These notes are intended to foster and guide an authentic celebration of the sacrament of the anointing of the sick in the parishes and institutions of the Archdiocese. The Church's special concern for the sick is grounded in the conviction that every human person possesses unique worth and dignity in the eyes of God. Even amid the pain and suffering of sickness, this dignity is undiminished. Faith assures us that just as the Father's unfailing love was with Jesus in his suffering and death, that same love is available to Christ's members who suffer illness and pain. As the Introduction to the Pastoral Care of the Sick. Rites of Anointing and Viaticum (#5) reminds us: 'through the sacrament of anointing, Christ strengthens the faithful who are afflicted by illness, providing them with the strongest means of support.' Particular pastoral responsibilities addressed in these notes are:

to make the sacrament available to every seriously ill Catholic who seeks to be anointed
to celebrate the sacrament authentically and effectively in a variety of settings including the church, hospital, nursing home, and private homes
to correct the tendency in recent years to administer the sacrament too widely to a variety of persons who do not meet the norms for reception of anointing
to provide catechesis to our people about the meaning of the sacrament with encouragement to celebrate when the need arises
to guide parish visitors and eucharistic ministers with an understanding of the proper rites for the sick and the dying.

Today, priest chaplains are not available for full-time hospital ministry in many areas of the Archdiocese. The obligations of parish ministry today often do not allow the priest large blocks of time to spend in hospital ministry. Both hospital and parish need to seek out ways in which the anointing of the sick can be celebrated well and, above all, be available to all the faithful who are facing serious illness or hospitalization. That is the focus of these pastoral notes.

1. THEOLOGICAL FOUNDATIONS

Jesus in his ministry showed special concern for healing the sick. 'Jesus went around to all the towns and villages, teaching in their synagogues, proclaiming the Gospel of the kingdom, and curing every disease and illness.' (Matt. 9:35)

In response to the Lord's example the New Testament Church anointed its sick so that 'the prayer of faith will save the sick one and the Lord will raise him up." (James 5:15) As Jesus healed body and soul, so the anointing of the sick gives the grace of the Holy Spirit to those who are sick: by this grace the whole person is helped and saved, sustained by trust in God and strengthened against the temptations of the Evil One and against anxiety over death. According to our Catholic tradition, a return to physical health may follow the reception of the sacrament if it would be beneficial to the sick person's salvation. If necessary, the sacrament also forgives sins and completes Christian penance. (Pastoral Care of the Sick #6) Anointing is not, however, a substitute for the sacrament of penance, which should be celebrated with the sick whenever possible and appropriate.

The anointing ought to be celebrated in the context of total pastoral care of the sick by the entire Christian community. Such care includes public and private prayer for the sick, Holy Communion for the sick, and the celebration of the sacrament of penance. It is important to state that the proper sacrament for the dying Christian is viaticum. The central place of this sacrament in the face of death is often not fully appreciated by the Catholic faithful.

In the celebration of the sacrament of anointing of the sick, the faithful meet Jesus in his healing ministry. In the sacrament, the power of Christ's death and resurrection, the Paschal Mystery, touches the lives of those who in faith carry the cross of Jesus in their mortal bodies. (2 Cor. 4, 10) Long pastoral practice has taught us the power of the sacrament to transform human suffering with meaning and dignity. As baptism first unites us to Christ's death and resurrection, and the Eucharist reaffirms our union with the Lord, so the anointing conforms us in sickness to Christ's glorious cross.

The care of the sick is the work of the whole community of the baptized. Gathered in faith, the community draws healing and comfort, strength and consolation from God's Word. In three distinct actions, the Church celebrates anointing: the prayer of faith, the laying on of hands, and the anointing with the oil of the sick. Carried out in unhurried reverence and prayer, these actions reveal God's healing and saving work in Christ.

