The Sacrament of Anointing of the Sick, as described by Venerable Fulton Sheen, 1962

1952 photograph of Venerable Fulton John Sheen produced as promotional material for the television show 'Life is Worth Living'There are two sacraments of “healing”: one for spiritual illness, which is the Sacrament of Penance; the other for physical illness, which is the Sacrament of the Anointing of the Sick. An older term for it was “Extreme Unction,” which some interpreted as meaning that it was administered only when death was inevitable. For that reason, the sacrament was sometimes postponed until there was no hope of recovery, so as not to frighten the recipient or unduly sadden the relatives and friends.

This is a misinterpretation of the sacrament which is directed to the uncertainty which sickness implies; the sacrament looks to sickness as such. Two extremes are to be avoided, one which would say it was destined only for death; the other, that it is solely a grace of healing. It is rather a sacrament for the time of serious sickness; that is why it may not be given to those who are facing death for any reason other than illness. If it were a sacrament destined solely for those who are about to die, it would be given to a criminal on a scaffold. But the sacrament may not be given in such a case. It may be given immediately after electrocution or hanging, or any violent death, but not before. In those under sentence of death there is no hope of recovery, which this sacrament implies.

It is not a sacrament exclusively for those at the point of death. In the liturgy of the sacrament, the priest does not mention death, but prays for a return to health of body and soul:

“Heal, O Redeemer, the infirmities of the sick person; heal his wounds and forgive him his sins. Make all the infirmities of his body and soul disappear, and by Thy Mercy, give him full spiritual and corporal health, that re-established by the effect of Your goodness, he can resume the fulfillment of his duties…. Grant that Thy servant, freed from sickness and restored to health, may be re-established by Thy Name and given back to Thy Holy Church.”

Two other prayers follow in which the restoration to health is emphasized:

“We implore Thee, O Lord, look with kindness on Thy servant [name] who is growing weak as his [her] body fails. Cherish and revive the soul which Thou didst create, so that, purified and made whole by his [her] sufferings, he [she] may find himself [herself] restored by Thy healing through Christ Our Lord. Amen.”

“O Lord, Father Almighty,…free Thy servant from sickness. Restore to him [her] his [her] health. Raise him [her] up by Thy right hand, strengthen him [her] by Thy power, protect him [her] by Thy might, and give him [her] back to Thy Holy Church with all that is needed for his [her] welfare through Christ Our Lord. Amen.”

The oil of the sick, which is consecrated at the Pontifical Mass on Holy Thursday, contains no allusions to death or the dying. The words of the bishop are:

“Pray that this oil may serve to give renewed strength to God’s temple…that all who are anointed with the heavenly remedy of this oil may find it a medicine for body and soul, quick to remove all suffering and to drive away all sickness and infirmity of soul and body.”

The official teaching of the Church condemns those who deny that it is a sacrament of healing. The Council of Trent stated:

“If anyone says that the anointing of the sick neither confers any grace nor remits sins, nor comforts the sick, but that it has already ceased, as if it had been a healing grace only in the olden days, let him be anathema.”

When the salvation of the person, under providence, calls for the postponement of death, the sacrament will bring about this recovery. The writer recalls giving the Sacrament of the Anointing of the Sick to a woman who was given to a life of sin. She had been poisoned. As the poison infected the brain, she had the impression of losing each of the external senses. She would reach for her eye and say to her mother: “Mother, here is my eye. You keep it when I am gone.” She would reach for her ear and say to me, “Here, you keep this when I am gone.” The Sacrament of the Anointing of the Sick was administered and immediately she was restored to health. The next day she came to the rectory and began leading an apostolic life which continued for many years, until her death. The anointing was for her death, but it happened to be for a postponed death.

Saint James, in describing the Sacrament of the Anointing of the Sick, puts the emphasis on the healing:

“Is one of you sick? Let him send for the presbyters of the church, and let them pray over him, anointing him with oil and the Lord’s name. Prayer offered in faith will restore the sick man, and the Lord will give him relief; if he is guilty of sins, they will be pardoned.” (James 5:14, 15)

Here it is to be noted that the people who are to benefit are not necessarily those at death’s door, but the sick. The sick man is described as one able to call in the priests of the Church. Saint James says also that the prayer of faith shall save the sick man, which is the physical side of the sacrament; the forgiveness of sins being the spiritual side.

