At present, Catholic Church discipline allows only priests and bishops to anoint the sick. I’d like to propose that, in light of the coming Year of Mercy, the Church consider an expansion of this ministry to include deacons and properly prepared and commissioned lay ministers among those who may anoint. This is not an idle question, but one which bears on real pastoral needs of entire families and communities, and is heightened by the priest shortage. The restrictions on anointing today, I would argue, diminish our evangelizing witness as a sacramental church.
Sickness and Suffering
At the close of the Second Vatican Council, Pope Paul VI delivered an address to the poor, the sick and the suffering. Here’s how it begins.
To all of you, brothers in trial, who are visited by suffering under a thousand forms, the council has a very special message. It feels on itself your pleading eyes, burning with fever or hollow with fatigue, questioning eyes which search in vain for the why of human suffering and which ask anxiously when and whence will come relief.
He goes on to say that we want to alleviate that suffering, as so many physicians, nurses, and others do, yet there is something more precious still that the Church has to give. “We have something deeper and more valuable to give you, the only truth capable of answering the mystery of suffering and of bringing you relief without illusion.” He is speaking of the mystery  of Christ, the Man of Sorrows, who embraces them with fraternal love and reveals them to be “the preferred children of the kingdom of God.”
The Gift of Anointing
The ordo for the Pastoral Care of the Sick voices many of the same themes Pope Paul VI named in this address—the mystery of suffering, the salvific effect of willingly sharing in Christ’s passion, and the profound love communicated by Christ, the Healer. The sacrament of anointing the sick beautifully announces and makes real the treasure we have through Christ’s compassion. holy-oils
Our problem today, I think, is not with any of that. The problem is that the priest shortage in many places has made it hard – if not impossible — to offer the Sacrament of the Sick to many of the people who could benefit from it. No longer framed as a sacrament celebrated only at the point of death (extreme unction), the Sacrament of Anointing the Sick is intended to bring solace and healing to anyone who is seriously ill, chronically ill, weakened by old age, or facing surgery. In this day and age when even medical interventions like chemotherapy can cause immense suffering before the person recovers, there is a wide range of instances when people are seriously sick and suffering. They are not at the point of death. Yet they surely deserve this powerful and beautiful ministry of the Church. Unfortunately, an increasing number of them won’t get it.
The Need Is Great
It’s not that the sacrament of the sick is never offered. Some parishes hold healing services. Anointing of the sick may be included in Sunday Mass, and it sometimes is (although I have to admit that only one parish I’ve ever belonged to did it on a regular basis). Parish priests do visit the sick, and hospitals generally have a priest they can call in an emergency.
The need on the whole, however, is far greater than our priests can hope to fulfill, even with the best of intentions. The challenge is keenly felt in rural areas, where priests may minister to two, three, or even four parishes. It is experienced in today’s mega-parishes that minister to thousands of Catholics. Also, priests who offer services to a particular language group or to persons with special needs face a formidable task in bringing this sacrament to their pastoral charges, who are typically under-resourced and far flung. Of all the sick, the letter of James, 5:15, says “Bring them to the presbyters.” Right. It may have worked in the first century. Look at today’s hospitals and health care institutions, nursing homes, and homecare networks. There’s no way we’re going to “bring them to the presbyters.” Someone has to go out to them.
It’s heartbreaking, really, to confront the barriers to anointing. I’ve heard it often in table talk with lay chaplains, deacons, and ministers to the homebound. They wish their beloved sick could receive this sacrament, but the chances are slim that they will get it because there just are not enough priests to go around.
The Costs and Challenges
This situation not only disadvantages the sick. It also diminishes the witness Catholics bring to the whole phenomenon of sickness, the frailty of old age, and the process of dying—critical times in the lives of whole families and communities. If we are not there for people sacramentally at such times, what is different about our approach from that of any other “good people” who practice other religions or no religion?
Some will say that the restriction of the administration of this sacrament to bishops and priests raises its status. I disagree. I think it actually undermines general esteem for the sacrament if it is not offered when the need is there. The message quietly sent by letting this sacrament go uncelebrated is this: Anointing the sick is nice but quite unnecessary.
