Passive Euthanasia Ratified in Italy by the Senate at the End of 2017

It was passed by 180 votes over 71 against and 6 abstentions. The so-called “living will” law was hotly debated at the legislature for two days, with over 3000 amendments proposed. An amendment that would have required hydration and nourishment to be maintained was rejected. For the first time, some key amendments were reviewed with a secret ballot.

A living will, according to bioethical news website Gènéthique, allows “every person having attained their majority the option to refuse medical treatment at the end of life, including hydration and nourishment.” This choice can be expressed via advance directives, signed in presence of a notary or entrusted to the registry, which can be revoked or changed at any time. For minors, the immediate family can decide, taking the minor’s opinion into account “to an extent proportionate to his age and level of maturity.”

For patients who are unable to express their choice, the decision is to be made by the legal guardian, and then by the court overseeing the guardian, should there be a disagreement with the medical team. Furthermore, the text allows for the possibility of inducing “deep and continuous sedation causing an alteration of consciousness, until the moment of death.”

The bill was passed by a majority composed of the Democrat Party (including Christian Democrats), the Five Star Movement, and the Italian Left, all supported by the government. The opposition of the center-right did not present an obstacle. Prime Minister Paolo Gentiloni tweeted that the new legislation was a “step forward for the dignity of the person.”

Italian neurologist and Catholic representative Gian Luigi Gigli, president of the Movement for Life, told the Italian bishops’ daily Avvenire that the “shameful” contribution of the Christian Democrats had “introduced passive euthanasia.”

Opposition from the Holy See

The Italian episcopate and the Holy See previously expressed opposition to the text. Cardinal Gualtiero Basseti, archbishop of Perugia and president of the Italian Catholic Bishops’ Conference, stated he was concerned that Catholic doctors and hospitals could never “cease to provide essential care such as nourishment, hydration and personal hygiene.” He asked that “in addition to ensuring every doctor has the right to conscientious objection, the same right be recognized for health-related institutions.” The law states, in fact, that advance directives will apply to all medical personnel, and “exempt from all penal responsibility” a doctor who “refuses to unplug a machine that is keeping his patient alive.” However, although “the right to object in conscience is recognized by law since 1972,” in Italy, the institution in which the doctor practices “is obliged to find a replacement doctor who does not object in conscience.”

L’Osservatore Romano called the law “controversial” in its December 16, 2017 edition. Cardinal Pietro Parolin, Secretary of State to the Holy See, upheld the position of Italian bishops’ conference, albeit somewhat weakly. In an interview with TV2000 on December 21, 2017, the Cardinal said that the lack of possibility for conscientious objection, especially for Catholic establishments, is a “weak point” of the law passed by the Italian senate.