickness when the danger of death ceases and returns again.

“It must be answered that this sacrament regards not only illness but also the state of the illness, because it should be given only to sick persons who according to human estimation seem to be approaching death. Some illnesses are not long-lasting; hence, if this sacrament is given in them when a person reaches the state in which he is in danger of death, he does not leave that state unless the illness is cured, and so he should not be anointed again. But if he suffers a relapse, it will be another illness, and another anointing can take place. Other sicknesses are long-lasting, such as consumption, dropsy, and the like; and in such cases unction should be given only when they seem to bring a person to danger of death. And if the person escapes that crisis while the same illness continues, and through that sickness is again brought to a similar state, he can be anointed again, because there is now as it were another state of the illness, although it is not simply another illness.”¹⁰ St. Bonaventure agrees with St. Thomas on this question. The teaching of St. Thomas and St. Bonaventure became the common doctrine of the schools, and it was adopted by the Council of Trent and the Roman Ritual. It is not a mere compromise between two opposite views. It is grounded on the nature and effects of the sacrament with which it deals. For Extreme Unction is a sacrament instituted for the benefit of those who are dangerously ill, of those who are in danger of death from sickness. So that it produces its effects whenever the recipient of it is reasonably presumed to be in danger of death. Those effects are many and various; Extreme Unction infuses sanctifying grace into the soul, it removes the remains of sin, it forgives venial sin and sometimes even mortal sin, it cheers, soothes, consoles the sick person, and if God sees good it restores him to bodily health. The effects which are peculiar to this sacrament are the cheering, soothing, consoling of the sick person, and at times the restoration of his bodily health. The other effects are common to other sacraments, and more properly belong to them, especially to Penance, of which Extreme Unction is the complement. If remission of sin or an increase of sanctifying grace is desired, it will be better for the sick person to go to confession or receive holy communion again. There is no necessity for him to receive Extreme Unction again in the same danger of death in order to obtain the special fruits of this sacrament. The reason is because those special fruits are in the nature of actual graces and favors which are not necessarily given immediately on

¹⁰ Summa theol. Supplementum, q. 33, a. 2.

receiving this sacrament, but the reception of the sacrament gives the recipient the right to receive them at suitable times during his sickness. As long as the same danger lasts the sacrament once received gives him a title to receive its special effects; a repetition of the sacrament could not do more for him in this respect. This does not prove that a repetition of Extreme Unction in the same danger would be invalid, but it does show that it is not necessary. Indeed Extreme Unction is not a necessary means of salvation at all, nor is its reception by the sick a matter of precept; but the above argument shows that its repetition is not even necessary in order to procure its special effects during the same dangerous state of illness, and its other effects can be more satisfactorily obtained in other ways.

The doctrine which has just been laid down does not, I think, differ in substance from that of Richard Middleton (Mediavilla), the celebrated Minorite of the thirteenth century. In his commentary on the Sentences he says : —

“I answer that this sacrament is repeatable in one way and not in another. With respect to the same sick person, the same illness numerically, and the same state of that illness, it should not be repeated; because every sacrament, with respect to its proper matter, obtains its entire effect on one occasion if there is no indisposition in the recipient. Therefore the same host is not consecrated twice, because in the first consecration it becomes the true body of Christ under one species, nor are the same spouses betrothed twice. Concerning baptism, confirmation, and order the matter is clear. In the sacrament of penance alone there is doubt, since with respect to the same sins numerically it would have some effect each time it was repeated. Yet because the same person numerically can be ill several times, and in the same illness numerically there can be different states in each of which the sick person is in notable and probable danger of death, therefore, since it imprints no indelible effect on the sick person, it can and should be conferred several times on the same person, either for different illnesses or for the aforesaid different states of the same illness. Nor let it move you that it was said that the sacrament of the Eucharist obtains its entire effect on one occasion with respect to the same matter, because it must be received several times by the same person. The essence of that sacrament does not consist in its reception; and therefore, although it is received several times and has an effect several times in the same recipient, nevertheless the essence of the sacrament is not repeated with respect to the same matter, and if repeated would have no effect. . . . And because, with respect to the same sick person, the same illness, and the same state of that illness, this sacrament obtains its entire effect if there is no defect on the part of the recipient, therefore it is not repeated in this manner.”¹¹

¹¹ In Lib. IV., dist. 23, a. 2, q. 6.

This, then, is the doctrine on which the modern discipline regarding the repetition of Extreme Unction is grounded. It would seem to show that no change in that discipline is desirable, and if taken together with certain other reasons it will, I think, explain why the historical investigations of such men as Launoi, Van Espen, and others brought about no change of discipline in the administration of Extreme Unction.

For it is not difficult to discover the reasons why Extreme Unction was administered less frequently than perhaps it might have been during the Middle Ages. Sometimes bishops forbade its too frequent reception in the same sickness lest it should come to be held in too little esteem and reverence. Thus Stephen Poucher, Archbishop of Sens, issued the following decree in 1514: —

“Priests must take care that no sick person is anointed more often in the same illness, lest this sacrament be held in low esteem; nevertheless this sacrament can be repeated in different illnesses or in the same illness when it recurs, because it does not have a perpetual effect, inasmuch as health of mind and body, which are its effects, can be repeated, lost, and recovered.”

A similar decree couched in the same words was issued by Louis, Bishop of Chartres, in 1524, and the authority of the Holy Fathers was claimed for it — Juxta sanctorum Patrum decreta.¹²

¹² Launoi, De sacram. Unctionis, I., p. 552.

This reason for not repeating Extreme Unction is not without its weight still. The Church even now forbids holy communion oftener than once a day, and some priests think that in some places the sacrament of Penance is beginning to lose something of its efficacy as a remedy against sin from its too frequent repetition without due preparation. Besides, it is only right that the priest should be considered. In populous districts, where each priest not unfrequently has two or three thousand souls to look after, there may easily be half a dozen who are in danger of death at the same time. Even under modern discipline the administration of the last sacraments to the sick makes a serious demand on the time of the overburdened priest. What would be the case if each sick person demanded Extreme Unction every day?

Another reason why Extreme Unction came to be administered less frequently than it might have been was the avarice of the clergy. Benedict XIV conjectured that this was the reason why the ancient custom of employing several priests in its administration fell into desuetude. Each priest required his fee, and the poor began to speak of Extreme Unction as the sacrament of the rich. It was doubtless on this ground that we find many English synods prescribing that this sacrament should be administered without fee by the parish priest. Thus, among the decrees of the Synod of Exeter held under Peter Quivil in the year 1287, we read the following: —