Interesting that two news events this week - a high court decision to allow an Italian woman in an "irreversible coma" to die and controversy over a possible change of policy on stem cell research in the US under Barack Obama - have brought the Pontifical Council for the Pastoral Care of Health Care Workers and its Mexican head, Cardinal Javier Lozano Barragan, into the limelight.

Cardinal Barragan is often described as the Vatican "health minister", but this is a bit of a simplification. The Council was created in 1985 by Pope John Paul II with a brief to "show the solicitude of the Church for the sick by helping those who serve the sick and suffering, so that their apostolate of mercy may ever more effectively respond to people's needs" and to "spread the Church's teaching on the spiritual and moral aspects of illness as well as the meaning of human suffering".

Javier Lozano Barragán, who is 75, trained as a priest at Zamora in Mexico and then at the Pontifical Gregorian University in Rome, and was ordained in 1955. He became auxiliary Bishop of Mexico City in 1979, then Bishop of Zacatecas in 1984 before returning to Rome in 1996 to head the Council, becoming a cardinal in 2003.

Cardinal Barragán therefore took part in the 2005 conclave which elected Pope Benedict, and has actively promoted the the canonisation of Pope John Paul II. He held a press conference this week on childhood diseases and infant mortality, only to find himself ambushed on two stories in the headlines: embryonic stem cell research, and the fate of Eluana Englaro, who as a teenager in 1992 was injured in a car crash which has put her into a "persistent vegetative state" for the past sixteen years.

The case has agonised Italy, which after all is still a Catholic country, even if attendances at mass and confession have fallen. In fact secular, left wing politicians complain that the influence of both the Italian Catholic Church and the Vatican over Italian life has if anything increased since the return to power of the Centre Right under Silvio Berlusconi in last April's elections.

Eluana Englaro's father has been fighting for a decade for the right to remove the feeding tubes that keep her alive at a hospital in the northern Italian town of Lecco. When the country's highest appeal court, the Court of Cassation, ruled this week that he could, he commented that the decision "shows that we live in a state of law" - in other words, Italy is a secular state in which the Church has a voice, but no more.

The Church's voice is pretty powerful, on the other hand. L'Avvenire, the daily newspaper of the Italian Bishops Conference, warned ahead of the ruling that the Court of Cassation would be "enacting the first death sentence in Italy since 1946" if it said yes. Cardinal Barragan was even blunter: to allow Eluena to die would amount to "monstrous and inhuman murder".

As for stem cells, asked whether the Vatican was concerned about reports that Mr Obama might reverse the Bush Administration's ban on embryonic stem cell research, the cardinal said such research had not resulted in any significant health cure so far and was "good for nothing".

But then Cardinal Barragan knows very well that health, far from being a low profile issue, puts him in the front line. I remember that when John Paul II was dying, it fell to Cardinal Barragan as well as to Joaquin Navarro-Valls, the then Vatican spokesman, to reveal that the Pope was in a "very, very serious" way.

He has also been asked by Pope Benedict to get to grips with the question of whether condoms can be used to help stop the spread of AIDS - to which his answer, unsurprisingly, is that the best answer to AIDS is premarital abstinence from sex before marriage and marital fidelity after it.

Cardinal Barragan has shared the spotlight this week with a younger prelate often described as one of the Vatican's brightest and best - Archbishop Salvatore Fisichella, head of the Vatican's Pontifical Academy for Life. Archbishop Fisichella, 57, known as "Rino", is also rector of the Pontifical Lateran University and a member of the Congregation for the Doctrine of the Faith and the Congregation for the Causes of Saints.

He described allowing Eluena Englaro to die as an "immense crime" and a "civil and moral defeat". Eluena would die an "atrocious death" by being deprived of water and nutrition, a step on the road to legal euthanasia, Monsignor Fisichella said.

But he added, less dogmatically, that he had "profound respect" for Eluena's father ("I pray for him"), and that no one who has not had a similar experience can possibly judge her family, or indeed "other families dealing with similar cases".

Archbishop Fisichella played a behind the scenes role in the conversion to Catholicism of Magdi Allam, an Italian Muslim journalist who was received into the Catholic Church by Pope Benedict himself last Easter. He takes robustly conservative stands on homosexual unions, abortion and embryonic stem cell research - but rarely loses his cool, debating calmly and rationally, always showing respect for other views. A rising star? Watch this space.