Go inside the Covid-wards of 2020 – the personal stories of real patients denied end-of-life sacraments and the Catholic priests who put their lives on the line to bring absolution to the dying. Their testimony is part of a much bigger story of how hospitals and nursing homes withheld the sacraments from Covid’s most vulnerable victims.
Part 1 will be available as a podcast on October 25, 2023. Be sure to subscribe to CatholicVote’s the LOOP for future installations of this six-part series.
Dangerous or deadly situations are those in which the sacraments of the Church are most needed, as the divinely-instituted ordinary means of grace and salvation. Many priests rose heroically to the challenge of the Covid pandemic, embracing their calling as “physicians of souls” and offering the sacraments in these critical circumstances.
Unfortunately, sacramental access was sometimes blocked by the actions of both government officials and hospital administrators. As one would hope, the nation’s Catholic hospitals generally did a much better job providing access to clergy and the sacraments, despite some lapses that show a need to solidify their religious identity.
During the early period of the pandemic, one Catholic bioethicist had a hospital experience that summed up both of these common tendencies – that is, the Church’s general eagerness to provide sacramental care, and the non-Catholic world’s inability (or unwillingness) to take this spiritual need seriously.
In May 2020, the president of the National Catholic Bioethics Center (NCBC) was hospitalized after unexpectedly losing consciousness and going into cardiac arrest from an undiscovered genetic condition. It was a grim surprise for Dr. Joseph Meaney to discover he had Brugada Syndrome, which affects the electrical activity of the heart.
He was also disturbed to find, in the early months of the pandemic, that he could not access the sacraments while hospitalized for a life-threatening condition.
“I was not able to see a priest during my four-day stay at the hospital, even though I tested negative for COVID-19 and my wife and I asked repeatedly for the sacrament of Anointing of the Sick,” Meaney wrote in a July 2020 commentary for the NCBC’s Ethics & Medics journal.
Meaney had been taken by ambulance to the hospital nearest to his house, which was not a Catholic facility. “When my wife heard I was in critical condition, already in the emergency room, she asked for a priest. They did call a Catholic chaplain who came quickly, but she was a lay person,” he recounted. “This chaplain could not administer the last rites to me.”
The following day, the NCBC president showed improvement and was removed from a ventilator. He was visited by another Catholic chaplain, a layman who “could not confess or anoint me, of course, and he did not have Holy Communion with him.” Meaney “later received a phone call, but not a physical visit, from a priest associated with the hospital,” as well as a final visit from the female chaplain before his discharge.
“Clearly, significant pastoral efforts were made for me,” wrote Meaney, “but hospital pandemic precaution policies made it impossible for me to receive what I needed most, the sacraments.”
Our parish priest was willing to go to the hospital, but he told my wife that he had been refused admittance under their current highly restrictive policy on access to the hospital. My wife was not allowed visiting privileges either, although she was told that if I took a turn for the worse and was dying, she would be allowed in to see me.
I emailed Philadelphia’s Archbishop Emeritus Charles Chaput, and he responded in minutes. He would have come personally if allowed, but he was also blocked from the hospital. Chaput delegated a priest to look into the matter further, but I was discharged from the hospital before a priest’s visit could be arranged for me.
In Meaney’s case, the lack of sacramental access apparently had nothing to do with the policies of his archdiocese, even during the early pandemic period in which bishops were most cautious. “It was quick and simple for me to get the sacraments of Reconciliation and Anointing of the Sick once I was discharged and out of the hospital,” the NCBC president noted.
The problem of sacramental access during the pandemic, especially in critical situations, was widespread. In a November 2020 message from the NCBC, Dr. Meaney further spoke of how “the terribly restrictive visitation and denial of sacramental access policies of many hospitals and other institutions [e.g., nursing homes] during this pandemic have led to tragedies and violations of human rights” – both in regard to religious freedom, as well as simply “the right not to be forced to die alone.”
While this problem was clear to see, it is more difficult to generalize about who was responsible for such restrictive policies. Federal, state, and local officials, as well as hospital administrators, all had a role in creating them.
Generally speaking, hospitals can and do set their own visitation policies – though their choices may be influenced by guidance from the federal Centers for Disease Control (CDC) and Centers for Medicare & Medicaid Services (CMS), as well as state health departments.
In some states, however, governors or government agencies also issued pandemic orders restricting visitation at hospitals and other care facilities. For instance, Michigan’s Governor Gretchen Whitmer used executive orders to bar most visitors from hospitals, and Chicago’s Commissioner of Health issued similar rules.
With these multiple levels of influence and control, it is impossible to make broad statements about exactly who was responsible for Catholic clergy being barred from hospitals and residential care settings. The precise responsibility for such decisions could vary by jurisdiction and change over time. (For instance, in Pennsylvania – where Joseph Meaney’s experience took place – hospitals seem to have set their own visitor policies during the period in question.)
Overall, during 2020, according to one analysis “93% of hospitals had implemented Covid-related visitor policies … Many prohibited all visitors except those coming to see children, patients with disabilities, or patients at the end of life.”
