What is the Anointing of the Sick, and who can receive it?

The Anointing of the Sick is the sacrament James describes in chapter 5, in which a priest anoints a seriously ill person with blessed oil in the name of the Lord and prays over him, and its guaranteed effect is not physical recovery but the forgiveness of his sins and the healing of his soul before he faces judgment. James 5:14-15 is as plain as anything in the New Testament. Is any man sick among you? Let him bring in the presbyters of the church, and let them pray over him, anointing him with oil in the name of the Lord. And the prayer of faith shall save the sick man, and the Lord shall raise him up, and if he be in sins, they shall be forgiven him. Luther did not like the epistle of James, and you can understand why. This one is clear as day, and it describes a power the Church has that nobody else claims. There are three details in the Greek that decide how to read it. First, the anointing is not medicinal. James adds "in the name of the Lord," which makes it a sacred act, the same way the name of the Lord is invoked while water is poured in baptism. Second, "the prayer of faith" carries the definite article both before "prayer" and before "faith," which is the only place in the New Testament that construction appears. That signals a set, formulaic prayer identified with the established faith of the Church, which in turn tells you this was already a well known and commonly practiced rite when James wrote. The third detail is the one that answers the question everybody actually asks, which is whether it is supposed to cure you. In verse 14 James uses astheneo for sick, the ordinary word for physical illness and weakness. In verse 15 he switches to a different word, kamno. That word appears only twice more in the New Testament, at Hebrews 12:3 and Revelation 2:3, and both times it refers to spiritual, not physical, sickness. Classical Greek used kamno for mental distress and fatigue, not bodily disease. James changed words deliberately. He is not guaranteeing that the sick man's body will recover. He is guaranteeing that his soul will be saved, which is why the verb in verse 15 is sozei, to save. So here is how I put it to people. You are physically ill and you come to the church. We cannot guarantee the physical. We do guarantee the spiritual, provided you are cooperating with your free will and with everything else the Church has taught you. Physical recovery does happen, and there are people who received this sacrament expecting to die and simply did not. But that is not the promise. Now, how this sacrament stands to confession. In the confessional you tell the priest exactly what you did, and he knows precisely what he is absolving. In the anointing you may not be able to verbalize your sins at all. You may be past speech. The Church takes over for you, and your sins are forgiven, and you are prepared for judgment. It is close kin to confession, but it reaches someone confession cannot reach. It is not a late medieval invention, whatever you are told. Origen, in his homilies on Leviticus, lists the kinds of forgiveness of sins available in the Church and includes the practice of James 5. Aphraates the Persian in the fourth century speaks of the sacrament of life that illuminates the darkness, anoints the sick, and leads back penitents. Chrysostom says our priests have received authority to deal not with bodily leprosy but with spiritual uncleanness, and to take it away, and he quotes James 5:14 to prove it. Cyril of Alexandria quotes the passage outright, and Caesarius of Arles tells his people that whoever is ill should hasten to the church, ask the presbyters for blessed oil, and by it merit the forgiveness of his sins. Pope Innocent I discusses its administration in the fifth century. Pope Leo IV at the Council of Ticinus in 850 calls it a truly great mystery that must be made known to the people by skillful teaching. On who may receive it and who may give it, the Church is specific. Trent gave four canons. Canon 1 condemns anyone who says extreme unction is not truly and properly a sacrament instituted by Christ and promulgated by blessed James, but only a rite accepted by the Fathers or a human fiction. Canon 2 condemns anyone who says the anointing does not confer grace, does not remit sins and does not relieve the sick, or that it has ceased as though it had only ever been a healing charism. Canon 4 condemns anyone who says the presbyters James speaks of are merely the older men of the community rather than priests ordained by a bishop, and therefore that a priest is not the proper minister. So the minister is an ordained priest, or a bishop, and the recipient is a member of the faithful who is seriously ill. Innocent I adds a restriction that surprises people: it was not administered to those under public penance, on the reasoning that someone barred from the other sacraments cannot be given this one either. James says bring in the priests. Not after the person has slipped into a coma, and not when the family finally gets nervous. Bring them in.