BURLINGTON, Vermont — As hospitals adjust their procedures due to the COVID-19 coronavirus, some Catholic priests are departing from prescribed liturgical practices to administer the anointing of the sick, earning opposition from Church leaders who say the adaptations could invalidate the sacrament.

The dispute concerns the performance of the rite “by proxy.” This modification — which is not endorsed by canon law —  enlists a nurse or family member to anoint the patient while the priest prays over them.

Proponents of the practice say it can bring comfort to patients at an extraordinary time when the typical administration of the sacraments is not possible, and preserve personal protective equipment as hospitals continue to battle the highly infectious coronavirus. 

Anointing by proxy made headlines last month when the Diocese of Springfield in Massachusetts authorized priests to provide the sacrament from a distance or over the phone while a nurse anointed the patient, provided the patient was “alert.” The diocese later rescinded the authorization. 

Jesuit Father Jim Shaughnessy, a chaplain at Tufts Medical Center in Boston, anointed by proxy last month when he allowed a son to administer the sacramental oil to his ill mother.

“It was the best way I came up with at that moment,” Shaughnessy told Crux, noting that he wanted to conserve protective equipment and reunite the mother with her son for her last moments. 

“I wasn’t sure whether or not it was valid or licit, but I was quite sure that the son was able to convey comfort,” Shaughnessy said, “not only on his own part, but also the prayers of the Church, with me standing literally over his shoulder behind glass.”

Shaughnessy — who has since stopped working onsite at Tufts to protect the religious he lives with — recognized that his methods may have been unconventional.

“I don’t think the way I look at this is the way everybody else should look at it,” he said. “These are special circumstances that we’re facing now. Each person’s got to do the best they can.”

“I’m usually confronted with real people, with real faces, and with real situations that we need to pastorally accommodate ourselves to as best we can,” he added.

Bishop Christopher Coyne, a member of the U.S. Bishops Conference Committee on Divine Worship, called efforts like Shaughnessy’s “well-intentioned,” but said they do not illustrate “what the sacrament is.”

Monsignor Fred Easton, the former judicial vicar for the Archdiocese of Indianapolis, agreed that anointing by proxy does not meet the matter for the sacrament as prescribed by the Church.

“The problem is the breaking up of the action of the prayers and the sacramental action of the anointing,” Easton told Crux.

All sacraments have a certain “oneness” about them, a unity of the physical and the spiritual, Easton said. By breaking up the two, one denatures the sacrament.

Under grave circumstances, priests are allowed to use an “instrument” to anoint the person, such as a cotton ball or a surgical glove, but that instrument cannot be another human being, Easton said.

“There’s a certain point at which the priest really has to be present,” Coyne said, noting that few Catholics would condone practicing the sacrament of reconciliation by proxy- in other words, having another person tell the priest their sins. 

Coyne, who leads the Diocese of Burlington in Vermont, said the anointing of the sick is not mandatory for dying Catholics.

“We have to do everything that we can to avoid the sense that it’s magic,” he said. “While it’s an important part of the life of a Christian, and everybody should have every access to the sacraments, the reality is that, when someone’s dying in the hospital, they don’t have to be anointed.”

Instead, Coyne and Easton both pointed to the plenary indulgence available for victims of the coronavirus, announced by Pope Francis on March 20. The indulgence forgives sins through the merits of the communion of saints, and is available if the person “habitually recited prayers during their lifetime.”

RELATED: Vatican says general absolution may be permissible during pandemic 

The National Association of Catholic Chaplains encouraged priests to inform patients about the indulgence in two documents released last month.

The reminders explicitly denounced anointing by proxy, and — when anointing is not possible — instructed chaplains to “provide the patient the prayer of the Church, prayers for a dying person, the prayer of Apostolic Pardon, and the assurance of the Plenary Indulgence granted the person with COVID-19.”

As for how priests approach pastoral conversations when patients cannot be anointed, Coyne said chaplains should remain positive with patients and their loved ones.

“It’s very hard to do catechesis at that point,” he said. “Rather than talk about what I can’t do, I say, ‘It’s great that we’re here. We can pray for your father who’s dying. Why don’t I give you a sheet with prayers on it, and you can go in with your family and you can be with him.’”

If patients or loved ones ask about an anointing, “you say, ‘Well, what’s more important than the anointing is our praying together,’” Coyne said, “‘and recognizing that God’s mercy is always open to [one whose] heart is sincere and is seeking to grow in God’s love.’”

To avoid the necessity for such conversations, though, some dioceses including Coyne’s are collaborating with hospital officials to make sacramental anointing available for Catholic patients.

The Archdiocese of Chicago established a team of 24 priests outfitted and trained to anoint victims of COVID-19 on the verge of death, according to the Chicago Tribune. The priests were selected last month from a pool of volunteers under the age of 60 with no chronic illnesses. 

David Lichter, the executive director for the National Association of Catholic Chaplains, told Crux that health systems have been very generous in giving protective equipment to chaplains.

Even in late March, when it was more uncertain how much PPE would be needed to weather the crisis, many hospitals considered chaplains a “vital” service.

“While they did not view chaplaincy as an ‘essential’ service — so that there would be priority for PPE — it was considered ‘vital’ service,” Lichter said. “They wanted to make sure, when there’s so great a need, that the service of chaplains could be accessed.”

Still, with the U.S. Food and Drug Administration advising health workers to conserve PPE as much as possible, some hospitals have told chaplains not to gown up at all, and to pray with patients or loved ones over the phone.

Even though it’s not the same as being in the same room, “that’s a very powerful way to provide care,” Lichter said.

In such situations where priests cannot anoint the faithful, some argue that lay people — such as nurses who are already outfitted with PPE — should be able to administer the sacrament on their own.

Father Michael Driscoll, a retired professor of liturgical theology at the University of Notre Dame, said the coronavirus outbreak could foster a broader interpretation of anointing of the sick, like the ones seen in Eastern rites of the Catholic Church.

“The Oriental Rite, they have all kinds of anointings,” Driscoll said. “It’s not like there’s this one kind of anointing only priests can do.”

“I think that a larger sense of anointing is helpful for them, because in situations like this, a person’s not denied anointing because a priest can’t be there,” he added.

While the Council of Trent determined that sacramental anointings by lay people are illicit, Easton said, that decision could be reversed by papal authority.

Nevertheless, just because Pope Francis can change liturgical practice in response to COVID-19 does mean he’s likely to, Coyne said

“Pope Francis is somebody who is always trying to do everything he can to allow people to have access to the Church’s sacraments and the Church’s works of mercy, so he could, down the road, if this continues to become a worse situation,” Coyne said. “But he’s also someone who says, ‘Look, let’s just use the regular means in which these things are done without having to necessarily make significant changes.’”

For the anointing of the sick, those “regular means” go beyond a physical anointing and include an entirely spiritual means of receiving grace, Easton said.

“God works outside of the sacrament,” he said. “People can pray; if they have that desire to receive the sacrament of the anointing of the sick… it opens their hearts to receive the grace that would normally have been coming by way of the sacraments.”