Along with broad restrictions on visitors, the physical nature of the sacraments also caused problems in making them accessible to Catholic patients, despite the Church’s commitment to doing this safely. The unique problem of sacramental access in hospitals – especially for patients facing imminent death – was discussed in a March 2022 report by Professor John F. Morris, Director of Catholic Health Care for the Diocese of Kansas City-St. Joseph.
Morris’ report further illustrates the conflict between the Church’s desire to provide sacraments in critical settings, and non-Catholic institutions’ difficulty in understanding or respecting this desire.
In general, Professor Morris found that “Catholic medical facilities adapted quickly [to Covid-19], following previously established protocols for the provision of end-of-life sacraments under emergency circumstances as during a pandemic.”
For instance, guidelines already existed for priests to safely offer the Anointing of the Sick under such conditions – not surprisingly, given the Church’s centuries of experience offering the sacraments in sometimes dangerous settings.
“But while Catholic hospitals and dioceses quickly implemented such protocols or formed specially trained teams of priest chaplains to meet the needs of patients requesting these sacraments, most non-Catholic hospitals did not,” Morris stated.
Instead, stories began to emerge that clergy were being denied admittance to COVID positive patients, and in some cases even denied access to non-positive patients because they were roomed on floors deemed as ‘COVID units’ during the worst of the outbreak.
As noted by Morris, some of these cases were later resolved as instances of religious discrimination by the Health and Human Services Department’s Office for Civil Rights. That office was led by a committed Catholic and religious freedom advocate, Roger Severino, during the Trump presidency. In contrast, the Biden administration seemed to drop the issue, taking no public action on it.
Legal violations aside, Morris reflected, “the more important issue was that many members of the faithful were not able to receive end-of-life sacraments at the time of their death.”
In his own work as a diocesan director of health care during Covid, Prof. Morris found that “most non-Catholic chaplains and medical professionals did not fully understand the Catholic view of sacraments, nor appreciate the specifics of how these rites must be conducted for them to be considered valid.”
“For example, people I spoke with did not understand that the end-of-life sacraments can only be performed by a priest who must be physically present with the patient.” Likewise, “the concrete, visible signs of the sacrament were not understood, such as the oil that is used for the anointing.”
Instead, he recounted, non-Catholics often saw the sacraments as no different from the prayers offered in many other religions, which require no physical proximity or material elements. This was a major problem of understanding and communication between the Church and non-Catholics as the pandemic took hold.
More disturbingly, similar misunderstandings led to a lack of sacramental access even in some Catholic hospitals – which sometimes employ non-Catholic staff, without ensuring they adequately understand Church teachings that pertain to a medical setting.
Morris and his colleagues discovered – “much to our surprise,” in his words – that some patients in Catholic hospitals “were not allowed to receive these sacraments when the priest chaplains were unavailable, and parish priests were being denied pastoral visits, because many of our non-Catholic staff had similar views to those noted above and concluded these sacraments simply could not be provided by outside clergy due to the risks posed by COVID-19.”
In response, Morris worked to clarify “the importance of these sacraments, and the need to make every accommodation possible for their provision when requested.”
Separate from Morris’ own important observations, some further comments on this issue are in order from the standpoint of the Catholic Accountability Project.
It is understandable, if not ideal, for the Church to employ non-members within Catholic hospitals in major decision-making capacities. But it is disturbing to find these staff ignorant of Catholic beliefs that directly relate to the medical field.
It is likewise troubling that Prof. Morris was, by his own admission, surprised to discover this ignorance of relevant Church teaching among the non-Catholic employees at Catholic hospitals. If even a diocesan Director of Catholic Health Care is caught off guard by this discovery, it is reasonable to wonder whether anyone was previously aware or attending to the problem.
All of this may be no one’s deliberate fault. Even so, it indicates a lack of reliable Catholic identity within Church hospitals, or proactive oversight towards them, even in a diocese that seems to have good leadership. That state of affairs, in turn, raises broader and more unsettling questions about the fidelity of America’s Catholic hospitals in this regard. (Quite apart from Covid-19, there is a longstanding and ongoing problem with the fidelity of some healthcare institutions that profess to be Catholic.)
Regarding the issues specifically raised by Covid, this much is clear: anyone working at a Catholic hospital should be required to understand and apply the Church’s teaching on the sacraments and their importance. This should be considered a bare minimum standard, if hospitals are to be authentically Catholic.
It should not have taken a deadly pandemic to reveal hospital employees’ ignorance of Church teaching on the sacraments – but now that this has happened, Prof. Morris’ experience of discovering that fact should serve as a wake-up call to all Catholic medical institutions that employ non-Catholic staff (as well as the many poorly-catechized Catholics likely also working in healthcare ministries, who may have a similar ignorance of Church teaching).
Morris notes correctly that “ongoing education remains a priority” in these circumstances.
While there are discouraging stories of Catholics unable to access the sacraments in critical situations during the pandemic, there are also many inspiring accounts of priests who stepped up to provide these channels of grace when they were most important.
