Is Anointing the sacrament of the dying? Yes and no

February 11^th, World Day of the Sick

Anointing of the Sick is surely the most misunderstood sacrament in today’s Church. However, I do not think it is so much that the faithful are too reserved in requesting it (as was the case in ages past), but rather it seems that the sacrament is far too often used in cases when it is not really appropriate. It is clear that the very close connection between Anointing and death has largely been lost over the past fifty years.

The Ecumenical Council of Trent declared that Anointing is the “sacrament of the dying”, and even Vatican II says that Anointing can still be called “Extreme Unction” (though admitting that “Anointing of the Sick” is better). Pope Paul VI specified that the “sick” who are to be anointed are those who are seriously ill. The Church’s teaching from Vatican II, to Pope Paul VI, to the Code of Canon Law specifies that Anointing of the sick is only to be given to those who have begun to be “in danger of death” whether from sickness or old age.

What the Church actually teaches about who can be anointed

“It is also declared, that this unction is to be applied to the sick, but to those especially who lie in such danger as to seem to be about to depart this life: whence also it is called the sacrament of the departing [i.e. “the sacrament of the dying” – sacramentum exeuntium]. And if the sick should, after having received this unction, recover, they may again be aided by the succour of this sacrament, when they fall into another like danger of death.” (Council of Trent, session xvi)

“‘Extreme unction,’ which may also and more properly be called ‘anointing of the sick,’ is not a sacrament for those only who are at the point of death. Hence, as soon as any one of the faithful begins to be in danger of death from sickness or old age, the fitting time for that person to receive this sacrament has certainly already arrived.” (Vatican II, Sacrosanctum Concilium 73)

“The Sacrament of the Anointing of the Sick is given to those who are seriously ill.” (Paul VI, Apostolic Constitution Sacram Unctione Infirmorum, 30 Nov 1972)

“The anointing of the sick can be administered to any member of the faithful who, having reached the use of reason, begins to be in danger of death by reason of illness or old age.” (Canon 1004.1)

“Great care and concern should be taken to see that those of the faithful whose health is seriously (periculose) impaired by sickness or old age receive this sacrament. A prudent or reasonably sure judgment, without scruple, is sufficient for deciding on the seriousness of an illness; if necessary a doctor may be consulted.” (General Introduction to the Roman Ritual, Pastoral Care of the Sick: Rites of Anointing and Viaticum, par. 8)

The Church has consistently taught and still continues to teach that Anointing of the Sick is given to the faithful above the age of reason who have: 1) begun to be in danger of death, 2) on account of some serious illness or old age. [in case of doubt, a doctor should be consulted]

Trent specifies that the sacrament is rightly called the “sacrament of the dying”, Vatican II says that it is given when a member of the faithful “begins to be in danger of death”, and this is affirmed also by Canon Law and the liturgical books. While it is true that the sacrament is not reserved only to those who are in the last moments of life, neither may it be given to those who are not yet in a real danger of death.

Further, it is clear throughout that Anointing is given not simply to all who are in danger of death generally, but only to those who are sick – just as St. James said, Is any man sick among you?

Anointing is not only for those who are “at death’s door”

Still, it is important to realize that the sacrament of anointing is not only for those who are at death’s door. The proper sacrament for one in the last moments of life is surely Viaticum – hence, this last Eucharist is most properly called the “sacrament of the dying” in the simple and absolute sense.

Let me make this very clear [since I know that there will be confusion]: Anointing of the sick IS NOT only for those who are at the last moment of life and at death’s door. I am not saying and have never said that Anointing is only for those who are dying in the very moment.

However, Anointing is nevertheless only for those who have “begun to be in danger of death” – if a person is not “dying”, in the sense that they have some illness or frailty (from old age) which puts them in a real though perhaps remote danger of death (i.e. it really could kill them at some point), then they must not be anointed. Indeed, if a person is not at least in remote but real danger of death through sickness or old age, then they CANNOT validly be Anointed.

