What Is the Anointing of the Sick?

 

 

A Sacrament for the Seriously Ill — Not a Sign That Death Has Arrived

A priest is called to a hospital room. He brings oil and a stole. He prays, lays his hands on a person's head, anoints the forehead and hands. To many of the family members watching, this means one thing: the end is near. The priest's arrival has always meant that.

The problem is that this reading — which generations of Catholics absorbed and many still carry — is exactly the misunderstanding the Second Vatican Council addressed. The Anointing of the Sick is not a signal that hope is lost, and it is not reserved for the dying. It is a sacrament of healing: it gives the sick person a special grace of strengthening, peace, and courage; it may include forgiveness of sins when sacramental confession is not possible; and it may restore physical health if that would serve the person's salvation. When death is near, it also prepares the Christian for the final passage.

This article explains what the Anointing of the Sick is, who should receive it, what happens during the rite, what the sacrament accomplishes according to Catholic teaching, how it differs from the old name Extreme Unction, and how it relates to the Last Rites cluster covered in our companion article. The place of this sacrament within the seven sacraments is established there; this article goes deeper into the sacrament itself.

What Is the Anointing of the Sick?

The Anointing of the Sick is one of the seven sacraments of the Catholic Church, belonging to the sacraments of healing alongside Penance. The Catechism opens its treatment with a single sentence from the Second Vatican Council that captures the sacrament's full scope: "By the sacred anointing of the sick and the prayer of the priests the whole Church commends those who are ill to the suffering and glorified Lord, that he may raise them up and save them. And indeed she exhorts them to contribute to the good of the People of God by freely uniting themselves to the Passion and death of Christ" (CCC 1499, quoting Lumen Gentium 11).

Several things are already visible in that sentence. This is the whole Church acting, not just a priest performing a private ritual. The sacrament commends the sick person to the suffering and glorified Christ. Catholic teaching holds that the sacrament gives a special grace of strengthening and union with Christ, and that physical health may also be restored when this is conducive to salvation. The person who receives the sacrament is likewise invited to unite suffering with Christ's Passion for the good of the Church.

The sacrament is one of healing, but Catholic theology has always been careful about what "healing" means. It does not mean the guarantee of a cure. It means the restoration of the whole person — body and soul — to right relationship with God and with life, according to what God wills and what genuinely serves the person's salvation.

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Biblical Foundation

The scriptural charter for the Anointing of the Sick is the Letter of James, chapter 5, and the Church has read it as such since apostolic times:

"Is anyone 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 one who is sick, and the Lord will raise him up. And if he has committed sins, he will be forgiven."

— James 5:14–15

Three elements from this passage have shaped the sacrament across the centuries: the presbyters of the Church, the anointing with oil, and the prayer of faith. Catholic tradition recognizes James 5:14–15 as the principal biblical foundation of the sacrament, and the Council of Trent drew on this text when teaching about its institution, minister, and effects. The promise that the sick person will be "raised up" is not treated as a guarantee of physical recovery; the Church understands the sacrament as giving salvific grace, strengthening, forgiveness of sins in the circumstances proper to the sacrament, and sometimes bodily healing.

Mark's Gospel provides another important biblical precedent. When Jesus sent out the Twelve, they "anointed with oil many who were sick and healed them" (Mark 6:13). Catholic teaching sees this apostolic practice as part of the biblical background of the sacrament, while James 5:14–15 gives the clearest New Testament description of prayer by the Church's presbyters together with anointing and forgiveness of sins.

Jesus's own ministry to the sick is the theological backdrop for all of this. The Catechism is explicit: "Christ's compassion toward the sick and his many healings of every kind of infirmity are a resplendent sign that 'God has visited his people' and that the Kingdom of God is close at hand. Jesus has the power not only to heal, but also to forgive sins; he has come to heal the whole man, soul and body" (CCC 1503). The healing miracles in the Gospels are not primitive medicine — they are signs of the Kingdom, demonstrations that the restoration of the whole human person is part of what Christ came to accomplish. The sacrament of Anointing is the Church's continuation of that ministry.

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Who Should Receive the Anointing of the Sick?

The Catechism states: "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, quoting SC 73). Canon 1004 §1 uses almost identical language.

The criterion is not simply that death is near. Canon 1004 §1 speaks of a member of the faithful who, having reached the use of reason, begins to be in danger due to sickness or old age. The Catechism also says that it is fitting to receive the sacrament just prior to a serious operation and that elderly people may receive it when frailty becomes more pronounced (CCC 1515). The Church does not provide a medical checklist for every diagnosis, so uncertain cases are best discussed with the priest who will apply the Church's criteria pastorally.

