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Sacraments for
Children in Danger of Death
by Dr. Edward N. Peters A torrent of feelings bear down upon parents when they learn that their child has been seriously injured or has been diagnosed as gravely ill. But while properly catechized Catholic parents or guardians will desire the benefits of the Church’s sacramental support for their stricken children, they might not know precisely which sacraments are available to children, or under what circumstances these sacraments should be celebrated. To assist parents and pastoral personnel in making sound sacramental decisions during times already crowded with stress and suffering, this article will examine the canonical norms for celebration of the sacraments with seriously sick or injured Catholic children. Before addressing these questions, though, we will need to say a few words on two concepts that will be used throughout this article–namely “children” and “danger of death.” Broadly, those aged 17 or less are considered “children” in canon law (Canon 97). In addition, some canonical norms on celebrations of sacraments for stricken children vary according to whether the child has attained the use of reason, which is presumed to be at age 7 (Canons 11 and 97.2). In close cases, though, keep in mind that what counts is not so much chronological age, but rather the actual use of reason or discretion, which is only presumed to set in at 7 years old. For purposes of determining eligibility for certain sacraments, parents and pastoral ministers need to assess the actual state of maturity attained by a specific child prior to falling sick or being injured and accept the implications of that assessment. In case of doubt about the facts, the parents’ evaluation of their children having generally attained or failed to attain the use of reason should probably be preferred, as their conclusions will be based on a much deeper knowledge of the child than can be attained by most ministers. The phrase “in danger of death” is not defined in canon law, but, clearly, extreme interpretations should be avoided. It is not necessary to be at death’s door before being considered in danger of death. On the other hand, many injuries and illness, while serious and even debilitating, are not life-threatening and do not warrant the celebration of sacraments licit only under danger of death. Examples, while not without their
own exceptions, might help: a diagnosis of diabetes probably does not qualify as
danger of death as understood in canon law, but a child in a diabetic coma
probably would; childhood epilepsy is generally not life-threatening, status
epilepticus is; malignant and metastasizing cancers should be considered
life-threatening; children in comas following head injuries or drug overdoses
are probably canonically considered in danger of death; and so on.
In all cases, what is called for is a frank assessment of the child’s
physical conditions and prospects for a timely recovery, using the advice of
physicians, but determined finally by the proper minister of the sacrament in
light of canon law. Baptism
There are four sacraments that the parents or guardians of seriously ill or injured Catholic children will have questions about: Confirmation, Eucharist, Confession and the Anointing of the Sick. We will consider each of these sacraments in turn. But, even though this article is concerned with sacraments for Catholic children and assumes that they are already baptized (see Canon 842.1), a few words by way of reminder should be said about the importance of securing baptism for children in danger of death. Fortunately, Church teaching on the importance of baptism is sufficiently widespread that few question its appropriateness concerning sick or injured children. Baptism, “the gateway of the sacraments,” is the first of the sacraments of initiation offered by the Church and is necessary for salvation (Canons 842.2, 849). Catholic parents are obliged to see to the baptism of their children “within the first few weeks of birth” (Canon 867). In situations of urgent necessity, moreover, and specifically in cases of children under age seven, baptism should be administered without delay (Canon 867.2). Anyone–pastoral ministers, family members, friends, medical personnel and so on–can validly and licitly baptize a child under age seven (Canons 851-852, 862) in case of necessity. For children older than seven, however, something more by way of an expressed desire for baptism will be needed (see Canon 865) for licitness. Generally, the closer the child has come to canonical adulthood, age 18, the more there should have been some expression of a personal desire for baptism and a willingness to assume the Christian life.
