Christian life as a whole is a preparation for death. Christians should live not only in hope of heaven but with the readiness to lay down their lives for others. Then daily living becomes, in imitation of Jesus, daily dying (see 2 Cor 4.7–12). The attitude of every Christian should be that of St. Paul in prison: “It is my eager expectation and hope that I will not be put to shame in any way, but that by my speaking with all boldness, Christ will be exalted now as always in my body, whether by life or by death” (Phil 1.20).76
Beyond that fundamental attitude, whenever a Christian faces death as a personal prospect, because of sickness, old age, or some external threat, both the individual and others concerned have some specific religious responsibilities. Central among these is the timely reception of the sacraments—penance, if necessary, Holy Communion, and anointing.
The sacrament of anointing, which is meant for all who are seriously ill, is closely linked with the sacrament of penance; the Council of Trent calls the sacrament of anointing a “culmination not only of penance but of the whole Christian life which itself ought to be a continual penance” (DS 1694/907; cf. S.c.g., 4.73). According to this teaching, the sacrament shapes the whole of Christian life into a penitential preparation for dying in the Lord Jesus (see CMP, 32.H). Thus, in this chapter on the penitential dimension of Christian life it is appropriate to summarize the religious responsibilities involved in preparing for death.
As John Paul II observes: “Our civilization tends to avoid the thought of death, because it does not wish to be disturbed from its dream of earthly contentment, as an exclusive value for man, who is understood as an absolute subject.”77 By contrast, Christians should face death realistically and with hope.78
a) The likelihood of death should be faced realistically. The realistic acceptance of any prospective evil is difficult, and from an emotional point of view no prospective evil is greater than one’s own suffering and death or that of a loved one. However, a person will not fulfill the other responsibilities involved in preparing for death without realistically accepting the likelihood of death as it approaches. The first responsibility in preparing for death is therefore to begin to face the fact and come to terms with it, for example, by frankly sharing one’s feelings with loved ones and friends.
Kindly and firmly, family members, friends, and health care personnel should encourage and support a realistic estimate of the situation by anyone whose death is approaching. If someone who might still be able to make a free choice is in danger of death but not aware of it, those who know the true state of affairs should make sure he or she is informed. This of course calls for prudence and gentleness, and is best done by someone close to the individual. But it is a grave matter to allow anyone enjoying the use of reason to die without an opportunity to prepare for death, and an even graver matter to mislead someone about something so important.
b) Faith teaches that death in itself is a great evil. Faith clearly teaches that death is a consequence of sin and a punishment for it: death is the wages of sin (see Rom 6.23; cf. Rom 5.12–21; CMP, 14.H). Even after the death and resurrection of Jesus, which atones for sin, death remains humankind’s last enemy, still to be overcome (see 1 Cor 15.26). It is unnatural, horrible, and final; human persons should not have to endure it (see GS 18; cf. 8.A.1.e).
c) Faith teaches that death in Jesus is the gateway to eternal life. By Jesus’ death and resurrection, God has destroyed death; Jesus’ victory over death is the triumphant message of the gospel. But Jesus is only the first to rise from the dead (see Col 1.18); those who eat his flesh will live forever (see Jn 6.51–58), and in the kingdom there will be no more death (see Rv 21.4). Whether one goes on living is not so important as whether one is united with Jesus (see Rom 14.7–9). The great evil of death is swallowed up by the hope of resurrection to heavenly glory, since Jesus’ sacrifice and resurrection deprive death of its sting (see 1 Cor 15.54–56).