The purpose of the sacrament is clear from the fact that the person is sick – not the body alone, nor the soul alone. All the sacraments are aimed at a single whole, made up of matter and spirit. Even the Eucharist pertains to the body, as well as the soul, for Our Lord said that He would “raise up on the Last Day” those who would receive it. Sickness has spiritual repercussions: no person can be sick in body without having his soul disturbed. The Anointing of the Sick, therefore, is to some extent psychosomatic.

Sickness and the Soul

A serious illness cuts us off from the occasion of sin. The will to sin is weakened by the physical inability to sin. It is true that many a man believes he has left the passions behind, when it is really that the passions have left him behind. This moment of enforced detachment from the allurements of the world is always an opportunity for the reception of grace.

The approach to death emphasizes the uniqueness of personality. During life we lose ourselves in the mob, in the anonymous “they,” in the masses, in “togetherness.” But the nearness of death confronts self with self: “I am I – unique – responsible for every thought, word, and deed of life.” The soul begins to see itself as it really is, and God in His mercy prepares a sacrament for this dread moment when personality is confronted with its load of sin.

Sickness breaks the spell that pleasure is everything, or that we ought to go on building bigger and bigger barns, or that life is worthless unless it has a thrill. Sickness enables us to adjust our sense of values, as an actual grace illumines the futility and emptiness of many ambitions: “What does it profit a man if he gain the whole world and lose his soul?”

There is a world of difference between the Christian in serious illness and the pagan. As Franz Werfel wrote:

“The skeptic believes in nothing more than death; the believer believes in nothing less. Since the world to him is a creation of spirit and love, he cannot be threatened by eternal destruction in his essential being, as a creature of the world.”

A man who in life never prepares for death, uses every means to conceal it, to render it unobtrusive, to disguise it, even feels awkward in the presence of death and knows not how to console those who are bereaved.

The pagan fears the loss of the body; the Christian fears the loss of the soul, knowing that the destiny of the body will be the destiny of the soul. To a pagan, this world is everything and death deprives him of all there is; to the Christian, this world is only a scaffolding through which souls climb to the Kingdom of God. When the last soul shall have climbed up through the scaffolding, then it shall be torn down and burned with fervent fire, not because it is base, but simply because it has done its work – it has brought us back again to God. Hence, to the Christian, his whole being is never threatened by death. All during life, the pagan is moving toward death; but the Christian is moving backward. He starts with the fact that he must die and render an account of his stewardship; knowing that he will die, he plans his life accordingly.

The Christian, having been signed with the sign of death, the sign of the Cross at Baptism, is committed to leading a life of mortification, which means a dying to the ego, in order that the Christ-life may be more manifest.

The Church is, therefore, constantly recommending a daily rehearsal for the great event, or tiny little deaths in preparation for the final one. No masterpiece is ever created in a day, and death itself is a masterpiece. The sculptor who wishes to carve a figure out of a block of marble uses his chisel; first cutting away great chunks of marble, then smaller pieces; finally he reaches a point where only a brush of the hand is needed to reveal the figure. In the same way, the soul at first has to undergo tremendous mortifications, then more refined detachments and little deaths until finally the divine image is revealed. Because mortification is recognized as a practice of death, it was fittingly described on the tomb of Duns Scotus: “Bis mortuus; semel sepultus” – He died twice, but was buried only once.

As evidence of how seriously the Church takes grace or divine life in the soul, in contrast to physical life, its liturgy calls the day on which saints die, their “birthday,” or natalitia. The world celebrates a birthday on the day a person was born to physical life; the Church celebrates it when a person is born to eternal life. There are three exceptions to this in the liturgy of the Church, and for very good reasons. The only physical birthdays in the liturgy are those of Our Divine Lord (December 25th), the Blessed Mother (September 8th), and John the Baptist (June 24th). This is because each of these births marked a special infusion of divine life into the world: Our Lord is Eternal Life; the Blessed Mother, through her Immaculate Conception, participated in that eternal life from the first moment of her conception; and Saint John the Baptist was sanctified in his mother’s womb, when he was visited by his Lord, still tabernacled within the Blessed Mother.

This does not mean, even for the Christian, that death has no terrors. There is still something very frightening about it. If death were merely a physical must, we would not fear it; our fear comes from the moral fact that we know we ought not to die. We fear death because we realize it was not part of the original plan. The dying Christian knows that the personal judgment at the moment of his death will be a revelation of the meaning of his personal life, just as the cosmic judgment at the end of time will be a revelation of how he lived in society.

