The royal commission into child sexual abuse will rule on Monday whether Australia's highest-profile Catholic, Cardinal George Pell, will be allowed to give evidence via video link from Rome.
Cardinal Pell's lawyers on Friday provided the commission with a medical report which warned a flight from Rome to Australia would be "difficult" and could pose a "serious risk" to his health.
Royal commission chairman Peter McClellan, however, questioned whether the two-page cardiologist's report precludes the 74-year-old from flying.
The commission wants to hear testimony from Cardinal Pell and former Bishop of Ballarat Ronald Mulkearns about decades of abuse at schools run by the Catholic clergy in Melbourne and Ballarat.
Hearings are scheduled in Ballarat this month.
Alan Myers, QC, representing Cardinal Pell, on Friday told the royal commission his client "certainly wants to avoid the appearance that he's unwilling to give evidence".
Cardinal Pell, when he was able, was "not unwilling" to return to Australia from Rome where he oversees the Vatican's finances, Mr Myers said.
But Justice McClellan said the medical opinion did not say Cardinal Pell could not travel to Australia.
"That doesn't preclude his travel, does it?" Justice McClellan asked.
"The doctor opines that it would be difficult for him to undertake a flight. It doesn't mean he can't come."
Senior counsel assisting the commission, Gail Furness, suggested "there are a number of ways of travelling to Australia which would permit shorter journeys to be made, albeit over a longer period of time".
Justice McClellan responded: "There are other means of getting in. One can come by ship, I suppose."
The commission was also told that Cardinal Pell does not want the details of the heart condition he suffers to be made public.
But Paul O'Dwyer, SC, representing one of the survivors of abuse, argued the report should be made public, telling the hearing that Cardinal Pell's health issues "were very common garden problems for a man of the Cardinal's age".
Justice McClellan, who has made it clear it is his preference for Cardinal Pell to appear in person, will announce on Monday whether applications for Cardinal Pell and Bishop Mulkearns to appear via video link will be allowed.
Bishop Mulkearns is in palliative care in Ballarat suffering cancer.
