On Thursday, 14 December, the Italian Senate adopted “biological testament” legislation, which provides for several end-of-life measures, by 180 votes to 71. This constitutes the “final green light” for legislation which had been broadly adopted by MPs in April (see In Italy, MPs adopt the “biological will” law), but sparked “heated debate”. Some officials, the Italian Episcopal Conference and several associations in particular denounced “the inclusion of euthanasia in Italian legislation in the most barbaric way: death due to hunger and thirst by ceasing food and hydration”. Assisted suicide is still considered a crime and active euthanasia as voluntary homicide but, as far as the Italian bishops are concerned, this law “introduced euthanasia under camouflage”.
The “bio testament” allows “any end-of-life adult to renounce medical treatment as well as food and hydration”. This choice can be explained by anticipated directives, signed in the presence of a lawyer, or allocated to the Civil Service, which can be revoked or revised at any time. For minors, the immediate family can decide, taking the patient’s opinion into account “in accordance with his/her age and maturity”. For patients who are incapable of expressing their wishes, the decision will be taken by the legal guardian and then by the guardianship judge in the case of disagreement with the medical team. Furthermore, the legislation allows the introduction of “continuous deep sedation, causing a change in the state of consciousness up until death”. Finally, “no treatment can be considered or continued without the patient’s voluntary, informed consent,” which “shall endeavour to alleviate the suffering of the patient in the event of refusal or withdrawal of consent regarding care”.
The law does not explicitly mention conscientious objection but it “exempts from criminal liability” any doctor “refusing to switch off a machine keeping a patient alive”. Furthermore, in Italy, “the right to invoke conscientious objection has been legally recognised since 1972”. However, the medical structure in which the doctor practises “must, as a mandatory requirement, find a replacement doctor, who does not exercise conscientious objection”.
AFP (14/12/2017); La Croix, Anne Le Nir (14/12/2017)