ON THE SACRED LITURGY
SOLEMNLY PROMULGATED BY
POPE PAUL VI
ON DECEMBER 4, 1963
73. "Extreme unction," which may also and more fittingly 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 him to receive this sacrament has certainly already arrived.
74. In addition to the separate rites for anointing of the sick and for viaticum, a continuous rite shall be prepared according to which the sick man is anointed after he has made his confession and before he receives viaticum.
75. The number of the anointings is to be adapted to the occasion, and the prayers which belong to the rite of anointing are to be revised so as to correspond with the varying conditions of the sick who receive the sacrament.
I was ten years old when Pope Pius XII lay dying behind the Vatican City walls in October 1958, and Catholics here in the U.S. naturally followed reports of his condition from the big networks like CBS and NBC. [Cable news was several decades in the future.] Reporters who generally did not cover Catholic affairs were not fully prepared for their on-camera reports, and one man breathlessly reported that Pope Pius was suffering from “extreme unctions.” My parents and relatives found this funny, and even I, armed with my Baltimore Catechism, caught the blunder. However, the mention of Extreme Unction on TV was recognized by informed listeners and viewers as an indication that the pope would be dead very soon.
Paragraph 73 of Sacrosanctum Concilium is an important theological and catechetical breakthrough for the Church, for it replaces the name “extreme unction” [from the Latin, “last anointing”] with the more inclusive “anointing of the sick.” The document states that this anointing is no longer reserved for those at the point of death, but also for those “in danger of death from sickness or old age.” In short, the sacrament engaged the ill, not just the dying. In the half century since the new rites for the sick were promulgated, A question for catechetics and pastoral practice is whether Catholics as a rule understand the broadening of sacramental opportunities for the ill and issues about the appropriate times and ways to celebrate this sacrament.
The history of the Sacrament of the Sick is quite complicated, but the sacramental historian Joseph Martos, in his Doors to the Sacred  indicates that late in the first millennium the anointing was a rite of physical healing and was not always performed by a priest. The anointing was granted to anyone who was ill or injured. The surviving lists of illnesses addressed by this sacrament include everything from fever to derangement. I suppose that with the medical care available in 800 A.D., most illnesses were potentially fatal. But Martos is careful to add that if an individual believed he was truly dying, he did not request the anointing. Rather, he sought sacramental reconciliation [or Penance] and the Eucharist. [p. 383]
There was a time in church history when pastoral practice included an anointing in the penitential rite to drive out evil spirits, such that anointing and absolution were for practical purposes indistinguishable. [Later, communion to the dying was called viaticum [Latin, “food for the road” or the journey]. Consequently, the anointing at death carried an almost entirely penitential cast into the twentieth century. The writings of the great high medieval doctors of the Church, St. Thomas Aquinas, St. Bonaventure, and St. Albert the Great agreed that the anointing, confession, and final reception of the eucharist composed the final acts of a human believer, and thus should be administered only at the moment of death. Again, Martos states that very few people in the Church ever received this triptych of sacramental experience in medieval times, due to geographic distances, cost, and the penitential acts they were bound to perform if they should-to their misfortune--recover.
The reform Council of Trent [1545-1563] continued to use the term Extreme Unction, and when this anointing was celebrated with confession and the final reception of communion, the collective term “last rites” came into use, and this term was widely used into my adulthood. In 1972 the post-Vatican II reformed rite referred to the sacrament as “The Anointing of the Sick.” Prior to 1972 the strengthening oil was viewed as a spiritual boost or strengthening for the journey to judgment; given that at various times in history one of the effects of Extreme Unction was believed to be the forgiveness of sins, the celebrant has always been a priest, though the two are separate sacraments.
The 1972 revision ordered in paras. 73-75 reflects the wisdom of considering greater pastoral application of this sacrament, i.e., that it does more good for a greater number of people. Specifically, the Church returned to its biblical roots where anointing brought physical as well as spiritual comfort. By the 1970’s the practice of holistic medicine raised awareness of the patient’s state of mind as a key component of recovery, remission, and/or reduction of pain. Those of us ordained in this era were generally comfortable with this interdisciplinary approach to pastoral care. When I graduated, I had formed a philosophy of celebrating this sacrament whenever illness or injury significantly altered the life of a baptized Catholic, regardless of whether death was imminent or not. The new ritual envisioned anointing with at least some members of the family and/or parish gathered round to hear the Word of God and to earnestly pray for the good of the sick individual as the priest performed the anointing with oil blessed at the Chrism Mass of Holy Thursday at the Cathedral.
For several decades afterward, parishes and institutions offered communal sacramental celebrations of the anointing of the sick. Such services were particularly appropriate in Catholic elder-care facilities where the danger of death was at least remotely more imminent and the pains of advancing age bringing mental and physical discomfort to the general population. I have no hard numbers, but my guess is that today fewer parishes have public sacramental anointings. To be honest, I haven’t heard a homily or public instruction on the Sacrament of the Sick in many years.
In one of those ironies of life, I became more theologically and clinically interested in the pastoral practice of this sacrament after I left the active priestly ministry and engaged in mental health practice. I was asked on numerous occasions in substance abuse facilities if recovering alcoholics, for example, could receive this sacrament. This was during the period when medical discussion of addiction started using the term “disease” to describe addiction and dependency. The Twelve-Step AA Program utilizes a secular progression to conversion, recovery, forgiveness, restitution and service that interfaces very well with existing Catholic sacraments and practices; use of the Sacrament of the Sick may be redundant unless there are other factors in play, such as grave illness.
