The Recipient of Extreme Unction

IN order to be able to receive Extreme Unction validly a man must be baptized, must have attained the use of reason, and must be in probable danger of death from sickness. Extreme Unction, then, may be administered to those adults who are in danger of death from disease, from the pains of childbirth, from a wound, from poison, and from old age, even though they be no longer in their right senses. It cannot be validly given to soldiers before going into battle, to criminals who are going to be executed, to imbeciles who have never had the use of reason, to children who have not yet come to the use of reason, nor to unbaptized persons.¹

¹ Ritual.

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.

We must speak first of the person receiving, then of the manner of receiving Extreme Unction, and finally of the repeated reception of Extreme Unction.

What is extreme unction? - Extreme Unction is so called because, of all the sacred unctions which the Lord our Savior entrusted to his Church, it is the last to be administered. Roman Catechism 3. Extreme unction is a sacrament of the New Law, instituted by Christ the Lord and promulgated by Blessed James the Apostle, by which, through anointing with oil and the prayer of the priest, there is conferred upon sick adults in danger of life the salvation of the soul, and sometimes also health of the body. James 5:14, 15; Trent, sess. 7, c. 1; sess. 14, de E. U., C. 1, c. 1, 2; Florence, Decree for the Armenians; L. 706; Decree of the Holy Office Lamentabili, July 3, 1907, prop. 48; St. Thomas, Suppl., q. 29, a. 1, 3; 4, d. 23, q. 1, a. 1; E. M.

What are the effects of extreme unction? - To confer grace. - To remit venial sins, and also mortal sins if they are present and there is at least attrition for them, if one can neither be contrite nor confess. This sacrament is the complement of penance, for it was chiefly instituted to wipe away the remnants of sins. "But because, when sin is found in the soul, the remnants cannot be taken away unless the sin is first taken away, therefore consequently this sacrament takes away sin." L. 731. Hence it is primarily a sacrament of the living, secondarily of the dead. Therefore Confession or contrition ought, of itself, to precede if the sick person is in mortal sin. - To wipe away the remnants of sin and to relieve and strengthen the soul of the sick person. - The remnants of sin are not only the punishments due to sins, but also anxiety and fear of soul, weakness and torpor toward good.

Therefore the effect of this sacrament is the strengthening of the sick person against the temptations of the devil, the relief and raising of the soul by hope in the divine goodness and mercy. - Sometimes to restore health of body, where this is expedient for the salvation of the soul, by aiding natural causes. Therefore they err who do not receive this sacrament except when the sickness has prevailed so much that they cannot be healed without a miracle. - James, l.c.; Trent, sess. 14, de E. U., C. 2, c. 2; Florence, Decree for the Armenians; Roman Catechism, n. 5-7, 9, 12, 14-16; L. 714, 716, 731; Billuart, art. 7; St. Thomas, Suppl., q. 29, a. 1 ad 2, ad 3, a. 2; q. 30; q. 32.

Does extreme unction confer grace in the individual anointings, or only when all are completed? - It is disputed, and each opinion is probable to St. Alphonsus. The reason is that each anointing is completed by its own matter and form; but from all of them one anointing at last coalesces. L. 707, H. A., tr. 17, n. 3. But St. Thomas, Suppl., q. 30, a. 1 ad 3, says: "grace is conferred in the last anointing." - Yet "it is certain that this sacrament is one; for although the anointings are several, nevertheless all pertain to one signification of interior healing." L. 706. - St. Thomas, Suppl., q. 29, a. 2; Benedict XIV, de Syn., l. 8, c. 3; Roman Catechism, n. 4.

What is the matter of extreme unction? - The remote matter of this sacrament is necessarily olive oil, which must be blessed by a Bishop not only for liceity but also for validity, even when extreme necessity presses. Trent, sess. 14, C. 1; Florence, Decree for the Armenians; S. I. C., Jan. 13, 1665; Sept. 14, 1842; Jan. 10, 1850; May 15, 1878. By a Bishop, namely by the diocesan, or, when the See is vacant, by another neighboring Bishop; on Holy Thursday the oil of the sick, just like the oil of catechumens and chrism, must be renewed each year, though not for the validity of the sacrament, from the precept of Clement VIII and from the Roman Ritual, de Extr. Unct. And this more probably is grave. Nevertheless, if new oil cannot be had, it is licit to use the old. L. 708. It was granted to Latin America by Leo XIII, Constitution Trans oceanum, "that sacred oils even old ones can be used, yet not beyond four years, provided they are not corrupted, and after all diligence has been carried out new or more recent sacred oils cannot be had." But if perhaps within the year the blessed oil seems to be failing, and no other blessed oil can be had, it can be repaired by pouring in a small amount of unblessed oil in lesser quantity. Roman Ritual. And this several times, although in the end the added quantity has been greater than that which was blessed by the Bishop and which was there from the beginning. Blessed; whether it must be blessed in order to extreme unction is disputed. Some probably deny, because the Church requires nothing else except that it be blessed by a Bishop. Others probably affirm, because by a special blessing it must be deputed to the sacrament of extreme unction. Yet in practice the safer opinion is to be held, except in a case of necessity, in which, after another oil of catechumens or chrism has been used, which is used in the sacrament of confirmation and in the ceremonies of baptism, if afterward the oil of the sick can be had, the sacrament is to be repeated. Blessed. A simple priest by concession of the Supreme Pontiff can bless oil of this kind, as is clear from the use of the Greek Church. Benedict XIV, de Syn., l. 8, c. 1, n. 4.

The oil is to be preserved in a clean and decently adorned place, in a silver or tin vessel, Roman Ritual, de Sacr. extr. unct., namely in the church or sacristy, or even at home, if the pastor's house is very distant from the church. S. R. C., Dec. 16, 1826, n. 2650.

The proximate matter is the anointing of five principal parts of the body, namely the eyes, ears, nostrils, mouth, hands, or, if someone lacks one of them, the part nearest to it, although he has lacked it from birth. But whether all these anointings are necessary by necessity of the sacrament, or whether one alone suffices, with a universal form comprehending all the senses, is disputed, and each opinion is probable; and in practice, outside the case of necessity, one must stand by the opinion affirming the necessity of all. Yet the resolution of the Holy Office about one form, although in a case of necessity, seems to favor one anointing. Cf. 869. Nor indeed is the order among the various anointings of parts necessary for the sacrament; nor, in paired senses, is the anointing of each necessary, but only by precept is it to be observed outside a case of necessity. Besides, unless the usage of the place provides otherwise, the feet and loins are to be anointed, but the loins only of men, provided they can conveniently be moved. In some places the anointing of the loins is omitted in male religious. Where however it is not in use, let it be introduced, if this can be done. S. R. C., Aug. 14, 1858. And it can never be omitted unless in particular cases, with precautions applied, decency cannot otherwise be sufficiently provided for. Holy Office, May 15, 1878. The Greeks anoint the forehead, chin, both cheeks, breast, hands, and feet. - Trent, sess. 14, C. 1, c. 3; Florence, Decree for the Armenians; Roman Ritual, de Sacr. Extr. Unct.; Roman Catechism, n. 5, 10; Benedict XIV, de Syn., l. 8, c. 1, n. 4, c. 3; L. 707, 710, 732; St. Thomas, Suppl., q. 29, a. 4, 6; q. 32, a. 5-7; E. M.

What is the form of extreme unction? - The form is: "Through this holy anointing, and his most loving mercy, may the Lord forgive you whatever you have committed through sight, or hearing, etc. Amen." Roman Ritual, de Sacr. Extr. Unct.; Florence, Decree for the Armenians. Certainly essential are: Through this anointing, by which the sacramental action is signified; May the Lord forgive you, by which the sacramental effect is expressed generally; more truly also, when it is conferred in the ordinary way, outside a case of necessity, cf. 869, Whatever through sight, etc., you have committed, by which the special effect of this sacrament is contained; and in a case of true necessity, when one anointing and one form have been used, whatever you have committed.

On the contrary, more truly the following are not essential: Through his mercy; for they are tacitly comprehended in the words, May God forgive you; nor certainly are these essential: Holy, Most loving, Amen, which signify neither the sacramental action nor the sacramental effect. To omit essentials is grave; accidentals light or grave according as the omission is light or notable.

Therefore it is grave to omit through his mercy; but light to omit holy, or most loving, or amen. The form of Extreme Unction is essentially deprecatory. Roman Ritual, l.c. Therefore, if it is pronounced in the indicative or imperative mode, according to the more common opinion, it is invalid. - Florence, Decree for the Armenians; Trent, sess. 14, de E. U., C. 1; Benedict XIV, de Syn., l. 8, c. 2; L. 710, 711; St. Thomas, Suppl., q. 29, a. 7, 8, 9. "Although some change certain words, when for May God forgive you they put May he remit or May he spare; sometimes also, May he heal whatever you have committed; nevertheless, because no change of meaning is made, it is clear that the same form is religiously observed by all." Roman Catechism, n. 6. Cf. here 869.

Who is the minister of extreme unction? - The minister of Extreme Unction is a priest. Any priest validly confers it; licitly only the pastor of the place in which someone is sick, who confers it also on clerics, but not on Regulars and those who enjoy the privileges of Regulars. For their own prelate confers it on Regulars. St. Pius V, Constitution Immarcescibilem, 1567. The Bishop himself chooses by whom he would prefer to be anointed, whether the Sacristan, i.e., the greater Dignitary of his Chapter, or the Curate. Ceremonial of Bishops, C. 38, § 4; S. C. C., June 7, 1760; March 24, 1873, A. S. S., vol. 8, p. 202 ff. - But any priest can more probably licitly also minister this sacrament from the reasonably presumed consent of the pastor. For it does not seem that one must proceed with such rigor where there is question of mere delegation for liceity, and in no way for the validity of the sacrament.

They validly confer it whether one priest or several; and these either simultaneously perform the various anointings, one anointing one part, another another, and pronouncing the form corresponding to that anointing; or successively, if namely one begins the anointings and another continues them. But outside the case of necessity this is grave, namely either of the sick person about to die soon, or because, once the anointings have begun and have not yet been completed, the minister fails. But if this happens, another minister must complete the anointings not yet performed, but must not repeat those performed, not even under condition, unless a notable delay intervenes, namely a quarter of an hour; therefore after a quarter hour they must be repeated under condition. - But in the Greek Church seven or at least three priests anoint the sick person. Benedict XIV, de Syn., l. 8, c. 4, n. 8. - James, Catholic Epistle, 5:14; Trent, sess. 14, C. 1, 3, c. 4; Florence, Decree for the Armenians; L. 722, 723, 724; St. Thomas, Suppl., q. 29, a. 2 ad 3; q. 31; Roman Catechism, n. 13; Benedict XIV, de Syn., l. 8, c. 4; E. M.

How are the anointings to be performed? - As regards validity, the part must be truly anointed; but to anoint is to smear with oil. Therefore if the oil is only dripped, there is no anointing; but whether one drop of oil suffices is disputed. Moreover, it suffices in the individual anointings to dip the tip of the finger in the oil and anoint. L. 709. - All the senses are to be anointed, and indeed continuously.

The reason is that it is probable that from all of them one anointing coalesces, and that grace is conferred when all have been completed; but if a longer delay is interposed between one and another anointing, the moral union is no longer preserved and the sacrament becomes doubtful. - As regards liceity, the anointing must be made with the thumb, and it is light matter to use another finger; nor may a little rod or brush be used, even if usage has this, except from a cause of necessity, if, e.g., the sick person is laboring under a contagious disease. S. R. C., May 9, 1857, Portus Aloysii, ad 2; Benedict XIV, de Syn., l. 13, c. 19; L. 710. Likewise, except for a cause of necessity, neither in baptism is it lawful to use a little rod or brush. S. R. C., Aug. 31, 1872, n. 3276. The anointings must be made in the figure of a cross, and again this is light matter, L. 728; and in the prescribed order, which some judge grave, others of itself light, since there is question only of a certain accidental manner, L. 710; and in paired senses, which is grave, and one must begin from the right; nor is the form to be completed before paired members of this kind have been anointed, which seems light. Roman Ritual, de Sacr. extr. unct.; L. 711; St. Thomas, Suppl., q. 29, a. 2; q. 32, a. 5; E. M.

