Introduction to the Sacrament of Anointing of the Sick


The sacrament of anointing of the sick is administered by a priest to bring both spiritual and physical health to a Catholic during a serious illness, most especially near the moment of death. Like all sacraments, the sacrament of anointing of the sick, is “an efficacious sign of grace, instituted by Christ and entrusted to the Church, by which divine life is dispensed to us.”[1] The sacrament of anointing of the sick is a rite performed by a priest to give God’s grace to a seriously sick person through the power of the Holy Spirit.

History of the Sacrament

Like all sacraments, the sacrament of anointing of the sick was instituted by Christ Himself. In the Gospel of Mark we read, “they drove out many demons, and they anointed with oil many who were sick and cured them.”[2] The Gospel of Mark makes it clear that the apostles, following the command of Christ who “summoned the Twelve and gave them power and authority over all demons and to cure diseases, and he sent them to proclaim the kingdom of God and to heal [the sick],”[3] anointed people with oil and cured them.

In the Letter of James we see the sacrament of anointing of the sick more explicitly.

Is anyone among you sick? He should summon the presbyters of the church, and they should pray over him and anoint [him] with oil in the name of the Lord, and the prayer of faith will save the sick person, and the Lord will raise him up. If he has committed any sins, he will be forgiven.[4]

The Letter of James shows unquestionably that priests are called to pray over sick people, anointing them with oil and forgiving their sins. The word save, used in verse 15, is a translation of the Greek word sozein which refers to a saving on a supernatural level and not necessarily on a human level which shows that while there can be a desire for a natural cure, the sacrament ensures a supernatural healing, preparing the soul to enter the Kingdom of Heaven.

The sacrament of anointing of the sick did not cease with the death of the apostles. Hippolytus of Rome, a third century priest and theologian, leaves a somewhat obscure prayer for the consecration of oils to be used for the sick dating from the year 215AD. “O God, sanctify this oil: grant holiness to all who use it and who receive it, and as you anointed kings, priests and prophets, so may it give strength to all who consume it and health to all who use it.”[5] While some might argue this is a blessing for a non-sacramental oil the anointing referred to in the Letter of James is explicitly referred to as a sacrament by Pope Innocent. “For, that cannot be administered to penitents, because it is a kind of sacrament. For, how is it supposed that one species (of sacrament) can be granted to those to whom the rest of the sacraments are denied?”[6]

By the early 1400’s we have a record of an English priest, John Drury succinctly describing the sacrament of anointing of the sick saying “the last anointing alleviates both the ghostly and the bodily sickness, and strengthens the soul in his passing.”[7] In 1274 St. Thomas Aquinas’s Summa Theologica addressed a systematic theology of the  sacrament of anointing of the sick.[8] Further development to the sacrament of anointing of the sick came with the Second Vatican Council. In the year 1551 the Council of Trent definitively taught in the face of the errors of the Reformation that anointing of the sick was a sacrament and that it was an anointing of the body with the holy oil.

While the Rite continued to develop, it was left relatively the same until the Second Vatican Council, generally taking on a form where the sacrament was only administered to those near death. The Second Vatican Council’s document on the liturgy Sacrosanctum Concilium reminded the faithful that the sacrament can be received more than once. “Anointing of the Sick 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 appropriate time for him to receive this sacrament has certainly arrived.”[9] Pope Paul VI, following Vatican II issued an Apostolic Constitution, Sacram Unctione Infirmorum in 1972 in which he drew out the practicalities of Sacrosanctum Concilium concerning last rites. It is from this Apostolic Constitution that the current rite of anointing of the sick has been devised.

The Rite Explained

The rite of anointing of the sick is performed either in the midst of Mass, outside of Mass or in a shortened form in the fear of death. In all three versions of the rite the priest lays hands on the sick persons head and then anoints the forehead saying “Through this holy anointing may the Lord in his love and mercy help you with the grace of the Holy Spirit.” Next the priest anoints the hands of the sick person saying “May the Lord who frees you from sin save you and raise you up.” If desired and decent the priest may also anoint the sick body part of the person.

