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Question 66.
Dear Fr Christopher,
greetings in Christ.
Is it possible for the sacrament of holy unction or other prayers to be read without the direct consent of the patient (e.g. in cases of comma or brain-dead patients etc.), given the fact that the holy grace acts upon the man only through his own free will and choice?

Thank you.


Answer to Question 66.

Dear Constantine,

Many times priests are called by family members to say prayers for their loved ones who are in a non-responsive state. We do not always know the person's history to know if that person was an active member of the church. If he/she was, then surely they would not object to the church's prayers on their behalf. If he/she wasn't, this is still not a sign that they do not believe in God and would object (if they could respond) to such prayers. As baptized Christians they are full members and children of the church and as such the church has a responsibility to tend and pray for her children's welfare. Unless a person has left strict instructions with their family that they do not wish to be considered as a Christian (if such an incident should occur) then the responsibility of a person's religious needs falls with the family. This includes not only prayers while still alive, but also the arrangement of an Orthodox Christian burial. People often pass away suddenly, but we perform the funeral rite for them taking it for granted that, as members of the Church, that is what they would want. Someone in a coma can be compared to a child who cannot communicate to tell us if he/she wants to be baptised and taken regularly for Holy Communion. The parents decide what is best for the child and in the case of the non-responsive patient, the family decides. But prayers are one thing and Holy Communion is something completely different. We do not and cannot give Holy Communion to a person without that person being awake and indicating by some sign that he/she wants to partake. This said, it is sometimes very difficult to recognise these signs. Every month we go to the local old people's home to give them Holy Communion and although most can communicate there is always one or two who suffer from senile dementia such as severe Alzheimer's disease and are in a state commonly referred to as a vegetable state. They cannot give any sign that they want to partake, but as long as they open their mouths we take it for granted that it is not against their will.

As you said, divine grace can only act on a person through his own will or rather if he allows divine grace to act upon him. Our prayers will not change this. The body might not be able to communicate, but the soul can still accept divine grace or reject it even if the prayers said on his behalf were against his will.

You also mentioned cases of coma or brain-dead patients, but they are not similar. A person in a coma is still very much alive and can breath on his own, while a brain dead person is considered legally dead and bodily organs are only kept alive by a life support machine, which if turned off, the person's heart would stop beating and he would immediately stop breathing. Because brain death is the legal term for death, physicians keep the body alive in the hope that family will consider donating certain organs for organ transplantation. This is something with which the church still has some reservations. She is not against organ transplantation, but whether the person pronounced as brain dead is actually and totally dead during the removal of the organs. But so far there is no possible way to verify this 100% unless the person is taken off the life support machine and the organs are left to die on their own, which in this case would make them useless to be used.

Nevertheless, for the time being we accept the medical world's definition of death so if a person is declared brain dead then he is legally dead and there would be no purpose in performing the sacrament of holy unction or saying other prayers which we say only for the living.   


With love in Christ

Fr. Christopher