The anointing of the sick

The anointing of the sick is administered to bring spiritual and even physical strength during an illness, especially near the time of death. It is most likely one of the last sacraments one will receive. A sacrament is an outward sign established by Jesus Christ to confer inward grace. In more basic terms, it is a rite that is performed to convey God’s grace to the recipient, through the power of the Holy Spirit.

The Sacrament’s Institution
Like all the sacraments, holy anointing was instituted by Jesus Christ during his earthly ministry. The Catechism explains, “This sacred anointing of the sick was instituted by Christ our Lord as a true and proper sacrament of the New Testament. It is alluded to indeed by Mark, but is recommended to the faithful and promulgated by James the apostle and brother of the Lord” (CCC 1511; Mark 6:13; Jas. 5:14-15).
The anointing of the sick conveys several graces and imparts gifts of strengthening in the Holy Spirit against anxiety, discouragement, and temptation, and conveys peace and fortitude (CCC 1520). These graces flow from the atoning death of Jesus Christ, for “this was to fulfill what was spoken by the prophet Isaiah, ‘He took our infirmities and bore our diseases’” (Matt. 8:17).
Mark refers to the sacrament when he recounts how Jesus sent out the twelve disciples to preach, and “they cast out many demons, and anointed with oil many that were sick and healed them” (Mark 6:13). In his epistle, James says, “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 the prayer of faith will save the sick man, and the Lord will raise him up; and if he has committed sins, he will be forgiven” (Jas. 5:14–15).
The early Church Fathers recognized this sacrament’s role in the life of the Church. Around A.D. 250, Origen wrote that the penitent Christian “does not shrink from declaring his sin to a priest of the Lord and from seeking medicine . . . [of] which the apostle James says: ‘If then there is anyone sick, let him call the presbyters of the Church, and let them impose hands upon him, anointing him with oil in the name of the Lord; and the prayer of faith will save the sick man, and if he be in sins, they shall be forgiven him’” (Homilies on Leviticus 2:4).
In the year 350, Bishop Serapion wrote, “We beseech you, Savior of all men, you that have all virtue and power, Father of our Lord and Savior Jesus Christ, and we pray that you send down from heaven the healing power of the only-begotten [Son] upon this oil, so that for those who are anointed . . . it may be effected for the casting out of every disease and every bodily infirmity . . . for good grace and remission of sins . . . ” (The Sacramentary of Serapion 29:1).

The Sacrament’s Effects
“The special grace of the sacrament of the Anointing of the Sick has as its effects: the uniting of the sick person to the passion of Christ, for his own good and that of the whole Church; the strengthening, peace, and courage to endure in a Christian manner the sufferings of illness or old age; the forgiveness of sins, if the sick person was not able to obtain it through the sacrament of penance; the restoration of health, if it is conducive to the salvation of his soul; the preparation for passing over to eternal life” (CCC 1532).
Does a person have to be dying to receive this sacrament? No. The Catechism says, “The anointing of the sick is not a sacrament for those only who are at the point of death. Hence, as soon as anyone of the faithful begins to be in danger of death from sickness or old age, the fitting time for him to receive this sacrament has certainly already arrived” (CCC 1514).

Does God Always Heal?
Today some Christians go to extremes in their expectation of divine healing. On one hand, some say that if a Christian is not healed of all his diseases, this reflects his lack of faith. Others claim that divine healings were only for the apostolic age, when all diseases were healed instantly and automatically. Both extremes are wrong.
God does not always heal the physical infirmities that afflict us. Paul preached to the Galatians while he was afflicted by a “bodily ailment” (Gal. 4:13– 14). He also mentions that he had to leave his companion Trophimus in the town of Miletus because he was too sick to travel (2 Tim. 4:20). In his first letter to Timothy, Paul urges his young protégé to “no longer drink only water, but to use a little wine for the sake of your stomach and your frequent ailments” (1 Tim. 5:23).
The last passage is especially informative. Not only does it reveal that illnesses were not always healed in the apostolic age, but it also shows an apostle’s practical advice to a fellow Christian on how to deal with an illness. Notice that Paul does not tell Timothy to pray harder and have more faith that God will heal him from his stomach ailment. Rather, he tells him how to manage the illness through medicinal means.
Some argue that healings were always instantaneous and were only for those living during the apostolic age, but that afterward the gift of healing disappeared. The problem with that theory is that the Bible tells us otherwise. For example, when Jesus healed the blind man at Bethsaida, he laid his hands upon him twice before the man was fully healed (Mark 8:22–26).
Finally, we have a standing command of the New Testament in James 5:14–15, cited earlier. This command is never revoked anywhere in the Bible, and there are no statements anywhere that God will cease to heal. Thus the command is in effect to this very day.
Of course, our healing, like all things, is subject to God’s will. As James pointed out just a chapter earlier, “You do not know about tomorrow. What is your life? For you are a mist that appears for a little time and then vanishes. Instead you ought to say, ‘If the Lord wills, we shall live and we shall do this or that’” (Jas. 4:14–15, emphasis added). We have a promise of healing, but not an unqualified one. It is conditional on the will of God.

