The Orthodox sacramental mystery of Holy Unction is intended not simply as a preparation for imminent death, but as an instrument of recovery and life. The relevant New Testament text is as follows,
Is anyone among you sick? Let him call the presbyters of the church and let them pray over him having anointed 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, it will be forgiven him. (James 5:14–15)
The context is clearly ecclesiastical, for it assumes that the sick person is a member of the local church, able to call for the presbyters1 who rule the local church. These clergy will come to the sick man and anoint him with oil in the Name of Jesus and then lay hands on him, praying for life, recovery, health, and salvation, for all these things are all bound up together. When this prayer is offered in faith, the Lord will respond and save the sick, bestowing healing and (if sins have caused the sickness in some way) forgiveness as well. The measure of healing bestowed of course is left in the hands of God, but life and health will be given—whether it be physical healing, spiritual healing, or both.
The rite of Unction is often used in churches on Holy Wednesday, as a kind of substitute for the sacrament of Confession in preparation for Pascha—and indeed the prayers used in that service speak of forgiveness of sins as well as physical healing. Regardless of whether one’s parish serves Holy Unction on Holy Wednesday or not, this sacrament is of spiritual benefit even to those not physically ailing, for we are all ailing spiritually, and in need of God’s mercy and inner healing. Thus, all who come to be anointed in this sacramental mystery must open themselves up to the Lord, allowing and expecting him to touch not only their physical weaknesses but their souls as well. That is, they must come in faith and repentance, turning away from their own sins, and forgiving the sins of any who have sinned against them. Only by so doing can they hope to find healing from the Lord.
The service books make provision for seven priests at the church service or around the bed of the afflicted, but obviously in a contemporary parish setting this is rarely possible, especially if the prayer is offered in a hospital setting. ↩