When "these precautionary measures have not had their effect or in which they were not possible," and the person in question, with obstinate persistence, still presents himself to receive the Holy Eucharist, "the minister of Holy Communion must refuse to distribute it"
I am fairly new to Catholicism but in the 200+ masses I have attended I have never seen anyone refused communion. It would be quite a spectacle. I did see a Priest chase down someone who just took the Host in hand and walked away.
Cardinal Ratzinger gave this document to Cardinal McCarrick, who immediately went back to the bishops’ meeting in the U.S. and lied about it. He concealed the document’s existence, and LIED in front of all the bishops about Ratzinger’s position. They adopted a wishy-washy “policy” on Communion that year—2004. McCarrick got what he wanted—It took heat off Kerry.