The Moral Minute #3

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From Owensboro Catholic Radio, The Moral Minute features Fr. Thomas Petri, OP, a priest of the Dominican Order of the Province of St Joseph. This clip is a part of a series of short lessons on Moral Theology produced by Owensboro Catholic Radio that aired daily on the radio channel. Fr. Thomas Petri grew up in the diocese of Owensboro, KY. Fr. Petri entered the Dominican Order in the Province of St Joseph on August 8, 2003. He made his solemn profession of vows in November of 2007, was ordained a priest in May of 2009. Fr. Petri has a Licentiate in Sacred Theology from the Dominican House of Studies in Washington, D.C. as well as a Doctorate in Sacred Theology from The Catholic University of America. His area of expertise is moral theology and ethics with special interests in St. Thomas Aquinass moral theory, the thought of Pope John Paul II, and the Theology of the Body. Currently, Fr. Petri is an assistant professor of theology at Providence College in Rhode Island. Providence College is the only college in the United States staffed by Dominican friars.

COMMUNION FOR NPO PATIENTS

Part 1 of 2

By

Greg F. Burke, M.D.

Robb McIlvried, M.D.

“I cannot be without my Lord.” These were the words of a holy Carmelite nun as she recovered in the hospital from a major gastrointestinal hemorrhage. The physician staff had ordered NPO (nil per os, or “nothing by mouth”) shortly after her admission. This is standard medical practice in acute-care hospitals for a variety of medical and surgical indications. This cloistered nun’s deeply sincere request to receive Holy Communion should remind all clinicians about the supreme importance this Sacrament has in the life of seriously ill Catholics. Traditionally, the hospital has been seen as a place to heal the body, often with the mind and spirit ignored. Ideally, the hospital’s mission should be to treat the person as a whole-body, mind and spirit.

In the November 2005 issue of Ethics & Medics, Brother Ignatius Perkins, O.P., and Father Peter-John Cameron, O.P., spoke of this concern in “The Eucharist and Tube Feeding: Our Pastoral Obligation.”¹ The authors discuss the theology of the Eucharist and its central place as the source and summit of Catholic spiritual life. They address the practical concerns of how to provide the Eucharistic species to those who are dependent on feeding tubes as well as how to assess a patient’s ability to recognize the sacramental moment. The authors conclude with a call to all hospitals, Catholic chaplains, bishops, and pastoral committees to develop liturgical norms to respond to the spiritual needs of brothers and sisters who are prevented from receiving Christ in the context of Holy Mass.

The importance of Perkins’ and Cameron’s call cannot be overemphasized. Patients are often temporarily denied Communion when physicians order NPO status in anticipation of a surgical procedure or other acute gastrointestinal illness. We then have to ask what medical and pastoral approach is appropriate for these souls.

NOTHING BY MOUTH

Physicians often find in practice that strict interpretation of NPO status is maintained for hospitalized patients despite scant evidence that the patients would be harmed by receiving Communion. Our review of the literature revealed only two related cases. In one, a patient who had already been sedated before surgery received the host and developed laryngeal obstruction.²

The host was easily removed from the larynx, and the surgery proceeded as planned. The author of the case study speculated that the obstruction occurred because of the medications the patient had received (pentobarbital and atropine). In the second case, the host interfered with a probe used during a transesophageal echocardiogram, so that images could not be obtained. The patient was not harmed.³ 

To gain greater clarity on this subject, we performed a survey of clinicians across specialties at our institution, Geisinger Health System, relating to Communion and NPO status.⁴ Geisinger is a network of three hospitals and thirty-seven specialty and community practice sites that provide primary through tertiary care throughout central and northeastern Pennsylvania. Opinions on whether patients could safely receive Communion in three clinical scenarios were assessed: (1)patients at risk for aspiration; (2) patients in the preoperative period who are at risk for aspiration during intubation, and (3)patients with bowel obstruction. The size of the Communion host could be very small-a quarter of a normal-sized host or even a “tiny particle.” Even the smallest particle of consecrated host contains the entire divinity and humanity of the risen Christ.

