End of life, the process begins in Parliament: what it includes and how it works

The center-right is accelerating on the end of life which, barring any surprises, will officially begin its parliamentary journey this morning (Wednesday, July 2) in the Senate, just when Prime Minister Giorgia Meloni will meet Pope Leo XIV in audience for the first time and immediately after the Secretary of State, Cardinal Pietro Parolin. With ethical issues - first and foremost the new law on assisted suicide - together with international conflicts that will be at the center of this meeting in which the Prime Minister, in addition to reiterating her full commitment to peace, will reassure the Vatican that there will be no rush to euthanasia. Yesterday evening, the select committee of the Justice and Social Affairs commissions reviewed the bill that could arrive in the Senate on July 17.
The text worked on by the two rapporteurs Pierantonio Zanettin (FI) and Ignazio Zullo (FDI) has been partly corrected as requested by the opposition, for example by reducing the initial four-year deadline to 180 days to be able to ask the brand new «National Evaluation Committee» of 7 members - composed of a jurist, bioethicist, anesthetist, palliative care specialist, psychiatrist, psychologist and nurse - appointed by Palazzo Chigi to access the treatment if the first request has been rejected. But on other fronts the new text risks unleashing a tough clash with the opposition who have been on a war footing for weeks. Among the most complex issues is the role of the National Health Service: for the centre-right, assisted suicide cannot become a service provided by the NHS. And in fact the bill states that «the personnel in service, the instruments and the drugs, which the National Health System has at its disposal in any capacity, cannot be used to facilitate the intention of ending life». This means that if the terminally ill patient is in a hospital or a public nursing home, he or she will be able to access assisted suicide - if authorized by the Committee - on one condition: that the patient equips himself or herself with a "do-it-yourself" approach, paying for the equipment, lethal drug and doctor (who may also be from the National Health Service, but "overtime"), unless he or she finds "hospitality" in private facilities. In short, the end-of-life process in public hospitals risks becoming practically impossible.
The other crucial point is that of palliative care, which must always be made available (even if it cannot be mandatory) and where the Regions are not yet equipped - at least half are behind in the availability of these therapies - "substitute powers" may be triggered with the appointment by the Government, in the absence of a regional plan, of "a commissioner ad acta until the standard" of care is reached. Not only that: "If the Region has not achieved the objectives of strengthening palliative care set in the project presented for the previous year, the Minister of Health - as stated in the draft - assigns a deadline of no more than six months to achieve them". The text then introduces a new article in the penal code on assisted suicide that reiterates that it is "not punishable" if the "intention" was formed "in a free, autonomous and conscious way" and if the person is "included in the palliative care pathway, kept alive by treatments that replace vital functions and affected by an irreversible pathology, a source of intolerable physical and psychological suffering, but fully capable of understanding and willing". So far only a few patients have been able to access it in line with the conditions set by the Constitutional Court, while yesterday Martina Oppelli, the 49-year-old woman who has been suffering from multiple sclerosis for twenty years, presented a new objection after the third denial by her Local Health Authority because she does not have any life-sustaining treatment underway.
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