Be Our Guest / Dr. Hans Geisler

Communion can be given in most cases to ‘NPO’ patients

For extraordinary ministers of holy Communion (EMHC), it is important to know whether and, possibly, how the sacrament of the Eucharist can be administered to a patient under orders not to consume anything by mouth.

Especially in this day when so many patients have their procedures performed on an outpatient basis, it has become routine for an EMHC to encounter a situation where the physician, for one reason or another, has ordered the person, to whom holy Communion is being brought, not to receive anything by mouth. Using medical parlance, the doctor has declared that the patient should be listed as being in an “NPO” status. NPO is an acronym for the Latin phrase “nihil per os” (“nothing by mouth”).

It could be that the patient is going to have surgery or be anesthetized for another cause. Another reason would be that the patient is unable to swallow or that the administration of something orally could result in aspiration of the administered substance into the lungs. Other instances could be related to the fact that a patient is being fed via a tube implanted into the stomach because the patient is comatose or has an illness or disability which necessitates such feeding.

In an article titled “Communion for NPO Patients,” the May 2010 issue of Ethics and Medics, published by the National Catholic Bioethics Center, focuses on this very problem. The authors, Dr. Greg Burke and Dr. Robb McIlvried, cite a study conducted by the Geisinger Health System, a large multi-specialty health care system located in Pennsylvania, on Communion and the NPO status.

Their conclusion is that, in almost every instance, unless the physician in charge is adamant about maintaining an absolute NPO status for a particular patient, holy Communion can be administered. Since even the most minute fragment of the eucharistic host contains the body and blood, soul and divinity of our Lord, if necessary, a tiny, tiny fragment may be given orally without compromising any of the reasons which necessitate the patient not being allowed to consume anything by mouth.

It is our obligation, as commissioned EMHCs, that when we minister to a person who has been placed on an NPO status to communicate to the health care provider in charge the facts concerning the spiritual importance of holy Communion for those who wish to receive our Lord.

We must ensure that no conflict or problem with the physician, nurse or other health care provider will result for those who wish to receive holy Communion. To accomplish this goal, we must carefully and politely clarify our beliefs and reasons to those who may not initially understand that even the tiniest fragment of the host is sufficient for a valid Communion to take place. Those who are “NPO” who receive holy Communion because of our effort will reap untold spiritual benefits if we do.

(Dr. Hans Geisler is a retired gynecologist-oncologist and member of St. Luke the Evangelist Parish in Indianapolis. He is certified in health care ethics by the National Catholic Bioethics Center.) †