The anointing of the sick is administered to bring spiritual and even physical strength during an illness, especially near the time of death. It is most likely one of the last sacraments one will receive. A sacrament is an outward sign established by Jesus Christ to confer inward grace. In more basic terms, it is a rite that is performed to convey God’s grace to the recipient, through the power of the Holy Spirit.
The Sacrament’s Institution
Like all the sacraments, holy anointing was instituted by Jesus Christ during his earthly ministry. The Catechism explains, "This sacred anointing of the sick was instituted by Christ our Lord as a true and proper sacrament of the New Testament. It is alluded to indeed by Mark, but is recommended to the faithful and promulgated by James the apostle and brother of the Lord" (CCC 1511; Mark 6:13; Jas. 5:14-15).
The anointing of the sick conveys several graces and imparts gifts of strengthening in the Holy Spirit against anxiety, discouragement, and temptation, and conveys peace and fortitude (CCC 1520). These graces flow from the atoning death of Jesus Christ, for "this was to fulfill what was spoken by the prophet Isaiah, ‘He took our infirmities and bore our diseases’" (Matt. 8:17).
Mark refers to the sacrament when he recounts how Jesus sent out the twelve disciples to preach, and "they cast out many demons, and anointed with oil many that were sick and healed them" (Mark 6:13). In his epistle, James says, "Is any among you sick? Let him call for the elders 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 save the sick man, and the Lord will raise him up; and if he has committed sins, he will be forgiven" (Jas. 5:14–15).
The early Church Fathers recognized this sacrament’s role in the life of the Church. Around A.D. 250, Origen wrote that the penitent Christian "does not shrink from declaring his sin to a priest of the Lord and from seeking medicine . . . [of] which the apostle James says: ‘If then there is anyone sick, let him call the presbyters of the Church, and let them impose hands upon him, anointing him with oil in the name of the Lord; and the prayer of faith will save the sick man, and if he be in sins, they shall be forgiven him’" (Homilies on Leviticus 2:4).
In the year 350, Bishop Serapion wrote, "We beseech you, Savior of all men, you that have all virtue and power, Father of our Lord and Savior Jesus Christ, and we pray that you send down from heaven the healing power of the only-begotten [Son] upon this oil, so that for those who are anointed . . . it may be effected for the casting out of every disease and every bodily infirmity . . . for good grace and remission of sins . . . " (The Sacramentary of Serapion 29:1).
The Sacrament’s Effects
"The special grace of the sacrament of the Anointing of the Sick has as its effects: the uniting of the sick person to the passion of Christ, for his own good and that of the whole Church; the strengthening, peace, and courage to endure in a Christian manner the sufferings of illness or old age; the forgiveness of sins, if the sick person was not able to obtain it through the sacrament of penance; the restoration of health, if it is conducive to the salvation of his soul; the preparation for passing over to eternal life" (CCC 1532).
Does a person have to be dying to receive this sacrament? No. The Catechism says, "The anointing of the sick is not a sacrament for those only who are at the point of death. Hence, as soon as anyone of the faithful begins to be in danger of death from sickness or old age, the fitting time for him to receive this sacrament has certainly already arrived" (CCC 1514).
Does God Always Heal?
Today some Christians go to extremes in their expectation of divine healing. On one hand, some say that if a Christian is not healed of all his diseases, this reflects his lack of faith. Others claim that divine healings were only for the apostolic age, when all diseases were healed instantly and automatically. Both extremes are wrong.
God does not always heal the physical infirmities that afflict us. Paul preached to the Galatians while he was afflicted by a "bodily ailment" (Gal. 4:13– 14). He also mentions that he had to leave his companion Trophimus in the town of Miletus because he was too sick to travel (2 Tim. 4:20). In his first letter to Timothy, Paul urges his young protégé to "no longer drink only water, but to use a little wine for the sake of your stomach and your frequent ailments" (1 Tim. 5:23).
The last passage is especially informative. Not only does it reveal that illnesses were not always healed in the apostolic age, but it also shows an apostle’s practical advice to a fellow Christian on how to deal with an illness. Notice that Paul does not tell Timothy to pray harder and have more faith that God will heal him from his stomach ailment. Rather, he tells him how to manage the illness through medicinal means.
Some argue that healings were always instantaneous and were only for those living during the apostolic age, but that afterward the gift of healing disappeared. The problem with that theory is that the Bible tells us otherwise. For example, when Jesus healed the blind man at Bethsaida, he laid his hands upon him twice before the man was fully healed (Mark 8:22–26).
Finally, we have a standing command of the New Testament in James 5:14–15, cited earlier. This command is never revoked anywhere in the Bible, and there are no statements anywhere that God will cease to heal. Thus the command is in effect to this very day.
Of course, our healing, like all things, is subject to God’s will. As James pointed out just a chapter earlier, "You do not know about tomorrow. What is your life? For you are a mist that appears for a little time and then vanishes. Instead you ought to say, ‘If the Lord wills, we shall live and we shall do this or that’" (Jas. 4:14–15, emphasis added). We have a promise of healing, but not an unqualified one. It is conditional on the will of God.
Why Doesn’t God Always Heal?
