The Care of the Dying

“Whether and when Pastors are bound under grave sin, personally or at least through another, to assist the dying until the final agony of life, although they have already been duly fortified with the sacraments and appear to be well disposed?—Response. The prescriptions of the Roman Ritual are to be followed; in the remaining matters, let approved authors be consulted.” Sacred Congregation of the Council, 23 March 1878.

Whether and when are parish priests bound under grave obligation, either personally or at least through another, to assist the dying until the final agony of life, although they have already been duly fortified by the sacraments and appear well disposed?—Response. “The prescriptions of the Roman Ritual are to be followed; in the remaining matters, let him consult approved authors.” Sacred Congregation of the Council, 23 March 1878; A. S. S., vol. 11, p. 189 ff.

563. Preliminary Remarks. (a) There is no work of charity more acceptable to God than to help the sick and dying to die holily, since the eternal salvation of souls depends on the manner in which these overcome the last difficulties and temptations; hence one of the chief duties of the confessor is to have care of the sick. "Wherefore as soon as he shall have known," says the Ritual, "that any one of the faithful committed to his care is sick, he shall not wait until he is called to him: but of his own accord let him approach him, and this not only once, but more often, insofar as there shall be need; and let him exhort his parishioners to warn him when someone in his parish happens to be sick, especially if the illness shall be more grave."

² Rituale Rom., De visitatione et cura infirmorum, Modus juvandi morientes; Polanco, Methodus juvandi moribundos, Dillingen, 1578; St. Alphonsus, Praxis, n. 227-291; H. A., Appendix II; Reuter, n. 209-227; Lehmk., n. 516-522; Marc, n. 1854; Aertnys, Theol. Pastor., n. 187-203; Gaume, Manuel, n. 371-401; Ciolli, t. I, n. 83-85; Alberti, Theol. Pastoralis, Part. I; Dubois, Pratique du zele, 2nd Part, ch. 12; Card. Gibbons, The Ambassador of Christ, ch. 30; Scavini, t. IV, Append. VII, De Cura infirmorum; Frassinetti, Manuale pratico del Paroco novello (in English: Parish Priest's Practical Manual), p. II, c. 2, Append.

(b) "But let him approach the sick person," the Ritual continues, "so prepared that he may have at hand arguments apt for persuading; and especially examples of the Saints, which have very great force, by which he may console, stir up, and refresh him in the Lord." - But since the confessor of himself is unequal to so great a matter, let him trust in divine help, and pray for the sick whom he visits. Moreover, that he may be better able to help the sick, let him explore their character, morals, and condition, insofar as this can be done. Then let him premeditate the manner of acting with each sick person, revolving in his mind those things which are to be said and done.

(c) If the family of the sick person is not likely easily to admit the priest, by indirect means at least, for example, by the intervention of friends, care must be taken that he be called as a friend; if he has tried this in vain, let the priest himself with all prudence and courtesy ask that, at least for the sake of politeness, he be permitted to visit the sick person; if he knows that his ministry is desired by the sick person, let him urge more insistently, and conduct the cause of the sick person in the best way he can, even personally. - If he is not permitted to approach the sick person without witnesses, and these are unwilling to withdraw, an entire confession is not to be demanded, but only a general accusation or one of a lighter fault; this having been posited, let the sick person be excited to contrition and absolved.

(d) Having entered the room of the sick person, let him show charity and commiseration, by asking about the illness, the pains, and other things of this kind, and by consoling him and exhorting him to patience, especially by the example of the suffering Christ.

564. On the Confession Itself. (a) If danger of death is not pressing, let him not speak immediately about confession, especially when the sick person fears to make it; but let him first strive to conciliate his soul to himself, by setting forth divine mercy and the love of Christ toward sinners. But on the second or third visit, let him propose the usefulness of confession, showing at the same time that it is not difficult nor requires much time; afterward let him exhort the sick person to make it without delay, especially if delirium is foreseen to be about to supervene shortly. If the sick person asks for some delay, so that he may prepare himself, it can be granted, unless danger stands in the way; but one must beware lest it be deferred too long. If he cannot be brought to confess, one must not wholly despair, but as long as he lives, various and efficacious exhortations of priests and other pious persons are to be used, and also both private and public prayers for obtaining divine grace for the salvation of the wretched one lying ill.

(b) Let him exhort the sick person now prepared for confession to perfect sincerity, and kindly ask him whether he has doubts or anxieties concerning past confessions, since this is the best opportunity for correcting all defects.

(c) In questioning, let him beware lest he bring annoyance to the sick person by too many or indiscreet questions: it is better to devote effort to exciting sorrow for sins than to procuring material integrity. Once the confession has been heard, let him excite confidence, by recalling to memory the mercy of Christ toward the greatest sinners, the Samaritan woman, Magdalene, the thief on the cross, etc.; - immediately before absolution, let him ask whether the sick person has anything which disturbs his soul, and let the motives of contrition be briefly proposed.

