In a recent post on the ministry of priests, there were a few comments that reflected both frustration and pain over the fact that a loved one had been in the hospital and, though the priest was called, he either never came or did not come at once. To be sure, it is lamentable that any priest would receive a request for a visit and do nothing in response to it. The Church as a whole, and pastors in particular, have obligations to the faithful who are seriously ill, especially if they are in danger of death. That said, there are very real difficulties that priests face in responding immediately and personally to all requests. In this post I would like to ponder some of the pertinent issues involved in sick calls, especially to the hospitalized.

Perhaps it is best to begin with a mini-catechesis on the Sacrament of Anointing of the Sick.

  1. By the sacred anointing of the sick and the prayer of the priests, the whole Church commends those who are ill to the suffering and glorified Lord, that he may raise them up and save them. And indeed she exhorts them to contribute to the good of the People of God by freely uniting themselves to the Passion and death of Christ. (Catechism # 1499).
  2. Scripture teaches that the sick are to be anointed by priests – Jesus sent the apostles forth two by two to proclaim the kingdom. The following description is given of their actions: So they went out and preached that men should repent. And they cast out many demons, and anointed with oil many that were sick and healed them. (Mk 6:12-13). We also read, Is any among you sick? Let him call for the presbyters [i.e. “priests”] of the church, and let them pray over him, anointing him with oil in the name of the Lord; and the prayer of faith will save the sick person, and the Lord will raise him up; and if he has committed sins, he will be forgiven. (James 5:14-15).
  3. The Sacrament of the Sick is given to baptized Catholics who are seriously ill. Thus, a person with an ordinary virus, flu or injury is not usually anointed unless such illness or injury has a serious nature due to other pre-existing situations. Since most surgeries are presumed to involve serious maladies and involve significant risk, those scheduled for surgery (especially when general anesthesia is used) ought to be anointed before the surgery. A person is usually anointed only once in the course of an illness or injury. However those suffering from illnesses of a long duration or due to advancing age may be anointed periodically and especially if their condition takes a turn for the worse.
  4. Children under the age of seven are not anointed. This is because the sacrament is related to the Sacrament of Confession and is designed to be a remedy against temptations and the effects of sin. Children under the age of seven are usually not presumed to have sufficient use of reason to be considered responsible for sins committed and hence have no need of this sacrament.
  5. Those who receive this sacrament ought also to have recourse to confession if it can reasonably be offered and celebrated. While confession is not strictly required, anointing and confession both related to the problem of sin. Anointing is not just celebrated with the idea of physical cure in mind, but of spiritual strengthening and the avoidance of temptation that often comes with illness. Hence, confession and anointing are integrally related.
  6. In the past, many often waited to the point of death before requesting this sacrament of the priests of the Church. Pastoral care today however emphasizes that this sacrament should be offered long before the final stages of dying set in. When physical illness of a serious or chronic nature sets in the sacrament should be administered sooner rather than later. Likewise, it is a good idea to celebrate the sacrament before surgery takes place. The Sacrament of Anointing of the Sick is meant foremost to help us experience healing and assist us to live gracefully with our illnesses, and not merely as a Sacrament that prepares us to die.
  7. The purpose of the sacrament - One gift to be hoped for in this sacrament is the complete recovery of health. This is sometimes experienced. Miraculous cures are surely a sign of the power of the risen Lord and they were promised as a sign of the reign of God (cf. Mk 16:18). And yet this is not all that is meant by the “healing” that is given and experienced in this sacrament. The word “healing” however involves more than just the notion of cure. In his own day Jesus did not heal everyone. Christ also taught of the inevitability of suffering and the need to remain faithful: If any man would come after me, let him deny himself and take up his cross daily and follow me (Lk. 9:23). St. Paul too experienced the call to faithful endurance as he prayed for a cure of his own illness: Three times I besought the Lord about this, that it should leave me; but he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” (2 Cor. 12:9-10). Hence the healing that this sacrament offers is more often the grace to endure suffering with holiness, and faith. Hence, a grace of this sacrament is one of strengthening, peace and courage to overcome the difficulties that go with the condition of serious illness or the frailty of old age. This grace is a gift of the Holy Spirit, who renews trust and faith in God and strengthens against the temptations of the evil one, the temptation to discouragement and anguish in the face of death. (Catechism # 1590)

Especially to be noted in the mini-catechesis above is that the anointing of the sick is not primarily a sacrament for emergencies and should not be delayed until death is imminent, unless this cannot be avoided. There are certain circumstances that require an emergency administration of the sacrament, such as in the aftermath of a serious accident or when  one is suddenly stricken. However, as a general practice, anointing of the sick ought to be a more routine aspect of the lives of the chronically ill and the aged, or of those who have entered the various stages of serious illnesses. If death seems to be certainly approaching, one ought to be anointed well before the final stages, and surely before unconsciousness ensues. In no case should a family wait “for the last moment” to summon the priest. This is a Sacrament for the living, not merely for those on the very threshold of death. Those who are scheduled for surgery ought to be anointed before entering the hospital, preferably at the parish, if this can be arranged.

