Unction of the Sick, also known as the Sacrament of Anointing of the Sick, is a Christian sacrament or rite that involves the anointing of a sick person with blessed oil, accompanied by prayers for healing and forgiveness of sins. This sacrament is practiced in various Christian traditions, including Roman Catholicism, Eastern Orthodoxy, and some Protestant denominations. It is intended to provide spiritual and sometimes physical healing, as well as to offer comfort and strength to those who are seriously ill or facing death.

Biblical Foundations of Unction of the Sick

Old Testament Precedents

While the specific practice of anointing the sick with oil as a sacrament is not found in the Old Testament, anointing with oil was a common practice in ancient Israel and held significant symbolic meaning. Oil was used for consecration, healing, and as a symbol of the Holy Spirit’s presence.

• Exodus 30:22-25 – “Then the LORD said to Moses, ‘Take the following fine spices: 500 shekels of liquid myrrh, half as much (that is, 250 shekels) of fragrant cinnamon, 250 shekels of fragrant calamus, 500 shekels of cassia—all according to the sanctuary shekel—and a hin of olive oil. Make these into a sacred anointing oil, a fragrant blend, the work of a perfumer. It will be the sacred anointing oil.'” (NIV) This passage describes the preparation of a sacred anointing oil used for consecrating the priests and the tabernacle. This sacred oil was a symbol of God’s presence and blessing.
• Psalm 23:5 – “You prepare a table before me in the presence of my enemies. You anoint my head with oil; my cup overflows.” (NIV) In this well-known Psalm, anointing with oil symbolizes God’s blessing, protection, and provision.
• Isaiah 1:6 – “From the sole of your foot to the top of your head there is no soundness—only wounds and welts and open sores, not cleansed or bandaged or soothed with olive oil.” (NIV) This verse highlights the use of oil for healing purposes, suggesting a tradition of using oil as a form of medicinal care.

New Testament Foundations

The New Testament provides a more direct foundation for the practice of anointing the sick, particularly in the writings of the Apostle James and the Gospel accounts of Jesus’ healing ministry.

• Mark 6:12-13 – “They went out and preached that people should repent. They drove out many demons and anointed many sick people with oil and healed them.” (NIV) This passage describes the mission of the disciples, who anointed the sick with oil as part of their healing ministry. This practice reflects the early Christian understanding of anointing as a means of invoking God’s healing power.
• James 5:14-15 – “Is anyone among you sick? Let them call the elders of the church to pray over them and anoint them with oil in the name of the Lord. And the prayer offered in faith will make the sick person well; the Lord will raise them up. If they have sinned, they will be forgiven.” (NIV) This passage is the most explicit New Testament reference to the practice of anointing the sick with oil. It emphasizes the role of the church community, the power of prayer, and the potential for both physical healing and spiritual forgiveness.
• Luke 10:34 – “He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, brought him to an inn and took care of him.” (NIV) In the parable of the Good Samaritan, the use of oil for healing wounds illustrates the medicinal and soothing properties of oil, which are metaphorically extended to the sacrament of anointing the sick.

Historical Development of Unction of the Sick

Early Church Practices

In the early Christian church, the practice of anointing the sick with oil was understood as a continuation of the healing ministry of Jesus and the apostles. The early Christians believed that physical healing was a sign of God’s kingdom and that the anointing with oil was a means of invoking God’s healing presence.

1. Anointing in Early Christian Communities: The practice of anointing the sick with oil was likely widespread in the early Christian communities, as evidenced by the writings of the Apostolic Fathers and other early Christian texts. The anointing was often accompanied by prayers and was seen as both a physical and spiritual remedy.
   

   Historical Reference: The Didache, an early Christian manual of instruction, mentions the importance of prayer and fasting in conjunction with healing practices, reflecting the early church’s emphasis on spiritual preparation for healing.

2. Sacramental Understanding: By the fourth and fifth centuries, the practice of anointing the sick began to be understood more explicitly as a sacrament, particularly in the Western Church. This understanding was influenced by the developing theology of the sacraments as outward signs of inward grace. The anointing with oil was seen as a means of conveying God’s grace and healing power to the sick.
   

   Patristic Reference: St. Augustine (354-430) and other Church Fathers wrote about the importance of anointing the sick, emphasizing the role of the sacrament in providing spiritual comfort and the possibility of physical healing.