565. (d) If any restitution or reconciliation must be made, or scandal repaired, efficacious means should immediately be employed for accomplishing this, for example, by writing without delay a note in which it is declared that such a sum of money is owed to such a person, or by leaving through a will to a person above every exception money sufficient for extinguishing the debts. Often scandal is sufficiently repaired by public reception of the sacraments; nevertheless, sometimes retraction is required, as is explained in its place in the various Treatises.

(e) When certain danger of death is present, which the confessor will be able to recognize either by himself or by secretly questioning the physician¹, let him exhort the sick person to dispose of his affairs opportunely: for this is expedient for the peace of the family and the relief of his own conscience. In this, however, let the priest beware to avoid every suspicion of gain.

¹ Let him be questioned secretly, because many physicians are accustomed to deceive the sick, and, unless they are questioned secretly, they do not tell the truth. Read the signs of mortal sickness in Capellmann, Medicina Pastoralis, 11th ed., 1896, p. 174-181; in the same place you will find useful things concerning the care of the sick, p. 215 sq. Cf. Amer. Eccles. Review, April 1900, p. 388; Feb. 1901, p. 145; Oct. 1901, p. 280-292; etc.

566. On the Temptations of the Dying. (a) Since the sick are accustomed to be attacked by various temptations, the confessor must fortify them against these. First, proximate occasions of sinning should be removed, such as dangerous images, or persons who are accomplices in sins; on the contrary, before them let pious images of the Crucified or of the Blessed Virgin Mary be hung, by which they may be helped to think about God and eternity.

(b) If they experience temptations against faith, let them not discourse about them, but let them divert the mind elsewhere and frequently say: "I believe whatever God has revealed, whatever the Church teaches. - I believe, Lord, but help my unbelief." - If against hope, let words or examples of Scripture be recalled to memory, by which it is established that God is prone to forgive, and does not wish the death of the sinner, but that he be converted and live; that Christ said: "I came not to call the just, but sinners"; that the publican was justified as soon as he said: "Be merciful to me a sinner"; that paradise was promised to the thief hanging on the cross, etc. - If against patience, let Christ be placed before their eyes, who, although innocent, for us sinners patiently suffered so many and such great things in mind and body; that that which torments is momentary and light, that which delights is eternal; that pains cannot be avoided: wherefore if they are borne impatiently, they are increased and remain fruitless; if patiently, for God's sake, their bitterness is softened, the punishments of Purgatory are lessened, and new merits are acquired.² - If against charity, insofar as they pursue a determinate person with hatred, let them think that he who does not forgive cannot hope for pardon from God¹; that Christ, hanging on the cross, prayed for those crucifying Him, and died for us at the time when we were enemies. And so concerning the rest.

² For consoling the sick these or similar books will be very profitable: Perreyve, La Journée des Malades; Ozanam, Le Livre des Malades; Caussade, Abandon à la divine Providence.

¹ "Forgive, and you shall be forgiven" (Luke VI, 37). - Hence the priest can address them thus: "Do you not say, daily reciting the Our Father: And forgive us our debts, as we also forgive our debtors? Do you not wish your sins to be forgiven by the heavenly Father?"

567. On the affections to be suggested. In visiting the sick, let the confessor suggest to them, but in few words, and at intervals, acts of faith, hope, charity, contrition, conformity to the will of God, desire for paradise, acceptance of death, etc. Let him offer them an image of the Crucified to be kissed, and exhort them often to invoke, by mouth or at least in heart, the Most Holy Names of Jesus, Mary, and Joseph. Yet let him beware lest by longer prayers and exhortations he bring annoyance to them. - He himself, with those assisting, should recite a few prayers for them; should bless them, and several times impart absolution anew², especially before he departs.

² "According to the prescription and mind of the Roman Ritual, let the pastor of souls be diligent in visiting the sick and those in agony, even after they have received the last sacraments ... and, after there has been elicited from them, if they can, a new act of confession and contrition, let him anew, repeatedly, give absolution." (Conc. Plen. Balt. II, n. 116.)

He will likewise help them to gain indulgences, especially the plenary indulgence in the article of death, according to those things which we shall set forth where we treat of Indulgences. But he will recall to memory that, for gaining these, the interior dispositions of hatred of sin and love of God are more profitable than the recitation of many prayers.

568. On helping those in agony. (a) "As the sickness grows heavier," says the Ritual, "the parish priest shall visit the sick person more frequently, and shall not cease diligently to help him unto salvation; and he shall admonish that, when danger is imminent, he be called at once, so that he may be present to the dying person in time." By these words is inculcated the obligation of helping those in agony by prayers, exhortations, and especially by repeated absolution, lest perhaps they have internally committed some mortal sin and die in it. The gravity of this obligation depends on the condition of the dying; if they have lived in a Christian manner and are surrounded by pious persons, the presence of the confessor is indeed useful, but not necessary; but if they have led a vicious life and remain exposed to grave temptations, or, a fortiori, if up to this time they have not received the last sacraments, the parish priest is bound under grave obligation to attempt all things, while breath remains, for procuring their salvation. But if he is legitimately impeded, let him entrust this office to another priest. Let him also exhort pious persons who live in the neighborhood to visit the dying and to help them to die in a Christian manner.

