The anointing of the sick is a sacrament closely associated with that of reconciliation, and follows the example of Christ who showed his love for the sick and sinful by healing them and forgiving their sins (e.g. Mark 2: 1—12). Both then in his earthly ministry and now through that of the Church, the remission of sins and the care for the sick announce that the kingdom of God is already powerfully working to bring the whole human family to its final fulfilment. When Mark recalls how Jesus sent the Twelve on a trial mission for the kingdom, we see the same care for the sick and sinful: 'they proclaimed the need for repentance, drove out many demons, anointed many sick people with oil, and cured them' (Mark 6: 7-13).
After the resurrection of Jesus from the dead and the coming of the Holy Spirit, the Acts of the Apostles reports many healing miracles worked through the mediation of Peter, Paul, and others. When Paul, for instance, spent three months on Malta as a prisoner en route to Rome, he visited the sick father of Publius, the island's chief official; Paul prayed, laid his hands on the sick man, who had been suffering from recurrent bouts of fever and dysentery, and cured him. This gesture recalled the tender care of Jesus in touching and curing the sick and suffering (e.g. Mark 1: 40-2; Luke 13: 11-13). After the healing of Publius' father, Paul also cured other sick people on the island (Acts 28: 7-9)—the last examples of a healing ministry,
177 See R. Arbesmann, 'The Concept of "Christus Medicus" in St Augustine', Traditio 10 (1954), 1-28. For a summary account and basic bibliographies, see 'Penance', Oxford Companion to Christian Thought , 528-9; and 'Penance', Oxford Dictionary of the Christian Church , 1250-1. On the contemporary situation see D. M. Coffey, The Sacrament of Reconciliation (Collegeville, Minn.: Liturgical Press, 2001).
which come at the very end of Luke's two-volume work on Christian origins. The ministry to sick people carried on by Jesus and then by his followers belongs essentially to the proclamation of the kingdom of God, a theme that runs through the Gospel and serves to close the whole story Luke wants to tell (Acts 28: 31).
As a sacrament, the anointing of the sick took shape from the practice of Jesus and his first followers, and was inspired, in particular, by a passage from James:
Are any among you sick? Let them call for the elders of the church and have them pray over them, anointing them with oil in the name of the Lord. The prayer of faith will save the sick and the Lord will raise them up; and if they have committed sins, they will be forgiven. Therefore confess your sins to one another, and pray for one another, so that you may be healed. (Jas. 5: 14—16; italics ours)
James invited the entire community to acknowledge to one another their sinfulness and intercede for one another. The 'elders' had the specific role of 'praying over' the sick and anointing them with oil, understood to be endowed with special power from the Spirit. As the four italicized verbs indicate, believers should expect the power of the risen Lord to be at work to save, raise, forgive, and heal the sick and sinful.
From the early third century the Apostolic Tradition included a blessing for oil to be used for anointing the sick (5. 2). Innocent I, when writing in 416 to the bishop of Gubbio, quoted James 5: 14—15 and spoke of the ministry to the sick. The bishop was instructed to bless the oil to be used; yet the sick could be anointed not only by bishops and priests but also by any Christians (DH 216; ND 1603). The Pope, relying on the Letter of James, talked of 'the sick' as being candidates for this anointing. But neither James nor Innocent I excluded anointing those whose illness had brought them to death's door. During the first millennium the sacrament became associated with the end of life and hence called 'extreme unction'. Penance before readmission to the Eucharist, as we saw from the letters of Basil, could last fifteen or twenty years, and, as in the case of apostates who repented, even a whole lifetime. Some sinners preferred to delay their request for the sacraments until they were dying; they feared lapsing back into sin after receiving a 'once-in-a-lifetime' absolution. Thus absolution, anointing with oil, and Eucharist were administered to those on their deathbed or 'in extremis'.
In 1439 the Council of Florence reflected the shift from the anointing of the sick to 'extreme unction': 'this sacrament may not be given except to a sick person whose life is feared for'. The minister for the sacrament is a priest, and 'its effect is the healing of the mind and, as far as it is good for the soul, of the body as well' (DH 1324—5; ND 1613). It was customary in the fifteenth century for a priest to be accompanied by a procession of believers when he visited the dying. After the whole group arrived, the dying received absolution, the Eucharist as viaticum or food for the journey into the next life, and extreme unction, in that order. When the sick came near death, some or all of the penitential psalms were read, as was one of the Gospel accounts of Our Lord's passion and death. A commendation for a dying person and prayers for the dead developed, along with prayers for the bereaved after a person died. This tradition of prayers with and for the dying remains in the current rituals of the Church.
In the sixteenth century the Council of Trent followed the teaching of Florence when insisting on the sacramental status of 'extreme unction' against Luther, Calvin, and other Protestant Reformers, who appealed to the permanent efficacy of baptism throughout Christian life. Trent stated that the sacrament is 'to be administered to the sick, especially to those who are so seriously ill that they seem near to death; hence it is also called the sacrament of the dying'. Thus it 'protects the end of life' with 'a very strong safeguard'. Trent summed up the effects of this sacrament: 'it confers grace, remits sin, and comforts the sick'. Without condemning him by name, the Council maintained against Calvin that 'the elders' of James 5: 14 are 'priests ordained by a bishop' and not simply 'senior members of a community' (DH 1694, 1698, 1717, 1719; ND 1635, 1638, 1657, 1659).
When restoring the original name of the sacrament, 'the anointing of the sick', the Second Vatican Council emphasized that 'it is not a sacrament only for those who are the point of death'. It can and should be received by those suffering from serious illness and the onset of old age (Sacrosanctum Concilium, 73). Through the 1972 renewal of the rite for the anointing of the sick, this sacrament has come to be celebrated much more frequently, and with a number of people often receiving it together in church. When the sacrament of anointing is celebrated at home or in a hospital room, its ecclesial dimension is brought out by the presence of the family and other caregivers. They take their proper place in the liturgy, with readings, songs, and prayers. If the sick person receives communion, the rest of the assembly should do so as well. This renewal of the sacrament has also encouraged suffering Christians to find, through faith in the crucified and risen Christ, a spiritual value in their pain that can contribute to the good of the Church and the whole world. While maintaining the promise of saving and healing expressed by the Letter of James, the new rite invites the sick and the old to let their suffering become part of the passion and redeeming mission of Jesus.
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