Why Doesn’t God Always Heal?
If God can heal us, why doesn’t he? Why isn’t it always his will to do so? One answer to this question is found in the spiritual discipline and training that can result from facing illness and adversity. Scripture asks, “Have you forgotten the exhortation which addresses you as sons?—‘My son, do not regard lightly the discipline of the Lord, nor lose courage when you are punished by him. For the Lord disciplines him whom he loves, and chastises every son whom he receives’ [Prov. 3:11–12]. It is for discipline that you have to endure. God is treating you as sons; for what son is there whom his father does not discipline?
“If you are left without discipline, in which all have participated, then you are illegitimate children and not sons. Besides this, we have had earthly fathers to discipline us and we respected them. Shall we not much more be subject to the Father of spirits and live? For they disciplined us for a short time at their pleasure, but he disciplines us for our good, that we may share his holiness. For the moment all discipline seems painful rather than pleasant; later it yields the peaceful fruit of righteousness to those who have been trained by it” (Heb. 12:5–11).

The Value of Suffering
Sometimes God allows us to undergo sickness as a form of discipline and training in righteousness. God often permits these trials for our sanctification, as Paul himself learned when he prayed that God would remove from him an angel of Satan who was afflicting him: “And to keep me from being too elated by the abundance of revelations, a thorn was given me in the flesh, a messenger [Greek: angelos] of Satan, to harass me, to keep me from being too elated. 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.’ I will all the more gladly boast of my weaknesses, that the power of Christ may rest upon me” (2 Cor. 12:7–9).
Even though we must face a certain amount of suffering and affliction in this life, we know God’s grace is sufficient to sustain us. All of God’s graces, including physical health, are bestowed to lead to the salvation of our souls. The Catholic Church teaches that the sacrament brings “the restoration of health, if it is conducive to the salvation of his soul” (CCC 1532).
God also uses our suffering to help others. If Paul had not become ill while on his first missionary journey and been forced to stop traveling, he would not have preached to the Galatians, for he tells them, “You know it was because of a bodily ailment that I preached the gospel to you at first” (Gal. 4:13). If he had not preached to the Galatians, he would not have later written them the epistle that appears in our New Testament. God used Paul’s illness to bring salvation to the Galatians and to bring us a work of Scripture, through which we are still receiving benefits from God.
This is just one example of how God used suffering to bring about good. Therefore, if we suffer, we should look upon it as an opportunity for good, such as by offering up our sufferings for our own sanctification and for our departed brothers and sisters in Christ.
This applies also to the physical suffering of death, which will come for each of us one day. The Bible reminds us, “As for man, his days are like grass; he flourishes like a flower of the field; for the wind passes over it, and it is gone, and its place knows it no more” (Ps. 103:15–16).