Note: The anointing begins from the eyes. That they may be anointed conveniently, they must be closed, and the anointing made upon both eyelids. If they cannot be closed, let the anointing be made on the eyebrows, near the corners of the eyes, as the very ancient Catalan Ritual has it. - The ears come next, which are anointed on the lobe or lowest part of the ear; not on the helix or in its hollow, and this so that they can more easily be wiped. - The nostrils; let the nostrils be anointed outside, which are the lateral wings of the nose, to avoid sneezing, which would easily arise if it were done otherwise. - The mouth, with the lips pressed together: here there must be one anointing, and therefore the lips are to be joined so that it can be done more easily; but, if this could not be obtained, it will suffice that the lower or upper lip be anointed; nevertheless there are those who still anoint each. - The hands; the anointing is made in the middle of the palm of each hand, or on another nearer part if it cannot be done otherwise, nevertheless on the inner side; for only priests and Bishops must be anointed on the outer part of the hand. - The feet; the anointing is made at the metatarsus, commonly the instep; according to St. Charles it is made on the soles, because namely we use them for walking. Moreover it will suffice if that part of the feet is anointed which conveniently can be; nor does it matter if both cannot be anointed because of sickness, or difficulty, or because one has been cut off; for this anointing is only an integral part. And indeed the feet fall under the sense of touch. The anointing of the loins may be omitted while the essence of the sacrament nevertheless remains. For the loins fall under all the other five senses, which according to St. Thomas, Suppl., q. 32, a. 6, are, as principles of acting, so principles of sinning.

Each piece of cotton or similar thing prepared for wiping the anointed parts serves for each paired member anointed. The priest rubs well with bread crumb the thumb with which he anointed, and washes it with water in some vessel prepared for this, then wipes it with a towel; but he brings the water-washing together with the crumbs and the tufts of cotton used for wiping to the sacrarium. Yet some are accustomed to hand over all these things to be burned in the house itself of the sick person, and to carry to the sacrarium only the cotton or tow that was anointed. - Trent, sess. 14, c. 3; Benedict XIV, de Syn., l. 8, c. 3; L. 711, 730; E. M.

Is it ever lawful to minister extreme unction with one form and one anointing? - If danger of imminent death is present, it is lawful to perform all the anointings under one formula: "Through this holy anointing and his most loving mercy may God forgive you whatever you have committed through sight," while he anoints the eyes, "hearing," while he anoints the ears, etc., putting the word committed before, lest if it is placed after and the sick person dies in the meantime, the anointings performed would be utterly invalid. Indeed, when death is soon imminent, one anointing on the forehead, or breast, or shoulders will suffice, with these words: whatever you have committed THROUGH THE SENSES; or better, by expressing the senses thus: Through this holy anointing, etc., may God forgive you whatever you have committed through the senses: sight, hearing, taste, smell, and touch. And "in a case of true necessity the form suffices: Through this holy anointing may the Lord forgive you whatever you have committed. Amen." Holy Office, Apr. 25, 1906. And consequently one anointing also suffices. - L. 710; Benedict XIV, de Syn., l. 8, c. 3; A. S. S., vol. 33, fasc. 7.

What of the various ceremonies and prescribed prayers? - It is grave, without urgent necessity, to omit the prayers prescribed by the Roman Ritual; and if they have been omitted because of danger of instant death, afterward, if time is available, they will have to be said. The prayers which precede the anointings; the Psalms and Litanies are not to be said by the minister, but by the bystanders, because from even the Ambrosian Ritual they are to be said only by counsel and not by precept. S. R. C., June 20, 1902. - It is likewise grave, apart from necessity, to minister this sacrament without surplice and stole. - But it is light matter to minister it without a light, without a minister, or with a woman serving. According to several, however, it is not even light matter to minister without a light, or to employ no minister. - If a cleric or layman cannot easily be found, the priest alone should perform all the ceremonies, and he himself should respond to the prayers. - Roman Ritual, h.t.; L. 724-728; E. M.

Pastors cannot for their own convenience retain the holy oil of the sick in their own houses, except however in the case of great distance from the church, in which case the rubric concerning honorable, decent, and safe custody must altogether be observed even at home. S. R. C., Aug. 31, 1872, ad 5, n. 3276; Nov. 15, 1890, Comp. ad 2, n. 3739; June 23, 1892, ad 7, Laud. n. 3779.

Who is the subject of extreme unction? - The subject of Extreme Unction is a baptized man who has reached the use of reason and is sick in probable danger of death, from disease, difficult childbirth, a received wound, poison, or old age, although he has not yet communicated, although he is mute, deaf, or blind from birth; although he is insane, if he has lucid intervals; although he is delirious or deprived of the senses, if beforehand he asked for the sacrament or would have asked for it if he had thought of this, and all irreverence toward the sacrament is absent. - Therefore it is invalidly given to healthy persons about to enter battle, to those condemned to capital punishment, to children not yet having attained the use of reason, or to those like children, namely idiots and the insane from birth, and to the sick outside the aforesaid danger. - But it is to be given only once in the same infirmity and danger; if the infirmity is long-lasting and the danger has at least probably passed, when a new danger is imminent it can be given again; and it must be given if the new danger is certain. - Trent, sess. 14, Doctrine on the Sacrament of Extreme Unction, C. 3; Decree for the Armenians; Roman Ritual, de Sacr. E. U.; Benedict XIV, Constitution Ex quo primum, de Syn., l. 8, c. 5-8; Suarez, d. 4, s. 2; L. 713-721, 732; St. Thomas, 4, d. 23, q. 2, a. 4, q. 2; Suppl., q. 32, q. 33; Roman Catechism, n. 9, 11; E. M.

Is there a grave obligation of receiving extreme unction? - No precept is present concerning this matter. Therefore, with contempt, scandal, and danger of combat with the devil removed, one who does not receive it does not sin gravely. L. 733; St. Thomas, III, q. 65, a. 4. But the proper pastor is nevertheless bound from office to minister it, and consequently sins gravely, unless some grave cause excuses him, by not conferring it on those asking, or by deferring it until the sick person, with health despaired of, is deprived of the senses. For thus the sick person lacks the richer fruit which he would have perceived, is deprived of spiritual strength for resisting the devil and for enduring the inconveniences of sickness; if he were in mortal sin, by conceiving attrition he would have obtained grace; and if it had been given at a suitable time, he could also have obtained bodily health. - It is given by custom after Viaticum, but it can be given before it. S. R. C., March 8, 1879, n. 3486. - Roman Ritual, de Sacr. E. U.; Roman Catechism 9; La-Croix 2120; L. 714, 716, 728, 729.

1. Petrus, a parish priest, was called to a dying man so that he might minister to him Viaticum and Extreme Unction. Since death was pressing, he thought that he would act better and more usefully if he first ministered Extreme Unction and then Viaticum, both lest that sick man lack the peculiar grace of that sacrament of Extreme Unction, and because already in the morning he had received Holy Communion from devotion, whence Viaticum seemed to him less necessary. The matter having been done, Petrus anxiously asked whether he acted rightly by ministering Viaticum after Extreme Unction.

It is asked: What is to be said to the question of Petrus?

R. Petrus acted rightly. For 1.º in the Roman Ritual it is thus had: "From the general custom of the Church, if time and the condition of the sick man permit, before Extreme Unction the sacraments of Penance and Eucharist are to be furnished to the sick." But in the aforesaid Case of Petrus, death was pressing. Therefore the condition of the sick man prudently advised that Extreme Unction could be ministered first, lest the sick man lack the peculiar grace of that sacrament, which is useful especially at the time of proximate death. 2.º Since that sick man had received Communion in the morning from devotion, he indeed could, but was not bound to, receive Viaticum; and therefore, death pressing, Extreme Unction could be ministered to him first, lest he lack that sacrament; and then, if time should suffice, Viaticum also could be ministered. But if time were lacking, no inconvenience would have redounded from this to that sick man. 3.º St. Alphonsus, l. 6, n. 716, says openly: "To receive Extreme Unction before Viaticum will either be no sin, or scarcely venial, as Suarez, d. 44, s. 1, n. 2, and Croix, n. 2120, say; nor does Benedict XIV disapprove it, de Syn., l. 8, c. 8, n. 2, because the custom of placing Viaticum before it has not been received at least under grave obligation." Therefore, a reasonable cause standing for the inversion made by Petrus, that inversion is free from every aforesaid fault. - I. M. 562, 872.

2. "In the kingdom of Buganda, lest a new persecution be stirred up against Christians, the faithful cannot publicly profess religion, and live as almost unknown among infidels. Hence there is the greatest difficulty for missionaries in visiting the sick; for from the presence of a missionary danger would arise for the sick man, and for those among whom he dwells; indeed even for all Christians, who are not tolerated, once their office has been known by the king. Therefore it is asked whether, to avoid this danger, missionaries can and ought not to visit the sick, or whether, despising any danger whatsoever, whether of private persons or of the Christian community, they can or ought to visit the sick constituted in grave danger of dying, so that they may refresh them with the sacraments of the Church.

R. According to the mind; and the mind is that the faithful are to be admonished by the missionaries that, considering the difficulty of having the assistance of a missionary at the article of death, they strive with every zeal to avoid sins, and in danger of death furnish mutual assistance to themselves; and besides, that the missionaries instruct well the catechists, who in the exposed cases may in some manner fulfill the places of missionaries." S. O., Apr. 3, 1889.

3. Geminus, a parish priest, confers Extreme Unction even on dying infants before the use of reason. For, he says, why ought they to be deprived of grace, which they will certainly have ex opere operato? But he does not confer Extreme Unction on adults unless death is certain and proximately imminent. Otherwise, he says, the sacrament is exposed to the danger of nullity. - Does he act rightly?

R. Negatively. For first, "those who lack the use of reason are not apt to receive this sacrament, and children who admit no sins, the remains of which there is need to heal by the remedy of this sacrament." Roman Catechism, n. 9. The reason of Geminus proves too much, for then it ought also to be ministered to the healthy and to those not dangerously sick. Besides, as the same Catechism says in the same place, "they sin most gravely who are accustomed to observe that time for anointing the sick man when, all hope of health already lost, he begins to lack life and senses." But it is to be ministered to those "who seem to be sick so dangerously that it is to be feared lest the last day of life be upon them." Catechism 16. And if the last period of life is awaited, the sacrament of Extreme Unction is now perhaps frustrated of the effect of bodily health, which it does not work by way of miracle, which then would be necessary, but by a certain power, supernatural indeed, but in a certain manner ordinary, which aids natural causes. Wherefore the reason of Geminus rather proves the contrary. - I. M. 862, 871.

“When an adult pagan, sufficiently instructed and rightly disposed, is baptized because he has fallen into a grave illness, must—indeed, can—the Sacrament of Extreme Unction be conferred upon him immediately after Baptism?—Response. Affirmative, with the form of the decree of the Holy Office of the year 1703 being observed.” Sacred Congregation for the Propagation of the Faith, 26 September 1821.

“Is Extreme Unction to be conferred upon dying adults whom we sometimes believe capable of Baptism, but not of the other sacraments?—Response. The Sacrament of Extreme Unction is not to be conferred upon a dying neophyte whom the missionary has judged capable of Baptism, unless he at least has some intention of receiving the sacred anointing ordained for the benefit of the soul at the time of death.” Holy Office, 1703 and 10 April 1861. Cf. no. 271; Canon 1158.

"When some adult Pagan sufficiently instructed and duly disposed is baptized, because he has fallen into grave illness, ought, indeed can, the sacrament of Extreme Unction be conferred upon him immediately after Baptism? Resp. Affirmatively, with the form of the Decree of the Holy Office of the year 1803 observed." S. C. de P. F. 26 Sept. 1821.

"Whether Extreme Unction is to be conferred on dying adults whom we sometimes believe capable of Baptism, but not of the other Sacraments? Resp. The sacrament of Extreme Unction is not to be conferred on a dying neophyte whom the Missionary believed capable of Baptism, unless at least the same person has some intention of receiving Sacred Unction ordered for the benefit of the soul for the time of death." Holy Office, 1803; 10 Apr. 1861. Cf. On Confirmation, N. 271.

689. • The subjects of this Sacrament are all and only sinners who are sick and in danger of death. This is established: first, from the words of St. James: Is any man sick among you? Let him bring in the Priests of the Church, etc.; but the Greek word is sick signifies a dangerous illness. Second, from the definition of the Church. For thus in the Decree of Union: This Sacrament ought not to be given except to a sick person concerning whose death there is fear. The Council of Trent, session 14, chapter 3, agrees.

Hence children before the use of reason and the perpetually insane are not capable of this Sacrament, because they have committed no actual sins.