The sacrament may also be celebrated communally, including within Mass, provided those who receive it meet the conditions for the sacrament. A communal celebration does not turn Anointing into a general blessing for everyone present; it remains the sacrament for the sick and for those whose frailty places them within the Church's criteria.

Canon law also addresses situations in which the sick person cannot communicate. Canon 1006 directs that Anointing be administered to sick persons who, while they possessed the use of their faculties, at least implicitly asked for it. Canon 1005 further provides that when there is doubt whether the person has attained the use of reason, is dangerously ill, or is dead, the sacrament is to be administered. Because the Church's universal law does not reduce eligibility to a list of diagnoses, difficult cases — including serious psychological or neurological conditions — should be referred to the priest rather than decided by a general rule in an article.

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How the Rite Is Celebrated

The Order of Anointing of the Sick (Ordo Unctionis Infirmorum), promulgated in its reformed form by Pope Paul VI in 1972, provides several different forms adapted to different circumstances — a bedside visit, a celebration within Mass, or the administration of Anointing together with Viaticum when death is near. The essential act is the same in each form.

The rite ordinarily includes introductory prayers, Scripture, the laying on of hands, prayer over the oil, the anointing itself, intercessions, and a concluding blessing, with adaptations according to the circumstances. The priest lays his hands on the sick person's head in silence. This liturgical gesture is a prayerful invocation within the Church's rite; it is distinct from the anointing that follows.

The priest then uses the properly blessed Oil of the Sick. In the Roman Rite, the sick person is anointed on the forehead and hands while the priest pronounces the sacramental formula: "Through this holy anointing may the Lord in his love and mercy help you with the grace of the Holy Spirit. May the Lord who frees you from sin save you and raise you up." In case of necessity, a single anointing on the forehead — or, when the person's condition requires it, on another suitable part of the body — is sufficient, with the entire formula pronounced. If suitable blessed oil is not available in a case of necessity, a priest may bless the oil for the celebration.

After the anointing, the priest prays and invites those present to join in the Lord's Prayer. If Viaticum is to be given, it follows at this point. The rite concludes with a final blessing.

Where possible, the sick person participates consciously and is encouraged to receive the sacrament with faith and good dispositions. Conscious participation is pastorally desirable, but it is not an absolute condition for Anointing: Canon 1006 allows the sacrament to be given when the sick person can no longer express a request, provided that person at least implicitly asked for it while still possessing the use of the faculties.

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The Oil of the Sick

The oil used in this sacrament is the Oil of the Sick. In the Latin Church it is olive oil or, when appropriate, another oil obtained from plants and properly blessed. It is distinct from sacred chrism, used in rites including Baptism, Confirmation, and Holy Orders, and from the Oil of Catechumens used in preparation for Baptism. The bishop ordinarily blesses the Oil of the Sick, but in a case of necessity a priest who administers the sacrament may bless suitable oil for the celebration.

In the Roman Rite, the Oil of the Sick is ordinarily blessed by the bishop at the Chrism Mass and distributed for use in parishes and pastoral ministry. Its blessing within the diocesan liturgy expresses that care for the sick belongs to the life of the whole local Church, even though the sacrament itself is ordinarily administered by a priest at the bedside, in a hospital, in a church, or wherever pastoral need requires.

Oil carries a long biblical and Christian association with strengthening, healing, and consecration. In the parable of the Good Samaritan, oil and wine are poured onto the wounds of the injured man (Luke 10:34). In the Anointing of the Sick, however, the Oil of the Sick is not being applied as medicine; it is the sacramental sign used by the Church together with the priest's prayer for the grace of Christ.

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What the Anointing Accomplishes

The Catechism gathers the effects of the sacrament in one paragraph (CCC 1532) that repays careful reading:

• Union with Christ's Passion — the sick person's suffering is joined to Christ's own suffering, so that it has redemptive value for the whole Church, not merely personal misfortune
• Strengthening, peace, and courage to endure suffering in a Christian manner, and to resist the temptations toward despair, anguish, or rebellion against God that serious illness brings
• Forgiveness of sins, if the sick person was not able to obtain it through the sacrament of Penance
• Restoration of health, if it is conducive to the salvation of the soul — the most commonly misread of the effects
• Preparation for passing over to eternal life — when the sacrament is given near death, it includes a specific grace for the passage itself

Each of these deserves attention. The union with Christ's Passion means the sacrament does not treat illness as meaningless adversity to be overcome. Suffering consciously united to Christ's suffering participates in something real and redemptive. Paul could speak of completing "what is lacking in Christ's afflictions for the sake of his body, that is, the Church" (Colossians 1:24) — not because Christ's sacrifice was insufficient, but because the members of his Body are invited into it.