569. (b) When the time of expiring is at hand, the priest, or, if he is lacking, a pious person, should devoutly recite the commendation of the soul, as it is contained in the Ritual or in prayer books. Short aspirations should be suggested to the one in agony: "Jesus, receive my spirit. - Into Thy hands, O Lord, I commend my spirit. - Holy Mary, my mother, help me in the hour of death. - St. Joseph, succor me, etc."

(c) As soon as death is established, let the Subvenite be recited for the departed, and let other prayers be poured forth. Before he departs, let the priest console the relatives, and admonish them that prayers will profit the departed more than tears, that we all shall die shortly, and that the best preparation for death is a Christian life.

— The sick and the dying must be helped and comforted with the greatest care. "It is expedient that every recently ordained priest compose for himself methods and manners of helping the dying and of acting with the sick." Thus Lacroix, l. 6, p. 2, n. 1864. St. Alph., Praxis confessarii, Appendix II; Reuter-Lehmkuhl, Neo-Confessarius, etc., can be approached. Thus the confessor will strive to act so that he is troublesome to no sick person, and at the same time endeavors to increase the merits of the sick person, by frequent reception of the sacraments, by renewed acts of the theological virtues, by joyful acceptance of the divine good pleasure, for example according to the formula commended by Pius X and Benedict XV, by recalled sorrows of the Blessed Virgin Mary, by proposed union of one's own trial with the Passion and death of Christ, by brief little prayers repeated opportunely.

If he has been present in mind, it will help, says St. Alph., op. cit., §5, to confer absolution on him as often as a brief confession can prudently be obtained. But if he has been destitute of senses, the confessor "must direct himself from the conscience which he has known of the sick person. If he had been habituated in depraved thoughts, if he dies from some wound or is entangled by some passion of hatred or impure love, if the illness is too bitter and he himself does not suffer with willing soul, then absolution can be given rather often; but otherwise it suffices that a space of three or four hours intervene; more frequently, however, if he is now about to die. But it will not be beside the matter to admonish the sick person, while he is strong in mind, that, if he cannot speak, he give some determined sign when he seeks absolution, or when the priest wishes to confer it on him; for example, that he close or open his eyes, raise his hand, incline his head, and the like" (St. Alph., l. c.). But scarcely anything will help more than to raise the soul into vivid hope, founded on the mercy of God and the merits of Christ, of which as pledges there are the protection of the Blessed Virgin Mary, and the power of the sacraments, especially of the sacrament which gives Christ to be possessed, and of Extreme Unction, which takes away the remains of sin.

But lest the visitation of the priest seem as if to portend proximate death, let the priest to whom souls have been committed take care that from the beginning of illness he visit also those sick persons who are hoped to be going to arrive at convalescence.

VII. Concerning the manner of helping the dying.⁴ - Certainly no work of charity is more acceptable to God than to help the sick and the dying toward a holy death; wherefore one of the principal priestly duties is to have care of the sick. This principally regards the parish priest, who, says the Ritual, tit. 5, c. 4, n. 1, "as soon as he knows that any one of the faithful committed to his care is sick, will not wait until he is called to him; but of his own accord he should go to him, and this not only once, but often, insofar as there is need; and let him exhort his parishioners to inform him when anyone in his parish happens to be sick, especially if the illness should be graver." But, St. Alphonsus adds, care of the sick is not the duty of parish priests only, but the work of all confessors.

⁴ Cf. St. Alphonsus, Pr. conf., nn. 105-107 and 227-280; Reuter, o. c., nn. 209-227; Billuart, de Poen., diss. 6, art. 10, § 7; Aertnijs, Th. P., nn. 187-203; Theol. Mechl., de Poen. (4), n. 74, pp. 218-219; Berardi, Pr. conf., nn. 772-791; Marc, Th. M., II, nn. 1854-1855; Lehmkuhl, Th. M., II, nn. 645-658; Noldin, Th. M., III, nn. 292-295; Tanquerey, de Poenit., nn. 557-559.

For rightly exercising this duty authors are accustomed to hand down various admonitions, to be applied not invariably but according to opportunity; the principal of these we set down here. First:

A. General counsels: 1) "Let the priest approach the sick person," says the Ritual, ib. n. 7, "so prepared that he may have at hand arguments fitted for persuading; and especially examples of the Saints, which have very great force, by which he may console him in the Lord, excite and refresh him." - Therefore a) let him trust in divine help and pray to Christ, the Blessed Virgin, and the guardian angel for the sick person whom he visits, and whom he will not convince unless the grace of God so counsels as to persuade; b) and that he may help better, let him, as far as he can, explore the sick person's disposition, manners, and condition, on the way or in the house of the sick person, e.g., whether he is an educated and prudent man, uses his senses, has asked for a confessor, is believed to be near death, whether he has already confessed, whether he has made a testament, what kind of life he has led, whether there is something of some moment concerning which it is necessary to admonish him, whether he desires another confessor, etc.; c) then let him premeditate the manner of acting with the sick person, turning over in his mind what things are to be said and done.

