Chapter 73 — On the sacrament of extreme unction

The body is the instrument of the soul. Now an instrument is intended for the use of the principal agent; hence the instrument needs to be disposed so as to be suitable to the principal agent. Consequently, the body is disposed so as to be suitable to the soul. By dispensation of the divine judgment, it happens sometimes that the disease of the soul (which is sin) spreads to the body. This bodily ailment is sometimes profitable to the soul’s health insofar as a man bears his bodily infirmity with humility and patience, since this is credited to him as punishment, as it were, in satisfaction for his sins. But bodily infirmity is sometimes a hindrance to the health of the soul insofar as it is an obstacle to virtue. It was therefore fitting that a spiritual remedy should be applied against sin, insofar as sin is an occasion of bodily infirmity, and sometimes this remedy heals the bodily ailment (that is to say, when it is good for the soul’s health). For this purpose the sacrament of extreme unction was instituted; of which it is said: Is any among you sick? Let him call for 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 will heal (RSVCE: save.) the sick man (Jas 5:14–15).

Nor is the efficacy of the sacrament prejudiced if sometimes the sick who have received this sacrament are not completely cured of their bodily ailment, because the healing of the body is not always good for the soul, even for those who have received this sacrament worthily. Nor do they receive it in vain, although they do not recover the health of the body. For while this sacrament is directed against bodily sickness as a result of sin, it is evidently directed also against other consequences of sin—namely, proneness to evil and difficulty in respect of good—and all the more so as these latter infirmities of the soul are more akin to sin than sickness of the body. It is true that these infirmities should be repaired by penance, insofar as the penitent is withdrawn from evil and inclined to good by deeds of virtue, which he does in satisfaction for sin. But, seeing that man does not completely repair these defects in himself either through negligence, or the manifold business of this life, or the shortness of time (and so forth), he is fortunately provided with a sacrament which completes his cure and delivers him from the debt of temporal punishment. Thus when his soul departs from his body, there is no longer anything in him to prevent his entering into glory. Thus James adds: And the Lord will raise him up (Jas 5:15). It also happens that a man is not cognizant or mindful of all the sins he has committed, so as to be cleansed of them all in penance. Moreover, these are his daily sins, from which this life cannot be free. From all these man needs to be cleansed by this sacrament in the hour of death, so that nothing remain in him to prevent his entrance into glory. Therefore, James adds: If he has committed sins, he will be forgiven (Jas 5:15).

It is evident, therefore, that this sacrament is the conclusion and consummation of the whole spiritual healing, since it prepares man for a participation in glory: and for this reason it is called extreme unction.

Therefore, it is plain that this sacrament is not to be given to any sick person, but only to those who, through sickness, are likely to be near death. And if they get well again, they can receive this sacrament a second time, if they return to the same state of danger. The reason is that the anointing in this sacrament is not one of consecration, as the anointing of confirmation, the washing of baptism, and certain other anointings. These latter are never repeated, because consecration remains forever (so long as the consecrated thing remains), on account of the efficacy of the divine power which consecrates. But the anointing of this sacrament is directed to healing, and a healing remedy should be repeated as often as the sickness recurs.

Now there are some who, without being sick, are near death (as, for instance, a man condemned to die) and who need the spiritual effects of this sacrament. But it may be given to none except those who are in sickness, for it is given under the form of a bodily remedy, which is unsuitable except for one who is sick of body, and the signification of the sacraments must be observed. Consequently, just as a bodily washing is required in baptism, so in this sacrament is there required the application of a remedy for bodily infirmity. Hence oil is the special matter of this sacrament, because by easing pain it is useful for healing the body; even as water, which washes the body, is the matter of the sacrament in which the soul is cleansed.

Hence again we may see that as bodily remedies are applied to the source of the disease, so is this unction applied to those parts of the body that are the source of the disease which is sin. Such are the organs of sense, the hands, and feet, with which sins are committed (also, as is the custom in some places, the thighs, which are the seat of lust).

Again, seeing that sins are remitted in this sacrament, and that sin is not remitted without grace, it is evident that grace is bestowed in this sacrament.

Now those things which bestow illuminating grace may be given by none but a priest, whose order is illuminating, according to Dionysius. (Pseudo-Dionysius, Ecclesiastical Hierarchy,* ch. 6.)* A bishop is not necessary, since this sacrament does not confer excellence of state, as is the case in those things of which a bishop is the minister. (Cf. ch. 60.)

Since, however, this sacrament has the effect of producing a complete cure, and requires an abundance of grace, it becomes the sacrament that many priests be present, and that the prayers of the whole Church combine to secure the effect of this sacrament. Hence James says: Let him call for the priests of the church . . . and the prayer of faith will save the sick man (Jas 5:14–15). Yet if there is only one priest present, he is understood to confer this sacrament as proxy of the whole Church, whose minister he is, and who speaks through him.

As in the other sacraments, the effect of this sacrament is hindered by insincerity on the part of the recipient.