The Sacraments And Death

I write this post with a heavy heart. My best friend from law school is in the hospital suffering greatly from COVID-19. He has some children who are still minors. Neither his wife, children, nor I can see him because the hospital has banned visitors (as have all New York City hospitals) due to the inherent dangers. Please pray for his family and him. This past week, we remembered the Passion of Christ on Good Friday, and our thoughts turn to The Four Last Things: Death, Judgement, Heaven, and Hell. This year, I'm reminded more than ever of these truths than I was in the past. New York City looks like a ghost town compared to what it was usually like just one month ago. The hospitals all have morgues around them to accommodate the bodies of the deceased. I've been working from home and haven't left the house in many days, in order to keep my family and myself safe. My friend is struggling to survive, and it pains me to no end.

Not to be morbid, but death will one day come for us all, and we must be prepared. "Give an account of thy stewardship: for now thou canst be steward no longer." (St. Luke 16:2). One of the ways we must be ready is to make sure we, and our loved ones, receive the Sacraments; especially in danger of death. I see the bravery of the Traditionalist priests and the attendant cowardice of the Vatican II sect clergy, some of whose "bishops" agree they should not give the Last Rites (invalid anyway) to their parishioners in hospitals, but instead have nurses "pray for them" during this pandemic.  "But the hireling, and he that is not the shepherd, whose own the sheep are not, seeth the wolf coming, and leaveth the sheep, and flieth..." (St. John 10:12).

We all know when we should call for a priest when someone is in danger of death--or do we? One of my friends (much older than me), was one of the first male nurses in NYC. He worked in a Catholic hospital which, after 1964, fell as another "victim of Vatican II." It was 1972, and droves of priests started leaving the priesthood. The new "priests" were invalidly ordained, and they had embraced whole-heartedly the Modernism of the new sect. Almost all of the chaplains in his hospital left to cover parishes or left the priesthood. At this point they only had one chaplain left; a monsignor in his late fifties who was ordained in the early 1940s.  During an operation, my friend relates that the procedure was not going well for the patient. The surgeon, a member of the Vatican II sect, asked my nurse friend to "call the priest, I don't think he's going to make it." He called for the chaplain immediately and returned to assist the doctor.

Ten minutes later, the patient went into cardiac arrest, and they were working furiously to save his life. After twenty minutes or so, the doctor said it was no use, and he pulled the sheet up over the man on the operating table. My friend said a brief prayer for his soul, and went outside the doors to the OR. Just then, the monsignor arrived out of breath. "I'm here," he announced, "I had two other patients needing the Last Rites." My friend shook his head and said, "It's too late monsignor. He passed." The monsignor turned red with anger, "Stand aside!" he screamed. "It's never too late!" Stunned, my friend stood aside, and the priest went in to administer the Sacraments. This priest knew from his seminary training (and still believed it) that death is not as easy to determine as many assume.

This post will explore when, exactly, death occurs, and how the Last Rites are to be administered to those who are pronounced/considered dead.

Preliminary Considerations Concerning Death

Doctors themselves are not certain the exact moment death takes place. In the words of Dr. Cory Franklin, an intensive care unit director:

What is the exact moment when death occurs? The outer boundaries are obvious — a walking, talking individual is alive, a body with rigor mortis is not — but the precise instant when a person is considered dead is uncertain.

If the heart stops beating long enough, the person dies. But a stopped heart often can be restarted; this is routine during heart surgery. Likewise, someone who stops breathing can be kept alive by a mechanical ventilator. If both the heart and breathing cease, physicians may institute CPR. When the physician decides to stop CPR and declare a person "dead" is a matter of discretion, not an established fact.
(See https://www.chicagotribune.com/opinion/ct-xpm-2014-01-10-ct-death-jahi-brain-legal-perspec-0110-20140110-story,amp.html; Emphasis mine).

Dr. Franklin also correctly describes the two means of declaring death, "Death might now be declared in two ways — if a person's heart and lungs ceased functioning or if there was no brain activity." (Ibid). The former is called clinical death, and the latter is biological death. 

There are some things that happen prior to death that show (a) death is near and (b) the person is not as "out of it" as was thought. Cheyne-Stokes breathing is a cycle of anywhere from 30 seconds to two minutes where the dying person's breathing deepens and speeds up, then gets shallower and shallower until it stops.Then there is a pause, which can sometimes stretch on so long that you think the person has stopped breathing altogether before the cycle resumes. It is sometimes called the "death rattle" because of the sound. This is because the dying person is not clearing their throat or swallowing. Take solace that there is little evidence of distress or discomfort.

