The Sacrament of Anointing is a sacrament of healing and of forgiving. Both have their origin in the life and works of Jesus.
All four Gospels recount healing “miracles” performed by Christ. The Gospels also provide a context for understanding the significance of these works. The evangelists clearly wish to avoid portraying Jesus solely as a “healer.” The closely connected healing miracles and exorcisms in the Gospel of Mark are cast in cosmic settings to demonstrate Jesus’ power over evil, sickness, and even death. For Matthew, Jesus’ miracles signaled the advent of the Messianic Age. Luke’s re-telling of Jesus’ healing ministry is particularly sensitive to our Lord’s compassion. John does not use the term “miracle” but calls the wondrous deeds of Jesus “signs” which tell us who Jesus is and what he is for us. John and those so disposed could perceive the true identity of Jesus and come to believe. In each Gospel, the miracles reveal something about the identity of Jesus.
The New Testament mentions a healing ministry in the early Church. James 5:14-15 specifically speaks of an anointing of the sick performed by leaders in the community. Many scholars also assume that Mark 6:13 actually reflects the early Church’s practice of anointing. However, while a healing ministry did exist both in the life of Jesus and in the early Church, there was as yet no set form for a sacrament of healing. Paul’s Corinthian correspondence implies the presence of a charismatic gift of healing, while James’ epistle infers a more ecclesiastical healing ministry.
References to Christian healing (usually by prayer and an anointing with oil) by both Hippolytus and Tertullian make it clear that this ministry continued during the early Patristic Period. In the 3rd and 4th Centuries, however, Origen and John Chrysostom interpreted the passage in James as a reference to spiritual rather than physical healing. This spiritual/physical dichotomy would have been foreign to the Jesus, who as a Jew, would have viewed healing as affecting the whole person.
A switch happened from prayer of faith accompanied by anointing. Now prayer over the oil takes precedence. Ceasarius of Arles refers to holy oil as “the medicine of the Church.” Christians used it to anoint one another, as well as themselves. Its use was highly unstructured. At times it was drunk. At times it was used to rub on the diseased or painful parts of the body. For many Christians of the Patristic Period, holy oil replaced magical means of healing formerly used in pagan contexts. It was used to put demons to flight. The same oil used to anoint the sick was also used for exorcism on cattle, in stables, and in dangerous places. Pagan folk medicine was christianized.
In the early 5th Century Pope Innocent I wrote to Bishop Decentius of Gubbio concerning anointing (Denz.- Schon. 216). He said that oil prepared by the bishop could be used not only by the priests, but also by the laity whenever there was need for anointing. In the late Patristic Age, the laity were still ministers of this rite, along with the clergy. The effects of anointing with holy oil continued but diversity of opinion concerning its use grew.
The most dramatic shift in the theology of anointing came during the Carolingian Period. In the rituals for the pastoral care of the dying, one received the Sacrament of Penance followed by anointing. At the time of Charlemagne, anointing followed the Sacrament of Penance. By the 10th Century Penance and anointing was commonly received only by those on their deathbed. In this rite the reception of the Eucharist followed. Soon the order of these “Last Rites” changed, and the anointing was done after Viaticum (so named because the final reception of Eucharist was to be “food for the journey”. This anointing was called “Extreme Unction” from the Latin extrema unctio, the “Last Anointing”. What once had been the Sacrament of Healing was becoming a sacrament of the dying. Because of this new association of anointing with the Sacrament of Penance, the administration of anointing became reserved to the clergy. This clericalization of ministry also fitted well into the class-consciousness of feudal society.
By the 12th Century, all references to physical healing were dropped from the prayers, and the sacrament took on an increasingly penitential character. Prayers for the forgiveness of sins were recited in place of the earlier prayers for healing. Previously, only the part of the body in need of healing was anointed. Now it had become a practice to anoint each of the five senses, the hands and the feet, reflecting the idea that the senses were the principal causes of sin. However, even though references to physical healing were no longer found in the prayers, it was not completely forgotten. In 1215 the Fourth Lateran Council, with an awareness of psychosomatic realities that is surprisingly modern, decreed that doctors should call the clergy to minister to the sick, because sickness is sometimes related to sin. The council recalled the Jesus warned the paralytic he had cured, “Sin no more, that nothing worse befall you.” (John 5:14)
This emphasis on the forgiveness of sins nevertheless created a theological problem concerning the unique effects of the sacrament. The Church already viewed Penance as the sacrament of forgiveness. Several Franciscan theologians speculated therefore that Extreme Unction specifically forgives only venial sins. Some Dominican theologians felt that the Sacrament of Anointing eliminates the “remnants of sin,” sinful habits which may remain even after the guilt has been forgiven. Both understandings eventually were incorporated into the scholastic theology of the sacrament.
In the 16th Century, the Council of Trent made an effort to restore the earlier meaning of anointing. Bishops overruled a first draft proposal which limited the sacrament “only to those who are in their final struggle and who have come to grips with death.” Instead, the final draft said that anointing is to be used for the sick, particularly those who are dangerously ill. Trent’s listing of the effects of the Sacrament of Anointing reflects a rich appreciation for the physical and psychological as well as the spiritual dimensions of the human person. In spite of this, anointing continued to be viewed by the faithful as a sacrament for the dying.
The Liturgical reform called for by Vatican Council II continued the reform of the sacrament. The prayer recited during the anointing again made reference to physical healing. The Council encouraged anointing at the onset of illness rather than only when one was at the point of death. Instead of anointing the five senses, the priest now anoints the forehead and hands. Furthermore, whereas anointing was part of the last rites, it was now to precede Viaticum. Viaticum, rather than anointing, is the principal Sacrament for the Dying.