2. If relatives are foreseen as not easily going to admit the priest, a) let him take care, at least by indirect means and the intervention of friends, that he be called as a friend; b) but if he has attempted this in vain, with all prudence let him ask that at least for the sake of courtesy he may be able to visit the sick person; c) and if he knows that his ministry is desired by the sick person, let him press more urgently and personally plead the cause of the sick person in the better way; d) if he cannot approach the sick person without witnesses who are unwilling to withdraw, let him not urge an entire confession, being content with a general accusation only or with that of a lighter fault; this being posited, having first excited the sick person to contrition, let him absolve him; - but if he cannot approach him at all, what would prevent him, in an extreme case, from addressing him with a loud voice through the door or window and inducing him to contrition and absolving him under condition?

But once admitted and having entered the room, let him kindly greet the sick person, with a great affection of charity and compassion inquire concerning the disease, pains, inconveniences, rest, etc., bring consolation and exhort him to patience, especially by the example of Christ suffering.

B. Specially as regards the sacrament of Penance. 1. Before confession: If he was not called by the sick person for confession and the danger of death is not imminent, let him not at once speak of it, especially if the sick person fears to undertake it, but a) first let him strive to conciliate his mind to himself, by setting forth the mercy of God and His benefits and paternal care, and Christ's love toward sinners; b) on the second or third visitation, let him propose the utility of confession for quiet of mind, and at the same time show that it is not difficult and does not require much time, that the sacrament can contribute to bearing the illness fruitfully, indeed to obtaining health; and then let him exhort the sick person to wish to confess at once; c) if he asks for some delay to prepare himself, this can be granted, e.g., one or another hour, unless danger stands in the way; but care must be taken that it not be deferred longer; d) but if he cannot be brought to confessing, let the confessor carefully explore the cause: if it is difficulty of the work, let him explain that the difficulty is exaggerated and promise every help and ease; - if it is lack of confidence or even despair, with every effort let him raise him to hope and confidence, recalling to mind the Passion of Christ, the parables of the prodigal son or the lost sheep, the examples of David, Peter, Magdalene, the good thief, etc.; - if finally it is hardness of heart, to these let him add the unhappiness of the impenitent sinner, the rigor of divine judgment, the eternity of punishments, and the happiness and peace of conscience of him who returns to God. Nor should he ever despair, but let him solicit the exhortations of other priests or upright persons, especially the physician, together with private and public prayers for obtaining grace for the salvation of the bedridden person; e) but if the sick person is now prepared for confession, let him inquire from what time he has confessed, exhort him to perfect sincerity, and kindly ask whether he has doubts or anxieties concerning past confessions, since now there is the best opportunity of correcting all defects.

2. In confession a) of itself: he ought to question, but sparingly, so that, avoiding excessive and indiscreet questions, he takes care that the sick person not have to speak much, being more solicitous concerning contrition than concerning procuring material integrity; nevertheless it will often be opportune to ask concerning four things: concerning a sin never accused, concerning hatred, concerning a depraved custom formerly had and never expiated by general confession, and concerning restitution or reparation to be made. The accusation having been heard, let him excite confidence by recalling Christ's mercy toward sinners in words and examples; immediately before absolution let him ask whether the sick person has anything that disturbs his mind; let him briefly propose to him motives of contrition and help him in eliciting acts of faith, hope, charity, and contrition, and impose a lighter satisfaction;

b) accidentally, if restitution, satisfaction, or reconciliation is to be made, or scandal repaired, let the confessor smooth the way and at once indicate or apply efficacious means according to the manner in which we spoke above, n. V.

3. After confession: a) if there is certain danger of death, for knowing which he will be able, by himself or through another, secretly to ask the physician, let him exhort the sick person to dispose of his affairs opportunely, for the peace of the family and the relief of conscience; b) likewise to prepare himself for receiving Viaticum with great desire and Extreme Unction; c) secretly let him tell the household to ask the sick person whether he does not desire another confessor, and add that this will not be displeasing to him.

C. When agony is imminent. 1. "When the disease grows heavier," says the Ritual, "a) the parish priest, likewise the confessor, will visit the sick person more frequently, and will not cease diligently to help him toward salvation; and, when danger is imminent, he will admonish him that he be called immediately, so that he may be present in time for the dying person." By these words the obligation of helping those in agony more diligently is proclaimed; the gravity of this obligation depends on the different condition of the dying person. For if he has lived as a Christian and is surrounded by pious persons, the presence of the priest will be most useful, but by no means necessary; but if he has led a vicious life and remains subject to grave temptations, much more if up to this point he has not received the last sacraments, the parish priest, or even the confessor, is held under grave obligation to attempt all things for procuring his salvation, or procuring it more certainly. He will accomplish this last by helping with prayers, exhortations, and especially by repeated absolution, after confession has been at least very briefly renewed, or even by Holy Communion.

b) But if he is legitimately impeded, let him commit the office to another priest, and exhort pious persons from the neighborhood to visit the dying person and bring help for dying well.

c) Let him take care, as far as he can, that in the room of the sick person all things be ordered and clean, even among the poorer; and especially that profound silence be preserved there and that they speak only in a subdued voice, and only concerning those things which edify and refresh the sick person; nor should just anyone be admitted to conversation, but only those by whose company the sick person is relieved. Let this person be ordered to be wholly occupied in the business of the soul, and not to admit profane conversations; let too frequent visits of parents, children, wife, and especially the sight of those persons from whom temptation could arise, be kept away. Near the sick person let holy water be placed, and in his sight a Crucifix and image of the Blessed Virgin Mary.