Death is not just a mere emancipation of the soul from the limitations and burdens of the body, and a passage into a purely spiritual state, such as Plato conceived. This would completely forget the resurrection of the body. The body has had a share in the virtues or the vices of the soul; therefore, it will take on a quality after death corresponding to the quality of the soul. If a green liquid is poured into a glass, the glass looks green. If the liquid poured in is red, the glass looks red. So too, when evil is poured into the soul, the body takes on the quality of evil, and is in a state of incorruptible “corruption,” whereas the body of the person who dies in the state of grace shares in the glory of the soul.

What this glorified body will be like we do not know, except that it will correspond with the “new heaven” and the “new earth” of which the “Apocalypse” speaks. When the soul leaves the body at death, it does not leave the body’s sphere altogether. The soul still has a tendency to be reunited with the body. We put our hand on warm wax and we leave the imprint of the hand. So too, the imprint of the soul is in some way in the body, and the soul to some extent bears the body within itself. In the resurrection of the dead, God will give the soul its body-forming power, and the opportunity to build up the body will be entrusted to it, as it was meant to be.

To understand the sacrament, one must never lose hold of the fact that there is a double life: biological and spiritual. So there is a double death, death of body and death of the soul. Saint John states: “Thou dost pass for a living man, and all the while art a corpse” (Apoc. 3:1). A body may be physically alive but the soul spiritually dead. Such would be a person in the state of serious sin and alienation from God. We see corpses walking on the street every day; biological life is in them, but not spiritual life.

The real reason man dies in his flesh is because his soul, having turned away from God, has lost the dominion it once exercised over the body. One of the penalties of original sin was that the body should die. When the sinful soul is restored to the state of grace, it has its power returned potentially to effect the quickening of the flesh and the restoration of the body, but the actual rejuvenation is deferred until the last day.

In its present state, the body often depresses the soul; it restrains it in its upward flight. It is almost a cage which prevents the soul, as a dove, from flying to God. A sickness accentuates this weight, producing sometimes a lethargy in the soul. Herein is the purpose of the Anointing of the Sick: to enable the soul to be free in this life, either through the healing of the body, or else to be eventually free from the body in death, with all the traces of sin blotted out.

How the Sacrament Is Administered

In speaking of the sacrament, Saint James said that the priests of the Church were to be called in – not merely the priest. Though it is one person who is sick and one organism that is disordered, nevertheless, sickness is not considered a private affair any more than sin is a private affair. Just as one sin in a soul diminishes the sum or the content of charity in the Mystical Body, so the sickness of any one of the members of the Church, grieves in some way the fellowship of the saints. The Church, representing Our Lord, responds to this sickness in any one of her members, by sharing her own corporate wealth with the one who is ill. Her prayer is that the sick person be cured of his weakness, and if it be God’s will, be restored to the life of the Mystical Body.

The unction of the sick is a kind of a prolongation both of Baptism and of Penance, in the sense that it is a remedy for sin. It is not to be thought that the sacrament operates in the sick in the nature of a miracle, or takes the place of medical science, any more than Baptism takes the place of birth, or Holy Communion takes the place of eating. The Council of Trent said that the Anointing of the Sick was a consummation not only of Penance, but of the whole Christian life which ought to be a continual penance. The Anointing of the Sick is a sacrament of the living and, therefore, normally presupposes the state of grace, just as medicine is given only to the living, and holy oil is a medicine.

As was pointed out above, physical life may have either wounds or diseases. There is a difference between having a finger cut by a knife and a body suffering from smallpox or cancer. Penance looks more to the wounds of the soul; Anointing of the Sick more to the sickness of the body, but never apart from the soul.

The administration of the sacrament starts with the basic psychological fact that we cannot think of a single sin that ever got into our soul that did not come through our body. The sin of envy, for example, comes through the eyes; we may have seen how much more the Joneses have. The sin of pride, in like manner, often comes from the eyes, as one makes a comparison between how much richer, smarter, or more beautiful one person is than another. Drunkenness, adultery, robbery, blasphemy – we often walk into these occasions of sin. Even the nose contributes to sin and to vanity, either through the smell of good food leading to gluttony, or through perfumes which, according to advertisements, are allurements to sin.

