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Revised Edition — Approved by the United States Conference of Catholic Bishops on June 15, 2017.
The
Church continues to affirm the dignity of every human being, and to
grow in knowledge and understanding of the gifts and needs of her
members who live with disabilities. Likewise, the Church recognizes that
every parish community includes members with disabilities, and
earnestly desires their active participation. All members of the Body of
Christ are uniquely called by God by virtue of their Baptism. In light
of this call, the Church seeks to support all in their growth in
holiness, and to encourage all in their vocations. Participating in, and
being nourished by, the grace of the sacraments is essential to this
growth in holiness. Catholic adults and children with disabilities, and
their families, earnestly desire full and meaningful participation in
the sacramental life of the Church.
In this regard, as it issues a revised and expanded Guidelines for the Celebration of the Sacraments with Persons with Disabilities,
the United States Conference of Catholic Bishops wishes to reiterate
what was said in previous pastoral statements on this issue:
It is essential that all forms of the liturgy be completely accessible
to persons with disabilities, since these forms are the essence of the
spiritual tie that binds the Christian community together. To exclude
members of the parish from these celebrations of the life of the Church,
even by passive omission, is to deny the reality of that community.
Accessibility involves far more than physical alterations to parish
buildings. Realistic provision must be made for Catholics with
disabilities to participate fully in the Eucharist and other liturgical
celebrations.1
Preface
Catholics with disabilities, as well as those who minister to or with
them, often point out that pastoral practice with regard to the
celebration of the sacraments varies greatly from diocese to diocese,
even from parish to parish. Inconsistencies arise in such areas as the
provision of sign language interpreters and captioning for persons who
are deaf, in the accessibility of church facilities for persons with
mobility needs, and in the availability of catechetical programs for
persons with intellectual, developmental, and other disabilities.
Pastoral inconsistencies may occur in other areas as well.
The inconsistencies in pastoral practice often arise from distinct yet
overlapping causes. Some result from a misunderstanding about the nature
of disabilities. Others arise from an uncertainty about the appropriate
application of church law toward persons with disabilities. Others are
born out of fear, misunderstanding, or unfamiliarity. Still others seem
to be the result of the real or perceived limitations of a parish’s or
diocese’s available resources.
These guidelines were developed to address many of the concerns raised
by persons with disabilities and their families and advocates, and also
clergy and other pastoral ministers, for greater consistency in pastoral
practice in the celebration of the sacraments throughout the country.
With this objective in view, and with the desire to meet the spiritual,
sacramental, and pastoral needs of persons with disabilities, the
guidelines draw upon the Church’s ritual books, its canonical tradition,
and its experience in ministering to or with persons with disabilities
in order to dispel misunderstandings that may impede sound pastoral
practice in the celebration of the sacraments. It is our hope that the
guidelines will enhance diocesan policies already in existence.
The bishops of the United States offer the Guidelines for the Celebration of the Sacraments with Persons with Disabilities
in order to give a more concrete expression to our longstanding concern
for “realistic provision” for the means of access to full sacramental
participation for Catholic persons with disabilities.2
While they do not address every conceivable situation that may arise in
pastoral practice, the guidelines present a set of general principles to
provide access to the sacraments for persons with disabilities.
Diocesan staff, pastoral leaders, catechists, parishioners, health care
workers, and all those who minister to or with Catholics with
disabilities are invited and encouraged to reflect upon and utilize
these guidelines in their continuing effort to bring Christ’s healing
message and call to justice to the world.
I. GENERAL PRINCIPLES
1. All human beings are equal in dignity in the sight of God. Moreover,
by reason of their Baptism, all Catholics also share the same divine
calling.