Responses to the various scenarios were combined into a summary score for each respondent, indicating how likely the physician was to allow reception of the sacrament. Logistic regression was used to correlate the summary score with each physician’s characteristics- gender, field of practice, religious affiliation, and religious practice.

Dr. Burke and Dr. McIlvried are with the department of General Internal Medicine at Geisinger Medical Center in Danville, Pennsylvania. The authors thank statistician G. Craig Wood, M.S., of the Geisinger Center for Health Research in Danville, for his data compilation and analysis.

¹Ignatius Perkins and Peter Cameron, “The Eucharist and Tube Feeding: Our Pastoral Obligation,” Ethics & Medics 30.11(November 2005): 1-3.

²Ennio Gallozzi, “An Unusual Cause of Laryngeal Obstruction,” Anesthesiology 28.4 (July-august 1967): 784.

³Nina Wokhlu and Daniel M. Shindler, “Communion Wafer Impedind Transesophageal Echocardiographic Imaging,” letter, Journal of clinical Anesthesia 17.7 (November 2005): 571.

⁴Data from the survey are available from Dr. McIlvried at rmcilvried1@geisinger.edu.

©Reprinted with permission.

THE REAL PRESENCE OF JESUS CHRIST

This text is the sixth of six excerpts from

The Real Presence of Jesus Christ in the

Sacrament of the Eucharist

15. Why Do We Call the Presence of Christ in the Eucharist a   “Mystery”?

The word “mystery” is commonly used to refer to something that escapes the full comprehension of the human mind. In the Bible, however, the word has a deeper and more specific meaning, for it refers to aspects of God’s plan of salvation for humanity, which has already begun but will be completed only with the end of time. In ancient Israel, through the Holy Spirit God revealed to the prophets some of the secrets of what he was going to accomplish for the salvation of his people (cf. Am 3:7; Is 21:28; Dan 2:27-45). Likewise, through the preaching and teaching of Jesus, the mystery of “the Kingdom of God” was being revealed to his disciples (Mk 4:11-12). St. Paul explained that the mysteries of God may challenge our human understanding or may even seem to be foolish­ness, but their meaning is revealed to the People of God through Jesus Christ and the Holy Spirit (cf. 1 Cor 1:18-25, 2:6-10; Rom 16:25-27; Rev 10:7).

The Eucharist is a mystery because it participates in the mystery of Jesus Christ and God’s plan to save human­ity through Christ. We should not be surprised if there are aspects of the Eucharist that are not easy to under­stand, for God’s plan for the world has repeatedly sur­passed human expectations and human understanding (cf. Jn 6:60-66). For example, even the disciples did not at first understand that it was necessary for the Messiah to be put to death and then to rise from the dead (cf. Mk 8:31-33, 9:31-32, 10:32-34; Mt 16: 21-23, 17:22-23, 20:17-19; Lk 9:22, 9:43-45, 18:31-34). Furthermore, any time that we are speaking of God we need to keep in mind that our human concepts never entirely grasp God. We must not try to limit God to our understanding, but allow our understanding to be stretched beyond its nor­mal limitations by God’s revelation.

Conclusion

By his Real Presence in the Eucharist Christ fulfils his promise to be with us “always, until the end of the age” (Mt 28:20). As St. Thomas Aquinas wrote, “It is the law of friendship that friends should live togeth­er. . . . Christ has not left us without his bodily presence in this our pilgrimage, but he joins us to himself in this sacrament in the reality of his body and blood” (Summa Theologiae, III q. 75, a. 1). With this gift of Christ’s presence in our midst, the Church is truly blessed. As Jesus told his disciples, referring to his pres­ence among them, “Amen, I say to you, many prophets and righteous people longed to see what you see but did not see it, and to hear what you hear but did not hear it” (Mt 13:17). In the Eucharist the Church both receives the gift of Jesus Christ and gives grateful thanks to God for such a blessing. This thanksgiving is the only proper response, for through this gift of himself in the celebration of the Eucharist under the appearances of bread and wine Christ gives us the gift of eternal life.