d) One should accept death, humbly submitting to God’s will. While a person usually may, or even should, do what is possible to mitigate pain and delay death (see 8.F.3), faith empowers Christians to accept unavoidable suffering and death with hope. It also requires recognition that only God can determine the right time and conditions for each person’s death. Christians should not face suffering and death like nonbelievers: cursing fate, resigning themselves to ultimate meaninglessness, or taking matters into their own hands by killing themselves so as to “die well.” Jesus provides the model of dying truly well: “Father, into your hands I commend my spirit” (Lk 23.46; cf. Ps 31.5). Thus, when death approaches, Christians should abandon themselves and their loved ones to God’s providence and mercy, confident that, being both wise and gentle, he will raise up to glory all who die in Jesus. Then death will be happy in the Christian sense.79
Although old age has its proper blessings, it also is a time of fading. Daily life can become a burden as physical and mental powers decline and health deteriorates. Familiar activities become impossible; the aging person becomes dependent on others and is likely to be treated as a child. This situation itself is an element of vocation, an opportunity to practice resignation and forgiveness. Moreover, as people grow old and see many close friends and relatives die, the inevitability of death becomes plain. Knowing that death is imminent, they have a real advantage over younger people in preparing for it.80
Usually, people afflicted with serious illness or the infirmity of old age cannot engage in most of the activities they once enjoyed, and often others find it emotionally repugnant or practically difficult to spend much time with them. In danger of being, or at least of feeling, abandoned, such afflicted people usually need company and look forward to it. Those who visit someone facing death not only help him or her but are themselves helped to profit from the experience’s lessons about life and death. Prayer and worship should be shared during such visits.
For Catholics, spiritual preparation for death centers on preparing for and receiving the sacraments with the best possible dispositions. Neither those facing death nor those concerned about them should put off seeking the sacraments. Vigorous action should be taken as needed to ensure that a priest comes in time; and, lest anyone die without the sacraments, it should be kept in mind that even a laicized priest or a non-Catholic minister of a church with valid sacraments (for example, a priest of an Eastern Orthodox church) should, if necessary, be asked to administer them.81
Throughout their lives penitents go from the sacrament of penance to lead lives of penance—lives of reparation for sin by renewal according to the gospel. The suffering they endure and the good they do are consecrated for their conversion, which is to end in eternal life. This consecration is renewed and completed as they receive the sacraments in preparation for death (see S.t., sup., q. 29, a. 1; q. 30, a. 1).
a) Anyone in danger of death should receive Holy Communion. The Eucharist unites people with Jesus’ death and resurrection. Received worthily, it guarantees eternal life. Thus, the Church requires that those facing death receive Holy Communion as Viaticum, that is, food for the journey to the next world. Viaticum should be received when a person becomes aware of the danger of death, even if he or she already has received on that day; fasting is not required. If the danger of death persists, the Eucharist should be received repeatedly as Viaticum, but not more than once daily.82
Of course, before receiving Viaticum, those in danger of death have the usual responsibility to examine themselves and receive the sacrament of penance if necessary. If a person facing death is able to make an inclusive confession—that is, a more or less comprehensive confession of sins committed throughout his or her life—and wishes to do so, that may produce great peace of conscience.
b) The sacrament of anointing is to be received promptly. The sacrament of anointing is for anyone who, having been baptized, is mature enough to have committed some sin (has the use of reason), and begins to be in danger of death due to sickness or old age (see SC 73; CMP, 32.H). Although it is reserved for those whose death is feared (see DS 1324/700), such fear normally arises at the beginning of any serious illness and with the early signs of decline common among those growing old. It is wrong to delay receiving the sacrament of anointing until death is near.83 Promptly received, it can work powerfully on behalf of the restoration of health, since it is the Church’s continuation of Jesus’ work of healing. It also offers a special opportunity for a renewal of conversion, provides spiritual strength against Satan’s assaults, and consecrates the whole process of suffering and dying.
c) This sacrament should be received with the right dispositions. Danger of death provokes a crisis, since a person easily is tempted to rebel against God or to lose confidence in his mercy. But someone in this situation also enjoys a special opportunity to renew faith, hope, and love. In receiving the sacrament of anointing, one should submit to God’s will as Jesus did: “Father, if you are willing, remove this cup from me; yet, not my will but yours be done” (Lk 22.42). Having received the sacrament with the proper intentions, one should bear witness to faith and hope by the way one accepts God’s will and offers whatever happens in union with Jesus’ offering (see LG 11).