Perhaps the most significant post-conciliar reform concerns the context in which the Sacrament of Anointing is addressed. The new Rite of 1983 and the new Code of Canon Law speak of anointing as one element in the pastoral care of the sick. Consideration is given to the complementary dimensions of such pastoral ministry as frequent visitation by a priest sharing a Scripture reading, prayer with the sick, counseling, Eucharist, and the Sacrament of Penance (Reconciliation). Furthermore, a sensitivity is assumed for the concerns and needs of the family of the sick and dying.
Theologically, these changes represent a return to the holistic notion of the human person embraced by the Hebrew people. Inner and outer healing are considered the principal effects of the sacrament and both are intimately connected.
Even the dimension of forgiveness, which the Church attached to the sacrament in the beginning of the Second Millennium, can be understood as contributing to the healing of the whole person. Mark made this connection in his re-telling of the healing of the paralytic (Mark 2:1-12). In this account, Jesus forgives sins even as he heals. The physical healing is a sign of the spiritual healing. More importantly, this integral healing is rooted in the suffering, death and resurrection of Jesus. By grounding this sacrament in the Paschal Mystery we are able to see the relationship of the Sacrament of Anointing, and all sacraments, to the redemptive work of Christ through the Church.
The Sacrament of Anointing of the Sick should be part of the overall care and concern of the Church for the sick of the community. This care includes visits to the sick and prayers for their well-being.
The Sacrament of Anointing is appropriate for those whose health is seriously impaired by sickness, or for those weakened by advanced age. This includes persons who are seriously ill whether at home, in hospitals or in nursing homes, as well as sick children who are old enough to experience benefit from the sacrament.
The nature of this sacrament asks for celebration at the beginning of a serious illness. To postpone anointing conveys the faulty impression that this is a sacrament for the dying.
The Sacrament of Anointing of the Sick should be celebrated at the beginning of a serious illness. Viaticum, celebrated when death is close, will then be better understood as the last sacrament of Christian life. (PCS 175).
The actual time of the anointing should be chosen in consultation with the family and the sick person so that a convenient time may be chosen for all to participate. It should be done before scheduled surgery.
The Sacrament of Anointing may be celebrated in the sick person’s room, at home or in the hospital. It may also be celebrated in the parish church or hospital chapel. Consideration should be given to the condition of the patient, others in the room, the space available and the needs of a real celebration.
If the sick person(s) wishes to celebrate the Sacrament of Penance, provision for this is made prior to the celebration of anointing.
The Sacrament of Anointing of the Sick may be repeated if the sickness recurs or if the condition becomes more serious.
Persons who are already dead are not to be anointed. Rather, the priest will say the “Prayer after Death.” (PCS, #221)
It is recommended that the priest be prepared to celebrate the Sacrament of Anointing of the Sick when visiting the sick in a hospital or nursing home. Diocesan guidelines for Nursing Home Ministry (Diocesan Journal, IV, 10, 13, February 1990) recommend communal anointing on at least a quarterly basis.
Anointing of the Sick will be celebrated in parishes at least once or twice annually during Mass after appropriate preparation of the congregation. On these occasions it is desirable that a special effort be made to bring shut-ins and residents of nursing homes to the parish church, if their condition permits. On such occasions the sick, surrounded by the Church in the person of their family or friends, can receive special support and encouragement from the faith community. (NCD, #128).
This celebration may occur during Ordinary Time, even on Sunday. Appropriate readings are found in the Lectionary (2nd Edition #s 790-795), and in the Pastoral Care of the Sick Rites of Anointing and Viaticum, pp. 286 ff.
“All baptized Christians who are able to receive communion are bound to receive viaticum by reason of the precept to receive communion when in danger of death from any cause. Priests with pastoral responsibility must see that the celebration of this sacrament is not delayed, but that the faithful are nourished by it while still in full possession of their faculties.” (PCS 27)
The Sacrament is intended for those seriously ill because of sickness or old age. Patients undergoing surgery on account of serious illness, or elderly persons who are in a weak condition though not seriously ill, and children who are seriously ill and have sufficient understanding may receive this sacrament. Since this is a departure in many respects from the Church’s practice in the past, catechesis is imperative concerning the Christian interpretation of sickness and healing. (CCC 1491-1532)
The Sacrament of Anointing of the Sick is intended to comfort the sick in time of anxiety, to encourage them to fight against illness and perhaps to restore them to health.
When the sick person recovers after being anointed and, at a later time becomes sick again.
When, during the same illness, the condition of the sick person becomes more serious.
In the case of a person who is chronically ill, or elderly and in a weakened condition, the sacrament of anointing may be repeated when in the pastoral judgment of the priest the condition of the sick person warrants the repetition of the sacrament (PCS #102)
The practice of Indiscriminately anointing numbers of people simply because they are ill or have reached an advanced age is to be avoided. Only those whose health is seriously impaired by illness, or old age are proper subjects for the sacrament. (PSC 108)
Sick children are to be anointed if they have sufficient use of reason to be strengthened by the Sacraments. In case of doubt, the Sacrament of Anointing is to be administered. (PCS 12, CIC 1005)
For persons who no longer have the use of their faculties -- but as Christian believers would have asked for the sacrament – may be anointed. (CIC 1006)
Persons who are already dead are not to be anointed. Instead the priest should pray for them and for strength for their families. Samples of appropriate prayers are found in the ritual.
Christians who regain their health after anointing give thanks to God for this gift.