A sponsor (godparent) can, but need not, be used in emergency baptisms,
selected in accord with the regular norms (see Canon 872-874) and, if the
minister of baptism was not the pastor of the child in question, the minister
should notify the pastor of the place in which the baptism occurred so that a
proper notation of it can be made in parish records (Canon 878). Confirmation
Confirmation, also a sacrament of initiation (Canon 842), impresses an indelible character on baptized recipients, seals them with the gift of the Holy Spirit and binds them more closely to the Church (see Canons 842.2, 879). Although the 1983 Code of Canon Law calls for the administration at around the age of reason (Canon 891), celebration of this sacrament is usually delayed far past that time. Thus the majority of Catholics under age 18 are probably not confirmed, and this percentage rises rapidly as the age of the children in question decreases. Thus the majority of stricken Catholic children are not confirmed by the time of crisis. As a general rule, Roman Catholic children in danger of death due to sickness or injury should receive the Sacrament of Confirmation (Canons 889.2, 891. Note that Eastern-rite Catholic children are confirmed, or chrismated, at the time of their baptism). This advice comes as a surprise to many parents and pastoral personnel who have grown accustomed to seeing confirmation delayed until one’s teenage years and who, in any event, do not think of it as a sacrament to be celebrated during a crisis in health. And yet Church law is clear: the usual requirements for licit confirmation in the Latin Church (having use of reason, being suitably instructed and disposed and able to renew one’s baptismal promises) do not apply in cases of danger of death. Thus the general canons fostering the reception of sacraments by the faithful (see, for example, Canons 214 and 843) combine with the sound sacramental theology to urge the administration of confirmation of Catholic children in danger of death. Moreover, and despite the fact that the bishop is the ordinary minister of confirmation (Canon 882), to facilitate the administration of confirmation in danger of death, Canon 883.3 grants to pastors, and indeed to any priest, the faculty of conferring the sacrament. Pastors are expressly mentioned in the canon because administratively and pastorally it is more suitable to have an individual’s pastor aware of and participating in that person’s sacramental life. Nevertheless, the canon leaves no doubt whatsoever that any priest, by the law itself, has the faculty of conferring this sacrament upon those in danger of death without the necessity of giving prior notice to the pastor or bishop or of getting prior authorization from either. Indeed, so generous is the 1983 Code in regard to the confirmation of those in danger of death that even extern priests validly can confer this sacrament outside of their own territory on those not otherwise considered their subjects under these circumstances (Canon 887). Insofar as possible, a sponsor (godparent) for the one being confirmed should be present, with a preference being given to one who serves as a sponsor at the child’s Baptism (Canons 892-893), but delays in securing a sponsor should not be accepted at the risk of failing to celebrate the sacrament. If confirmation was administered by someone other than the child’s pastor, the minister should notify the pastor in accord with Canons 894-896. If the child recovers, of course, the later regular catechesis for confirmation, would be appropriate.
Simply put, the 1983 Code could not make it any clearer that the
faithful, including children in danger of death, should be fortified by the
Sacrament of Confirmation, nor could Church law make it easier for them to
receive this sacrament or for ministers to provide it. Eucharist
The Eucharist, that sacrament of initiation in which Christ the Lord Himself is contained, offered, and received, is the source and summit of the Christian life (Canons 842.2, 897). Prescinding from the usual catechetical requirements for the reception of the Eucharist by children (see Canons 913.1, 914), for any child in danger of death, regardless of age, the Eucharist can be administered if he or she is simply able to distinguish the Body of Christ from ordinary food and can be received reverently (Canon 913.2). Care should be taken not to exclude children from the Eucharist solely because of tender years. Particularly in active Catholic families, young children might well have expresses an understanding that “something special” happens at Mass when mom and dad and older siblings receive Communion. They might have already shown a nascent desire to receive Communion on their own, or they might even have begun catechesis for the sacrament. The 1983 Code makes a special point to stress the right of the faithful, which includes children, to receive Holy Communion in the form of viaticum when they are in danger of death, even if they had received the Eucharist earlier that same day (Canon 921). Under typical circumstances, viaticum should be repeated once a day as long as the danger of death persists.
The revised Code has greatly expanded the list of those qualified to
bring Holy Communion to the sick (see Canons 910-911, 921-922) and for practical
purposes there are no significant restrictions in this regard.
Even if the administration of the Eucharist to a stricken child happens
to be that child’s first Communion, there is no sacramental recording
requirement for Eucharist, as there is in the case of baptism or confirmation.