As we approach the upcoming Year of Mercy, I think the church should revisit the question of who may anoint the sick—not as an abstract question, but as a question in all its concreteness. And I hope we might do so with evangelical boldness.
History and Theological Questions
Anointing the sick is a practice going back to apostolic times. It is the subject of exhortation in the letter of James. A literal reading of James 5:15 to warrant an absolute restriction to priests however (“bring them to the presbyters”) is not supported by Christian history. Lay persons anointed the sick during the patristic era, as church sources attest. Anointing of the sick was not restricted to clergy until the eighth century.
The letter of James associates anointing with forgiveness, but it does not say explicitly that forgiveness comes through the priest who anoints. The statement is more general, clothed in the exhortation to pray for one another. The Council of Trent however did explicitly say that the priest or bishop is the proper minister of anointing and that the sacrament of the sick forgives sins. The Second Vatican Council repeated these assertions.
The question of whether a permanent deacon may anoint the sick has come up in our time because of pastoral need. This has been argued against on the basis that the anointing of the sick also forgives sins and a deacon does not have that power. This argument does not dispose of the question, however. Deacons are permitted to baptize (and even a lay person may baptize in case of an emergency), and baptism forgives all sin. Is it theologically possible to distinguish between the sins of the unbaptized, which can be forgiven by a deacon who baptizes, and the sins of a baptized person, which may not be forgiven via the anointing of the sick? It’s also interesting to note that the practice of private confession and reconciliation as we know it today originated with Irish monks (lay people) and was only later restricted to priests. The question of how forgiveness is mediated – even in the Sacrament of Reconciliation — has been answered variously in Christian history, prompted by pastoral circumstances and needs.
David N. Power, writing in the journal Concilium (“The Sacrament of Anointing: Open Questions,” Concilium, 1991/2) noted that there are three historical factors that must be taken into account in considering the question of the minister of anointing in the present age. First is the identity of the presbyteroi of whom the letter of James speaks. They had some official role in the church, but it is not clear that these elders received it by the laying on of hands—an assumption usually made by those who simplify the question and say they are the exact equivalent today’s priests. Second is the widespread practice of lay anointing in the early centuries, as we’ve already noted. Third is the intention of the Council of Trent in defining the “proper” minister. Drawing on the work of André Duval, he observes that the word “proper”—an unusual usage—may have been chosen to counter attacks by the Reformers on the nature of priesthood rather than to settle once and for all the question of who may anoint.
Imagine New Solutions
The Catholic community has been resourceful in ministering to the sick through the years, founding hospitals and health care institutions, devoting whole religious apostolates to care of the sick, and praying in various ways for their welfare. In our own day, deacons, lay chaplains, parish visitors to the homebound, and extraordinary ministers of Holy Communion have augmented the role of priests in meeting the spiritual needs of the sick. They show the face of Jesus by their caring presence, by their prayers, and by bringing the Eucharist to those who cannot come to church. I am profoundly touched whenever I see ministers of the Eucharist sent out from the altar at the end of the communion rite at Sunday Mass—knowing that they are taking Holy Communion from our celebration and going out to bring it into the homes of the sick, and into hospitals and other facilities. It deepens our sense of being united with the sick and homebound.
We already send out ministers to bring  the Eucharist, the premier sacrament to which all other sacraments are ordered. Could the bishop not also properly train and depute special ministers to anoint the sick, and similarly send them out to places where the need is great? To increase the number of people who may anoint the sick is not the same as creating a free-for-all in which anyone with a warm heart can take a bottle of Bertoli’s and do what they will. A preparation process and an adapted rite would have to be devised, the limits of which would need to be carefully delineated. But the point is, we have the ingenuity to do it. We have the faith to do it. If we can come up with an order of service for a Sunday celebration in the absence of a priest, we can certainly do this.
And as we do it, perhaps the most important ministry to remember is the ministry of the sick themselves. The sick are also ministers of the celebration. They themselves are a powerful sign and a true participant in Christ’s saving work of redemption. In the words of Paul VI: “Know that you are not alone, separated, or useless. You have been called by Christ and are His living and transparent image” and “with him, if you wish, you are saving the world.” The experience of anointing the sick that brings forward this grace-filled truth is well worth extending.