The “Last Rites”
Though the psalmist teaches us to ponder our mortality, he immediately comforts us by saying, “But the steadfast love of the Lord is from everlasting to everlasting upon those who fear him, and his righteousness to children’s children, to those who keep his covenant and remember to do his commandments” (Ps. 103:17–18).
In his steadfast love for us, the Lord gives us the sacraments involved in the last rites to comfort us in our final days and prepare us for the journey ahead. “These include penance (or confession), confirmation (when lacking), anointing of the sick . . . and Viaticum (which is meant to be the last reception of Communion for the journey from this life to eternity). . . .
“The present ritual orders these sacraments in two ways. The ‘continuous rites of penance and anointing’ include: Introductory Rites, Liturgy of Penance, Liturgy of Confirmation, Liturgy of Anointing, Liturgy of Viaticum, and Concluding Rites. The ‘rite for emergencies’ includes the sacrament of penance, Apostolic Pardon, Lord’s Prayer, Communion as Viaticum, prayer before anointing, anointing, concluding prayer, blessing, sign of peace” (Fr. Peter Stravinskas, Catholic Encyclopedia, 572).
The most important part of the last rites is the reception of the Lord in one’s final Communion, also called “Viaticum” (Latin = that which you take on the road, i.e., provisions for a journey) This special Communion prepares us to travel with the Lord on the final part of our journey.
The comfort of Viaticum has been valued by Christians since the beginning of Church history. The first ecumenical council, held at Nicaea in 325, decreed: “Concerning the departing, the ancient canonical law is still to be maintained, to wit, that, if any man be at the point of death, he must not be deprived of the last and most indispensable Viaticum” (canon 13). Having repented of our sins and received reconciliation, we travel with the Lord Jesus out of this earthly life and to eternal happiness with him in heaven.
From the earliest times, the sacrament of the anointing of the sick was cherished among Christians, not only in immediate danger of death, but even at the beginning sign of danger from illness or old age. A sermon of Caesar of Arles (ca. A.D. 470-542) contains the following: “As often as some infirmity overtakes a man, let him who is ill receive the body and blood of Christ; let him humbly and in faith ask the presbyters for blessed oil, to anoint his body, so that what was written may be fulfilled in him: ‘Is anyone among you sick? Let him bring in the presbyters, and let them pray over him, anointing him with oil; and the prayer of faith will save the sick man, and the Lord will raise him up; and if he be in sins, they will be forgiven him. . . . See to it, brethren, that whoever is ill hasten to the church, both that he may receive health of body and will merit to obtain the forgiveness of his sins” (Sermons 13[325]:3).

John Chrysostom
“The priests of Judaism had power to cleanse the body from leprosy—or rather, not to cleanse it at all, but to declare a person as having been cleansed. . . . Our priests have received the power not of treating with the leprosy of the body, but with spiritual uncleanness; not of declaring cleansed, but of actually cleansing. . . . Priests accomplish this not only by teaching and admonishing, but also by the help of prayer. Not only at the time of our regeneration [in baptism], but even afterward, they have the authority to forgive sins: ‘Is there anyone among you sick? Let him call in the 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 shall save the sick man, and the Lord shall raise him up, and if he has committed sins, he shall be forgiven’” (On the Priesthood 3:6:190ff [A.D. 387]).

Deacons can baptize and they can witness marriages, they can even distribute communion as an ordinary minister, and yet the Church does not allow deacons (nor any who are not priests) to confer the sacrament of Anointing of the Sick.
A brief consideration of this question – Why can’t a deacon confer Anointing of the Sick? – will teach us a great deal about this sacrament.

