Can Catholic Children Receive the Last Rites?

Q: Some years ago, a good friend’s two-year-old daughter died of a congenital problem. Only recently she told me that when the priest came to see them all in the hospital when the girl was dying, they asked him to anoint their daughter, but he said no. He told them she didn’t need it because she was “innocent.” This evidently didn’t bother the family, but I was shocked! Isn’t every Catholic supposed to receive the last rites when he’s dying?  —Melanie

A: It may be surprising to many Catholics, but no, it is not appropriate to administer the sacrament of Anointing of the Sick—also known as Extreme Unction—to every baptized Catholic, even when he is dying. (See “Can a Public Sinner Have a Catholic Funeral?” for a different example of this.)  The rules regarding who should and should not be anointed, and when an anointing should be requested, are unclear to many average Catholics today.  This is partly because after Vatican II, some of the rules regarding this sacrament received an overhaul—and while this was intended to clarify its application, the changes actually sparked some confusion. Let’s take a look first at the general purpose of this sacrament, and then at the answer to Melanie’s specific question.

The Catechism sums up beautifully the theological rationale behind the Anointing of the Sick:

A particular gift of the Holy Spirit, the first grace of this sacrament is one of strengthening, peace and courage to overcome the difficulties that go with the condition of serious illness or the frailty of old age. This grace is a gift of the Holy Spirit, who renews trust and faith in God and strengthens against the temptations of the evil one, the temptation to discouragement and anguish in the face of death. This assistance from the Lord by the power of his Spirit is meant to lead the sick person to healing of the soul, but also of the body if such is God’s will. Furthermore, “if he has committed sins, he will be forgiven” (CCC 1520).

Most Catholics traditionally have viewed this sacrament as providing aid to the dying so that they die a good Christian death, and that’s not incorrect. But there is more to the anointing of the sick than simply giving dying Catholics a good spiritual “push” in the right direction as they depart from this life. There is an underlying link between this sacrament and the sacrament of Penance. Both are directed, each in its own way, toward spiritual healing. The Catechism notes further that “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’ or the sacraments that complete the earthly pilgrimage” (CCC 1525).

In other words, it is because we are sinners that we may, as the Catechism puts it, be tempted to discouragement and anguish in the face of death. For centuries, moral theologians have routinely noted that after the devil successfully tempts us to sin, he next tempts us to despair of God’s forgiveness. This anguish can be hard enough to battle when we are in the best of health and thinking lucidly. But when a person realizes that he is dying, such doubts about his salvation and the fear of punishment are heaped on top of the physical illness and weakness that accompany the natural dying process. Needless to say, this can be a tremendously difficult combination—and thus the real need for this sacrament.

What exactly was the post-Vatican II “overhaul” mentioned above? Basically, the Church’s emphasis on the fact that anointing is for the dying sometimes used to lead people to defer reception of the sacrament until it was too late. Catholics were hesitant to request anointing if it wasn’t completely obvious that the sick person was actually dying right now. Unfortunately, this meant that sick Catholics and their family members often waited too long to contact a priest, and the person died without this valuable spiritual benefit. And since it makes no theological sense to anoint the body of a person whose soul has already left it, the sacrament cannot be administered once it is clear that a person has died (cf. c. 1005).

To counter this problem, the Church began officially to stress that anointing of the sick is not to be postponed until the very last minute. This is why the law on this subject in the current Code of Canon Law is worded more broadly than was the previous law. Canon 1004.1 notes that any Catholic who has reached the use of reason may be anointed once he begins to be in danger by reason of illness or old age. The phrase, “begins to be in danger” is key. If someone might reasonably conclude that a serious illness, a grave accident, or significant health complications arising from old age may cause him or a loved one to die soon, it is time to request the sacrament of anointing of the sick.

Obviously, discerning whether or not the time is right is a judgment call. One might very well receive the sacrament and then recover his health completely! In fact, there are countless Catholics alive today who will tell you that after receiving this sacrament on their hospital beds, they felt renewed physical as well as spiritual strength. Many are personally convinced that their recovery was connected to their anointing, and this is totally in keeping with the healing of the body mentioned in the Catechism paragraph cited above. Their subsequent survival does not mean that they were wrong to receive the sacrament, which can be received multiple times as circumstances warrant (c. 1004.2).

At the same time, however, care should be taken not to err in the opposite direction, by requesting the sacrament the instant that one feels unwell. After the phraseology of the law was changed, there was much misunderstanding as to the nature of this sacrament, which sometimes was misleadingly described as being “not only for the dying any more.” Parishes occasionally would organize “healing services,” at which the anointing of the sick was administered to anyone with any health problem. I myself remember well a pastor who, after the promulgation of the new Code of Canon Law in 1983, encouraged parishioners with hayfever and other non-life-threatening medical conditions to be anointed! It should be clear from the wording of the code that this is an abuse of the sacrament, which is still intended for the dying. Fortunately, such blatant abuses appear to be disappearing.

But what about anointing dying two-year-old children? The answer to Melanie’s question lies in a single phrase of canon 1004.1, already quoted above: the sacrament is to be administered to the faithful who have reached the age of reason. We all know that infants and very young children are mentally incapable of understanding right and wrong; only when they are old enough can they comprehend the significance of their actions and be held accountable for them. Thus a child who has not yet reached the age of reason cannot sin, because he cannot choose between good and evil. He is intellectually unable to make such a conscious moral decision.

The actual age at which a child attains the use of reason naturally varies. But both moral theologians and canonists traditionally have held it to be roughly the age of seven. This is why canon 97.2 notes that a child is not legally presumed to have reached the age of reason until his seventh birthday.

If a child has never sinned, and is too young to even understand what sin is all about, it follows that “the temptation to discouragement and anguish in the face of death” which the Catechism describes as a consequence of sin will be absent. Thus the intended purpose of the anointing of the sick is not served by administering it to a child under the age of reason.

Interestingly, while already we’ve seen that the current canons on this sacrament reflect some different, post-Vatican II wording, the fact that very young children should not be anointed has not changed. A document from the Sacred Congregation for Divine Worship back in 1972 noted that “sick children may be anointed if they have sufficient use of reason to be strengthened by this sacrament.” That was nearly 40 years ago, but no subsequent directives have ever been issued by the Vatican to change it.

The fact that some children attain reason at a younger-than-average age is addressed in canon 1005, which states that if there is a doubt as to whether the person to be anointed has reached the age of reason, the priest is to administer the sacrament. Again, this is a judgment call. If (say) a precocious five-year-old has previously demonstrated that he appreciates the implications of choosing between good and bad, it is entirely possible that even at such a young age he has already committed sin. Anointing a child in such a case may therefore be appropriate.

But in the case Melanie describes, the priest who would not anoint a two-year-old girl because she was “innocent” was correct. While some children attain reason at a younger-than-average age, it is difficult to find cause to assume this of someone so young as two! Assuming that this child had already been baptized, she was spiritually prepared to enter Heaven at her death. (We see here incidentally a good example of why children should be baptized as early as possible, an issue addressed in “How Soon Should a Baby be Baptized?”)

There’s no question that family members and friends should naturally mourn the death of a loved one, particularly of such a tiny child. It was entirely fitting that the parish priest should visit the family in the hospital, to console and strengthen them all spiritually as best he could. He probably blessed the dying little girl, but he rightly understood that there was no need to anoint her. As one who was surely sinless, her soul flew right to Heaven without it.

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