690. Questions. - QUESTION 1. Must Extreme Unction be conferred upon delirious sick persons?

Reply. Yes, if they previously asked for the Sacrament, or would have asked for it if they had thought of this, or showed a sign of sorrow for sins. Indeed, also upon sick persons deprived of the senses, as is established from the Roman Ritual. - Recall what was said concerning the Sacraments in general, no. 230.

QUESTION 2. Can this Sacrament licitly be conferred upon a sick person in doubtful, or probable, danger of death?

Reply. Yes, with the common and true opinion, because for administering this Sacrament validly and licitly, it suffices that the sick person labor under a disease so grave that he is prudently judged to be in danger of death. This is confirmed from the Roman Ritual, where it is thus established: This Sacrament must be furnished to the sick who labor so gravely that the danger of death appears imminent. - St. Ligorius, no. 714, etc.

QUESTION 3. Can Extreme Unction be conferred upon children?

Reply. Yes, provided they are possessed of reason and are judged capable of malice and fault. Thus Benedict XIV (On the Synod, book 8, chapter 6), who sharply condemns certain synodal Constitutions by which a determinate age was fixed before which children could not be anointed.

691. • QUESTION 4. Can this Sacrament be repeated, or when can it be repeated?

Reply 1. It can certainly be repeated whenever a sick person anointed in a dangerous illness recovers and again falls into a dangerous disease. This is established from the Council of Trent, session 14, On Extreme Unction, chapter 3, where it is said: But if the sick, after receiving this anointing, recover, they can again be assisted by the aid of this Sacrament when they fall into another similar danger of life.

Reply 2. It can also be repeated in the same illness if it has been prolonged and the sick person has notably recovered, so that he appeared to have been rescued from the danger of death, and falls into the same danger again. The reason is that then there is truly a new danger of death. This is established from the Roman Ritual, where it is said: In the same illness this Sacrament ought not to be repeated unless it is prolonged, as when the sick person, after having recovered, falls again into danger of death.

QUESTION 5. Can it be repeated in the same prolonged disease if it is doubted whether the state of the disease has truly changed?

Reply. More probably, yes, if the doubt is truly positive, namely, when it is truly probable that the sick person has passed out of the danger of death; for this repetition in these cases is more conformable to the ancient custom of the Church. - St. Ligorius, no. 715.

692. • QUESTION 6. Is there a grave obligation to receive this Sacrament?

Reply. There is a twofold probable opinion.

The first OPINION affirms it. First, it is evident (they say) from the words of the Apostle James himself: Is any man sick among you? Let him bring in the Priests of the Church, etc. But the word let him bring in contains a precept. Therefore, etc. Second, there is added the practice of the Church, which has always taken the greatest care that it be received by all the sick. It also appears to be established from the custom and sense of the faithful. Third, in addition, it is grave and contrary to the charity which each owes to himself to omit a means so efficacious and a most firm protection, as the Council of Trent says, against the attempts of the demon in the final agony. - Thus Roncaglia with others.

The second OPINION denies it. The reason is that neither from Tradition nor from the Decrees of Councils is a precept of receiving this Sacrament established. But what St. James says, let him bring in the Priests..., is understood and explained as counsel. Therefore, a grave obligation of receiving Extreme Unction cannot be imposed. - Thus Billuart, article 7, after St. Thomas, part 5, question 65, article 4; Sporer, no. 106, etc.; and St. Ligorius, no. 733, where he calls this opinion common, although he thinks the first altogether to be recommended, chiefly by reason of the charity which each owes to himself: For in so great a danger, he says, he appears to expose himself to succumbing to temptations who neglects to fortify himself with this Sacrament instituted by Christ the Lord as a most firm protection in so great a conflict.

693. • QUESTION 7. What disposition is required for the reception of this Sacrament?

Reply 1. Confession of sins, if the sick person is in mortal sin; for this Sacrament is the complement of Penance, and therefore Penance must precede it. - Billuart, article 7, at the end.

Reply 2. But if the sick person cannot confess his sins, it is necessary that at least contrition precede; for this Sacrament of Extreme Unction is primarily a Sacrament of the living and was instituted chiefly for removing the remnants of sins. - Billuart, ibid. But in such a case attrition itself seems able to suffice; for it is at the same time a Sacrament of the dead and can remit mortal sins with attrition. - The Salmanticenses, no. 13, and others.

1. SUBJECT OF THE SACRAMENT. —The Sacrament of Extreme Unction (extrema unctio) was instituted for the corporal as well as spiritual well-being of the sick. One of its special effects is to confer upon the dying the grace of a happy death. While it is essential for the validity of this Sacrament that the recipient be seriously ill or, as the technical phrase runs, in periculo mortis,¹ it is altogether immaterial whether this condition be due to disease or to old age.² Hence the sacra infirmorum unctio may not be administered to persons who are ex- 188 posed to the danger of death but are not seriously ill, e. g., soldiers going into battle, condemned criminals preparing for execution, etc. The Sacrament may, however, be given to those in danger of dying from an operation or after confinement, but not to those who have not yet attained the use of reason or have not committed a personal sin, that is to say, infants and permanently insane adults (perpetuo amentes).³ If an insane person enjoyed the use of reason at any moment of his previous life, or has occasional lucid intervals, he may and should be given Extreme Unction,⁴ because a habitual and interpretative intention suffices for the valid reception of this Sacrament, and there is a well-founded presumption that many insane persons temporarily regain the use of reason at the approach of death, though they are unable to manifest their sanity by definite signs.

¹ Jas. V, 14-15. —Cfr. the Deereturn pro Armenis of Eugene IV: "This Sacrament ought not be given except to a sick person whose death is feared." (Denzinger-Bannwart, n. 595). — The Council of Trent says (Sess. XIV, De Extr. Unct.t c. 3): "It is also declared that this anointing is to be applied to the sick, but especially to those who lie so dangerously ill that they seem to be placed at the departure from life, whence it is also called the Sacrament of the departing." —Cfr. Cat. Rom., P. II, c. 6, qu. 9: "Since only those who suffer from illness need healing, therefore this Sacrament ought to be given to those also who seem so dangerously ill that it must be feared that their last day of life is at hand."

² Rit. Rom., tit. 5, c. 1, n. 5: "This Sacrament ought to be given to sick persons who, after attaining the use of reason, labor so gravely that danger of death seems imminent, and to those who are failing from old age and seem likely to die from day to day, even without another illness." —"Senectus est morbus," was a received axiom among the Scholastics.

³ Cat. Rom., P. II, c. 6, qu. 9.— Rit. Rom., tit. 5, c. 1, qu. 9; cfr. Codex Iuris Canonici, can. 940, 941, 943. —Cfr. H. Noldin, S. J., Summa Theologiae Moralis, 11th ed., Innsbruck 1914, Vol. III, pp. 543 sqq. —J. P. Gury, Compendium Theol. Mor., Vol. II, n. 519, says: "The subjects of this Sacrament are all and only sinful human beings in danger of their lives. Hence children before the use of reason and the perpetually insane are not capable of this Sacrament, because they have committed no actual sins; Extreme Unction can be conferred upon those mute, deaf, and blind from birth, for they can be anointed near the organs they lack, since even if they did not sin outwardly through those organs, they could nevertheless sin through the interior powers of the soul to which those organs correspond."

⁴ Cat. Rom., P. II, c. 6, qu. 9: "The insane and the delirious also are not fit to receive this Sacrament unless they sometimes had the use of reason and at that time especially gave an indication of a pious disposition and asked to be anointed with sacred oil. For one who from birth was never possessed of mind and reason is not to be anointed; but it is otherwise if the sick person, while his mind was still sound, wished to partake of this Sacrament and afterward fell into insanity and frenzy."

Extreme Unction may be administered to a sick man who is really or apparently unconscious, provided there is reason to think that he would ask for, or at least not refuse, the Sacrament if he had full control of his faculties.⁵

⁵ Rit. Rom., tit. 5, c. 1, n. 6: “But it is nevertheless to be given to sick persons who, while of sound mind and in possession of their senses, asked for it, or would probably have asked for it, or gave signs of contrition, even if afterward they lost speech, became insane, are delirious, or are unconscious.” —Ibid., n. 7: "But if the sick person, while suffering frenzy or insanity, might probably do something contrary to reverence for the Sacrament, let him not be anointed unless the danger is removed." —Cfr. Gury, Comp. Theol. Mor., II, n. 520: "This Sacrament ought to be given to the delirious if they asked for it beforehand, would have asked for it if they had thought of it, or showed a sign of sorrow for sins."

Even impenitent sinners and those who have lost consciousness while in the act of sinning (e. g., habitual drunkards) should not be deprived of Extreme Unction, unless they consciously and positively refuse to receive the Sacrament, because a possible subsequent attrition would make it operative.⁶

⁶ Rit. Rom., tit. 5, c. 1, n. 8: "But it is to be entirely denied to the impenitent, to those dying in manifest mortal sin, to the excommunicated, and to the not yet baptized."

In conformity with the axiom, "In dubio pars tutior est eligenda," ⁷ the Sacrament of Extreme Unction may be validly and licitly administered if the danger of death is merely probable or even doubtful.

⁷ Cfr. St. Alphonsus, Theol. Mor., 1. VI, n. 714. —J. P. Gury, Comp. Theol. Mor., Vol. II, n. 520: "Can this Sacrament lawfully be conferred upon a sick person in doubtful or probable danger of death? The answer is affirmative according to the common and true opinion, because for administering this Sacrament validly and lawfully it suffices that the sick person suffer from an illness so grave that he is prudently judged to be in proximate danger of death."

The name Extreme Unction or Last Anointing, which is of popular origin, is not a very fortunate one because of the implication that the Sacrament forebodes death. But as this name correctly describes the primary purpose of the rite, i. e., to prepare and fortify the soul for its last journey, it was adopted by the Church after it had obtained currency among the people. The Council of Trent employs the older term, "sacra infirmorum unctio" and the modern " extrema unctio" indiscriminately.

As Father Kern has pointed out, the custom, which has grown wide-spread since the twelfth century, of demanding and administering Extreme Unction only when all hope of recovery has vanished and death is imminent, "is opposed to the usage of the ancient Church and owes its existence to such causes as popular superstition, false theological teaching, and avarice, which have nothing in common with the operation of the Holy Ghost. This deplorable practice endangers to a very large extent the attainment of the object for which Extreme Unction was instituted by Christ. The principal effect of this Sacrament is the supernatural strengthening of the sick in order to enable them to bear the sufferings and temptations by which they are harassed, for the honor of God, so that, to apply St. Paul's dictum, 'that which is at present momentary and light of our tribulation, worketh for us above measure exceedingly an eternal weight of glory.'⁸ This supernatural strengthening of soul and body is intended also to induce the sick man, with the extraordinary assistance of divine mercy, to which he is commended in the name of Christ, to make acts of confidence, resignation, patience, contrition, and charity, and thereby to obtain forgiveness of his sins and the complete remission of the temporal punishments due to them. Thus he will be ready, when God calls him hence, to enter straightway into eternal bliss, without passing through the fiery furnace of purification. It was for this reason that the early Christians appropriately called Extreme Unction 'sanantis divinae gratiae dulcedo' Its true purpose is to restore the soul to complete health and to prepare it for immediate entrance into glory. This is intimated by the Fathers, clearly expressed in the liturgical prayers of the ancient Church, taught as a revealed truth by the leading Scholastics —including Bl. Albert the Great, St. Thomas, St. Bonaventure, Duns Scotus, Richard a Mediavilla, Peter de Palude, Innocent V, Aureolus, and Capreolus —and acknowledged by the Council of Trent. It often happens that the full recovery of the soul involves such a strong alleviation of bodily suffering that the power of disease is broken and physical recovery follows. In that case the fruition of eternal beatitude is postponed, but it will be all the more glorious if he to whom the privilege has been granted cooperates with the graces bestowed by this wonderful Sacrament." ⁹

⁹ J. Kern, S.J., in the Zeitschrift fur kath. Theologie, Innsbruck 1906, pp. 617 sqq.

⁸ 2 Cor. IV, 17.

Though Extreme Unction is not strictly necessary for salvation, every Catholic who is dangerously ill, is in duty bound to receive this Sacrament, and should receive it as soon as there is probable danger of death, and not wait till he has become unconscious or entered into agony.¹⁰ Hence when it is possible to receive this Sacrament, a Catholic in danger of death is bound under pain of mortal sin to ask for it, if failure to do so would give grave scandal or involve contempt of the Sacrament,¹¹ or if Extreme Unction were the only Sacrament the patient was still able to receive. According to the commonly accepted teaching of St. Thomas, however, refusal to do so is not per se a mortal sin.