The forgiveness of sins is an effect of Anointing when the sick person was unable to obtain forgiveness through the sacrament of Penance (CCC 1532). When a person is conscious and able to confess, Anointing should not be presented as a substitute for Confession; the rites of pastoral care ordinarily provide for Penance where it is possible and appropriate.

The restoration of physical health is conditional and not guaranteed. It is offered where it serves the person's salvation. This is not a theological evasion of the obvious — sometimes people do recover after Anointing, and sometimes they do not. Catholic teaching does not attribute physical recovery to the sacrament as a mechanism, but holds that God sometimes acts through it for healing in the body, and that this is always in service of a larger purpose.

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Does the Anointing Guarantee Healing?

No. This must be stated plainly because the contrary claim — whether made by well-meaning pastoral language or by misreading the sacrament's effects — leads people into real spiritual harm. A family that believes Anointing should produce a cure, and then watches their loved one die anyway, is left with a crisis of faith that did not need to happen.

The Catechism addresses this with unusual directness: "But even the most intense prayers do not always obtain the healing of all illnesses. Thus St. Paul must learn from the Lord that 'my grace is sufficient for you, for my power is made perfect in weakness'" (CCC 1508). Physical healing is a possible effect of the sacrament, not its primary purpose. The primary gifts are spiritual: strength, peace, union with Christ, and the grace to face whatever comes — including death — as someone held by God rather than abandoned by him.

Christian faith has always held that illness and suffering are not simply evils to be eliminated. They are part of the human condition shaped by the Fall, and through Christ's own suffering they have been given a new meaning. The sacrament of Anointing does not ignore that the body is sick; it addresses it directly through oil and prayer. But its deepest concern is the whole person — the soul that will outlast the illness, and the relationship with God that illness can strengthen or damage.

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The Meaning of Christian Suffering

The Anointing of the Sick does not exist in isolation from Catholic theology's broader account of suffering. Illness confronts every person with their limits, their mortality, and their dependence on God. The Catechism acknowledges this directly: "Illness can lead to anguish, self-absorption, sometimes even despair and revolt against God. It can also make a person more mature, helping him discern in his life what is not essential so that he can turn toward that which is" (CCC 1501).

The sacrament answers illness not with an explanation for every instance of suffering but with Christ's presence and the Church's prayer. Catholic teaching holds that the sick can be strengthened by grace and united more closely to Christ's Passion. The same Christ who "took our infirmities and bore our diseases" (Matthew 8:17, quoting Isaiah 53:4) remains the center of the Church's care for those who suffer.

The Stone of Anointing in Jerusalem — where according to Christian tradition Christ's body was prepared for burial — carries its own layer of this theology. The Stone of Anointing is a place where anointing and death and the hope of resurrection all touch at once — not an argument, but a place where the faith becomes concrete.

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Who Administers the Sacrament?

Only a priest or bishop may validly administer the Anointing of the Sick. Canon 1003 §1 is unambiguous: "Every priest, and only a priest, validly administers the Anointing of the Sick." This was definitively confirmed by the Congregation for the Doctrine of the Faith in its Note of 11 February 2005, which stated that this teaching is definitive tenenda — held as definitive by the Church — and that any administration of the sacrament by a deacon or layperson constitutes a simulation of the sacrament.

The canon further specifies (§2) that priests entrusted with pastoral care have the duty and right to administer the sacrament to the faithful committed to their care. Another priest may administer it for a reasonable cause with at least the presumed consent of the priest responsible. In a hospital, a Catholic chaplain may often be the most direct contact; otherwise the patient's parish or another nearby Catholic parish can be called.

Deacons play an important pastoral role in visiting and accompanying the sick, and may bring Holy Communion (including as Viaticum, where lawfully permitted) to the dying. But they cannot anoint. A family should be clear when they call a parish or hospital that they are asking for a priest.

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Can It Be Received More Than Once?

Yes. Unlike Baptism, Confirmation, and Holy Orders, the Anointing of the Sick does not imprint a permanent sacramental character. It may be received whenever the conditions are met.

Canon 1004 §2 provides that the sacrament may be repeated if the sick person, having recovered, again faces a serious illness, and also during the same illness if the danger becomes more serious. A person with a chronic degenerative condition may receive the sacrament multiple times across the course of that illness as their situation worsens. A person who had a serious operation, recovered, and then faces a new serious medical situation may receive it again. There is no canonical limit on the number of times a person may receive Anointing across a lifetime, provided the conditions of serious illness or danger are genuinely met each time.

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From Extreme Unction to Anointing of the Sick

The sacrament's current name is relatively recent, but the sacrament itself is ancient. Understanding the shift in name requires understanding what changed — and what did not.

