be confined in the West to the Bishop of Rome, a practice that was firmly in place by the 11th century, when Pope Gregory VII declared it reserved for the Bishop of Rome. As bishop of the Church of Rome, he is successor to the co-patrons of that local church, Saint Peter and Saint Paul. As such, the Church of Rome, and its bishop, has always had a prominence in the Catholic communion and at least to some degree primacy among his peers, the other bishops, as Peter had a certain primacy among his peers, the other apostles. The exact nature of that primacy is one of the most significant ecumenical issues of the age, and has developed as a doctrine throughout the entire history of the Church. The Catechism of the Catholic Church, quoting the Second Vatican Council's document Lumen gentium, states: "The pope, Bishop of Rome and Peter's successor, 'is the perpetual and visible source and foundation of the unity both of the bishops and of the whole company of the faithful.'" Communion with the bishop of Rome has become such a significant identifier of Catholic identity that at times the Catholic Church has been known in its entirety as "Roman Catholic," though this is inaccurate in Catholic theology (ecclesiology). Three other of the pope's offices stem directly from his office as bishop of the Church of Rome. As the Latin Church owes its identity and development to its origins in the liturgical, juridical, and theological patrimony of Rome, the bishop of Rome is de facto the patriarch of the Latin Church. According to Pope Benedict XVI, there has been much 'confusion' between the pope's primacy as patriarch of the western church and his primacy as first patriarch among equals, that this "failure to distinguish" between the roles and responsibilities of these two distinct positions leads in time to the "extreme centralization of the Catholic Church" and the schism between East and West. As the first local Church of Italy, the bishop of Rome is the Primate of Italy and is empowered to appoint the president of the Italian Bishops' Conference. The Church of Rome is also the principal church of the Province of Rome, so the bishop of Rome is Archbishop and Metropolitan of the Roman province. As a bishop, the pope is referred to as a Vicar of Christ. This title was common to all bishops