By Samuel López | USA Herald

VATICAN CITY — As Pope Leo XIV undergoes surgery in Rome on Tuesday, an unusual constitutional question hangs over the smallest country in the world and the largest Christian church…

Who is running the Vatican while the pope is unconscious?

Technically, the answer remains Pope Leo XIV.

The Vatican announced Tuesday that the pontiff was admitted to Rome’s Agostino Gemelli University Hospital for surgery involving a nodule in his lung.

But his trip into the operating room isn’t something that automatically triggers a transfer of papal power, nor is there a Vatican Vice President to accept such a transfer.

The United States has a constitutional mechanism designed specifically for presidential incapacity.

Under the 25th Amendment, presidential authority can temporarily pass to the vice president when a president is unable to discharge the powers and duties of the office.

The Vatican has no direct equivalent.

There is no vice pope.

There is no official who automatically becomes acting pope.

And general anesthesia does not create a vacancy in the papacy.

Under the Church’s existing legal structure, Leo remains Roman Pontiff even during a period when he is unconscious and physically incapable of personally exercising his authority.

That distinction exposes one of the more unusual features of modern Vatican government.

In practical terms, Vatican City and the broader government of the Holy See do not stop operating whenever the pope is unavailable.

Much of the ordinary administrative and diplomatic machinery can continue through existing Vatican institutions.

At the center of that operation is Cardinal Pietro Parolin, the Vatican Secretary of State.

Parolin’s office coordinates significant portions of the Holy See’s governmental and diplomatic activity and works across the Vatican’s departments, known as dicasteries.

That means Parolin and other senior Vatican officials can continue performing duties already entrusted to their offices while Leo recovers.

But that is fundamentally different from assuming the papacy.

Parolin does not inherit Leo’s supreme authority simply because the pontiff is unconscious.

Another office frequently misunderstood during papal health emergencies is the Camerlengo of the Holy Roman Church.

The Camerlengo assumes important administrative responsibilities when a pope dies or the Apostolic See otherwise becomes vacant.

But hospitalization is not sede vacante.

Leo is alive. He has not resigned. The papal office therefore remains occupied.

The special procedures associated with a vacant Apostolic See — eventually including the process leading to a conclave and election of another pope — are not triggered merely because a pontiff undergoes surgery.

The Vatican’s 25th Amendment Problem

Tuesday’s operation raises a much bigger question than who signs paperwork while Leo is anesthetized.

What happens if a pope goes under anesthesia and never regains the ability to govern?

Imagine a pontiff suffering catastrophic brain damage, a massive stroke, advanced dementia or another medical event leaving him alive but permanently incapable of communicating.

He cannot govern.

He cannot meaningfully issue decisions.

And, potentially, he cannot resign.

Yet he may still legally remain pope.

That is where Vatican law enters territory that the U.S. Constitution addresses much more directly for the presidency.

The 25th Amendment establishes a procedure for determining that a president is unable to discharge the powers and duties of the office. No comparable universal mechanism allows a group of cardinals, Vatican officials or physicians simply to declare a pope incapacitated and install an acting pontiff.

Canon 335 of the Code of Canon Law acknowledges the possibility that the Roman See can become “entirely impeded,” but directs that nothing should be altered in the governance of the universal Church and that special laws governing such circumstances should be observed.

The difficulty is that the Church does not presently have a comprehensive modern law comparable to the 25th Amendment spelling out exactly how permanent papal incapacity would be determined and resolved.

That leaves an extraordinary legal question sitting beneath an otherwise routine hospitalization.

Why the Cardinals Cannot Simply Remove Him

The College of Cardinals could not simply vote to declare Leo incompetent and elect another pope.

The pope occupies a unique position under canon law.

Canon 1404 states bluntly:

“The First See is judged by no one.”

That principle protects the independence of the papacy, but it also makes incapacity unusually complicated.

That is the Vatican’s 25th Amendment problem.

But, for the hours Pope Leo XIV is unconscious on an operating table in Rome, the legal answer remains remarkably simple:

The pope is still the pope.