Just as physical diseases leave certain marks on the body – tuberculosis leaves spots on the lungs, smallpox marks on the face, leprosy scars – so too, sin leaves behind some traces in the senses and in the body. The spiritual scar of every sin is evident from the fact that one feels weaker after the sin than before, and less resistant to wrong. Other diseases or viruses leave little “tails” – not speaking scientifically – or traces of their existence in the body. Just as sewers become clogged and chimneys sooted and ships contract barnacles, so too, the germs of sin leave little “tails” behind, which are remnants or relics of the rebellion which ravished the soul and the body. Though an alcoholic may give up his alcohol and repent for his sin, alcoholism may remain in the body in marred and ruined organs.

The Church now comes along in a serious illness, not only to blot out the sin, which is done primarily in the Sacrament of Penance (also here if Penance cannot be received), but also to cleanse away the remains of sin. Because sin came into the soul through the eyes, ears and nostrils, mouth, hands and feet, the Church lays hold of these senses and organs which in some way cooperated with the soul in sinning. It prepares the soul either for the restoration to the Mystical Body of Christ or for a passage to God. The poor member of the Church is covered with the dust of action and the spatterings of life, with the mire and dregs of half-fought battles, with the weakness of swords half-drawn; with one eye toward the world and the other toward Christ. That is why the Church prays: “Remember not, then, his old sins, nor the excesses to which anger or the fervor of an evil will has led him. For, though he has sinned, yet he has not denied Thee, O God.”

When the eyes are anointed, the priest says: “By this holy anointing and with His holy loving Mercy, may the Lord forgive you whatever wrong you may have done by the use of your sight. Amen.”

When the ears are anointed, the priest says: “By this holy anointing and His most loving Mercy may the Lord forgive you whatever wrong you have done by the sense of hearing. Amen.”

When the nose is anointed, the priest says: “By this holy anointing and His most loving Mercy, may the Lord forgive you whatever wrong you have done by your use of the sense of smell. Amen.”

When the mouth with closed lips is anointed, the priest says: “By this holy anointing and His most loving Mercy, may the Lord forgive you whatever wrong you may have done by the use of the sense of taste and the power of speech. Amen.”

When the hands are anointed, the priest says: “By this holy anointing and His most loving Mercy, may the Lord forgive you whatever wrong you may have done by the use of the sense of touch. Amen.” The priest on dying is anointed on the back of his hands, his palms having been anointed in Holy Orders. The lay person is always anointed on the palms.

When the feet are anointed, the priest says: “By this holy anointing and His most loving Mercy, may the Lord forgive you whatever wrong you may have done by the use of your power of walking. Amen.”

In the following prayer which the Church recites, there is no mention of death:

“Cure, we beseech Thee, our Redeemer, by the grace of the Holy Sacrament, the ailments of this sick man [woman]; heal his wounds and forgive his sins. Deliver him from all miseries of body and mind; mercifully restore him to perfect health inwardly and outwardly, that having recovered by an act of kindness, he may be able to take up his former duties. Thou, Who with Father and the Holy Spirit, liveth and reigneth God world without end. Amen.”

If the illness is to last for some time, the sacrament gives to the sick person the necessary grace to endure his sickness in the spirit of holiness; it also remits to some extent the temporal punishment that is due to sin. There have not been wanting some theologians in the past who have held that, if received with great faith, it remits all temporal punishment due to sin, and in case of death, prepares the soul for heaven.

In this sacrament, sins are not remitted in virtue of an act of jurisdiction or by judicial sentence, as they are in the Sacrament of Penance. Why? Because with serious illness there is the possibility of passing into another community; that is, from the Church Militant to the Church Suffering or the Church Triumphant. The soul particularly in danger of death is about to go before the throne of the Eternal Judge and, therefore, to Him alone is reserved the jurisdiction or the judgment of the Sacrament of the Anointing of the Sick. That too is why, in the administration of this sacrament, there is more of the imprecatory form of prayer than in Penance. The priest puts the prayer in the form of a petition because he is exercising his power only as a delegate of the Church Militant. In the Sacrament of Penance, the priest said: “I absolve you from your sins”; in the Sacrament of the Anointing of the Sick, “May the Lord forgive you any sins, etc.” The measure of the distribution of grace here is left entirely to the merciful Love of God.

Because oil is used in the sacrament, it must not be forgotten that oil has a double purpose – strengthening and illumination or enlightenment. The aspect of strengthening has already been mentioned, but enlightenment also comes with this sacrament: it sheds a new outlook on the meaning of death. Many who receive this sacrament have the fear of death taken away from them, and may even desire it, as Saint Paul said: “I desire to be dissolved and be with Christ.”