Around this time, terminal lucidity, or lightening up may occur. It was first described in the medical literature as early as 1833. It refers to a period of awareness or consciousness, sometimes a complete return to form and personality in someone who may have been gone (for all intents and purposes) due to Alzheimer's disease, brain tumors, vascular dementia, etc. Just as a light bulb burns brightest before going dark forever, this happens in many people. How can brain damage magically repair itself, even for a short time? Many consider this a sign of the soul working outside the normal route of the brain.

The Lazarus Syndrome

This phenomena, described in the medical literature since 1982, is so named after Jesus' friend Lazarus, whom Our Lord raised from the dead after four days (the name "Lazarus Syndrome" or sometimes "Lazarus Phenomenon" was coined in 1983). (See St. John 11:38-44). There have been thirty-eight (38) confirmed cases since 1982 of people pronounced dead, but they were not. According to the Journal JRSM Open:

The Lazarus phenomenon or the unassisted return of spontaneous circulation after cardiac arrest is a grossly under-reported phenomenon in medical literature which essentially implies the "resurrection" of an individual after cardiac arrest. Although there have been a handful of such cases reported, the clinical incidence and significance may be underestimated. Because of the presumed infrequency of this condition, there are no studies specifically researching Lazarus phenomenon in scientific literature. (See Vaibhav Sahni, The Lazarus Phenomenon https://journals.sagepub.com/doi/full/10.1177/2054270416653523). 

The cases are incredible:

• 91 year old Janina Kolkiewicz was declared dead. Eleven hours later, she woke up in the morgue asking for tea and pancakes

• In 2014, a 78-year-old man from Mississippi was declared dead after a hospice nurse found him with no pulse. The next day, he woke up in a body bag at the morgue

• In 2014 came a report of an 80-year-old woman who had been "frozen alive" in a hospital morgue after being wrongly pronounced dead

And it's not only the cardiac arrest victims, but brain death as well:

• St. Joseph's Hospital in Syracuse, NY came under fire in 2014 when incorrectly declaring a woman as brain dead following a drug overdose. The woman awoke shortly after being taken to the operating room for organ harvesting

• In May 2015, 14 year old Taylor Hale was declared irreversibly brain dead. A friend of the family, a chiropractor by profession, went in and prayed for her. She awoke and made a complete recovery

(See https://www.medicalnewstoday.com/amp/articles/317645; See also, https://insider.foxnews.com/2014/03/10/syracuse-woman-wrongly-declared-dead-ny-hospital-opens-eyes-during-organ-harvesting; See also https://www.usatoday.com/story/news/nation/2015/05/13/hand-of-god-heals-iowa-girl/27274399/). 

What causes the Lazarus Syndrome? No one knows for sure; there is no medical consensus. The delayed return of spontaneous circulation (ROSC) after CPR has ceased in cardiac arrest patients, accounts for many cases of Lazarus Syndrome. What causes ROSC to happen after some time has passed? Some hypotheses include a pressure buildup in the chest caused by CPR. Once CPR is ceased, this pressure may gradually release and kick-start the heart back into action. It could be a delayed action of medication, or hyperkalemia, whereby blood levels of potassium are too high. (See https://scholarblogs.emory.edu/gravematters/tag/lazarus-syndrome/)

 For "brain death" or the apparent finding of someone dead, who then comes "back to life," there are other hypotheses, which include hypothermia. The low body temperature can cause heartbeat and breathing to slow to the point where it is almost undetectable. Another theory is catalepsy, which is characterized by a trance-like state, slowed breathing, reduced sensitivity, and complete immobility, which can last from minutes to weeks. The condition may arise as a symptom of neurological disorders. Finally, there's "locked in syndrome," whereby a patient is aware of their surroundings, but they experience complete paralysis of voluntary muscles, with the exception of muscles that control eye movement. (See medicalnewstoday.com/amp/articles/317645). All of this makes the person appear dead. 

Two points to be learned from the above:

1. Organ donation is good and honorable but don't let anyone know in advance of death. Someone should produce the legal documentation after death is certain.