2. THE RECIPIENT OF THE ANOINTING

The 'Introduction' to the Rite of Anointing of the Sick describes the baptized 'whose health is seriously impaired by sickness or old age' (PCS #6) as proper recipients of the sacrament. The same text goes on to note that a "prudent or reasonably sure judgment, without scruple' is sufficient to decide if an illness is serious. (PCS #8) For example, the common cold, not usually a justification for anointing, is apt to be a u serious" illness for an otherwise healthy ninety year old. The age and general health of the person is as important a factor as the specific ailment in making a decision about the sacrament.

Persons facing surgery are appropriate candidates for anointing when the surgery aims to correct an illness. The elderly may be anointed if they are notably frail or weakened even when no serious illness has been diagnosed. Seriously ill children who have the use of reason may be anointed. The unconscious' or seriously ill persons who have lost the use of reason may be anointed if, as, baptized believers, they would probably have asked or wanted to be anointed. (PCS#9-14)

Those who suffer serious psychological illness may be anointed 'if they would be strengthened by the sacrament.' (PCS #53) Although acute mental illness renders many incapable of certain sacraments such as marriage, they may have sufficient use of reason to be comforted by the sacrament of anointing.

Alcoholism is considered a disease, although the acute symptoms disappear when the alcoholic stops drinking. Hence, alcoholics 'in recovery' can perhaps best be assisted by celebration of penance and the Eucharist. On the other hand, in an acute phase, such as a residential or outpatient treatment program, it is often the case that the alcoholic is acutely ill physically and emotionally. Judgment is best made on a case-by-case basis.

When a priest is called to attend those who are already dead, he should not administer the sacrament. Instead he, or another minister when no priest is available, should lead the family in 'Prayers for the Dead,' Chapter VII of Pastoral Care of the Sick, or 'Prayers after Death" in the Order for Christian Funerals 101-108. In cases where death is uncertain, he is to administer the rites conditionally. One sometimes hears the plea that anointing the dead is 'good pastoral practice.' Such an approach is totally out of keeping with the nature and purpose of anointing.

3. CATECHESIS

In parishes, regular catechesis about the anointing of the sick should be done through homilies, the parish bulletin, and education programs. Many of our people still have an understanding of anointing as the sacrament of approaching death, and thus avoid it, fear it, or delay it. Others have the misconception that the sacrament may be properly received by anyone, without regard to the person's state of health. With goodwill but misplaced inclusiveness, some parishes have even encouraged all who wish to receive anointing to do so. The nature of the sacrament in the life of the faithful is not honored by such an invitation. The sacrament is celebrated authentically only in the face of serious illness. (See Section 2)

The sick and their families need to be encouraged to celebrate anointing within the parish setting. Communal liturgies of anointing are a powerful invitation to see the parish as a source of consolation and strength in sickness. The scheduled availability of the sacrament may be advisable for very large parishes, parish clusters, or parishes near a hospital. Some parishes find a regularly scheduled celebration meets the needs of many of the faithful.

We should not neglect the Sunday homily as a source of catechesis for anointing. The many Gospel pericopes proclaiming Jesus' healing work provide excellent occasions for describing the sacrament of anointing as the ongoing healing touch of the Lord. Such a homily might include a description of the Church as the presence of Christ's healing power, the meaning and acceptance of sickness and old age, or a reflection on the central images, symbols, and actions of the rite.

4. ANOINTING OF THE SICK IN THE PARISH

Communal celebrations of the anointing of the sick are a regular feature of parish life in many places. Such celebrations may take place at Sunday or daily Eucharist, or outside Mass when a form is judged to be pastorally suitable. Parishes will find excellent opportunity for collaborative ministry when two or more parishes join in common celebration. Such celebrations will follow the liturgical directives in Chapter IV (97-148) of Pastoral Care of the Sick.

Outside these communal celebrations, individuals should be encouraged to seek the anointing when they face serious illness or surgery because of such illness. This availability may take several forms:

a) the priest could go to the home of the person to be anointed. The participation of family and friends should be strongly encouraged to witness to the ecclesial character of the sacrament

b) the parish could invite the sick person to participate in a scheduled weekday or Sunday Eucharist along with family and friends

c) nursing homes and other long-term care facilities, such as hospice facilities, could schedule communal anointing liturgies in their institutional calendars.