Finally, in case of necessity, Holy Communion can be administered under
the form of wine alone (Canon 925). A
single drop suffices sacramentally. Confession
In the Sacrament of Penance the faithful express sorrow for their sins to a legitimate minister and receive absolution from that priest or bishop, thereby obtaining God’s forgiveness for their sins and reconciliation with the Church (Canons 959, 965-966). Manifestly, the Sacrament of Penance cannot be received by or sought on behalf of one who has not attained and retained the use of reason, since some degree of knowledge, followed by some sufficient exercise of the will, is necessary both to incur personal guilt for sin and to express contrition for it. These factors indicate that sacramental confession for those age six or less, regardless of their state of health, would be rarely indicated.
Catholic children in danger of death above the age of seven, however,
should be offered the opportunity for Confession, and the strength of the
suggestion should increase in accord with the age of the child (especially for
teenagers) and the length of time it has likely been since the child’s last
penance (see Canons 988-989). While the exercise of reason and exercise of
reason and will are, as noted above, necessary to the operation of penance, that
is not to say that such powers need to be manifest in the child at the actual
time of the sacrament. Interior assent to the sacrament suffices and therefore
the exterior or apparent unresponsiveness of the child should not, by itself,
preclude celebration of the sacrament. Anointing of the Sick
The sacrament most commonly sought by Catholic parents on behalf of their stricken children is anointing of the sick, by which the seriously infirm (whether from sickness, old age, or injury) are commended to the Lord that He might relieve and save them (Canon 998). The canons on the sacrament of anointing of the sick operate, however, somewhat differently from those of other sacraments considered in this article. First, in order for the anointing of the sick to be licitly celebrated, it is not necessary that the recipient be in danger of death, but rather that the recipient begin to be in danger of death (see Canon 1004). Thus any physical condition which can proximately result in death is a proper condition for the celebration of the anointing. Children who are, however, seriously ill or injured, but not in a life-threatening way, are not proper candidates for this sacrament. Doubts about the sufficiency of the degree of danger, however, are to be resolved in favor of celebrating the sacrament (see Canon 1005). Second, the revised Code has done away with most of the restrictions as to which ministers may perform the anointing. Any priest (and of consequence, any bishop, but not a deacon or lay minister) may administer the anointing. The 1983 Code expresses the usual preference that an individual’s own pastor or the pastor’s associate perform the anointing. But in the case of necessity, any priest has the faculty by the law itself to administer the sacrament, the only exception to this being the rare case in which the pastor has clearly communicated a refusal to permit the anointing of one of his subjects (Canon 1003.2). To facilitate the availability of the sacrament, all priests are allowed to carry holy oils with them, and in cases of necessity the may even bless plant oils for use during that actual celebration of the sacrament (Canons 999-1001).
With regard to children who have not attained the use of reason, however,
regardless of the degree of danger they might be in, the canons read
differently. The Sacrament of Anointing of the Sick is not to be
celebrated with those who have not attained the use of reason (Canon 1004.1).
This, too, comes as a surprise to most parents and to many pastoral staff. Only
if there is doubt as to whether the child has attained to the use of reason are
such doubts to be resolved in favor of conferring the sacrament (see Canon
1005). As above, this determination of fact calls for a careful and honest
assessment, predominantly by the parents, as to the level of maturity attained
by the child prior to the crisis. Keeping in mind, however, that confirmation
is, as a matter of canon law, much more available to children in danger of death
than many expected, that sacrament should probably be considered more than
anointing of the sick, especially with regard to the very young. Concluding remarks
The sacraments of the Church confer spiritual and physical health upon recipients in accord with the providence of God. We should always be alert to expressions of desire – or refusal – of sacraments by competent children. The Church’s sacramental system was instituted by Christ for the benefit of the recipients, not necessarily for the convenience of ministers or the assuaging of parental consciences. Fortunately, there is not usually a conflict among these factors. +++ An
earlier version of this article appeared in
The Catholic Answer (November-December 1997) This article is dedicated to Monica Breda (1994-1997) and her family.
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