2. Catholics with disabilities have a right to participate in the
sacraments as fully as other members of the local ecclesial community.3
“Sacred ministers cannot deny the sacraments to those who seek them at
appropriate times, are properly disposed, and are not prohibited by law
from receiving them.”4
3. Parish sacramental celebrations should be accessible to persons with
disabilities and open to their full, active, and conscious
participation, according to their capacity. Pastoral ministers should
not presume to know the needs of persons with disabilities, but should
rather—before all else—consult with them or their advocates before
making determinations about the accessibility of a parish’s facilities
and the availability of its programs, policies, and ministries. Full
accessibility should be the goal for every parish, and these adaptations
are to be an ordinary part of the liturgical life of the parish.5
4. Since the parish is the center of the Christian experience for most
Catholics, pastors and other parish ministers should make every effort
to provide for all Catholics with disabilities who reside within a
parish’s boundaries. Special effort should be made to reach out to and
welcome all parishioners, including persons with disabilities who live
independently, with their families, in institutions, or in other living
arrangements. Pastoral visitation, the parish census, and the diverse
forms of parish and diocesan social communication are just a few of the
many ways in which the pastoral staff can work toward the inclusion of
all parishioners in the parish’s sacramental life.
5. Pastors are responsible to provide evangelization, catechetical
formation, and sacramental preparation for parishioners with
disabilities,6
and dioceses are encouraged to establish appropriate support services
to assist pastors in this duty. Persons with disabilities, their
advocates and their families, as well as those knowledgeable in serving
those with disabilities can make a most valuable contribution to these
efforts. Parish catechetical and sacramental preparation programs may
need to be adapted for some parishioners with disabilities, though, as
much as possible, persons with disabilities should be integrated into
the ordinary programs. They should not be segregated for specialized
catechesis unless their disabilities make it impossible for them to
participate in the basic catechetical program.7 Even in those cases, participation in parish life is encouraged in all ways possible.
6. Having received the sacraments, which “contribute in the greatest way
to establish, strengthen, and manifest ecclesiastical communion,”8
persons with disabilities, like all other parishioners, should be
encouraged to participate in all levels of pastoral ministry that are
available and for which they are qualified. For example, members of the
laity are often needed to perform various services or functions in
liturgical celebrations, particularly in the celebration of Mass. In
choosing those who will be invited to use their gifts in service to the
parish community, the parish pastoral staff and lay volunteers,
including ushers and liturgical ministers, should be mindful of
extending Christ’s welcoming invitation to qualified parishioners with
disabilities. Like others, Catholics with disabilities are not only
recipients of the Gospel, but are also called to proclaim it and to be
witnesses to its truth.9
7. The creation of a fully accessible parish reaches beyond mere
physical accommodation to encompass the attitudes of all parishioners
toward persons with disabilities. All members of the faith community
have a role to play in the invitation, welcome, and inclusion of people
with disabilities. Pastoral ministers are encouraged to foster attitudes
and a parish culture, and to develop informational materials, aimed at
forming a community of believers known for its joyful inclusion of all
of God’s people around the table of the Lord.
8. Difficult situations may be encountered by those making pastoral
decisions. Dioceses are encouraged to establish appropriate policies for
handling such instances, which respect the rights of all involved, and
which ensure the necessary provision of evaluation and recourse.
II. PARTICULAR SACRAMENTS
Baptism
9. Through the Sacrament of Baptism the faithful are incorporated into
Christ and into his Church. They obtain forgiveness of all their sins
and are formed into God’s people. They become a new creation and are
called, rightly, the children of God.10
10. So that Baptism may be seen as a sacrament of the Church’s faith and
of admittance into the People of God, it should be celebrated
ordinarily in the parish church on a Sunday or, if possible, at the
Easter Vigil.11
The Church, made present in the local community, has an important role
to play in the Baptism of all of its members. Before and after the
celebration of the sacrament, the baptized have the right to the love
and help of the community.12
11. Because it is the sacrament of universal salvation, Baptism is to be
made available to all who freely ask for it, are properly disposed, and
are not prohibited by law from receiving it. In the case of infants and
those who cannot request it for themselves, Baptism may be deferred
only when there is no reason for hoping that the person will be brought
up in the Catholic faith.13
Disability, of itself, is never a reason for deferring Baptism. Persons
who lack the use of reason are to be baptized provided at least one
parent or guardian consents to it.14
Parents who receive a prenatal diagnosis of a life-threatening condition
should receive the support they need to assure that their child will be
baptized “without delay.”15
Indeed, priests, deacons, and other pastoral ministers should provide
spiritual and emotional support to families who have received any
difficult prenatal diagnosis and offer on-going support before and after
the birth of a child, with special concern in the event of the death of
a child.
