Answered by Legionary of Christ Father Edward McNamara, professor of liturgy and dean of theology at the Regina Apostolorum university.
Q: A friend of mine has an autistic child, and the local parish priest is hesitant to give him first Communion. Is this correct? How should such questions be addressed? — E.K., New York
A: With a few rare exceptions it should be almost always possible to administer Communion to people with autism and most other ailments.
First of all, there is a general canonical principle that the faithful have a right to receive the sacraments and the pastors a consequent obligation to provide them unless there is some grave impediment. Mental or developmental disability should only impede the right to the Eucharist in the most extreme cases.
Thus Canon 213 of the Code of Canon Law says, “The Christian faithful have the right to receive assistance from the sacred pastors out of the spiritual goods of the Church, especially the word of God and the sacraments.”
Mental disability is no impediment to receiving baptism. It should not be an insurmountable hurdle for confirmation, and even those people who might never reach the age of reason can and should continue on the path of initiation and be given this sacrament. The minimum requirements for first Communion in the Latin rite are not very demanding and can usually be easily verified.
The U.S. bishops’ conference has provided ample guidelines regarding this subject which, because they are in line with general canonical principles, could be adopted in any country: http://www.usccb.org/about/divine-worship/policies/guidelines-sacraments-persons-with-disabilities.cfm.
The document’s introductory paragraphs indicate the spirit with which the Church faces this question:
“The Church continues to affirm the dignity of every human being and to grow in knowledge and understanding of the gifts and needs of her members who live with disabilities. Likewise, the Church recognizes that every parish community includes members with disabilities, and earnestly desires their active participation. All members of the Body of Christ are uniquely called by God by virtue of their Baptism. In light of this call, the Church seeks to support all in their growth in holiness and to encourage all in their vocations. Participating in, and being nourished by, the grace of the sacraments is essential to this growth in holiness. Catholic adults and children with disabilities, and their families, earnestly desire full and meaningful participation in the sacramental life of the Church.
“In this regard, as it issues a revised and expanded Guidelines for the Celebration of the Sacraments with Persons with Disabilities, the United States Conference of Catholic Bishops wishes to reiterate what was said in previous pastoral statements on this issue:
“It is essential that all forms of the liturgy be completely accessible to persons with disabilities since these forms are the essence of the spiritual tie that binds the Christian community together. To exclude members of the parish from these celebrations of the life of the Church, even by passive omission, is to deny the reality of that community. Accessibility involves far more than physical alterations to parish buildings. Realistic provision must be made for Catholics with disabilities to participate fully in the Eucharist and other liturgical celebrations.”
With respect to the Eucharist for people with mental and other difficulties, these guidelines say the following:
“21. The Eucharist is the most august sacrament, in which Christ the Lord himself is contained, offered, and received, and by which the Church constantly lives and grows. It is the summit and the source of all Christian worship and life, signifying and affecting the unity of the People of God, providing spiritual nourishment for the recipient, and achieving the building up of the Body of Christ. The celebration of the Eucharist is the center of the entire Christian life.
“22. Parents or guardians, together with pastors, are to see to it that children who have reached the use of reason are correctly prepared and are nourished by the Eucharist as early as possible. Pastors are to be vigilant lest any children come to the Holy Banquet who have not reached the use of reason or whom they judge are not sufficiently disposed. It is important to note, however, that the criterion for reception of Holy Communion is the same for persons with intellectual and developmental disabilities as for all persons, namely, that the person be able to ‘distinguish the body of Christ from ordinary food,’ even if this recognition is evidenced through manner, gesture, or reverential silence rather than verbally. Pastors are encouraged to consult with parents, those who take the place of parents, diocesan personnel involved with disability issues, psychologists, religious educators, and other experts in making their judgment. If it is determined that a parishioner who is disabled is not ready to receive the sacrament, great care is to be taken in explaining the reasons for this decision. Cases of doubt should be resolved in favor of the right of the Catholic to receive the sacrament. The existence of a disability is not considered in and of itself as disqualifying a person from receiving Holy Communion.
“23. Given the paramount significance of the Eucharist in the lives of the faithful, and in light of medical and technological advancements that affect Catholics with disabilities, new questions have arisen regarding the reception of Holy Communion, and circumstances that were once rare have even become relatively common. Clergy and extraordinary ministers of Holy Communion are encouraged to become familiar with the needs of their parishioners. In many instances, simple accommodations can be very helpful and should be embraced by all at the parish level.
“24. Catholics who require nourishment through feeding tubes are encouraged to receive Holy Communion, as are all the Catholic faithful. Christ is sacramentally present under each of the species, and Holy Communion can be received under the species of bread or wine alone. Since the full presence of Christ and his sanctifying grace are found in even the smallest piece of the consecrated host or in a mere drop of the consecrated wine, the norm of receiving through the mouth remains the same for those who otherwise use a feeding tube for sustenance, and Holy Communion is not to be administered through a feeding tube. For these communicants, it will commonly be possible to place one or a few drops of the Precious Blood on the tongue. Clergy and pastoral ministers are encouraged to use these guidelines and consult with physicians, family members, and other experts on a case-by-case basis, to determine how those who use feeding tubes may avail themselves of the abundant fruits of Holy Communion. Specialized instruction for extraordinary ministers of Holy Communion is to be provided as required.
“25. Catholics with Celiac Sprue Disease or other conditions that make them gluten intolerant should be given the opportunity to receive a small fragment of a regular host and made aware of the options to receive a low-gluten host or to receive under the form of wine alone. In the event of intolerance to gluten and wine, mustum may also be an option, with the approval of the local ordinary. Clergy and extraordinary ministers of Holy Communion need to be aware of the possibility of cross-contamination and related issues in order to plan for the safe administration of the sacred species to Catholics with gluten intolerance. For example, the chalice given to a person with gluten intolerance should not contain a particle of the host, and low-gluten altar breads should never be intermingled with regular altar breads. As people may feel self-conscious at the prospect of needing special arrangements for the reception of Holy Communion, pastoral sensitivity in this area is particularly important.
“26. When baptized Catholics who have been regular communicants develop advanced Alzheimer’s or other age-related dementias, there is to be a presumption in favor of the individual’s ability to distinguish between Holy Communion and regular food. Holy Communion should continue to be offered as long as possible, and ministers are called to carry out their ministry with special patience. If swallowing becomes particularly difficult, decisions regarding the continued reception of Holy Communion may have to be faced. This pastoral decision is to be made on a case-by-case basis, in consultation with the individual, those closest to him or her, physicians, and the pastor.”
Many larger dioceses have an office dedicated to disabilities and special needs ministries. These offices can assist parents and pastors in resolving doubts and providing solutions. Even where such offices do not exist, parents should not be afraid to resort to the diocese if the parish is unable to accommodate them.
The wider experience had at the diocesan level will often reveal possibilities that the parish priest failed to see. The vast majority of priests want to serve their parishioner but might hesitate if they fear any danger to the sanctity of the Eucharist. While this is a possibility, as the above document comments, it can usually be solved.
Among other services Loyola Press has produced a simplified sacramental preparation program for children with special needs: https://www.loyolapress.com/products/special-needs/adaptive-learning/adaptive-first-eucharist-preparation-kit. Its product page quotes the National Directory for Catechesis by the USCCB: “All baptized persons with disabilities have a right to adequate catechesis and deserve the means to develop a relationship with God.”
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