Southwestern Indiana's Catholic Community Newspaper

Sacraments And The Sick

By Dr. Peter Rosario

A close relative was to undergo a minor medical procedure. She requested the Anointing of the Sick despite being young and healthy. Some family members became upset that she would “require” this sacrament, which, in their minds, was only for the dying. Their concept of the sacrament was the “last rites.” 

The sacrament of Extreme Unction, as it was once called, hasn’t gone away as much as it has evolved from being a sacrament primarily for persons at their point of death to being for anyone facing an illness or surgery. It may even be administered more than once in a lifetime and even more than once for the same illness if the patient’s condition worsens.

Commonly, persons are asked upon admission to the hospital if they have a religious affiliation.  After admission, a doctor performs a history and physical examination. The history should contain questions concerning spiritual matters. In fact, medical schools have started to emphasize the importance of the spiritual history as studies now point to the value of such a history and its contribution to the healing process.

For this reason, answers to questions of religious affiliation and the spiritual life should not be ignored or minimized by the patient even if one has been away from the Church or the sacraments for many years.  The “Catechism of the Catholic Church” states in paragraph 1501:  “Very often illness provokes a search for God and a return to him.” A physical or emotional healing is sought, but a spiritual healing may be what is really needed.

Therefore, one should not hesitate to request a visit from a chaplain or priest. A visit may lead to reception of the sacraments of Reconciliation, Anointing of the Sick, and Holy Communion.  Similarly, patients are often asked by astute healthcare providers if they would like to receive Communion. 

Administration of these sacraments is fairly straight forward for the alert and oriented individual.  But what about those patients in the intensive care unit, or who have some sort of advanced physical or mental dysfunction?

A key point for receiving the Body of Christ is that its sacredness must be realized and not considered ordinary food or medicine. Comatose, unresponsive or sedated patients, who lack this awareness, should not receive Holy Communion; not even a small portion of the consecrated host. 

The awake and alert patient who has been placed on nothing-by-mouth (NPO) status, may receive Holy Communion as a small fragment with permission from the medical staff. Hospital policy needs to be followed. Intractable vomiting eliminates reception of this sacrament.

When patients have plastic tubes passed through the nose or mouth, reception of a portion of the consecrated host or wine should be avoided as the sacred species might adhere to the plastic tubing or be removed through suctioning.  In cases where patients need to receive nourishment or hydration through a feeding tube, which would require dissolving or diluting the host or wine, the Church’s recommendation is not well defined and needs further evaluation.

Given these few exceptions, it is important to note that most people may receive the sacraments as patients in the hospital. Equally important is the need to ask for the sacraments even if the setting is unusual as illustrated in the following two true cases.

An elderly gentleman was in the ICU with pneumonia and respiratory failure requiring life support (mechanical ventilation, that is, a breathing machine.)  He requested baptism insisting it be with full immersion. The nursing staff secured an inflatable kiddy pool, placed it in his ICU room, filled it with warm water, and the baptism was performed with all matter of tubing and breathing apparatus attached as he went under water.  He emerged no worse off for the effort while feeling spiritually a new person.

The second case involved the sacramental marriage of a woman and man, the couple having been together for many years. She was also on mechanical ventilation with no hope of ever being free of the ventilator. She was awake and oriented, indicating her desire for marriage as a priest witnessed the sacrament in her room.

The grace the sacraments bring to the ill is a healing that may be immense. The sacraments should not be ignored even if the setting is strange or unfamiliar.

Dr. Rosario is president of the Southwestern Indiana Guild of the Catholic Medical Association.