None but the priests can confer Anointing of the Sick
That only priests (including bishops) can confer the sacrament of Anointing is the clear teaching of the Catholic Church.
“Only priests (bishops and presbyters) are ministers of the Anointing of the Sick.” (CCC 1516)
“Every priest, but only a priest, can validly administer the anointing of the sick.” (Code of Canon Law 1003.1)
“All priests, and only priests, validly administer the anointing of the sick.” (Eastern Code of Canon Law 739.1)
“Further, it is also indicated there [James 5:14] that the proper ministers of this sacrament are the presbyters of the Church, under which name in that place are to be understood not the elders by age or the foremost in rank among the people, but either bishops or priests duly ordained by them with the imposition of the hands of the priesthood [1 Timothy 4:14].” (Trent, Session XIV)
That priests and only priests can confer this sacrament is clearly taught in Sacred Scripture: Is any man sick among you? Let him bring in the priests of the church, and let them pray over him, anointing him with oil in the name of the Lord. (James 5:14)
This is not the type of teaching which can change. The minister of the sacrament of Anointing of the Sick has been and will always be priests and only priests (including, of course, bishops). Still, we ask, Why is it so?
Anointing of the Sick forgives sin, even mortal sin
Anointing of the Sick is principally directed to spiritual healing. But what is the spiritual healing which this sacrament effects? St. James tells us that it forgives sin, and the Council of Trent teaches dogmatically that both mortal and venial sins are forgiven through this sacrament. However, the forgiveness of sin per se is not the principal effect of this sacrament, but is more of a side-effect. This is why St. James does not say simply, “Anoint the sick person and his sins will be forgiven”, but, if he be in sins, they shall be forgiven him. (5:15)
The sacrament given for the forgiveness of actual sins is Reconciliation or Confession. For the forgiveness of mortal and venial sin, Penance is the proper sacrament. This is why the Church encourages the faithful to receive the sacrament of Reconciliation in preparation for Anointing. Further, if a man were to attempt to receive Anointing of the Sick as a way of having his sins forgiven while despising and refusing Confession, the Anointing would have no effect in him except his condemnation. Again: Even though Anointing does forgive sin (and even mortal sin, but not original sin), if a man attempts to use this sacrament as a way of avoiding Confession, he condemns himself, and the Anointing becomes for him a marking unto judgment rather than a balm of forgiveness.
Anointing of the Sick is for the remission of sins, that is, of the remnants of sin
Still, Anointing of the Sick is for spiritual healing and is directed to the forgiveness of sins – however, it is not principally for the forgiveness of sin as to the guilt of sin (this is what Confession is for), but rather as to the “remnants” or “vestiges” of sin.
Actual sin weakens the will and burdens the soul. When a person begins to be in danger of death, he has need of a spiritual healing and strengthening so that he might be well prepared to meet his Lord in the particular judgment. Most especially, the sacrament of Anointing gives a special grace to strengthen the sick person “against the temptations of the evil one, the temptation to discouragement and anguish in the face of death.” (CCC 1520)
As the sacrament of Anointing removes all the “remnants” of sin (that perduring weakness of the will which remains even after sin has been forgiven), so too does it wash away any sin which it finds still staining the soul.
Additionally, if it is conducive to the spiritual healing of the individual, the sacrament may effect a physical healing as well.
Why only priests can anoint: Confession and Anointing
Now, seeing that Anointing is directed to the forgiveness of sins (that is, of the remnants of sin) and is truly a completion of the sacrament of Penance, it is becomes clear that only priests can confer this sacrament.
While it is true that deacons can baptize, we do not say that they can forgive sins. Indeed, the sacrament of baptism does forgive all sin (both original and actual sin), but it is not so much through the power of the minister as through the sanctifying power of regeneration through water and the Holy Spirit. Thus, we do not say that a priest or deacon or lay person “forgave that baby’s sins” when he baptized him – Baptism is not given through the “power of the keys”.
Hence, since Anointing is the completion of the sacrament of Penance (especially as to the effect of the two sacraments), and because Anointing is directed principally to spiritual healing through the remission of the remnants of sin, only those who have the power to absolve from sin through the sacrament of Reconciliation are able to confer Anointing of the Sick.
Since the “power of the keys” was entrusted only to the priests (and bishops), only these can confer Penance and Anointing. Because neither deacons nor the laity can hear confessions, neither can they confer Anointing of the Sick.
On the profound confusion regarding this sacrament in the Church today
1) Danger of death: First, there are many in the Church who do not realize that Anointing of the Sick can only be given to those who have begun to be in a real danger of death [for more on this, see our earlier article – here]. Surely, Anointing is not only for those who are on their death bed, but neither is it for those who do not suffer from a serious illness or from old age such that they have at least begun to be in danger of death. If Anointing is divorced from the notion of a spiritual healing in preparation for death and the particular judgment, then it will very likely be thought of as being principally for physical, emotional, and psychological healing.
I am convinced that this error – separating Anointing from danger of death – is the font of all the modern confusion about this sacrament. [n.b. Though many priests and even bishops are confused on this point, the Church still teaches that Anointing is only to be given to those who have begun to be in danger of death from sickness or old age (cf. CCC 1514, Code of Canon Law 1004.1, Eastern Code of Canon Law 738)]
2) Not principally about physical healing: Many in the Church today divorce Anointing of the Sick from Penance and speak as though this sacrament is not directed principally to the remission of the remnants of sin in preparation for a holy death. Such persons make the sacrament to be more about physical healing (including psychological comfort) than about spiritual healing (which is the forgiveness of sin and of the remnants of sin). Thus, it is no surprise that so many people in the Church do not understand why this sacrament can only be conferred by priests and bishops. Because they do not realize the close connection between Confession and Anointing, they do not realize that Anointing is sacramentally unintelligible if not seen as the completion of the sacrament of Penance.
3) Why young children cannot receive Anointing: From this second error, a third follows – people begin to think that the Church could (or, even, should) confer Anointing on young children below the age of reason. But, in truth, these youngsters have no need of the sacrament since they have not committed any sins. If Anointing were primarily about physical healing, then the Church would give the sacrament to young children (and there would be no clear reason why the sacrament couldn’t be given by deacons or even the laity). However, Anointing is primarily about spiritual healing gained through the remission of the remnants of actual sin. And, since young children below the age of reason have not yet committed any actual sins, they cannot receive Anointing of the Sick (they have no need of it, just as they have no need of Reconciliation). [for more on this, see our earlier article – here]