Amen, amen, I say to you, unless you eat the flesh of the Son of Man and drink his blood, you do not have life within you. Whoever eats my flesh and drinks my blood has eternal life, and I will raise him on the last day. For my flesh is true food, and my blood is true drink. . . . Just as the living Father sent me and I have life because of the Father, so also the one who feeds on me will have life because of me. (Jn 6:53-57)

Questions for Reflection and Discussion

 1.How does the mystery of the Eucharist shape the way in which you live out your faith?

 2. How do you show your response of thanks and praise to God for the gift of Jesus Christ in the Eucharist outside of the Mass?

 The resource, The Real Presence of Jesus Christ in the Sacrament of the Eucharist: Basic Questions & Answers, was produced by the Committee on Doctrine of the United States Conference of Catholic Bishops and was approved by the full body of bishops at its June 2001 General Meeting. This reproduction of the text, along with additional questions for reflection and discus­sion, is authorized for publication by the undersigned, with the approval of the Committee on Doctrine.

Monsignor William P. Fay

General Secretary, USCCB

Scripture texts used in this work are taken from the New American Bible, copyright © 1991, 1986, and 1970 by the Confraternity of Christian Doctrine, Washington, D.C. 20017, and are used by per­mission of the copyright owner. All rights reserved.

Excerpts from Vatican Council II: The Conciliar and Post Conciliar Documents edited by Austin Flannery, OP, copyright © 1975, Costello Publishing Company, Inc., Northport, N.Y., are used with permission of the publisher, all rights reserved. No part of these excerpts may be reproduced, stored in a retrieval system, or trans­mitted in any form or by any means—electronic, mechanical, pho­tocopying, recording, or otherwise—without express written per­mission of Costello Publishing Company.

Copyright © 2001, United States Conference of Catholic Bishops, Washington, D.C. All rights reserved.

Parishes and schools have permission to reproduce this document in this format for free distribution. If you take advantage of this offer, please inform us at publications@usccb.org so we can track usage.

To order the full resource, call 800-235-8722 or visit www.usccb.org and click on Bookstore.

United States Conference of Catholic Bishops • 3211 Fourth Street, N.E. • Washington, DC 20017-1194

THE REAL PRESENCE OF JESUS CHRIST Part 5

This text is the fifth of six excerpts from

The Real Presence of Jesus Christ in the

Sacrament of the Eucharist

12.       Does One Receive the Whole Christ if One Receives Holy Communion under a Single Form?

Yes. Christ Jesus, our Lord and Savior, is wholly present under the appearance either of bread or of wine in the Eucharist. Furthermore, Christ is wholly present in any frag­ment of the consecrated Host or in any drop of the Precious Blood. Nevertheless, it is especially fitting to receive Christ in both forms during the celebration of the Eucharist. This allows the Eucharist to appear more perfectly as a banquet, a banquet that is a foretaste of the banquet that will be cele­brated with Christ at the end of time when the Kingdom of God is established in its fullness (cf. Eucharisticum Mysterium, no. 32).

13.       Is Christ Present during the Celebration of the Eucharist in Other Ways in Addition to His Real Presence in the Blessed Sacrament?

Yes. Christ is present during the Eucharist in various ways. He is present in the person of the priest who offers the sacri­fice of the Mass. According to the Constitution on the Sacred Liturgy of the Second Vatican Council, Christ is present in his Word “since it is he himself who speaks when the holy scriptures are read in the Church.” He is also present in the assembled people as they pray and sing, “for he has prom­ised ‘where two or three are gathered together in my name there am I in the midst of them’ (Mt 18:20)” (Sacrosanctum Concilium, no. 7). Furthermore, he is likewise present in other sacraments; for example, “when anybody baptizes it is really Christ himself who baptizes” (ibid.).