If the rite is performed within Mass a ritual Mass for the sick is said unless it is a Sunday or a solemnity. Mass is said like normal until after the homily when a litany is usually said. After the litany hands are laid on the heads of those who are to receive the sacrament and they are anointed. The sacrament of anointing of the sick is concluded with a prayer after anointing, which varies depending on who is being anointed (is the person terminally ill, advanced in age, about to have surgery etc.) After the prayer the Mass continues as normal.

If the sacrament of anointing of the sick is performed outside of Mass it is usually done in the context of a prayer service. The rite begins with a greeting and a penitential rite and is followed by an opening prayer. After the prayer there is usually a Liturgy of the Word with a Gospel reading and a short homily. Then the litany is said followed by the laying on of hands and anointing of the sick person just as at Mass. After the anointing comes the prayer as it does in the context of Mass and then the Our Father is prayed. Following the Our Father the Liturgy of Holy Communion can be celebrated with the Lamb of God said followed by the reception of Holy Communion and the prayer after communion.

In the case that death is very near or one is in a hospital setting the rite can be shortened to simply the anointing, the Our Father and the prayer after the anointing. In any case where death may be near viaticum, literally meaning provisions for the journey, should also be included. After greeting the sick person with the sign of the cross the dying person should be offered the opportunity to go to the sacrament of reconciliation. Following the sacrament of reconciliation that Apostolic Pardon should be given with the following words “By the authority which the Apostolic See has given me, I grant you a full pardon and the remission of all your sins in the name of the Father and of the Son and of the Holy Spirit.” The apostolic pardon is a prayer said by the priest which grants a plenary indulgence, the “the full remission of the temporal punishment due to sin.”[10] In other words all venial sins are forgiven and any temporal punishment due to forgiven sins is removed. Said most simply if one has just received the sacrament of reconciliation and one dies after receiving the Apostolic Pardon without having sinned again they will be perfectly purified and ready to enter heaven without passing through purgatory. (This is why it is very important that we pray daily for the grace of a happy death.) Following the Apostolic Pardon a reading from scripture may be proclaimed, baptismal promises may be renewed and a litany may also be said followed by the Our Father. If possible the dying person may also receive Holy Communion which is followed by a prayer after communion and a final blessing.

The Effects of the Sacrament of Anointing of the Sick

The sacrament of anointing of the sick has five primary effects. Firstly it unites the sick person to Christ’s passion, making his suffering meritorious for himself and for the whole Church.[11] Secondly the sacrament strengthens and gives courage and peace to assist the sick person to endure their illness in a Christian manner. Thirdly it forgives the sins of the sick person if they are not able to receive the Sacrament of Reconciliation. The sacrament fourthly assists the sick person to make a physical recovery if it is for the good of the person’s soul and the will of God. Fifthly the sacrament of anointing of the sick prepares the soul to pass over to eternal life.[12]

It can be easy to be tempted to question why God did not heal a loved one. While Jesus heals many people in the gospels we have no proof he healed everyone and he certainly did not heal everyone immediately.[13] In the letters of St. Paul we see that St. Paul himself frequently evangelizes even while he is sick.[14] Not only does he persevere through his illnesses he leaves his companion Trophimus behind because he is sick rather than healing him and bringing him along.[15] More importantly we hear from Paul that we should use medicine to deal with our illness. “Stop drinking only water, but have a little wine for the sake of your stomach and your frequent illnesses.”[16] Seeing that Paul does not tell Timothy to have more faith or prayer harder reminds us of the need of medical treatment and that illness comes not because of our lack of faith or as a punishment from God.

