by Massimiliano Fanni Canelles
Italian law prohibits any action intended to end a human life even when it is in terms of suffering and near death. The debate on this act is called euthanasia, that has been greatly expanded in recent years, affecting not only families and professional groups involved in the care of the incurably ill, but also ordinary people. The legal problem is identified in the particular interpretation of Article 32 of the Constitution that guarantees free care to indigent, but specifies that no one can be forced to a specific treatment except under the provisions of law.
From this reading is evident as each of us can refuse medical treatment and therefore also reject our use of machine that can keep us alive in times of severe disease.
This attitude of respect for freedom also applies to the refusal of hydration and nutrition, the right which is guaranteed for example in the hunger strike, during which the citizen can refuse food and water until the end to let die. Also, Article 32, however, been at the chance to speak, and then forced to care for a sick person, if he is incapable of understanding and the will or whether it is under the influence of external pressures: the health care instituted mandatory and regulated by law 180/78.
The problem becomes complicated indeed when we are in presence of an unconscious person, that is unable to decide and / or communicate a willingness to suspend the treatment, in a situation where the law is the rule, in a composite medical and legal type, to take decisions appropriate to the situation. Here come into play four points and contrasting.
The first, is the fact that again in accordance with Article 32 of the Constitution, the state must ensure the care, not death and that action towards the termination of life is not legally accepted.
The second point, however, is that always the same article, the constitutional law cannot violate the limits imposed by respect for the human person and therefore cannot force the treatment of life unworthy of being lived.
Third is to ensure that this right to dignity is necessary to transfer the moral problem on the exchange of the suspension by a third person, almost always the doctor, who can put the objections of conscience and refuse to perform the act.
The fourth point, discussed the most fundamental point because it is able to provide certainty on the will of the patient. On this issue was brought to life the application of biological tests that correspond to the will of the care that you wish or do not wish to receive if no one could express more of their individual intentions.
But a written document, as well as informed consent to the acceptance of medical treatment, can only be valid only close to the court. Time as each of us has changed his mind is in the new situation or with the wealth of new experiences? Ultimately the management of end of life if the patient is not aware of difficult resolution. My opinion as a doctor is to reject both the aggressive treatment, the application of assisted suicide, always to respect the will if it is expressed at the time and to focus all energies to defending the dignity and remove, especially in the unconscious patient every type of suffering.
Translated by Martina Delser
