End of life, the majority draft: "Without requirements, application frozen for 4 years"

“The 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 (an adult, with an irreversible pathology, a 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 same person will not be able to submit other requests in the following 48 months, because they are declared "inadmissible". This is what is written in the draft law on the end of life that the majority proposed in the meeting of the restricted committee in the Senate.

The draft also outlines the profile of the national ethical evaluation committee. It will be made up of seven members: a jurist chosen from university professors of legal subjects or lawyers authorized to practice law, a bioethics expert, a specialist in anesthesia and resuscitation, a doctor specialized in palliative care, a psychiatrist, a psychologist and a nurse. They would be appointed by decree of the Prime Minister who appoints, from among them, the president, the vice president and the secretary. They remain in office for 5 years with the possibility of renewal for two terms, even non-consecutive.

On palliative care - one of the key issues

of 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 those treatments, and left unused, will be returned to the State and cannot be used for other purposes. Finally, 2028 is indicated as the deadline by which the Regions must try to reach the objectives set for palliative care, citing "90% of the population concerned".

Among the first to comment from the majority was the president of the Senate Justice Committee, Giulia Bongiorno : "In my opinion, it is a draft text with good balance, it is not on someone's side", "it takes into account the principles of the Constitutional Court" and in the text "palliative care is the object of great attention, and no longer just on paper". When asked whether the text will take into account the ruling of the Constitutional Court on the case of a Tuscan woman, suffering from primary progressive multiple sclerosis who received the go-ahead to access assisted suicide and asked her trusted doctor, not being able to do it alone, Bongiorno replied: "Wisdom means that we have taken into account the sentences pronounced so far by the Consulta and we will take into account that of 8 July".

The opposition is critical. Senator Alfredo Bazoli , vice-president of the PD group, comments: "Finally, after 6 months, some concrete proposals on the end of life have arrived in the restricted Committee. These are drafts that outline a very different procedure from the one we imagined and that require significant corrections and additions, also to make them consistent with the ruling of the Constitutional Court. In particular, the points relating to the composition and tasks of the national ethics committee, the role of the national health service and attending physicians are lacking, and some conditions for access to assisted suicide are excessively restrictive". And he adds: "There is still a lot to do, in short, for a broad consensus, as we have pointed out to the rapporteurs, who have committed to presenting an amended and integrated text next week, in view of the commission. I hope it is still possible to arrive at an acceptable text, we will see what they propose to us next week".

Marilina Castellone and Anna Bilotti , senators of the 5 Star Movement in the select committee, state: "Once again on the end of life, the right-wing majority is changing the rules of the game and with the draft presented today in the select committee they are retracting all the work done so far. The changes made have completely distorted the previous text and we had to demand a further session of the committee to make corrections to various critical issues. First of all, the provision of an ethics committee appointed by the government, which opens up a disturbing scenario in which, depending on the government in office, the position on such sensitive issues will be more or less permissive. In practice, rather than an ethics committee we could speak of an ideological committee. The second worrying aspect concerns palliative care, because the path in which the majority would like to include patients is not foreseen by the ruling of the Constitutional Court, ending up calling into question some rights. This is absolutely unacceptable. As is the reference, in the first article of the draft, to the 'protection of life starting from conception”.