THEOn 27 August 2020, almost a year and a half ago, Mario (real name), 43, a quadriplegic for 11 years due to a road accident, asked the national health service to apply the sentence of the Constitutional Court intervened on Cappato / Dj Fabo case. That sentence, which in Italy has the force of law, had for the first time in our country declared the right of a sick person to request that a public structure of the national health service check his health conditions in order to have access to voluntary death by suicide. assisted.
In Italy, suicide aid is legal, but on 4 conditions
From 2019, therefore, suicide aid is legal in Italy, in the presence of four conditions established by the Constitutional Court which with sentence 242 which declared the unconstitutionality of article 580 of the criminal code “in the part in which does not exclude the punishment of whom […] facilitates the execution of the intention to commit suicide, autonomously and freely formed, of a person kept alive by life-sustaining treatments and suffering from an irreversible pathology, a source of physical or psychological suffering that she deems intolerable, but fully capable of making free and conscious decisions, provided that these conditions and implementation procedures have been verified by a public structure of the national health service, after obtaining the opinion of the territorially competent ethics committee “.
Despite this, to assert his right, Mario due to bureaucratic and institutional pitfalls, he had to activate courts, send warnings, file complaints and write letters to the government so that the right sanctioned by the Constitutional Court was respected.
Good law should guarantee rights
A good end-of-life law would therefore help define procedures, guaranteeing people’s rights.
Unfortunately, however, despite the fact that Parliament has waited more than three years from the first recall of the Constitutional Court, in recent days, the debate begun on the basic text of the law proposal on aid for suicide is disappointing and inadequate to respond to all those people who want to exercise their right of choice at the end of their life.
The consolidated text adopted by the competent Commissions and arrived in the courtroom raises more than one perplexity, first of all because it only partially reports what was already legalized by the Constitutional Court in 2019. It is up to Parliament to legislate to complete the necessary regulatory process to recognize the rights of all sick people.
The first discussion, which took place in an empty classroom, gave the photograph of a Parliament that has no interest in legislating, so much so that the work was postponed until after the holidays, without dates and deadlines.
In order for the law to be really useful, and not to represent a step backwards, it must therefore dissolve these knots, contained in the text and not addressed.
Discrimination between patients
With respect to the requirements of the Constitutional Court, the law requires the presence of an irreversible pathology with a poor prognosis or an irreversible clinical condition, unnecessarily complicating the scenario clearly outlined by the Constitutional Court with respect to this requirement. A further requirement is that there is also psychological suffering, not as a possible and alternative requirement as envisaged by the Council: in this case, discrimination is created between patients. The necessary requirement of life-sustaining treatments is then reiterated, which effectively excludes all those people who, despite suffering from irreversible diseases and carriers of serious suffering considered intolerable (let’s think of a terrible cancer that is no longer curable), are not connected to machinery or not they still need life-sustaining health treatments.
With regard to these people, the agreement between the parties is that they must continue to live their condition of suffering and can request medical assistance upon suicide only in the face of a worsening such as to make them dependent on health treatments and only if in the meantime they do not have lost their physical autonomy.
Palliative care
They would become compulsory medical treatment in order to access assisted suicide. Only after having been involved in a path of this type and having refused it will it be possible to apply for medical assistance upon voluntary death. A forecast that has as a consequence only the lengthening of the times for those who do not have time. Furthermore, the absurdity seems to emerge according to which a person who does not refuse palliative care, and who therefore wants to continue receiving them until the last moment (remember that they alleviate suffering), cannot proceed with the request for assisted suicide.
Timing: 10 steps with no guarantee of response
In the forecasts of the unified text it will be necessary to complete 10 steps, without defining the necessary times. All this net of any disputes, in which case the intervention of the Court is also necessary.
Conscientious objection
In the approved text, conscientious objection was introduced through a list of medical personnel who objected. An alternative way would have been possible: with the law on DAT, for example, the legislator chose to allow the conscientious objection of health professionals on the specific case, without creating a list of objectors always and in any case.
Marco Cappato, Mina Welby and Filomena Gallo (Photo by Simona Granati – Corbis / Getty Images)
These are the issues that should be adequately regulated so that the bill under discussion does not present elements of unconstitutionality.
The debate in the two houses of Parliament will be able to modify the text, eliminating discrimination present today, only in this way will we have a good law on assisting medically assisted suicide, otherwise for all of us it will be a missed opportunity and we will have to go to the courts again.
The proposal under examination does not deal with active euthanasia, it remains forbidden for a patient to ask for the administration of a drug where he cannot or does not want to do it independently, art. 579 of the Criminal Code configures the crime of murder of the consenting party.
The Luca Coscioni Association
L’Luca Coscioni Association he promoted the legal euthanasia referendum and also with others collected 1,240,000 signatures to call a referendum for the partial abrogation of the crime of murder of the consenting party.
After the hearing in the Constitutional Court for the admissibility check, we will know if next spring the Italians will be called to the polls to cancel a ban of the 1930s that does not respect the guarantees provided for by Constitutional Charter entered into force in 1948.
Prohibition in contradiction with the already regulated possibility of refusing treatment, suspend life-sustaining treatments in progress, access palliative treatments with deep sedation and after hours, days reach death.
What is the difference between these different end-of-life choices?
People’s freedom of choice is not recognized by politics, which is also hindered in not legislating to discuss a law on euthanasia as regulated in other countries.
Legally, the referendum is a source of law which by repealing a text of law in whole or in part guarantees democracy and intervenes in the legal system even if the Government and Parliament do not legislate.
The campaign to collect signatures has already managed to have an important consensus that manifests regulatory will that wants to lead to an abrogative popular vote capable of introducing active euthanasia under certain conditions while maintaining protections and prohibitions for those who do not want or cannot decide.
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