Medieval and Scholastic Theology

During the medieval period, the sacrament of anointing the sick, also known as Extreme Unction, became more formalized in the Western Church. The practice was closely associated with the preparation for death, although it retained its connection to physical healing.

1. Development of Extreme Unction: By the time of the Scholastic theologians, the sacrament of Extreme Unction was primarily seen as a means of preparing the soul for death, providing forgiveness of sins, and offering spiritual strength in the face of death. The emphasis on physical healing diminished, and the sacrament became more closely associated with the last rites.
   

   Theological Reference: St. Thomas Aquinas (1225-1274), in his Summa Theologica, discussed the sacrament of Extreme Unction as one of the seven sacraments instituted by Christ. He emphasized its role in remitting sins and providing spiritual consolation in the face of death.

2. Liturgical Practices: The liturgy for Extreme Unction during the medieval period included prayers for the sick person’s spiritual and physical well-being, but the focus increasingly shifted towards the remission of sins and preparation for death.
   

   Liturgical Reference: The Rituale Romanum, a book of rites used in the Roman Catholic Church, included specific prayers and rituals for the administration of Extreme Unction, reflecting the sacrament’s role in the broader context of the last rites.

Reformation and Post-Reformation Developments

The Protestant Reformation brought significant changes to the understanding and practice of the sacrament of anointing the sick. While some Protestant traditions retained a form of the practice, others rejected it or reinterpreted its significance.

1. Lutheran and Reformed Views: Martin Luther and other Protestant Reformers critiqued the medieval understanding of Extreme Unction as a sacrament primarily focused on preparation for death. Luther rejected the sacrament as it was practiced in the medieval church, arguing that it was not instituted by Christ in the form it had taken. However, he did not entirely dismiss the practice of anointing the sick, seeing it as a possible aid to healing when accompanied by prayer and faith.
   

   Theological Reference: Luther’s Small Catechism and other writings reflect his emphasis on the Word of God and faith as the primary means of grace, rather than the sacramental rituals of the medieval church.

2. Anglican Practice: The Anglican Church, following the Reformation, retained the practice of anointing the sick in its liturgical tradition, though it reinterpreted its significance. The Book of Common Prayer includes a rite for the anointing of the sick, emphasizing the importance of prayer, faith, and the possibility of both physical and spiritual healing.
   

   Liturgical Reference: The 1662 Book of Common Prayer includes a service for the Visitation of the Sick, which provides for the anointing of the sick with oil, along with prayers for healing and forgiveness.

3. Roman Catholic Reforms: The Council of Trent (1545-1563) reaffirmed the sacrament of Extreme Unction as one of the seven sacraments instituted by Christ. However, the focus remained on its role as part of the last rites, providing spiritual comfort and forgiveness of sins to those near death.
   

   Theological Reference: The Council of Trent’s decrees on the sacraments emphasized the importance of Extreme Unction as a sacrament that prepares the soul for the final journey to eternal life, reinforcing its association with the last rites.

Modern Developments

In the 20th century, particularly following the Second Vatican Council (1962-1965), there was a renewed emphasis on the sacrament of Anointing of the Sick as a means of healing and spiritual strength, rather than solely as preparation for death.

1. Second Vatican Council: The Second Vatican Council brought significant reforms to the understanding and practice of the sacraments in the Roman Catholic Church. The council emphasized the sacrament of Anointing of the Sick as a means of providing spiritual and, if God wills, physical healing to those who are seriously ill. The term “Extreme Unction” was largely replaced by “Anointing of the Sick,” reflecting this broader understanding.
   

   Theological Reference: The Vatican II document Sacrosanctum Concilium emphasized the communal and healing aspects of the sacraments, encouraging greater participation by the faithful and a renewed focus on the sacrament’s role in the life of the church.

2. Liturgical Reforms: Following the Second Vatican Council, the Roman Catholic Church revised the rites for Anointing of the Sick, allowing for its administration not only to those near death but also to those facing serious illness or undergoing surgery. The sacrament is now seen as a means of strengthening the sick person’s faith, providing comfort, and invoking God’s healing power.
   

   Liturgical Reference: The current Rituale Romanum includes prayers for healing, forgiveness, and spiritual strength, emphasizing the sacrament’s role in the overall pastoral care of the sick.