12. Either personally or through others, the pastor is to see to it that
the parents of an infant with a disability, those who take the place of
the parents, and those who will fulfill the function of godparent are
properly instructed as to the meaning of the Sacrament of Baptism and
the obligations attached to it. If possible, either the pastor or a
member of the parish community should visit with the family, offering
them the strength and support of the community, which rejoices at the
gift of new life, and which promises to nurture the faith of its new
member. It is recommended that preparation programs for Baptism gather
several families together so that they may commonly be formed by
pastoral direction and prayer, and so that they may be strengthened by
mutual support.16
13. “The Initiation of catechumens is a gradual process that takes place within the community of the faithful.”17
Adults and children of catechetical age with disabilities should be
welcomed into all stages and rites of the initiation process. If the
catechumen is of catechetical age, the rites may be adapted according to
need.18 In these cases, catechesis for persons with disabilities must be adapted in content and method to their particular situations.19
Like others, adults and children of catechetical age with disabilities
should normally receive the Sacraments of Baptism, Confirmation, and
Eucharist in a single celebration. 20
14. A sponsor is to be chosen who will assist the catechumen in
preparing for the Sacraments of Initiation and, as such, will have a
special role in fostering the faith life of the catechumen. Likewise,
godparents are to be chosen who will guide the catechumen through the
final preparation for Baptism, and to assist the newly-baptized adult or
child through the rest of their Christian life. The same person may be
both sponsor and godparent. Catholics with disabilities may serve as
sponsors and godparents, and like others who fulfill these roles, they
are to be carefully chosen and formed for these responsibilities.21
Confirmation
15. “Those who have been baptized continue on the path of Christian
Initiation through the Sacrament of Confirmation.” In this way, they
receive the Holy Spirit, conforming them more perfectly to Christ and
strengthening them so that they may “bear witness to Christ for the
building up of his Body in faith and charity.”22
16. Parents, those who care for persons with disabilities, and shepherds
of souls—especially pastors—are to see to it that the faithful who have
been baptized receive the formation needed for the Sacrament of
Confirmation and approach it at the appropriate time.23
“The diocesan bishop is obliged to take care that the Sacrament of
Confirmation is conferred on subjects who properly and reasonably seek
it.”24
17. Confirmation is to be conferred on the faithful between the age of
discretion (which is about the age of seven) and about sixteen years of
age, within the limits determined by the diocesan bishop, or when there
is a danger of death, or in the judgment of the minister a grave cause
urges otherwise.25
18. All baptized Catholics who possess the use of reason may receive the
Sacrament of Confirmation if they are “suitably instructed, properly
disposed and able to renew the baptismal promises.”26
Persons who because of intellectual or developmental disabilities may
never attain the use of reason can receive the Sacrament of Confirmation
and should be encouraged either directly or, if necessary, through
their parents, to receive it. It is important that they receive the
pastoral guidance needed, along with the welcome and embrace of the
whole community of faith. To the degree possible, those with
disabilities should be included along with others during the preparation
and celebration of the sacrament. At times, pastoral need may
necessitate an accommodated setting and a simpler manner.
19. A sponsor for the one to be confirmed should be present. The sponsor
assists the confirmed person on the continuing path of Christian
Initiation.27 For this reason, it is desirable that one of the godparents chosen for Baptism be the sponsor for Confirmation.28
20. When those with disabilities who are already baptized Christians desire to become Catholic, they should participate in the Rite of Reception of Baptized Christians into the Full Communion of the Catholic Church, which normally includes the reception of the Sacraments of Confirmation and Eucharist.29
Eucharist
21. The Eucharist is the most august sacrament, in which Christ the Lord
himself is contained, offered, and received, and by which the Church
constantly lives and grows. It is the summit and the source of all
Christian worship and life, signifying and effecting the unity of the
People of God, providing spiritual nourishment for the recipient, and
achieving the building up of the Body of Christ.30 The celebration of the Eucharist is the center of the entire Christian life.