Extreme Unction is the older Latin name commonly associated with the sacrament. The Catechism summarizes the historical development carefully: over the centuries Anointing came to be conferred more and more exclusively on those at the point of death, and because of this it received the name "Extreme Unction" (CCC 1512). The association with death was therefore real, but it did not exhaust the sacrament's older biblical and liturgical purpose of strengthening the seriously ill.

The Council of Trent taught authoritatively on the sacrament while describing it especially in connection with those whose illness had brought them toward the end of life. The Second Vatican Council then stated explicitly in Sacrosanctum Concilium 73 that "Extreme Unction," more fittingly called "Anointing of the Sick," is not a sacrament only for those at the point of death. Pope Paul VI's 1972 apostolic constitution Sacram Unctionem Infirmorum promulgated the revised Roman rite and specified its essential sacramental form.

The sacrament itself was not created by Vatican II. The Council clarified and restored emphasis to a broader practice already rooted in Scripture and the Church's ancient tradition: Anointing belongs to the seriously ill and elderly in danger from sickness or frailty, not only to those in their final hours.

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Anointing and the Last Rites

When a Catholic approaches death, Anointing of the Sick is one element of a broader pastoral care the Church calls the sacraments that complete the earthly pilgrimage: Penance, Anointing, and Viaticum (the Eucharist given to the dying). These three together are what people commonly call the Last Rites — though that term is not a formal liturgical title for any single sacrament. The Catechism groups them in deliberate parallel with the sacraments of initiation that open Christian life (CCC 1525).

The Catechism is also clear about which of these three is specifically proper to the dying. It is not Anointing — it is Viaticum, the Eucharist received as the final reception of Holy Communion. Anointing belongs to the seriously ill at any stage; Viaticum is specifically ordered to the approach of death. Understanding this distinction matters practically: it means Anointing should be given before death is close, while the person can participate fully, not saved as the final act.

The full theology of the Last Rites — including Penance, the Apostolic Pardon, Viaticum, and the prayers for the dying — is covered in our companion article on what the Catholic Last Rites involve.

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Eastern Christian Practice

Eastern Catholic and Eastern Orthodox Churches also preserve ancient rites of sacramental anointing, often called Holy Unction or, in Byzantine usage, Euchelaion. Their liturgical forms should not be treated as simply the Roman rite with different terminology. The Catholic Church itself recognizes that the form and bodily places of anointing vary among the Eastern rites.

In the Byzantine Orthodox tradition, the full service traditionally includes a sequence of seven Epistle readings, seven Gospel readings, seven priestly prayers, and repeated anointings. The rite calls for seven priests when possible, although it may be celebrated by fewer priests and, when necessary, by one. Its purpose is healing of soul and body and the forgiveness of sins, always within the conviction that physical recovery is subject to God's will.

A well-known Orthodox practice is the communal celebration of Holy Unction on Great and Holy Wednesday. In Greek Orthodox usage, this service may be offered broadly to the faithful for the healing of bodily and spiritual infirmities. Eastern Catholic Churches celebrate Anointing according to their own liturgical books and discipline, so particular practices vary among the sui iuris Churches. These Eastern traditions share the biblical foundation in James 5 while preserving liturgical patterns distinct from the Latin Church.

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When and How to Request the Sacrament

The practical answer to "when?" is earlier than most Catholic families think. The sacrament is most fruitfully received when the sick person is conscious, can participate in the rite, and can receive Holy Communion if Viaticum is to follow. Waiting until the person is beyond communication means receiving the rite under its most attenuated pastoral conditions.

These are the situations in which Anointing of the Sick is appropriate and should be sought:

• A Catholic facing a serious or potentially life-threatening illness
• A Catholic about to undergo a serious operation, especially when serious illness is the reason for the procedure
• A Catholic who is seriously weakened by age and declining health
• A Catholic whose chronic illness has entered a dangerous new phase
• A Catholic facing cancer treatment or another serious medical situation involving genuine danger
• A Catholic approaching death, whether suddenly or after a long illness

To request the sacrament, contact the person's parish and ask to speak with a priest about the Anointing of the Sick. Be clear about the situation — priests receive many different kinds of calls, and clarity helps. Most hospitals have Catholic chaplains who can be reached through the hospital's pastoral care office or switchboard. If neither the parish nor the hospital chaplain is reachable in an emergency, call any Catholic parish and explain that a priest is needed urgently.

A family should not delay calling because they are unsure whether the situation is serious enough. The parish or hospital chaplain can help determine whether Anointing is appropriate, and the Church encourages the sick to ask for the sacrament in good time rather than postponing it until the final moments.

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