The Roman Catholic sacrament of anointing of the sick or extreme unction is performed on a seriously ill person for spiritual and physical strength, or when a person is close to death as preparation for heaven. The priest anoints the sick person with oil and prays over him. When combined with confession and the Eucharist, it is called “Last Rites.” At one time it was reserved for those extremely ill and thought close to death. The Roman Catholic Church has been seeking to make it clear that it is not just for those near death. The Roman Catholic Church states that this sacrament can be repeatedly used during the long course of an ongoing illness and that it should be used before serious surgery when a dangerous illness is the reason for the surgery. It can also be requested for those who are unconscious or who have lost the use of reason if they would have asked for it were they in control of their faculties.
The Roman Catholic Church states that the biblical basis for the sacrament is the following passage: "Is anyone among you suffering? Let him pray. Is anyone cheerful? Let him sing psalms. Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord. And the prayer of faith will save the sick, and the Lord will raise him up. And if he has committed sins, he will be forgiven. Confess your trespasses to one another, and pray for one another, that you may be healed. The effective, fervent prayer of a righteous man avails much" (James 5:13-16). The Roman Catholic Church also cites Mark 6:13 ("And they cast out many demons, and anointed with oil many who were sick, and healed them") as the first allusion to the sacrament of the anointing of the sick. And while the Roman Catholic Church sees it as the responsibility of every Christian to care for the sick, it states that Christ charged “His priests to anoint the sick while praying over them in a sacramental gesture that would be more properly a deed of His own personal care” (cf. James 5:14).
The Roman Catholic Church teaches that “sacraments are outward signs of inward grace, instituted by Christ for our sanctification” (taken from the Catholic Encyclopedia). The Roman Catholic Church teaches that, while God gives grace to man without outward symbols (sacraments), He has also chosen to give grace to man through visible symbols and that, because He has, man is foolish to not make use of this God-provided means of gaining sanctification. In order to qualify as a sacrament, the Roman Catholic Church states that an action must meet the following three criteria: "a) the external, that is a sensibly perceptible sign of sanctifying grace; b) the conferring of sanctifying grace; c) the institution by God or, more accurately, by the God-Man Jesus Christ." Thus, sacraments are not merely a symbol but are believed to actually confer sanctifying grace upon the recipient.
But when one examines the biblical passages that the Roman Catholic Church uses to validate their sacraments, one finds that the belief that they convey "sanctifying grace" is not in keeping with the context of the rest of the Bible. The Roman Catholic Church’s foundation for its belief in sacraments is its teaching that its priesthood is capable of exercising the sacraments in order to dispense the sanctifying grace, yet the only priesthood mentioned for New Testament times is the priesthood of all believers (1 Peter 2:9). So, even this core doctrine (of the Roman Catholic Church priesthood), necessary for their sacramental system, is unfounded in Scripture.
Most evangelical churches would see the “anointing with oil” as the “rubbing in” or application of olive oil, used in ancient times as a healing salve. Thus, this passage would encourage the combining of prayer with the current medical treatment appropriate to the illness. Typically, evangelical churches will have their elders (who represent the congregation) come and pray with the ill person while that ill person also seeks the use of modern medicine. And, at times, in answer to prayer, God is gracious and grants a healing. Also, James 5:16 would seem to imply that the illness may sometimes be the result of a chastening sent by God because of sin. As that sin is confessed and forsaken, the need for His chastening is removed and healing is granted. First Corinthians 11:30 is often cited as an example of illness being used as a chastening of God for sin in the life of a Christian.
Salvation is not determined by confessing all sins the moment before death. Salvation is not determined by “extreme unction,” being anointed and prayed over by a priest. Salvation is determined by personal faith in the Lord Jesus Christ (John 3:16). Thankfully, God allows for the decision of faith to be made up to the point of death. However, this must be a personal and genuine receiving of salvation by grace through faith in Jesus Christ alone (Ephesians 2:8-9). Observance of a ritual before death is meaningless in determining salvation and eternal destiny.