Theological Significance of Unction of the Sick

The Sacrament as a Means of Grace

Unction of the Sick is understood as a sacrament of grace, where God’s healing power is invoked through the anointing with oil and the prayers of the church. This grace is seen as both spiritual and, potentially, physical, depending on God’s will.

1. Healing and Wholeness: The sacrament is intended to bring about healing and wholeness, not just in the physical sense but also in the spiritual and emotional dimensions. It is a reminder of God’s care and presence in the midst of suffering and illness.
   

   Biblical Reference: James 5:15, “And the prayer offered in faith will make the sick person well; the Lord will raise them up. If they have sinned, they will be forgiven.” (NIV) This passage emphasizes the dual aspects of healing and forgiveness, central to the sacrament’s theology.

2. Forgiveness of Sins: The sacrament also provides for the forgiveness of sins, reflecting the understanding that illness can be both a physical and spiritual burden. By receiving the sacrament, the sick person is absolved of sins and strengthened in their faith.
   

   Biblical Reference: Matthew 9:2, “Some men brought to him a paralyzed man, lying on a mat. When Jesus saw their faith, he said to the man, ‘Take heart, son; your sins are forgiven.'” (NIV) Jesus’ act of healing is closely tied to the forgiveness of sins, a connection that is mirrored in the sacrament of Anointing of the Sick.

The Sacrament as a Sign of Christ’s Presence

Unction of the Sick is a tangible sign of Christ’s presence with those who are suffering. It is a reminder that Christ is the healer who comes to the sick and the suffering, offering comfort, strength, and the hope of eternal life.

1. Christ the Healer: The sacrament points to Jesus Christ as the ultimate healer, who brings both physical and spiritual healing. By participating in this sacrament, the sick person is united with Christ in their suffering and is invited to share in His redemptive work.
   

   Biblical Reference: Matthew 8:16-17, “When evening came, many who were demon-possessed were brought to him, and he drove out the spirits with a word and healed all the sick. This was to fulfill what was spoken through the prophet Isaiah: ‘He took up our infirmities and bore our diseases.'” (NIV) Jesus’ healing ministry is seen as a fulfillment of prophecy, and the sacrament of Anointing of the Sick continues this ministry within the church.

2. Participation in Christ’s Suffering: The sacrament also has a Christological dimension, in that it allows the sick person to participate in Christ’s suffering and to offer their own suffering in union with His. This participation is seen as a means of drawing closer to Christ and sharing in the redemptive power of His passion.
   

   Biblical Reference: Colossians 1:24, “Now I rejoice in what I am suffering for you, and I fill up in my flesh what is still lacking in regard to Christ’s afflictions, for the sake of his body, which is the church.” (NIV) Paul’s understanding of suffering as a participation in Christ’s afflictions is reflected in the sacrament’s theology, where the sick person’s suffering is united with Christ’s.

The Sacrament as a Pastoral Care

Unction of the Sick is also a key component of the church’s pastoral care for the sick. It is a means of providing spiritual support, comfort, and reassurance to those who are facing illness, suffering, or the prospect of death.

1. Communal Aspect: The sacrament is typically administered within the context of the church community, emphasizing the communal nature of the Christian faith. The prayers of the church, along with the anointing, provide a sense of solidarity and support for the sick person.
   

   Biblical Reference: 1 Corinthians 12:26, “If one part suffers, every part suffers with it; if one part is honored, every part rejoices with it.” (NIV) This verse reflects the communal nature of the church, where the suffering of one member affects the entire body. The sacrament of Anointing of the Sick is an expression of this communal care.

2. Spiritual Comfort: The sacrament provides spiritual comfort to the sick person, reminding them of God’s love and care in the midst of their suffering. It is a source of hope and reassurance, particularly for those who are near death.
   

   Biblical Reference: Psalm 23:4, “Even though I walk through the darkest valley, I will fear no evil, for you are with me; your rod and your staff, they comfort me.” (NIV) The assurance of God’s presence and comfort in the face of suffering is central to the sacrament’s theology.

Practical Implications for Worship and Devotion

Liturgical Practice of Anointing

The liturgical practice of anointing the sick varies between different Christian traditions, but it generally includes the use of blessed oil, prayers for healing, and the laying on of hands.