22. Parents or guardians, together with pastors, are to see to it that
children who have reached the use of reason are correctly prepared and
are nourished by the Eucharist as early as possible. Pastors are to be
vigilant lest any children come to the Holy Banquet who have not reached
the use of reason or whom they judge are not sufficiently disposed.31
It is important to note, however, that the criterion for reception of
Holy Communion is the same for persons with intellectual and
developmental disabilities as for all persons, namely, that the person
be able to “distinguish the body of Christ from ordinary food,” even if
this recognition is evidenced through manner, gesture, or reverential
silence rather than verbally.32
Pastors are encouraged to consult with parents, those who take the
place of parents, diocesan personnel involved with disability issues,
psychologists, religious educators, and other experts in making their
judgment. If it is determined that a parishioner who is disabled is not
ready to receive the sacrament, great care is to be taken in explaining
the reasons for this decision. Cases of doubt should be resolved in
favor of the right of the Catholic to receive the sacrament. The
existence of a disability is not considered in and of itself as
disqualifying a person from receiving Holy Communion.
23. Given the paramount significance of the Eucharist in the lives of
the faithful, and in light of medical and technological advancements
that affect Catholics with disabilities, new questions have arisen
regarding the reception of Holy Communion, and circumstances that were
once rare have even become relatively common. Clergy and extraordinary
ministers of Holy Communion are encouraged to become familiar with the
needs of their parishioners. In many instances, simple accommodations
can be very helpful, and should be embraced by all at the parish level.
24. Catholics who require nourishment through feeding tubes are
encouraged to receive Holy Communion, as are all the Catholic faithful.
Christ is sacramentally present under each of the species, and Holy
Communion can be received under the species of bread or wine alone.33
Since the full presence of Christ and his sanctifying grace are found
in even the smallest piece of the consecrated host or in a mere drop of
the consecrated wine, the norm of receiving through the mouth remains
the same for those who otherwise use a feeding tube for sustenance, and
Holy Communion is not to be administered through a feeding tube. For
these communicants it will commonly be possible to place one or a few
drops of the Precious Blood on the tongue. Clergy and pastoral ministers
are encouraged to use these guidelines and consult with physicians,
family members, and other experts on a case-by-case basis, to determine
how those who use feeding tubes may avail themselves of the abundant
fruits of Holy Communion. Specialized instruction for extraordinary
ministers of Holy Communion is to be provided as required.
25. Catholics with Celiac Sprue Disease or other conditions that make
them gluten intolerant should be given the opportunity to receive a
small fragment of a regular host, and made aware of the options to
receive a low-gluten host or to receive under the form of wine alone. In
the event of intolerance to gluten and wine, mustum may also be an
option, with the approval of the local ordinary.34
Clergy and extraordinary ministers of Holy Communion need to be aware
of the possibility of cross-contamination and related issues in order to
plan for the safe administration of the sacred species to Catholics
with gluten intolerance. For example, the chalice given to a person with
gluten intolerance should not contain a particle of the host, and
low-gluten altar breads should never be intermingled with regular altar
breads. As people may feel self-conscious at the prospect of needing
special arrangements for the reception of Holy Communion, pastoral
sensitivity in this area is particularly important.
26. When baptized Catholics who have been regular communicants develop
advanced Alzheimer’s or other age-related dementias, there is to be a
presumption in favor of the individual’s ability to distinguish between
Holy Communion and regular food. Holy Communion should continue to be
offered as long as possible, and ministers are called to carry out their
ministry with a special patience. If swallowing becomes particularly
difficult, decisions regarding the continued reception of Holy Communion
may have to be faced. This pastoral decision is to be made on a
case-by-case basis, in consultation with the individual, those closest
to him or her, physicians, and the pastor.
Reconciliation
27. In the Sacrament of Penance, the Catholic faithful obtain from the
mercy of God pardon for their sins. At the same time, they are
reconciled with the Church, which they have wounded by their sins and
which works for their conversion by charity, example, and prayer.35
28. Only those who have the use of reason are capable of committing
mortal sin. Nevertheless, even young children and persons with
intellectual disabilities often are conscious of committing acts that
are sinful to some degree and may experience a sense of guilt and
sorrow. As long as the individual is capable of having a sense of
contrition for having committed sin, even if he or she cannot describe
the sin precisely in words, the person may receive sacramental
absolution. Those with profound intellectual disabilities, who cannot
experience even minimal contrition, may be invited to participate in
penitential services with the rest of the community to the extent of
their ability.
