Pope Francis, who has been battling pneumonia for over two weeks, experienced two new acute respiratory crises on Monday. These crises necessitated a return to noninvasive mechanical ventilation, another setback in his fight against the infection.
During two bronchoscopies, doctors extracted substantial amounts of mucus from his lungs. These bronchoscopies involved inserting a camera-tipped tube into his airways with a suction device to remove fluid. The Vatican clarified that the mucus was a reaction to the original pneumonia infection and not a new one, as laboratory tests indicated no new bacteria.
Despite these setbacks, Francis remained alert, oriented, and cooperative with medical personnel. However, the prognosis remains uncertain. Doctors did not specify whether he remained in stable condition, but they referred to the crises in the past tense, suggesting they had resolved.
These crises represent a new challenge for the 88-year-old pope, who has chronic lung disease and had part of one lung removed. The respiratory infection he is battling is complex and demanding.
Dr. John Coleman, a pulmonary critical care doctor at Northwestern Medicine in Chicago, noted that the episodes were more concerning than the one on Friday. On Friday, Francis experienced a coughing fit, inhaled vomit that required extraction, and was subsequently put on noninvasive mechanical ventilation for a day before no longer needing it.
Coleman expressed concern about the level of mucus and phlegm in Francis’ lungs, noting that the manual removal of mucus during bronchoscopies indicated that he was not clearing his secretions effectively. He described Francis’ progress as “taking little steps forward and then steps back.”
In a recent update, the Vatican revealed that the episodes of difficulty breathing were caused by a substantial accumulation of mucus in the Pope’s lungs and bronchial spasms. During the bronchoscopies, “copious secretions” were extracted, and the Pope was transitioned back to non-invasive mechanical ventilation, a mask that covers his nose and mouth and provides oxygen to his lungs.
The Vatican has not released any photographs or videos of Francis since his hospitalization on February 14 due to a complex lung infection. This prolonged absence marks the longest in his 12-year papacy.
Doctors often resort to non-invasive ventilation to prevent the need for intubation, a procedure that involves inserting a tube into the trachea. Francis has not been intubated during his current hospitalization. It remains uncertain whether he has expressed any advance directives regarding the limits of his care if he declines or loses consciousness.
Catholic teaching emphasizes the protection of life from conception until natural death. While it acknowledges the need for “ordinary” care, such as hydration and nutrition, for chronically ill patients, including those in vegetative states, it permits the suspension of “extraordinary” or disproportionate care if it ceases to be beneficial or prolongs a precarious and painful existence.
In 2017, Francis addressed a meeting of Paglia’s bioethics body, stating that there is no obligation to resort to every possible remedy in all circumstances. He clarified that this allows for a morally qualified decision to withdraw “overzealous treatment.”
Paglia, who serves as a spokesperson for the Catholic Church’s stance on end-of-life care, emphasized that Francis, like any other Catholic, would adhere to church teachings if necessary.