2. When death approaches: a) let him timely admonish the sick person concerning the imminent danger of death, not importunately but cautiously, so that he announces it more obscurely at first, then openly, gently nevertheless, and at the same time suggesting pious affections;

b) by name let him inspire in the sick person, but with few words, and only at intervals, acts of faith, hope, charity, especially perfect contrition, conformity to the divine will and acceptance of death, and other brief ejaculatory prayers, according to the circumstances, e.g., "O my Jesus, mercy! Thy will be done!"

c) let him often offer the Crucifix and image of the Blessed Virgin Mary to be kissed;

d) let him take care that the sick person gain all the indulgences he can, especially the plenary indulgence in the article of death which the apostolic blessing has attached to itself;

e) hence let him admonish him to invoke the names of Jesus and Mary once or more often, by mouth if he can, otherwise in heart;

f) let him frequently sprinkle him with holy water, especially if he is vexed by diabolical temptations; frequently also let him fortify him with the sign of the cross and bless him.

3. When the time of expiration is now imminent, let the priest, or in his absence a pious person, with knees bent recite the prayers of the dying and the commendation of the soul, "Go forth...," admonishing those assisting to pray at the same time for the dying person; let him hand the dying person a blessed candle that he may hold it, to signify that he dies in the holy faith. He himself or another will suggest to the one in agony, and often repeat aloud to his ears, brief aspirations: "Into Thy hands, O Lord, I commend my spirit" - "Holy Mary, my mother, help me in the hour of death" - "Jesus, Mary, Joseph..." - etc.

4. After death. - Let the priest beware lest he say prematurely that the sick person is dead. Yet, as soon as there is now moral certainty concerning death, let him exhort those standing around to pray with him for the departed, e.g., "Come to his assistance...," or a decade of the rosary, or the Litany of the Blessed Virgin Mary. Then let him sprinkle the dead person with holy water; afterward let him console the relatives, speaking confidently and from the heart concerning the great mercy of God and eternal happiness; and to those standing around, according to opportunity and circumstances, let him inculcate that prayers will profit the departed more than tears; let him call back to their memory the brevity of life, the vanity of the world, the happiness of those who die well, and on this occasion excite them to a truly Christian life. All these things in very few words, but from the heart.

VIII. As regards the temptations of the dying, since they are accustomed to be attacked by various temptations, the confessor must fortify them against these. And indeed:

1. He must remove impediments to salvation; hence a) let bad companions and proximate occasions of sinning be removed, such as dangerous images or persons complicit in sin; on the contrary, let pious images of the Crucified and the Blessed Virgin Mary be hung before the sick, by which they may be helped in pious thoughts concerning God and eternal life;

b) if love of life presents an impediment, let there be proposed the great merit of death accepted for God's sake, the great misery and calamity of the present life together with the joy of the future life, and the counsel of divine goodness which cuts off life for us when this conduces most to our salvation;

c) if the obstacle comes from love of relatives, let it be said that God will receive into the guardianship of His paternal providence the spouse, children, family, and all affairs of him who subjects his own will to the divine will and from it freely accepts death;

d) if care of temporal things renders him anxious, the sick person is to be exhorted not only to dispose of all things in good time, but also, if he is endowed with goods of fortune, to provide for his own soul and take care that Masses be celebrated and alms be given, yet without the priest exciting any suspicion of cupidity or stirring up the hatred of the family against himself.

2. The confessor must guard against temptations: if the sick person experiences temptations

a) against faith, let him not discuss these, but turn the mind elsewhere and frequently profess the faith with simple affection, repeating: I believe whatever God has revealed, whatever the Church teaches. I believe, O Lord, but help my unbelief;

b) if against hope, let him recall to mind words or examples of Scripture which show that God is ready to pardon; that He does not will the death of the sinner but that he be converted and live; that He sent His Son Christ, who said: "I came not to call the just but sinners"; that He at once pardoned the publican saying, Be merciful to me a sinner; that He promised paradise to the thief hanging on the cross, etc.;

c) if against charity toward the neighbor, so that he has hatred for a determined person, let him think again upon the words of the Lord's prayer, by which he may know that he who does not forgive cannot hope for pardon from God; - that he himself has inflicted greater injuries on God; - and that Christ hanging on the cross prayed for those crucifying Him, and for us, while we were enemies, gave His life;

d) if against patience, let these three things be inculcated: it is necessary to suffer, both because we are men, whose common lot is that pains cannot be avoided, and because we are Christians, to whom it is fitting to bear the cross just as Christ, who was innocent, suffered most bitter pains in soul and in body for us sinners; - it is just to suffer, because as sinners we have risen up against God, whom it is fitting to compel to be subjected again by adversities, and because by sinning we have merited to suffer more than the pains of this life; - it is most useful to suffer; for if pains are borne impatiently, they are increased and remain fruitless; but if patiently, for God's sake: they purge the affection while they draw it away from earthly and illicit things and lift it up to heavenly things; - they blot out sins by offering an obvious and opportune reparation, kinder than the punishment of Purgatory; - they merit glory by a new merit, for "the momentary and light tribulation of ours works in us an eternal weight of glory," II Cor. IV, 17. Therefore it is glorious to God to have sons who gladly accept from His hand whatever things He sends, and to us it will be glorious in eternity; but to bear impatiently adversities sent by God Himself is harmful to the soul, dangerous, and most unbecoming.