The goal is for every Catholic to be “up-to-date” on their Sacraments long before death or the danger of death ensues, or even the advent of sudden and unexpected death. Of every Catholic who faces death, whether sudden, or at the end of a long illness, we ought to be able to say they have very recently received Holy Communion, and that confession has been celebrated with a reasonable period prior to death. Further those who have not died suddenly and unexpectedly, ought to have been anointed at some time significantly prior to death. In such cases there is no emergency need to summon the priest, for the ordinary pastoral care has already been provided. Emergency anointing ought be reserved for those who are suddenly and unexpectedly stricken, or for those who are in accidents.

And that leads us to the concerns that some have expressed that a priest was sought, and no priest came, or did not come soon.

There are a number of factors that affect the availability of the parish priest. And while these factors do not excuse a complete lack of pastoral care, they ought to be considered as we look to a solution to the problem. These factors include:

  1. There are far fewer priests than years ago. Until about 25 years ago, most parishes had more than one priest. Many larger parishes which had as many as four or five priests, back in the 1960s, have only one priest now, and that priest has many, many duties.
  2. Fewer hospitals have assigned and full time chaplains. Here in DC only the largest hospital centers have regular and full-time chaplains. The smaller hospitals and nursing homes depend on local parishes for pastoral care.
  3. Most Catholics no longer go to neighborhood hospitals near the parish. Rather they are assigned to hospitals that specialize in their issues. For example, in my own parish, I may have parishioners in as many as 6 or 7 different hospitals spread all throughout the area (Providence, Georgetown, Johns Hopkins, Southern Maryland, PG Hospital, Adventist Hospital, Holy Cross, Washington Hospital Center, Children’s Hospital, Veterans, and so forth). Some of my parishioners are taken as far away as Baltimore. Regular visits to hospitalized members may not be possible when they are in such varied locations. Pastors often need to depend on clergy more local to the hospital in question. This leads to concerns that “my pastor never came and saw me.” But some parishioners simply do not realize how unrealistic this is for pastors, often without assisting clergy, with dozens of parishioners in as many as half a dozen different and often distant hospitals.
  4. Pastors and priests also have serious duties at the parish which cannot always be dropped at a moment’s notice. A pastor may get an urgent call to come at once, yet he is just getting ready to celebrate a wedding. He cannot simply say to the couple they will have to have their wedding another day. Calls may come in as well in the middle of a Sunday Mass, or other significant function where a priest cannot reasonably dash off. A priest may also be teaching a class or bible study involving thirty or more people and it may not be reasonable for him to rush out in the middle of a class. He may be completely away from the parish teaching or filling in for another priest. It is simply not possible for a parish priest to be 100% available at every moment for a possible sick call, even an emergency. Sometimes the best he can do is to ask a parish staff member or the hospital to find another priest. It is not always right to allow the urgent to wholly eclipse the important.

Towards a solution. The care of the sick is important and reasonable urgencies need to be addressed by the Church. What are some of the things that can be done to realistically address the needs of Catholics given the factors seen above?

  1. Large hospital centers should have full time chaplains if this is possible. This is especially true if the hospital has a shock and trauma unit that routinely receives accident victims and those suddenly stricken. The chaplain would also need to a coordinate with local parishes to cover any gaps caused by his day off or vacation. Here in Washington, we are often able to depend on priests from religious orders. Other dioceses are less blessed with options.
  2. If a full time chaplain really cannot be found, the parishes near the larger hospitals need to develop a carefully coordinated plan to cover the hospitals and field emergencies. The plan should make sure that gaps are properly covered and emergency calls can be quickly handled. Further, parishioners and hospital staffs should be well aware of how to contact the priest on duty.
  3. Smaller hospitals and nursing homes still need coverage from the local parishes. The diocese should have a carefully crafted plan on who covers them and when. Emergency clergy numbers for each hospital and nursing home should be easily available to all the priests and staff of the parishes in each diocese; for it often happens that a brother priest near the hospital will need to be contacted by a priest or staff member from across town who cannot reasonably make a visit.
  4. Some teaching on the nature of a true sacramental emergency needs to be made to both the faithful and to hospital staffs. When death is clearly imminent we usually have an emergency. However, just because some one has gone to an emergency room does not mean that death is imminent, and that a priest is needed at once. Sometimes it is fine to wait for the next day when a priest routinely visits. Even when death is imminent, it is sometimes the case that a priest gave sacraments just the day before. It is not necessary for the priest to return and be there at the moment of death, when a person has been receiving ordinary pastoral care given to those who are seriously ill. It is sufficient in such cases that the person has recently received the sacraments and there is no reason to summon the priest to come at once or in the middle of the night. True sacramental emergencies usually occur for those who are suddenly and unexpectedly stricken or who are in an accident and are, for these reasons, in immediate danger of death.
  5. Parish priests should well instruct their staff how to field emergency calls, assess their importance, and know options to pursue if the parish priest cannot be reasonably reached.  Families should not simply be told, a priest cannot be found, they must be helped to find a priest in an authentically urgent situation.
  6. To the degree possible, hospital staffs should also be able to know how to contact a priest quickly. Their phone lists should be up to date and include several options.
  7. The faithful may have to accept that a priest will not always be found in time. In such cases they ought to remember that God does not reject any who call on him. And, though anointing is surely helpful, it is not absolutely necessary for salvation. Even confession in dying moments should not be thought of as magic. If a person seeks a priest and a priest cannot be reasonably found in time, it suffices for the person to make an act of contrition – no one who calls on the Lord will he ever reject. If a person is unconscious, a priest saying absolution over them, will only have effect if they had some contrition and openness to receive the sacraments prior to the unconscious state. Even when a priest rushes he does not always get there in time. In such cases, we have to trust in God.
  8. Again, an important goal for every Catholic is to be up to date on their sacraments and in a state of grace. Sacraments are to be part of ordinary pastoral care and an ordinary part of the life of a Catholic. They are not to be merely postponed to the moment of death.