Danger of death - an error made by Mark Shea (among many others)

When the Church teaches that Anointing of the sick can only be validly administered to those who have begun to be in danger of death, she does not mean that only those who are in immediate and proximate danger of death (i.e. those who are “at death’s door”) can receive the sacrament. Still, it is true that one must be in a true and real danger of death due to sickness or old age in order to receive the sacrament of Anointing.

Thus, for example, when the popular Catholic blogger and apologist (for whom I have a good deal of respect), Mark Shea, says “I know of numerous women who have received the Sacrament of Anointing because of chronic infertility and miscarriage problems” [here], he (together with those priests who gave the sacrament) is profoundly confused as to the Church’s teaching regarding the administration of this sacrament. Unless the “chronic infertility” or “miscarriage problems” are putting the life of the mother in a real danger of death, the attempts at Anointing do nothing more than expose the sacrament to nullity (a serious sin on the part of those priests, and something which Mr. Shea should think about before publicly promoting the idea). And, if any should think that the sacrament could be received by a mother on behalf of her unborn child, we direct them to our previous article [here].

Anointing is only for those who have “begun to be in danger of death” – this means that the illness or old age really puts the individual into at least a remote danger of death. It cannot be, however, merely a potential danger of death – since even a simple illness could theoretically and potentially under unusual circumstance develop into something serious. Rather, it must be a real and actual danger of death, no matter how remote. The illness must be serious and life-threatening in order to justify anointing.

Hence, for example, a person diagnosed with cancer (even if they probably have years to live and may well even be cured) could and should certainly receive Anointing of the Sick. An elderly person who is not on his death-bed, but who is generally worn down by the burden of years, could receive the sacrament. A person with a serious heart condition, but one which does not put him into the emergency room at the moment, could well justify receiving the sacrament.

But a man or woman struggling with infertility? No, it is absurd. Someone struggling with mild obesity (setting aside other possible health issues)? No. Someone with general (non-life-threatening) problems of arthritis? Certainly not.

There must be a real and actual, though perhaps remote, danger of death in order for a member of the faithful to receive the sacrament of Anointing of the Sick. This is why the Sacred Council of Trent calls it the “sacrament of the dying” and also why Vatican II and Pope Paul VI continue to call it “Extreme Unction” (while also stating that “Anointing of the Sick” is a better term).

Anointing is not for everyone who is “at death’s door”

While Anointing is only for those who have begun to be in some real danger of death, neither is it for all those who are in danger of death. The Church teaches that it is Anointing of the SICK, which means that the danger of death must stem from either sickness or old age.

Hence, if a soldier is going off to war, the proper sacrament is Confession, not Anointing. Likewise, a man on death row – who is not seriously ill – cannot receive Anointing of the Sick in preparation for his execution, because he is not sick! Again, the proper sacrament is Confession (and, of course, Viaticum).

It is simply amazing how many of the faithful, and even of the priests are confused on this point.

Is Anointing of the Sick the “sacrament of the dying”?

If we understand the “dying” properly – meaning, not simply those who are in the very last moments of life, but all those who are in a real danger of death – then we say that only the “dying” (i.e. only those in danger of death) are to receive the sacrament of Anointing, this is what Trent taught and what Vatican II still teaches though with different words.

However, because “dying” is often thought to mean “those at death’s door”, the Church generally does not use this term any more. Still, it is good to recall that the sacrament is still called “Extreme Unction” and is always to be connected with at least a remote danger of death.

Such is the faith of the Church. If anyone says differently, even if he be a priest, ask him to explain how his opinion corresponds to the teaching presented by Vatican II and codified in Canon Law.


Update: And, lest any should think that there is room for debate on this issue, hear the teaching of the Council of Florence, which has been followed by Trent and Vatican II: "This sacrament should be given only to the sick of whose death there is fear."