¹⁰ Cfr. St. Alphonsus, Theol. Mor., 1. VI, n. 733; Gury, Cotnp. Theol. Mor., II, n. 522.

¹¹ Conc. Trident., Sess. XIV, De Extr. Unct., c. 3: "Contempt for so great a Sacrament cannot be without enormous wickedness and injury to the Holy Spirit Himself."

The state of grace is required for the worthy reception of Extreme Unction, and hence the administration of this Sacrament is generally preceded by Confession and Communion. Extreme Unction, in fact, is the consummation of Penance.¹² When Penance and Holy Communion can no longer be administered, it is sufficient that the patient give a sign of contrition, or, if he be unconscious, that he may be reasonably presumed to desire the Sacraments of the dying.

¹² Conc. Trident., Sess. XIV, De Extr. Unct., c. 3; Cat. Rom., P. II, c. 6, qu. 12; Pohle-Preuss, The Sacraments, Vol. IV, p. 1, 2nd ed., St. Louis 1918.

The positive disposition required for the worthy reception of Extreme Unction consists in acts of faith and hope, and confidence in God's mercy.¹³ The Roman Catechism admonishes pastors to preach often on Ex- treme Unction in order to remind the faithful of their last end and to aid them in repressing evil desires and leading a good Christian life.¹⁴

¹³ Cat. Rom., P. II, c. 6, qu. 9: "Fides et religiosa animi voluntas." —Cfr. Gury, Comp. Theol. Mor., II, n. 523: "What disposition is required for the reception of this Sacrament? Confession of sins, if the sick person is in mortal sin, for this Sacrament is the complement of Penance and therefore confession ought to precede it. But if the sick person cannot confess his sins, it is necessary that contrition at least precede, for the Sacrament of Extreme Unction is primarily a Sacrament of the living and was instituted especially to remove the remnants of sins. Yet in such a case attrition itself seems able to suffice, for it is at the same time also a Sacrament of the dead and can remit mortal sins with attrition."

¹⁴ Cat. Rom., P. II. c. 6, qu. 1, 14. —Conc. Trident., Sess. XIV, De Extr. Unct., Prooem. 14a Codex Iuris Can., c. 938 sq.

— "Extreme Unction cannot be given except to a faithful person who, after having obtained the use of reason, by reason of infirmity or old age is in danger of death" (c. 940, §1).

Therefore there is required a baptized subject, possessed of the use of reason, in danger of death not because of an extrinsic cause of battle or capital sentence, but because of a cause intrinsic to the body from illness or old age. Moreover a wound and childbirth are assimilated to illness.

The Greek word of the epistle of St. James, asthenei, designates a serious illness, by which someone is broken in strength. From the decree of Eugene IV for the Armenians, it can be given "to him concerning whose death there is fear." The Council of Trent, sess. XIV, c. 3, says only that it is especially to be conferred on those who are placed at the end of life. From the Ritual, it is to be given to those who "labor so gravely that danger of death seems imminent, and to those who fail by reason of old age and seem about to die day by day." Therefore they admit that a probable indication, or positive doubt concerning death to follow from this infirmity, suffices. And nothing compels us, as it were, to obtain the license of a physician.

If the danger itself is doubtful, as if it is doubted whether the sick person has attained the use of reason or whether he is dead, this sacrament is to be administered under condition.

— Corollaries. Therefore, from Fr. Kern, a) it is not even validly conferred in an illness which neither greatly afflicts a man nor is actually dangerous;

b) it is validly and licitly conferred in an illness which, although it lightly afflicts the sick person, is nevertheless joined with danger of imminent death; in a grave illness and one dangerous by its nature, although objectively there is no risk of life; in an illness which by its nature is dangerous and which at the same time gravely afflicts the sick person, although subjectively it does not yet seem to bring with it risk of life.

If the sick person is gravely afflicted by an illness whose nature is not yet established, he will be able to be anointed at least conditionally.

In an illness which brings a certain danger of death, but only remote danger, so that death is not indicated as to follow before several months, Extreme Unction is validly conferred. Liceity will depend on the adjuncts: on the opportunity which the sick person will have, or will not have, of receiving the sacrament, on the state of the illness, hope of fruit, etc.

On account of opinions not so long ago put forth concerning apparent death, the sacrament can be conferred conditionally, at least when an expert man is absent who can render us more certain concerning perfect death, within a half-hour from the moment at which, according to common judgment, death has followed; indeed within an hour, if someone has been affected by sudden death. Indeed R. P. Ferreres thinks that absolution and Extreme Unction can be conferred at least for a half-hour after an expert physician, after every inspection has been made, has declared the person dead.

At least illicit would be an administration made to a sick person consenting to a safe use of the knife, or operation, by which every danger from the illness which he now has will be removed.

Those who are about to suffer the hands of a surgeon generally are already actually subject to an internal danger of death, so that even before the use of the knife they can be anointed. Yet if someone bodily healthy is about to undergo a dangerous use of the knife, for example for correcting a deformity, he cannot be anointed before the very use of the knife has induced a danger from an internal reason.

— To those who, impenitent in manifest mortal sin, contumaciously persevere, Extreme Unction is not to be conferred; but if this is doubtful, let it be conferred under condition (c. 942).

Observe that the contumacy of one who is destitute of the senses is no longer established. In what way there is introduced here a condition which is not necessary for validity was explained above, n. 184. What if he who with doubtful disposition was anointed under condition afterward arrives at a better disposition? Let the sacrament be given again under the condition "if you have not yet been anointed," rather than under the condition "if you are capable." For, as will be said immediately, repeated administration is rather to be judged valid; and since repeated administration is forbidden, the condition "if you are capable," which does not exclude repetition, would not impede illicit administration.

— The sacrament is to be conferred absolutely on sick persons who, when they were in possession of their mind, asked for it at least implicitly, or likely would have asked for it, even if afterward they have lost sense or the use of reason (c. 943).

— "It is lawful for no one to neglect this sacrament; and with every care and diligence it must be seen to that the sick receive it while they are fully in possession of themselves" (c. 944).

Yet a grave obligation of receiving this sacrament is not judged to be present of itself. Thus the probable opinion. Yet it would be grave to contemn this sacrament, or to neglect it with scandal of contempt of this kind.

Moreover the abuse of delaying the sacrament until instant death, or until health is certainly despaired of, meanwhile deprives the sick person a) of the spiritual helps of this sacrament; b) of the effect of recovering health.

Counsel. - One who has weighed the marvelous effects of this sacrament, how would he not desire for himself, even several times in life, that spiritual renewal which the holy oil works? Therefore we judge it most to be commended that it not be reserved for desperate sick persons alone, nor be for many a dreaded omen of certain death, but that it become the common sacrament of all who are afflicted by an illness dangerous by its nature. Our Most Holy Lord Pius XI calls it "a deadly error," by which it happens that, with detriment to the soul, the sick are not anointed with holy oil before, death being imminent, they have almost or altogether lost the senses. One who, when a probable indication of danger is present, "takes care that it be administered, not only follows the doctrine of Mother Church, but piously and salutarily fulfills her desires." Brief Explorata res, February 2, 1923, concerning the sodality of Our Lady of a good death (Tinchebray).

— So that he may receive this sacrament with fruit, the sick person who is conscious of mortal sin must either confess before he is anointed, or be contrite if he can. Therefore judged contrition suffices; indeed a later attempt of contrition suffices, if opportunity for confession is not had, provided attrition is had.

— "In the same infirmity this sacrament cannot be repeated, unless the sick person, after receiving the anointing, has recovered, and has fallen into another risk of life" (c. 940).

Therefore the sacrament is licitly repeated in a twofold case: a) in a different illness; b) in the same illness but in a new danger of death, as if the sick person has imperfectly recovered and then again is brought into risk.

Formerly it was conferred on several successive days, so that the forbidden repetition is to be referred to more recent discipline, unless nevertheless those successive anointings can be held as one integral administration. Therefore repetition of this sacrament in the same danger, although gravely prohibited, nevertheless does not seem invalid.

— I. The subject of Extreme Unction is a baptized man, possessed of the use of reason, who, because of a cause intrinsic to the body, from illness, to which a wound or childbirth is assimilated, or from old age, is in danger of death.

In doubt concerning the danger, concerning life, concerning the use of reason, let it be administered conditionally. To him who perseveres in manifest impenitence, which a man destitute of the senses is not, Extreme Unction is not to be conferred. If this is doubtful, let it be conferred under condition. The sacrament is conferred absolutely on sick persons who, while possessed of sense, would have asked for it.

It must be seen to that the sick receive it while they are fully in possession of themselves.

A grave obligation of receiving it is not proved.

It cannot be repeated in the same infirmity. Yet if the sick person has sufficiently recovered and has fallen into a new risk of life, it can be administered anew.

580. Principle. The subject of Extreme Unction is every baptized man capable of malice and placed in probable danger of death, and this not from another source, but from illness or old age.

Thus it follows from the words of the Code of Canon Law, c. 940: "Extreme Unction cannot be given except to a member of the faithful who, after attaining the use of reason, is placed in danger of death because of illness or old age."

It is said, first: a baptized man, because Baptism is the gateway of all the sacraments. But Baptism of water is required, nor does Baptism of desire suffice, which indeed confers sanctifying grace but is not a sacrament. Therefore neither pagans nor catechumens can receive this sacrament; but if a gravely ill adult pagan is baptized, he can receive Extreme Unction immediately after Baptism, because he is capable of an increase of grace and still needs strengthening against diabolical temptations. Thus the Sacred Congregation for the Propagation of the Faith on September 26, 1821, and the Holy Office on May 10, 1703,⁴⁹ appear to have determined. Nor is St. Thomas contrary to this doctrine when he says: "[Extreme Unction] is not given against the remnants of original sin, except insofar as they are in some manner strengthened by actual sins. Hence it is given principally against actual sins, which are not in children."⁵⁰ For the Angelic Doctor: a) speaks only of children incapable of actual sin; b) teaches that Extreme Unction is principally against the remnants of actual sin. But in a baptized adult there can be remnants of actual sins committed before Baptism, for example, if perhaps his attrition did not extend to all sins.

More probably, however, the Blessed Virgin neither received nor was capable of receiving Extreme Unction, because she was without every sin and the fomes of sin, nor did she need strengthening against diabolical temptations.

It is said, secondly: capable of malice, that is, capable of personal sins. For children before the use of reason, as also those perpetually insane, cannot sin by their senses, and therefore in them the form is not verified: "Whatever you have sinned through hearing, sight," and so forth. But as soon as children are capable of sin, they are to be anointed when placed in a dangerous illness, although they have not yet approached first confession nor completed their seventh year. Insane persons who have or have had lucid intervals are capable of sin and consequently also of Extreme Unction.

It is said, thirdly: placed in probable danger of death, and this not from another source, but from illness or old age. Therefore a probable danger of death arising from a grave illness is altogether required. Consequently, if the danger of death arises from another source and not from illness, this sacrament cannot be validly administered; for example, Extreme Unction can be conferred neither licitly nor validly upon soldiers setting out for battle or upon those soon to be punished by death. The reason is that St. James expressly says: "Is anyone among you sick?" (ἀσθενεῖ), and: "shall save the sick man" (τὸν κάμνοντα). Therefore, as long as someone is healthy or not gravely ill, he is incapable of Extreme Unction.

Since advanced old age is itself an illness, Extreme Unction is to be administered to a decrepit old person placed in probable danger of death, as is evident from the cited words of the Code of Canon Law.

Note. 1. This sacrament is not to be conferred upon those who contumaciously persevere impenitent in manifest mortal sin.⁵¹ But if this impenitence is not altogether certain but doubtful, Extreme Unction is to be conferred under condition. Similarly, it is to be conferred under condition in three other cases, namely, when it is doubted: a) whether the sick person has attained the use of reason; b) whether he is actually placed in danger of death; c) whether he is dead. The condition added must be: "if you are capable," and not: "if you are disposed." For otherwise, in a case in which the sick person was indeed indisposed but capable, the sacrament would not afterward revive when the obstacle had been removed.

2. Before childbirth this sacrament cannot be administered to a healthy woman, just as neither can Viaticum. But if a danger to life arises during childbirth, it is lawful to confer both sacraments, because then an illness is also truly present.

3. It is not required that the danger of death be altogether imminent and certain. Indeed, it is counseled that Extreme Unction not be deferred until the very end of life, because then the effect of recovering health is always frustrated.