3. The confessor must minister every assistance; first

a) the sacraments; wherefore it will be opportune that, after a renewed petition for pardon and contrition, he impart absolution anew several times and invite him again to Holy Communion; but if it should happen that the sick person falls into mortal sin, let him instill confidence in him, suggest contrition, and absolve him at once;

b) let him propose brief ejaculatory prayers and pious affections toward God to be repeated rather often, and remove earthly matters, having no conversation about children, wife, goods;

c) let him suggest acts of the virtues in few words: of faith, hope, charity, contrition, desire of eternal life, conformity to the will of God, forgiveness, acceptance of death: "this is necessary; we are not greater than Christ and the Blessed Virgin; it procures happiness and frees us from the valley of tears!" etc., without bringing annoyance by longer exhortations;

d) let him offer images of the Crucified or of the Blessed Virgin to be kissed, and suggest that the most holy names of Jesus and Mary be invoked by mouth or at least by heart;

e) let him impose the scapular and procure a blessed rosary, and take care that the sick person gain indulgences according to his strength, especially the plenary indulgence in the article of death.

1854. "No work of charity is present which is more acceptable to God and more conducive to the salvation of souls than to help those placed in the extreme danger of life to die holily; for at the time of death, on which the eternal life of each one depends, the powers of hell are stronger, but those of the sick are weaker."¹⁸

Moreover, the sick lying dangerously ill are of a twofold kind: some enjoy the use of reason and the senses; others are destitute of the senses. As regards guilty persons condemned to capital punishment, see in St. Alphonsus¹⁹ (cf. n. 2300 and 2311, 2).

I. As regards the sick USING REASON AND THE SENSES, the Ritual admonishes: "Let the confessor approach the sick man so prepared that he have ready arguments apt for persuading, and especially examples of the Saints, which avail very much; by which he may console, excite, and refresh him in the Lord."

Moreover, to many other things which the Ritual hands down concerning the visitation and care of the sick, and which are to be observed faithfully, it is helpful to add some things excerpted from the writings of St. Alphonsus,²⁰ namely the following:

1. Having entered the room of the sick person, let the confessor speak to the one lying ill in a friendly manner, by inquiring how he is; and having exhorted him to conform himself to the will of God, let him gradually transfer the conversation to instituting confession. Yet in the first visit, unless necessity urges, let him generally be silent concerning it; but after, on the second or third visit, he has begun to speak about it and has assigned the day and hour for instituting it, let him skillfully take care that the sick man make it without procrastination, especially if the disease is of such a nature that delirium could easily supervene. See also n. 2332.

2. If the sick man is a scandalous man, for example living in concubinage or in a merely civil marriage, an author of bad books, notoriously excommunicated, etc., commonly he must not be heard unless first he has promised amendment and due satisfaction; for it is to be feared lest, confession already having been begun, he refuse to obey; from which it could easily happen that the confessor, bound by the sacramental seal, would be forced to administer the last Sacraments to one unworthy. - Nevertheless circumstances can persuade otherwise, for example if death is imminent, and immediate confession already signifies reparation of scandal.

3. As regards confession itself, let him take care that it be made so diligently that nothing of those things which are required for integrity and contrition be omitted, and so moderately that the penitent is neither affected by annoyance nor wearied by too much application of mind. - But if imminent danger of death, or the gravity of the disease itself, or other grave reasons persuade this, let the confessor urge material integrity less, but, with the admonition premised that the penitent complete his confession afterward if he recovers, let him watch much and almost solely over the dispositions of his soul.²¹

4. If those serving the sick man cannot withdraw, let the confessor admonish him to declare at least one sin, and this a light one; when this has been declared, let him incite him in a few words to sorrow concerning all sins which he has committed, and then impart absolution to him. - Finally, if someone could confess no special sin, for example because he is deprived of speech, but gives signs of penance, and shows that he wishes absolution, he is also to be absolved; absolutely, if no prudent doubt concerning his disposition underlies; otherwise, conditionally (cf. n. 1663, q. 5).

5. Let him impose a light penance, indeed sometimes a very light one, such as invocation of the Most Holy Names of Jesus and the Virgin Mary; but let him add, as the Ritual wills, to this penance another more proportioned one for the time in which the sick man will have recovered. But it will be enough, says St. Alphonsus, to enjoin on him that he return in time of health; or, that he satisfy by alms, if he can (cf. n. 1720, 2).