As it became clear that Covid-19 posed different risks for individuals based on their age and prior health, many dioceses formed teams of younger and less-vulnerable priests who could more safely offer the sacraments in potentially infectious environments. This practice began quickly after Covid-19 was first declared to be a global pandemic on March 11, 2020. By April, the phenomenon was widely reported in places like Chicago, Worcester, Minneapolis-St. Paul, Boston, and Kansas City.
In May 2020, an anonymous priest of the Green Bay, Wisconsin diocese published a remarkable account of offering the Last Rites early in the pandemic. It is worth reading in full, and quoting at length:
The first call came early on in the crisis, when even less was known about this mysterious virus … This virus is known to be a killer. Questions flooded my mind. I could hear the voices of well-meaning cradle Catholics asking, “Do you really believe that God would let someone go to hell for dying without the sacrament?”
A series of lies were presented to my mind at that moment. “Everyone would understand if you just stayed home. It’s not worth the risk. You can just say a prayer for the person right here.” Shaking off the barrage of confusing thoughts, I prayed the rosary on the way to the hospital and uttered some sort of, “Here I am Lord, I come to do your will.”
I had to admit, as I was driving to the hospital, that this sacrament is either about Jesus saving someone from sin, death and the devil, or I might as well just stay home.
I arrived at the hospital. A doctor met me at the door. He snuck me an N95 mask and told me not to say a word about it. They took my temperature and questioned me. I was told, ‘No one is allowed to go to that floor.’ … The doctor cleared matters up and started walking me to the wing.
I was called in because the patient checked the Catholic box on the intake form and because the doctor felt passionate about the sacrament … The doctor said aloud a few times, “I think you will be safe. Keep it to 30 seconds in the room.”
I entered the room. The patient was writhing in pain. There were two tubes going down the patient’s throat. The patient seemed in a state of delirium. The patient was on heavy oxygen because the lungs stopped absorbing it due to the virus. I said to myself, “This is not the flu, this is really messed up.”
I began the rite, and there is nothing romantic about saying these prayers in such a hurry. As a priest, you feel nothing other than compassion. There is no pulse of energy running through your body and there are no choirs of angels singing over your head.
I pray that there will be a priest, any priest, available when I am dying. I lose more sleep at night over that prayer request, that the last rites will find their way to me in my final hour, than worrying about getting a virus that can kill the body, but not kill the soul.
None of this, of course, is meant to promote an irrational fear or despair over those who died without access to the sacraments. The Church understands that God is free to convey his grace in other ways, especially if someone desires to receive the sacraments but is unable. The point, rather, is that those in positions of authority have a duty to make the sacraments as accessible as the moral demands of a pandemic will allow.
Sadly, there was a subset of facilities that locked down even harder than hospitals did, making it even more difficult for residents to receive in-person pastoral care and the sacraments. Assisted living facilities for the elderly and disabled imposed even more restrictive and isolating policies than hospitals.
This grave problem was documented in a report by Catholic University of America professor Lucia A. Silecchia, “COVID-19, Visitation and Spiritual Care: Responding to the Silent Suffering of the Isolated in Times of Crisis.”
Silecchia recounted in detail how “those living in nursing homes, assisted living communities, and other congregate settings were deprived of visitation, companionship, and spiritual support for months,” sometimes even to the point of being sequestered in their own rooms in a kind of solitary confinement for long periods. This had many devastating effects, including on the spiritual life and religious practice of vulnerable and suffering people.
Similar to hospital lockdowns, this happened because “the Center for Medicare and Medicaid Services, Centers for Disease Control, state and local governments, and individual institutions determined that an efficient, effective way to reduce COVID-19 transmission was, essentially, to lock down and allow visitors only in strictly limited situations.”
Professor Silecchia wrote that the deprivation of pastoral and sacramental care in nursing homes and other assisted living facilities was “particularly ironic since many congregate residential settings were founded by religious communities who understood the importance of spiritual care for those most vulnerable.”
In a further irony, restrictions on religious practice in these facilities received relatively little attention, even while similar rules in other settings gave rise to high-profile disputes.
“Restrictions limited residents’ access to clergy, sacraments, worship services, and other spiritual care during the Covid-19 era. This has not received much attention – although paradoxically, in the litigation over Covid-19 restrictions in the ‘outside’ world, the impact of such restrictions in the context of religious free exercise was the subject of significant attention and litigation.”
At a minimum, such treatment of the elderly and disabled should never be repeated. But perhaps it is also not too late to hold these facilities specifically accountable for their recent actions. Although the issue of long-term care lockdowns never achieved prominence, the Trump administration was reportedly responsive to disability groups’ concerns. A future administration might be open to revisiting the issue and ensuring residents’ rights.
Likewise, religious freedom advocates may want to focus more attention in the future on these long-term care settings – whose residents can indeed fall between the cracks of a “throwaway culture,” even to the point of being denied pastoral care.
About the Author: Benjamin Mann is a Byzantine Catholic and has written for several publications including Catholic News Agency, Catholic Exchange, and Real Clear Religion.
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