1. Roman Catholic Practice: In the Roman Catholic Church, the sacrament of Anointing of the Sick is typically administered by a priest. The rite includes prayers for the sick person, the laying on of hands, and the anointing of the forehead and hands with blessed oil. The sacrament may be administered individually or in a communal setting, such as during a Mass for the sick.
   

   Liturgical Reference: The Rituale Romanum provides specific prayers and rituals for the administration of the sacrament, including the prayer for healing: “Through this holy anointing may the Lord in his love and mercy help you with the grace of the Holy Spirit. May the Lord who frees you from sin save you and raise you up.”

2. Eastern Orthodox Practice: In the Eastern Orthodox Church, the sacrament of Holy Unction is usually administered by a group of priests and may be given to any baptized Christian, not only those who are gravely ill. The rite includes multiple anointings with oil, accompanied by prayers, readings from Scripture, and the chanting of hymns. It is often celebrated during Holy Week but can be administered at any time of need.
   

   Liturgical Reference: The Orthodox service of Holy Unction includes the prayer: “O Holy Father, physician of souls and bodies, who didst send Thine Only-begotten Son, our Lord Jesus Christ, to heal every infirmity and deliver from death: Heal Thou also Thy servant from the bodily ills that afflict him, and quicken his soul with the grace of Thy Christ.”

3. Protestant Practices: In Protestant traditions, the practice of anointing the sick varies. Some denominations, such as Anglicans and Lutherans, retain a formal rite of anointing, while others may offer prayers for healing without the use of oil. The focus is often on the power of prayer and the faith of the community.
   

   Liturgical Reference: The Anglican Book of Common Prayer includes prayers for the sick and a rite for anointing, which may include the laying on of hands and the anointing of the sick person’s forehead with oil.

Personal and Communal Devotion

The sacrament of Anointing of the Sick also has implications for personal and communal devotion, as it encourages a deeper reliance on God’s grace and a greater awareness of the church’s role in caring for the sick.

1. Intercessory Prayer: The practice of praying for the sick, both individually and as a community, is an important aspect of the Christian response to illness. Intercessory prayer is seen as a way of participating in the healing ministry of Christ and supporting those who are suffering.
   

   Biblical Reference: James 5:16, “Therefore confess your sins to each other and pray for each other so that you may be healed. The prayer of a righteous person is powerful and effective.” (NIV) The emphasis on intercessory prayer reflects the communal nature of the Christian faith and the power of prayer in bringing about healing.

2. Spiritual Preparation for Illness and Death: The sacrament encourages believers to view illness and death in the context of their faith, recognizing them as moments of spiritual significance. It invites the sick person to prepare spiritually, through prayer, confession, and reception of the sacraments, for whatever outcome may come, whether healing or passing into eternal life.
   

   Biblical Reference: 2 Corinthians 4:16-18, “Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.” (NIV) This passage encourages believers to maintain an eternal perspective, even in the face of physical suffering.

Broader Biblical Themes

Healing and Restoration

The sacrament of Anointing of the Sick is deeply connected to the biblical themes of healing and restoration, both of which are central to the message of the Gospel.

• Isaiah 53:5 – “But he was pierced for our transgressions, he was crushed for our iniquities; the punishment that brought us peace was on him, and by his wounds we are healed.” (NIV) The connection between suffering, atonement, and healing is central to the Christian understanding of Christ’s redemptive work.
• Revelation 21:4 – “‘He will wipe every tear from their eyes. There will be no more death’ or mourning or crying or pain, for the old order of things has passed away.” (NIV) The ultimate promise of healing and restoration is found in the eschatological hope of the new creation, where suffering and death will be no more.

The Role of the Community in Caring for the Sick

The sacrament emphasizes the role of the Christian community in caring for the sick and supporting them through prayer, presence, and the administration of the sacraments.

• Galatians 6:2 – “Carry each other’s burdens, and in this way you will fulfill the law of Christ.” (NIV) The call to bear one another’s burdens reflects the communal responsibility of the church to care for its members, especially in times of illness.
• Matthew 25:36 – “I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.” (NIV) Jesus’ identification with the sick and the suffering underscores the importance of compassionate care as an expression of Christian discipleship.