We speak of the presence of Christ under the appearances of bread and wine as “real” in order to emphasize the special nature of that presence. What appears to be bread and wine is in its very substance the Body and Blood of Christ. The entire Christ is present, God and man, body and blood, soul and divinity. While the other ways in which Christ is present in the celebration of the Eucharist are certainly not unreal, this way surpasses the others. “This presence is called ‘real’ not to exclude the idea that the others are ‘real’ too, but rather to indicate presence par excellence, because it is sub­stantial and through it Christ becomes present whole and entire, God and man” (Mysterium Fidei, no. 39).

14.           Why Do We Speak of the “Body of Christ” in More Than

                One Sense?         

First, the Body of Christ refers to the human body of Jesus Christ, who is the divine Word become man. During the Eucharist, the bread and wine become the Body and Blood of Christ. As human, Jesus Christ has a human body, a resur­rected and glorified body that in the Eucharist is offered to us in the form of bread and wine.

Secondly, as St. Paul taught us in his letters, the Church is the Body of Christ, using the analogy of the human body, in which many members are united with Christ their head (1 Cor 10:16-17, 12:12-31; Rom 12:4-8). This reality is fre­quently referred to as the Mystical Body of Christ. All those united to Christ, the living and the dead, are joined together as one Body in Christ. This union is not one that can be seen by human eyes, for it is a mystical union brought about by the power of the Holy Spirit.

The Mystical Body of Christ and the eucharistic Body of Christ are inseparably linked. By Baptism we enter the Mystical Body of Christ, the Church, and by receiving the eucharistic Body of Christ we are strengthened and built up into the Mystical Body of Christ. The central act of the Church is the celebration of the Eucharist; the individual believers are sustained as members of the Church, members of the Mystical Body of Christ, through their reception of the Body of Christ in the Eucharist.

Playing on the two meanings of “Body of Christ,” St. Augustine tells those who are to receive the Body of Christ in the Eucharist: “Be what you see, and receive what you are” (Sermon 272). In another sermon he says, “If you receive worthily, you are what you have received” (Sermon 227).

The work of the Holy Spirit in the celebration of the Eucharist is twofold in a way that corresponds to the twofold meaning of “Body of Christ.” On the one hand, it is through the power of the Holy Spirit that the risen Christ and his act of sacrifice become present. In the eucharistic prayer, the priest asks the Father to send the Holy Spirit down upon the gifts of bread and wine to transform them into the Body and Blood of Christ (a prayer known as the epiclesis or “invocation upon”). On the other hand, at the same time the priest also asks the Father to send the Holy Spirit down upon the whole assembly so that “those who take part in the Eucharist may be one body and one spirit” (Catechism, no. 1353). It is through the Holy Spirit that the gift of the eucharistic Body of Christ comes to us and through the Holy Spirit that we are joined to Christ and each other as the Mystical Body of Christ.

By this we can see that the celebration of the Eucharist does not just unite us to God as individuals who are isolated from one another. Rather, we are united to Christ together with all the other members of the Mystical Body. The celebration of the Eucharist should thus increase our love for one another and remind us of our responsibilities toward one another. Furthermore, as members of the Mystical Body, we have a duty to represent Christ and to bring Christ to the world. We have a responsibility to share the Good News of Christ not only by our words but also by how we live our lives. We also have a responsibility to work against all the forces in our world that oppose the Gospel, including all forms of injus­tice. The Catechism of the Catholic Church teaches us: “The Eucharist commits us to the poor. To receive in truth the Body and Blood of Christ given up for us, we must recognize Christ in the poorest, his brethren” (no. 1397).

Questions for Reflection and Discussion

1.The Eucharist is “a banquet that is a foretaste of the banquet that will be cel­ebrated with Christ at the end of time when the Kingdom of God is established in its full­ness.” As you reflect on your experiences of receiving Holy Communion, what do you imagine the heavenly banquet might be like?

2. How have you experienced the pres­ence of Jesus Christ in his Word, in the priest, in the assembled people, and in other sacraments?

3. In what ways do you see the connection between the Mystical Body of Christ and the Eucharistic Body of Christ in your parish? In your community?

