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The point of this passage is that the petitioner is asking for Mary, Theotokos, to pray to her Son, Jesus Christ, to assist them at that time, and at their death. It is hoped that her prayer and support will assist with the life of the petitioner, and assist them with grace to meet the Lord with final perseverance and strength.
While the process of death itself can be easy, sometimes what leads up to it can be horrifying, violent, brutal, painful, or otherwise tortuous. It is the hope of believers that at this time of trial, we will not fall away from Our Lord, but remain faithful to him. It is as if we are asking Mary to help us so that if we are faced with trials or pain or even torture, we will not forsake or speak against God.
Even Pope Francis has said something to this effect: "If anything should happen to me, I have told the Lord, I ask you only to give me the grace that it doesn't hurt because I am not courageous when confronted with pain. I'm very timid."
Given the history of Christianity, and when considering the number of individuals who have been persecuted, tortured, and murdered for their faith in Christ, it makes sense that one of our key shared prayers would ask this for ourselves and all our brothers and sisters in Christ through Mary.
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What are the theological implications of “pray for us sinners, now and at the hour of our death”?
The prayer of the Hail Mary (Ave Maria) is a prayer of petition, in which the faithful implore the intercession of the Mother of Jesus for the two most important moments of our lives: now and at the hour of our deaths. It is that simple.
The “Hail Mary” prayer that Christians have been praying for centuries is composed of two main parts. The first part of the prayer is derived from the Annunciation, when the angel Gabriel greeted Mary by saying, “Hail, full of grace, the Lord is with you!” (Luke 1:28) The next part of the prayer is taken from the Visitation, when Elizabeth greeted Mary with the words, “Blessed are you among women, and blessed is the fruit of your womb!” (Luke 1:42)
At first the prayer was known as the “Salutation of the Blessed Virgin,” and only consisted of the two verses joined together. However, during the Black Plague (also known as the “Black Death”) the prayer was further developed and a second part was added to it.
This second part (“Holy Mary, Mother of God, pray for us sinners now, and at the hour of our death”) is believed by many to have been added during the plague to ask for the Blessed Mother’s protection from the fatal disease.
Venerable Fulton J. Sheen explains this origin in his book The World’s First Love.
Since it seizes upon the two decisive moments of life: “now” and “at the hour of our death,” it suggests the spontaneous outcry of people in a great calamity. The Black Death, which ravaged all Europe and wiped out one-third of its population, prompted the faithful to cry out to the Mother of Our Lord to protect them at a time when the present moment and death were almost one.
An expert in Marian devotion, Fr. Donald H. Calloway, confirms this conclusion in his book Champions of the Rosary and explains how, “After the Black Death, the second half of the Hail Mary began to appear in the breviaries of religious communities, especially those of the Mercedarians, Camaldolese, and Franciscans … the people of the 14th century greatly needed the ‘hope-filled’ dimension of the second half of the Hail Mary prayer.”
The prayer took various forms during this bleak period in Europe, but was officially recognized after the publication of the Catechism of the Council of Trent and the full prayer was then included in the Roman Breviary of 1568. How the Black Plague changed the “Hail Mary” prayer
In the end, we are asking Mary help at all times, especially at the moment of our death which is equivalent of asking her maternal care towards final perseverance in the faith.