End of life: decisions to a National Ethics Committee chosen by Palazzo Chigi and the Health Service will be excluded

The establishment of a single national ethics committee instead of the regional ones activated for example in Tuscany after the approval of the regional law and then the exclusion of the National Health Service, the non-punishability of the helper and the mandatory provision of palliative care. These are some of the main points ready to be included in the first law on assisted suicide that the majority is working on in the restricted committee on the end of life that met at Palazzo Madama. The text is now ready for its presentation at the next committee meeting on Tuesday. "The individual articles are being discussed and next week, at the first possible meeting of the joint Justice and Health committees, the text will be presented for the start of discussion", explained the president of the Senate Justice Committee, Giulia Bongiorno of the Northern League. According to the draft, which has already made the opposition turn up their noses because it would establish a list of obstacles to freedom of choice, the National Ethical Evaluation Committee is expected to have 7 members appointed by decree from Palazzo Chigi and who will remain in office for five years.

As stated in the drafts of the law, the National Ethical Evaluation Committee is expected to have 7 members: a jurist chosen from university professors of legal subjects or lawyers authorized to practice before higher courts, a bioethicist, a medical specialist in anesthesia and resuscitation, a medical specialist in palliative medicine, a medical specialist in psychiatry, a psychologist and a nurse, all appointed by a Prime Ministerial Decree, which appoints the president, vice president and secretary from among them. This single national body will act as a filter for all requests without any more decisions at the local level: today in Tuscany - the only Region to have legislated - the decision is taken by an ethics committee appointed at the level of a single ASL. This new National Ethical Evaluation Committee will be responsible for examining the requests of people who ask to access medically assisted suicide (with 60 days to express their opinion, plus another 60) and if it is found that the requirements set out in the ruling of the Constitutional Court of 22 November 2019 are not met (adult, with an irreversible pathology, source of unbearable physical and psychological suffering, included in a palliative care program, kept alive with substitution treatments, fully capable of understanding and willing) the interested party will have to wait "the next forty-eight months" before submitting a new request, under penalty of inadmissibility. Time that the people involved - often terminally ill - may not have.

Excluded, for now, the national health service: end-of-life treatment will not go through public hospitals except for people available for assisted suicide and already hospitalized. "They will not be forced to leave and the helper will enter the hospital", explains Bongiorno. The non-punishability of those who accompany the person in the last mile has also been confirmed. On palliative care - one of the key issues in the bill on end-of-life - the draft, proposed in the meeting of the restricted committee today in the Senate, provides for an observatory set up by Agenas (the National Agency for Regional Health Services) to examine the Regions' projects on these treatments. The observatory will then have to send an annual report to the Prime Minister, the Ministry of Health and the presidents of the Chamber and Senate, also indicating "the Regions that have not presented the project to strengthen palliative care, including pediatric, home and for any pathology". It is also expected that any residual sums allocated to the Regions for these treatments, and left unused, will be returned to the State and cannot be used for other purposes. Finally, 2028 was indicated as the deadline by which the Regions must try to reach the objectives set for palliative care, citing "90% of the population concerned".