4. Since Extreme Unction is a sacrament of the living, the sick person must make confession beforehand if he is in the state of mortal sin. But if confession is impossible, there must be made beforehand: a) an act of supernatural sorrow on the part of the sick person, and b) sacramental absolution, at least conditionally.⁵²

⁴⁹ Collect. de Prop. Fide, nn. 768 and 256.

⁵⁰ Suppl., q. 32, a. 4 ad 2.

⁵¹ Code of Canon Law, c. 942.

⁵² Ibid., c. 941.

581. The obligation of receiving Extreme Unction is not considered grave, apart from scandal or contempt. The reason is: a) because no certain precept concerning this matter is found either in Sacred Scripture, in tradition, or in ecclesiastical law; b) because this sacrament is ordinarily not of such necessity for salvation; and therefore, in the time of an interdict, Extreme Unction formerly could not be administered to those who were able to receive other sacraments, for example, Penance and the Eucharist.⁵³ But since even in the time of an interdict the Church permits sacraments necessary for salvation to be administered, it follows from this that Extreme Unction is not altogether necessary.⁵⁴ It is evident of itself that one who refuses the reception of Extreme Unction with grave scandal (for example, a bishop or priest), or who contemns this sacrament, sins gravely.

Although ordinarily there is only a light obligation of receiving Extreme Unction, nevertheless the faithful are to be strenuously exhorted not to deprive themselves of so excellent an assistance in the danger of death. Therefore the Code of Canon Law, c. 944, establishes: "Although this sacrament is not of itself of the necessity of means for salvation, nevertheless no one is permitted to neglect it; and it is to be ensured with every zeal and diligence that the sick receive it while they are fully in possession of themselves."

⁵³ Cf. c. 11, X 5, 38. According to the discipline in force, it is lawful during the time of an interdict to administer sacraments and sacramentals to the dying (Code of Canon Law, c. 2270, § 1).

⁵⁴ Cf. St. Thomas, Suppl., q. 29, a. 2 ad 1; St. Alphonsus, Theol. mor., l. 6, n. 733.

582. Extreme Unction cannot be repeated (validly and licitly)⁵⁵ in the same illness and in the same danger of death, because the efficacy of this sacrament endures as long as the same danger of death remains for which it was conferred. This repetition remains prohibited even when this sacrament (validly conferred) was sacrilegiously received. For such a sacrilegious sacrament afterward revives when the obstacle has been removed through Penance.

Concerning this matter the Council of Trent⁵⁶ defined: "But if the sick recover after receiving this anointing, they will be able to be aided again by the assistance of this sacrament when they fall into another similar danger of life"; and the Code of Canon Law, c. 940, § 2, establishes: "In the same illness this sacrament cannot be repeated unless the sick person, after receiving the anointing, has recovered and has fallen into another danger of life." The general rule is this: As often as an imminent danger of death departs and a new one succeeds, even during the same prolonged illness, so often is it lawful to repeat this sacrament.⁵⁷ In practice it is not infrequently difficult, indeed impossible, to decide whether the same danger of death has remained or not. If the sick person for some time, for example, for a month or even for a week, has been notably better, and then falls again into danger of death or "another danger of life," it is lawful to repeat Extreme Unction; but if the change for the better is very doubtful, the same danger of death is considered to continue.

⁵⁵ A few theologians (for example, Kern, De extr. unct., l. 5, prop. XIII) teach that Extreme Unction is validly conferred in the same illness and in the same danger of death.

⁵⁶ Sess. 14, c. 3, De extr. unct. (Denz., n. 910).

⁵⁷ Cf. St. Thomas, Suppl., q. 33, a. 2. Blessed Albert (IV, d. 23, a. 21) and other older Scholastics thought that Extreme Unction could not be repeated in the same illness except once each year.

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."

1881. Principles. I. The SUBJECT of Extreme Unction is only a baptized man, who has attained the use of reason and is in danger of life from disease. - It is clear: 1. from the words of St. James: Is any one of you sick?, etc.; 2. from Trent (sess. 14, cap. 3), where it is declared: "This anointing is to be applied to the sick, but especially to those who lie so dangerously ill that they seem to be placed at the exit of life."

Hence, for the VALID reception of this Sacrament the following things are required:

It is required, 1. that the one to be anointed BE BAPTIZED; for Baptism is the gate of the Sacraments. But this Sacrament can be conferred on an adult immediately after Baptism. "The reason is both because, more truly, through Baptism the remnants of mortal faults committed before Baptism are not wiped away, such as torpor toward good and proneness toward evil; and because the primary effect of this Sacrament is not so much the remission of faults as the strengthening of the sick person against the temptations of the devil, as Suarez and others commonly say."¹³

It is required, 2. that the one to be anointed HAS ATTAINED THE USE OF REASON. For otherwise the form would become vain: May the Lord forgive thee, etc. Hence it follows: 1) Children who have not yet attained the use of reason cannot be anointed. On the contrary, whatever Soto with others may say, children endowed with reason are to be anointed, although they cannot receive the Sacrament of the Eucharist and have not yet reached the age of seven, as Benedict XIV teaches.¹⁴ In doubt concerning the use of reason, let them not be deprived of so salutary a remedy, but let them be anointed under condition: If thou art capable.¹⁵ - 2) The perpetually insane cannot be anointed; otherwise, if they have had lucid intervals; or even if it is probable that they had them, in which case they ought to be anointed under condition. But the RITUAL admonishes: "If the sick person, while he labors under frenzy or insanity, likely could do anything against the reverence of the Sacrament, let him not be anointed, unless the danger is removed altogether," for instance, if he is held or even bound. - 3) The sick who are destitute of the senses ought to be anointed, and indeed without condition, if they have given a sign of a pious soul, or have lived as Christians, so that it can be presumed that they would have asked for the Sacrament if they had been masters of reason: or, as the Ritual speaks, if they likely would have asked. And the reason is that, in one receiving this Sacrament, an interpretative intention suffices (cf. n. 1434, 3).

It is required, 3. that the sick person BE SICK UNTO DEATH, "so that there is fear concerning his death," as the Council of Florence says in the Decree to the Armenians. - Hence, neither validly nor licitly can the healthy be anointed, even if they are in open danger of death, such as those in danger at sea, in battle, etc.; those to be punished by public death; women laboring only with common pains in childbirth, even if they give birth for the first time, or at other times have been in danger of life; otherwise, if most grave torments supervene, through which illness with danger of death is verified. But those can be anointed who are infected with lethal poison; likewise those laboring under some evil on account of which they are about to undergo a difficult operation of surgery; likewise decrepit old persons "who fail from old age (as the Ritual speaks) and seem to die day by day, even without another infirmity": for old age itself is a disease.¹⁶

To the following question: "Sometimes, when Missionaries are visiting Christians committed to themselves, there occurs a sick person laboring with hectic fever or a similar disease, who according to experience will live still several months, but within a year will die. - It is asked whether, in such a case, the Missionary can administer Viaticum and Extreme Unction to him, because when the truer case for receiving them will be present, a Missionary will not be able to be had present, on account of the great distance and other circumstances impeding this?" The S. C. DE PROPAG. FIDE responded on February 20, 1801: Affirmatively.¹⁷

1882. II. For the LICIT and FRUITFUL reception of Extreme Unction, certain dispositions of the subject are required besides. For it is primarily, and of itself, a Sacrament of the living (cf. n. 1395).

Hence, besides the intention, at least presumed, of receiving the Sacrament, which is also necessary for validity, there IS REQUIRED: 1. Confession of sins, if the sick person is in the state of mortal sin. - 2. Contrition, at least estimated, in the case in which he cannot confess; for he must be at least putatively in grace; but if he has only attrition, the Sacrament will not lack its effect (cf. n. 1395 and 1397, qu. 2). - 3. The Most Holy Eucharist, from the general custom of the Church (but at most under venial sin), must be premised, unless vomiting or another reasonable cause excuses.¹⁸ - The other dispositions, such as lively faith, firm hope, perfect conformity with the divine will, etc., effect that a richer fruit is perceived from the Sacrament (cf. n. 1437).

The RITUAL admonishes: "But to the impenitent, and those who die in manifest mortal sin, and the excommunicated... (the Sacrament) is to be denied." - Nevertheless, it is given both to the drunken now about to die, and to those wounded in a brawl now destitute of senses, and to any others whatever concerning whom it is doubted whether they are in the state of mortal sin or are sufficiently disposed. - Benedict XIV also says:¹⁹ "Concerning any faithful person, concerning whom the contrary is not established, it must be presumed that he would have asked for this Sacrament, if he could have."²⁰

1883. Questions. Q. 1. In what degree of infirmity CAN or OUGHT Extreme Unction be conferred?

Resp. 1. It CAN be conferred validly and licitly as soon as the sick person is prudently or probably judged to be in danger of death, although not yet proximate. It is proved from Trent (sess. 14, cap. 3, on Extreme Unction), where it is had: "This anointing is to be applied to the sick, but especially to those who lie so dangerously ill that they seem to be placed at the exit of life." That particle especially sufficiently indicates that Extreme Unction can be ministered also to the sick who do not yet seem to be at the exit of life. The matter is proved more strongly from the Bull Ex quo of Benedict XIV,²¹ in which it is read: "Let the Sacrament of Extreme Unction not be administered to those well in health, but only to those who labor under a grave disease." Wherefore, whenever Viaticum can be furnished to a sick person who is not fasting, Extreme Unction can also be given to him; indeed, it is expedient that it then be given. - But if it were given in a GRAVE disease, though danger of death at least remote were not judged to be present, it would indeed be given validly, but illicitly; if in a LIGHT disease, it would be administered neither licitly nor validly.²²

2. It OUGHT to be given when danger of death urges; for thus the RITUAL speaks: "This Sacrament ought to be furnished to the sick who labor so gravely that danger of death seems to be imminent." - Nor is the last time of life to be awaited, as the Roman Catechism says:²³ "They sin most gravely (priests) who are accustomed to observe that time for anointing the sick person when already, all hope of health having been lost, he begins to lack life and senses." The reason is, says St. Alphonsus, because the sick person is deprived of the richer fruit which he would have received if, master of himself, he had received the Sacrament; likewise because he is deprived of spiritual strength for resisting the devil and for bearing the inconveniences of disease; he is perhaps deprived also of health of body, if he had been anointed at the suitable time, according to what was said at n. 1872; indeed also of the eternal salvation itself of the soul, in the case in which, existing in mortal sin, he would have attained grace with the help of attrition. - All these things, at least heaped together, seem to bring grave damage to the sick person.²⁴

Q. 2. Whether and when can this Sacrament be REPEATED?

Resp. It must be repeated: - 1. In a different and dangerous infirmity; for it is ordered to healing; "but healing medicine ought to be repeated as often as infirmity is repeated," as D. Thomas says.²⁵ - 2. In a different danger of a long infirmity; for the RITUAL says: "In the same infirmity it ought not to be repeated, unless it is long-lasting, as when the sick person has grown better and again falls into danger of death."

Hence, IN A LONG-LASTING DISEASE, such as phthisis and dropsy, if the sick person after anointing certainly has remained in the same state of infirmity, or only for a brief time, for instance for 4 or 5 days, has had himself better, it ought not to be repeated. - But if such a change has intervened in his state that with probability it must be judged that he had exited from the danger of death, because for a notable time, for instance for a month, he had had himself better than before, in such a case, with Benedict XIV as witness,²⁶ one must stand for repetition of the Sacrament, "because," he says, "this repetition is more conformed to the ancient custom of the Church, and through it a new spiritual help comes to the sick person."

Q. 3. Whether the reception of this Sacrament is NECESSARY for salvation?

Resp. 1. It is not necessary by necessity of means, since salvation can be obtained without this Sacrament. Thus all. - But whether it is necessary by necessity of precept is controverted. St. Alphonsus judges the affirmative opinion as very probable, and altogether to be advised in practice: but this, not now by reason of a precept, concerning whose grave obligation it is not established; but by reason of charity which the sick person owes to himself, and which urges especially in the extreme article of life. For although other protections, with which he can fortify himself, are not lacking to him, nevertheless he would act mercilessly toward himself if willingly he deprived himself of this most powerful protection. For he who is in danger of death, on the one hand, is able to excite himself to good acts only with great difficulty, and on the other hand is subject to strong attacks of enemies, since "in this point of time (as Trent speaks), the snares of the devil are more vehement." Hence (thus the Blessed Doctor concludes) he seems to expose himself to great danger of succumbing to temptations, who neglects to fortify himself with this Sacrament instituted by Christ the Lord as a most firm protection in so great a conflict.

