Pope rumored to have received last rites

VATICAN CITY -- Pope John Paul II developed a high fever Thursday because of a urinary tract infection and was being treated with antibiotics at the Vatican, his spokesman said. The latest health setback for the 84-year-old pontiff came one day after he began receiving nutrition through a feeding tube.\nThere were reports that the pope received the sacrament of the anointing of the sick -- what used to be called the last rites.\nBut the Italian news agency Apcom, without citing any sources, reported that John Paul's condition was "stable" early Friday, several hours after he started receiving antibiotics. Another Italian news agency, ANSA, said the pope "seems to showing a first positive reaction" to antibiotic therapy.\nAt the Gemelli Polyclinic, the hospital where the pope has been treated before, an emergency room chief said there were no plans to admit John Paul "at the moment," ANSA reported.\nHis assessment could mean that the Vatican medical staff feels confident it can handle the latest medical crisis with the sophisticated medical equipment installed at the Vatican. But it could also mean that the pope's condition was considered so precarious it would be better not to move him immediately.\nAt the edge of St. Peter's Square, hundreds of people gathered early Friday in a sign of concern over the pope's fragile condition. A few kneeled down on the cobblestones to pray, others wrapped blankets around themselves as they prepared to keep vigil throughout the night.\n"There's nothing we can do but pray. We're all upset," said Agriculture Minister Giovanni Alemanno, who was in the crowd.\n"I was in the car and I heard on the radio about the grave condition of the pope. I immediately thought I would come to St. Peter's," said Antonio Ceresa, a Roman.\nPolice barriers kept the faithful and curious out of the square itself.\nVatican officials could not be reached for comment on a report by CNN quoting an unidentified Vatican source as saying that John Paul received the sacrament of the anointing of the sick. The sacrament is often misunderstood as signaling imminent death. But it is performed not only for patients at the point of death, but also for those who are very sick -- and it may be repeated.\nThe pope's spokesman, Joaquin Navarro-Valls, told The Associated Press by telephone that "the Holy Father today was struck by a high fever caused by a confirmed infection of the urinary tract."\nThe pontiff was started on "an appropriate" course of antibiotics, Navarro-Valls said. "The medical situation is being strictly controlled by the Vatican medical team that is taking care of him."\nIn medical terms, "appropriate" often refers to a choice of antibiotics based on laboratory analysis of the kind of bacteria causing the infection.\nLights in the papal apartment above St. Peter's Square were on until about 11 p.m., generally well past the papal bedtime. The light remained on in the Apostolic Palace's nursing station on the same floor as the pope's apartment.\nPolice cars and other vehicles were seen going in and out of the Vatican gates as the evening wore on, and a small crowd of Italians who were following news on television began gathering at the edge of the square.\nEarlier, ANSA and Apcom said the pope had suffered an alarming drop in blood pressure Thursday evening.\nA urinary infection can produce fever and a drop in blood pressure as reported in the pope, said Dr. Marc Siegel, a specialist in internal medicine at the New York University Medical Center.\nThe pope's risk of such an infection is heightened because he is elderly -- which suggests his prostate is probably enlarged -- debilitated and run down from the illness that recently sent him to the hospital, Siegel said.\nUrinary infections tend to respond well to antibiotics, given either as pills or intravenously, and "I would suspect there's a very good chance he's going to recover well," Siegel said.\nHospitalized twice last month following two breathing crises and with a tube placed in his throat to help him breathe, John Paul has become a picture of suffering. When he appeared at his apartment window Wednesday to bless pilgrims in St. Peter's Square, he managed to utter only a rasp.\nLater that day, the Vatican announced he had been fitted with a feeding tube in his nose to help boost his nutritional intake.\nThe use of the feeding tube illustrates a key point of Roman Catholic policy John Paul has proclaimed: It is morally necessary to give patients food and water, no matter their condition.\nAs Parkinson's disease and other ailments have left him increasingly frail, the pope has been emphasizing that the chronically ill, "prisoners of their condition ... retain their human dignity in all its fullness."\nThe Vatican's attitude to the chronically ill has been apparent in its bitter condemnation of a judge's order two weeks ago to remove a feeding tube from Terri Schiavo, the severely brain-damaged American woman who died Thursday.\nVatican Cardinal Jose Saraiva Martins, reacting to Schiavo's death, denounced the removal of her feeding tube as "an attack against God."\nAlthough different, some see parallels in the two cases.\nUnder John Paul, Vatican teaching on the final stages of life includes a firm rejection of euthanasia, insistence on treatments that help people bear ailments with dignity and encouragement of research to enhance and prolong life.\nA 1980 Vatican document makes the distinction between "proportionate" and "disproportionate" means of prolonging life. While it gives room for refusal of some forms of aggressive medical intervention for terminally ill patients, it insists that "normal care" must not be interrupted.\nJohn Paul set down exactly what that meant in a speech last year to an international conference on treatments for patients in a so-called persistent vegetative state.\n"I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory."\nJohn Paul's 26-year papacy has been marked by its call to value the aged and to respect the sick, subjects the pope has turned to as he battles Parkinson's disease and crippling knee and hip ailments.\nIt is not clear who would be empowered to make medical decisions for an unconscious pope. The pope has no close relatives, but the Vatican has officially declined to comment whether John Paul has left written instructions.\nThe Rev. Thomas Reese, editor of America, the Jesuit weekly magazine, published in New York City, said Thursday, "We don't know whether or not the pope has a living will. But if he does not, the statement issued a year ago would be a clear indication of his desire that he would not want to be disconnected from a feeding tube unless he was clearly dying"