Are there people sick among you? Let them send for the priests of the Church, and let the priests pray over them anointing them with oil in the name of the Lord.”
(James 5:14)

The quotation begins the rite of Sacrament of the Sick from the book, Pastoral Care of the Sick: Rites of Anointing and Viaticum. The Church and the Bible teach that the sacrament was instituted by Jesus and was further made known in the early Church by the Apostle James. It takes a unique place in the Church’s pastoral care of the sick.

Known by different names over the centuries — “anointing of the sick,” “extreme unction” and “last rites” — it was administered only at the point of death. The Church now teaches it “is not a sacrament intended only for those who are at the point of death. Hence, it is certain that as soon as any of the faithful begins to be in danger of death from sickness or old age, this is already a suitable time for them to receive this sacrament.”

The Church also teaches that “each time a Christian falls seriously ill, he may receive the Anointing of the Sick, and also when, after he has received it, the illness worsens.” Only priests and bishops can administer the sacrament using the Oil of the Sick blessed by the bishop at the Chrism Mass during the Holy Week.

Through the ministry of hospital priest-chaplains, the sacrament is available to Catholic patients in all hospitals and other places of care in an archdiocese. During my regular visits at St. Michael’s, I administer the sacrament to those preparing for surgery, in intensive care and palliative care units as well as patients who feel “spiritually unwell.”

Some patients can request the sacrament themselves but family members can make the request on behalf of incoherent or unconscious patients. In rare cases, I have anointed terminally ill patients who have no known relatives. 

Over the years, I have learned that some Catholics still understand the sacrament as essentially for patients who are “certainly dying” or “actively dying.” During pastoral visits to newly admitted Catholic patients, I have heard: “Thank you for coming to visit me. I am preparing for a big surgery but I am not ready to receive the Last Rites”; or “My mother was admitted last night. Please let us speak softly so she won’t be afraid because the priest is here to anoint her.”

Those with such understanding of the sacrament usually push its celebration to the last minute. Once, I was called to celebrate the sacrament for a patient who had just died. Even though I knew the patient had been in the hospital for a while, the family wanted him anointed at the “last minute.” I could not celebrate the sacrament but stayed with the family to offer support and prayers.

The sacrament “has as its purpose the conferral of a special grace on the Christian experiencing the difficulties inherent in the condition of grave illness and old age.” The effects of this special grace include the restoration of health if it is conducive to the salvation of the soul, the forgiveness of sins if the sick person was unable to go to Confession, strengthening, peace and courage to endure in a Christian manner the sufferings of illness or old age, and uniting the sick person to the passion of Christ. 

It is different from Viaticum, the Eucharist given just prior to death. Viaticum means “food for the passage through death to eternal life.” It is understood as the last sacrament of Christian life. Despite the misunderstanding, most Catholics expect their dying loved ones to receive it before they die.  I work with the spiritual care department and the medical teams to ensure it can be celebrated when requested. Through the celebration of the Sacrament of the Sick, we continue the ministry of healing Jesus entrusted to the early disciples.

Through the power of the Holy Spirit, the sick encounter the compassion, comfort and peace of God. In the sacrament, Jesus, the merciful Suffering Servant, journeys with the dying patients as “the sacrament prepares them to eternal life.” It is in the celebration of the Sacrament of the Sick that as a faith community we gather and recognize and experience God’s healing and love. 

(Fr. Yaw Acheampong is priest-chaplain, St Michael’s Hospital in Toronto)