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Question 4: In which cases should nurses baptize babies in danger of death?

Having previously worked in the pediatric department, I have been transferred to the neonatal nursery at this public hospital. Sometimes babies are in danger of death, and the question arises whether to baptize them. The answer, of course, is clear in certain cases. If Catholic parents ask that their baby be baptized, I don’t hesitate. On the other hand, if the parents of a possibly dying baby say they are nonbelievers and certainly do not want me to baptize the child, that is the end of the matter. But there are many other cases that are not so clear.

Perhaps you will tell me to avoid the difficulty by leaving it to the chaplain. However, we have no resident chaplain in the hospital and, while I can call a priest from one of the nearby parishes, it usually takes a while to locate one and the priests often take their time coming. Moreover, I’ve asked them the question I’m asking you—when to baptize a baby in distress—and gotten conflicting and confusing answers. One priest even told me the baptism of babies is no longer necessary and my concern is “preconciliar.”


This question concerns the responsibility to baptize babies in danger of death. In general, babies ought to be baptized, and claims to the contrary should not guide action. Ordinarily, the service of an ordinary minister—deacon, priest, or bishop—should be sought for baptizing babies of Catholic parents unless the baby’s death is imminent. According to the Church’s law, babies in danger of death may be baptized even against non-Catholic parents’ wishes. However, both prudence and respect for the parents’ role argue against baptizing babies contrary to the expressed wishes of parents. If the parents’ wishes cannot be ascertained, one should proceed on a reasonable presumption regarding them or, if doubt remains and death is imminent, one should baptize the baby.

The reply could be along the following lines:

Though your question does not concern the babies of Catholic parents who wish them to be baptized, I shall begin with that sort of case. Since bishops, priests, and deacons are the ordinary ministers of baptism (see CIC, c. 861, §1), you should not baptize a baby whose parents are Catholic unless the child is in imminent danger of death and an ordinary minister is unavailable. Despite the inconvenience and difficulty you have encountered, try to obtain a cleric’s service when such a baby needs to be baptized unless the need is plainly urgent. Moreover, many other pastoral services should be readily available to meet other Catholic patients’ spiritual needs. The bishop probably has assigned some priest—or, perhaps, due to scarcity of priests, a nonclerical pastoral worker—primary responsibility for the hospital. Find out who that person is and ask him or her to do three things: see to it that he or she or someone competent to provide the necessary service is always available, provide an efficient way of summoning the person who is needed, and make known throughout the hospital the availability of this Catholic pastoral service. If you cannot identify a person who has been assigned to serve Catholic patients in the hospital or if the assigned person is uncooperative, bring the problem to the bishop’s attention.

Similarly, you should find out what pastoral services are available for non-Catholic Christians who make use of the hospital, and, when possible, should encourage and assist those whose babies require baptism to make use of the services of their own church’s ministers.

I turn now to your question, which concerns cases that will pose a problem even if and when adequate pastoral services are provided.

You certainly are right to ignore the advice of the priest who told you baptizing of babies is no longer necessary. Based on the words of Jesus himself, the whole Catholic tradition is that baptism is necessary for salvation.7 This belief implies that infants ought to be baptized, and almost all Christians have baptized them.8 In accord with this tradition, the Catholic Church’s law still requires infant baptism, normally within the first few weeks after birth, but without delay if a baby is in danger of death (see CIC, c. 867). The Congregation for the Doctrine of the Faith has reiterated the traditional doctrine about infant baptism in the face of theological speculation to the contrary.9 Even those who think that such speculation is plausible should not put it into practice—the baby’s eternal welfare may be at stake, and baptizing him or her is very easy. Therefore, to withhold baptism would be inexcusable; it would be like withholding a cheap and readily available drug that surely would cause no harm and might be absolutely essential to prevent death.

Someone might object that since the Church teaches that a person not actually baptized can be saved by baptism of desire (see DS 1524/796), baptizing babies is not essential provided a parent or someone else desires their baptism—a desire at least implicit in a parent’s intention to meet a baby’s needs, your concern about baptizing babies, and the Church’s constant effort to carry out her salvific mission.

This objection is unsound, however, for two reasons. First, while the Church does teach that an individual’s desire for baptism can suffice for his or her own salvation, she nowhere teaches that others’ desire that a baby be baptized suffices for the baby’s salvation. Second, someone who consciously and sincerely desires that a baby be baptized will see to it, if possible, that baptism is administered when the baby is in danger of death. Thus, if you and others did not try to administer baptism when you can to babies in danger of death, there would be no sincere desire that they be baptized.

