For a Roman Catholic, in addition to the prayers one can say for the sick and dying, the last sacrament is actually the Eucharist (communion) in the form of Viaticum. If a priest were available, he would hear the person's confession, give the sacrament of the sick, and give communion. Only a priest can hear a confession or give the sacrament of the sick. However, a deacon, or a lay person, who is designated a Eucharistic Minister by his/her pastor in accordance with the regulations of the local bishop can give communion to the dying. When a Eucharistic Minister becomes aware that someone is dying, and no priest is available he or she should go to the Church and obtain a consecrated host and take it to the sick person.
Can. 911 sec.1 The duty and right to bring the blessed Eucharist to the sick as Viaticum belongs to the parish priest, to assistant priests, to chaplains and, in respect of all who are in the house, to the community Superior in clerical religious institutes or societies of apostolic life.
sec.2 In a case of necessity, or with the permission at least presumed of the parish priest, chaplain or Superior, who must subsequently be notified, any priest or other minister of holy communion must do this. Code of Canon Law, Sanctifying Office of the Church, Article One, the Minister of the Eucharist.
If the sick person wishes to receive communion but indicates the need to go to confession first, the lay minister cannot hear the person's confession. The sick person should make a sincere, or perfect, act of contrition and then receive communion. (However, if a confused sick person admits, or confesses, some sin anyway, the minister is bound to the same secrecy as is a priest.)
"The eucharist, which continuously makes the paschal mystery of Christ to be present among us, is the source of every grace and of the forgiveness of sins. Nevertheless, those who intend to receive the body of the Lord must approach it with a pure conscience and proper dispositions of soul if they are to receive the effects of the paschal sacrament.
On this account the Church prescribes 'that those conscious of mortal sin, even though they think themselves to be contrite, must not go to the holy eucharist without sacramental confession beforehand.' When there is a serious reason and no opportunity for confession, they are to make an act of perfect contrition with the intention of confessing individually [to a priest], as soon as possible, the mortal sins that they cannot confess at present." A Ritual for Laypersons, The Liturgical Press, copyright 1993 by Order of St Benedict. Published under authority of NCCB of USA, pp. 7-8.
"Can. 916 Anyone who is conscious of grave sin may not celebrate Mass or receive the Body of the Lord without previously having been to sacramental confession, unless there is a grave reason and there is no opportunity to confess; in this case the person is to remember the obligation to make an act of perfect contrition, which includes the resolve to go to confession as soon as possible." Code of Canon Law, Sanctifying Office of the Church, Participation in the Blessed Eucharist.
(Being in danger of death should certainly constitute a "grave reason" and the "absence of a priest" would mean no opportunity to confess.)
1452. "When it arises from a love by which God is loved above all else, contrition is called 'perfect' (contrition of charity). Such contrition remits venial sins; it also obtains forgiveness of mortal sins if it includes the firm resolution to have recourse to sacramental confession as soon as possible. Catechism of the Catholic Church, contrition.
1492 Repentance (also called contrition) must be inspired by motives that arise from faith. If repentance arises from love of charity for God, it is called "perfect" contrition; if it is founded on other motives, it is called "imperfect."
1. Penitential Rite:
a. Normally one would use the "I confess..." from mass, or the "Lord have mercy..." but
b, If the sick person is concerned about serious sin, he or she should make an act of contrition. The lay minister should help the person to make the act of contrition if he or she does not remember the words to a suitable prayer of contrition. If there is time, suggest to the sick person an examination of conscience and an examination of the motives for being sorry for sin. The minister could encourage him or her to focus on a desire for forgiveness not out of fear of punishment but based on sorrow for being hostile or indifferent to God's love. Then suggest it is that very love which God has for each of us personally and individually that makes possible His mercy and forgiveness. Remind the person that a plenary indulgence is granted to someone at the point of death. (See Indulgences of the Catholic Church.)
Optional Readings: John 6:54-58, John 14:6; John 14:23; John 15:4; I Cor. 11:26; 1 John 4:16.
2. Have the person repeat their baptismal promises, or say the Apostles Creed.
3. Recite the Lord's Prayer.
4. When the dying person is ready, give him or her communion. (Remember that even a very small particle of a host is sufficient.)
Say: "This is the Lamb of God who takes away the sins of the world. Happy are those who are called to his supper."
The sick person responds: "Lord I am not worthy to receive you, but only say the word and I shall be healed."
Then say: "The Body of Christ."
He or she responds: "Amen."
5. After they receive, say: "May the Lord Jesus protect you and lead you to eternal life."
[A Ritual for Layperson's, Liturgical Press, all rights reserved, (1983), p. 46.]
6. Conclude with prayer and blessing. For example, in these or similar words:
We commend to you, O Lord! the soul of this your servant N, and beseech you, O Jesus Christ, Redeemer of the world,
that, as in your love for him (her), you became man, so now you would grant to admit him (her) into the number of the blessed.
May all the Saints and Elect of God, who, on earth, suffered for the sake of Christ, intercede for him ( her) ; so that, when freed from the prison of his ( her) body, he ( she) may be admitted into the kingdom of heaven: through the merits of our Lord Jesus Christ, who lives and reigns with the Father and the Holy Spirit, world without end. R. Amen.
May the blessing of God Almighty the Father, and the Son, and the Holy Ghost descend upon you and remain with you
always. (A lay person would place his/her hand on the person or make the sign of the cross on himself.)
you are the source of eternal health
for those who believe in you.,
May our brother (sister) N.,
who has been refreshed
with food and drink from heaven,
safely reach your kingdom of light and life.
We ask this through Christ our Lord.
The Minister makes the sign of the cross on himself or herself while saying:
May the almighty and merciful God bless and protect us the Father, and the Son and the Holy Spirit.
[A Ritual for Layperson's, Liturgical Press, all rights reserved, (1983), p. 47.]
It is possible that a lay minister may feel that the dying person is unworthy to receive Viaticum. The lay minister must remember the Lord's command to not judge others. See Matt. 7:1-5. No one may judge another guilty of sin, and refuse the sacrament, based on "mere conjecture, presumption, and rumor..." Pope Benedict XIV. St. Thomas Aquinas states: "[A]fter repentance and reconciliation, Communion must not be refused even to public sinners, especially in the hour of death." If sinfulness may be reasonably suspected, then urge the dying person to make a good act of contrition.
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