Anointing of the Sick
Extreme Unction from James 5 to the Deathbed
he Anointing of the Sick, known for
most of its history as Extreme Unction, is the fifth of Rome’s seven sacraments. The priest
anoints a seriously ill or dying person with oil blessed by a bishop and prays for him. Rome teaches
that “this sacred anointing of the sick was instituted by Christ our Lord as a true and proper
sacrament of the New Testament” (§1511), and that through it “the whole Church commends
those who are ill to the suffering and glorified Lord” (§1499).
The sacrament touches believers at the most tender moment of life. For that reason it deserves careful examination. Does it rest on a command of Christ and a promise of God, or on a reading of one verse in James that the verse itself will not bear?
Background
Rome rests the sacrament on two texts. Mark records that the twelve, sent out by Jesus, “anointed with oil many that were sick, and healed them” (Mark 6:13). James writes, “Is any sick among you? 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 shall save the sick, and the Lord shall raise him up; and if he have committed sins, they shall be forgiven him” (James 5:14–15). Trent called the rite “hinted at indeed in Mark, but recommended and promulgated to the faithful by James the apostle.”1
The early church did use blessed oil with prayer for the sick. The most important early witness is a letter of Pope Innocent I (416) to Bishop Decentius of Gubbio, which Rome’s own theologians call “the most striking Patristic authority on the subject.” Yet the letter shows a practice quite unlike the later sacrament:
The words of St. James must without doubt be taken or understood of the faithful who are sick, who may be [lawfully] anointed with the holy oil of chrism, of which, having been prepared by the bishop, not only priests, but all Christians may avail themselves for anointing in their own need, or in that of their connections.2
In the fifth century, then, the oil was for the sick, not the dying, and lay Christians could use it for themselves and their households. Its purpose was the healing for which James asked.
History
Over the following centuries the anointing moved from the sickbed to the deathbed. The Catechism acknowledges the change: “Over the centuries the Anointing of the Sick was conferred more and more exclusively on those at the point of death. Because of this it received the name ‘Extreme Unction’” (§1512). Pohle and Preuss date the name: “The name Extrema Unctio became a technical term in the West towards the end of the twelfth century.”3 The rite was now joined to penance and to the last communion as preparation for death.
The change bred superstition. Pohle and Preuss quote a Catholic historian who observed that “in the Middle Ages . . . the reception of Extreme Unction was often regarded as a complete break with the world, a formal exit from the various relations of denizens of this terrestrial globe.”4 People delayed calling the priest, fearing that the anointing itself meant death.
Development
Pope Eugene IV’s decree for the Armenians at the Council of Florence (1439) listed Extreme Unction among the seven sacraments and gave the fullest statement of the doctrine before Trent.5 The Council of Trent then defined it in its fourteenth session (November 25, 1551), treating it as an appendix to penance. Trent called it the sacrament “regarded by the Fathers as the completion, not only of penance, but also of the whole Christian life, which ought to be a perpetual penance.” Christ, it said, “did He guard the close of life by the sacrament of Extreme Unction, as with a most firm defence.”6
The council fixed the matter as “oil blessed by a bishop” and the form as the words “By this unction.” It declared that the elders of James 5 are not the “elders by age” but “either bishops, or priests by them rightly ordained,” and that the sacrament is given especially to those “who lie in such danger as to seem placed at their departure from this life: whence, also, it is called the sacrament of the departing.”7 It anathematized anyone who said that the rite is “a human invention” or that the presbyters of James are “the seniors in years in each community.”8
After the Second Vatican Council, Paul VI’s apostolic constitution Sacram unctionem infirmorum (1972) revised the rite and restored the older name. The sacrament “is not a sacrament for those only who are at the point of death,” but for anyone who “begins to be in danger of death from sickness or old age” (§1513, §1514). The reform quietly conceded much of what the Reformers had said four centuries earlier.
