Should Anointing of the Sick be given before surgery?

JUL. 9, 2011 (http://newtheologicalmovement.blogspot.com)  -  Is any man sick among you? Let him bring in the priests of the church, and let them pray over him, anointing him with oil in the name of the Lord. And the prayer of faith shall save the sick man. (James 5:14-15)

“The Sacrament of the Anointing of the Sick is given to those who are seriously ill.” (Paul VI, Apostolic Constitution Sacram Unctione Infirmorum, 30 Nov 1972)

“It is fitting to receive the Anointing of the Sick just prior to a serious operation.” (CCC 1515)
Happily, the sacrament of Extreme Unction is no longer (in the popular thought of the faithful) relegated solely to the last moments of life, but is celebrated much more conveniently when the sickness first begins to seriously threaten life. Most unhappily, a widespread confusion has occurred as to the whether (and, as the case may have it, why) the sacrament of Anointing is to be given before serious surgery.

Many of the Christian faithful (indeed, even many of the priests) are of the mistaken opinion that serious life-threatening surgery is, in itself, a cause for the administration of the sacrament of Anointing. This confusion could be perpetuated by the brief words of the Catechism of the Catholic Church (as reproduced above), but can be easily corrected if we consider the nature of the sacrament.

As we shall see, serious (and even life-threatening) surgery is not a cause for the reception of Anointing of the Sick. Likewise, other foreseen life-threatening events (such as deployment for military service or capital punishment) do not render a person fit to be a recipient of this sacrament.

What is this sacrament?

The sacrament of Anointing of the Sick confers a spiritual healing through the sacramental sign of a physical healing – even though it is not always the case that a physical healing actually occurs. Sacraments effect what they signify, such that the very nature of the sacramental order is that signification is essential to the working of the sacramental effect.

In the case of Extreme Unction, oil is used to signify physical healing. We must recall that, in ancient times (and still today), oil is used unto medicinal effect. The anointing of oil is meant to produce physical health. This physical healing itself signifies the spiritual healing.

As baptism washes the soul through the sacramental sign of a bodily washing, and the Eucharist feeds the soul through the sacramental sign of a bodily feeding (and so forth for all the sacraments), so too, Anointing heals the soul through the sacramental sign of bodily healing. Neither does it matter that the waters of baptism may not literally wash the body, nor that the Sacred Host provide little physical nourishment, nor that the anointing of oil not effectively produce physical healing – the sacramental sign is enough (even without the accomplishment of a substantial physical effect) to signify and effect the spiritual reality.

Who is to receive this sacrament?

The Church is quite clear: Only those who suffer from a grave illness which puts the individual in a real danger of death are to receive the sacrament of Anointing of the Sick. There is a reason why it is not called merely “Anointing”, but rather “Anointing of the Sick” – it is for sick persons, indeed for those whose sickness is unto death.

St. James makes this clear as he writes: Is any man sick among you? Further, Pope Paul VI re-iterates this point in his Apostolic Constitution: “The Sacrament of the Anointing of the Sick is given to those who are seriously ill.” Even the Catechism states: “The Church believes and confesses that among the seven sacraments there is one especially intended to strengthen those who are being tried by illness, the Anointing of the Sick.” (CCC 1511)

As the sacrament effects spiritual healing through the sign of physical healing, only those who are physically ill (i.e. whose health is gravely impaired through some serious illness) are capable of receiving this sacrament.

St. Thomas conveys this point with great clarity: “This sacrament is a spiritual healing, as stated above (q.30, aa.1,2), and is signified by way of a healing of the body. Hence this sacrament should not be conferred on those who are not subjects for bodily healing, those namely, who are in good health.” And again, “Although spiritual health is the principle effect of this sacrament, yet this same spiritual healing needs to be signified by a healing of the body, although bodily health may not actually ensue. Consequently spiritual health can be conferred by this sacrament on those alone who are competent to receive bodily healing, viz. the sick.” (ST Supplement, q.32, a.1, co.; q.32, a.1, ad 1)

The sacrament is very clearly intended not merely for any who are in danger of death from any cause – whether from surgery or from military deployment or from execution – but only for those who are in danger of death due to an illness (and this includes also those whose health is seriously impaired due to old age). The sacrament is not of the “dying” in generally, but of the “sick” (meaning, of those who are seriously ill).

Still, the Church advises both priests and faithful to avoid scrupulosity in this matter: “A prudent or reasonably sure judgment, without scruple, is sufficient for deciding on the seriousness of an illness; if necessary a doctor may be consulted” (General Introduction to the Rite of Anointing of the Sick, 8). Hence, two extremes must be avoided: On the one hand we must not delay Anointing, on the other hand we must not administer the sacrament when there is no illness which gravely impairs the health of the individual. Until the person is seriously ill, they are not to receive the sacrament of Anointing.

In other words, if a sickness is present and there is reasonable evidence to conclude that this illness is serious (i.e. could result in death and already significantly impairs health), then Anointing of the Sick should be administered. However, if there is no serious sickness, then the sacrament should not be given. Hence, it is not to be given on account of serious surgery nor before war nor before execution – for none of these events constitute a serious illness. It is not enough simply to be in danger of death – one must be sick (including extreme old age which seriously impairs health) in order to receive the sacrament of the sick.

[it must be noted that certain severe forms of mental illness, which seriously impair health as to potentially lead to death, are also cause for the administration of Anointing]

Why Anointing is not to be given for surgery, but may be given before surgery

If it is clear that serious and even life-threatening surgery is not a cause for Anointing, why does the Catechism of the Catholic Church state: “It is fitting to receive the Anointing of the Sick just prior to a serious operation” (CCC 1515)? We can find our answer by looking more closely at the Introduction to the Rite (which is provided by the Church and approved by the Holy Father).
The Introduction to the Rite of Anointing of the Sick states (paragraph 9): “A sick person may be anointed before surgery whenever a serious illness is the reason for the surgery.” Thus, it is fitting, when a serious illness is present and when this illness has necessitated a serious surgery, to receive this sacrament before undergoing surgery. The seriousness of the surgery is not itself the cause of the administration of the sacrament, but rather provides an occasion in which it becomes more necessary that the sacrament be received.

While Anointing of the Sick is always given for the spiritual healing of those who are seriously ill, it is especially necessary when there is grave danger of death. If a person suffering from a serious illness must undergo a dangerous surgery, it will be all the more necessary for him to receive Anointing – the cause of Anointing is the serious (and life-threatening) sickness, but the occasion is brought about by the danger of death which accrues to the surgery.

In this matter, there is grave need for reform (at least in the United States) – indeed, all too often the sacrament is given before surgery when there is no serious illness present, resulting in the exposing of the sacrament to nullity, which is a serious matter indeed.
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