From Last Rites to First Rite: Reimagining the Sacrament of the Anointing of the Sick
- Guest Contributor
- 2 hours ago
- 5 min read
By Msgr. Edward L. Buelt, J.C.L.
A Midnight Call
The nursing home’s night nurse called me in the middle of the night, waking me from a sound sleep. She asked that I come immediately to administer the last rites to a non-responsive, near-death resident.
When I arrived, the woman’s daughter explained her mother’s condition. She was certain her mother would not live to see the morning. I sat beside the woman, greeted her softly and found that she did not respond. She was unable to make her Confession, so I proceeded to administer the Sacrament of the Anointing of the Sick, which includes the apostolic pardon.
When I finished, I turned to the daughter, assured her of my prayers and invited her to call again if needed. To my surprise, she shouted across the room, “Mom, the priest has given you the last rites — you’re going to go straight to Heaven!”
“Oh, good,” the “non-responsive” woman replied. “I was so worried about that.”
When the Sacrament Should Be Celebrated
Over more than forty-three years of priestly ministry, I have administered the Anointing of the Sick to hundreds of people. Most often, I was called when death seemed imminent to family and caregivers. Many times, I was summoned in emergencies, before major surgery or when an illness had taken a turn for the worse. Rarely, however, was I asked to administer the sacrament when the sick person was first diagnosed with a potentially mortal illness.
Yet that moment — the time of diagnosis — is the most opportune time to be anointed. It is when the sick person can draw the greatest comfort and strength from the sacrament, and when loved ones can be most consoled by the experience of Christ’s healing and mercy.
Not “Extreme Unction” or “Last Rites”
One of the ongoing frustrations of my ministry has been helping people understand that the Anointing of the Sick is not “extreme unction,” nor is it itself the so-called “last rite.”
It was not until the twelfth century that the adjective extreme was used to describe anointing, and that by Peter Lombard. From then until the reforms of the Second Vatican Council, many came to believe the sacrament could be received only once, and only at the end of life. Out of fear, the faithful began to delay calling the priest until all hope was gone. In their minds, summoning the priest became a death sentence — the priest, an angel of death rather than Christ’s minister of grace. Yet at that, too, for some, the sacrament became a final reassurance, as in the story above, that receiving the last rites guaranteed getting past St. Peter and through the gates into Heaven.
The Teaching of the Church
When, then, should a priest be called to administer the sacrament?
The Baltimore Catechism instructed that we should not wait until we are in danger of death but receive the sacrament “while we have the use of our senses and are able to be comforted and strengthened by it” (Q. 959).
The Second Vatican Council teaches that anointing “is not a sacrament for those only who are at the point of death. Hence, as soon as any one of the faithful begins to be in danger of death from sickness or old age, the fitting time has already arrived” (Sacrosanctum Concilium, 73).
In his General Instruction for the Rites of Anointing and Viaticum, Pope St. Paul VI decreed that “those whose health is seriously impaired by sickness or old age receive the sacrament” (no. 8) and warned that the faithful “should not follow the wrongful practice of delaying the reception of the sacrament” (no. 13). When speaking of Viaticum, he further instructed that “the Anointing of the Sick should be celebrated at the beginning of a serious illness” (no. 175).
St. John Paul II reaffirmed this in the Code of Canon Law: the sacrament is to be administered to one “who, after having reached the use of reason, begins to be in danger due to sickness or old age” (c. 1004).
Notice that the Council and both popes identify the onset of a serious illness as the proper time for the celebration of the sacrament.
The Grace of the Sacrament
Certainly, the faithful should be anointed in emergencies, before major surgery, when becoming frail in old age and at life’s end. But we should stop referring to the Anointing of the Sick as extreme unction or the last rites.
Some of my most powerful pastoral experiences have occurred when parishioners were newly diagnosed with a grave illness — gathered with family and friends in the church, listening to the Word proclaimed and celebrating the laying on of hands and anointing, especially during the Eucharist.
The Catechism of the Catholic Church teaches that the Anointing of the Sick has six effects (nos. 1520–1522; 1532): (Notice that one of these effects is not a free pass into Heaven.)
It gives the sick person strength, peace and courage to endure illness or old age in a Christian manner.
It unites the sick person to the Passion of Christ for his own good and for the good of the whole Church.
It unites the sick more closely to the Church, contributing to her sanctification and mission.
It brings the forgiveness of sins.
It may restore health if conducive to the person’s salvation.
It prepares the person for the final passage to eternal life.
Who would not wish to receive these graces at the onset of serious illness rather than only at its end?
Illness as a Sacred Opportunity
We should pray for good health and give thanks to God for it. We should strive to care for our bodies and minds. Yet illness remains a privileged opportunity to know Christ more deeply — to suffer with him, trust him and share in his redemptive work for the Church and the world. In the Anointing of the Sick, Christ again makes himself like us in all things but sin and chooses to be close to us in suffering.
It is time we changed our mindset and vocabulary. The Anointing of the Sick is anything but the extreme or last rite; it is truly the first rite of serious illness — one meant to be celebrated not rarely, but often, whenever the need arises.
“Are any among you sick? They should call for the elders of the church and have them pray over them, anointing them with oil in the name of the Lord” (James 5:14).