2. Although of itself it is not established that there is a grave obligation of receiving Extreme Unction, nevertheless all agree that the sick person PER ACCIDENS is held, and indeed UNDER GRAVE SIN, to the reception of the Sacrament, whether by reason of special necessity, namely if, existing in mortal sin, he could not receive another Sacrament, or by reason of scandal to be avoided, or finally by reason of contempt. - For it is certain that formal contempt induces grave fault. Moreover, contempt is censured formal when the sick person refuses this Sacrament because he values it little; but not when he refuses from some repugnance or ignorance. It is confirmed from the Bull of Martin V: This Sacrament can neither be neglected without fault, nor contemned without mortal sin. "Hence, the Pontiff seems sufficiently to have expressed that contempt of this Sacrament indeed carries grave fault, but negligence no more than light fault."²⁷

Note. Concerning ASSISTANCE TOWARD THE DYING, see the Opuscule of St. Alphonsus at the end of the Praxis Confessarii, or in Hom. Apost., last Treatise, Appendix II. - Concerning the Indulgence to be imparted to the dying²⁸ (cf. n. 1854, 9).

1507. - The subject of this Sacrament is all, and only, sinners, i.e. those who are capable of sin or at some time were capable, and these sick persons whose life is in danger. It is established 1° from the words of St. James: Is anyone sick among you? Let him bring in the priests of the Church, etc.; but the Greek word is sick signifies a dangerous disease; 2° from the definition of the Church. For thus in the Decree of Union: This Sacrament ought not to be given except to a sick person, concerning whose death there is fear. Trent agrees. - But that they ought to be sinners is clear from the Form itself.

Hence children before the use of reason are not capable of this Sacrament, nor those perpetually insane, because they have committed no actual sins, nor could they commit them. In doubt concerning capacity, let it be conferred under condition.

1508. Questions. - Quaer. 1° Whether Extreme Unction ought to be conferred on the delirious sick?

Resp. Affirmatively, if previously they asked for the Sacrament, or probably would have asked for it if they had thought about this, or showed a sign of sorrow for sins. Indeed also to the sick destitute of the senses, as is established from the Roman Ritual. Cf. n. 1240. R. 4°. - But to one laboring under frenzy or insanity, who probably could do something against the reverence of the Sacrament, it is not to be ministered unless the danger is altogether removed, for example by binding him.

Quaer. 2° Whether this Sacrament can licitly be conferred on a sick person in doubtful or probable danger of death?

Resp. Affirmatively, with the common and true opinion, because for ministering this Sacrament validly and licitly it suffices that the sick person labor under a disease so grave that he is prudently judged to be in danger of death. It is confirmed from the Roman Ritual, where it is thus established: this Sacrament ought to be given to the sick who labor so gravely that the danger of death seems to threaten. I said: 1° that he is prudently judged to be in danger of death. For in mere doubt, i.e. unless there is truly probability of danger present, it will not be administered, since then it cannot be said that danger of life is present. - I said: 2° for ministering this Sacrament validly AND licitly. For St. Alphonsus judges that this Sacrament is always validly conferred if the infirmity is grave. This opinion, especially among us, can be brought into practice in this sense: that the priest ought to be much less anxious in judgment concerning the danger, if he is far distant from the sick person and cannot easily return. (29) p. 421.

Quaer. 3° Whether Extreme Unction can be conferred: a) on a woman laboring in childbirth; b) on those about to undergo a difficult surgical operation; those failing from old age; those infected by poison; c) on those to be punished capitally; those about to join battle; those placed in danger of shipwreck?

Resp. to a) Distinguish. Negatively, if there is question of a woman laboring under ordinary pains in childbirth, even if she gives birth for the first time, or at other times was in danger of life; affirmatively, if she labors under extraordinary and lethal pains. For in the latter case, not in the former, danger exists from disease.

Resp. to b) Affirmatively, because danger exists from disease. (51) p. 430.

Resp. to c) Negatively, for the contrary reason.

Quaer. 4° Whether Extreme Unction can be conferred on children?

Resp. Affirmatively, provided they "are in possession of reason, and are judged capable of deceit and fault." Thus Benedict XIV. Indeed in doubt concerning the use of reason, according to the opinion more probable to St. Alphonsus, they are to be anointed under condition. Cf. n. 1507.

Quaer. 5° Whether, or when, this Sacrament can be repeated?

Resp. 1° Certainly it can be repeated as often as a sick person anointed in a dangerous disease has recovered, and again falls into a dangerous disease. It is established from Trent.

Resp. 2° It can also be repeated in the same infirmity, if it has been long-lasting and the sick person notably recovered, so that he seemed to have been rescued from the danger of death, and again has fallen into the same danger. The reason is that then there is truly a new danger of death. It is established from the Roman Ritual, where it is said: "in the same infirmity this Sacrament ought not be repeated, unless it is long-lasting, as if, when the sick person has recovered, he again falls into danger of death."

Quaer. 6° Whether it can be repeated in the same long-lasting disease, if it is doubted whether the state of the disease has really been changed?

Resp. Affirmatively, more probably, if the doubt is truly positive, namely when it is truly probable that the sick person has come out of the danger of death; for this repetition in these cases is more conformable to the ancient custom of the Church. But a doubt of this kind will be present if the sick person seems to have escaped danger of death for a notable time, say for a month.

Quaer. 7° Whether there is a grave obligation of receiving this Sacrament?

Resp. There is a twofold probable opinion.

The first affirms. 1° It is clear, they say, from the words of the Apostle James himself: Is anyone sick among you? Let him bring in the priests of the Church, etc. But the word let him bring in contains a precept. Therefore, etc. 2° There is added the practice of the Church, which with the greatest solicitude has always taken care that it be received by all the sick. It seems to be established also from the custom and sense of the faithful. 3° Moreover it is grave, and against the charity which each one owes to himself, to omit a means so efficacious, and a most firm protection, as Trent says, against the efforts of the demon in the last struggle. - Thus Roncaglia with others.

The second denies. The reason is that neither from Tradition nor from the Decrees of Councils is there evidence of a precept of receiving this Sacrament. But what St. James says, let him bring in the priests, etc., is received and explained as counsel. Therefore a grave obligation of receiving Extreme Unction cannot be imposed. - Thus Billuart, after St. Thomas, Sporer, and St. Alphonsus, who calls this opinion common. Yet the first pleases St. Alphonsus more, and he calls it very probable in the case in which the sick person, exhortations having been employed, should continue to be unwilling to be anointed.

But he certainly would sin gravely: 1° who from contempt refused this Sacrament; or 2° could not overcome grave temptations without it; or 3° would give grave scandal by not receiving it.

Moreover Extreme Unction would be necessary for salvation to one placed in mortal sin, lacking contrition, and unable to give a sign of Confession. "But Suarez and Palaus say well that this case can scarcely occur," i.e. then indeed the necessity of Extreme Unction for salvation would be present, but not the obligation of asking for it, as being impossible to fulfill.

Quaer. 8° What disposition is required for the reception of this Sacrament?

Resp. 1° Confession of sins, if the sick person is in mortal sin, practically.

Resp. 2° But if the sick person cannot confess his sins, let contrition, at least estimated, precede: for this Sacrament of Extreme Unction is primarily a Sacrament of the living, and was instituted chiefly for taking away the remnants of sins. - But in such a case attrition itself suffices and is required; for it is at the same time a Sacrament of the dead, and can remit mortal sins with attrition. - The Salmanticenses, Benedict XIV, and others.

Hence it is clear that this Sacrament, as the Roman Ritual says, is to be denied to "the impenitent, ... and those who die in manifest mortal sin."

It is said: to the impenitent and those who die in MANIFEST mortal sin. But under these words there ought not to be comprehended the dying who, in the act of mortal sin, are destitute of the senses; for it is not altogether certain that they die in manifest sin. Therefore, absolution being given under condition, this Sacrament can be conferred on these conditionally. (30) p. 421.

Note. - He also can be anointed who is baptized in grave infirmity. (31) p. 422.

3. Those who are certainly dead cannot be absolved, nor anointed, even under condition; but from recent experiments it is established that life can remain for some time in the body, even when someone seems to have given the last breath, because generally life recedes from the body only successively. Hence certain persons who were apparently dead, e.g., suffocated, or rescued from water or fire, have been restored to life after three hours by rhythmic traction of the tongue. Therefore, the other conditions being posited, those can be absolved and anointed who by such a process give certain signs of life, at least sensitive life; indeed, under condition, those who, although they seem dead according to ordinary signs, are prudently judged to survive. Yet the complete cessation of the motion of the heart, lasting for some time, and invading corruption of the body, or putrefaction already begun, are deservedly held as certain signs of death; cadaveric rigidity is less certain.

In practice, when a certain sign of death is lacking, if here and now the judgment of a physician cannot be had:

a) in a case of wholly sudden death, generally they can be absolved within two or three hours, because then it is probable that life remains for some time because of the resistant vital powers, which are not immediately destroyed; not longer, because it is no longer probable, even if it is possible in an extraordinary case that life remains hidden even for some days. An exception is made if death was violent, e.g., from compression or tearing away of principal members, because then death is evident.

b) In a case of ordinary death from a long-lasting and gradually wasting disease, they cannot be absolved, because it is not probable that life remains.

c) In an intermediate case of death, from a long-lasting disease but with a sudden new influence, which is called a "complication" and greatly accelerates the expected death, they seem able to be absolved for a space of about half an hour after apparent death.

4. The condition to be added is this: if you are capable, but not that one: if you are disposed. For since it is probable that one contrition, namely sincere but not appreciatively supreme, is required for the capacity and validity of receiving absolution, and another, namely appreciatively supreme, for the disposition required that it produce fruit, grace, and therefore that the sacrament can revive: the formula if you are disposed, in a case in which the disposition were absent, would render the sacrament altogether null and would forever impede its reviviscence. On the contrary, the form if you are capable would leave the sacrament valid in a case in which that lesser contrition was present which would suffice as a part of the sacrament, while that greater contrition was not present which is required as a disposition for justification; whence, when the dying person disposes himself by greater contrition, the sacrament would revive and the penitent would obtain the effect of grace. And in this sense Cajetan, in his little work on confession, St. Antoninus, and the old Thomists, such as Capreolus and Paludanus, interpret St. Thomas, Supplement, q. 9, a. 1.

With greater reason the same must be said of Extreme Unction, because it is certain that disposition, namely contrition, is required only for the fruit, not for the essence and validity, but for this latter the intention alone of receiving the sacrament suffices.²

² Concerning the sacraments not to be ministered under the condition if you are disposed, we wrote an article in the periodical Revue Eccl. de Liege, Nov. 1909, which quite generally received the approval of experts. Nevertheless Fr. Castillon moved certain difficulties in Nouv. Revue Theol., May 1910, which we subjected to examination and to which we gave satisfaction in Revue Eccl. de Liege, July 1910. No further response succeeded this.

III. Concerning Extreme Unction. - Extreme Unction is not to be given to all Christians who are in danger of death, but to adults dangerously sick; for, besides Baptism, there is required for its validity that one be a) a sinner and therefore an adult, or have the use of reason; b) dangerously sick; c) intending to receive the sacrament. Therefore the following cannot receive the sacrament:

1. The insane, unless previously they had the use of reason and then formed the intention of receiving Extreme Unction.

2. The healthy, even if they are in extrinsic danger of death, as those condemned to death; those about to navigate or fight dangerously, unless after they have received a lethal wound; women who regularly give birth with some danger of death, unless death is to be feared on account of a special infirmity, or their strength has already been greatly weakened from childbirth; and those about to undergo a dangerous incision, unless from an illness already contracted they are in danger of death. - On the contrary, those can be anointed for whom, from illness, there is not only imminent but also probable intrinsic danger of death, as all who have contracted an infirmity that will probably bring death, those infected by poison, the gravely wounded, those who after surgical incision are greatly weakened, indeed also decrepit old persons even if they labor under no special disease, for old age itself is for them an incurable disease, can. 940, § 1.

