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Reconsidering dependence on life-sustaining treatment as a criterion for assisted suicide: the Italian legal unicum in comparative perspective

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Bibliographic Details
Title: Reconsidering dependence on life-sustaining treatment as a criterion for assisted suicide: the Italian legal unicum in comparative perspective
Authors: Marco Albore, Letizia Sorace, Sossio Del Prete, Raffaele La Russa, Gianpietro Volonnino, Paola Frati, Giorgio Bolino
Source: Frontiers in Public Health, Vol 13 (2025)
Publisher Information: Frontiers Media S.A., 2025.
Publication Year: 2025
Collection: LCC:Public aspects of medicine
Subject Terms: assisted suicide, end-of-life, life-sustaining treatments, health legislation, comparative analysis, Public aspects of medicine, RA1-1270
Description: The legalization of Medical Assisted Voluntary Death, including assisted suicide is spreading worldwide, alongside the recognition of the centrality of the patient’s right to self-determination even in case of therapeutic desistance. In Italy Law-no. 219/2017 has granted patients the option of refusing therapy including life-sustaining treatments even without justification. The present paper offers a critical analysis of the legal-normative aspects and ethical-clinical implications of constraining assisted suicide to dependence on life-sustaining treatments. Reviewing some of the key bioethical-legal pronouncements, we discuss the current Italian system on assisted suicide in which dependence on life-sustaining treatment, even after the recent Constitutional sentences, is still one of the mandatory requirements, despite several critical profiles. Through a literature overview on medical life-sustaining treatments notion, the dependence on them is analyzed and assessed in clinical, bioethical and validity terms as a requirement for access to assisted suicide. From this it appears how dependence on life-sustaining treatment constraint shows overly ambiguous definitional boundaries, with the risk of inhomogeneous interpretations especially in the Italian framework. Interestingly, our comparative analysis reveals that Italy is a global legal unicum among the main international systems regulating Medical Assisted Voluntary Death; which, conversely, tend to target the issue on terminally or irreversibly suffering patients, independently of dependence on life-sustaining treatment.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2296-2565
Relation: https://www.frontiersin.org/articles/10.3389/fpubh.2025.1657070/full; https://doaj.org/toc/2296-2565
DOI: 10.3389/fpubh.2025.1657070
Access URL: https://doaj.org/article/f2224ebb1fea496ab881f4b8c06aefcf
Accession Number: edsdoj.f2224ebb1fea496ab881f4b8c06aefcf
Database: Directory of Open Access Journals
Description
Abstract:The legalization of Medical Assisted Voluntary Death, including assisted suicide is spreading worldwide, alongside the recognition of the centrality of the patient’s right to self-determination even in case of therapeutic desistance. In Italy Law-no. 219/2017 has granted patients the option of refusing therapy including life-sustaining treatments even without justification. The present paper offers a critical analysis of the legal-normative aspects and ethical-clinical implications of constraining assisted suicide to dependence on life-sustaining treatments. Reviewing some of the key bioethical-legal pronouncements, we discuss the current Italian system on assisted suicide in which dependence on life-sustaining treatment, even after the recent Constitutional sentences, is still one of the mandatory requirements, despite several critical profiles. Through a literature overview on medical life-sustaining treatments notion, the dependence on them is analyzed and assessed in clinical, bioethical and validity terms as a requirement for access to assisted suicide. From this it appears how dependence on life-sustaining treatment constraint shows overly ambiguous definitional boundaries, with the risk of inhomogeneous interpretations especially in the Italian framework. Interestingly, our comparative analysis reveals that Italy is a global legal unicum among the main international systems regulating Medical Assisted Voluntary Death; which, conversely, tend to target the issue on terminally or irreversibly suffering patients, independently of dependence on life-sustaining treatment.
ISSN:22962565
DOI:10.3389/fpubh.2025.1657070