5. ANOINTING OF THE SICK IN THE HOSPITAL

Although the sacrament of anointing should be celebrated whenever possible in accordance with the full rites, the special circumstances of hospital ministry often make it necessary to abbreviate the rite. In these cases the priest should use the format prescribed in Chapter VI of Pastoral Care of the Sick #149-160 and in Chapter VII, especially #259-274. These rites should be studied and used by priests who are called to minister in hospital emergency rooms or trauma situations. Whenever possible the sacraments of penance and viaticum should precede the anointing of the sick in emergencies.

In extreme emergencies, when danger of death from illness or injury is sudden, the priest may only be able to offer the minimum of sacramental rites. In less extreme cases, it may be possible to use the 'Continuous Rite of Penance, Anointing, and Viaticum' (PCS 236-258) for people who are dying. Even in these emergency situations, family and hospital staff should take part in the celebration whenever this is possible.

6. FREQUENCY OF ANOINTING

In certain instances, the anointing may be repeated if the sick person recovers and again falls ill or if, during the course of an illness, the person's condition becomes even more serious. Anointing is properly celebrated at critical moments at the onset of serious illness and at critical moments in its progress. Hence, those who are chronically and seriously ill may repeat the anointing when in the pastoral judgment of the priest the sick person's conditions warrants this repetition. (PCS #102)

7. THE RITUAL OF ANOINTING

'The priest is the only proper minister of the anointing of the sick" (PCS #16). Under no circumstances may any person other than a bishop or priest administer this sacrament or apply the oil of the sick.

'If the anointing is to be an effective sacramental symbol, there should be a generous use of oil, so that it will be seen and felt by the sick person as a sign of the Spirit's healing and strengthening presence. For the same reason it is not desirable to wipe off the oil after the anointing.' (PCS #1 07)

'Depending on the culture and traditions of the place, as well as the condition of the sick person, the priest may also anoint additional parts of the body, for example, the area of pain or injury. He does not repeat the sacramental form.' (PCS #1 24)

The regular and repeated use of the .emergency form" for all hospital patients is not intended by the liturgical books. Most new admissions to hospitals are properly candidates for the full rite or for the abbreviated rites for hospitals.

It should be noted that Pastoral Care of the Sick in the 1983 edition is the only official liturgical book for rites for anointing of the sick and viaticum. The pastoral notes and introductions for this edition are recommended re-reading for every priest.

8. VIATICUM AND PRAYER FOR THE DYING

Viaticum is the proper sacrament of the dying. It is the completion and reaffirmation of Christian life on earth. When death is close, arrangements should be made to receive viaticum.

The ideal is to receive viaticum within the celebration of the Eucharist. When, because of institutional limitations, this is not possible, viaticum outside Mass is appropriate. Both rites are found in Chapter V of Pastoral Care of the Sick.

A distinctive feature of the celebration of viaticum is the renewal of the baptismal profession of faith by the dying person. At the conclusion of the penitential rite the 'Apostolic Pardon' may be given. A special form for administering communion as viaticum is provided. The dying person and all Catholics present may receive Holy Communion under both kinds. The sick and dying who are unable to receive under the form of bread may receive under the form of wine alone. If the process of dying lasts several days, the Eucharist may be given as viaticum on successive days.

Through prayers such as the 'Commendation of the Dying,' the Church sustains the dying person in union with the Lord. These may be led by others who have been prepared for this ministry in the absence of a priest or deacon.

The concrete details of celebrating viaticum can be a challenge to pastoral ministers, particularly in institutional settings. However, the central place of viaticum in pastoral care for the dying urges us to seek ways to make this sacrament available to as many dying Catholics as possible.

Office for Worship and Spiritual Life

Pastoral Notes - Anointing of the Sick

Copyright © 2004-2008 Archdiocese of Boston; all rights reserved