Anointing of the Sick
(‘Extreme Unction,’ ‘the Last Rites’)

“Is anyone among you sick? He should summon the presbyters [priests] of the church, and they should pray over him and anoint (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. If he has committed any sins, he will be forgiven.”

–James 5:14-15

This sacrament is one of healing. The Church community intercedes on behalf of the person who’s seriously ill or frail due to old age with prayers that offer comfort and peace, strength to handle the pain and suffering, and courage to face the end of one’s life. The recipient is anointed with oil and his or her sins are forgiven. This is the final preparation for one’s death.

In years gone by, one of the last things a family would do for a dying loved one was notify the local priest. He would hurry to the house or hospital and administer the “last rites.”

In general, the sacrament, then known as extreme unction (final anointing), was reserved for someone on his or her death bed. Since the Second Vatican Council (1962-1965), that’s no longer the case.

Now known as the Anointing of the Sick or Sacrament of the Sick, it’s commonly administered to anyone who has reached “the age of reason” (around seven years old) who’s seriously ill. And it’s also available for anyone who’s elderly. In either case, the recipient does not have to be near death.

It’s important to explain this to your care-receiver. “Calling the priest” does not mean he or she is dying. It does not mean your dad is in worse shape than he realizes or that you’re keeping some information about your mom’s medical condition from her.

It’s also important to know the Anointing of the Sick isn’t a “magical” sacrament designed to cure illness. Yes, sometimes a person does get well. But the purpose of the sacrament is to give the person grace and to forgive his or her sins.

In administering the sacrament, the priest will anoint your loved one’s forehead and hands with blessed oil and say some prayers. You, and others, are welcome to be present.

It could be that sometime during the year your care-receiver’s parish has a communal celebration at the church, perhaps at a Sunday Mass.

A person can receive this sacrament more than once. If you aren’t sure if it would be appropriate for your loved one to be anointed, ask your local priest.

When should someone receive the Anointing of the Sick?
If I asked you to close your eyes and picture the Sacrament of Anointing, what image would come to your mind? I think many Catholics would picture a priest standing at a hospital bedside. For an increasing number of Catholics, however, the mental picture would be different. They would picture a parish gathered for Sunday Eucharist, with 30 or so people-some visibly ill, some apparently perfectly healthy-coming up the aisle to be anointed, some with their spouses or caregivers.
Although the sacrament began as a ritual of healing, over time the emphasis shifted to the forgiveness of sins on the deathbed, when such forgiveness would be the final preparation for heaven. The Second Vatican Council returned the original meaning to the sacrament by emphasizing that it is not only for those who are at the point of death, but for anyone who is seriously ill, including mental or spiritual illness. It also helped move the Anointing away from a private service and back toward a community-based one.
Today we are all aware that tensions, fear and anxiety about the future affect not only our mind but our body as well. These illnesses can be serious. They can move us to ask for the healing touch of Christ in the Sacrament of Anointing. Persons with the disease of alcoholism or persons suffering from other addictions can be anointed. So can those who suffer from various mental disorders. The anxiety before exploratory surgery to determine if cancer is present is a situation in which Christ’s power can be invoked in the sacrament.
In these cases the person does not have to wait until the illness is so grave that he or she is in the hospital or institutionalized to celebrate the sacrament. Sacraments, after all, are community celebrations. It is preferable to celebrate them in the context of family and parish even before going to the hospital. The sick person has a better opportunity to appreciate the prayers and symbols of the rite when in her or his customary worshiping community.
Bro. Antony Dynish

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