What Rome Teaches
The Catechism lists five effects of the sacrament: “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” (§1532).
Three features stand out. First, the sacrament forgives sins, serving as a substitute for penance when the dying cannot confess. Second, it gives suffering a redemptive value: “Suffering, a consequence of original sin, acquires a new meaning; it becomes a participation in the saving work of Jesus” (§1521). Third, it belongs to a final cluster of rites. “Penance, the Anointing of the Sick and the Eucharist as viaticum constitute at the end of Christian life ‘the sacraments that prepare for our heavenly homeland’” (§1525). Only priests may administer it (§1516). The dying Christian’s comfort is thus placed in the hands of the priesthood and its oil.
The Reformers’ Response
Luther answered Rome from the very text it cited. James wrote of the sick in order that they might recover; Rome reserved the oil for the dying, as if they were not expected to recover:
Why do they make an extreme and special unction of that which the Apostle meant to be general? The Apostle did not mean it to be extreme, and to be administered only to those about to die. He says expressly: “Is any sick among you?” He does not say: “Is any dying?”9
Luther also pressed the logic of a sacrament. If the anointing were a sacrament, its promise of healing would be sure; yet “if the unction is extreme, it does not heal, but yields to the sickness; while if it heals, it cannot be extreme.”10 Above all, he denied that any apostle could create a sacrament: “it was not lawful for an apostle to institute a sacrament by his own authority; that is, to give a divine promise with a sign annexed to it. To do this belonged to Christ alone.”11
Calvin explained the anointing of Mark 6 and James 5 as part of the gift of healing given to the apostolic church, a sign that pointed away from the apostles to the power of God. That gift, he argued, was not meant to be permanent:
To designate the Holy Spirit and his gifts by oil is trite and common (Ps. 45:8). But the gift of hearing [healing] disappeared with the other miraculous powers which the Lord was pleased to give for a time, that it might render the new preaching of the gospel for ever wonderful.12
His conclusion was simple: “their unction is no sacrament, as it is neither a ceremony appointed by God, nor has any promise.”13 Calvin also noticed how far Rome’s rite had departed from the text it claimed: “James would have all the sick to be anointed,” but Rome anointed only those already “in extremis,” and James called for “the elders of the Church,” where Rome sent a single priest.14
Anointing and Scripture
James calls for the elders and for prayer. The power in James 5 lies in “the prayer of faith,” not in oil consecrated by a bishop. The elders are the pastors of the local church, and they are many, not one priest. James immediately broadens the exhortation to the whole church: “Confess your faults one to another, and pray one for another, that ye may be healed. The effectual fervent prayer of a righteous man availeth much” (James 5:16). Christians still do well to call their elders to pray over the sick.
The promise is recovery, not a passage to death. “The Lord shall raise him up” (James 5:15) speaks of healing. The forgiveness James mentions belongs to the same prayer of faith, for it is God who forgives, and he does so freely: “If we confess our sins, he is faithful and just to forgive us our sins” (1 John 1:9).
Our suffering does not add to Christ’s saving work. Christ “by himself purged our sins” (Hebrews 1:3), and “by one offering he hath perfected for ever them that are sanctified” (Hebrews 10:14). The believer suffers with Christ and is comforted by him (2 Corinthians 1:5), but he does not complete Christ’s atonement.
The dying believer rests on Christ’s promise. “I am the resurrection, and the life: he that believeth in me, though he were dead, yet shall he live” (John 11:25). “To be absent from the body” is “to be present with the Lord” (2 Corinthians 5:8), and nothing, not even death, “shall be able to separate us from the love of God, which is in Christ Jesus our Lord” (Romans 8:38–39). The Christian needs no final unction to be ready for heaven. He needs the Word of the gospel, the prayers of the church, and the Savior who said, “To day shalt thou be with me in paradise” (Luke 23:43). See also Purgatory.
Scripture quotations are from the King James Version.
