The right to euthanasia: a thorny issue involving dignity

On February 15 2022, the Constitutional Court of Italy declared inadmissible the amendment proposed by the association “Luca Coscioni” (a non-profit organization whose priorities are the affirmation of civil liberties and human rights) on the depenalization of “consented murder”. The association’s request for amendment of article 579 of the Italian Penal Code should have gone through a referendum, which would have taken place in spring. In particular, the request involved the removal of the categorization of “consented murder” as a crime when the person asking for the procedure is of old age, fit to plead and consensual to it. This change would have allowed the practice of active euthanasia in accordance to the provisions already present in the Italian legal system, namely informed consent and the “living will”. This gives the person the opportunity to express consent over a certain medical practice (including euthanasia) in a preventive way, thus allowing to fulfill his or her will in cases in which the patient is not able to do it.

What would the right to euthanasia involve?

The concept of euthanasia has always been a controversial topic. The word “euthanasia” derives from Greek, and literally means “good death”. Euthanasia is defined as an “act or practice of painlessly putting to death persons suffering from a painful and incurable disease or incapacitating physical disorder, or of allowing them to die by withholding medical treatment or artificial life-support measures”. It can be either “active” or “passive”. Active euthanasia would be the deliberate act of putting an end to a terminally ill patient’s life, whereas “passive” euthanasia implies the mere withdrawing or interruption of a medical treatment that kept the person alive.

The long path towards the right to euthanasia in Italy

In Italy, the question of legalizing euthanasia has been a troubling issue. Indeed, not only the crime of “consented murder” is regulated by a law that goes back to the Fascist period (it is part of the so-called “Codice Rocco”, which is the penal code still in force nowadays). However, the involvement of the Catholic Church in state affairs and its influence on the public sphere have rendered the path towards the potential legalization of euthanasia undoubtedly complicated.

Despite its controversy, the issue has been at the core of some notorious stories on which the media have shed light on. Back in 2006 there was the case of Piergiorgio Welby, a man who suffered from muscular dystrophy at an advanced state, and thus asked the Italian President of the Republic to obtain euthanasia. The President promptly called the national Parliament to discuss the issue, without results. The death of Mr. Welby a few months later stirred emotions all over the country. Another relevant case was that of Eluana Englaro, a woman who, after a car accident, was living in a vegetative state since 1992. The family was able to respect Eluana’s will only 17 years after, in 2009, and only by interrupting the feeding and hydrating treatments that she depended on. More recently, there was the case of “Dj Fabo” (Fabio Antoniani), a young man who became tetraplegic and blind after an incident, and who was able to go to Switzerland in 2017 to die through assisted suicide. He was accompanied by Marco Cappato, a member of the above-mentioned Luca Coscioni association, who had to go to trial accused of suicide assistance. In 2019, Mr. Cappato was declared innocent by the Court of Appeal (the Court of highest level in Italy).
With regard to the legislative efforts put forth to legalize euthanasia, the last request for a referendum is only one of the many law proposals that have not succeeded. In contrast to theopposition and resistance of the institutional realm, a 2019 survey issued by Swg found that 93% of Italian citizens would be in favor of legalizing euthanasia.

Euthanasia in the European Union

In the European Union, only Belgium, the Netherlands, Luxembourg and Germany allow both the practices of euthanasia and assisted death, whereas Austria and Finland accept passive euthanasia under strict circumstances. Countries like Spain and Portugal allow instead for withdrawing life-sustaining treatments, a practice that is usually considered as being part of palliative care rather than euthanasia. Among the states in which such practice is legal, the Netherlands and Belgium allow euthanasia also for children and teenagers under 18. In particular, the former allows euthanasia to children from 12 years old, and until the age of 15 parental consent is required. In Belgium, no age limit is established, but kids need to have the capacity to understand the situation. Parental consent is needed and very strict medical requirements must be met.

The issue was also subject to a parliamentary question to the European Commission in 2017. The MEP Mara Bizzotto (member of the Identity and Democracy group) asked whether the Commission had the power to make recommendations to the member states in this regard, given the existence of article 2 of the EU Charter of Fundamental Rights, which guarantees the inalienability of the right to life. The reply of the Commission stated that healthcare competencies, as well as ethical questions referring to care for terminally ill patients, remained within the power of the member states. Hence, the general picture shows that there is wide disagreement about the issue, and EU countries find themselves with very different legislation in this regard.

About dignity

Euthanasia is undoubtedly a delicate question, which makes all of us face the thorny debate on whether a life should be “worth being lived”. The right to life is guaranteed both at the national and European levels. However, individuals’ right to live the way they want and with dignity opens the question of to what degree life has to be deemed as a sort of public good, instead of being the core of our inalienable individuality.

[This article was first published in the issue 36 of the magazine]