It is surely an added grief when a priest cannot be found in cases of true emergency or when proper pastoral care is not reasonably extended to the chronically ill. And while it may be an explanation that parish priests are sometimes overwhelmed, it is not an excuse. Parishes and dioceses need to work together with the faithful to see that the sick and the dying are properly cared for, that emergencies are covered, and that the faithful are properly instructed on the nature of the sacraments and how to secure the ministry of a priest when such needs arise.

As always, I am interested in your experiences in this regard. It is most helpful if you can suggest how the Church might better help in such matters.

53 Responses

  1. Nolan says:

    Thank you for being a Priest, Monsignor.

    A few months ago, in Church, another Monsignor gave a brief explanation of the ‘Anointing of the Sick’ – as the Priest wanted to be called long before ‘death or imminent death’ whenever possible. The Priest emphasized the spiritual healing in the Sacrament as listed in #6 in the Catechesis of the Sacrament. The Priest explained everything before the opening prayer of the Mass. The Priest said, “Call us even if it is 3AM in the morning.”

    We should all remind ourselves of all the promises made to those that devoutly pray the Rosary and devoutly attend Mass. Good prayers, are good for us, good for the Priests, good for the Church, and good for the entire world.

    Excellent column – Monsignor!

  2. Lee Gilbert says:

    Father,

    Thank you for this post and also for your incredible output generally.

    However, there is a contradiction in what you say…or so it seems to me. You write, “Children under the age of seven are not anointed. This is because the sacrament is related to the Sacrament of Confession and is designed to be a remedy against temptations and the effects of sin. Children under the age of seven are usually not presumed to have sufficient use of reason to be considered responsible for sins committed and hence have no need of this sacrament.”

    Later, you say, “The purpose of the sacrament – One gift to be hoped for in this sacrament is the complete recovery of health. This is sometimes experienced. Miraculous cures are surely a sign of the power of the risen Lord and they were promised as a sign of the reign of God (cf. Mk 16:18). And yet this is not all that is meant by the “healing” that is given and experienced in this sacrament….”

    So, in view of the fact that occasionally complete cures are brought about through this sacrament, why and on what authority exactly are children to be deprived of this possibility? If I discovered that my infant child had autism, or my toddler cancer or a life threatening injury, practically the first thing I would think of is that he or she be anointed.

    This business about children under seven being incapable of sin is naive, imo, and I was happy to see in my reading of Newman that he agrees. To have children deprived of the sacraments on this basis seems very wrong.

    My wife was speaking the other evening of the peace she experienced 20 yrs ago going in for cancer surgery immediately after being anointed. Children have no anxiety when going under the knife? They are to be deprived of this consolation?

    Are we talking here about current theological opinion or a decision of the Magisterium, and where would the documentation be found if so? Under the heading of “Who Receives and Who Administers This Sacrament” CCC 1514 says, “As soon as anyone of the faithful begins to be in danger of death or old age, the fittting time for him to receive this sacrament has certainly arrived.” It seems the sole qualifications are baptism and danger.

    The scriptural basis for this sacrament in James 5:14-15 makes no mention of excluding children under seven, and the connection with Confession is in a subordinate clause: “Is any among you sick? Let him call for the elders of the Church and let them pray over him, anointing him with oil in the name of the Lord; and if he has committed sins, he will be forgiven.”

    What am I missing here?

    • The gift of healing is not limited to the sacrament of the sick. A priest can pray for healing. There are also lay persons who have this gift of healing.

      As for the authority of not anointing children under 7, Canon Law, # 1004 §1. The anointing of the sick can be administered to a member of the faithful who, having reached the use of reason, begins to be in danger due to sickness or old age.

      Hence the use of the age of reason is necessary since this sacrament is annexed to penance.

      Again, it needs to be stated, the prayer for a physical cure can be made at any time. The Sacrament of the sick is not a necessary component of such a prayer, though for a Catholic over 7 it is usually combined. Yet even here, there are many “healing services” conducted in the Church wherein a priest prays for healing yet without celebrating the sacrament, so even in Catholic settings the two are not strictly joined.

