Pope Francis faces setback in health battle, returns to noninvasive ventilation

ROME. Pope Francis suffered two acute respiratory crises on Monday, prompting doctors to place him back on noninvasive mechanical ventilation, the Vatican confirmed. This marks another setback in his ongoing battle with pneumonia, which has now stretched beyond two weeks.

Medical specialists performed two bronchoscopies to extract what was described as “copious” amounts of mucus from the pope’s lungs. A bronchoscopy involves inserting a camera-equipped tube into the airways to suction out fluid. The Vatican clarified that this mucus buildup was a reaction to the original infection rather than a sign of a new bacterial presence, as laboratory tests ruled out additional infections.

Despite the respiratory challenges, the 88-year-old pontiff remained alert and cooperative with medical personnel. However, his prognosis remains uncertain. Doctors did not explicitly state whether he was in stable condition but referred to the crises in the past tense, suggesting the worst of the episodes might be over.

Concerns Over Pope’s Recovery

Francis’ health complications are compounded by his pre-existing chronic lung disease and the partial removal of one of his lungs earlier in life. His recovery has been inconsistent, with incremental improvements followed by setbacks.

Dr. John Coleman, a pulmonary critical care specialist at Northwestern Medicine in Chicago, noted that the need for bronchoscopies indicates a serious level of mucus accumulation. “The fact that they had to go in there and remove it manually is concerning, because it means that he is not clearing the secretions on his own,” he explained.

The pope’s latest respiratory crises follow a similar incident on Friday, when he suffered a severe coughing fit, aspirated vomit, and required a day of noninvasive mechanical ventilation before stabilizing. However, Monday’s developments have renewed concerns about his ability to recover without further medical intervention.

Vatican Statement and Papal Silence

A late Vatican update attributed the respiratory issues to a “significant accumulation” of mucus in Francis’ lungs, coupled with bronchial spasms. The pope was once again placed on noninvasive mechanical ventilation—a mask that covers the nose and mouth, delivering oxygen to aid breathing.

Francis, who is overweight, wheelchair-bound, and not physically active, has been undergoing respiratory physiotherapy in an effort to improve lung function. However, the continued buildup of secretions suggests his body lacks the strength to expel them naturally.

Notably, the Vatican has refrained from releasing photos or videos of the pope since he was admitted to Gemelli Polyclinic on February 14, marking his longest absence from the public eye since the start of his papacy 12 years ago. The Vatican has defended his privacy, stating that Francis prefers to recover in peace. However, Archbishop Vincenzo Paglia, a close associate of the pope, urged him to make his voice heard. “We need men like him who are truly universal and not only one-sided,” Paglia said at a Vatican bioethics assembly.

Francis did contribute a written message to the assembly, expressing concern over global conflicts and criticizing international organizations for failing to address them effectively. The message, dated February 26, was signed “from Gemelli Polyclinic.”

Questions About the Pope’s Future Care

Doctors often use noninvasive ventilation to delay or prevent full intubation, an invasive procedure that involves inserting a tube into the airway. So far, Francis has not been intubated during this hospitalization. The Vatican has not disclosed whether he has issued advance directives regarding his medical treatment if his condition worsens.

Catholic doctrine emphasizes the sanctity of life from conception to natural death. While patients must receive basic care like hydration and nutrition, the Church allows for the withdrawal of “extraordinary” medical interventions if they no longer provide meaningful benefits. In 2017, Francis himself addressed this issue, stating, “There is no obligation to have recourse in all circumstances to every possible remedy,” and endorsing the moral acceptability of withdrawing excessive treatment.

Archbishop Paglia echoed this sentiment, emphasizing that the pope, like any Catholic, would adhere to Church teachings on end-of-life care. “Today, the pope is giving us an extraordinary teaching on fragility,” he said. “Not through words, but with his body, he reminds us that we are all fragile and must care for one another.”

A Papal Hospitalization Unlike Any Other

Despite the concerns surrounding his health, Francis’ 17-night hospitalization is far from a record among popes. St. John Paul II, for instance, endured several prolonged hospital stays during his 25-year papacy. His longest was a 55-day hospitalization in 1981 following an assassination attempt and subsequent infection.

For now, Pope Francis remains under close medical supervision as the world watches for further developments on his recovery.