Just as easily as questing why God didn’t heal a loved one we can be tempted to question if God can heal or if He simply allows nature to take its toll. In James 5:14-15 we hear the command to heal and recognizing that this command has not been revealed we should accept that God can still heal and does still heal and we should continue to pray for healing if it be God’s will.

To understand why God does not always heal loved ones we should turn to the book of Proverbs. “The discipline of the LORD, my son, do not spurn; do not disdain his reproof; For whom the LORD loves he reproves, as a father, the son he favors.”[17] While God does not make a person sick as a punishment, He permits them to be ill so that a good may come. He permits their suffering so that He may be glorified in the midst of the suffering.

The Value of Suffering

Even in the midst of suffering, one should realize there is value in their suffering. Firstly St. Paul reminds us suffering can be for one’s own spiritual good.

“Therefore, that I might not become too elated, a thorn in the flesh was given to me, an angel of Satan, to beat me, to keep me from being too elated. Three times I begged the Lord about this, that it might leave me, but he said to me, “My grace is sufficient for you, for power is made perfect in weakness.” I will rather boast most gladly of my weaknesses, in order that the power of Christ may dwell with me. Therefore, I am content with weaknesses, insults, hardships, persecutions, and constraints, for the sake of Christ for when I am weak, then I am strong.[18]

In the midst of suffering, we one should turn to God and use the sickness as an opportunity for humility and unity with Christ. Secondly, God may permit our suffering so we can help others. For example, St. Paul preached to the Galatians because he was ill.[19] If Paul had not become ill he may never have preached to the Galatians and we may not have his letter to them in the New Testament today. So too a sick person should see their suffering as a chance to preach through their witness to those who care for them etc. Thirdly, the pain a sick person experiences may give the sick person the opportunity to offer those sufferings for the good of a poor soul in purgatory.


In God’s great love for us He left us the seven sacraments to nourish our spiritual lives. During His life, Christ instituted the sacrament of anointing of the sick and commanded his disciples to anoint and heal the sick. Since that moment of institution the Church has not ceased to carry out Christ’s command. While the way the sacrament is celebrated has developed over the years it has always included the laying on of hands, an anointing and a prayer. Since the time of its institution and continuing until the end of the world, the Church will dispense the sacrament of anointing of the sick to give grace to the sick; to pray for physical healing if it be God’s will while preparing the soul for eternal life and strengthening the soul to endure the Christian life in the midst of the struggles of their illness.

[1] Catechism of the Catholic Church, 2nd ed. (Washington, DC: United States Catholic Conference, 2000), 1131.

[2] Mark 6:13

[3] Luke 9:1-2

[4] James 5:14-15

[5] Hippolytus, On the Apostolic Tradition, 5.2 trans. John Behr, (Crestwood: St. Vladimir’s Seminary Press, 2001), 76.

[6] Letter of Pope Innocent I, SI INSTITUTA ECCLESIASTICA, MARCH 19, 416

[7] John Drury “Tract on the Manner of Confession”, in S.B. Meech, “John Drury and His English Writings,” Speculum 0 (1934):78. Translated from the Middle English into modern English by James Monti in his work A Sense of the Sacred Roman Catholic Worship in the Middle Ages pg 234.

[8] Thomas Aquinas, Summa theologiae, S, Questions 29-33 in Summa theologica: Complete English Edition in Five Volumes, vol. 4, trans. Fathers of the English Dominican Province (Notre Dame, IN: Christian Classics, 1981), 2426-2427.

[9] Second Vatican Council, Constitution Sacrosanctum Concilium, 73. A.A.S. LVI (1964) 97.

[10] Baltimore Catechism of 1891. Question 234. Pg 50.

[11] See the section on the Value of Suffering below for more information.

[12] CCC 1532

[13] Mark 8:22-26

[14] Galations 4:13-14

[15] 2 Timothy 4:20

[16] 1 Timothy 5:23

[17] Proverbs 3:11-12

[18] 2 Corinthians 7-10

[19] Galatians 4:13

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