6. If a convenient occasion seems present, "let him exhort the sick man to dispose opportunely concerning his domestic affairs: for this is expedient for the peace of the family, and the more so if it is necessary for the relief of his conscience. - Yet in this the priest should carefully beware lest he himself fall into any note of gain (or into the hatred of relatives)."²²

7. The sick man must be forearmed against temptations.²³ If he is tempted against FAITH, he is to be exhorted to elicit acts of faith without any examination; that, as soon as the temptation rushes in, he have recourse to prayers and turn thought aside to other things; also, if the temptation persists in urging much, let the confessor explain to him in few words the motives of credibility, and take care that the one tempted, by his own prayers and those of others, obtain the grace of resisting and persevering. - If he is tempted against HOPE (and this temptation indeed is very frequent), let the confessor set forth to him the reasons why we must hope; let him pray for him, and rarely, while he is hearing, have conversation about matters which inject terror. - Let him also watch that temptations of vainglory, impatience, excessive aversion from death, excessive love toward relatives and temporal goods, as well as temptations of hatred and vengeance, be kept away from him.

8. Let the confessor suggest to the sick man, but with few words and only at intervals, acts of virtues by which Christians ought to dispose themselves for a holy death, namely acts of faith, hope, charity, contrition, conformity with the divine will, and acceptance of death. Nor should he omit now and then to offer him an image of the Crucified, and other holy images, that he may kiss them.

9. Finally let the priest take care that the sick man gain all the Indulgences which he can; but especially the plenary Indulgence in the article of death, which the Apostolic blessing has annexed to itself. - Hence let him admonish him, contrite, to implore the Most Holy Names of Jesus and Mary, once or more often (by mouth, if he can; but if not, by heart)²⁴ (cf. n. 1741).

10. When the sick man is already in his last moments, care must be taken that persons whose presence could bring some danger to the dying man be removed from his room.²⁵ But let the priest frequently sprinkle him with blessed water, frequently fortify him with the sign of the cross, and frequently offer him sacred things to be kissed. - Let him pour forth many prayers together with those standing by, nor omit to recite the accustomed prayers of the Church.

11. Let him hand him a blessed candle, so that, holding it, he may profess that he dies in the Faith. - But let him disturb him by no touch of the body, nor do anything by which death could be accelerated. - As long as the struggle with death endures, let him repeat the holy acts, and multiply them and pronounce them in a loud voice, so that thus they can be heard by the dying man.²⁶

12. The SIGNS of imminent death, see in St. Alphonsus.²⁷

1855. II. With dying persons DESTITUTE OF SENSE the following things are to be observed:

1. All dying persons destitute of senses who, before the privation of the senses, expressly showed a desire of confession, for example by ordering a priest to be called, are to be absolved, more safely however under condition. The reason is that confession, in the case, becomes known to the confessor sufficiently sensibly through the testimony of another, and is as it were confession by an interpreter. This is established from the Roman Ritual on the Sacrament of Penance.

2. All dying persons wholly destitute of senses who have lived as Christians are to be absolved under condition, even if they have manifested by no sign either sorrow concerning their sins or desire of confession. The reason is that in such persons sorrow and desire of absolution can be presumed through sensible signs, for example through sighs, movements of the body, anxious breathing manifested, although these are not perceived by the confessor.²⁸

3. For the same reason, other dying persons destitute of senses who have lived little as Christians are to be absolved under condition. Indeed, it is sufficiently probable that a dying Catholic who, in the very act of sin, has been deprived of senses, for example in a duel, adultery, theft; likewise free-thinkers, Freemasons, apostates, etc., is to be absolved conditionally. - Nor does it stand in the way that attrition and confession in these persons are very doubtful; because, in the case of extreme necessity, even in the administration of the Sacraments it is licit to use a slight and little-founded probability.²⁹

4. Under condition, similarly, those can be absolved who, although they have never professed the Catholic faith, nevertheless have shown a will inclined toward it; provided that they had already been baptized in their sects (but in doubt concerning the value of this Baptism, after Baptism has been repeated under condition); for there is a certain reason for conjecturing that they wish to depart life in the communion of the Church.³⁰ But if heretics have given no indication of this will, they are not to be absolved even if they give signs of sorrow; because such persons can never prudently be presumed to furnish those signs in order to confession, from which they shrink exceedingly.³¹

You will resolve for practice: 1. A dying Catholic, or one not certainly a heretic (even if perhaps unknown), in every case in which it is not evidently established that he is already dead, or actually altogether indisposed, or refusing the Sacraments, is to be absolved either absolutely or conditionally (according to his condition).

2. Nevertheless an act of contrition is to be suggested to him briefly and in a loud voice, if he has given no signs or doubtful signs of penance. For physicians testify that "hearing generally persists even to the last time, and not rarely, when the other senses have already plainly been extinguished, it still remains."³²

IT IS ASKED. How often must ABSOLUTION be renewed for a dying person?

Resp. 1. If, having already confessed duly, he still flourishes in the senses, absolution must be renewed for him several times; yet in such a way that, before it is imparted anew, a new sign of sorrow and confession, at least some sort of sign, is manifested. For thus the sick man is rendered more secure concerning the state of grace, or certainly sanctifying grace is increased, and the punishments of Purgatory are diminished.

