The decision by John Paul II to create 31 new cardinals, ahead of schedule, is inevitably being linked to new concerns over his health.
The question being asked is whether this the final attempt by an ailing pope to influence the choice of his successor?
It was expected that the consistory, the ceremony at which new cardinals receive their red hats from the Pope, would be held next February.
Health fears have turned attentions to the future
But the Pope's growing infirmity is making many people wonder if the next papal election may not be far away.
John Paul suffers from Parkinson's disease and severe arthritis.
He now makes all his public appearances on a wheeled throne.
To add to his ailments, it is now reported that he has an intestinal complaint.
In the Catholic hierarchy, cardinals are second in importance only to the pontiff.
Their most important job is to elect the pope, who is almost always drawn from their ranks.
COLLEGE OF CARDINALS (AFTER OCT, 2003)
194 cardinals (not including one whose name is being kept secret)
Oldest: 100 years
Youngest: 51 years
Average age of voters: 70.8 years
Only cardinals under the age of 80 can take part in a papal election, which is called a conclave.
It is a ritual that has hardly changed in centuries.
According to a rule laid down by Pope Paul VI, the number of electors is not supposed to exceed 120.
But in recent years, John Paul has disregarded this limit.
At the last consistory, in 2001, he increased the voters to 135.
Two and a half years later, as a result of cardinals dying or reaching the age of 80, the figure has come down to 109.
So, regardless of the Pope's health, it would have been necessary to create more cardinals in the coming months.
The choice of October can be justified by convenience.
Because of celebrations for the 25th anniversary of the Pope's election, and a ceremony to beatify Mother Teresa, nearly all the leaders of the Church will be in Rome. So why wait until February?
Whenever the Pope names new cardinals, the list is always scrutinised for evidence that John Paul has selected conservative-minded men who he can rely on to elect a pope in his own image - someone who will uphold traditional values.
In that sense, the new batch of cardinals is unlikely to make much difference, as the Pope has already put an indelible stamp on the electoral body.
Of the existing 109 voters, all but five were appointed by John Paul.
In any case, many Vatican experts question the extent to which a pope can influence the choice of his successor.
They point out that conclaves do not look for a carbon copy of the pope who has just died.
They draw up a job description, and look for the person they think has the right qualities.
For the cardinals, a papal election is a moment of real power, when the future of the Church is in their hands.
Locked away in the Sistine Chapel, they cast their ballots in conditions of absolute secrecy, each according to his conscience.
Latin American pope?
So will the new cardinals change the equation?
In terms of the mathematics of the election, the answer is probably not.
The list of new cardinals does not radically alter the make-up of the electoral body.
As usual, the new appointments cover a wide geographical spread, and include a number of archbishops from the developing world.
Some are from areas where the Church has had difficult relations with the state or other faiths.
ELECTORS BY REGION
Italy: 23 (17.0 %)
Rest of Europe: 43 (31.9%)
Latin America: 24 (17.8%)
North America: 14 (10.4%)
Africa: 13 (9.6%)
Asia: 13 (9.6%)
Oceania: 5 (3.7%)
The name of one of the new cardinals is being kept secret to avoid causing him further problems. Even if under 80, he will only be able to vote in conclave if his name is revealed.
As always, attention is focused on the Italians.
Their numbers have been dwindling in recent years, leading to speculation that the next pope could be from Latin America, a region with growing influence.
The October consistory will add six Italians to the College of Cardinals, all under 80 and therefore able to vote.
However, they will be joined by another 20 new electors from other nations.
So the Italian bloc will be only slightly bigger, rising from 15.6% to 17% of the electoral body.
And by early next year, two of the existing Italian cardinals will have reached the age of 80, and lost their votes.
These new cardinals will make the electoral body slightly younger.
The average age of the voters will be just over 70, with the youngest cardinal a mere 51.
More significant is the fact that 19 of the new cardinals are "residential" archbishops from different parts of the world.
Many observers feel that when it comes to choosing a new pope, the cardinals will be looking for a pastor close to the people, not a Vatican-based bureaucrat.
Certainly, many cardinals want the Church to become less centralised, with power being devolved to bishops around the world.
The October consistory is likely to reinforce those feelings.
So while John Paul II may have tried to preserve his legacy, his cardinals have the power to elect a pope who sees things a little differently.