If the chief justice's seat were left vacant for any significant period, however, it could complicate the internal workings of the court. There would still be a quorum of at least six justices, but the court would face the constant prospect of 4 to 4 votes, which automatically affirm the ruling of the lower court without creating a legal precedent.
A prolonged vacancy might also inhibit plans other justices would have to retire, since they might be reluctant to leave the court even more shorthanded.
The current Supreme Court posed for a group photo in December 2003. Seated, from left, are Antonin Scalia, John Paul Stevens, Chief Justice William H. Rehnquist, Sandra Day O'Connor and Anthony M. Kennedy. Standing, from left: Ruth Bader Ginsburg, David H. Souter, Clarence Thomas and Stephen G. Breyer.
(John Mcdonnell -- The Washington Post)
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The chief justice's duties include presiding over oral argument and the court's weekly closed-door conferences. If Rehnquist leaves the court or cannot perform these duties because of his health, the senior associate justice, John Paul Stevens, 84, would take his place.
The 25th Amendment to the Constitution sets up a mechanism by which a president who has become incapacitated can be temporarily or permanently relieved of his duties, but there are no comparable legal provisions for the justices. That has led to difficult situations in the court's past.
Probably the most famous such episode occurred in 1975, when Justice William O. Douglas lingered at the court for most of the year after suffering a debilitating stroke on Dec. 31, 1974. His refusal to step down despite obvious mental and physical problems led colleagues to decide secretly to stop counting his vote in some cases, until he finally quit at the insistence of his wife and friends.
Rehnquist's friends and court analysts said he would never put the court in such a position, in part because he experienced the Douglas episode firsthand, as an associate justice.
"He knows what can happen and what a terrific burden on the court someone can be if he lingers too long," Atkinson said.
All that is known for certain about the chief justice's illness is that he entered the hospital on Oct. 22 and had a tracheotomy related to the thyroid cancer diagnosis last weekend.
The court has released no other information about his condition, or about how and when he learned he was ill.
There are several kinds of thyroid cancer, ranging from relatively treatable varieties to a fast-growing and fatal malignancy known as anaplastic thyroid cancer, which occurs most commonly among men over 65.
In published reports this week, medical experts said the fact that surgeons gave the chief justice a tracheotomy, opening a hole in his throat to relieve a blocked windpipe, could be a sign that the cancer had spread and was hampering his breathing.
Also, the hoarseness from which the chief justice has been suffering recently is often symptomatic of thyroid cancer pressing on nerves in the throat, doctors said.
Rehnquist apparently looked in normal health as recently as mid-September. An old friend who ate a meal with him did not notice anything unusual, according to the friend, who asked not to be identified because of their relationship.
But another friend who saw Rehnquist in mid-October said "he looked terrible and sounded terrible." By the first week of October, the chief justice was concerned enough about his voice to cancel a long-planned speaking engagement at the University of Nebraska Law School, according to the school's dean, Steven L. Willborn.
In a letter to Willborn, Rehnquist said he had been having trouble with his throat and voice, and would not be able to give the lecture Oct. 29 as planned. He added that his physician did not know what was wrong, but that he was planning to have a magnetic resonance imaging (MRI) test in the second week of October.
Rehnquist offered to reschedule his visit for the next year, Willborn said.