4. In what ways does the Eucharist chal­lenge you to act on your responsibility to love and care for others?

The resource, The Real Presence of Jesus Christ in the Sacrament of the Eucharist: Basic Questions & Answers, was produced by the Committee on Doctrine of the United States Conference of Catholic Bishops and was approved by the full body of bishops at its June 2001 General Meeting. This reproduction of the text, along with additional questions for reflection and discus­sion, is authorized for publication by the undersigned, with the approval of the Committee on Doctrine.

Monsignor William P. Fay

General Secretary, USCCB

Scripture texts used in this work are taken from the New American Bible, copyright © 1991, 1986, and 1970 by the Confraternity of Christian Doctrine, Washington, D.C. 20017, and are used by per­mission of the copyright owner. All rights reserved.

Excerpts from Vatican Council II: The Conciliar and Post Conciliar Documents edited by Austin Flannery, OP, copyright © 1975, Costello Publishing Company, Inc., Northport, N.Y., are used with permission of the publisher, all rights reserved. No part of these excerpts may be reproduced, stored in a retrieval system, or trans­mitted in any form or by any means—electronic, mechanical, pho­tocopying, recording, or otherwise—without express written per­mission of Costello Publishing Company.

Copyright © 2001, United States Conference of Catholic Bishops, Washington, D.C. All rights reserved.

Parishes and schools have permission to reproduce this document in this format for free distribution. If you take advantage of this offer, please inform us at publications@usccb.org so we can track usage.

THE REAL PRESENCE OF JESUS CHRIST Part 4

This text is the fourth of six excerpts from

The Real Presence of Jesus Christ in the Sacrament of the Eucharist

8. Why Are Some of the Consecrated Hosts Reserved 

    after the Mass?

While it would be possible to eat all of the bread that is con­secrated during the Mass, some is usually kept in the taber­nacle. The Body of Christ under the appearance of bread that is kept or “reserved” after the Mass is commonly referred to as the “Blessed Sacrament.” There are several pastoral rea­sons for reserving the Blessed Sacrament. First of all, it is used for distribution to the dying (Viaticum), the sick, and those who legitimately cannot be present for the celebration of the Eucharist. Secondly, the Body of Christ in the form of bread is to be adored when it is exposed, as in the Rite of Eucharistic Exposition and Benediction, when it is carried in Eucharistic processions, or when it is simply placed in the tabernacle, before which people pray privately. These devo­tions are based on the fact that Christ himself is present under the appearance of bread. Many holy people well known to American Catholics, such as St. John Neumann, St. Elizabeth Ann Seton, St. Katharine Drexel, and Blessed Damien of Molokai, practiced great personal devotion to Christ present in the Blessed Sacrament. In the Eastern Catholic Churches, devotion to the reserved Blessed Sacrament is practiced most directly at the Divine Liturgy of the Presanctified Gifts, offered on weekdays of Lent.

9.     What Are Appropriate Signs of Reverence with Respect to the Body and Blood of Christ?

The Body and Blood of Christ present under the appearances of bread and wine are treated with the greatest reverence both during and after the celebration of the Eucharist (cf. Mysterium Fidei, nos. 56-61). For example, the tabernacle in which the consecrated bread is reserved is placed “in some part of the church or oratory which is distinguished, conspic­uous, beautifully decorated, and suitable for prayer” (Code of Canon Law, Can. 938, §2). According to the tradition of the Latin Church, one should genuflect in the presence of the tabernacle containing the

reserved sacrament. In the Eastern Catholic Churches, the traditional practice is to make the sign of the cross and to bow profoundly. The liturgical gestures from both traditions reflect reverence, respect, and adora­tion. It is appropriate for the members of the assembly to greet each other in the gathering space of the church (that is, the vestibule or narthex), but it is not appropriate to speak in loud or boisterous tones in the body of the church (that is, the nave) because of the presence of Christ in the tabernacle. Also, the Church requires everyone to fast before receiving the Body and Blood of Christ as a sign of reverence and rec­ollection (unless illness prevents one from doing so). In the Latin Church, one must generally fast at least one hour; members of Eastern Catholic Churches must follow the prac­tice established by their own Church.

