Pope’s Health Fuels Debate

In plain sight of a global audience, Pope John Paul II has endured an assassin’s bullets, a broken hip, four operations, an arthritic knee, the ravages of old age and the debilitating, immobilizing symptoms of Parkinson’s disease.

Now, as he prepares for a trip this week to the Americas, the most public of pontiffs is beset by an indignity no predecessor has had to face: increasingly open debate in the Vatican and the Roman Catholic Church over whether he should quit because of ill health.

The worry is not so much that he will suddenly die, but rather that he will become senile or be left in a coma, throwing the church into a leadership crisis. Under Catholic canon law, a pope may resign but cannot be retired against his will, even if he is mentally unfit to rule.

Concern has grown in the last 10 months as Parkinson’s, a neurological disorder whose symptoms first appeared in John Paul a decade ago, began to steal the pope’s already quavering voice. John Paul, 82, often looks like a spectator to his own pontificate, sitting passively as aides read homilies that he starts but cannot finish.

No one in the Vatican, a secretive bureaucracy that resembles the court of an absolute monarch, has dared to call publicly for the pope’s abdication.

But German Cardinal Joseph Ratzinger broke a taboo in May, telling reporters that he believed the pope would resign if his condition became so bad that he felt incapable of carrying on in his job. Ratzinger, the Vatican’s top theologian, is one of the pope’s most powerful aides, and his remarks were echoed by a leading Latin American cardinal, Oscar Rodriguez Maradiaga of Honduras.

According to Vittorio Messori, a Catholic writer who co-wrote a book with the pope, several unnamed cardinals have privately urged John Paul to “examine, in the presence of God,” the possibility of quitting, to avoid the scenario of a church paralyzed by his eventual incapacitation. Such appeals, Messori says, come as much from the pope’s allies as from his detractors.

John Paul, who trembles badly despite medication and who can no longer walk unassisted, has replied emphatically that he has no intention of stepping down. No pope has done so willingly since 1294. On Tuesday, he will begin an 11-day journey to Canada, Guatemala and Mexico--his latest display of will to soldier on.

“I feel every day that my ministry is sustained by the incessant prayer of the people of God, of so many people ... who offer their prayers for the pope,” the pontiff told pilgrims in St. Peter’s Square at the end of June. “In moments of great difficulty and suffering, this spiritual strength is an immense help and an intimate consolation.”

Vatican officials said the pope’s remark was meant to silence debate over his health. It has not.

In a nationwide poll in Mexico this month, 58% of Catholics, concerned about his frailty, said they wished John Paul would cancel his scheduled visit. In the survey by the Mexican newspaper Reforma, 52% said popes should retire after a certain age or term of office.

A Latin American cardinal who works at the Vatican said last week that John Paul should stay home. Catholic commentators now question the value of putting the pope’s suffering on display--a condition that adds poignancy to his pilgrimages but dramatizes his limitations as chief executive of a billion-member church.

A further decline of the pope’s health could cripple the Holy See and limit its voice in world affairs. Only the pope may appoint bishops and form dioceses. Vatican departments and diplomats require his approval on a wide range of decisions.

“In a church so exceptionally centralized, where does the balance lie between everyday weakness at the administrative center and the pope’s continuing capacity for occasional--but still sometimes astonishing--displays of charismatic leadership on the world stage?” the Tablet, a London-based Catholic weekly, asked in a recent editorial weighing the pros and cons of resignation. “The danger is that the pope’s frail physical state could be seen as a sign of church sclerosis.”

Vatican spokesman Joaquin Navarro-Valls acknowledges that the pope “is operating under limitations that are visible to all” but insists that John Paul’s memory, sense of humor and ability to plan “are all intact.”

And people who have seen John Paul up close recently say that, on a good day, he seems more lucid than the anguished glimpses of him on television might suggest.

But Parkinson’s in its advanced stages can cause dementia--a loss of memory and other mental functions. As many as 30% of Parkinson’s patients older than 70 develop this condition, scientists report, and some drugs that relieve tremors and other physical symptoms of the disease might actually aggravate dementia.

Experts noted that the pope’s difficulties in talking are a symptom of the disease rather than of mental impairment. And they cautioned that dementia, if it develops, can progress very slowly--beginning with mild symptoms and evolving into full-blown disease over two to three years.

In previous centuries, Catholics could muddle along with senile or sick pontiffs. The pope was less visible, his decisions less urgent, the church less centralized. Today an absent John Paul would be missed immediately.

“It’s more of a problem now that modern medicine can keep a pope alive well beyond his ability to function in the job,” said Father Thomas J. Reese, a Jesuit and author of a study on the workings of the Vatican. “What the church needs is an equivalent of the 25th Amendment to the U.S. Constitution,” which provides for a successor if the president is unable to discharge his duties.

Before his death two years ago, Father James H. Provost, then a professor of canon law at Catholic University in Washington, put forward such a proposal. He called for the adoption of church laws that would specify who would determine whether a pope was incapacitated and how the church would be governed until a new pontiff could be elected. His idea found no support in the Vatican, in part because no one wanted to be seen as trying to oust John Paul.

“John Paul should resign,” said a prominent Catholic theologian, noting that bishops must retire at age 75 and cardinals may not take part in electing a pope at 80.

“It’s absurd,” the theologian added. “If he were a priest, his bishop would make him resign. If he were a bishop, the Vatican would make him resign. The only job he’s qualified for is that of pope. But I can’t say that publicly, because someone would make me resign.”

Some officials and observers here believe that John Paul may have taken the problem in hand by preparing a resignation letter to be made public in the event of his total disability. Part of the debate here over John Paul’s condition centers on whether such a letter exists.

“John Paul II is a man of profound responsibility; it’s inconceivable he hasn’t thought of that scenario,” said George Weigel, an American theologian and author of a biography on the pope. “What measures has he taken to put his decision into effect? I have no idea.”

Italian Cardinal Ersilio Tonini insisted this month that “no such [resignation] letter exists,” although Vatican watchers doubt that he has inside information.

“The pope is not ashamed to show himself weak, tired,” the cardinal told the Roman newspaper La Repubblica. “He feels that it is divine will that leads him, and because of this he will never stop.”

*

Times staff writer Thomas H. Maugh II in Los Angeles contributed to this report.