Concurrently, while teaching sacramental courses for my diocese, I had to admit that “being old” is not a disease in its own right. [The chaplain of the Loyola of Chicago’s men’s NCAA basketball team is a 100-year-old Catholic religious sister.]
While the Church statements on this sacrament are clear enough, developments of full Catholic pastoral care of the sick cover multiple topics and needs and their development continues to this writing. My parish and others are developing pastoral support programs for care givers, many of whom are relatives caring for the ill and aged in their own homes with modest resources and little support. At this juncture it is probably best to say that the Sacrament of the Sick, the formal ritual extension of Christ’s healing ministry, is the summit of a multitude of pastoral services offered by the Church in a variety of places, needs, and settings.
This news story may have slipped under the radar, but the Pew Research Center recently studied the role of the Eucharist in the current practice of American Catholics. The results were released on Monday past. PEW, an independent researcher, dared to ask questions that the Catholic research center CARA may have feared to go, for the subject of this study cuts to the heart of a central Catholic belief.
Pew has done a number of studies on the Church before, and its religion staff is highly competent in matters Catholic. It has tracked the decline in Mass attendance in the U.S. over the years, and it may have been the dramatic statistical decline in Mass attendance that led its staff to examine a correlation between attendance and the most significant act of Sunday worship, receiving the Eucharist, the actual Body and Blood of Christ in holy communion under the form of bread and wine. It appears that a majority do not think of the Eucharist in this fashion.
In a sampling of over one thousand self-identified Catholics around the country, Pew discovered that only 31% of Catholics believe in Transubstantiation, the doctrine which holds that the bread and wine, by virtue of the Eucharistic Prayer, becomes the true and living Body and Blood of Christ, human and divine. The majority hold that the consecrated bread and wine, and its distribution, constitute a useful symbol of fellowship but do not believe that Christ is truly alive in the sacred food. Pew went on to question further how personal belief was formed along these lines. In looking at all available subsets—frequency of Mass, age, education, etc.—50% of Catholics do not know what the doctrine of Transubstantiation is, let alone that it is a central doctrine or essential teaching. Put another way, those who identify as Catholics do not know that communion is a real encounter with God. The full Pew statistics are here.
As I mentioned above, this story is getting erratic coverage. I have gone to many of my ordinary Catholic sources and come up pretty much empty. The news page of the USCCB has a link and presumably a commentary, but you must be a member of the Conference on-line services, which cost about $125 when I last checked. Only the Archdiocese of Philadelphia’s newspaper had a news story, and its prime source is a YouTube video featuring a response by Bishop Robert Barron, a piece that appeared within a day or so of the Pew’s study publishing.
Barron is a member, of course, of the United States Conference of Catholic Bishops [or USCCB] in his active status as Auxiliary Bishop of Los Angeles. But prior to his episcopal ordination, Barron developed the outstanding “Word on Fire” ministry of Catholic catechetical and evangelical ministry on YouTube from his home base of Chicago. Even after his elevation to the American College of Bishops, he continues to speak out clearly and forcefully on issues in the Church. I reviewed his Letter to a Suffering Church: A Bishop Speaks on the Sexual Abuse Crisis a few weeks ago here at the Café, a work which should have been written by the entire USCCB.
When the Pew study hit the streets a week ago, Barron—speaking again in his own name, as was true of his book—was first bishop to publicly acknowledge the results. In his post on YouTube this week, we see a very angry man, a righteously angry man. He states for the record that he is not angry at Pew but at the Church itself, citing a breakdown in religious education and the failure of clergy and bishops to preach and explain a belief that, theoretically, should hold us together. I agree that the content, format, and quality of religious education has reached a point where anything resembling a handing on of faith is grinding perilously to a halt. I suspect that Bishop Barron, fresh off his book about sex abuse, realizes that the Church’s credibility to teach its key beliefs has been so sorely wounded by events of recent decades that its teaching tradition may take generations to restore. This is my guess—very few of his bishop colleagues want to acknowledge this.
The results did not surprise me. In fact, the next time you attend Mass, observe the body language of those in the congregation—entering, genuflecting, socializing, dress styles, etc. Do we look and act like a people in the presence of the Almighty? One blog poster caught my eye in a humorous vein: a woman wrote that if we believed that God was really in the tabernacle and the bread and wine we consume at Mass, we would be genuflecting on both knees at least three times in the parking lot before we reached the door of the church.” Hyperbole, to be sure, but the point is taken.
The term “transubstantiation” to describe the change of the bread and wine into the body and blood of Christ deserves a better treatment than I can provide today. Some of the ultraconservative websites are calling for a return to the pre-Vatican II ritual and the elimination of lay eucharistic ministers, communion in the hand, lay persons’ [particularly women’s] removal from the sanctuary, installing communion rails, etc. as “remedies” to lack of understanding of the Eucharist. My suggestion—a strategy I actually incorporated into the construction of a new church three decades ago—was the separation of the church building into the main worship assembly and a separate chapel for Eucharistic adoration. Most churches in use today are elongated Eucharistic reservation chapels where reverence for the sacred species must constantly be balanced with the communal nature of sacraments, like the elderly who attend Mass and embrace one another’s company without a thought in front of the tabernacle. One man’s disrespect is God’s delight.
Scripture, which is quite clear on the nature of the sacred food, is equally clear on the interpersonal nature of the Eucharistic sacrament. Real Presence is denied primarily when the Mass is celebrated by clerics and laity without charity and fraternal concern. As Bishop Barron concludes, those who most love the poor, most ardently love the Lord in the Eucharist as well.
For more discussion on this topic, here is a link to my former teaching colleague, Amy Welborn, and her blogsite Charlotte Was Both. Amy has been a first-rate blogger for about two decades now and worth following.