3. Those who do not intend to receive the sacrament; but an actual or virtual intention is not required, but a habitual intention, not retracted, even implicit, suffices, such as the intention of Catholics not to die without the sacraments, or of dying as a Catholic; not, however, the simple intention of saving oneself. Hence:

a) Of itself and regularly Extreme Unction is to be given to all the sick to whom absolution is granted, even if they are deprived of the senses. The reason is that it is a more secure means of salvation than absolution itself, for it is certain that Extreme Unction remits mortal sins, Jas. V, 15, and it is also certain that it is valid if absolution certainly valid cannot be had. For when sufficient external signs of contrition are lacking and therefore absolution is very doubtful, Extreme Unction is received validly, because contrition, which is a part of the sacrament of Penance, is not a part of Extreme Unction required for its validity, but only a disposition for its fruitfulness.

b) Accidentally, however, it can happen that Extreme Unction must be denied, when it cannot be given without the scandal of those standing by to some impious man already deprived of the senses, to whom absolution was granted secretly; likewise to him who now appears dead. Scandal can often be prevented by secretly administering one anointing, or even by admonishing those standing by; but if this cannot be done, the sacrament is to be denied, because the spiritual evil of many prevails over the conjectural good of one.

c) In doubt whether the sick person has attained the use of reason, whether he is actually placed in danger of death, or whether he is dead, the sacrament is to be ministered under condition, can. 941.

d) Extreme Unction is to be ministered absolutely to all, even sinners, who in life had an intention, not retracted, of dying as Catholics, can. 943; under condition, if you are capable, if it concerns unknown persons, or those who do not certainly live, as was already said, or sinners so impious that it can be doubted whether they have the intention of dying as Catholics; but not to those who, impenitent, contumaciously persevere in manifest mortal sin, can. 942.

e) In a case of necessity, Extreme Unction is to be ministered by one anointing only on the forehead, with the form: Through this holy anointing may the Lord pardon you whatever you have sinned. Amen. But if death has not followed, the other anointings are to be added as indicated in the ritual, and indeed absolutely, not under condition. The anointing on the loins is now to be omitted; the anointing of the feet can be omitted for any reasonable cause, can. 947.

3. Viaticum, Extreme Unction, and the apostolic blessing are to be administered to children, provided they have sufficient discretion.

I say. § 1. Extreme unction cannot be furnished except to a faithful person who, after having attained the use of reason, is situated in danger of death on account of infirmity or old age (Can. 940).

It is established 1°. from the words of St. James: "Is anyone sick among you? Let him bring in the presbyters of the Church," etc.; but the word is sick in Greek signifies a dangerous disease; 2°. from the definition of the Church, for thus in the Decree of union: "This sacrament ought not to be given except to a sick person concerning whose death there is fear"; 3°. from the Council of Trent, sess. 14, ch. 3. - Hence infants are not capable of this sacrament, nor the perpetually insane, because they have committed no actual sins.

But children, if they are masters of reason and are judged capable of deceit and fault, can and must be anointed, even if they have not yet received first communion and have not even once approached to perform confession.

"Altogether detestable is the abuse of not ministering Extreme Unction to children after the use of reason," says Pius X in the Decree Quam singulari. - Cf. Can. just cited 940, § 1.¹

¹ Cf. Addenda, p. 1142, n. 111, n. 112.

Caius, a missionary, during Eastertide visits a certain village five or six miles distant from the church where some Catholics live. There he comes upon a previously unknown Catholic family whose members never come to church, either because of the distance or because of negligence. The mother of the family, perhaps forty years of age, evidently suffers from consumption, although she is not confined to bed; indeed, she attends to her ordinary occupations. When she says that she cannot come to church because of her domestic duties, Caius warns her to be ready at home on the following morning to receive the Easter sacraments. When she agrees, early on the following day he successively administers Penance, Communion, and Extreme Unction. After eight months he is called to the same woman, now dying, and when he finds her deprived of her senses and at the very point of death, without delay he anoints her again on the forehead under a general form; a little afterwards the woman expires. Hence it is asked:

1. Who is the subject of Extreme Unction?

2. Can Extreme Unction be repeated in the same illness?

3. What is to be said of Caius’s manner of acting in all these things?

1. Who is the subject of Extreme Unction?

To receive Extreme Unction validly one must be baptized, have attained the use of reason, and must be in probable danger of death from sickness.¹

1 Manual of Moral Theology, vol. ii, 238.

2. May Extreme Unction be repeated during the same sickness?

The Ritual lays down that this sacrament ought not to be repeated in the same sickness, unless it is prolonged, as when the sick man has got better and he is again brought into the danger of death. Many approved authors hold that in practice it may be repeated after a month’s interval.²

2 Ibid., 238.

3. What about the actions of Caius?

Caius found a mother of a family who never came to church, partly on account of distance, partly on account of negligence. She was now far advanced in consumption, but still attending to her household duties. He told her to prepare herself to make her Easter next morning, and then came again to the house and administered Penance, the Eucharist, and Extreme Unction. There is little difficulty about the administration of Penance. It is forbidden to take Holy Communion out of the Church except to the sick. The woman in question was apparently sufficiently ill for Easter Communion to be brought to her. Extreme Unction should not be given except to the sick who are in danger of death. If Caius judged that the woman was probably in danger, he did right to administer Extreme Unction, otherwise he did wrong.

Eight months afterward Caius was called to the same woman and found her dying in a state of unconsciousness. He anointed her on the forehead with the general form, and then she died. Caius should first of all have given her conditional absolution, for Penance should always precede Extreme Unction, as this sacrament is the complement of Penance. He did right after such an interval to repeat Extreme Unction, for although the sickness was the same, still without doubt there had been a change in the sick person’s state.¹

1 Génicot, vol. ii, n. 423.

A Catholic, for a long time estranged from his religion, who has hated the priests and used blasphemous language, suffered a stroke of apoplexy. He remained unconscious for an entire day. In this extremity it was thought best to give him absolution and Extreme Unction. Later the patient returned to consciousness, without being able to speak. He violently protested against the exhortations of the priest and of the good sister in attendance, once or twice he even attempted to spit upon the crucifix held before him. Meantime many prayers were being offered for him in the hospital where he had been taken. Suddenly he gave unmistakable signs of conversion; he kissed the crucifix with devotion, and listened willingly to the priest’s words; he repeatedly tried to make the sign of the Cross, and endeavored to utter the Holy Name, as well as other invocations, The chaplain rejoiced at this sudden change of mind and administered Extreme Unction once more. For this, however, he was later severely censured by a confrater, who pointed out that Extreme Unction must not be repeated in the same illness. Who was right?

The chaplain referred, in proof of his correctness, to the lack, on the part of the recipient, of the intention requisite for the validity of a Sacrament. As this intention on part of the subject was, in fact, not present at the first administration, the repetition of Extreme Unction after the patient’s conversion was perfectly justified. The action of this unfortunate man before his conversion proved his aversion for any religious act, and consequently the absence of the intention requisite for the validity of the Sacrament.

The reasons which the confrater cited against this view are not valid, as their closer examination will show.

1. Extreme Unction may only be administered once in the same illness. In this connection it may be said that in our case it was really only given once, as the first administration proved to be invalid.

2. But this unfortunate patient was already sacro oleo unctus, and all prayers prescribed by the Church had been said over him. The invalidity of this objection is obvious. Some one may be aqua ablutus, or chrismate unctus, and yet the particular Baptism, or Confirmation, may be invalid, and he is neither baptized nor confirmed, if in administering the Sacrament an essential defect occurred. Lack of intention, on part of the administrator or recipient, is such a defect in the essence of the Sacrament.

3. But Extreme Unction is often administered to an unconscious person who has led an unchristian life, has not received the Sacraments for a long time, nor manifested a desire now, and yet no solicitude is had for the validity of the Sacrament in such cases. From this it may be inferred only that in many cases the administration of this Sacrament is invalid. Following the principle in extremis extrema sunt tentanda the Church goes as far as possible in granting Extreme Unction, which for so many poor souls may be their only salvation. For the recipient of the Sacrament the intentio habitualis is requisite, in the case of unconscious persons the Church contents herself with the intentio interpretativa; i. e., the Church explains: if this patient hic et nunc could express his intention, he would desire the Sacrament, or: if he were conscious he would request Extreme Unction. If it is proved that this presumption was an erroneous one, the administration must be regarded as invalid. In our case we have in the patient’s behavior sufficient proof that the presumption this unconscious patient would, if in his senses, wish to receive the Sacraments, was erroneous. His demeanor denoted sufficiently that he was averse to receiving the Sacraments. On the part of this subject, therefore, all intention was lacking; it was administered to him against his will, against his intention.

4. But let us suppose the case—which often enough happens in deathbed conversions—that a person estranged from religion has received Extreme Unction in the state of unconsciousness; subsequently he comes to and gives evidence of a religious disposition, then in continued danger of death Extreme Unction is not again administered; and why not? Because in such a case the intentio interpretativa, upon the presumption of which the Sacrament was given him, was lawful and the contrary not in evidence. If, however, the contrary is proved, as in our case, if it is ascertained that the good will presumed and the intentio interpretativa was not present, then the matter is quite different, and another administration of Extreme Unction, even in the same illness, is certainly in order if the refractory patient afterward shows his willingness.

5. But does not theology teach of a sacramentum informe, that it may become sacramentum formatum and that the sacramental grace may be imparted later to a hic et nunc ill-disposed recipient, as soon as the indispositio is lifted and the obex gratiae removed? A Sacramentum informe can, it is true, become in such manner a sacramentum formatum, the validity of the same supposed. Sacraments invalidly administered can not be made valid. To administer a Sacrament to a subject who has no intention, does not mean merely to give it to an unworthy person, but it is giving it to a person incapable of receiving it.

As the case stands we can not perceive how the chaplain was liable to censure; the reasons advanced by his confrater against the second administration of Extreme Unction are not valid. John Ackerl, D.D.

A priest was administering Extreme Unction to a dying person, who seemed to be on the point of breathing his last just before being anointed, for which reason the priest hastily anointed him on the brow, saying: Per istam sanctam unctionem indulgeat tibi Deus, quidquid deliquisti. The sick man did not, however, die just then. Ought the priest to anoint the man's eyes, ears, etc., and use the formula of words proper to each application of the holy oil? or may he allow the one application to the brow to suffice?

Answer.—In the first place the wording of the formula needs correction. The priest ought to have said Dominus instead of Deus, and to have added Amen; although the valor sacramenti was not imperiled by the alteration. As to the validity of one single application of the holy oil, we may quote a rescript issued by the Holy Office on April 25, 1906: "When this supreme Congregation was asked that a single brief formula be determined for the administration of the Sacrament of Extreme Unction in a case of imminent death, the Most Eminent Fathers decreed: In a case of true necessity the following formula suffices: Per istam sanctam unctionem indulgeat tibi Dominus, quidquid deliquisti. Amen." On the following day, April 26, this decree received the Pope's sanction. Formally the decision refers only to the forma sacramentalis, but indirectly it affects also the materia (proxima) sacramentalis, as the materia et forma sacramentalis make one inseparable sign. If, then, one single sacramental form, in the words prescribed, suffices, it follows plainly that one single sacramental materia proxima (anointing on the brow) also suffices. As, moreover, the decree simply says " sufficere," it is not permissible to question the validity of the one anointing, and the anointing must be performed absolute, not sub conditione, for Extreme Unction can be administered conditionally only when there is a doubt as to the validity of the Sacrament. If the one anointing on the brow, given absolute, has already constituted a valid administration of the Sacrament, the anointing of the eyes, ears, etc. cannot be performed even conditionally, and the priest can only supply the omitted prayers and ceremonies.

This is the opinion of almost all the important modern authorities. Lehmkuhl says (Theol. mor., Ed. 11, Vol. II. n. 718): "A single anointing is certainly valid, for example on the forehead, if the general formula is used with it. This is now established beyond doubt by the decree of the Holy Office dated April 25 (26), 1906, which formally indeed decides concerning the abbreviated formula, but implicitly also concerning the single anointing." The same writer uses similar language in his Casus conscientiae (Ed. 3, Vol. II. n. 671 ): "There were some who doubted the validity of an anointing however abbreviated unless the individual senses were anointed one by one under their respective formulas.... But every reason for doubt was removed by the decree of the Holy Office dated April 25, 1906." In n. 673 there is another quite consistent remark on the question of conditionally completing the anointing of the various sense organs: "The validity of a conferral of this kind can no longer be doubted ... nor is there any further occasion to repeat or supply anything if the dying person should sometimes survive longer." Lehmkuhl expresses the same opinion with equal assurance in his Compendium theol. mor., n. 938, ed. 5. The same view is taken in Müller-Schmuckenschlager's Moraltheologie, ed. 7, III, Supplement, p. 24: "According to many, this formula, when used in necessity, is not to be repeated, not even conditionally. For there is no probable doubt concerning its validity, and outside the supposition of doubt the sacramental rite ought not and cannot be employed again. (See Collationes Brugenses, February 1907.) If, therefore, the dying person continues breathing, let the omitted prayers be supplied in their proper order, according to the prescription of the Roman Ritual, title V, chapter 1, number 10.