2.  The soul may not leave the body when we think it does, thereby permitting the person to receive the Sacraments.

The Sacraments Administered to the Seemingly Dead

 This section is condensed and taken from the theological tome Death Real and Apparent in Relation to the Sacraments, written by theologian Ferreres in 1906, during the reign of Pope St. Pius X. Fr. Ferreres was Professor of Moral Theology and Canon Law, at the Collegium Maximum, in Tortosa, Spain. Also used is the work of theologian Halligan,  The Administration of the Sacraments (1962). Most of this section comes from those two theological works, and some small commentary added by me---Introibo. 

Thesis: It is possible to save, by administration of the Sacraments, the souls of adults apparently dead.  It is certain that an adult, whilst still alive and in possession of requisite dispositions, is capable of receiving some of the Sacraments, no matter how strongly outward appearances may indicate a state of death. It is certain, likewise, that on receiving or not receiving these Sacraments may depend the salvation of his soul. 

1. The Sacrament of Baptism
Baptism may be conditionally applied in the case of someone who appears (or has been pronounced) dead, and is not baptized, but there is reason to believe he implicitly desires baptism (not being a catechumen). Maybe he inquired about Catholicism or has Catholic relatives that he joined at Mass. If he also has attrition (sorrow for his sins because of the fear of punishments and Hell), Baptism would be valid if the soul has not left the body. Baptism of Desire (BOD) requires supernatural contrition, and is a rare miracle of God upon which no one should rely, as the Sacrament is the normative means of conferring Church membership and forgiveness of sins. Hence, the person who knows and may believe the essential truths of faith, may implicitly desire baptism and have contrition. Baptism may be conditionally conferred. In the case of someone who was mentally retarded or habitually insane from childhood, baptism would certainly be valid, and need not be conditional.

2. The Sacrament of Penance
A Catholic who is apparently dead, may have absolution given conditionally in the hope that he had at least elicited an act of attrition and needs the Sacrament. Perhaps he even elicits it in a kind of "locked in" state prior to the soul separating from the body. According to theologian Noldin, the first six minutes after what is commonly called "the moment of death," might not be real death (the soul not yet having left the body), and the Sacraments may be administered. Since brain cells don't start to die until oxygen deprivation reaches about 5 to six minutes, it is a reasonable hypothesis that the soul may still be functioning through the brain and has not left the body.

3. The Sacrament of Extreme Unction
A Catholic in the state of apparent death should be given Extreme Unction. It is universally taught by the theologians that Extreme Unction will wipe away even mortal sin, provided that the person had elicited an act of attrition, and is unable to confess or make an Act of Contrition.

4. How Long Must We Consider Someone "Possibly Alive"?
The common teaching of the theologians is that in cases of extreme necessity (which these cases fall under), the Sacraments may and should be administered conditionally, even though, through the apparent lack of one or more of the essential requisites, their validity be very doubtful--and this despite the fact that the Sacrament's validity be only slightly probable or have little foundation or be based on the opinion of others.

Conclusion

If faced with the possibility of death (you or a loved one) do not wait until you think it must be done immediately. Give the person reasonable time; as well as giving the priest time to get to the hospital/hospice/home. Remember that any  validly ordained priest can give the Last Rites in danger of death, or when someone appears dead,and no Traditionalist priest is available. This includes priests validly ordained prior to Vatican II, Eastern Schismatic priests, even a complete apostate who abandoned his vocation. If conscious, you cannot agree to accept their errors; if that is not imposed, you may receive the Sacraments from them. 

In the case of Vatican II priests, make sure they use the Traditional Rite for Extreme Unction. It is always good to invest in a Rituale Romanum published in 1962 or prior, as they probably don't have one and forgot how to properly and validly administer the Sacrament. Most might not have the valid matter to anoint. The proper matter is "Olive oil alone[blessed by a bishop]" (Catechism of the Council of Trent). The Holy Office declared (September 14,1842), that "it is rash and close to error, to assert that this sacrament could be valid with another oil." The Vatican II sect has virtually no more valid bishops to bless anything. In addition to this problem, according to "Pope" Paul VI's "Apostolic Constitution" Sacram unctionem infirmorum, November 30, 1972, "The sick are to be anointed with blessed olive oil or, as circumstances suggest, with another oil extracted from plants." (Emphasis mine). At least they can give a valid absolution. You're better off with an Eastern Schismatic where there is no Traditionalist priest. 

Most importantly, don't turn a priest away because the sick person "just died." As that priest rightfully yelled, "It's never too late!"