      • Bender says:

        I have a couple of issues here.

        One is that, while certainly important as a matter of governance, canon law does not dictate dogma or theology on the sacraments. Canon law certainly does not dictate the state of each and every individual child’s soul.

        Second, I think we get into some dangerous ground when we leave the fate of someone’s soul to some “presumption” on our part. Surely you know the old adage about when you “assume” things?

        Better safe than sorry. Better to not presume that some five-year-old is incapable of being a holy terror, and to annoint instead, than to say to them later, “Sorry about you being in Hell, little Johnny, we had presumed that you couldn’t go there so we didn’t bother to do anything to prevent it.” Better to give a sacrament that is unneeded than to not give one that is.

        • Well, of course, I am a man under authority. Do you think I that should just pitch Church law to the winds because as you say, Canon Law does not dictate dogma? The sacrament of anointing is not necessary for salvation so your Hell scenario hardly seems relevant. Further, I puzzle over your notion of a five year old being in Hell merely because we (i.e. the Church) made an error in pastoral judgement. If the Church were in error as you presume, Deus Providebit. God isn’t calling technical fouls and punishing the innocent for the mistake (as you presume it is) of others.

          I would have no theological problem if tomorrow the Church said, anoint infants. Frankly, I think it would actually be more important to give young children in danger of death the Eucharist than anointing since I am not all that certain they are capable or at least likely to have committed serious sin. The Eucharist as viaticum is really more essential in such a case. But for now, I am bound by the pastoral rules the Church sets forth and do not feel “unsafe” as to that judgment.

          • Jan says:

            Hey Monsignor – I’m late to the discussion but here’s a story for you — about 16 years ago we had an emergency in the family. One of our kids, who was just shy of 4 years old, got sick. We watched her, trying to determine the seriousness of the illness, and after a time decided to have her chest x-rayed. Between the physician on-call, the radiologist, and my husband who is a pulmonologist (lung doc) none of them could figure out exactly what they were seeing on the x-ray, although it was obvious that something was terribly wrong.

            It was late in the evening and I was sent home to pick up the rest of the kids, pack a bag and then we would all head out for the 200 mile trip to the children’s hospital. Since I had to pass the rectory on the way home, I stopped and pounded on the door until Father answered – I told him what was going on and he asked if we could bring her by before we left.

            I was surprised that Father didn’t anoint her, but he did say some very specific prayer from his book – I don’t remember what it was any more, but I do know that it was comforting. (After I began a more serious study of the faith, I understood why he hadn’t given her the sacrament; and I agree with you Monsignor, that the Eucharist as viaticum would be even better.)

            By the time we got to the children’s hospital it was early morning; she had emergency surgery and afterwards, the surgeon, who had graciously consented to carry my husband’s rosary in the pocket of her scrubs, said our daughter had been very near death. It really was miraculous the way it all worked out.

          • jdl says:

            I know this thread is 2 years old, but I might mention the law of the church merely says that the child has to have attained the age of reason. It doesn’t specify what that age is, does it? If there is any doubt as to whether the child has reached the age of reason then I think it is prudent to err on the side of offering the sacrament of healing before offering the sacrament of Communion. (If I remember correctly, Church law also requires all children to go to confession before First Communion. Implicitly, this seems to be an acknowledgement that it is better to be safe than to be sorry.)

  3. Stephen Taylor says:

    I think that while the anointing should be done by a priest, in certain cases a Lay Pastoral Associate should be granted the permission to do it. Deacons should be too. I know of cases where the priest didn’t come simply because he didn’t like the person who was dying. With the shortage of priests new solutions need to be found. It is all the work of the Holy Spirit, as are Holy Orders, but with the few in Holy Orders and the great number of Catholics in need, there needs to be a solution worked out so that people do not die without that last rites.

    • Well, from the strictly human point of view, I understand your point. However there are significant difficulties in terms of sacramental theology in what you suggest. The text of James above links the sacrament to the calling of the priest and also links this sacrament to confession. To unravel all this would be difficult and perhaps not necessary since the Sacrament of the Sick is not strictly necessary for salvation. Baptism on the other hand is strictly necessary and, though the priest is the ordinary minister of it, any one may baptize in case of emergency.

  4. Nguyen Thuong MInh says:

    Epistle 215
    My some thoughts about “the homily” of Msgr. Charles Pope are here below:
    Firstly, in the homily, Msgr. Charles Pope said that sometimes we called for the priest to come in order to anoint the sick, but he never came because he was busy with his work and priests are fewer.
    In such cases, Msgr. Charles Pope suggested a group of eight solutions in which a best important solution is that we have to trust in God.
    I quite agree with Msgr. Charles Pope on the homily.
    Secondly, now permit me to add some matters to relate to the homily hereafter:
    What is the goal for the every Catholic?
    In my opinion, the goal for the every Catholic is to learn OT and NT, Catechism of the Catholic Church, and Compendium of the Social Doctrine of the Church so that we become talented men as Priests do.
    As a result, if Priests know to pray to God, know to preach Gospel of Jesus, know to anoint the sick, know to expel Demon, know to listen to confessions, etc., then I also can do as Priests do.
    However, before I will die for old age , if a certain priest comes to anoint me, then I will welcome him, on the contrary I will do them for myself or I will foretell them so that my two sons do them for me.
    I can do everything above because I believe that God be with me./.

