Eligibility for sacrament of the sick; When to offer both species

Q. I recently received the sacrament of the sick -- prior to a cardioversion, which involves an electric shock to the heart. After the anointing, my wife mentioned to our pastor that we might be asking for the sacrament again, prior to some planned knee surgery.
If we understood correctly, our pastor said that he only administered the sacrament for "serious" medical conditions -- leading us to believe that we should not ask for it for "routine" knee surgery. My wife and I are both in our 70s.
We are aware of the "consent" that must be signed at the hospital prior to surgery, and we believe this document is based on the possible effects of the anesthesia. Considering this, and the fact of our ages, are we wrong to ask to be anointed prior to such knee surgery? Who makes the call on whether we should have the sacrament -- we or our pastor? (Richmond, Virginia)
A. Both the Code of Canon Law and the Catechism of the Catholic Church offer some guidance as to when the sacrament of the sick can be administered. Canon 1004.1 says that it is given "to a member of the faithful who, having reached the use of reason, begins to be in danger due to sickness or old age."
The catechism highlights that this anointing is not meant to be limited to those who are right at the point of death (No. 1514). The pastoral judgement of the priest does determine when a person is eligible, but my experience has been that most priests tend to be permissive, especially when the person has asked for the sacrament.
In your own situation, I find your argument about anesthesia to be persuasive. In looking at parishes' websites with regard to this sacrament I found, for example, that St. Mary's Catholic Church in Sandusky, Ohio, says that "you may ask to receive the sacrament any time that you are to undergo surgery under general anesthetic."
I consider this a reasonable guideline and if your pastor is unwilling, I would encourage you simply to ask a different priest.
Q. In my new diocese, parishes do not seem to offer the precious blood at Communion time. Do certain dioceses restrict that as a "privilege," when in fact it is a command from Jesus? Christ opted to offer the two species to us separately: "Unless you eat the flesh of the Son of Man and drink his blood ..."
I am a religious sister with great devotion to the Eucharist for nearly 60 years, and I am wondering if the faith of Catholics who no longer believe in the real presence might not be strengthened by a catechesis on receiving under both species.
(And to be honest, it just seems like another way to exclude folks from a clerical privilege, as even our lectors are not invited to receive from the cup.) I would appreciate your thoughts. (Trenton, New Jersey)
A. For the first 11 centuries of the church's history, the Eucharist was customarily received by the faithful under the forms of both bread and wine; but then that custom fell out of practice, in part because Catholics began to receive holy Communion less frequently.
In 1963, the bishops of the Second Vatican Council restored the option for the faithful to receive also from the chalice. The "Norms for the Distribution and Reception of Holy Communion under Both Kinds," issued by the U.S. Catholic bishops in 2002, leave to local bishops the determination as to the occasions on which both species are to be made available; and in practice, most bishops have ceded that judgement to local pastors.
However, there is a clear preference expressed -- both in those "norms" and in the General Instruction of the Roman Missal, which is the church's universal "guidebook" on liturgical directives -- for the availability of both species.
The general instruction says: "Holy Communion has a fuller form as a sign when it takes place under both kinds" (No. 281).
(Both the general instruction and the norms do make it clear that distribution under both species is not mandatory and that Christ is fully present when either the consecrated bread or wine is received alone.)
My own experience, in celebrating Mass at many churches throughout the U.S., is that most parishes make both species available at most liturgies.
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Questions may be sent to Father Kenneth Doyle at [email protected] and 30 Columbia Circle Dr., Albany, New York 12203.