Legacy and Influence in Christian Doctrine and Church History

Influence on Roman Catholic Doctrine

The sacrament of Anointing of the Sick has had a significant influence on Roman Catholic doctrine, particularly in the development of the theology of the sacraments and the church’s understanding of pastoral care for the sick.

1. Council of Trent: The Council of Trent reaffirmed the sacrament as one of the seven sacraments of the church, emphasizing its role in providing spiritual comfort and forgiveness to those who are gravely ill or near death.
   

   Theological Reference: The Council of Trent’s decree on Extreme Unction emphasized that the sacrament was instituted by Christ and that it provides grace to the sick, including the forgiveness of sins and the strengthening of the soul.

2. Second Vatican Council: The reforms of the Second Vatican Council brought a renewed focus on the sacrament’s role in healing and pastoral care, encouraging its administration not only to those near death but to all who are seriously ill.
   

   Theological Reference: The Vatican II document Lumen Gentium (The Dogmatic Constitution on the Church) emphasizes the importance of the sacraments in the life of the church, including the sacrament of Anointing of the Sick as a means of grace and healing.

Influence on Eastern Orthodox Doctrine

In the Eastern Orthodox Church, the sacrament of Holy Unction is understood as a means of healing and spiritual renewal, available to all the faithful and not limited to those near death.

1. Patristic Foundations: The theology of the sacrament in Orthodoxy is rooted in the writings of the Church Fathers, who emphasized the healing power of God’s grace and the importance of the church’s prayers for the sick.
   

   Theological Reference: St. John Chrysostom (347-407) and other Church Fathers wrote about the importance of prayer and anointing in the healing ministry of the church, reflecting the sacrament’s role in providing both physical and spiritual healing.

2. Liturgical Practice: The Orthodox Church’s practice of Holy Unction includes a strong emphasis on the communal nature of the sacrament, with the entire church community participating in the prayers for the sick. The sacrament is often celebrated as part of a larger liturgical service, particularly during Holy Week.
   

   Liturgical Reference: The Orthodox service of Holy Unction includes multiple anointings with oil, prayers for healing, and readings from the Gospels, emphasizing the sacrament’s role in the life of the church.

Influence on Protestant Doctrine

While the sacrament of Anointing of the Sick is not universally practiced in Protestant traditions, it has influenced Protestant theology, particularly in the areas of pastoral care and the understanding of prayer and healing.

1. Reformation Perspectives: The Protestant Reformers generally rejected the sacrament of Extreme Unction as it was practiced in the medieval church, but they retained the importance of prayer for the sick and the possibility of anointing as a form of pastoral care.
   

   Theological Reference: John Calvin, in his Institutes of the Christian Religion, critiqued the medieval practice of Extreme Unction but emphasized the importance of praying for the sick and offering pastoral support to those who are suffering.

2. Modern Protestant Practices: In some Protestant traditions, particularly Anglicanism and Methodism, the practice of anointing the sick with oil has been reintroduced as part of the church’s pastoral care. This practice is often seen as a way of invoking God’s healing power and providing spiritual comfort.
   

   Liturgical Reference: The Anglican Book of Common Prayer and the United Methodist Book of Worship include rites for the anointing of the sick, reflecting a renewed appreciation for the sacrament’s role in providing healing and comfort.

Conclusion

Unction of the Sick is a significant and ancient practice within the Christian tradition that reflects the church’s commitment to caring for the sick, providing spiritual healing, and preparing believers for the journey to eternal life. Rooted in the biblical witness and developed through centuries of theological reflection, the sacrament of Anointing of the Sick serves as a tangible sign of God’s grace and presence in the midst of suffering.

From a Christian worldview, the sacrament emphasizes the holistic nature of God’s healing, addressing both the physical and spiritual needs of the sick person. It is a reminder that God’s care extends to every aspect of our lives, including our times of illness and weakness. The sacrament also highlights the communal nature of the Christian faith, as the prayers and support of the church community play a vital role in the healing process.

As Christians continue to face the challenges of illness and suffering, the sacrament of Unction of the Sick offers a powerful means of grace, providing comfort, strength, and hope in the midst of adversity. Whether through the formal rites of the sacrament or through the simple acts of prayer and care, the church is called to embody the healing ministry of Christ, offering His love and compassion to those in need.