    • Yes, the goal is to be prepared for death at every level.

    • Martin says:

      “As a result, if Priests know to pray to God, know to preach Gospel of Jesus, know to anoint the sick, know to expel Demon, know to listen to confessions, etc., then I also can do as Priests do.
      However, before I will die for old age , if a certain priest comes to anoint me, then I will welcome him, on the contrary I will do them for myself or I will foretell them so that my two sons do them for me.
      I can do everything above because I believe that God be with me./.”
      You seem to be making a point that anyone can do what priests do, and I hope that that is simply because English is not your primary language.

  5. Ann says:

    Excellent article. From what I’ve seen in my family, there is an idea that this Sacrament must be kept until the end. It seems to also have a connotation that you are dying if you are receiving it, therefore, I’ve also seen some avoidance of it, a denial of sorts, in the same way that hospice is often only called within the very last week or two.

    Perhaps we need to teach people that it can be given, well, whenever there is a need for healing, both spiritual and physical. To be blunt, perhaps when one receives their stage IV cancer diagnosis would be a good time to arrange for it, rather than thinking your family will be able to predict the timing of your end here on earth (they won’t).

    • The attitude you describe is, as you say, still common, though it is less so, especially among younger Catholics who never heard this sacrament called extreme unction (last anointing).

      • Martin says:

        About 20 years ago when I was a preteen, it seemed like they (my teachers) were trying to get away from referring to the sacrament as extreme unction and towards a modern name, annointing of the sick. Could this have been a mistake?

  6. Peony Moss says:

    Thank you for posting this. I used to be a nurse at Washington Hospital Center, and I often cared for people who were going to have open-heart surgery. Some patients prepared for their surgery (wisely) by asking for the Sacrament.

    These patients often arrived in the evening, after having been flown in from an emergency room at home, and time was short. It was very frustrating sometimes calling the chaplains’ answering service and having to insist, again and again, no, this couldn’t wait until morning (the first OR calls came at 0600) and no, the patient really needed to see a priest and not a lay chaplain. Sometimes the answering service would insist that I hang up, confirm the patient’s wishes, and then call back. (“The patient still wants to be anointed.”) I remember one back-and-forth that took two or three calls to the answering service. Finally a priest arrived. A good thing, too, for that patient was one of the first cases the next morning – and did not survive the surgery.

    • Yes, I must say, I too have had frustrations in calling for the chaplain of some of the larger hospitals. Theoretically they are full time, but it can be very hard to get them. I have had times where, in the middle of the night I have had to go clear across town to take care of an emergency that they are supposed to be on call to do. Further, I cannot be sure that merely leaving a message at a voice mail will be heard anytime soon. A live voice that confirms the priest is on the way is really what is needed.

  7. Cynthia BC says:

    There are times when I’d like nothing better than to say “poor planning on YOUR part is not an emergency on MY part.”

    The tone of this post is far more charitable than my thought-but-never-spoken assertion, but it does make the case that we have a certain responsibility in being prepared for death. We all will leave this earth at some point. For some of us, death will come in the form of an accident on the way home from work this afternoon. For others, it will come as we sit peacefully in a rocking chair while family members clean up after our 100th birthday party. We should always be ready.

    • Yes, this is well said. Some of the most difficult emergencies come from families that are unchurched. They can also be the most unreasonable when it comes to understanding the difficulties in the priest getting there.

  8. rosaryfixer says:

    Thank you for this explanation. Unfortunately it often depends upon diocesan policy. Last year a dear friend went to the hospital because of a severe illness. I called her parish where she has been a member for over 50 years, and was told that since the hospital was within another parish about 20 minutes away, that parish had to be called. I then called the other parish and was told that the patient herself or a close relative had to make the request. This lady was in no condition to ask for any spiritual help. I could not reach any of her adult children to make the request for her. And the hospital policy here is that only the patient or a lawfully appointed spokesperson can make the request!!! Thanks be to God, she was anointed a day later (the call to her own parish triggered a response, finally). Years ago I worked in a Catholic parish school where there were 4 priests. Unfortunately emergency calls during the night did not always get a response. There were occasions where a family in desperation called a nearby Protestant pastor to come and comfort the dying Catholic; the family decided since the Catholic priest did not seem to care, the deceased’s funeral was held at the Protestant church. With so many adult children no longer practicing the Faith, it’s a scary thought to think that when a lifelong faithful Catholic is dying, there will be no one to call the priest! But as you say, God does provide. My mother used to pray every night, “From a sudden and unprovided for death, Lord, deliver us”

    • The situation you describe is a real passing of the buck. There are no jurisdictional issues in celebrating the Sacrament of the Sick. Some one at parish one was misled and should have found priest.

