End of life, this is how the right wants to bury the right to die

The right is working on a new law on the end of life. Or rather, it is a select committee of senators from the Senate Justice and Social Affairs Commissions, busy trying to find a synthesis between five bills filed in recent months by the PD, M5S, Avs and FI. And even if the proposal is only a draft, provisional, perfectible, it is already causing discussion. Because problems immediately emerge that worry the opposition and organizations that have been dealing with the issue for years, the Luca Coscioni association first and foremost. And it is Marco Cappato , who is the treasurer of the Coscioni, who comments to L'Unità on the proposal that the majority has in mind. And according to him, it aims to "empty the existing law entirely and do everything possible so that it exists only on paper, without anyone being able to access it in practice" .

But let's start from the beginning. The story of the end of life was interrupted on June 10, 4 months after Tuscany approved the first regional law on "medically assisted voluntary death" . That day, Prime Minister Meloni and the center-right leaders met inspired by a single urgency: to give Italy a national law to regulate the matter. Up until now, in fact, we have relied on the rulings of the Constitutional Court, which in the meantime has repeatedly warned Parliament about the need for intervention. But that's how it is. And so the two rulings of the Constitutional Court were authoritative: the one from 2019 and then the "updated" one from 2024, with which the constitutional magistrates established that assisted suicide (and not euthanasia, which is something else) is admissible when certain conditions exist : the pathology is irreversible, the person suffers in a way that they deem intolerable, depends on life-sustaining treatments, and has the capacity to make free and informed decisions. Today the aim is to take those sentences in hand and make them law. But, as was said, the right is reworking them in its own way. Inserting here and there what Cappato defines as real " traps".

The first: the draft, says Cappato, aims to "do away with the national health service". And he explains: " While today it is the individual territorial health companies, on the indication of the Consulta, who decide and evaluate whether the person has the right to be helped to die, the government - having realized that there have been 8 cases of legally authorized voluntary aid to death - what does it do? It creates a national ethics committee appointed by the government to centralize all the requests". With one consequence: "Being appointed by the government, the right will fill it with people who are against and hostile to the right to freedom of choice" . Not only that. The aforementioned " ethics committee", which will be composed of 7 people including a jurist, a bioethics expert, a psychiatrist, has also caused controversy because of its name. On this point, Democratic Senator Alfredo Bazoli, who is part of the select committee, clarified to L'Unità: "The name will have to be changed: an ethics committee does not make an ethical State. Much better are terms like 'scientific committee' or 'clinical evaluation committee' ". The exclusion of the NHS, Cappato points out, also comes from another provision: an external person will go to the hospital to help the terminally ill patient die. " It's as if the government were to say: the NHS must not do anything, those who have the possibility of turning to private clinics, to private individuals, to go to Switzerland, can do so".

But according to Cappato there is another “trap” : the increase in response times to requests. The treasurer of Luca Coscioni says: “According to the draft, the waiting time should be 60 days plus an additional 60 days in some cases. And we are talking about requests from people with terminal illnesses and unbearable suffering, so responding after months risks being a way of letting them die early”. However, there is an even more worrying point: the one that provides that – in the event of a refusal of the request to access the end of life – the terminally ill patient cannot apply a second time until after four years. "The person, knowing that the disease is degenerative and the answer could arrive after months, perhaps asks the question a little earlier. But we must be careful in this case, because if they ask it too early the risk is that - even if it were to get worse later and meet all the criteria - they will no longer be able to request it after the first 'no'. There is no sense in this, because the conditions of a patient worsen even in the space of three months. What sense does it make to say 'you have to wait 4 years'? As if it were a game", says Cappato bitterly.

The other serious thing, he adds, is the change of terms applied to one of the conditions for access to the end of life described by the Consulta , the one that provides for dependence on life-sustaining treatments. “This expression – says Cappato – is changed to 'vital function replacement treatments'. The current terminology includes, in the Court's jurisprudence, also patients dependent on the assistance of third parties, not only those attached to machines (I'm thinking of things like catheters). While 'vital function replacement treatments' means substitutes for nutrition, hydration, therefore actual machines. A way to further restrict who can have access”.

Then there is a further trap, the one that requires the patient to be included in a palliative care program . And a final “icing on the cake”: the first point of the proposal talks about “protecting life from conception to death”. An anti-abortion nuance on which Bazoli reassures: “It is a crazy slip, but in the committee they told us that they will remove it”. In any case, the inadequate response that the government is developing has pushed Cappato to continue fighting. Yesterday in Milan, in Piazza XXV Aprile, a press conference was held by the Luca Coscioni association that inaugurated the start of the collection of signatures for a popular law proposal on all end-of-life choices, including euthanasia. The goal is to collect 50 thousand signatures before July 17, when the controversial and centralizing proposal of the right should arrive in the Chamber.

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Asia Buconi