A similar statement occurs in Schüch-Polz's Pastoraltheologie, Ed. 15: "A priest is under no obligation to employ the full form and matter under the condition 'si non es unctus,' even -if the sick person should live some considerable time. A conditional repetition of the Sacrament is unnecessary, because all has been done that St. James prescribes in his epistle, and that the Council of Trent requires in consequence. The prayers omitted may be finished in the sickroom, first those which precede the anointing, and then those which follow it. When contagious diseases are prevalent, the prayers before anointing may be said by the priest in the church, before he goes to the sick man, and those after it likewise in the church on his return. If there is danger in delay, all the prayers may be said in the church after his return (de Herdt, p. 6, n. 207)."

Finally we may refer to Göpfert (Moraltheologie, Ed. 6, III, n. 197) and to Noldin (De Sacram., Ed. 8, n. 452), where the same opinion is expressed.

Although there is no obligation to finish anointing the eyes, ears, etc. (sub conditione), yet there is no proof that it would be wrong to do so; in fact, other authors maintain that it should be done. The editors of the Acta S. Sedis (Vol. 39, fasc. 7) remark with regard to the decree of the Holy Office published in that volume: "If the immediate danger passes over, and especially should it be uncertain whether the sick man can receive the other Sacraments, all the anointings should be repeated sub conditione, with the proper form of words in each case, and all the prayers previously omitted should be said (according to the Rituale)." We should point out that this is nothing but the private opinion of the editors, not an official statement on the part of the Holy Office. We are aware that the opinion "licet repetere" is held by eminent professors in Belgium, and that in recent editions of the diocesan Ritualia this conditional repetitio per longiorem formam is given. In fact, where the Bishops state their adoption of this opinion in some official publication the parochial clergy are practically bound to adhere to this practice, as it has official sanction; they must, namely, use the forma abbreviata sub conditione and later anoint the various organs of the senses, also sub conditione.

So much as to the history of this controversy. The New Code, in Canon 947, while allowing in case of necessity one anointing on the forehead with the shorter form, demands that the other anointings be supplied right after, if the person still lives.

Case.—Cajus, a young priest, was called hurriedly to a gravely sick man whom we will name Titius. He finds the patient already unconscious, which was all the more distressing to Cajus as he had heard of him as a man who had long neglected his religious duties, had seldom or never visited a church, and had for some years neglected to fulfill his Easter duty. Cajus bestows upon him conditional absolution, and then, also conditionally, administers Extreme Unction, together with the general absolution.

Question.—Has Cajus acted correctly, or prudently?

Solution.—That Cajus in this case gave absolution conditionally was quite proper, as according to what he had heard he was naturally in doubt as to the man’s moral disposition. It is somewhat different with the administration of Extreme Unction. Cajus should have administered this sacrament unconditionally, not conditionally, and this would have been the right and prudent way. And why? Cajus should have distinguished between the valid and the worthy reception of this sacrament. When there exists a reasonable doubt as to whether a person is physically capable of receiving Extreme Unction, it must always be administered sub conditione (“si capax es’); for in such a case there is a question of validity. Instances of this kind would be the case of a sick child when there is doubt whether the necessary maturity of understanding has been reached, or that of an imbecile, when it is question whether the sufficient use of reason has ever been present. The same applies to a

X ee case of doubt whether a person is in a passing faintness or whether death has already set in, or, finally, whether the recipient is a Catholic. Since for the valid reception of any sacrament an essential condition is the intention on the part of the recipient—in the case of this sacrament at least a presumable intention—a justified doubt as to the presence of the intention prescribes the conditional administration, for instance in the case that a person before becoming unconscious would have expressed his will not to receive the last sacraments. Indeed, had such a patient so positively refused that a defectus intentionis must with certainty be concluded, the sacrament must not be given, on account of the lack of an essential condition.

It is different where it is a matter not of the valid, but of the worthy reception of Extreme Unction, of the moral disposition, therefore, of the recipient. Since Extreme Unction is in the first place a sacramentum vivorum, and as such is first of all intended for the remission of only venial sins, it must ordinarily be received in the state of grace. In so far, however, as this sacrament may become a sacramentum mortuorum, and then takes the place/of the Sacrament of Penance, which is the case when a person in grievous sin but bona fide receives it, then there are required for its worthy reception at least the dispositions required for the worthy reception of the Sacrament of Penance. May we, therefore, conclude that, where there is a positively reasonable doubt as to the moral disposition of the recipient, this sacrament is to be administered sub conditione, and did, therefore, Cajus act quite correctly when he gave to the unconscious Titius Extreme Unction conditionally? No! In our case, despite the requirements of disposition just spoken of, Cajus should have administered the sacrament unconditionally. The Sacrament of Extreme Unction, like Baptism (and this applies also to Confirmation, Holy Orders and Matrimony), possesses the peculiarity that even where it is received without the necessary dispositions it will exercise its sacramental effects. It revives, reviviscit as the theologians say, as soon as the indisposition (obex gratiae), which is present on part of the recipient, is removed. This is accomplished by mere attrition provided that after receiving this sacrament the recipient does not commit anew a grievous sin, and is not capable of receiving the Sacrament of Penance (St. Alphonsus, lib. VI. n. 707; Lehmkuhl II. n. 50-52).^* But how would it be, if Titius had become unconscious in actu peccati mortalis, through intoxication perhaps, or through attempted suicide? Should Cajus then have administered Extreme Unction unconditionally? Again, if this Titius had lived an irreligious life, was a notorious drunkard, libertine, etc., could Cajus without irreverence anoint him unconditionally, when for this reason (irreverentia) many Moralists and Pastoral Theologians, amongst them even St. Alphonsus (Theol. Mor. l. VI. n. 82 and 732) favor a conditional administration? Let us suppose that Titius had really led a notorious and sinful life, or that he fell into his dangerous condition in actu peccati mortalis, without previously having given any sign of repentance. And now Cajus appears hurriedly, and gives to the unconscious Titius absolution with the condition “si es dispositus,” and administers also Extreme Unction under the same condition. Titius later regains consciousness, for some moments, and, realizing the peril of his soul, awakens sorrow for his past sins, although only an imperfect sorrow. Cajus, again sent for at once, arrives after Titius has passed away. Had he given Extreme Unction unconditionally, then Titius after arousing contrition would “per reviviscentiam” have been reinstated in the state of grace, and thus would have owed his salvation to Extreme Unction. But by administering it with the condition, “si es dispositus,” this means of grace of the Church became ineffective for Titius, though in his extreme peril it might have been for him at the last a saving anchor! What a misfortune!

^* In the preceding case perfect contrition or attrition with the Sacrament of Penance was said to be necessary for reviviscence; but it must be borne in mind that here there is no question of sacrilege and bad faith, as there was in that case,

If, therefore, the salvation of a poor sinner may, and often does, depend directly and at the last upon the unconditional administration of Extreme Unction, one may with good conscience follow the view that when a proper disposition has not been evident or is doubtful, Extreme Unction should be given unconditionally. The reflection that through the absolute administration of this means of grace to a possibly unworthy subject the sacrament might suffer irreverence should not have deterred Cajus from administering it absolutely; for, as was said, a subsequent dispositio sufficiens revives the sacrament and thus reinstates the poor sinner, perhaps at the last moment, in the state of grace, although at the moment of receiving the sacrament he was morally unworthy. Persons bereft of their senses cannot commit an actual sacrilege. And should not the mere possibility of such reviviscentia sacramenti suffice to administer bona conscientia Extreme Unction unconditionally? But must not the minister Sacramenti, as far as lies in his power, follow the sententia tutior, i. e., take the utmost care that the sacrament be not dispensed to the unworthy? Yes, the respect due a holy sacrament no doubt requires such caution; yet the case is somewhat different if the recipient of the sacrament is in extrema necessitate, which is most certainly true in our case, where every effort must be made to save a threatened soul at the last moment. More than ever, therefore, the principle “Sacramenta propter homines,” must be taken into account and to the very extent required by the hope of saving the sinner, for “in extremis extrema sunt tentanda.” And since in our case a possible reviviscentia sacramenti gives hope of salvation, therefore, the Sacrament of Extreme Unction may and must be administered in a manner that allows a reviviscentia to take place: hence, absolutely.

Our Cajus will do well in future cases of the administration of Extreme Unction, where unconsciousness has already taken place, to adopt these principles:

1. Where there is a reasonable doubt about the validity of the sacrament to be administered, always administer it conditionate (“si capax es’).

2. Where the worthy reception is in doubt, it is always to be administered absolute (with previous conditional absolution). This should be done unless it is positively certain that a person wills to die in his unbelief and unrepentance, and unreconciled with his God, which we may never assume with certainty of a person bereft of his senses “since even the worst and most abandoned people, when brought to the confines of death, earnestly desire to be saved” and hence to such person, even if he became unconscious after an irreligious life, or indeed in actu peccati mortalis, the sacrament should be dispensed absolute —of course excluso scandalo.

Case.—Julian, a pastor, discovers in a non-Catholic hospital a dying woman who had been away from the Sacraments for many years. After long persuasion the zealous pastor arouses in her a sense of her pitiable condition. She consents to go to Confession and to receive Viaticum; she refuses, however, to allow the priest to administer the Sacrament of Extreme Unction. She is convinced that she will soon recover from her malady and entertains the notion that the reception of the Sacrament of the dying means the certain and rapid approach of death. Julian is only too glad of the chance to administer to her the other Sacraments, and does not urge very strongly the question of Extreme Unction. He hears her confession and gives her Holy Communion. Upon his return, three days later, he finds that the patient died suddenly the previous night. He is much disturbed over what he terms his neglect of a serious duty, and now seeks advice upon the matter.

Question.—Was Julian to blame?

Solution.—As the law stands, a pastor, or any priest having the care of souls, is obliged by his very office, and under the penalty of mortal sin, to administer this Sacrament to his subjects who may be placed in danger of death. And the law declares emphatically that he must do so even at the risk of his own life when the patient’s salvation depends upon this Sacrament, that is, when this is the only Sacrament that the dying person can receive. The Roman Catechism states expressly that a pastor is guilty of mortal sin if he delays the administration of this efficacious rite until the last hour of the sick person’s life, or until this person’s senses are impaired. In such an event there is a grave injury done to the penitent, who may possibly die without the reception of this Sacrament, as the woman in this case actually did, and who is certainly deprived of its good effects at the very time when these are most needed. But circumstances may minimize, or entirely remove, this obligation of the pastor. He has fulfilled his duty when he has done his best to persuade the dying person to receive this Sacrament, which he stands ready to administer if the one in need of it will consent to receive it. Thus it can be affirmed that Julian has not been lacking in the discharge of his duty. He did all that he was obliged to do. Had he done more, that is, had he insisted on the administration of Extreme Unction, in all probability he would have lost the opportunity afforded him of saving a soul through the effects of Penance and Viaticum. The danger of such an alternative, which in this case was a real danger, warranted him in moderating his insistence. Moreover, the hospital authorities might have taken the stand that his action was interfering with the well-being of their patient, and likely to frustrate their efforts for her recovery. Then he would have been denied admittance to the needy soul. The responsibility, therefore, rested not with the pastor but with the sick woman. We can not say that she committed sin in refusing to receive this Sacrament. Her motives did not involve any scandal or contempt. She did receive the Sacraments necessary for her salvation. This one would have been extremely useful to her, but was in no sense necessary. So she was not obliged to receive it, certainly not under pain of mortal sin. Very many people wish to defer the reception of this Sacrament, not because they believe it will hasten their death (such belief would be sinful), but because, not being properly instructed in the knowledge of its effects, they have accustomed themselves to the opinion that its reception means that all hope of recovery must be abandoned. Of course we know that such a state of mind is based on ignorance. This undoubtedly was the position assumed by the dying woman, and hence it is evident what little hope of success awaited Julian in his attempts to persuade her to have recourse to this Divine aid. He pursued the proper course when he followed his determination to administer Penance and Viaticum, and to await a more favorable opportunity for the renewal of his entreaties in behalf of Extreme Unction. He has no reason to be disturbed.

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: —