  9. Dante says:

    In many parishes that are blessed with the ministry of a deacon it is typically he who makes the most visits to the sick and homebound (sans the Sacrament of course). I know that a while back the USCCB asked the Vatican to study the possibility of deacons as ordained clergy being authorized to administer this sacrament when necessary. I think the repsonse at that time was negative but I also heard it has been resumed. I do not think lay ecclesial ministers should do so as they are not ordained ministers of the Church.

    We know that in St. Cyprian’s time the deacons of North Africa was commissioned to hear confessions and grnt absoliution ONLY if the bishop or priests were unavailable (time of persecution) so it seems that our Tradition may have this option of the Sacrament of the Sick administered by a deacon as possible under certain circumstances.

    But even if a deacon cannot provide this sacrament for the seriously ill person and the consolation of the family. could he not offer the Apostolic Pardon/Blessing? It is not the sacrament of course but it would at least provide spiritual assistance to the sick and demonstrate the Church’s desire to accompany the family at this difficult time. While this Pardon/Blessing sounds very similar to sacramental absolution, we know it is not so I would imagine a deacon may be authorized to grant it…or do they have this privilege already?

  10. Claire says:

    Monsignor Pope,
    I appreciate your article. I do not have much suggestions but I would like to share with you an event that I witnessed concerning the Sacrament of the Anointing of the sick. 27 years ago, my father was at the hospital very sick from cancer but the doctors thought he could live a few more months. Soon after I went to visit him
    and found him in wrost condition ever, agitated and very confused. Most of the staff was gone to lunch. I was very afraid he might die and all I could think of at the moment was to pray out loud the ‘Our Father’ and couldn’t go on further past ‘Thy will be done on earth as it is in heaven’. I don’t know why but at that very moment the hospital Chaplain intered the room and seeing that my father’s death was imminent proceded to giving him the Sacrament of the Anointing of the sick. My father became calm during the administration of the sacrament.
    Then he opened his eyes wide and lifted his arms upwards and then he died. The Chaplain said he was sure
    that my Dad saw or experienced something extraordinary. Many thanks to God for having intervened in such a special way.
    I have two questions concerning the Sacrament of the Anointing of the sick. Since the sins of the sick are forgiven, does it mean that at death this soul won’t go to hell but only to the purgatory? And what are the consequenses if someone dies without the Sacrament of the Anointing of the sick as it happened to my mother?
    Thank you father.

    • The priest, when celebrating the sacrament for some one who is most surely dying also prays the prayer of absolution. This does in fact forgive sins presuming the person had some contrition before entering the comatose or non communicative state. In cases where the dying person is still able to communicate the priest should ask if they want or need confession and celebrate the sacrament of confession prior to anointing. In certain cases where, because of the presence of doctors or nurses the person cannot make confession out loud, I ask them merely to call their sins to mind and I say the prayer of absolution.

      As regards your mother, if she had contrition for her sins and a priest could not be reasonably found in time, she too could find God’s mercy and forgiveness. The sacrament of confession is always the ordinary way for this to be given, but when a priest cannot be reasonably found in time, an act of contrition or some recognition of the need for mercy and the desire to receive it, with the intent to confess to the priest if he should in fact arrive. Sometimes, if a person dies suddenly we cannot be sure if they made an act of contrition or demonstrated to God some desire for his mercy. But we ought to trust that God provides any necessary graces at the time since he wants to save us and will not reject any who call on him. It is only for those who refuse to admit their need for mercy and thus do not ask for it who are lost.

  11. Taylor Marshall says:

    Reverend Father,

    Thank you for this post and the reminders.

    I often my make Mass intention simply “to die a happy death with the Sacraments of the Catholic Church.”

    I hope that when that day arrives, the Holy Spirit grants me this humble prayer. It will be the most important day of my life…

    Holy Mary, Mother of God, pray for us sinners now and and at the hour of our death.

    ad Jesum per Mariam,
    Taylor

  12. Dan Sexton says:

    Dear Monsignor Pope:
    Do you think that there might be a problem with the new theology? The change of the sacrament from extreme unction to kind of a supernatural get well kit is what we have experienced. Perhaps in the past, there was a sense of neurotic paranoia about dieing without having the sacraments immediately admininistered. Yet there is almost no sense of viaticum now- a girding of the Christian for the final passage, encouragment for final contrition, sustenance for final perseverance. This naturally follows the funeral rites which are now “celebrations of the deceased life.” My mother had a sudden and unexpected brush with death three years ago. I was upset because apparently there is no provision to give a dying person communion. Wasn’t the practice to put a particle on the dying persons mouth even if unconscious in the past? (We know now from testimonies that while very sick people are “unconscious” they may actually have a much greater awareness than is apparent).

    I think we have to honsetly ask: VII was not dogmatic yet made many changed in sacremntal theology that have a profound effect on actual Christian life demonstrating the law of unintended consequences in so many ways.

    I wonder if it would not be better to return entirely to Extreme Unction as was previously known and then incorporate the Eastern practice of heaing annointings.

    Yours,

    Publius

    • I am not sure about the small particle on the tongue of an unconscious person having been practiced in the past.

