Papal Illness and Incapacity: What Happens to Catholic Church Leadership?

VATICAN CITY — The Vatican has clear procedures for papal transitions upon death or resignation, but these do not cover situations of illness or incapacitation. There are no defined rules for how the Catholic Church should be led if the Pope becomes completely unable to function.

Despite Pope Francis’s critical condition in the hospital due to a lung infection, he remains the Pope with full authority. The Vatican reported on Sunday that he was conscious and receiving oxygen. He rested well after a respiratory crisis the previous day that required significant oxygen support.

Francis’s hospitalization is raising questions about the consequences of prolonged unconsciousness and the possibility of him resigning, similar to Pope Benedict XVI, if he becomes unable to lead. His current hospital stay will reach ten days on Monday, matching his 2021 stay for colon surgery.

His age and continuing illness have renewed discussions about papal power, its exercise, transfer, and the conditions under which it changes. Here’s an overview of how it functions:

The role of the pope

According to canon law, the Pope is the successor to the Apostle Peter, the leader of the bishops, the Vicar of Christ, and the shepherd of the global Catholic Church.

Francis’s status, role, and power have remained unchanged since his election as the 266th Pope on March 13, 2013. This stability is intentional from a theological standpoint.

The Vatican Curia

While Francis is in charge, he delegates the daily operations of the Vatican and the Church to a team of officials, regardless of his location or state of consciousness.

The Secretary of State, Cardinal Pietro Parolin, is the most important of these officials. Indicating that Francis’s hospitalization would not disrupt Church governance, Parolin was in Burkina Faso when Francis entered the hospital on February 14 but has since returned to the Vatican.

Other Vatican activities are proceeding as usual, including preparations for the 2025 Holy Year celebrations.

For instance, Archbishop Rino Fisichella celebrated a Jubilee Mass in St. Peter’s Basilica on Sunday, an event Francis was originally scheduled to lead. Fisichella offered a prayer for Francis before delivering the homily prepared by the Pope.

What happens when a pope gets sick?

Canon law includes provisions for when a bishop is ill and cannot manage his diocese, but it lacks similar rules for a Pope. Canon 412 states that a diocese can be declared “impeded” if its bishop is unable to perform his duties due to circumstances like “captivity, banishment, exile, or incapacity.” In such cases, an auxiliary bishop, vicar general, or another official takes over the diocese’s daily management.

Although Francis is the Bishop of Rome, there are no specific provisions for the Pope becoming similarly “impeded.” Canon 335 simply states that when the Holy See is “vacant or entirely impeded,” no changes can be made to the governance of the Church. However, it does not define “entirely impeded” or specify what measures would be implemented in such a situation.

In 2021, a group of canon lawyers aimed to address this gap by proposing new rules for a retired Pope and for situations where a Pope is temporarily or permanently unable to govern.

The proposed rules acknowledge that medical advancements make it likely that a Pope could be alive but unable to govern. They argue that the Church must establish a process for declaring a “totally impeded see” and transferring power to maintain unity.

According to these proposed rules, the College of Cardinals would assume governance of the universal Church. In the case of a temporary impediment, they would appoint a commission to govern, with regular medical evaluations every six months to assess the Pope’s condition.

What about the letters?

Francis confirmed in 2022 that he wrote a letter of resignation shortly after becoming Pope, to be used if he became medically incapacitated. He stated that he gave it to the then-Secretary of State, Cardinal Tarcisio Bertone, and assumed Bertone passed it on to Parolin’s office upon his retirement.

The letter’s contents are not public, and the conditions under which Francis intended it to be used are unknown. The canonical validity of such a letter is also uncertain. Canon law requires a papal resignation to be “freely and properly manifested,” as was the case with Benedict’s resignation in 2013.

In 1965, Pope Paul VI wrote letters to the Dean of the College of Cardinals, suggesting that if he became seriously ill, the Dean and other cardinals should accept his resignation. This letter was never invoked, as Paul lived for another 13 years and remained in office until his death.

What happens when a pope dies or resigns?

Papal power only changes hands upon the death or resignation of a Pope. At that point, a series of rites and rituals govern the “interregnum,” the period between the end of one papacy and the election of a new Pope.

During this period, known as the “sede vacante” or “empty See,” the Camerlengo (Chamberlain) manages the administration and finances of the Holy See. He confirms the Pope’s death, seals the papal apartments, and prepares for the Pope’s burial and the conclave to elect a new Pope. Currently, Cardinal Kevin Farrell, head of the Vatican’s laity office, holds this position.

The Camerlengo has no authority or responsibilities if the Pope is merely ill or incapacitated.

Similarly, the Dean of the College of Cardinals, who would preside over a papal funeral and organize the conclave, has no additional role if the Pope is simply sick. Italian Cardinal Giovanni Battista Re, 91, currently holds this position.

Earlier this month, Francis decided to retain Re in his position even after his five-year term expired, rather than appointing someone new. He also extended the term of the Vice-Dean, Argentine Cardinal Leonardo Sandri, 81.