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ROME — The case of a quadriplegic who asked doctors to end his life 10 years after he was left paralyzed by a car accident has brought Italy a step toward legalizing assisted suicide.
Campaigners launched a petition for a referendum on the issue after the 43-year-old spinal-injury patient, identified only as Mario, won a landmark case against his local health service. On Monday, they got the support they needed.
If the half a million signatures are confirmed, it could bring euthanasia activists within sight of the finish line after a crusade of almost 40 years. Polls suggest as many as 9 in 10 Italians back legalization of assisted suicide.
In an open letter to Health Minister Roberto Speranza last week, Mario said he lived “in constantly increasing pain,” writing that: “Just as I have the right to treatment, I have the right to end my suffering.”
Speranza, a member of the center-left Democratic Party, responded that he was personally convinced of the need to change the law and hoped parliament “would find a consensus.”
Any response to the petition would have to be introduced as a parliamentary initiative. Prime Minister Mario Draghi’s grand coalition has a narrow mandate to enact reforms, and is unlikely to seek to introduce such divisive legislation.
Any new bill would face strong opposition from both the powerful Catholic Church and some politicians.
Maurizio Gasparri, a senator in Silvio Berlusconi’s Forza Italia party, who is against the measures, said it was not up to Speranza to make a decision and said it was “improper” that the country’s constitutional court had effectively sought to bring in legislation through the back door.
“This tendency to suggest laws and say parliament must create them by a certain date leaves me perplexed. It must be a matter for parliament,” Gasparri said.
Even leaders of progressive parties have so far remained silent.
‘Right to die’
Italian activists are hoping to follow in the footsteps of Spain, which in March passed a law to allow those who are affected by a terminal or chronic illness to end their lives with the assistance of medical staff.
Up to 50 people are estimated to travel from Italy to right-to-die clinics in Switzerland every year, one of a handful of European countries alongside Belgium, Luxembourg and the Netherlands in which euthanasia is legal. Activists say as many as 8,000-10,000 Italians could choose to die if the law was changed in Rome.
Doctors can already stop nutrition and treatment if patients request it via a living will, under rules introduced in 2018, but campaigners say the practice is little-known and rarely used. The proposed referendum would go further by legalizing an active role for doctors, removing the charge of “killing of a consenting person” from the penal code.
Opponents warn that the sick could be pressured into requesting death if it were successful.
Francesca Romana Poteggi of the nonprofit Pro Vita & Famiglia, which campaigns against both euthanasia and abortion, said that those who request assisted suicide “usually just don’t want to die, they just want their suffering to end.” More should be done to improve palliative care, to invest in treatment for depression and to help the lonely, she said.
“Maybe an old person alone in a care home could consider suicide but if he were cared for at home with family it could be another story. We retain that the state should try to eliminate suffering, not the sufferer,” said Poteggi.
Pope Francis said in 2019 that doctors faced with legislative changes around the world, “must reject the temptation, to use medicine to support a possible willingness of the patient to die, providing assistance for suicide or directly causing death by euthanasia.”
“There are three main lobbies: hospital management who want us in hospital for longer, and Big Pharma who want people on drugs for longer, and the Vatican, who want people to suffer because they believe those who suffer inherit the kingdom of heaven,” said Emilio Covari, president of the right-to-die campaign group Exit Italia.
“We want the right to die in Italy without going to Switzerland and spending €10,000,” he said.
Since the first bill to legalize assisted suicide was filed in 1984, the activists’ campaign has hit numerous setbacks.
Marco Cappato, a campaigner with the Luca Coscioni Association, said the changes are needed to “complete the circle of human rights” won since the 1970s, alongside changes to laws on abortion and divorce.
Cappato himself faced charges after accompanying Fabiano Antoniani, a DJ, to a Swiss clinic in 2017 after a car crash a few years earlier left Antoniani blind and paraplegic. Cappato was absolved of assisting suicide in 2019.
After Cappato’s trial, Italy’s constitutional court ruled the law banning suicide was incompatible with the constitution as it infringed on individual freedom. The court ordered parliament to legislate within a year, and ruled that assisting in the suicide of a sick and lucid person is not punishable if their condition is confirmed by the health service.
In April, Mario the paraplegic won a court order against his local health service to force them to carry out an assessment to determine if he is incurably ill and lucid. So far the health service has not carried out the order.
The implementation of any new laws would be complicated by the fact that the regions that control many of Italy’s health services are governed by right-wing parties opposed to assisted dying.
Covari, from campaign group Exit Italia, said that in the meantime he was willing to take anyone who wanted to die and meets the criteria set out by the constitutional court to a Swiss clinic, an option that Mario hasn’t ruled out.
But for now, the struggle for rights has given him something to live for, according to Cappato. “Earlier he was more discouraged; now for as long as he can take it, he will continue the fight. He wants to win his battle in Italy,” he said.
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