Pope health poses Vatican dilemma

By Peter Gould Religious affairs analyst, BBC News

The latest health scare for John Paul II may be a sign that his illness has entered a new phase.

The Pope's illness poses a real challenge to ancient Vatican law

The present crisis was triggered by flu, with Vatican aides becoming alarmed when the Pope began to have difficulty breathing.

But the underlying problem is the progressive debility brought on by Parkinson's disease, an illness he has endured for more than 10 years.

The 84-year-old pontiff is now so frail that even a common ailment like flu carries a serious risk of complications.

The Pope is now largely confined to a wheelchair.

He tires quickly and frequently has difficulty speaking.

Sometimes he has to write notes to make his wishes clear.

'Lucid moments'

John Allen, the Vatican correspondent of the National Catholic Reporter, says the Pope has good days and bad days.

"There are moments when he is lucid, quite alert, processing information, responding intelligently," he says.

The Catholic faithful were not ready to accept the contemporary presence of two popes - one retired pope, and one acting pope Marco Politi, Vatican expert Life goes on at the Vatican

"There are other moments when - to use American slang - he does seem to be a little bit out of it.

"I think the ratio of good moments to bad moments is increasingly going to skew in the favour of the bad."

And around the Vatican, there is a sense that this latest episode marks a new stage in the physical decline of the man elected Pope in 1978.

In past centuries, a sick pope either got better or died fairly quickly.

Father Thomas Reese, author of the book Inside the Vatican, believes that in the modern world, with all the advances of medical science, the Church is facing a dilemma.

"Suppose the Pope goes into a coma, or suppose a Pope becomes mentally unbalanced," he says.

"If it gets to that kind of a situation where the Pope is very sick and can't function, but he's not even well enough to resign, then we don't know what to do.

JOHN PAUL II 1920: Born Karol Wojtyla near Krakow, Poland 1946: Ordained a priest 1964: Appointed Archbishop of Krakow 1978: Elected Pope and takes name of John Paul II Profile: Pope John Paul II The Pope's hospital

"In the Catholic Church there is no procedure for dealing with a pope who becomes incapacitated.

"This could cause a major constitutional crisis in the Church, because medical technology today can keep someone alive way beyond the point where they are capable of functioning."

Over the centuries, the tradition has been for popes to die in office, rather than retire.

Marco Politi, one of Italy's leading commentators on the papacy, says the Vatican considered the issue of resignation a few years ago.

"The Pope submitted the question to a secret group of advisers," he says.

"They said the Catholic faithful were not ready to accept the contemporary presence of two Popes - one retired Pope, and one acting Pope."

Election?

Under Church law, a papal resignation can only be only valid if it is voluntary. The problem is what happens if the pontiff is unable to clearly state his wishes.

It is rumoured that the Pope has written a letter, telling the Church to hold an election if he becomes mentally incapacitated.

Senior officials are running the Vatican whilst the Pope is ill

However, senior Vatican officials have repeatedly denied knowledge of any such document.

If John Paul II struggles on, his health becoming steadily worse, more of the day-to-day running of the Church will inevitably be left in the hands of Vatican officials.

John Wilkins, former editor of The Tablet, insists the Catholic Church needs the active involvement of its spiritual leader.

"The Pope is essential, we can't get on without a pope," he argues.

"Parkinson's disease could land us with a Pope in a coma, unable to in any way tell us what his wishes are, and in that case there is nothing in the Roman Catholic constitution which can deal with it."

'Beginning of the end'

The Vatican has been at pains to point out that John Paul II has remained conscious throughout his hospital stay.

But everyone now accepts the reality of his frail health.

"Curtailing his schedule and carefully adjusting his medical regime are no longer sufficient to ensure he does not enter a zone of grave risk," says Allen.

"There will be other sleepless nights in Rome, awaiting word about the pope after a potentially serious incident.

"Ultimately, despite the best efforts of all involved, and the prayers of much of the world, one of these nights will be the beginning of the end."

For now, the Catholic Church and its one billion followers can only pray for their ailing spiritual leader.