Ministering to Ebola Patients

Answered by Legionary of Christ Father Edward McNamara, professor of liturgy and dean of theology at the Regina Apostolorum university.

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Q: Please guide me on how to administer the sacrament of the sick to someone who is suffering from Ebola, without making that person think he is rejected by his own priest. What measures to be taken in such situation? — V.B., Kokstad, South Africa

A: According to the Code of Canon Law we read:

«Canon 1000 §1. The anointings with the words, order, and manner prescribed in the liturgical books are to be performed carefully. In a case of necessity, however, a single anointing on the forehead or even on some other part of the body is sufficient, while the entire formula is said.

«§2. The minister is to perform the anointings with his own hand, unless a grave reason warrants the use of an instrument.»

A contagious infection such as Ebola would be more than sufficient to warrant the use of an instrument.

Canonists commenting on this canon state that ordinarily, whatever the person’s condition, the minister will be able to take the same safeguards against infection as do nurses and doctors.

In the case of Ebola and other dangerous infections this would mean that a minister should don a high-level bio-containment suit and follow the strict protocols necessary to avoid contracting the disease himself and possibly spreading it to others.

It would also require carefully preparing the celebration beforehand in such a way that the receptacle containing the holy oil (and probably the one with the Blessed Sacrament) can be duly destroyed or fully decontaminated.

If these precautions can be taken, then the priest can confess the patient, administer the sacrament of the sick and give Communion.

If it is not possible to carry out all of these precautions, then the priest should limit himself to do whatever is materially possible.

For example, the priest might lack the necessary level of medical knowledge required to follow the protocols to avoid contagion, and it would be the duty of the medical personnel to forbid him to have any physical contact with a patient. In such cases he could confess and absolve the patient from a distance or even from behind an isolation screen.

In such cases it is possible to use artificial means such as an intercom telephone to facilitate communication, provided the priest can physically observe the patient making the confession, even if separated by Plexiglas. It is also possible to delegate one of the medical staff to administer Communion. Unfortunately, in this case, it would be impossible to anoint the patient for the sacrament of the sick.

This is certainly a sacrifice for both patient and priest, but both also share responsibility to avoid doing anything that would place the lives of others at risk.

Apart from the case of anointing those already showing signs of infection, bishops may promote other precautionary measures to limit infection, depending on the nature of the particular disease.

In contagions that spread through physical contact, some bishops have eliminated the sign of peace at Mass or mandated that it be done through a simple bow or some similar gesture toward those nearest rather than through a handshake or embrace.

Some bishops have temporarily forbidden Communion on the tongue during epidemics.

Some deny that it is within the bishop’s authority to make such a blanket prohibition. In 2009, during a severe flu epidemic, the Congregation for Divine Worship reiterated in a private letter (Prot. N 655/09/L) that the faithful always and everywhere have the right to receive on the tongue (Redemptionis Sacramentum, No. 92).

At the same time, in truly grave circumstances — for example, a deadly infection that is spread almost exclusively through body fluids — it is difficult to sustain that a bishop would not be able to suspend such general laws for the sake of the common good.

In similar circumstances bishops in various parts of the world have even gone so far as to cancel all public Masses in a diocese so as to prevent contagion. Attendance at Sunday Mass is a higher law than that regarding the manner of receiving Communion. Thus if there is no doubt regarding a bishop’s authority to do the former, it certainly falls within his province to do the latter.

In both cases, however, prudence is required. Such actions should not be taken lightly. They should be backed up by medical recommendations regarding the real danger of contagion and should be for the minimum time necessary.

In this case the faithful, even if they prefer to receive Communion on the tongue, should accept the bishop’s mandate as an act of charity toward others in avoiding all possible danger to themselves and others.

Some writers argue that in some kind of infections Communion in the hand is no safer than Communion on the tongue. It is possible, but I do not have the necessary medical knowledge to enter into that discussion.

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Readers may send questions to Please put the word «Liturgy» in the subject field. The text should include your initials, your city and your state, province or country. Father McNamara can only answer a small selection of the great number of questions that arrive.

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Fr. Edward McNamara

Padre Edward McNamara, L.C., è professore di Teologia e direttore spirituale

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