29. In the case of individuals who are nonverbal or have minimal verbal
communication ability, sorrow for sin is to be accepted even if this
repentance is expressed through some gesture rather than verbally. Many
Catholics experience significant communication difficulties related to
autism spectrum disorder, traumatic brain injury, post-stroke
complications, and other conditions. Catholics with significant
communication disorders may be permitted to make their confessions using
the communication system with which they are most fluent. Individuals
preparing for the sacrament are to be taught to be as independent as
possible in the use of their communication system to allow for the norm
of private reception of the sacrament.
Confessors are encouraged to work with families and individuals to
familiarize themselves with various alternative communication options to
ensure that all who desire to celebrate this sacrament may do so,
provided that the seal of confession is properly safeguarded. In posing
questions and in the assignment of penances the confessor is to proceed
with prudence and discretion, mindful that he is at once judge and
healer, minister of divine justice within the context of divine mercy.36
30. Catholics who are deaf should have the opportunity to confess to a
priest able to communicate with them in sign language, if sign language
is their primary means of communication. They may also confess through
an approved sign language interpreter of their choice.37 The interpreter has the obligation to observe secrecy.38
When neither a priest with signing skills nor a sign language
interpreter is available, Catholics who are deaf should be permitted to
make their confession in writing or through the use of an appropriate
portable electronic communication device that can be passed back and
forth between the penitent and confessor. The written or digital
materials are to be returned to the penitent and properly destroyed or
deleted.
31. Pastoral consideration needs to be given to those for whom reception
of the sacrament within the confines of the confessional may be
problematic. While this would certainly constitute a just cause for
Reconciliation outside of a confessional, every effort should be made to
ensure that penitents who are wheelchair users have access to both
face-to-face and private confessionals, with due regard for the right of
the priest to insist on confession behind a fixed screen.39
Anointing of the Sick
32. Through the Anointing of the Sick, the Church commends to the
suffering and glorified Lord the faithful who are seriously ill, so that
they may be relieved of their suffering and be saved.40
33. Those who have the care of souls and those who are close to the sick
are to see to it that the faithful who are in danger due to sickness or
old age are supported by the Sacrament of the Anointing of the Sick at
the appropriate time.41
34. Since disability does not necessarily indicate an illness, Catholics
with disabilities should receive the Anointing of the Sick on the same
basis and under the same circumstances as any other member of the
Christian faithful.42
35. The Anointing of the Sick may be conferred if the recipient has
sufficient use of reason to be strengthened by the sacrament, or if the
sick person has lost the use of reason and would have asked for the
sacrament while in control of his or her faculties.43 If there is doubt as to whether the sick person has attained the use of reason, the sacrament is to be conferred.44 Persons with disabilities may at times be served best through inclusion in communal celebrations of the Anointing of the Sick.45
Holy Orders
36. By divine institution, some among the Christian faithful are
constituted sacred ministers through the Sacrament of Orders. They are
consecrated and deputed to shepherd the People of God, each in accord
with his own grade of orders.46
37. The existence of a physical disability is not considered in and of
itself as disqualifying a person from Holy Orders. However, candidates
for ordination must possess the necessary spiritual, physical, human,
moral, intellectual, emotional, and psychological qualities and
abilities to fulfill the ministerial functions of the order they
receive.47
The proper bishop or competent major superior makes the judgment that
candidates are suited for ordained ministry in the Church.48
Cases are to be decided on an individual basis and in light of pastoral
judgment and the opinions of diocesan personnel and other experts
involved with disability issues.
38. Diocesan vocations offices and offices for ministry with persons
with disabilities should provide counseling, informational resources,
and reasonable accommodations for men with disabilities who are
discerning a vocation to serve the Church through one of the ordained
ministries.
