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I am a fan of communion rails. But I am wondering how a practical point is managed? Our son is in a wheelchair and cannot kneel at altar rails. When we are at a church that uses them, it is an awkward and perhaps risky (re dropping the Host) lean that the priest needs to do - even if our son is by the “gate” on the main aisle. (We’ve been to more than one church with the altar rail.)

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Hm. I would think that going to a main “gate” or opening every time would be the best choice. You could also ask the priest if they have another suggestion as well

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At my nearest church on weekend Masses the deacon or an EMHC goes out at the start of communion to distribute anyone who should not have to get up and stand in line (an organized body of ushers provides practical support for this I think). So I expect we would still need to have a thoughtful protocol for distribution if we used the altar rail since the people here who currently cannot move from a pew once they are in it will not simply cease to exist.

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This is not a problem. The ushers simply open the gates and the priest/Deacon goes out to those who need that. And people who can approach but can't kneel simply stand at the rail. An ordinary part of distribution with the rail.

The rail is not there to exclude. It's there to encourage a norm of reverential reception and to be a symbol of heaven approaching the earth. Even those who can't kneel will benefit from the norm.

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At my church the people who cannot kneel generally go the gate. We use patens, so the risk of dropping the Host is pretty minimal, and I think the guy with the longer electric chair tends to angle a bit to make it easier.

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I attend a TLM parish, and this past Sunday, an elderly woman came to the rail who could not kneel. The priest simply stepped through the communion rail gate and gave her the Eucharistic standing.

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This is an every day part of distribution with a rail. The ushers just opens the gates for the priest or the priest will open it himself. Not a problem. We have a gentleman in our parish who is wheelchair bound and we're happy to do this.

The rail represents the separation of heaven and earth that exists until the second coming. The gate is the gate to heaven. Our Lord goes out to his flock at the rail or all the way out to the pews. And even outside the church itself

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