This comes from a higher wisdom of the soul, because it has been purified of the remains of sin. Just as we see what is outside a window more clearly when the window has been washed, so too, our soul more clearly sees the purpose of life once the senses and soul have been purified. Saints very often undergo in life, through a great penance, what is called a “dark night of the soul.” Thanks to this dark night, they then arrive at a kind of mystical union with God, or even a mystical espousal. Thanks to the anointing of this sacrament, one may also pass through a dark night of the soul, but in a much shorter period of time, and one looks forward to mystical union with Christ. Therefore, there can take place in the soul, in a very short space of time, both the purgative and illuminative way at the last moments of life: a cleansing of the soul and a greater vision of the glory and beauty of God.

The spiritual life would be terrible if the Good Lord had not instituted this sacrament for an illness, which is a rehearsal for the final battle of life. Thanks to it, the Church takes us in her maternal arms and shows us heaven saying:

“My children, here is your fatherland. Come with me. If it be God’s Will, we will cross over this arid desert of life together, and we will confide you to the angels who will carry you through to your eternal repose.”

The Viaticum

The Sacrament of the Anointing of the Sick is not the sacrament of the dying or, in the strict sense of the term, the “last sacrament.” In the Liturgy of the Church, the Sacrament of the Anointing is given before the Eucharist; when the latter is administered to the dying it becomes the “last sacrament.” This is very fitting, for the Sacrament of the Eucharist has reference to the body as well as to the soul. Our Blessed Lord said that those who received Him in the Eucharist would be assured of the resurrection of the body. Furthermore, in the Mass there is a prayer immediately before Communion, which begs that the Eucharist “may be to me a safeguard for body and soul, and a remedy.”

When given to those who are dying, the Eucharist is called Viaticum, which means “going with you” on the way to eternity. The Eucharist deposits in our body “a seed of immortality.” It is a provision for the journey to eternity, when one is at the door of death. The Church makes its reception at this moment a matter of grave obligation, even more strict than the anointing of the sick.

The Viaticum received in danger of death, just as the Eucharist received in life, is social in its implications. There is not merely the union of Christ and the soul, but there is also the union of the sick with the whole Church. The dying person, if he is in a state of grace, is leaving the Church Militant on earth for either the Church Triumphant in heaven or the Church Suffering in purgatory. Hence, when a priest places the Eucharist on the tongue of the recipient, he says: “Receive, brother, [or sister] the Viaticum of Our Lord Jesus Christ that He may preserve thee from the malignant enemy and bring thee to everlasting life.” The reference to “brother” or “sister” refers to the family and the fellowship of the Church and the saints. There should even be a solemnity about the last Communion, as there is about the First Communion. The family should gather about the one who receives the Viaticum, and its solemnity is increased when administered by the pastor himself who is the head of the parochial community.

The Catholic who is dying is never lonely because there is another rite connected with the Viaticum; namely, the commending of the soul to God. The priest gives him a crucifix to kiss while an invocation is said to the Cross: “We adore Thee, O Christ, and we bless Thee, because by Thy Holy Cross Thou has redeemed the world.” As the moment of death approaches there is the official discharge to the dying:

“Go forth, Christian soul, out of this world, in the Name of God, the Father Almighty, Who created thee; in the Name of Jesus Christ, the Son of the Living God, Who suffered for thee; in the Name of the Holy Spirit, Who has poured forth upon thee…. May thy place be this day in peace and thy abode in holy Sion.”

Then the Church calls on the angels and the saints:

“May the Angels lead thee into Paradise. At thy coming, may the Martyrs receive thee and lead thee into the holy city, Jerusalem. May the choir of Angels receive thee, and with Lazarus, who was once poor, mayst thou have eternal rest.”

Death is one of the penalties for sin but, when accepted, it becomes an atonement also for sin. Every Christian knows that it is not just a happy life that one must seek for, but also a happy death. Hence, he prays that he may be fortified by the sacraments, and that he may be fully conscious when he receives the last rites, in order that he may, as it were, peer through the door of heaven to his eternal reward.

– from These Are The Sacraments, by described by Venerable Fulton John Sheen, 1962; published by Hawthorn Books of New York; Nihil Obstat: William F. Hogan, S.T.D., Censor Librorum; Imprimatur: James A. Hughes, J.C.D., LL.D., P.A., Vicar General, Archdiocese of Newark, 22 October 1962; Scripture quotes are from the Knox translation of The Holy Bible