39. In preparation for responsible leadership in ordained ministry, the
diocesan bishop or major superior is to see to it that the formation of
all students in the seminary includes awareness of and experience with
persons with disabilities. Formation personnel should consult with
persons with disabilities, parents, psychologists, religious educators,
and other experts in the adaptation of programs for ministerial
formation related to disabilities. Indeed, these Guidelines might even be part of the course of studies in seminaries and in ongoing formation of the clergy.
40. Some men with disabilities already serve the Church as bishops,
priests, or deacons. Clergy who have or acquire a disability are to have
access to resources and accommodations that will aid them in continuing
in their ministry.
Marriage
41. In the Sacrament of Matrimony, Christians signify and participate in
the mystery of the unity and fruitful love which exists between Christ
and his Church. They help each other to attain holiness in their married
life and in the rearing and education of their children.49
42. “All persons who are not prohibited by law can contract marriage.”50
43. Pastors of souls should make the necessary provisions to ensure the
inclusion of persons with disabilities in marriage preparation programs.
Through this preparation all couples may become predisposed toward
holiness and to the duties of their new state. In developing diocesan
policies, the local ordinary should consult with men and women of proven
experience and skill in understanding the emotional, physical,
spiritual, and psychological needs of persons with intellectual
disabilities.51
Including persons with disabilities in sponsor couple programs is an
especially effective way of supporting both the needs and the gifts of
couples preparing for marriage.
44. Couples with intellectual or developmental disabilities who believe
they are called to the vocation of married life are encouraged to seek
counsel by discussing the Sacrament of Matrimony with their families and
pastors. For matrimonial consent to be valid, it is necessary that the
contracting parties possess a sufficient use of reason; that they be
free of any grave lack of discretion affecting their judgment about the
rights and duties to which they are committing themselves; and that they
have the mental capacity to assume the essential obligations of the
married state.52
It is also necessary that the parties understand that marriage is a
permanent union and is ordered to the good of the spouses and the
procreation and education of children.53
Pastors and other clergy are to decide cases on an individual basis and
in light of pastoral judgment based upon consultation with diocesan
personnel involved with disability issues, and canonical, medical, and
other experts.
A physical disability, in and of itself, does not necessarily constitute
an impediment to marriage. Medical and canonical opinions should be
sought in determining the presence of any impediments to marriage. It
should be noted, moreover, that paraplegia does not always imply
impotence, nor the permanence of such a condition, and it is not in
itself an impediment. In case of doubt with regard to impotence,
marriage may not be impeded.54
45. Catholics who are deaf are to be offered the opportunity to express
their matrimonial consent in sign language, if sign language is their
primary means of communication.55
Marriage may also be contracted with the assistance of a sign language
interpreter whose trustworthiness has been certified by the pastor.56
Likewise, those who are nonverbal or have minimal verbal communication
ability should be offered the opportunity to express their matrimonial
consent using the communication system with which they are most fluent.
46. Pastoral care for married persons extends throughout their lives. By
their care and example, the entire ecclesial community bears witness to
the fact that the matrimonial state may be maintained in a Christian
spirit and make progress toward perfection. Special care is to be taken
to include parishioners with disabilities in parish programs aimed at
assisting and nourishing married couples in leading holier and fuller
lives within their families.57
As people live longer, more will experience loss of mental and physical
capabilities, including Alzheimer’s and other age-related dementias. The
faith community must minister both to the spouse whose body or mind
begins to fail and also to the spouse who becomes the caregiver. The
witness to their matrimonial commitment “in good times and in bad, in
sickness and in health”58
should be recognized and honored by the whole faith community. Adult
children who care for their parents also deserve the community’s support
and encouragement.
Conclusion
These guidelines are presented to all who are involved in liturgical,
pastoral, and catechetical ministry. All persons with disabilities have
gifts to contribute to the whole Church. When persons with disabilities
are embraced and welcomed, and invited to participate fully in all
aspects of parish community life, the Body of Christ is more complete.
“The Church owes persons with disabilities her best efforts in order to
ensure that they are able to hear the Gospel of Christ, receive the
sacraments, and grow in their faith in the fullest and richest manner
possible.”59
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