      I agree with you that the notion of viaticum and mentioned in my response to Bender as well.

      However, I think the current theology of the Sacrament of the Sick is more biblical. Speaking of it as extreme unction limits the sacrament and, to some extent, I think, is the cause of our current problem because people do not routinely ask for it as they should when serious and or chronic illness set in. It is thus left for articulo mortis situations rather than ordinary pastoral care, which seems what the biblical text has in mind.

      Not sure about the Eastern practice. I’d have to know more about it than I do to comment.

  13. Matt R says:

    Great post! The shortage of priests is lamantable but we must recall is nothing new. I just finished reading a book on the life of St John Neumann (my confirmation saint). Fascinating. Anyway, he came to America during a period of tremendous immigration and an extreme lack of priests. He often wrote back home to Bohemia begging for more missionaries to come to America because, as he put it, “for every Native American that is converted to the faith, 12 German immigrants fall away due to a lack of priests”. His first assignment when he came to America was in the diocese of New York serving the area around Buffalo. He had no rectory (he stayed with parishoners) and supported three parishes that were 12 hours apart by horseback! He was also the only priest in the area and often wrote about his loneliness.

    I know this can’t happen…but I believe St Cyril once wrote that he felt Deacons could hear confessions and forgive sins in danger of death if the Bishops/Priests weren’t available.

    • I’m not sure it can’t happen. It is more likely to be sure that deacons could anoint than give absolution but I leave all this to great minds than my own.

    • Dante says:

      Matt – St. Cyrpian states clearly that in his day (3rd century) in North Africa during the persecuations, deacons were authorized to hears confessions and grant absolution to reconcile siners to the Church AS AN EMERGENCY when the bishop or priests were not available. I forgot what letter this is found in but it is stated clearly in one of the books on the history of the diaconate.

  14. Sarah says:

    I just want to make sure I’m clear here so I do the right thing. I have a chronic illness (Chron’s disease) and will have to go under general anesthesia for testing (colonoscopy) approximately once a year for the rest of my life. Is it appropriate for me to receive anointing of the sick each time?

  15. Regine says:

    Thank you for this post, Msgr. Pope, though it has brought back some pain and still raw. My husband was hospitalized just for a minor thing when it turned out to be something very serious. He became very weak, and he must have sensed his end. He asked for a priest, and we informed the nurses as is the strict policy of the hospital that they would be the ones to make arrangements. We also told the Lutheran Chaplain several times, but no priest came. We put in the request almost everyday in that 10-day confinement, and they gave us their assurance each time. One day, my husband seemed to be desperate and struggled to tell the pastor that he wanted a priest for confession. The pastor assured him that he was a pastor and that my husband could talk to him, to which, my husband replied that he needed and wanted a priest. Nothing came out of all these, until one day, in desperation, I told our attending physician, and she personally called our parish that morning. The priest arrived around noon, and my husband was already in coma, and I remember asking him why he came too late. He died that evening. After that, I inquired from our parish office if they received calls from the hospital at all, but they could not find any report in their log book. I believe that my husband has found peace and that God has honored his intentions, but the negligence of people concerned has left a deep wound, despite the forgiveness.
    The caregivers should take into consideration that in moments such as this, the family is in extreme anguish and confusion, and rely heavily on their assistance.

    • Cynthia BC says:

      I’ve worked in healthcare for over 20 years, and find it very odd that any hospital would have such a policy controlling access to pastoral care in place. I hope that you complained to the hospital’s administrators, because what you describe clearly is negligent in the quality of care provided. Those of us who work in healthcare are conscious that there is FAR more to providing quality care than doling out meds and changing bandages.

      • Regine says:

        Thank you so much, Cynthia BC, for your response, and great to know that there are people like you. There really is such a policy, and I have learned that even Eucharistic Ministers will have to go through training with them (
        and maybe, understandably). Yes, I filed my complaint, and now, they have a new chaplain. Thanks again and I appreciate your sharing. May we have more people in pastoral care like you!

        • Cynthia BC says:

          I am glad you filed a complaint about the staff’s failure to follow through with your request for a priest. Although it won’t fix the care your husband received, perhaps you have prevented another family from having a difficult experience made all the more painful. You did both the hospital and its patients an important service by speaking up.

  16. TeaPot562 says:

    One thing that many of us lay persons can do to alleviate the shortage of priests: Pray for more people to answer God’s call for priestly vocations, and for needed grace for those He has called to these vocations.
    If the laity in the Parish pray more, especially before the Blessed Sacrament, more young people will respond to God’s call.
    TeaPot562

  17. TheInformer says:

    YES!

    And the priest is the PARISH FATHER. He has a duty to his parishoners and not primarily to any guy or gal who happens to be around (and who never darkened the doorstep of the church, for example).

    Imagine if a priest had to be called away to any situation at any time, thereby not being home for his own family, and neglecting his own family, over some stranger.

    So, sign up with your parish! Get to know your father!