d) This sacrament should be obtained for unconscious Catholics. This sacrament generally presupposes that the recipient is in grace. If possible, therefore, those in mortal sin should receive the sacrament of penance first. However, if someone is at least imperfectly contrite, the sacrament remits both sins and their residual temporal punishment (see DS 1696/909). Thus, whenever there is a reasonable presumption that an unconscious person in danger of death would desire this sacrament—and there normally is such a presumption in the case of any Catholic with the use of reason who has not explicitly refused it—a priest should be summoned to administer the sacrament.
e) This sacrament may and sometimes should be repeated. If a dangerously ill person recovers and then becomes dangerously ill again, the sacrament should be repeated. If an elderly or seriously ill person’s condition deteriorates or becomes more critical, the sacrament also may be repeated, especially if some time has passed since its previous reception.84
76. On the meaning of sickness and death, see Leonard Bowman, The Importance of Being Sick: A Christian Reflection (Wilmington, N.C.: Consortium Books, 1976).
77. John Paul II, Homily at Liturgy of the Word at Milan Cemetery, 2, Inseg. 7.2 (1984) 1101, OR, 3 Dec. 1984, 6.
78. A source of the following treatment: Pius XII, Radio Address to the Sick of Italy and of the World (21 Nov. 1949), AAS 41 (1949) 610–14, Catholic Documents 3, no. 3 (1951): 15–17.
79. John Paul II, Salvifici doloris, 23, AAS 76 (1984) 232, OR, 20 Feb. 1984, 5, teaches: “Suffering as it were contains a special call to the virtue which man must exercise on his own part. And this is the virtue of perseverance in bearing whatever disturbs and causes harm. In doing this, the individual unleashes hope, which maintains in him the conviction that suffering will not get the better of him, that it will not deprive him of his dignity as a human being, a dignity linked to awareness of the meaning of life. And indeed this meaning makes itself known together with the working of God’s love, which is the supreme gift of the Holy Spirit.”
80. See John Paul II, Address to the Elderly in the Cathedral of Munich, Inseg. 3.2 (1980) 1365–74, OR, 22 Dec. 1980, 6–8.
81. See CIC, c. 844, §2, and c. 922. While c. 292 prohibits a laicized Catholic priest from exercising the power of orders, it makes one exception: he may absolve someone in danger of death (c. 976).
82. See CIC, c. 921. If necessary, Viaticum may be received under the form of wine alone: c. 925. Of course, the sick and dying are blameless if they cannot ask for the sacraments or if their request is not answered; chaplains, family members, health care workers, and others share responsibility to see to it that the spiritual needs of those in danger of death are met. If no priest is available to give Viaticum to a Catholic in danger of death, anyone having access to the reserved Blessed Sacrament should be asked to obtain It for the dying person. If such a person is conscious of grave sin and prepared to repent, he or she should pray for the Holy Spirit’s help, make an act of contrition as perfect as possible (including the intention to confess if and when possible), and devoutly receive Holy Communion (see c. 916; 3.B.3.a).
83. See CIC, c. 1001, c. 1004, §1. For the history of the sacrament prior to Vatican II, see Paul F. Palmer, S.J., “The Purpose of Anointing the Sick: A Reappraisal,” Theological Studies 19 (1958): 309–44. While the reception of the sacrament of anointing should not be delayed, it is an abuse to ask for or receive it for minor physical or psychological illnesses (see CMP, 32.H.5). A still useful study, even though written before Vatican II and the 1983 code: Charles George Renati, The Recipient of Extreme Unction (Washington, D.C.: The Catholic University of America Press, 1961).
84. See CIC, c. 1004, §2.