ITALY – First assisted suicide in Italy; political tug-of-war continues
23 August 2022
The political path to self-determination over one’s own end of life remains difficult. The path via the courts continues to be the one enabling people in Italy to exercise their right to a self-determined and accompanied end of life at the place where they live.
In Italy, the first legal assisted suicide took place on 16 June 2022 with the support of the Italian organisation Associazione Luca Coscioni. In the so-called “Mario case” in the Marche region, the health authority had decided on the medication to be used for assisted suicide at the beginning of February 2022, after several court complaints by the man concerned (including for failure to act). There were also practical hurdles in the run-up. Associazione Luca Coscioni had to conduct a public fundraising campaign to finance a suitable device for the patient to trigger the infusion – even though the state must ensure that the appropriate means are available.
The 44-year-old man, real name Federico Carboni, had been paraplegic since an accident 11 years earlier and was dependent on artificial means to sustain his life. The legal basis for this first assisted suicide is a ruling by the Italian Constitutional Court of 25 September 2019 in connection with the so-called “Fabiano Antoniani case”, also known as “DJ Fabo”; according to this ruling, it is generally permissible to provide assisted suicide to a severely ill person with legal capacity and a firm wish to die, provided that he or she can only be kept alive with artificial means (“trattamenti di sostegno vitale”).
Referendum rejected
A rather unpleasant surprise was the rejection of a popular referendum on the partial repeal of Article 579 of the Penal Code “Killing on demand” (voluntary euthanasia). Although the petition for the popular referendum launched by the Associazione Luca Coscioni in the summer of 2021 was an overwhelming success and around 1.2 million signatures were submitted at the beginning of October 2021 (500,000 are required), a referendum will not be held. On 15 February 2022, the Italian Constitutional Court decided – assumably under political pressure – that the amendment to the penal code called for in the petition could lead to unconstitutional loopholes to the detriment of particularly vulnerable persons. The rejection of the referendum by the Constitutional Court, especially its formalistic justification, caused great incomprehension in Italy.
To put it somewhat briefly, with the proposed law changes, ending someone’s life with the person’s explicit consent would have been punishable in Italy only if that person was a minor or incapable of judgement, or if their consent was forced in some way. And in these cases, it would then not have been a case of killing on demand, but rather the criminal offence of murder. This is regulated in Articles 575-577 and would have been punished accordingly.
Still no law
The possibilities for assisted self-determined termination of one’s own life remain very limited for seriously ill persons in Italy despite the ruling in the Fabiano Antoniani case. The legal provisions and institutional structures necessary for compliance with the preliminary examination of requests for assisted suicide as stipulated by the Constitutional Court are still missing. On 10 March 2022, the Italian parliament approved a draft law on assisted suicide with a few amendments, after tough back and forth in the commission, attempts at torpedoing from the right and repeated postponements of the agenda item. Only 371 out of 630 MPs were present for the vote. The result of the vote: 253 yes, 117 no, one abstention. Since then, the bill has been in the Senate, where it is likely to remain for a while. After the resignation of prime minister Mario Draghi, early parliamentary elections will take place in Italy on 25 September 2022; accordingly, the assisted suicide law will hardly have top priority.
The draft law is not without controversy. In particular, it is disturbing that in the current version, only persons who are dependent on artificial means of life support, i.e. who need artificial respiration, for example, have access to assisted suicide. Such a provision would continue to exclude numerous severely suffering individuals from access to assisted suicide.
Further precedent should bring clarification
In order to counter the existing unequal treatment, self-determination activist Marco Cappato of the Associazione Luca Coscioni brought a woman suffering from terminal cancer to Switzerland for an assisted suicide in early August 2022 and reported himself to the Italian police for suicide assistance after his return. Unlike Federico Carboni, the woman was not dependent on life-sustaining measures and therefore could not legally seek assisted suicide in Italy. With his action, which he had announced in advance, Cappato now wants to overturn this discrimination with a legal precedent.
Cappato had taken the same course of action for Fabiano Antoniani in 2017. He had been charged at the time with inciting and assisting suicide because on 27 February 2017 he had accompanied Fabiano Antoniani to Switzerland for an assisted suicide and subsequently reported himself to the Milan police. He was acquitted by the jury court in Milan on 23 December 2019. The fact that Federico Carboni was able to claim an assisted suicide in Italy is the result of this precedent, which was provoked with great civil courage and legal preparation.
