281. Eucharist for the mentally disabled?
281. EUCHARIST FOR THE MENTALLY DISABLED?
Should Communion be given to the severely mentally disabled?
Whether those who have not the use of reason ought to receive this sacrament?
We read in the First Council of Orange, Canon 13, and the same is to be found in the Decretals (26:6): All things that pertain to piety are to be given to the insane; and consequently, since this is the sacrament of piety, it must be given to them.
Men are said to be devoid of reason in two ways. First, when they are feeble-minded, as a man who sees dimly is said not to see; and since such persons can conceive some devotion towards this sacrament, it is not to be denied them.
In another way men are said not to possess fully the use of reason. Either, then, they never had the use of reason and have remained so from birth; and in that case this sacrament is not to be given to them because in no way has there been any preceding devotion towards the sacrament; or else they were not always devoid of reason; and then, if when they formerly had their wits they showed devotion towards this sacrament, it ought to be given to them in the hour of death. . . .
Those lacking the use of reason can have devotion towards the sacrament: actual devotion in some cases, and past in others (III,80,9).
We might argue that Communion should not be given to anyone who is not able to exercise a conscious act of faith, since the Eucharist is not magic, or impersonal, and its effects, though they come ex opere operato from God rather than from the soul of the recipient, are increased or decreased by the degree of faith and devotion of the recipient. But this argument is wrong. There are many kinds and degrees of faith and devotion, and we must err on the side of compassion rather than caution in allowing as many people as possible, and as many kinds of people, access to the greatest privilege on earth, real sacramental union, in body and soul, with Jesus Christ, God incarnate.
What, exactly, do we mean by calling some people “insane”, “mentally retarded”, “mentally defective”, “mentally handicapped”, “feebleminded”, or “lacking the use of reason”? The first honest answer is that we do not know, exactly. The terms are meaningful but vague, as uncertain as we are. There are many true stories of surprisingly rational things said and done by supposedly non-rational persons (using the ancient, broader and deeper concept of “rational” here: not just “clever” but “understanding”).
St. Thomas distinguishes two kinds of lack of reason in human beings, and both kinds may be given Communion. The “feeble-minded”, those who have from birth always had a very low IQ, are quite capable of deep and real and precious devotion, as all caregivers to such persons are profoundly aware. Down syndrome persons are beautiful examples. And those who once had a normal use of reason and are now deprived of it (e.g., those in coma, or with Alzheimer’s) are still the persons they once were, they are not ex-persons; so if they once had faith and devotion to the Eucharist they must be given Communion—not because we fantasize about what they “would have wanted” if they were now in possession of full reason but because they are in fact now the same person they once were when they expressed a faith and desire for Communion. This is so especially (but not only) at the hour of death.
Devotion as such, in the abstract, assumes reason as such, in the abstract. Rocks and birds cannot have it. But devotion in actual practice is often present but hidden, and admits of many degrees, like reason itself. For instance, even an embryo is a “rational” animal, i.e., a human person, even though its brain and nervous system have not yet developed; for that is a human embryo which is growing a human brain which will be the instrument of human consciousness, i.e., “reason”. It is human and therefore “rational” already, actually and not just potentially; that’s why it’s growing a human brain. It’s the human soul that’s doing that. We have one soul, not two. The same human soul that first grows brains, later thinks with them.