WORCESTER MEDICAL ETHICS

A Roman Catholic Perspective

Monsignor Peter R. Beaulieu, M.A., S.T.L.

Sacrament of the Sick

Introduction
For over eight centuries, it was called Extreme Unction, but the Fathers of the Second Vatican Council decreed that “Extreme Unction….may also and more fittingly be called ‘anointing of the sick’” and Sacrosanctum concilium went on to declare, “anointing of the sick is not a sacrament for those only who are at the point of death...as soon as any one 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” (SC, n.73). The change in the name resulted in a shift from extreme (or last) anointing to reception of the sacrament when there is a life-threatening condition with the emphasis on the healing aspects of anointing—a sacrament for the seriously sick and not exclusively for the dying.
The Meaning and Impact of Illness

There is a significant, though often overlooked, difference between illness and disease. Physicians are attentive to facts which patients relate to them that the doctor determines to be relevant in leading to a diagnosis of a disease state. Patients, on the other hand, focus on how the condition (or illness) that precipitated their visit to the doctor has already affected their lives. The subjective meaning of that illness has already been formed in people’s minds based upon the knowledge they have about the inner workings of their body and the significance this illness has had on them, which is all filtered through religious, spiritual and cultural predispositions. Illness can often provoke a grave spiritual problem in a religious man or woman or, conversely, it can also prompt a search for God or a return to a vibrant life of faith. Both sickness and death were not part of God’s original creation; no, those two evils are the result of sin. The problem of suffering, too, has been a stumbling block to faith in God. These realities are undoubtedly hardships that are the byproduct of sin and manifest the presence of evil in the world. The avoidance of illness, suffering and pain is in accord with God’s plan. However, embracing those realities can be salvific because it demands more than we can usually give and does so in situations that we would rather avoid. The faith requirement necessary is uniting our lives with that of the suffering Christ. Every human person is endowed with the prospect of immortality and is, thus, an embodied spirit—fashioned by God in a manner that makes each person His potential child. This is a promise God has made and which He will not renege upon. Christ not only was moved to pity at the sight of the sick, but He made their infirmities His own. Some who were sick, He healed, but not all—physical healing was a sign of the dawn of the kingdom of God that proffered an even more radical healing, the destruction of sin and death and the prospect of life eternal.
Anointing of the Sick

Each of the sacraments imparts a certain grace or divine help. The holy anointing bestows the grace necessary for the ill person to persevere in the midst of sickness. Being sick can lead to despair and a loss of faith in God—the grace of this sacrament dispels doubt and serves to strengthen the resolve to tangle with sickness and squarely face the threat of death—the hope that comes from faith in God is its only antidote. The sacrament can take place in a variety of settings, but, if at all possible, anointing should be preceded by the confession of sins and followed by reception of holy communion. The priest (or bishop) invokes the Holy Spirit on the sick person by the laying on of hands which is done in silence and this epiclesis (or calling down) of the Spirit is the prayer of faith which saves. Finally, the forehead and hands are marked with the sign of the cross and anointed with the oil of the sick, with the required formula: Anointing the forehead, the priest says, “Through this holy anointing may the Lord in his love and mercy help you with the grace of the Holy Spirit” and all respond Amen. Then, while anointing the hands, he continues, “May the Lord who frees you from sin, save you and raise you up” while the participants respond, Amen. According to the Catechism of the Catholic Church, this ritual action (i.e., the words and deeds of Christ) has these effects: as a gift of the Spirit it yields strength, peace and renewed trust. Union with Christ’s suffering gives spiritual benefit to human suffering; the union of all suffering earthly souls contribute to the prospect of universal sanctification; the last (or extreme) anointing is the sacrament of those departing this world and the culmination of the previous anointings—in Baptism and in Confirmation. Anointing, then, is a sacrament for the seriously ill, whereas viaticum (or last communion) is more properly understood as the sacrament for the dying.