Focusing exclusively on the preceding considerations, many sound theologians in times past held that every baby in danger of death should be baptized. Moreover, the Church’s law states: “The infant of Catholic parents, in fact of non-Catholic parents also, who is in danger of death is licitly baptized even against the will of the parents” (CIC, c. 868, §2). However, not all that is licit (that is, in accord with law) is obligatory; and even what is in general obligatory sometimes is rightly omitted in particular cases to avoid bad side effects. Like other aspects of the care of children, their religious care is primarily their parents’ responsibility, and parents are likely to resent the unwanted baptism of their child. In our society, such resentment might well lead to hatred—of those immediately responsible, of the Church, and even of the Christian religion as such—and that hatred often would have further bad effects. Therefore, it seems to me you should try to conform to parents’ wishes about the baptism of their infants.10

You plainly are assuming and acting on that norm in the clear cases you mention. Of course, parents sometimes misunderstand their responsibility and, for example, might want their baby baptized in the hospital even though there is no significant danger of death. In such a case, you should not comply but, instead, should explain that they ought to arrange their baby’s baptism in the usual way as soon as convenient after taking him or her home from the hospital. In other cases, where the child is in serious distress and the parents ask you to baptize, or where you communicate with the parents and obtain approval, you should comply with their wish.

If you cannot communicate with the parents but know they are Catholics or members of another Christian communion that practices infant baptism, proceed on the reasonable presumption that they would desire baptism for their baby in danger of death and baptize him or her. Similarly, if you know that the parents’ convictions exclude or are incompatible with infant baptism, proceed on the assumption that they refuse consent and do not baptize the baby.

If you neither can communicate with the parents nor have any ground for a reasonable presumption regarding their wishes, delay acting, unless the infant’s death is imminent, and try to ascertain the parents’ wishes. But if death is imminent, baptize the baby, on the basis that the parents should desire eternal life for their child and probably would wish him or her to be baptized if they were accurately and fully informed and could express their wishes.

In speaking here of “the parents,” I also am referring to a guardian, foster parent, or other person who takes the place of a baby’s parents. Moreover, if only one parent is available, you may assume that he or she speaks for both. If the two should disagree, accept as authoritative the judgment of the one who wishes the baby baptized, since that judgment is objectively correct.

What about deliberately aborted babies who certainly are or may be alive but are sure to die soon? They have been abandoned by their parents and left to die. Like other abandoned children, they need and deserve adoption by anyone willing to fulfill, insofar as possible, parental duties toward them. Therefore, you should fulfill the urgent parental duty of providing for their salvation by baptizing them (see CIC, cc. 867, §2; 870; 871).

If an aborted baby—or any other baby to be baptized—is still enclosed within tissues, open them so that the baptismal water will flow on the baby’s skin as you pronounce the words of baptism. Only a living human individual can be baptized, and sometimes you will be unsure whether that is what you are dealing with. In such cases, baptism should be administered. In doing so, your intention will be conditional: “If this is a living human individual, I baptize you . . .,” though the condition need not be expressed in words.

In every case in which you administer baptism, carefully and promptly record as much of the following information as is available: the date, the baby’s name, his or her date and place of birth, the parents’ names and address or addresses, whether one or both are Catholic, and the name of the parish in which the Catholic parent or parents reside. As soon as convenient, send this information to the pastor of the parish in which the hospital is located (see CIC, c. 878). When applicable and different, send it also to the pastor of the parish in which the baby would have resided—or, if the baby survives, will reside—with a Catholic parent or parents. You also should call Catholic parents’ attention to the need to arrange with their pastor to supply the rites of baptism. When neither parent is a Catholic, you should encourage the parent or parents to report the baby’s baptism to their church, so that its baptism will be recorded.

Since you will not always be on duty when babies need to be baptized, you also should discuss this matter with the physicians and other nurses with whom you work. Perhaps Catholics and some other Christians who practice infant baptism will cooperate with you in meeting this need. If necessary, even a non-Christian can baptize validly, provided he or she both intends (simply as a favor to a Christian) to do what a Christian would do in baptizing and performs the rite correctly—that is, by pouring water on the head of the child while saying: “I baptize you in the name of the Father and of the Son and of the Holy Spirit.”

7. See DS 184/88, 223/102, 780/410, 794/424, 1349/712, 1514/791, 1626/869; CCC, 1257). Well before Vatican II, theologians argued for the view, now proposed by the magisterium, that there is reason “to hope that there is a way of salvation for children who have died without Baptism” (CCC, 1261). But neither those theologians nor the magisterium regards that reason to hope as a justification for neglecting infant baptism; see William A. Van Roo, S.J., “Infants Dying without Baptism: A Survey of Recent Literature and Determination of the State of the Question,” Gregorianum, 35 (1954): 406–73.

8. Cogent arguments support the position that infant baptism was practiced from apostolic times; see Joachim Jeremias, Infant Baptism in the First Four Centuries, trans. David Cairns (Philadelphia: Westminster Press, 1960); The Origins of Infant Baptism: A Further Study in Reply to Kurt Aland, trans. Dorothea M. Barton (London: SCM Press, 1963).

9. See Instruction on Infant Baptism, AAS 72 (1980) 1137–56, Flannery, 2:103–17.

10. St. Thomas, S.t., 2–2, q. 10, a. 12; 3, q. 68, a. 10, teaches that the children of Jews and unbelievers should not be baptized against their parents’ wishes. He points out that doing so would violate the Church’s practice and infringe upon parents’ responsibility over their children.