  18. Katherine G ERT says:

    Thank you for this post. We are fortunate in my ER to have a chaplain for the hospital. And he is wonderful, and has come to be with families at 3am because of a death, or someone dying.

    I have often put aside my own illness in regards to Anointing of the Sick, knowing and seeing that there are others out there suffering more or that need it more, in my mind. I have also received different opinions on whether to receive Anointing of the Sick – some priests have told me that I cannot receive it unless I am literally on a hospital bed, or dying (I have asked about it in the past, especially when I’ve been ill enough that I could not make it to church let alone out of my own house). I am doing a lot better now, but reflecting back on the time when I was very sick and discussing Anointing of the Sick with various priests and people has left me wondering and confused.

    I am grateful for all that you do, and it can’t be easy knowing some beloved parishioners are in far away hospitals and there is not much you can do with your other duties to the parish.

  19. Maria Key says:

    Great article. I would just add that we, the faithful, need to be happy with a chaplain whom we have never met, and not insist on our parish priest who may not be able to make it.

    • Regine says:

      I think Catholics would be happy to talk to any priest at this stage, and not necessarily ask for their parish priest. The problem only arises, I think, when hospitals have Chaplains of another denomination and do not understand that a Catholic wants to confess to a Catholic priest and not to a Protestant minister.

  20. Concerned Priest says:

    Msgr,

    Although I have heard of the so called ‘going under’ clause as a valid reason for receiving the sacrament, I have never found the source. If you have a church document on this I would be grateful if you could share it with us. The problem with the idea that every one who goes under needs to be anointed is that healthy people are being anointed (wisdom teeth, knee surgery, cosmetic surgery, etc…). In today’s medical climate general anesthesia is by no means dangerous. One is more likely to die in a car wreck on the way to and from the hospital than by general anesthesia.
    Plus, a clarification on how many times the sacrament should/can be repeated would be helpful as well. Too often the case in many parishes is to have anointing given out once a month after a daily Mass. The same people come up to receive anointing bc of old age. I know of plenty of people in their 70′s who have been anointed well over 50 times (12 times a year for over 4 years) This seems to be an abuse. I don’t think the permission to repeat the sacrament had this in mind. Certainly anointing should not be received more than confession, which is becoming more and common.

    • Well, its just a pastoral judgement. It would seem that tooth extraction might be an exception. I understand your concerns about too frequent anointing but its not a huge problem in my parish. I guess each priest has to help his people make good decisions. Anesthesia does remain a significant risk for many but, as you say, perhaps my thinking, at 50 is dated. Again, this involves prudential and pastoral judgement not dogmatic certainty.

  21. Mike Sirilla says:

    Dear Fr. Pope,

    Wow! What a beneficial post. Thank you for spending the time (and I know you have precious little of it!) to go above and beyond and provide these reflections both on the theology of anointing and pastoral care of the sick as well as on the concrete circumstances and conditions we’re faced with right now. I can’t tell you how truly healing it is for me personally to reflect on your thoughtful remarks as I’ve in the past, regretfully, reacted with bitterness at some situations similar to ones you describe. It’s late at night and I’m overtired so I’m not expressing well how much this post means to me. You’re a very kind man. God bless you, Father. Be assured of our prayers for you and keep me and my family in yours as well!

    -Mike

  22. Louise says:

    I have heard that the faithful can gain a plenary indulgence at the moment of death if a priest is not present but am not sure what is required. is that true, Father?

  23. F. Nazar says:

    The Enchiridium states that there is plenary indulgency at the moment of death if you kiss a crucifix (cross with Jesus on it) with love and perfect contrition (REAL repentance, purpose of amendment, purpose of sacrametal confession as soon as possible). That is why all faithful and doctors and nurses should always wear a blessed cricifix, not only for themselves, but as an eternal life-saver at hand in case anybody needs it!

    Catholic Hospitals should train doctors and nurses about this and have crucifixes in every room and provide blessed medals to all sick. Hospital chaplains should impose the scapular on all who accept it.

    Blessings in the Holy Family
    F.nazar at gmail.com

  24. Fr. Paul M. Hartley says:

    Msgr, thank you for your fine detailing of the meaning and purpose of the Sacrament of the Anointing of the Sick. I am the pastor of three rural parishes in NE Missouri and the closest hospitals are more than 25 miles from me and most of my parishioners go to get treatment at hospitals more than an hour driving distance. This makes it very difficult for me to arrive quickly when an emergency happens, but I try to do my best. Often the hospitals are not concerned or inclined to call the local priests and often the family calls me to come and anoint their loved ones. I do my best when this happens, but it is also up to the family to make sure I am aware of the fact that someone is going in for surgery, tests or some other foreseen time in the hospital so that I can anoint them ahead of time. I try to do my best to help my neighboring priests when I am called because they are out of the parish, but the fact is there are too few priests in my part of the world. That should be a concern of every good Catholic whether they live in the big city or the small town.

  25. Eliza says:

    Can a person who is ill and cannot swallow the Holy Eucharist(Viaticum) be blessed with the Eucharist by a lay Chaplain, is this only for a priest to do, and does the persons death have to be imminent?

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