If God can heal us, why doesn’t he? Why isn’t it always his will to do so? One answer to this question is found in the spiritual discipline and training that can result from facing illness and adversity. Scripture asks, "Have you forgotten the exhortation which addresses you as sons?—‘My son, do not regard lightly the discipline of the Lord, nor lose courage when you are punished by him. For the Lord disciplines him whom he loves, and chastises every son whom he receives’ [Prov. 3:11–12]. It is for discipline that you have to endure. God is treating you as sons; for what son is there whom his father does not discipline?
"If you are left without discipline, in which all have participated, then you are illegitimate children and not sons. Besides this, we have had earthly fathers to discipline us and we respected them. Shall we not much more be subject to the Father of spirits and live? For they disciplined us for a short time at their pleasure, but he disciplines us for our good, that we may share his holiness. For the moment all discipline seems painful rather than pleasant; later it yields the peaceful fruit of righteousness to those who have been trained by it" (Heb. 12:5–11).
The Value of Suffering
Sometimes God allows us to undergo sickness as a form of discipline and training in righteousness. God often permits these trials for our sanctification, as Paul himself learned when he prayed that God would remove from him an angel of Satan who was afflicting him: "And to keep me from being too elated by the abundance of revelations, a thorn was given me in the flesh, a messenger [Greek: angelos] of Satan, to harass me, to keep me from being too elated. Three times I besought the Lord about this, that it should leave me; but he said to me, ‘My grace is sufficient for you, for my power is made perfect in weakness.’ I will all the more gladly boast of my weaknesses, that the power of Christ may rest upon me" (2 Cor. 12:7–9).
Even though we must face a certain amount of suffering and affliction in this life, we know God’s grace is sufficient to sustain us. All of God’s graces, including physical health, are bestowed to lead to the salvation of our souls. The Catholic Church teaches that the sacrament brings "the restoration of health, if it is conducive to the salvation of his soul" (CCC 1532).
God also uses our suffering to help others. If Paul had not become ill while on his first missionary journey and been forced to stop traveling, he would not have preached to the Galatians, for he tells them, "You know it was because of a bodily ailment that I preached the gospel to you at first" (Gal. 4:13). If he had not preached to the Galatians, he would not have later written them the epistle that appears in our New Testament. God used Paul’s illness to bring salvation to the Galatians and to bring us a work of Scripture, through which we are still receiving benefits from God.
This is just one example of how God used suffering to bring about good. Therefore, if we suffer, we should look upon it as an opportunity for good, such as by offering up our sufferings for our own sanctification and for our departed brothers and sisters in Christ.
This applies also to the physical suffering of death, which will come for each of us one day. The Bible reminds us, "As for man, his days are like grass; he flourishes like a flower of the field; for the wind passes over it, and it is gone, and its place knows it no more" (Ps. 103:15–16).
The "Last Rites"
Though the psalmist teaches us to ponder our mortality, he immediately comforts us by saying, "But the steadfast love of the Lord is from everlasting to everlasting upon those who fear him, and his righteousness to children’s children, to those who keep his covenant and remember to do his commandments" (Ps. 103:17–18).
In his steadfast love for us, the Lord gives us the sacraments involved in the last rites to comfort us in our final days and prepare us for the journey ahead. "These include penance (or confession), confirmation (when lacking), anointing of the sick . . . and Viaticum (which is meant to be the last reception of Communion for the journey from this life to eternity). . . .
"The present ritual orders these sacraments in two ways. The ‘continuous rites of penance and anointing’ include: Introductory Rites, Liturgy of Penance, Liturgy of Confirmation, Liturgy of Anointing, Liturgy of Viaticum, and Concluding Rites. The ‘rite for emergencies’ includes the sacrament of penance, Apostolic Pardon, Lord’s Prayer, Communion as Viaticum, prayer before anointing, anointing, concluding prayer, blessing, sign of peace" (Fr. Peter Stravinskas, Catholic Encyclopedia, 572).
The most important part of the last rites is the reception of the Lord in one’s final Communion, also called "Viaticum" (Latin = that which you take on the road, i.e., provisions for a journey) This special Communion prepares us to travel with the Lord on the final part of our journey.
The comfort of Viaticum has been valued by Christians since the beginning of Church history. The first ecumenical council, held at Nicaea in 325, decreed: "Concerning the departing, the ancient canonical law is still to be maintained, to wit, that, if any man be at the point of death, he must not be deprived of the last and most indispensable Viaticum" (canon 13). Having repented of our sins and received reconciliation, we travel with the Lord Jesus out of this earthly life and to eternal happiness with him in heaven.
From the earliest times, the sacrament of the anointing of the sick was cherished among Christians, not only in immediate danger of death, but even at the beginning sign of danger from illness or old age. A sermon of Caesar of Arles (ca. A.D. 470-542) contains the following: "As often as some infirmity overtakes a man, let him who is ill receive the body and blood of Christ; let him humbly and in faith ask the presbyters for blessed oil, to anoint his body, so that what was written may be fulfilled in him: ‘Is anyone among you sick? Let him bring in the presbyters, and let them pray over him, anointing him with oil; and the prayer of faith will save the sick man, and the Lord will raise him up; and if he be in sins, they will be forgiven him. . . . See to it, brethren, that whoever is ill hasten to the church, both that he may receive health of body and will merit to obtain the forgiveness of his sins" (Sermons 13[325]:3).