10. If Someone Without Faith Eats and Drinks the Consecrated   

      Bread and Wine, Does He or She Still Receive the Body and

      Blood of Christ?

If “to receive” means “to consume,” the answer is yes, for what the person consumes is the Body and Blood of Christ. If “to receive” means “to accept the Body and Blood of Christ knowingly and willingly as what they are, so as to obtain the spiritual benefit,” then the answer is no. A lack of faith on the part of the person eating and drinking the Body and Blood of Christ cannot change what these are, but it does prevent the person from obtaining the spiritual benefit, which is communion with Christ. Such reception of Christ’s Body and Blood would be in vain and, if done knowingly, would be sacrilegious (1 Cor 11:29). Reception of the Blessed Sacrament is not an automatic remedy. If we do not desire communion with Christ, God does not force this upon us. Rather, we must by faith accept God’s offer of commun­ion in Christ and in the Holy Spirit, and cooperate with God’s grace in order to have our hearts and minds trans­formed and our faith and love of God increased.

11. If a Believer Who Is Conscious of Having Committed a Mortal

      Sin Eats and Drinks Questions for Reflection and Discussion

      the Consecrated Bread and Wine, Does He or She Still

      Receive the Body and Blood of Christ?

Yes. The attitude or disposition of the recipient cannot change what the consecrated bread and wine are. The ques­tion here is thus not primarily about the nature of the Real Presence, but about how sin affects the relationship between an individual and the Lord. Before one steps forward to receive the Body and Blood of Christ in Holy Communion, one needs to be in a right relationship with the Lord and his Mystical Body, the Church, that is, in a state of grace, free of all mortal sin. While sin damages, and can even destroy, that relationship, the sacrament of Penance can restore it. St. Paul tells us that “whoever eats the bread or drinks the cup of the Lord unworthily will have to answer for the body and blood of the Lord. A person should examine himself, and so eat the bread and drink the cup” (1 Cor 11:27-28). Anyone who is conscious of having committed a mortal sin should be recon­ciled through the Sacrament of Penance before receiving the Body and Blood of Christ, unless a grave reason exists for doing so and there is no opportunity for confession. In this case, the person is to be mindful of the obligation to make an act of perfect contrition, that is, an act of sorrow for sins that “arises from a love by which God is loved above all else” (Catechism, no. 1452). The act of perfect contrition must be accompanied by the firm intention of making a sacramental confession as soon as possible.

What sign of reverence for the Body and Blood of Christ has particular significance for you? Why?

1. In what ways are you most aware of the Real Presence of Christ in the Eucharist? What helps increase your awareness?
2. How has the state of your relationship with God affected your desire to receive Holy Communion? How has it affected your ability to receive the spiritual benefit?

The resource, The Real Presence of Jesus Christ in the Sacrament of the Eucharist: Basic

Questions & Answers, was produced by the Committee on Doctrine of the United States

Conference of Catholic Bishops and was approved by the full body of bishops at its June 2001

General Meeting. This reproduction of the text, along with additional questions for reflection

and discus­sion, is authorized for publication by the undersigned, with the approval of the Committee on Doctrine.

Monsignor William P. Fay

General Secretary, USCCB

Scripture texts used in this work are taken from the New American Bible, copyright © 1991, 1986, and 1970 by the Confraternity of Christian Doctrine, Washington, D.C. 20017, and are used by per­mission of the copyright owner. All rights reserved.

Excerpts from Vatican Council II: The Conciliar and Post Conciliar Documents edited by Austin Flannery, OP, copyright © 1975, Costello Publishing Company, Inc., Northport, N.Y., are used with permission of the publisher, all rights reserved. No part of these excerpts may be reproduced, stored in a retrieval system, or trans­mitted in any form or by any means—electronic, mechanical, pho­tocopying, recording, or otherwise—without express written per­mission of Costello Publishing Company.

Copyright © 2001, United States Conference of Catholic Bishops, Washington, D.C. All rights reserved.

Parishes and schools have permission to reproduce this document in this format for free distribution. If you take advantage of this offer, please inform us at publications@usccb.org so we can track usage.