Resp. 2. If the dying man (likewise having confessed) is already destitute of senses, and manifests no sign of sorrow, it is not expedient to impart absolution to him frequently within the same day, i.e., not more often than every three or four hours; for a grave and urgent cause (on account of which alone the Sacrament can be administered under condition) is not present here of itself, so that the words of absolution should be repeated more frequently. We have said of itself; for, upon a dying man accustomed to bad thoughts, or entangled by some passion of hatred or impure love, or very impatient with the troubles of disease, or also now about to die, they can be repeated more often. "It will not be out of place," adds St. Alphonsus, "to admonish the sick man, while he is capable in mind, that if he cannot speak, he give some determined sign when he seeks absolution, or when the priest wishes to confer it upon him, for example that he close or open his eyes, lift his hand, incline his head, and similar things."³³

Resp. 3. Finally, if the dying man has been so destitute of senses that he could never either confess or express contrition, he is to be absolved much more often, at least under condition; because it can happen that he succumbs to hidden temptations, and especially because it can happen that the infinite mercy of God mercifully grants him the grace of compunction, which he previously lacked, in a lucid interval.³⁴

NB. Recall what was said at n. 929, II, 1282 and 1777.

2274. • I. The Pastor "ought diligently TO ASSIST THE DYING, and especially habituated sinners, who greatly need special assistance. But it is true that the pastor can commit this assistance to other priests; yet he ought not trust any priest whatever; for in this occasion of assisting the dying, scandals of no mediocre harm can happen."¹⁵ - Recall what was said n. 473, 3, 1854, and 1880.¹⁶

1370. - I. Any dying person who in some way, by voice or sign, confesses, or asks for absolution, can and must be absolved, and indeed absolutely. The reason is that all requisites are present for the Sacrament and for Confession formally integral.

II. Any dying person in whom attrition and Confession can be presumed in some way, however slightly probable, can and must be absolved, but conditionally; because in a case of extreme necessity, even in the administration of the Sacraments, it is lawful to use even a slightly founded opinion. - St. Alphonsus and others more commonly against others.

III. A dying person who altogether refuses the Sacrament of Penance, or who can in no way be presumed attrite or to have wished or to wish Confession, can in no way be absolved. The reason is most plainly clear.

1371. Resolves. - 1° All dying persons not yet deprived of the senses and consenting to absolution, and obeying the commands of the confessor, are to be absolved: absolutely indeed, if they spontaneously ask for Confession, or if with a willing mind they propose to confess; but conditionally, if with difficulty they are scarcely induced to some Confession, or if there is prudent doubt concerning their sufficient disposition. - Thus commonly.

2° All dying persons deprived of the senses, who before the deprivation of the senses expressly showed a desire of Confession, e.g. by ordering a priest to be called, etc., are to be absolved, but more safely conditionally. The reason is that in the case Confession becomes known sufficiently sensibly to the confessor through the testimony of another, even of one person or mediately. This is clear from Councils and from the Roman Ritual.

3° All dying persons wholly destitute of the senses, who lived as Christians, are to be absolved under condition, even if at that time they gave no sign either of sorrow or of desire for Confession. The reason is that in these persons sorrow and the desire of absolution can be presumed through sensible signs, e.g. through sighs, motions of the body, anxious breathing, which were manifested although not perceived by the confessor.

4° For the same reason other dying persons destitute of the senses, who lived little as Christians, are also to be absolved conditionally.

5° For the same reason, sufficiently probably, a Catholic dying person, destitute of the senses in the very act of sin, e.g. in a duel, adultery, theft, etc., can and must be absolved under condition.

6° "Those who, although they have never professed the Catholic faith, have shown a will inclined toward it, can in that crisis," i.e. if they are dying and destitute of the senses, "be absolved under condition, ... if they have already been baptized in their sects" (but in doubt concerning the value of this Baptism, after Baptism has been repeated under condition); "for there is some reason for conjecturing that they wish to finish life in the communion of the Church. But if no indication of his will has been given, they are not to be absolved, even if they give signs of sorrow": because such persons can never prudently be presumed to give those signs in order to Confession, from which they greatly abhor.

Note. - Absolution is usefully conferred several times on a sick person still enjoying his senses after a brief Confession; for thus he is rendered more secure concerning the state of grace, he receives an increase of grace, and purgatorial punishments are diminished for him. - But to one destitute of the senses and giving no sign of sorrow and of desire for absolution, "it is not expedient to impart absolution very often within the same day," i.e. more often than every three or four hours, even if only conditionally; for the grave and urgent cause which is required in order that a Sacrament be administered under condition does not exist per se for this kind of absolution "repeated very often within the same day."

I say: per se; for it could be given more frequently to a dying person habituated in evil thoughts, or entangled in some passion of hatred or impure love, or not bearing a very bitter infirmity with a willing mind, or also now on the very point of dying. - "Moreover, it will not be beside the matter to warn the sick man, while he is in possession of mind, that" when "he will not be able to speak," he should "give some determinate sign," or one agreed upon with him, "when he seeks absolution, or when the priest wishes" to confer it "upon him," e.g. to close or open the eyes, lift the hand, incline the head, and the like. Thus St. Alphonsus in Praxis Conf., where he treats the matter more explicitly than in Theol. Mor. or in Hom. Apost.

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.